【My medical skills can add experience points】【】
The patient who underwent urethral dilatation was sent to the recovery room. After the anesthesia recovered, a new patient was brought in soon.
It was a female patient about forty years old, with a yellow face, and she walked very slowly.
Zhou Can had read her information, and the main symptoms of this patient were jaundice, emaciation, nausea, and vomiting when he was admitted to the hospital. After investigation, there was a tumor in the head of the duodenum.
This operation requires a clean resection of the tumor, which is a third-level major operation.
Duodenal surgery is basically a third or fourth level operation, which is difficult and risky.
According to Zhou Can's assessment in the emergency department, the previous urethral dilation was just an appetizer. Now is the real big game.
Dr. Xu is a senior attending physician. According to the surgical safety access system, senior attending physicians are qualified to preside over tertiary surgeries. Junior deputy chief physicians can preside over third-level operations, and gradually carry out fourth-level operations under the on-the-spot guidance of superior doctors.
Therefore, this duodenal head tumor resection is already the limit of Dr. Xu's assessment of Zhou Can.
He couldn't preside over a higher level of surgery.
If Zhou Can successfully completes this operation, he will be provided with enough surgeries up to the third level in the emergency department in the future.
He was still the anesthetist who performed the previous operation. After guiding the patient to lie down on the operating table, he began to anesthetize him step by step.
"Call me when it's over here!"
Dr. Xu went to the operating room outside for surgery.
In order to maintain the total number of operations in the emergency department every month, the surgeons are working hard. Even so, due to the lack of surgical experts like Zhou Can, Dr. Xu could only do it himself.
He works very hard every day.
In fact, Dr. Xu is also quite old. A person in his fifties is far from being able to compare with the physical strength and energy of a young man.
[To be honest, I have recently followed up, changed sources, and have many voices for reading aloud. Both Android and Apple are available for .huanyuanapp. 】
Even so, he is still working hard, just to make the operating room of the emergency department grow a little bit.
Hospitals only look at the performance of departments and the quality of operations.
If the number of operations in the department is small, the number of surgical personnel will also be reduced. At the same time, various hardware resources will also shrink significantly.
Take a look at the 10,000-level operating rooms of cardiothoracic surgery, neurosurgery, and general surgery, with top-level configurations, endoscopes, laser scalpels, high-frequency radio-frequency radio waves, etc. I even heard that neurosurgery is building a top-level hybrid operating room.
Look at the emergency department again, there is only such a dedicated operating room that really belongs to you.
The equipment is also quite backward.
If you want to obtain a better surgical environment and high-tech equipment, you can only rely on your own efforts to fight for it.
What kind of fighting method?
Help the hospital earn enough money to perform more operations and improve the quality and quantity of operations.
"Qiao Yu, do your preparations first, I'll study the patient's examination data carefully!"
"OK!"
Qiao Yu readily agreed.
She needs one person to take on multiple responsibilities, and she is a very hard worker as an equipment nurse.
Typically, a tertiary surgery will have at least two surgical nurses.
If it is a more gorgeous surgical team, the three nurses are normal.
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【My medical skills can add experience points】【】
Zhou Can's surgery team has just started. Strictly speaking, there are only her and Zhou Can, and hard work is inevitable.
After more than forty minutes, the preoperative preparations here were completed, and Zhou Can had a deep understanding of the patient's condition. The most suitable surgical plan has been worked out in my mind.
"I'm going to invite Dr. Xu over here!" Qiao Yu took the initiative to run outside to invite Dr. Xu, and waited until Dr. Xu finished the operation in hand before notifying him that it was ready.
From these details, it can be seen that Qiao Yu is very measured.
It is a blessing to have such an excellent nurse on the surgical team. In the future, in the coordination process of the surgical team, she can become Zhou Can's good wife and help him coordinate the cooperation of the entire surgical team.
This can save Zhou Can a lot of unnecessary trouble, and improve the unity and tacit understanding of the surgical team to a certain extent.
Before the operation officially started, Zhou Can first placed a nasogastric tube for the patient.
Originally, according to the surgical requirements, a nasogastric tube should be placed on the patient during the ward round at seven or eight o'clock in the morning.
In addition, when conditions permit, endoscopic surgery is often used for resection of tumors in the head of the duodenum, especially for type B cases.
The operating conditions in the emergency department are simple, there is no endoscopy, and there is a lack of advanced inspection equipment in some operating rooms.
This will undoubtedly add some difficulty and trouble to the operation.
When Zhou Can returned to the emergency department this time, he wanted to bring together the surgical team, and then step by step to obtain surgical resources, so as to directly make the operating room of the emergency department bigger and stronger.
As long as the operating room becomes bigger and stronger, other departments of the emergency department will also be pulled to develop together.
Zhou Can finished examining the patient and stood on the chief surgeon's position to start the operation.
After careful consideration, he did not choose a straight incision.
Instead, the oblique incision was made from the costal margin of the patient's right upper abdomen, reaching the anterior axillary line on the outside and skipping the midline on the inside.
Dr. Xu was an assistant at the side, seeing the incision method he chose, he couldn't help but nodded secretly.
The advantage of this incision is that it is well exposed. Although the muscles of the abdominal wall need to be cut, the incision rarely dehisces after the operation. There is no small intestine under this incision, so complications such as postoperative adhesive ileus rarely occur.
From this point, it can also be seen that Zhou Can has extremely rich surgical experience.
Three years of experience has transformed him, improving not only medical skills, but also medical knowledge, clinical operation experience, comprehensive prediction ability, etc.
At the same time, Dr. Xu was extremely shocked when he saw his new knife technique that combined the fast knife technique and the steady knife technique.
It also gave him a new direction of thinking about the fast knife method and the steady knife method.
I used to think that the fast sword technique and the steady sword technique are incompatible, but now I see that the apprentice has successfully integrated the two sword techniques. Checking and balancing each other, but there is no conflict, but it makes the scalpel more stable.
It really surprised him.
After opening the chest and abdomen, Zhou Can first made a comprehensive exploration of the patient.
He found a metastatic nodule in the liver, and along the duodenal ligament of the liver, he found enlarged lymph nodes. Looks like it's going to be an uphill battle.
If the patient's tumor metastasizes, if it is not completely removed, the postoperative survival period will definitely not be long.
It's easy to relapse.
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【My medical skills can add experience points】【】
After knowing it well, he touched the size and scope of the duodenal papilla with his hands to ensure that he could know the size of the duodenal papilla with his hands.
Next, he makes a kocher incision on the lateral side of the duodenum.
Kocher, also known as the Koch method, is originally a reduction technique for shoulder dislocations.
The incision requirements at this moment are similar to those of the Coriolis method.
[The experience value of the fast knife method is +1, and the experience value of the steady knife method is +1. 】
[Congratulations on your quick knife technique advancing to the proficient level. 】
After completing the kocher incision, Zhou Can obviously felt that his knife skills seemed to have made a major breakthrough and improvement.
His quick knife technique has always been at the entry level, but now it has been upgraded to a level, but it is really not easy.
It should have been upgraded to the proficient level long ago.
Fortunately, I studied with Director Hu Kan in cardiothoracic surgery for nearly a year, and I was able to get one or two surgeries every day. He can even act as the chief knife occasionally. It was only then that the experience value of the quick knife method was gradually accumulated.
[Fast knife method, current experience value: proficiency level 1\\/, win with speed, correct other surgical shortcomings quickly, and can skillfully use fast knife method in various complicated surgical procedures. Integrate into all knife-wielding surgical procedures. 】
He calmed down, suppressed the excitement in his heart, and proceeded to the next operation step, incision of the retroperitoneum.
After cutting this knife, I immediately felt the benefits brought by the upgrade of the quick knife technique.
I can't say it, but I feel very relaxed.
It's a bit of a weight-lifting feeling.
At the same time, he also noticed that after the upgrade of the fast knife technique, the steady knife technique was obviously weakened. The scalpel has suffered a bit in terms of stability.
If I have to describe it in detail, I feel that the invisible mountain pressed by the scalpel has become lighter.
If the steady sword method is regarded as a means to check and balance the fast sword method, and the fast sword method advances, but the steady sword method does not advance, there will definitely be some adverse effects. There is an increased risk of error during the procedure.
To put it bluntly, the Tao is one foot tall, and the devil is one foot tall.
The magic of the fast knife technique is extremely strong, without the restraint of the steady knife technique, it will make it easy for Zhou Can to follow the old path of Dr. Xu during the operation.
For a surgeon, medical malpractice is a very scary thing.
"Um?"
Dr. Xu's eyes lit up, a hint of surprise appeared on his face, and there was admiration and relief in his eyes.
With his level, it is natural that Zhou Can's sharp knife technique has been greatly improved immediately.
However, he did not interfere with Zhou Can's operation, but silently acted as Zhou Can's assistant.
After incision of the retroperitoneum, Zhou Can began to mobilize the descending segment of the duodenum.
The small scalpel seemed to come alive in his hands, with different depths and agility. The whole dissociation process is like showing an art.
…
Nearly an hour and a half later, Zhou Can looked at the excised nodules, lymph nodes, and duodenal head tumors, and he felt a sense of accomplishment in his heart.
The patient has successfully completed the operation, closed the cavity, and is in good physical condition.
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【My medical skills can add experience points】【】
"Yes, quite excellent! It seems that in the past three years, you have not been wasted, and your surgical ability, diagnostic ability, medical knowledge, and judgment level have all been improved. Did you have a major breakthrough in your quick knife technique just now? promote?"
After the operation, Dr. Xu asked about this aloud.
"Well, I did have some insights, and I have more experience and a deeper understanding of the knife skills and knife handling techniques."
Zhou Can admitted it frankly.
He knew that the sharp knife technique was what Dr. Xu valued the most, and he always hoped that he could inherit the mantle.
"Just now I saw that you were fast and steady during the operation, which is very good. It shows that the steady knife technique taught by Director Hu Kan can indeed be mutually beneficial with the fast knife technique. Now that Director Hu is no longer around, among his heirs It is best to count your talent, and you can practice more steady sword skills when you are free."
Zhou Can almost thought that he had heard it wrong. For the first time in history, Dr. Xu asked him to practice more steady knife skills.
Really unexpected.
Is this an alternative mourning for Director Hu Kan's death, or is it a recognition of Director Hu Kan's bold and innovative medical skills?
The combination of the steady knife method and the fast knife method was first proposed by Director Hu Kan. It's just practiced by Zhou Can.
On this point, whether Dr. Xu admits it or not, Director Hu Kan is definitely ahead of him.
"Seeing that your surgery level has been raised to such a high level, in fact, there is not much I can teach you. The master leads the door, and the practice depends on the individual. In the future, in the operation, you can boldly explore on your own. When you are undecided You can ask me anytime you want. However, I suggest that you ask me as little as possible. Each surgeon may have different surgical ideas, diagnosis methods, and treatment plans. The one that suits you is the best."
Seeing this apprentice growing up so fast, Dr. Xu was filled with joy and felt even more gratified.
"Teacher, I still have a lot to learn..."
Zhou Can disagreed.
He didn't want to leave the teacher so soon.
Just as he opened his mouth, Dr. Xu raised his hand to stop him from continuing.
"Don't worry, I will teach you what I need to teach you. You are my only successor. Is it possible that I will still bring those medical skills into the coffin?"
Choked by Dr. Xu, Zhou Can was speechless.
"Three thousand roads, all roads lead to Rome. Everyone has their own surgical path and surgical style. I only need to teach you the basic methods and some important surgical experience and skills, and you can understand and explore the rest by yourself. It is more beneficial to you. When educating children, if we ask them to blindly follow the thinking of their parents, the children will definitely not be as good as their parents when they grow up. Only by letting them go, can they go far and fly higher."
Dr. Xu really cared for Zhou Can.
Just to let him have higher achievements in the future and not be trapped by the teacher's shadow.
"Understood! Thank you for thinking so hard about me."
Zhou Can nodded vigorously, with a relieved expression on his face.
"I'll ask an intern to come in to be your assistant. Next, you can use as much strength as you want. As long as the operation is safe, you can do whatever you want. If you don't understand or are not sure, you can do it at any time." Call me, I'm right outside."
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【My medical skills can add experience points】【】
Dr. Xu completely delegated power to him.
It means the test is passed.
And got a very high score.
This is normal. Not to mention anything else, just Zhou Can's breakthrough in the quick knife technique during the operation and his promotion to the proficient level is enough to make Dr. Xu look up to him.
The master and the apprentice have been in contact for a long time, and Dr. Xu has a deep understanding of his personality, surgical style, and personality.
Naturally, I can rest assured.
After Dr. Xu went out, he quickly called an intern doctor in.
It was a young man of twenty-two.
Because he was wearing a hood and a mask, he could only roughly see the young man's appearance.
"Mr. Zhou, hello~www.mtlnovel.com~ My name is Luo Shishen, a clinical major, a general practitioner. I have been practicing in Tuya for almost half a year now. Please give me your advice." The young man respected Zhou Can very much.
Unknowingly, Zhou Can has gone from an intern to a regular trainee, becoming a formal resident doctor, and even a teacher in the eyes of interns.
Of course, this is a polite name.
"Do you know how to pull hooks?"
"Pull the hook, sew the skin, and so on. I have basically learned the basics. If you have anything to do, just ask."
"Okay! I'll tell you what I need to do later."
Zhou Can nodded, Qiao Yu had already brought in the third surgery patient.
Good guy, a patient with acute appendicitis came directly.
There is no endoscopy in the emergency department, and laparoscopic surgery cannot be performed. Then only traditional surgery can be done.
The pre-operative talk must have been done.
Otherwise, it is impossible to enter the operating room.
Zhou Can didn't ask too much, such as why the patient didn't go to a specialist for laparoscopic surgery, but chose to go to the emergency department for traditional surgery. He just looked at the patient's examination data carefully, made sure there was nothing wrong, and then waited for the anesthesiologist to administer anesthesia to the patient.
The new guy named Luo Shishen is quite diligent, he is busy, and he will help with many things without taking the initiative to ask him to do them.
This made Zhou Can quite satisfied.
During the operation, Luo Shishen seemed to be a bit talkative, asking this and that non-stop.
At the beginning, Zhou Can patiently answered him one by one because of his face. But this guy didn't have any sharp eyesight. Even when Zhou Can was performing some extremely risky surgical procedures, he still kept asking questions.