Doctor's Life Simulator

Chapter 233 It turns out that in the auxiliary position, it can also shine!
Before the operation, Dr. Yan and others had a detailed understanding of the patient's condition, and completed a comprehensive physical examination, laryngeal X-ray, CT, and biopsy. cell carcinoma.

Laryngeal incision and tumor resection were performed, and the patient was given oral phenobarbital and subcutaneous injection of atropine half an hour before the operation.

The anesthesiologist infiltrated the patient with 1% lidocaine plus 1:1000 epinephrine solution to anesthetize the patient through an incision in the front of the neck, and blocked the superior laryngeal nerve on both sides.

When Qin Lang and others entered the operating room, the anesthesiologist had already completed the anesthesia for the patient. Seeing Director Han and Professor Shen Xi coming in to watch the operation together, the anesthetist was also a little surprised.

"Qin Lang, I'll leave it to you. Don't worry, I'll watch over it for you."

Dr. Yan is very familiar with this kind of operation, so he asked Qin Lang to perform the first step of tracheotomy.

Although he is still at the entry level for laryngostomy and tumor resection, he is already perfect for tracheotomy, so he is not stage fright at all.

The incision of the larynx is divided into straight incision and transverse incision, and a cross-shaped incision is completed in the larynx.

Standing at the position of the chief surgeon, Qin Lang directly began to give instructions. After taking the scalpel, he first began to make a straight incision from the subhyoid bone to the sternum of the patient.

Watching Qin Lang holding a silver scalpel, he skillfully completed the incision of the skin, followed by the incision of the subcutaneous tissue and platysma muscle.

"What a skillful technique!"

Seeing Qin Lang's operation and the precise control of the scalpel, Dr. Yan was slightly surprised.

Under the close observation of Dr. Yan, Qin Lang has already started a transverse incision, making an incision about 5 cm long from the lower edge of the cricoid cartilage, repeating the incision of the skin, subcutaneous tissue, and platysma muscle.

The entire strength and the length of the incision are well-chosen.

"This guy's cutting technique is too powerful."

After completing the first step, the thyroid cartilage and cricothyroid membrane are exposed.

".Automatic retractor. Anesthesia intubation"

Under the aura of the chief surgeon, Qin Lang began to order his assistant, Dr. Yan, who instinctively began to cooperate with the automatic retractor to retract the incision under Qin Lang's order.

It wasn't until the posture was set that Dr. Yan came to his senses, and he actually had a sense of obedience as an assistant to Director Han.

However, before he could respond, Qin Lang had already started the tracheotomy, and performed a tracheotomy on the 3rd to 4th tracheal rings.

".1% tetracaine solution."

Qin Lang gave instructions very skillfully, and at the same time made a small transverse incision on the patient's cricothyroid membrane.

".Re-cut 1% tetracaine yarn."

Qin Lang's instructions, one after another, are very close, but very targeted.

Professor Han Hu and Professor Shen Xi on the side also had a flash of admiration on their faces. Very few beginners would think of using 1% tetracaine gauze to fill the trachea cavity to prevent blood from flowing into the trachea.

At this point, Qin Lang has completed his task, the patient's throat cavity is fully exposed, and he can see the tumor area perfectly.

The whole process is chic and freehand!
"Doctor Yan, I'll leave the rest to you."

After Qin Lang finished his work and retired, Dr. Yan was taken aback for a moment, and was only admiring Qin Lang's achievements. He didn't recover until he stood in the chief surgeon's position.

This was done so fast!

Looking at it again, he saw a fully exposed tumor site.

"Awesome separation and revealing technique."

After performing so many laryngeal dehiscence tumor resections, it is the first time that Dr. Yan has seen such a perfect exposure of the surgical field.

And when he was about to give the order, Qin Lang had already handed over the scalpel and tweezers.

"Oh."

Dr. Yan picked it up, and began to carefully observe the extent of the tumor exposed by Qin Lang again. Seeing the clear boundary, he began to cut the mucosa around the tumor.

The whole operation process was still very solid and meticulous, and soon with rich experience, the entire submucosal tumor was completely resected, which was also the most difficult operation step in the operation.

After all, complete resection of the tumor is at the heart of this surgery.

As soon as Dr. Yan finished this step, Qin Lang had already handed over the hemostatic gauze.

Unknowingly, Dr. Yan found that the operation of the whole operation was much smoother than before. Taking a deep breath, he entered the next step: repairing the wound.

The method of the whole operation is to place a free skin flap on the wound of tumor resection.

Although Qin Lang's laryngeal dehiscence tumor resection is only an entry-level operation, and the specific operation is still very rough, but he still has a cutting-edge awareness of the process and specific operation of this operation.

Qin Lang deliberately guided Dr. Yan to choose the most suitable sternohyoid muscle flap for this patient by handing over the instruments and marking the direction at the first time.

Physician Yan who was in the middle of the game didn't feel anything, but the eyes of Shen Xi and Han Hu on the side were slightly brightened.

Especially the experienced Han Hu, in fact, he wanted to remind and guide Dr. Yan in the selection of this flap, but he didn't expect Qin Lang to take the lead.

Han Hu already knew it in his heart, and Qin Lang obviously knew something about this operation.

Professor Shen Xi also has an idea in mind, it seems that Qin Lang will be given some opportunities to try this laryngeal dehiscence tumor resection.

Dr. Yan quickly completed the interrupted sutures. It has to be said that the basic skills of the suture technique are still very solid.

Of course, there is still a big gap with Qin Lang's textbook-level stitching.

After repairing the wound with interrupted catgut sutures, due to the large wound in the laryngeal cavity, Dr. Yan made a judgment. Just as he was about to speak, he found that Qin Lang had already thought of it one step ahead and prepared a support there.

Moreover, according to the specific situation during the operation, a soft support was made by myself, that is, a rubber finger cot, and iodoform gauze was placed in the finger cot, and it was tied tightly with thick silk thread. The whole thread was also placed very long. In order to facilitate the later placement of the stent into the laryngeal cavity, the ligature can be drawn out from the tracheotomy.

After receiving Qin Lang's self-made soft support, Dr. Yan felt an unspeakable joy in his heart, such an assistant is too comfortable to cooperate with his operation.

Qin Lang was able to think ahead without opening his mouth, so that Dr. Yan had reached the peak state since he started the whole operation.

Afterwards, for the suture of the perichondrium, Dr. Yan was very detailed, aligning the wings of the thyroid cartilage neatly.

Then suture the cricothyroid membrane and the anterior neck band muscles. When the whole operation was connected, Qin Lang handed over the most suitable thin silk thread.

Doctor Yan nodded with great satisfaction, and after receiving it, he began to suture the subcutaneous tissue and skin in layers.

Even if the whole operation is in Zijingang First Hospital, it is at the upstream level.

Han Hu on the side was also very satisfied. Generally speaking, Dr. Yan's performance today made him look good.

Of course, what caught their attention even more was Qin Lang who always did auxiliary work one step ahead. The two chief physicians both had plans in their hearts to let Qin Lang be the chief surgeon.

Another 5 minutes later, with the top-level assistance of Qin Lang, Dr. Yan completed the sterile dressing, put in the tracheal cannula, pulled out the anesthesia intubation, put in the tracheal cannula, and finally tied the stent ligature to the trachea on the casing.

It wasn't until the operation was completed that Dr. Yan noticed that his operation was the fastest in history, taking only two-thirds of the normal time.

Doctor Yan was in a complicated mood. Of course he understood Qin Lang's assist, and finally couldn't hold back and asked:
"Doctor Qin, you really haven't learned laryngeal dehiscence tumor resection?"

Qin Lang naturally responded honestly: "I haven't been a formal surgeon yet, but I have watched some surgical videos before, and I still understand the steps of the entire operation, and I also know some tips and experience of senior doctors."

Dr. Yan's whole mentality is a bit broken, and it is really possible to achieve such a level of assistance just by watching the video.

This talent is also great.

After completing the operation, Dr. Yan also reluctantly admired his results before leaving.

Before leaving, Shen Xi and Director Han at the side said in unison: "Qin Lang, come over tomorrow morning, and you will perform a laryngeal dehiscence tumor resection."

Physician Yan at the side was slightly taken aback, and immediately developed a kind of envy and admiration. It's only been a few days, and now he has the qualifications to be the chief surgeon.

Thinking back to my year, but throughout my postgraduate career, I didn't get a few chances for first aid.

Sure enough, people are different.

[Ding, new task, complete five laryngeal dehiscence tumor resections with your own ability.Task reward: 1.1 life simulation points, 2. Pleural tumor resection: entry level]

(End of this chapter)