My medical skills add experience

Chapter 195 Not gentle at all, shocking everyone with skills

Zhou Canneng has made such great progress. On the one hand, he has learned a lot from Dr. Feng;

Of course, it has a lot to do with his accumulation over time.

I learn a little bit every day in practice such as ward rounds, patient management, and surgical participation. As the days go by, I will make great progress.

"Doctor Guan, do you want to place a nasogastric tube for him?"

"Of course you have to let it go! You are better than me in this regard, so I leave it all to you!"

Doctor Guan was very relieved of him.

When performing partial bowel resection, it is advisable to place a nasogastric tube for gastrointestinal decompression, which is beneficial to the exposure during the operation.

It can also prevent accidents such as suffocation due to vomiting during anesthesia.

Zhou Can has considered all aspects very thoughtfully, and there are many skills and knowledge that only professional anesthesiologists know.

Doctor Guan couldn't help being amazed.

He didn't know that Dr. Feng had already started teaching Zhou Can about anesthesiology.

Among the several doctors watching from the sidelines, two of them were of a higher level, they had already discovered that Zhou Can was not easy.

If there is no real thing in the stomach, there is definitely no way to accurately make some preoperative suggestions.

After connecting all the instruments to the patient and preparing for general anesthesia, Director Jia finally rushed to the operating room.

"Hey, how did Zhou Can participate in the anesthesia task?"

Director Jia asked in surprise.

"Junior Brother Zhou knew the anesthesiologist, so he stepped forward to help. He seems to know a lot about anesthesiology, and I really admire him." Qiu Hong replied with a smile.

"Although anesthesiology is only a sub-discipline, it involves many aspects of life knowledge and comprehensive application. When you see anesthesiologists operating in the future, you can also participate more."

Director Jia said to several doctors.

These words are almost equivalent to praising and affirming Zhou Can's behavior.

"Get ready for surgery! There are two tough battles to be fought today, so we must hurry up."

After all, Director Jia is too old, so he can only participate in the core part of the operation, and he can no longer complete a major operation that takes four to five hours by himself like a young guy.

A partial bowel resection, even if it involves just the rectum, usually takes about four hours.

This is still a smooth operation, and the surgeon's skills are excellent, so it can be completed within four hours.

If there is a little accident during the operation, or if there are difficulties during the operation, the operation time will only be longer.

This patient required resection of part of the colon.

Surgery will be more difficult.

Coupled with the severe intestinal adhesion of the lesion, the separation is enough to make people's brain hurt.

No wonder Director Jia called it a tough battle.

"Doctor officer, is the patient okay?"

"Not bad! You can start the operation!"

The anesthesiologist will have four rating criteria for the patient's physical condition.

Very good, not bad, poor, very bad.

Generally, when it reaches a poor level, surgery will be carefully selected.

If the anesthetist feels that the patient's condition is poor, the anesthesiologist has the right to terminate the operation directly.

This kind of thing happens less often, but it happens.

For example, before the patient was pushed into the operating room, all signs were good.As a result, after general anesthesia was implemented, the vital signs dropped rapidly.At this time, the anesthesiologist will stop the anesthesia immediately, and then decide whether to continue the operation or stop it after observation.

For the safety of the operation, there is a high probability that it will be aborted.

This is also a regular large hospital, and anesthesia rarely causes accidents.

An important reason why medical and aesthetic institutions frequently explode.

Anesthesiologists in medical aesthetic institutions are just technicians themselves, and lack a highly professional ability to predict the vital signs of patients.

There is no way to detect danger in advance.

Moreover, ten out of ten medical aesthetic institutions are all private hospitals, and they pursue profits.

After only half a month of training as a 'plastic surgeon', he dared to give patients breast augmentation, nose augmentation, double eyelid cutting, face slimming and liposuction, etc.No accident.

"The surgical marking lines are drawn, who will operate the laparotomy?"

Director Jia looked at his deputy chief physician and attending physician.As for resident doctors, it is difficult to have the opportunity to practice surgery.

"I'll come! Can I?"

Zhou Can was the first to do it.

The other doctors were stunned.This kid is like a hungry wolf, he is not polite at all when he grabs the job.

It's just that he doesn't look at what kind of work it is?

Thought it was leather?This is a belly break.

Risk is extremely high.

Even the general attending doctors dare not say that they are fully sure.

He is a regular trainee who is robbing here, and he has no brains at all.

"Opening the abdomen is a highly technical job, and you can't do it with a regular trainee. Let me do it!"

The deputy chief physician was young, only in his early 40s.

He is a very young deputy chief physician.

When he speaks, he speaks slowly, with the demeanor of a big brother.

"Director Jia said that as long as you are sure, you can speak at any time, and you can perform surgery tasks at any time."

Zhou Can didn't argue with this person directly, but looked at Director Jia.

"Zhou Can, this is not a joke. Are you sure you want to get started? The ugly words are up front. If I do practical tasks under my staff, as long as there is a surgical error, the surgical authority will be suspended for at least three months. Give it to the medical department. Therefore, you must do what you can, and you must not use what I said as a shield to wantonly grab the chance of surgery."

Director Jia spoke very straightforwardly.

He didn't regret what he said.

Just to prevent the doctors under him from showing off their abilities, the punishment conditions prescribed are also extremely severe.

"Respect for life is my first creed. Don't worry, I will never have any jokes about using a knife." Zhou Can's words were sonorous and powerful.

Also shows great self-confidence.

If you rush for an operation, you must not shrink back.

Otherwise, the superior doctors will not entrust you with dangerous surgical tasks at all.

As long as you are sure, go boldly.

However, for the vast majority of regular trainees and residents, getting a chance to have their mouth closed is enough to enjoy them for several days.

In the actual operation, the novice may close the abdominal cavity and sew for an hour or two.

In general, the chief surgeon leaves the scene early after finishing the key part of the operation.Leave a senior attending to watch the situation.

Then the newcomer can take the opportunity to fight for the opportunity to sew the skin.

It's okay to sew slowly.

In order to prevent the senior attending physician who was watching the situation from waiting impatiently.

Plus he's watching, and you'll be nervous when you sew.

You can let him go first, or ask him to sit next to you and rest.

Wait until the sewing is finished and ask him to check it.

As long as you speak beautifully, try to gain the trust of the superior doctors, and try to build a good relationship with them.Most of the remaining attending physicians will let you suture as much as you like.

It is very cooperative to leave temporarily, or leave the operating room directly.

Because they are very busy, and they have also come all the way from newcomers.

Naturally understand the sadness and difficulty.

"Come on! I told you to stop, and you must stop immediately. Also, during the operation, don't act too hastily." Director Jia couldn't scare Zhou Can with his words.

I had no choice but to bite the bullet and agree.

If he knew that Zhou Can was so strong-headed and so courageous, he would definitely not have said that to Zhou Can.

Now it's hard to get over the water, and he can't save face.

I had to let Zhou Can try.

"Director Jia, he's just a training doctor! The risk of laparotomy is too high..."

The job of the deputy chief physician was taken away, and he seemed a little unwilling.

It's more of a worry.

"Let him try it! I'll watch from the side, the risk is controllable."

Director Jia spoke with confidence, but his expression was nervous.

His eyes were fixed on Zhou Can.

Zhou Can was not polite to these people at all. He stood on the chief surgeon's seat, asked the nurse to put on sterile gloves, took the knife, and started directly.

It was not the first time for him to open his abdomen.

Now fully able to do it alone, and do it well.

The operation area has been disinfected and the scalpel position line has been drawn.Just cut it.

I saw that his movements were extremely smooth.

With a single stroke, the cortex was cut open.

Seeing him as casually as if cutting pigskin, and at an extremely fast speed, Director Jia covered his heart with his hands, staring at the wound, not daring to blink.

After Zhou Can made the first cut, he hurriedly yelled to stop.

I almost had a heart attack just now.

"The length and depth of the surgical incision were just right. The incision was done so quickly and casually, boy, no wonder you are so confident, so you are hiding everything!"

Director Jia breathed a sigh of relief after seeing the surgical incision.

Seeing Zhou Can slashing the knife so casually, he was still thinking, it's over, the subcutaneous tissue layer and even the muscle layer must have been cut open.

After reading it, he realized that Zhou Can's abilities were more than ten times stronger than he had imagined.

This knife seemed to be done casually, but in fact it was just right.

The deputy chief physician was so startled that his eyeballs almost fell out.

Up to now, he still has a bloody shocked expression on his face.

Senior sister Qiu Hong's beautiful eyes also widened.

Several other doctors, no matter attending or resident, were horrified by Zhou Can's knife skills.

"Can we continue?"

Zhou Can couldn't wait to open the patient's abdominal cavity to see the condition of the colon.

"continue!"

Director Jia's confidence in him has increased several times, and his sense of trust has also increased a lot.

Next, Zhou Can opened the abdominal cavity layer by layer, like a butcher dissolving an ox.

When cutting through the muscle layer, his knife passed through one of them, and he obviously felt a different knife feeling, which was extremely subtle.

It's something he's never had before.

At present, his incision is close to the middle level of attending, and has not yet reached it.

It stands to reason that such a clear sense of knife can only be obtained at the level of the deputy director.

Now you can get a clear knife feeling a big state ahead of time, which is often referred to as tactile feedback.This made Zhou Can very happy.

He secretly guessed that it may have something to do with the integration of the sharp knife technique into the incision.

When his brain received the abnormal knife sensation, his hands stopped immediately.

One of the biggest disadvantages of the quick knife method is that the hand is faster than the brain.

Zhou Can was able to quickly stop the knife in his hand when he found a problem, which is a very good phenomenon.It shows that so far, his calmness can still restrain the magic brought by the quick knife technique.

Will not be swayed by extreme speed pleasure.

"It's a blood vessel with a relatively thick diameter... well, it's a vein, can it be cut off directly?"

After Zhou Can stopped the knife, he raised his head and asked Director Jia.

"Let me see!"

Director Jia has rich experience in surgery. Although the knife position he drew was drawn by an assistant, he has already passed it secretly after entering the operating room.

You can be sure there is nothing wrong with it.

Important blood vessels and nerves have been avoided.

"Really! It's okay to cut off a vein with a diameter of no more than two millimeters. Of course, you can find it in advance when you cut it. The knife feels very powerful. The cutting is so fast, and the knife can be stopped immediately This is even more powerful. Surgical talent, I have seen it with my own eyes today."

Director Jia was amazed at Zhou Can's ability to discover this blood vessel that is not too thick in advance.

An old surgeon like him, immersed in surgery for more than 40 years.It is not surprising to be able to find important tissues such as blood vessels or nerves with a keen sense of knife.

After all, the level of incision at the director level is there.

Zhou Can, a novice Gui Peisheng, can do this, which is quite abnormal.

In the end, Director Jia attributed it to talent.

To be honest, Zhou Can's traditional surgery talent is not good.

At best, it's above average.

On the contrary, his nerve anastomosis and advanced surgery talent are particularly outstanding.

Now that he can show his super traditional surgical strength, it is entirely the result of the comprehensive result of the quick knife technique and the experience value system that helped him raise the basic surgical skills to a higher level.

"Can I ligate it before cutting it?"

Zhou Can wanted to take this opportunity to show off his medical skills so that he could gain more opportunities for surgery after the abdominal cavity was opened.

Grabbing the training opportunity, Director Jia's subordinates are very gentle and polite.

When Zhou Can was practicing in general surgery, those people rushed to practice surgery, all of them were like hungry wolves.

That's scary.

"Yes, of course!"

Director Jia readily agreed.

This matter should have been the responsibility of Yisuke.However, the deputy chief physician stood there indifferently relying on his status.It's clear that I don't want to be Zhou Can's assistant.

Because it would make him feel cheap.

Zhou Can quickly put down the scalpel, asked the nurse for a needle holder, crochet needle, and thread, and then ligated the blood vessel.

The whole ligation action is fast and handsome, and the ligation is very good.

"Tsk tsk, this level of ligation is conservatively estimated, and it has reached the level of the deputy director. It's too unscientific."

Director Jia let out a series of surprises.

The deputy chief physician, who couldn't put down his face and refused to take the initiative to be Zhou Can's assistant, looked at Zhou Can with a change in his eyes.

There has been a rare tinge of respect.

Zhou Can is so young, but can have such a high level of incision and ligation, which is enough for him to re-examine and quickly adjust his impression of Zhou Can in his mind.

Qiu Hong was even more terrible. When she looked at Zhou Can with her beautiful eyes, there were already bits and pieces of admiration.

Although she is already an attending physician, compared with this Junior Brother Zhou who is still Gui Peisheng, her surgical skills are far behind.

Her exact qualifications are not yet known.At least they are postgraduate masters.

All doctoral students, including some excellent postgraduate masters, are academically well-equipped.

Not so good in terms of surgery.

After all, it takes a lot of practice to get results.

The seemingly simple ligation involves many surgical skills.

It must be explained here that ligation is not equal to knotting.

Tying a knot is only part of a ligation.

Just like men belong to human beings, but not all human beings.

In addition to men, human beings also have women, children, and the elderly.

Ligation often requires the skillful use of crochet needles to pass through some tissues, and bind the blood vessels as perfectly as possible without damaging important tissues and blood vessels.Then tie a knot to secure.

This process should avoid involving the surrounding tissues, and ensure that the degree of tightness and firmness of the ligation meets the requirements.

Therefore, ligation is not the same as knotting.

In medicine, knotting has never been called the four basic medical skills of surgery.

After Zhou Can knotted the blood vessel, he cut it off decisively.

He felt the tactile feedback when he cut the blood vessel again.

Especially wonderful.

This provides safety protection for his subsequent surgical procedures.As long as the knife touches a blood vessel, you can get this kind of signal feedback imprinted deep in the brain.Then stop immediately.

With his current ability, he should only be able to get vascular feedback of about 2 mm.

With the continuous improvement of surgical capabilities, it may be possible to capture the signal feedback of smaller blood vessels in the future.

Because this blood vessel was ligated in advance, there was not much bleeding.

The entire laparotomy process was quick and efficient.

After Zhou Can opened the peritoneum, the internal organs in the abdominal cavity were exposed.

After seeing Zhou Can's surgical prowess, the deputy chief physician's attitude changed completely.

Began to actively help stop the bleeding.

For those small bleeding points, implement electrocoagulation.

"Open the abdominal wound to fully expose the surgical field of vision."

Director Jia said to Sansuke and one of the residents.

Sansuke is Qiuhong.

Her current surgical ability can only be mixed up to this position.

In the operating room, it may be the only place that doesn't look at academic qualifications.

Whoever has the stronger surgical ability is the boss.

Academics are theory, and surgery is practical ability.

"Oh, this man's colon disease is quite serious! If he could come to the hospital for treatment earlier, he might not need to remove part of his intestines. Many diseases are only considered to be treated when they are delayed to a very serious level. Fortunately, His is just an intestinal obstruction, if the polyps in the intestines are delayed so late to deal with, it may become malignant."

Director Jia sighed while observing the diseased intestinal segment in the patient's abdominal cavity.

"When you go to the clinic in the future, you must remember that after you find that the patient's intestines have lesions, if you need to deal with them in a timely manner, you must explain clearly to the patient and their family members. Don't let them think that nothing is wrong, and then delay the treatment until it becomes a major issue."

(End of this chapter)