Chapter 482 The linkage of director-level medical skills, Dr. Pu's request
Surgery is mainly divided into three parts, anatomy, repair, and transplantation.
Anatomy is easy to understand, including dissecting the cortex, muscle layer and even organs, and then removing or cleaning up the lesion. The most important part of anatomy is incision.
The second is separation and debridement derived from incision.
Anatomy is pure destruction of the intact human body. To heal the patient, the damaged tissues and organs must be repaired.
For example, if a blood vessel is cut, the bleeding must be stopped!
Nerves, blood vessels, and tendons are broken, and they must be anastomosed!
Therefore, the two main categories of surgery are anatomy and repair.
As for transplantation, it depends on actual needs.
Take a piece of skin from the thigh and transplant it to the face and neck, which is also called transplantation. Cutting off the head and transplanting it to a complete body is also called transplantation. The difficulty level of the two is very different.
To practice any kind of medical technique, you must first learn and practice from the basics and simple ones.
Zhou Can's incision technique has successfully reached the sixth level, which can be regarded as a major breakthrough in the field of surgery.
It means that he already has the foundation of the third and fourth level of difficult surgery.
In the past, the anatomical part of some three- and four-level highly difficult operations required the use of quick and steady knife techniques to barely complete. Nowadays, various dissections and resections are performed, and the surgical ability in this area has been improved to a higher level, and can be done better.
The most important thing about major surgery is safety.
The incision has reached the primary level of the director, which is equivalent to improving the safety of surgery by at least one step.
He tried to remove a lymph node cancer lesion, and the feeling was completely different from the five-level incision. What tissue is cut, the depth, and whether the edge of the lymph node has been cut can be clearly sensed.
Even some tiny tubules, nerve endings, can have a more subtle sensation when cut.
If you want to achieve the level of clear perception when even small blood vessels and nerve endings are removed, you may need to upgrade the incision to the intermediate level of the chief physician, or even the advanced level.
Rice must be eaten bite by bite.
Zhou Can is very satisfied to be able to reach the current level of surgery.
To be more arrogant, in the entire Tuya Hospital, there may not be more than forty surgeons who can perform incisions at the junior level of chief physicians.
The level of a certain surgical skill has nothing to do with the professional title level.
For example, Director Liu of the General Surgery Department.
Because of his poor academic level, he is still stuck with the title of deputy chief physician at the age of nearly 60. However, his actual surgical ability may not be worse than that of the chief physician, and may even be better than many chief physicians.
Of course, he has now successfully rated Zhenggao, which can be regarded as fulfilling his wish.
Zhou Can is now a junior resident doctor, but his incision skills have reached the junior level of chief physician.
There are still, and possibly many, examples of unequal professional titles and medical skills.
It is not uncommon for some academic and scientific chief physicians to have less surgical ability than an ordinary surgical resident physician.
"The six-level incision technique is really cool!"
After Zhou Can experienced the director-level dissection ability, he accelerated the progress of the operation.
At this moment, his incision and separation experience points are still increasing rapidly.
Work harder and strive to raise the separation technique to level six as soon as possible.
There are many application scenarios of dissection in difficult operations. It is also an advanced medical technique that all surgeons have a headache.
Some medical skills are easy to learn but difficult to master.
Such as suture, ligation, debridement.
Separation is difficult to learn and even more difficult to master.
Even if it is as powerful as Director Hu Kan, accidents occurred because of the separation of the adhesion between key diseased tissues and large blood vessels. Since then, my body has not been as good as before.
It can be seen that if you want to become a real top surgical master, you must upgrade the separation technique.
Otherwise, there will be a major shortcoming, and it will stumble at a critical moment.
Others find it difficult, but Zhou Can is not afraid.
Anyway, as long as he keeps earning experience points for the separation technique, he can forcefully push this medical skill to level six.
…
After nearly three and a half hours, the operation was finally over.
In this operation, Zhou Can gained a lot.
In addition to the promotion of incision to level six, the separation technique is also very close to level six. There is still more than 1,700 experience points short. If he is lucky, maybe two or three major surgeries can help him get promoted successfully.
Anyway, these days, I have to go to the cardiothoracic surgery department almost every day to help with major operations.
Unlike before standing by the side for Director Xueyan and Director Le, his current operation mode basically requires him to be the chief surgeon, with Director Xueyan or Director Le as his assistant.
It is equivalent to standing by and 'guiding' him to perform the operation.
Risks at the level of laws and regulations must be avoided.
Those who don't need him to be the chief surgeon, but who need him to sweep the formation and cover the bottom line, he only needs to stay in the same operating room.
The largest operating room in cardiothoracic surgery, there are three operating rooms, which can perform three operations at the same time.
Taking advantage of this convenience, it is often like just now, Director Xueyan leads people to perform surgery in the nearby operating room. Zhou Can and Deputy Director He were performing surgery in the nearby operating room.
In case Director Xueyan needs support, Zhou Can can rush over to help immediately.
The benefits of doing so are very great, and it can greatly improve the digestibility of difficult operations.
In the past, a large number of people worked overtime overnight, and maybe only two major surgeries could be completed. Now it can be doubled.
This is extremely beneficial for the expansion of cardiothoracic surgery.
Zhou Can's harvest tonight is also very big. After his incision was upgraded to level six, when removing tumors or other tissues that may have cancerous changes, he found that there seemed to be a slight linkage between debridement and incision.
This linkage is amazing.
When resecting the lesion, he could use the debridement technique to faintly sense whether there is any residual diseased tissue around the resected tissue.
For example, when he removed a lymph node, he sensed a lesion in a larger blood vessel next to it.
Since it was the first time he had this wonderful feeling, he was a little puzzled at the time.
With the attitude of being responsible for the patient, he carefully observed the blood vessel with the help of the magnifying glass on his eyes. Then a small, inconspicuous spot was discovered. Later, after repeated identification, and based on surgical experience, it was compared with previously cut cancerous blood vessels.
In the end, it was determined that this section of the blood vessel was likely to have undergone early canceration.
After cutting it off, immediately contact the pathology department for testing.
It didn't take long for news to come back that the blood vessel was really cancerous.
At that time, Zhou Can was very excited.
Because if his incision hadn't been promoted to level six, it happened to be linked with the debridement, and he sensed that there was a problem with that blood vessel. Even with the most advanced inspection equipment in the world, it is difficult to find this early cancerous blood vessel.
Don't underestimate such a cancerous blood vessel, as long as the operation does not remove it, the patient will relapse again in a short time.
You know, cancer is like bad weeds.
Therefore, the ability that Zhou Can possesses now is of great significance.
It can ensure that the cancerous tissue of the lesion is removed to the greatest extent during cancer surgery.
Why do many malignant tumor patients go to the hospital for examination and find that the cancer cells have metastasized in the middle and late stages. The doctor will tell the patient that the opportunity for surgery has been lost.
It is because according to the doctor's surgical experience, it is meaningless to perform surgery after metastasis.
Cut off the big tumors, and the small ones will grow back soon.
In addition to making the patient suffer more and draining the money of the patient's family, it does not prolong the life of the patient.
Instead of knowing that the cure is not good, and the patient's family will be out of money, it is better to let the patient go home to eat and drink, and spend the last time of life with the company of his family.
This is actually a kindness of the doctor.
It’s just that the family members and patients sometimes couldn’t understand, so they scolded the doctor severely, and before leaving, they even scolded fiercely, “You quack doctor, you can’t even perform such an operation. Let’s find a smart doctor who can do it.”
When encountering this kind of situation, doctors often suffer silently.
It was already eleven forty-two when I came out of the operating room. The operation time was much earlier than expected.
This is because Zhou Can's incision has been upgraded, and the operation speed has been accelerated a lot.
"I hope the cancerous tissue in this patient's body has been removed." Zhou Can could only pray silently.
Such patients must undergo radiotherapy after surgery to consolidate the surgical results.
Radiotherapy and chemotherapy are still the two conventional means of treating cancer.
Chemotherapy, in particular, is basically demonized.
Many people think that chemotherapy is fatal, that chemotherapy is useless, and that it will ruin the body. This argument is now deeply ingrained in the hearts of many ordinary people. As soon as you hear the doctor say you need chemotherapy, you immediately shake your head like a rattle.
It can only be said that everything has two sides.
There are pros and cons.
Chemotherapy, of course, is the use of chemical agents to kill cancer cells and prevent recurrence.
It is a double-edged sword. While killing cancer cells, all chemotherapy drugs are cytotoxic, directly destroying cell structure, causing the most damage to proliferating cells, and damaging important organs of the body such as liver, kidney, heart, and lung. All have certain toxicity. If the function of these organs is damaged too much, the patient will suffer from organ failure and even die.
In addition, chemotherapy can suppress the immune system, which is also a terrible side effect.
Patients who have just completed chemotherapy should be especially careful of various infections.
Even a common cold can take life.
Although chemotherapy has so many harms, it is also recognized that it kills cancer cells.
At least it is a treatment that can guarantee to kill cancer cells without directly killing people.
In addition, because cancer cells are extremely tenacious, chemotherapy cannot destroy them all at once.
Only part of it can be eliminated.
As a result, patients need to undergo multiple courses of chemotherapy in order to achieve a satisfactory therapeutic effect.
It is conceivable that patients who are weaker can hardly survive two or three more chemotherapy treatments.
This is one of the big reasons why chemotherapy has become notorious.
Killing 800 enemies and losing 1,000 to yourself is not everyone can afford it.
Fortunately, today's advanced drugs are on the market one after another, or have entered the research and development stage. Such as targeted drugs, immune cancer drugs. Drugs that create super T-cell fighters fall into this category.
Human immune cells can be divided into two types, T and B. T cells are equivalent to scouts, and B cells are equivalent to missile soldiers.
As long as T cells can find the enemy, B cells have a thousand ways to kill the enemy.
But when encountering cunning enemies, such as AIDS virus and cancer cells, T cells cannot recognize their identities. At this time, B cells become blind and deaf, unable to attack at all.
In developed countries in the West, it is indeed a good idea to treat cancer by using drugs to build super T cells and improve their detection capabilities.
Speaking of it, this idea still comes from the theory of traditional Chinese medicine in our country.
Many developed countries are paying more and more attention to Chinese medicine, and learning Chinese medicine is precisely because they have tasted the sweetness of it.
For example, Little Devil, there are almost all kinds of traditional Chinese medicine decoctions available now.
The price is even more expensive than imagined.
The key is that the therapeutic effects of these decoctions are gradually recognized by the public.
Otherwise, it would not be possible to develop to the scale it is today.
There is absolutely no one willing to do something that is not profitable.
In contrast, in our country, Chinese medicine is declining more and more, and there are fewer and fewer qualified Chinese medicine practitioners. It's actually embarrassing and heartbreaking to watch.
It can only be said that there is still a long way to go, and the revival of Chinese medicine still has a long way to go.
The main reason is that young medical students must believe in Chinese medicine, be willing to spend time learning Chinese medicine, and give them opportunities to practice.
It's just too difficult to have these market conditions.
Even if someone has studied Chinese medicine and has a certain level, but after the common people get sick, there are not many people who are willing to try Chinese medicine treatment. Without the market, there will be no motivation, which will form an endless loop.
If a group of powerful Chinese medicine practitioners can grow up in the future and use their reputation and real therapeutic effects to vigorously promote Chinese medicine, then it is possible to change this unfavorable situation.
Therefore, the revival of TCM has a long way to go.
At present, the mainstream consciousness of domestic doctors is basically that when they encounter patients who have no money, or difficult patients, or people who say they are sick when they are not sick, UU reading www.uukanshu.com doctors will persuade these people Go see a Chinese medicine doctor.
This is not to belittle traditional Chinese medicine. This kind of ideology is indeed the mainstream of doctors at present.
There are very few Chinese medicine practitioners like Mr. Chen Guoli.
"Doctor Zhou, I watched you perform the mediastinal lymph node removal operation today. It was really shocking. You are younger than me, but you have such superb surgical skills. I especially admire you."
Doctor Pu chased him up from behind.
On weekdays, Zhou Can had relatively little contact with this person.
The other party was a newly recruited doctor in the cardiothoracic surgery department, and the two didn't even know each other very well.
However, Director Tingle and others gave Dr. Pu a good evaluation.
Dr. Pu was able to enter the operating room this time because of his status as a bed doctor, so he had a chance with the operation.
"Dr. Pu, my level is about the same as yours. It means that I have more opportunities to practice and become more proficient."
Zhou Can replied modestly.
"You are always so humble. Regardless of medical skills, medical ethics, and human beings, they are all worth learning from me. Can I...can I have a few words with you alone?"
Dr. Pu took the initiative to catch up with him, and approached him to talk, which seemed to have some purpose.
"Well, no problem, if you have anything, please tell me!"
Zhou Can turned and looked at him.
"Uh... that, can we talk about it in another place? I'm afraid you won't agree to what I said, and then I will lose my job. It's really not easy to enter Tuya's cardiothoracic surgery this time."
Doctor Pu had a hesitant expression.
"Yes! You lead the way ahead!"
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