My medical skills add experience

Chapter 380 Level [-] Enclosure, Urethral Dilation

"You know all about this! It seems that you pay attention to me a lot!"

Qiao Yu showed a happy smile.

"Didn't you say hello to me when I was studying surgery? The directors of several departments were very self-effacing and took extra care of me. Later, I felt that the skills I had learned were far from enough, and I was also worried that I would be inappropriate for a long time. The instrument nurse, who is unfamiliar with skills, will be disgusted by you at that time. So I simply begged the director of cardiothoracic surgery and neurosurgery to let me work overtime for free after work, and study more in the operating room."

Where there is a will, there is success.

Only she knows how much Qiao Yu put in behind the scenes in order to be an equipment nurse for Zhou Can.

It is also her hard work and hard work that makes Zhou Can look up to her even more and value her.

"Comrade Qiao Yu, thank you for your hard work in order to be my right-hand man during the operation. The first surgical patient is expected to come in soon, and I look forward to your performance."

Zhou Can highly affirmed her dedication.

"Ok!"

After she finished speaking, she might feel that the conversation was too serious, so she covered her mouth and giggled.

After three years, Qiao Yu has obviously become more beautiful and her temperament is more outstanding.And he is very capable in speaking and doing things, and his eyes are still as clear as water three years ago.

In the past three years, the number of times the two met can be counted on the fingers.

However, I often chat on WeChat and occasionally call to chat.Usually Qiao Yu took the initiative to call him.

"Xiao Zhou, get ready, there will be a urethral dilation operation for you to preside over soon!"

Dr. Xu changed into his surgical gown and walked in.

"I have no problem, it's just that this operation requires a doctor's assistant." Zhou Can felt quite surprised, Dr. Xu is known for being strict and cautious.

As soon as I came up today, I directly arranged a urethral dilation surgery for him. This is not like Xu Yidao's style!

"I will be the medical assistant! This is a highly difficult operation in the second-level operation, and it is also your first battle after returning to the emergency department after three years of experience. Don't mess it up with me. Director Lou and others are watching !"

As expected, Xu Yidao was still Xu Yidao. With him watching Zhou Can himself, there was no need to worry about any accidents.

Although Zhou Can has gained a certain reputation in various departments, Director Lou and others in the emergency department did not see it with their own eyes, so they are still a little worried after all.

Yesterday, Zhou Can raised a lot of conditions, and Director Lou agreed to them one by one.

If he can't show the corresponding strength today, even if Director Lou doesn't say anything, Zhou Can himself will feel embarrassed.

"Teacher, this kind of secondary surgery that requires general anesthesia is usually an elective surgery! It takes a while to prepare for the preoperative interview, anesthesia assessment and interview. Is this patient just received?"

Zhou Can accompanied him and asked cautiously.

Early in the morning, even if the patient was admitted last night, it should not be possible to arrange the operation so quickly.

"Ask if you know? I collected it yesterday and left it for you to do."

Doctor Xu glared at him.

Then pass the patient's information to Zhou Can.

The patient was quickly brought in.

This is a male patient in his 20s. Due to urethral stricture caused by trauma, the current symptom is that it is extremely difficult to urinate, and even some complications have occurred.Although it was just a small problem of urination, it made the patient's life extremely painful.

"Doctor, please be more concerned. Since I was injured, my girlfriend has been making noises to break up with me. Now every urination is like torture. I live in too much pain."

The patient's main confidant is Dr. Xu.

"We will definitely do our best to help you treat, now please lie down on the operating table."

After Dr. Xu guided the patient to lie on the operating table, the anesthesiologist began to administer general anesthesia.

For urethral dilatation, adults generally choose local anesthesia and can also perform surgery.

The doctor will generally conduct a comprehensive assessment of the patient's condition and choose an optimal anesthesia method.The risk of general anesthesia is greater, and the advantage is that the patient's vital signs can be monitored at any time during the operation.The patient is under general anesthesia, and the doctor does not have to worry about the patient's non-cooperation or tampering.

There is actually only one disadvantage, which will increase the cost of surgery.

Today, anesthesia technology is very mature.Although anesthesia accidents occur every year, even causing the death of patients.

However, the risk of general anesthesia is still extremely low.

In addition, local anesthesia is safer and general anesthesia is more dangerous. This is nonsense.Even with brachial plexus anesthesia, fatal accidents have occurred in major hospitals.

And it happened more than once.

There has never been a saying which kind of anesthesia is safer.Any surgery has risks.

As long as there is risk, there is unpredictability.

Zhou Can continued to check the patient's information and examination report while the patient was under anesthesia.

After the anesthesia was successfully implemented, the anesthesiologist said to Qiao Yu, "Nurse, help him insert a urinary catheter! Let the urine out first."

"Ok!"

Qiao Yu agreed very simply.

Nurses may encounter almost all the dirty work of cleaning up patients' feces and urine, purulent infected skin, wounds, changing dressings, and inserting urinary catheters.

This requires nurses to have a strong psychological quality.

"Let me do it!"

Zhou Can took the special small catheter to avoid Qiao Yu's embarrassment.

As long as he is present, he will take care of the nurses and female doctors as much as possible.

Qiao Yu was considered his confidante, so she naturally cared for her even more.

Inserting a urinary catheter is a trivial matter for Zhou Can.

It's just that this patient's situation is quite special. Zhou Can obviously encountered obstacles when inserting the urinary catheter.

Fortunately, he took the initiative to help Qiao Yu, otherwise, she would be even more embarrassed.

The level of nurses inserting urinary catheters, even if they are quite old chief nurses, will be at the level of attending if they are exhausted.For a novice like Qiao Yu who has only been working for about three years, it is not bad if he can reach the lower level of a resident doctor.

After a lot of effort, Zhou Can finally successfully inserted the tiny urinary catheter into the bladder.

[Urinary catheter insertion is successful, insertion experience +1.After completing the difficult catheter insertion, the reward experience value +100. 】

It was a little surprising that he actually got an extra reward of [-] experience points.

Is this good intentions rewarded?

[Congratulations on your successful promotion to the fifth level of implantation, the current experience value is 1/100000, and the junior level of the deputy chief physician.It can complete difficult intratube and intracavity insertions, can complete the deep insertion of special medical devices, and can complete the insertion of some organs...]

This medical skill may seem tasteless, but it is of great significance in clinical practice.

It can be said that in many operations, the tasks that need to be completed for implantation are basically finishing touches.

For example, the placement of vascular stents and rings, many doctors began to tremble before the operation.Why, because some malformed hemangiomas are really difficult to deal with.

Not to mention arterial dissection.

If you are a little careless, a life will be in your hands, so I ask you if you are afraid?
In Zhou Can's previous four-level implantation surgery, at the attending level, if he wanted to complete the deep implantation of some special medical devices, he could only try to challenge, the success rate was not high, and it took a very long time.

It's different now. After being promoted to level five, even if he hasn't tried it yet, he already has some confidence.

Plus, the placement of organs sounds absurd.

In fact, in some major operations, it is often used to send an organ back to its original chamber or a certain tissue.However, the risk is very high and the difficulty is extremely high, and there are extremely strict requirements on the technical requirements and experience of the performer.

Many organs and tissues are easy to take out, but difficult to put back.

Zhou Can now officially has this ability.

"The patient's vital signs are normal and can be operated on!"

The anesthesiologist didn't say much.

He just glanced at Zhou Can in a little surprise. Under normal circumstances, the chief surgeon would not care too much about the nurses in the operating room because of his high status.

He could see Zhou Can's care for Qiao Yu.

"let's start!"

Doctor Xu spoke.

Zhou Can was not given any hints, but this operation was deliberately used to test Zhou Can's surgical ability.

Even the knife position was not drawn in advance.

Everything has to be handled by Zhou Can himself.

"Qiao Yu, are all the urethral scouts ready?"

Zhou Can looked at Qiao Yu.

She looked at Zhou Can with an extremely intimate look.

"Well, everything is ready!"

It seems that before the operation, she knew what operation to do.

"The patient's urine is still quite a lot!"

Zhou Can found that the tiny special urinary catheter was still pumping out the urine in the bladder for so long.

I can also understand why the patient would rather die than live.

It is extremely difficult to urinate, and it will be particularly painful when urinating. The bladder is full, and it is obviously full of urination, but it is difficult to pass.You can imagine how sour this feeling is.

In his current situation, there is a high probability that he will have physical problems, and it is quite normal that he cannot complete the married life with his girlfriend.

This is probably the main reason why his girlfriend wants to break up.

No woman wants to be a widow all her life at a young age.

It is unrealistic to bind a woman's lifelong happiness with only the word love.

"Okay, the urine is basically drained! Teacher, can we remove the catheter and start the operation?"

Zhou Can consulted Dr. Xu for his opinion.

"Today's operation is equivalent to a test for you, so you only need to seek my opinion when you encounter difficulties. At other times, all steps are up to you. Remember, try to solve it yourself. Every time Please teach me once, this will lower your surgical score, and future surgeries for you will be affected.”

Doctor Xu reminded him.

This operation is deliberately used to assess Zhou Can's surgical ability and level. If Zhou Can performs well, he may be open to such difficult operations in the future.

If the performance is not good, considering the safety of the operation, Zhou Can can only be downgraded.

It is also possible to supply only primary and secondary surgeries.

At present, Dr. Xu is still in the body of guilt, because of the medical accident that year, he is still working with invisible "shackles".For Level [-] surgery, Dr. Xu is forbidden to enter.

Therefore, the emergency department can only do tertiary surgery at most.

Zhou Can was given a surgery that was infinitely close to the third level, which shows how high expectations are placed on Zhou Can.

"understand!"

Zhou Can stopped asking for instructions and directly withdrew the special catheter from the patient.

Then the scout was taken, and because the patient was in a supine position, he stood on the left side of the patient.

In fact, you can also stand on the right side to do this inspection, it all depends on the personal habits of the surgeon.

If the patient is in the lithotomy position, the surgeon generally needs to stand between the patient's legs.

The lithotomy position is relatively rare.

Zhou Can supported a certain organ of the patient with one hand, and the spies slowly entered the external opening of the urethra.This is just the first step, the next step is to send the probe into the urethra.

This operation process is quite difficult. If the surgeon's technique is not in place, or lack of experience, it is very easy to damage the patient's urethra.

During operation, it is necessary to keep the probe parallel to the patient's abdominal wall, and continue to probe inward. After passing through the pendant urethra, the tip of the probe slides into the bulbous urethra.

After the tip of the probe enters the bulbar urethra, the operator releases his left hand to stretch the patient's organ.

Then gently push the probe toward the posterior urethra gradually, and lift the probe from parallel to the abdominal wall to a vertical position while pushing, so that its tip crosses the membranous urethra and enters the prostatic urethra.

It can be seen that Zhou Can's forehead secreted a fine layer of sweat.

He was careful during the whole operation.

Because this operation is an evaluation of his personal surgical ability by the emergency department, and it is related to the construction and development of his surgical team.

Only first- and second-level surgeries are performed, with strong substitutability and limited development potential after all.

Only those who undergo level [-] or [-] surgery are eligible to gain the right to speak in the hospital.

Zhou Can is very clear about this.

After the tip of the probe passes through the membranous urethra, push the probe forward, and push it down from the vertical position to the abdominal wall to make it parallel.

"Success!"

Zhou Can happily said something to himself.

When it is completely parallel, it means that the front part of the probe has entered the bladder, thus completing the operation of the entire urethral dilation.

The whole process seems to be very simple, but in fact there are many difficulties, and there are huge risks in every step.

But one thing can be assured, even if the operation is wrong, it is impossible to kill the patient.

At most, it will make the patient's condition worse, and even make it difficult to become a real man in the second half of his life.

When Zhou Can was operated on in the emergency department, careful consideration was also given to ensure that no one would be killed in case of an accident.

After the probe entered the bladder, Zhou Can manipulated the probe to twist left and right in the urethra and bladder.

Then carefully withdraw the spies, change to a larger one and repeat the previous steps.

Dr. Xu stood by and watched, with a satisfied expression on his face.

After all, Qiao Yu is a girl, and her eyes are more often looking at other places.

After more than 40 minutes, Zhou Can put down the spy and looked at Dr. Xu.

"Teacher, the operation has been completed, please check it."

"Well, the whole operation process is quite remarkable. Your first operation can be regarded as passing the test. But this operation is only a second-class operation, and the point is to test your operating skills. The next operation will be the real one. Level [-] surgery, you get ready."

Doctor Xu's assessment of Zhou Can did not stop.

Today, he wants to see how far this beloved apprentice has grown after studying outside for three years?
In particular, Zhou Can's steady knife technique and quick knife technique are what Dr. Xu looks forward to and values ​​the most.

Zhou Can let out a sigh of relief, his face relaxed a lot.

"I'm going to the bathroom first!"

The patient was under a lot of pressure when he performed this operation just now.The spirit has also been in a state of tension.

Relaxing now, all he could think of was that the next operation would be more challenging.

Go to the toilet first and keep your body in peak condition in order to meet the next tertiary surgery.

To preside over a tertiary operation, even the attending physician is not qualified.

A deputy chief physician is required.

Giving him a tertiary operation must have been approved by Director Lou.

　Five-level implantation technique, I have no right to change the chapter name, readers please forgive me

　　
　
(End of this chapter)