Doctor's Life Simulator

Chapter 175 Perfect surgery, is this really a novice?

【Under Director Wei's arrangement, you became a doctor on duty in the surgical team of the emergency department.During the first appendix operation with Liu Peichun, you encountered difficulties in the process of finding the appendix.After Dr. Liu took over, according to the conventional thinking and experience, he searched around but couldn't find it. He suspected the possibility of missing appendix. 】

【Finally, I called Deputy Director Pang from the second line to come to the rescue. Under the careful inspection of Deputy Director Pang, after extending the incision upwards, I used my hands to search along the cecum wall and the colon belt. I saw that the appendix was located in the right paracolic ditch close to the side. Peritoneum, about 6.0cm in length and 1.0cm in diameter. 】

[After finding the appendix, everyone breathed a sigh of relief, but due to the special location, a retrograde appendectomy was performed.Afterwards, in retrospect, Director Pang also admitted that the right paracolic appendix is ​​extremely rare, and the cause of its formation is still unclear.However, it should be taken as a lesson. In order to effectively avoid misdiagnosis and missed diagnosis, ultrasound, X-ray, and CT examinations should be performed when necessary. Once an ectopic appendix is ​​diagnosed, surgical treatment should be performed as soon as possible.The appropriate abdominal exploration incision should be selected based on the specific location of the fixed tenderness, so that the appendix can be found during the operation.At the same time, during exploratory laparotomy, the appendix should be carefully searched, and the absence of the appendix should not be easily diagnosed, so as not to miss the diseased appendix. 】

[In the days that followed, you gradually got used to the emergency department, and under Director Zhuang's intensive care, your appendectomy and cholecystectomy skills continued to improve.Under the perfect basic surgical skills, after gaining more experience, your level progresses very quickly, and soon you will become the backbone of the emergency surgery team. 】

[Six months later, your rotation time is up, and at the same time, you have published papers on several topics you carried out in the treatment center, and the development of surgery has also entered a mature stage.You are promoted to attending physician. 】

[In the same year, your Qin method project and Qin's allograft tendon vitrification preservation method project were all shortlisted for the first prize of Hecheng City Natural Science. 】

[At the age of 26, you joined the Zhejiang Branch of Burn Surgery as a standing committee member and was promoted to deputy chief physician in the same year. 】

[At the age of 27, you joined the Burn Professional Committee of the Huaguo Medical Association on the recommendation of Director Xie Yuhua. 】

[Because of your outstanding performance, the treatment center is also progressing rapidly.Wei Guoqiang entrusts you with a heavy responsibility.During this period, you also often went to the emergency department for rotation, and continued to improve appendectomy and cholecystectomy. 】

[At 30, you married Tang Yue.Under the arrangement of Wei Guoqiang, you continue to develop new topics. 】

[At the age of 36, you were promoted to chief physician.Due to his outstanding contribution in the treatment center, Wei Guoqiang served as the executive vice president of the city's first hospital.Tang Yue wants to go abroad for further study for her dream of scientific research.You did not agree.However, Tang Yue's field of research does not have a good soil in China. After a heart-to-heart exchange, you expressed your understanding, and in the end she chose to study abroad. 】

[At the age of 40, you continue to be in the treatment center, because there is no major breakthrough, no success.Became a backbone chief physician of the treatment center. 】

[50 years old, in an important rescue operation, continuous high-intensity work, your body has problems.In one operation, overworked and fell asleep forever. 】

【You ended your career as a doctor】

[Simulation ends, doctor career evaluation, chief physician 61/80]

【You can retain one of the following abilities】

[1.50-year-old doctor skills]

[2.50-year-old clinical experience]

[3.50-year-old medical wisdom]

Qin Lang was also a little surprised. Such an appendix operation had to alarm the second-line deputy chief physician, which is really a bit embarrassing.

[Congratulations to the host for obtaining clinical experience at the age of 50]

[Host: Qin Lang
professional skills

Grade: Chief Physician 61/80
professional skills:
Rounds: Master
Tube Bed: Master
Debridement: Perfect

Basic surgical operations (cutting, suturing, exposure, etc.): perfect level
Burn plastic surgery skills: (omitted)
Long bear technique: master level (multiple improved skills)
Neck dissection: master level (creating improved surgery)
Negative Pressure Drainage (VSD) Technique: Master Class

Appendectomy: Master Class

Cholecystectomy: Advanced
Special Skills:
Blessing to the Mind: There is a chance to create (improved) spells (real or simulated world)
Pain Relief: Debridement, there is a chance to reduce the pain of patients during dressing changes

Black heart: The Bodhisattva lowers his brows, the Vajra stares glaringly, and is no longer soft-hearted towards the wicked
Help from noble people: at some point in the future, you will get unexpected help
Magic hand: 15% reduction in scar hyperplasia and scar nodule formation in patients
English: Master-Level Reading and Speaking

Chen Mu's Guitar Talent

artist's aesthetic
】

Doctor Liu's tone was a little serious, but also a little nervous: "Qin Lang, let me take a look."

Qin Lang shook his head, did not give way, and said firmly, "Doctor Liu, I will try again."

".Scalpel"

Seeing Qin Lang's response, Dr. Liu was a little surprised and wanted to take over the position of chief surgeon, but seeing Qin Lang's determination, he hesitated for a while. After all, Qin Lang's excellent performance was vividly remembered just now. Maybe, he can really do it. ?

The next moment, I saw Qin Lang on the patient's incision, and extended the incision upwards.

At the same time, he made a movement that surprised Dr. Liu. He actually took out the retractor, and then directly inserted the index finger and middle finger of his right hand into the abdominal cavity, and searched along the right side wall, along the cecum, and the colon belt.

"A little brave!"

The anesthesiologist at the side also slightly admired this little doctor. Indeed, when some ectopic appendixes are difficult to find, the surgeon will try to use his hand to feel behind the cecum to see if it is buried behind the peritoneum.

However, only experienced physicians dare to try this kind of operation, which is based on a lot of clinical experience.

Seeing Qin Lang's operation, Dr. Liu was also a little flustered:

"Qin Lang, if you really can't find it, we'll stop and call the second-line deputy director Pang over to have a look. It's also possible that the patient is missing the appendix."

While Dr. Liu was persuading, Qin Lang's fingertips finally touched the appendix, which was located inside the paracolic groove and was close to the peritoneum.

"Found it!. Scalpel Gauze"

Qin Lang issued a series of instructions, and the equipment nurse cooperated quickly.

Since the position of the appendix is ​​not easy to fix, Qin Lang cut the retroperitoneum outside and below the cecum, and then wrapped the cecum with gauze and turned it up, finally exposing the appendix.

An ectopic appendix with a length of about 6.0 cm and a diameter of about 1.0 cm, congested and swollen, and covered with pus moss appeared in the field of vision.

Dr. Liu finally breathed a sigh of relief, and then realized how Qin Lang's response was so proficient, especially the technique of wrapping the cecum with gauze, even he couldn't react immediately.

"Is this the clinical talent?"

Doctor Liu's mentality is a little broken again.

After finding the appendix, the rest is the routine operation. Dr. Liu had to praise:
"Qin Lang, you did it beautifully!"

Next, Qin Lang began to deal with the mesoappendix.

".7 wire, vascular clamp"

Qin Lang controlled the vascular forceps to gently squeeze the root of the appendix, ligated it with the No. 7 thread, and then gently lifted the entire appendix.

A purse-string suture was made on the wall of the cecum at about 0.5 cm from the base of the appendix.

Seeing Qin Lang's suture technique, Dr. Liu's eyes widened again:

"What a powerful suturing technique, completely avoiding damage to the mesangial blood vessels. This is completely the strength of an old surgeon who has worked in surgery all his life."

The anesthetist Chu Fei was also an eye-opener. Although it was only a small appendectomy, the whole process was full of ups and downs.

"This little doctor is really amazing!"

Amidst the amazement of the crowd, Qin Lang firmly controlled the appendix and removed the appendix at 0.3cm from the base of the appendix. The mucous membrane of the stump was treated with carbolic acid, ethanol, and normal saline in turn, and put into the purse, while pulling the purse suture ligation.

The whole process is smooth and smooth, and the operation is flawless.

Dr. Liu remembered that he had already performed more than a dozen appendix operations in those years. When he pulled the purse suture, the stump was not ideally buried. Needle interrupted sutures.

The gap between people, sometimes, is indeed greater than that between humans and dogs.

After completing these operations, Qin Lang checked that there was no bleeding point, and after the gauze instruments were correct, he chose the No. 4 continuous suture to close the peritoneum, and used short sutures to suture the muscle layer, external oblique aponeurosis, subcutaneous and skin.

Seeing the whole stitching process of Qin Lang, Dr. Liu was amazed again, the stitching is really like a work of art.

"As expected of a doctor from the Department of Plastic Surgery and Burns, this suture is amazing!"

Soon, the entire operation was completed, and the anesthetist Chu Fei felt a little bit reluctant.

After waiting for Qin Lang and Liu Peichun to leave the operating room, they rested for a while, and it was time for the shift.

Two other doctors from the surgical team came to change shifts.

[Congratulations to the host for completing the task, completing the first appendectomy in life, and receiving task rewards: 1. Diagnostic paracentesis: master level. (According to the nature, color, clarity, smell, etc. of the peritoneal fluid, the etiology can be clearly diagnosed and the treatment plan can be determined.)]

And when Qin Lang was about to leave, he received a call from Wei Guoqiang.

"Hi, Qin Lang, I'm on a business trip in Hangzhou today. At the Second Municipal Hospital, my junior, director Zhang Jindong admitted a patient with deep electrical burns. The patient's condition is serious. So, please ask me for help. I hope we can send An expert went over to conduct a consultation to discuss a suitable treatment plan. I just recommended you there, you should have just finished work in the emergency department, and if you are affected, go see it."

"I have already passed on your prestige to Director Zhang. He will contact you in a while and tell you the basic situation of the patient."

Wei Guoqiang himself is a workaholic, so the same is true for his subordinates. Minor injuries can't leave the line of fire. Qin Lang naturally said that there is no problem with this.

"I'll let Dr. You take you there later, and you just take a nap in the car. Thank you for your hard work."

Not long after Wei Guoqiang hung up the phone, Lord You rushed over, with a somewhat honored tone in his tone:

"Doctor Qin, Director Wei asked me to come over and take you to the Second Hospital of Xiashi for a consultation, shall we start now?"

Of course, Dr. Liu knew Dr. You. This is a senior attending doctor with a higher rank than him, so Director Wei arranged to be Qin Lang's driver?
Moreover, at such a young age, Qin Lang is already able to support the Second City Hospital and participate in expert consultations?
Dr. Liu suddenly felt that it was not a big deal that his appendectomy was not as good as Qin Lang's.

PS: Thank you for another 100+100 coin reward from Mingyuetianxingkongye, happy~
(End of this chapter)