Doctor's Life Simulator

Chapter 246 Complete five laryngeal dehiscence tumor resections and start the simulation!
After confirming the patient's illness, Wang Heng naturally had a targeted surgical plan soon. After all, he was an elite talent who could be introduced by Zijingang No. [-] Hospital.

[Ding, congratulations to the host for completing the task: to propose a new diagnosis plan to Wang Heng’s team, using CT simulation tracheal endoscopy technology, assisting CT enhancement and MRI enhancement, to find the real cause of the patient.At the same time, work out the best treatment plan with Wang Heng.Obtained task rewards: 1.1 life simulation points, 2. Treatment of massive bleeding during chest tumor surgery: master level. 】

After completing the task, Qin Lang also left Zijingang No. [-] Hospital and returned to the emergency department of No. [-] City Hospital.

In the next few days, Qin Lang continued to follow the same rhythm. Whenever there was an opportunity for surgery, he rushed to Zijingang No. [-] Hospital, and followed Yan Zhengqi and others to learn about laryngeal dehiscence tumor resection.

For the rest of the time, he stayed in the emergency department of the city's first hospital and continued to complete his rotation.

Tang Minjia, 48 years old, was diagnosed with stage III esophageal cancer T3N1M0.

He was admitted to the Department of General Surgery of the No. [-] Hospital in the city, and it was confirmed that he would undergo a left thoracotomy under general anesthesia three days later.

Before the operation, linear accelerator radiation therapy of 45Gy had also been arranged.This patient was watched by Director Zu Liang himself.

Because the patient's condition is very serious, there may be some risks during the operation, especially the esophageal tumor, which is very easy to injure the proper artery when it is free. Director Heng, consult together and formulate a surgical plan.

Zhou Hengnai is very experienced, especially in the resection of esophageal cancer tumors, and after consultation, he also put forward pertinent and effective suggestions:
"We need to conduct accurate clinical staging before surgery, learn more about the exact location of the tumor and the depth of local invasion, and its relationship with important surrounding structures such as large blood vessels, so as to correctly judge the possibility of radical resection."

"Afterwards, in addition to endoscopy, a barium meal radiography is required to understand the lesions in the esophageal lumen. In addition to chest CT, I think it is necessary to add esophageal endoscopic ultrasonography to judge the situation of tumor infiltration into large vessels. Before , in some operations, we often encounter huge tumors in the anterior mediastinum, oppressing or invading the left and right innominate veins or the superior vena cava. If necessary, simultaneous injection of contrast medium through both upper limbs can be considered to clean the innominate veins on both sides. of the development."

After listening to Director Zhou's introduction, Zu Liang also very much recognized that such a major operation should be done with caution before the operation.

After the two directors had a discussion, they began to choose the surgical approach again.

"According to the UICC international staging standard for esophageal cancer, this patient should be included in the upper thoracic tumor, and had undergone radiotherapy before surgery. In this case, it is very dangerous to use the left thoracic approach to dissect under semi-direct vision, or even blind blunt dissection. It may be better to choose to free the esophagus behind the aortic arch through the right chest incision, which can reduce the occurrence of uncontrolled bleeding.”

Zhou Heng put forward his own point of view. Regarding the choice of this surgical approach, Zu Liang obviously had his own thinking. After discussing for a while, he still decided to follow his own considerations and adopt the international standard approach plan. road.

Zu Liang is also considered a very senior chief physician. He has experienced many thoracic tumor resections. He does not deny that Director Zhou is worried that there may be massive bleeding, but after all he is better at and familiar with the left thoracic approach.

"Shouldn't be so unlucky."

Zu Liang also cheered himself up in his heart, after all, bleeding during the operation is still a small probability event.Moreover, as long as it is not an uncontrollable hemorrhage, with his qualifications and experience, he can deal with it calmly.

The two of them discussed it again, and finally came up with a plan that was familiar and convenient for Zu Liang, who was the chief surgeon, although it had some flaws.

Of course, Zhou Heng respected Director Zu's opinion. After all, in the end, it was up to the surgeon to bear everything. The pros and cons of the operation were different for different people.

Sometimes, experience and proficiency are more important than the advantages of a technique itself.

After Zhou Heng provided some suggestions and ideas, he left the meeting room first.

In Zijingang No.[-] Hospital, Qin Lang came to the General Surgery Department early, and followed Dr. Yan Zhengqi to complete the preoperative preparations.

Today is Qin Lang's fifth laryngeal dehiscence tumor resection. As long as you complete this one, you can complete the progress task and start the simulation to upgrade the laryngeal dehiscence tumor resection to the master level.

Before that, Qin Lang could only keep his face and continue to accept the disgusting gazes of Dr. Yan, Han Hu, and Professor Shen.

After all, it has already reached the fifth station, and Qin Lang's laryngeal dehiscence tumor resection is still at the entry level, without much progress at all.

Regarding this, these days, except for the first and second sets, Han Hu did not appear on the third or fourth sets.

The same is true for Professor Shen Xi, probably because he had too high expectations for Qin Lang, so he was a little disappointed to see that there is still no progress in four consecutive sets.

However, Professor Shen is still willing to give Qin Lang some time to grow up. After all, he has solid basic surgical skills, as well as excellent surgical ideas and concepts, which are still exciting.

These days, Dr. Yan also thinks that he has figured out the details of Qin Lang. Although Qin Lang started learning the new surgery very quickly, his subsequent progress is at the level of ordinary people.

For this, Dr. Yan is also a little puzzled, how did Qin Lang's basic skills and previous operations in the field of burns come from training.

Soon, today's laryngeal dehiscence tumor resection began.

In the operating room, Han Hu didn't show up today, but Shen Xi had some time today, so he took the time to watch Qin Lang's study progress.

In addition to Shen Xi, the star doctor of the general surgery department, the popular fried chicken Wang Heng also came to observe Qin Lang's operation in his spare time.

After Wang Heng and Shen Xi entered the operating room, Qin Lang's surgery had already started.

Qin Lang was also a little depressed about the doctors who were on the sidelines, but fortunately, as long as he completed this operation, he could start to improve by leaps and bounds.

Qin Lang sorted out his mentality and started the routine operation. The first step was a perfect tracheotomy.

Looking at Qin Lang's gesture of attack, Yan Zhengqi and Shen Xi were no strangers to it.

So, it was the first time Wang Heng saw Qin Lang's perfect tracheotomy, and his whole body was short of breath. This Qin Lang is really amazing.

How long has it been since I've been studying, have I mastered this laryngeal dehiscence tumor resection perfectly?
Wang Heng took a deep breath, kept calm, and continued to watch Qin Lang's operations.

Yan Zhengqi certainly admired Qin Lang's tracheotomy, but he still had a sense of superiority over the whole operation.

He counted the time in his mouth, and sure enough, after he counted down a few numbers, Qin Lang entered the stage of tumor resection, and his operations and movements began to return to the state of normal people. Compared with the previous ones, it is of course somewhat improved, but compared with Everyone's expectations for Qin Lang are still a bit slow.

After all, five stages have already been performed, Shen Xi frowned slightly, feeling a little disappointed in his heart, it seemed that he overestimated this disciple a bit.

"Just give him more time."

Shen Xi sighed secretly, watched Qin Lang's well-regulated operation, persisted for a few more minutes, and left the operating room directly.

Shen Xi decided to give Qin Lang another month, hoping that by then, he would be able to master this technique proficiently.

Professor Shen's departure, of course, was in Yan Zhengqi's peripheral vision. A person of Professor Shen's level, after confirming Qin Lang's progress, would not waste time on such a mediocre operation.

Yan Zhengqi's tone also revealed a trace of sympathy for Qin Lang. Perhaps Qin Lang's talent lies in basic clinical skills and burns, and he has not yet enlightened on this kind of chest tumor surgery:
"Qin Lang, any surgery takes time to accumulate, don't be discouraged, just do it steadily. When I learned this surgery before, I also learned it for several months. You are only the fifth one, slow down Take your time."

Regarding Yan Zhengqi's comfort, Qin Lang nodded and accepted it humbly.However, I was holding my breath in my heart. When I finish this one, Professor Shen will shock you!

Qin Lang continued his ordinary operation.

Seeing Qin Lang's performance on the operating table, Wang Heng also calmed down a little. Is this a reasonable state? He really thought that Qin Lang was a self-taught man who knew everything at a glance. monster.

"However, Qin Lang's basic skills and some operations are still amazing."

Wang Heng has a general judgment on Qin Lang. Five laryngeal dehiscence tumor resections are still in the entry state, which means that Qin Lang is not the kind of true genius in certain surgical procedures. The only explanation , is the hard-working type.

It is conceivable how much he has paid for being so solid in basic skills. For this, Wang Heng did not underestimate it, but respected it a little more.

It's just that, with this kind of learning ability, it's okay in the early stage. In the later stage, I don't know how high Qin Lang's upper limit can be. After all, Qin Lang showed some first-level and second-level surgeries before, just basic skills.

"I hope that after a few years, Qin Lang can still keep up with his own pace. After all, you are a young doctor whom I recognize very much."

Wang Heng is a pretentious person, his ability and achievements are also worthy of his arrogance.

After seeing Qin Lang's general operation again, Wang Heng also left the operating room ahead of time, so as not to make Qin Lang feel embarrassed after the operation was completed.

Yan Zhengqi looked at it and yawned. Although Qin Lang's progress was not fast, the operation was very stable and there would be no major mistakes.

Finally, after another long time, Qin Lang completed the operation.

[Ding, congratulations to the host for completing the task, and completing five laryngeal dehiscence tumor resections with his own ability.Task reward: 1.1 life simulation points, 2. Pleural tumor resection: entry level]

Hearing this wonderful voice, Qin Lang immediately chose to simulate.

[Ding, consume 1 life simulation point and start the simulation! 】

PS: Thank you for the reward of another 1000 coins from the dangerous boss of the tunnel machine, happy~
(End of this chapter)