Doctor's Life Simulator

Chapter 214 Academic leaders in the field of acute abdomen
"As Director Pang said, traditional LA requires the use of CO2 to form pneumoperitoneum under general anesthesia. CO2 is easy to diffuse under the skin to form emphysema, and diffuse into the blood through the omentum to cause hypercapnia, cardiopulmonary dysfunction, etc. Complications, for very elderly patients, their cardiopulmonary function is often in a compensatory state, so the application of LA is obviously limited. Suspension airless laparoscopic technology can complete minimally invasive surgery under hard anesthesia, reducing the risk of injury. Cardiopulmonary function requirements and intraoperative anesthesia risks in ultra-elderly patients."

While explaining, Qin Lang continued to scroll through the photos of the surgical design that he had drawn by hand.

Regardless of whether the technique is Qin Lang or Director Pang, Zhuang Tong figured it out, and seeing Qin Lang's hand-painted photo of the technique, both Zu Liang and Li Ming became quiet.

They realized that this form of surgery had never been used before, that is to say, it was specially designed for this patient.

Zhuang Tong and Director Pang have another idea. Originally, the establishment of a provincial-level key subject of acute abdomen has requirements for the quantity and quality of the new surgical procedure. If the surgical procedure proposed by Qin Lang is successfully implemented, it will be an additional Increased likelihood of success.

Zhuang Tong finally understood Wei Guoqiang's happiness.

This Qin Lang is really a baby bump, and he brings improved spells wherever he goes.

"We must increase the time Qin Lang stays in the emergency department."

Zhuang Tong said something silently in his heart.

"Qin Lang, please give a good introduction to the entire operation process."

Zhuang Tong rubbed his hands, his eyes glowed, and the suspended airless laparoscopy technology sounds very high. Although the application field is limited, it can solve the postoperative risks of super elderly patients, which is also a great deed. .

Zhuang Tong even thought that with this innovative technique, Qin Lang might be able to start a star-like medical career like those big names in the field of acute abdomen.

After all, the opportunity and talent to create a new technique during his residency is one of a kind.

Although Zhuang Tong didn't have a complete understanding of Qin Lang's contribution to Wei Guoqiang's side, he still knew that Qin Lang proposed and improved several new techniques.

Although these few small improvements are not enough to shake the medical world, but with the growth of Qin Lang, this pioneering medical talent and potential.

Zhuang Tong's heart became hot, so let yourself protect Qin Lang in the early stages of his growth.

After making up his mind, Zhuang Tong looked at Qin Lang's technique in a different mood. If there is a chance, he must let Qin Lang go out and participate in various academic exchanges, medical forums, and of course more participation Accumulated experience in various surgeries...

Qin Lang should not be limited to a burn department and wound treatment center.

As long as Qin Lang is on rotation in the emergency department for one day, then he is a member of the emergency department.

[Ding, new mission: live up to the ardent expectations of the director of the emergency department, become the academic leader in the field of acute abdomen in the first hospital of the city, become a star doctor, mission time limit: long-term, mission reward: 1.3 life simulation points, 2 An SCI paper achievement with an impact factor of 10 or more. 】

"The academic leader in the field of acute abdomen? This means that you want to stick to the emergency department for a long time."

Qin Lang does not reject the long-term adherence to the emergency department. After all, the emergency department can contact a variety of patients, and at the same time trigger tasks in various disciplines and learn surgical techniques in various disciplines.

Qin Lang was a little surprised, and even glanced at Zhuang Tong. Of course, he would not disappoint Director Zhuang, and continued his analysis of the spell:
"Firstly, epidural anesthesia was used. Then, the first incision was made 1.0 cm below the navel of the patient as an observation hole, and an artificial pneumoperitoneum was established out of context. 1/2 of the conventional pressure was controlled, and a laparoscope was inserted.

The second step, which is also the core of this operation, is to make an incision at the 3 fingers below the navel as an operation hole. After exposing the appendix, the patient’s abdominal cavity is lifted and fixed on the bracket through external sutures, and the pneumoperitoneum is released. The patient's abdomen is suspended to form an operating space.The average time of establishing an insufflation process was controlled at 3 minutes.

The final step is to establish another operation hole at the McBurney's point, adjust the patient to the height of the head and feet, lift the appendix, and perform a routine free resection.After that, the routine procedure was followed until the residual fluid in the abdominal cavity was sucked out.During the operation, it is decided whether to indwell the abdominal drainage tube according to the situation, the suspension purse string and laparoscopic instruments are withdrawn, and the abdominal incision is sutured.

that's all.

After Qin Lang finished speaking, he stood quietly, waiting to answer the questions and opinions of several directors and senior attending physicians about this technique.

Seeing Qin Lang's calm and calm demeanor, several directors and Li Ming fell silent.

"Clap clap clap!"

Zu Liang was the first to take the lead in applauding, and Li Ming naturally followed, applauding for Qin Lang, or the person behind Qin Lang who designed such a technique.

Being able to offer such an improved solution that has never been used before to a young man like Qin Lang, as the first shot of his debut, is really costly.

Zu Liang put down his palm, looked at Zhuang Tong and Director Pang, and said meaningfully:

"From the analysis and introduction of Qin Lang, this improved surgical method can be promoted and applied to super-senile patients, and it is universal. It can be used as a symbolic surgical method in our city's first hospital. It is of great significance to develop the subject of acute abdomen. Director Zhuang really opened our eyes during this consultation."

As expected of Zu Liang, he saw the core of the matter and the naked temptation at a glance.

"Director Zu is right, and I can't believe it. Qin Lang's improved surgery is indeed of great significance for the city's first hospital to develop the key discipline of acute abdomen, but now we still have to solve the specific problem right now. case."

Zhuang Tong directly prevented Zu Liang's derivation of the grand subject of discipline construction, as well as some malicious speculation.

"Is it still insisting that such a groundbreaking, feasible, and profound technique is an improvement of Qin Lang?"

Zu Liang was a little surprised in his heart, it seemed that Zhuang Tong was determined to help Qin Lang to the top, but Zhuang Tong didn't seem to have a daughter either.

If Qin Lang is the future son-in-law recognized by Zhuang Tong, then it makes sense to use such an important improvement technique in his name.

If this operation is carried out smoothly, it will definitely be able to be published in core journals, which is self-evident for the doctor's future.

Zu Liang even thought about whether the director of "Farewell My Concubine" was Chen Kaige or his father, and whether Han Han's works were written by himself or by his father.
After all, this kind of technique improvement is just icing on the cake for an old Jianghu like Zhuang Tong, but for a fledgling young doctor, it is a new genius born out of nowhere.

After all, Eileen Chang has a famous saying: Be famous as soon as possible!
Zu Liang looked at Qin Lang's perfect appearance again, coupled with such a genius conceived improvement of surgery, most female doctors would be fascinated by the charm of such a male doctor.

After Zu Liang had a lot of inner drama, he continued to test Qin Lang's quality, asking direct and sharp questions:

"Qin Lang, I agree with the general framework concept of your operation. If it is a long-term research topic, I will undoubtedly only applaud you. But as a specific plan for the operation that is about to be performed, the details cannot Neglected, so I still have a few questions."

Although Zu Liang's tone was soft, Li Ming on the side was used to his thorny manner.

Sure enough, Zu Liang was not polite at all:
"The subcutaneous tissue of the abdominal wall in super-senile patients is loose, and the suspension effect of the subcutaneous layer is poor. It may not be possible to form an effective surgical space, and there is also the risk of accidentally injuring the inferior epigastric artery. How do you solve this problem?"

Listening to Zu Liang's question, several doctors were also curious about the details of this operation, especially the loose subcutaneous tissue and accidental injury of the inferior artery, which cannot be dealt with without practical experience.

Under the watchful eyes of several directors, he was not in a hurry at all, smiled slightly, and looked at Zu Liang:
"Just suspending the subcutaneous tissue of the abdominal wall is naturally risky, but I will use full-thickness suspension in the operation later, avoiding the abdominal wall blood vessels for puncture under direct vision, which is safe and reliable, and the relaxation of the abdominal wall of the elderly can instead form A more efficient operating space."

After Qin Lang finished answering, he was not impatient at all, but urged Zu Liang: "Director Zu has other questions, I will answer them one by one."

"This"

Seeing Qin Lang calm and calm, Li Ming couldn't calm down anymore, especially Qin Lang's sentence: I will be in the operation later.
What do you mean?
Zu Liang watched Qin Lang respond freely, and even asked himself to question it, but he was a little uncertain.

Just looking at such a young face, he really couldn't believe that Qin Lang made such a powerful improvement plan himself.

Being able to become the director of general surgery, Zu Liang naturally has excellent patience and self-cultivation.

Zu Liang calmly raised a second question:

"According to your surgical design, it can be predicted that the exposure of the surgical space of the suspended airless laparoscopic technique is poorer than that of the round arch space formed by the traditional pneumoperitoneum, and the exposed area is smaller, which means that it will bring inconvenience to the operation. It is very difficult, so an operator with a high level of laparoscopic operation must be the first surgeon, and since it is the first time to carry out, the uncertainty is actually no less risky than traditional laparoscopy."

"Yes, Qin Lang, although your plan has improved the success rate of the operation, but due to the difficulty of the operation and the first deployment, it has increased the uncertainty of the operator. Therefore, after comprehensive consideration, for such an important patient, it is safe. It’s better to go the traditional way.”

Li Ming took up Zu Liang's words, that any new surgical method needs to be fully prepared, and the chief surgeon must have a good enough psychological quality to start.

"For other doctors to perform the surgery, it is true that there may be mistakes and the doctor's own great psychological pressure for the first time, but if I do it myself, I have full confidence."

Qin Lang's daring to say this naturally has something to do with it.

A perfect level of appendectomy, plus hundreds of years of accumulation, if he can't, who can?

Moreover, Qin Lang's new talent, the aura of the main sword can increase the cooperation and success rate of assistants.

Whether it is for the consideration of the patient's recovery or to complete the tasks of the system, Qin Lang does his part.

So this time he chose to show his sharpness. However, with a system and such accumulation, what is there to be afraid of?
With great power comes great responsibility.

Qin Lang looked around the crowd without any fear at all, and finally looked at Zu Liang: "Director Zu, as long as I am the chief surgeon, none of the above problems will be a problem."

Zu Liang didn't expect Qin Lang to say such arrogant words so straight to the point, his eyes widened and his mouth opened slightly.

"Nonsense, Director Pang didn't dare to guarantee it, yet you dare to say that you are absolutely sure? Don't you think your laparoscopic technique is better than Director Pang's?"

"I dare not talk about other laparoscopic techniques, but I am competent in hanging airless laparoscopic appendectomy! Director Zhuang, Director Pang, I want to be the chief surgeon for this operation."

Qin Lang ignored the doctors in the general surgery department, but directly looked at Zhuang Tong and Director Pang, determined to win.

(End of this chapter)