Doctor's Life Simulator

Chapter 256 Director Zhou who is comfortable with the support
Although thoracoabdominal aortic aneurysm is very difficult to diagnose in the early stage, the mortality rate after rupture is extremely high, but with Qin Lang's early diagnosis, Director Zhou is still very confident about this early stage aortic aneurysm. It is also very calm in dealing with it.

Before the operation, Director Zhou performed CT three-dimensional reconstruction of the patient's thoracoabdominal aorta to understand the extent and shape of the aneurysm and the involvement of visceral arteries.

A comprehensive examination of the patient's vital organs, heart, lung, kidney, and liver was also performed. Fortunately, the patient could tolerate the surgery.

Before the operation, intestinal preparation and cross-matching were carried out for the patient. Two hours before the operation, antibiotics were injected intravenously, and everything was in order.

For this operation, besides Director Zhou, Zhang Anyi, the first assistant, is also looking forward to it.

After the anesthesiologist completed continuous epidural block anesthesia and hypothermic general anesthesia on the abdominal aorta, he began to insert a radial artery catheter to monitor blood pressure changes at any time and perform blood gas analysis when necessary.

While Zhang Anyi was doing this, he introduced to Qin Lang beside him. After all, in his eyes, Qin Lang was still very young, so let him introduce and share.

At the same time, Zhang Anyi also wants to show his basic skills. Although he is not sensitive to cutting-edge technology, he is still very solid in this traditional surgery.

Listening to Zhang Anyi's introduction, Qin Lang nodded slightly, and also recognized Zhang Anyi's basic skills. These operations are still very accurate and efficient.

Next, Zhang Anyi placed the internal vein and upper extremity vein catheters on the patient, and asked casually:
"Qin Lang, do you know the purpose and significance of this operation?"

Director Zhou also paid attention to Qin Lang's response. During the operation, the superior doctor would often ask some questions to investigate the accumulation and reaction of the subordinate doctor.

For such a simple question, Qin Lang is naturally able to deal with it freely:

"The internal jugular vein and upper extremity venous catheters are mainly used to monitor the central venous pressure to ensure unobstructed and effective infusion and blood transfusion. At the same time, it is best to indwell a urinary catheter and observe urine output regularly."

Qin Lang answered while helping Zhang Anyi to adjust the patient's position, adopting a supine position with the head lowered slightly, so as to facilitate the passage of the small intestine from the lower abdomen to the upper right abdomen.

Seeing Qin Lang's skillful operation, Zhang Anyi was slightly taken aback, this little doctor is not simple.

The next moment, Qin Lang had already placed the patient's stent on the lower 1/3 of the foot and calf. Since the pulsation of the dorsalis pedis artery should be checked after artificial blood vessel transplantation, this position is the best position.

Looking at the details of Qin Lang's operation, Zhang Anyi didn't feel it. Zhou Heng's eyes lit up slightly, and he had a further judgment on Qin Lang in his heart. However, he didn't speak, and continued to observe calmly.

After a while, Qin Lang cooperated with Zhang Anyi to complete various auxiliary preparations.

Director Zhou officially entered the stage. After receiving the scalpel, he made an incision in the center of the patient's abdomen, from the xiphoid process to the pubic symphysis.

Seeing Director Zhou's incision and laparotomy, showing off his skills, Qin Lang also raised his eyebrows, a bit powerful, this skill has about [-]% of his own, he is worthy of being a well-known director of thoracic surgery in Zhejiang Province.

However, this traditional method of laparotomy, no matter how good the technique is, will cause far more trauma to the patient than the minimally invasive surgery in the abdominal aorta lumen that Qin Lang tried in the simulated world with a brand-new stent graft. Treatment programs.

Of course, Qin Lang also understands that the Department of Thoracic Surgery of the No. [-] Hospital of the city has not yet carried out such a cutting-edge operation. For this newly developed operation, the success rate may not be as good as that of a skilled traditional resection.

After all, not everyone, like Qin Lang, can perform a new technique without any pressure and freely.

Qin Lang silently observed Director Zhou's operation. Generally speaking, it was still very powerful. How could he be mediocre if he could become the department director of a tertiary hospital like the No. [-] Hospital in the city?

After entering the abdomen, Director Zhou quickly completed the investigation with the assistance of Zhang Anyi.

Immediately afterwards, the greater omentum and transverse colon began to be pushed upwards. Director Zhou’s operation was stable and calm. After a while, the small intestine moved to the upper right, the sigmoid colon to the lower left, and then the very difficult free duodenum The horizontal, ascending, and duodenal jejunum curve and push it to the upper right.

After some operations, Director Zhou once again showed the demeanor of the old director. He directly touched the aorta proximal to the aneurysm with his fingers, which tested his experience and strength.

".Scalpel and scissors."

Director Zhou issued an order, and Zhang Anyi was about to follow the director's instructions to get the equipment when he saw that Qin Lang had delivered the scalpel and scissors.

Huh, why does it feel like his actions are one step ahead of Director Zhou.

Zhang Anyi didn't dare to think too much, and continued to cooperate with Director Zhou. After all, he didn't dare to relax and distract the chief director.

Director Zhou began to dissect the front, left and right sides of the aorta.

Looking at Director Zhou's operation, Qin Lang frowned slightly. This operation has already scored 85 points, but in the eyes of the master Qin Lang, he can actually do better. It seems that Director Zhou has some subtle bad habits. In fact, the free operation does not take a week, but it is easy to damage the lumbar artery and inferior vena cava.

While Qin Lang was appraising in his heart, he had already gone to take the aortic forceps, and handed it to Zhang Anyi's hand, just like a relay race.

Zhang Anyi took the aortic forceps with some doubts, and heard Director Zhou's voice:
".Aortic Clamp"

Zhang Anyi handed it over casually. Director Zhou looked at the surgical field and didn't notice Qin Lang's movements. He was slightly surprised. Zhang Anyi had made some progress recently, and he was able to start thinking about the operation steps by himself.

After completing the 2cm mobilization of the aorta, Director Zhou is ready to place the aortic clamp.

On the other side, under Qin Lang's super-surgical field, a conclusion has been drawn, that is, the aorta can be better exposed by freeing the left renal vein and pulling it upward with a vein retractor.

Thinking about it, Qin Lang asked for the vein retractor directly from the equipment nurse, and handed it to Zhang Anyi who was still watching Director Zhou's operation.

Zhang Anyi was a little puzzled, but Qin Lang's previous operations were done correctly, so without thinking too much, Zhang Anyi handed over the vein hook.

Director Zhou was considering, judging the exposure of the aorta, took the vein retractor from Zhang Anyi, and smiled knowingly. Indeed, this is a better optimized detail, smart!
Director Zhou hasn't had such a smooth operation for a long time, and this kind of assistance is really worry-free and comfortable.

"Doctor Zhang, recently, it seems that he has been working hard. Well done."

Director Zhou immersed himself in the operation, and calmly praised Zhang Anyi.

Hearing Director Zhou's praise, Zhang Anyi was really flattered, but he really didn't understand when he had to work hard and how he did well.

Didn't he just change hands with the vein hook handed over by Qin Lang?

Next, Director Zhou still focused on the anterior, medial and lateral sides of the iliac arteries on both sides of the distal end of the free aneurysm in preparation for the placement of blocking forceps.

Sure enough, before Director Zhou raised his head to speak, the corresponding equipment had already been handed over to him. Director Zhou made it easier and smoother, this piece of An Yi can do it.

PS: Thank you Nangong Yi for another 100 coins reward, happy~
(End of this chapter)