My medical skills add experience

Chapter 485 Rectal Repair, Director Qu Please Join
"What do you mean?" Qiao Yu tilted her head and asked Ma Xiaolan.

"Don't ask, just concentrate on the surgery!"

As Zhou Can is the chief surgeon, he must control the atmosphere and atmosphere of the operating room.Some topics should not be discussed too much.

"Looking at each of you with weird expressions, smirks, and secretiveness, you must know the cause of the patient's anal prolapse. Doctor Zhou, come and tell me the answer!"

Qiao Yu usually makes requests to Zhou Can, and is almost never rejected.

Seeing that Ma Xiaolan refused to speak out now, she asked Zhou Can to speak.

"Ah... It's better not to discuss things that are not suitable for children. The patient will need to use Teflon net suspension for a while, are you ready?"

Zhou Can changed the subject directly.

"It's already ready."

Seeing that they were all mysterious, Qiao Yu refused to say the reason.

She looked at Yang Zhi unwillingly.

"Doctor Yang, you must know it too, right?"

"Uh——I really don't know. The patient is already under anesthesia, so let's do the surgery quickly!"

Yang Zhi is an honest man, but not stupid.

If you shouldn't say it, you won't say it even if you kill him.

"Give me the catheter!"

A urinary catheter is required prior to this procedure.This is Zhou Can's favorite job, for nothing but to earn experience points for implantation.

Surgery began soon.

Zhou Can made an incision about 20cm long from the patient's private part through the left lateral midline.

The skin and subcutaneous layers are then incised into the abdominal cavity.

"Soak the gauze in warm salt water and bring it to me." Zhou Can had already told Qiao Yu some items that need to be prepared for the operation before the operation.

"Give!"

Qiao Yu handed him the gauze.

After receiving it, a pad is made of gauze soaked in warm salt water, and the small intestine is pushed all the way up the abdomen.

"Yang Zhi, there are dozens of operations to treat rectal prolapse. About eleven are still in use. For example, anal ring reduction, mucosal resection, rectosigmoid resection through female private parts, combined rectal fixation Surgery, application of synthetic mesh to reinforce the presacral fascia... These surgical methods can treat rectal prolapse. The one I use now is the most commonly used, and the treatment effect is excellent. Postoperative complications are relatively few, There is almost no relapse."

Zhou Can guided Yang Zhi while operating on the patient.

The master leads the door, and the practice depends on the individual.

After learning many surgical methods, the specific flexible use needs to be studied by oneself and more comprehension in practice.

In the face of different rectal prolapses, the surgical methods chosen are not the same.

"Be optimistic, the next step is the most critical step in the operation."

Zhou Can carefully freed the back wall of the rectum until it stopped at the tip of the tailbone, and then raised the rectum.

After completing the mobilization work of the posterior rectal wall, he was rewarded with 100 points of separation experience.This made him happy.

It is one step closer to the sixth-level separation technique.

"Qiao Yu, prepare the Teflon net sling."

Zhou Can greeted her in advance.

Because it is the first time that this kind of operation is used to repair the prolapsed rectum.

"Use a wide Teflon mesh sling around the upper rectum. Here it goes."

Zhou Can taught by example and tried his best to teach Yang Zhi once.

"Remember, it is better to choose a 5cm mesh sling. Then use thin non-absorbable thread to fix it to the presacral fascia and periosteum under the sacral eminence, and sew the edge of the sling to the front and side walls of the rectum. "

It is not easy to teach and operate at the same time.

Because you can't be distracted during the operation, it must be safer to concentrate on the operation.

"Does the pelvic floor need repairing?"

"No need to fix it."

Zhou Can replied.

Many of Yang Zhi's questions during the operation can be asked to the point.It shows that his comprehension ability is very strong, and he really learned the surgical knowledge taught by Zhou Can.

After learning it, he can immediately ask some questions that he doesn't understand through thinking.

"The rest of the sewing work, you do it!"

Zhou Can left the suturing opportunity to Yang Zhi.

If a surgeon wants to grow, the fastest way is to get started and participate in surgery.

Just watching, watching for a lifetime may still be a novice.

It is an eternal law that seeing things is easy but doing things is difficult.

For Zhou Can, suturing the peritoneal incisions on both sides of the rectum and the layers of the abdominal wall is a very simple matter.After all, his suturing skills have been promoted to level six, and his ligation skills are still a little bit worse, but he is about to be promoted.

In his eyes, this ordinary surgical operation is no longer very attractive.

The difficult operation that can earn 100 experience points is the most attractive to him.Doing one operation like that can equal the experience value of dozens or hundreds of general operations.

Rectal repair is a tertiary operation, and Yang Zhi rarely has the opportunity to practice this risky operation.

He went all out excitedly to suture the patient carefully.

Zhou Can stood by the side to point and check.

"Director Qu, it's already past twelve noon, how about you two having a quick meal in the operating room?"

Zhou Can looked up at the wall clock on the wall, it was past twelve twenty.

time flies.

It is estimated that it will be at least after [-]:[-] when Yang Zhi finishes suturing.Not everyone has Zhou Can's operation speed.

General surgeons, under normal circumstances, perform eleven or two simple primary and secondary operations a day, which is almost the limit.As for the third-level major surgery, even if the strength reaches the level of the deputy director, there are at most two operations a day.

Purely performing three or four major surgeries, as long as they are not particularly complicated, Zhou Can can do five or six surgeries a day with a simple surgical team, which is two or three times that of others.

In terms of the speed of the operation, only the former Xu Yidao could overwhelm him.

Today's Dr. Xu is walking on the shoulders, and what he pursues is no longer speed, but safety and stability.

He is also getting old, and there is no way for a young guy like Zhou Can to output like crazy.

"No need!"

Qu Zi glanced at the anesthetist nurse before answering Zhou Can.

Equipment nurses and itinerant nurses are the assistants of the chief surgeon.An anesthetist is an assistant to the anesthetist.

Like surgical nurses, anesthesia nurses also belong to a special category of nurses.

High professional requirements.

They can become the right-hand man of the anesthesiologist and help with many things.

"There's a major operation in the afternoon, so why don't you just eat here! I can discuss the operation plan with you during the meal."

In fact, what should be discussed has already been discussed.

Zhou Can said this just to give her and the anesthetist a reason to stay for dinner.

"Alright then! Qin Yue doesn't eat spicy food."

Qu Zi nodded in agreement.

Zhou Can signaled Ma Xiaolan to call and order food.

One thing must be said, in the past, the operation room was strictly controlled, and doctors were not allowed to bring mobile phones into the operation room.

As for ornaments such as watches, rings, and earrings, they are not allowed to be brought into the operating room.

Can stay in the changing room.

Tuya's current management is relatively humane, even if it is an intern, it is fine to bring a mobile phone into the operating room.The premise is that it must be muted.

If your mobile phone rings when the superior doctor is performing an operation, you will probably be scolded in all likelihood.

As for some patients reporting to media reporters, some doctors were playing with mobile phones in the operating room.This is basically impossible.The area above the waist can be regarded as a relatively sterile area. During the operation, hands must be cleaned and disposable sterile gloves should be worn.

Sometimes it is even necessary to wear two layers of gloves.

For example, when performing finger examinations for pregnant women, experienced midwives will wear two layers of gloves on their right hands.

Throw away the outer layer after the obstetric examination, which can reduce maternal infection during the operation.

After more than half an hour, the operation was over.

In fact, when Zhou Can handed over the finishing work of the operation to Yang Zhi, the operation was basically successful.

"After sending the patient to the recovery room, everyone went to the rest room to eat as fast as possible and rest for a while. We are going to do the second major operation in a row."

Zhou Can is currently undergoing general tertiary major surgery, and Dr. Xu at most only occasionally comes to take a look and then leaves.

He was quite reassured about Zhou Can.

Zhou Can would not take the initiative to ask Dr. Xu to help unless he encountered a high-risk and extremely difficult operation.

With the addition of Yang Zhi and Ma Xiaolan's rapid growth, their team is now doing ordinary tertiary surgery, and there is no need to call in extra help.

If Dr. Pu from the Department of Cardiothoracic Surgery can join his surgical team these days, the camp will expand again, and his surgical team can become complete.

……

In the rest room, everyone was already hungry, and everyone had a fast food.

Even a ladylike girl like Qiao Yu is cooking like crazy.

"Doctor Zhou, I wonder if you have heard about the reform of the anesthesiology department?"

Qu Zi took the initiative to talk to Zhou Can.

She looks close to 40 years old and is currently the deputy chief physician.The professional strength is quite powerful.

And Zhou Can believed that her potential was much stronger than that of chief physician Dongfang Xueluo.

"I've been so busy recently that I really haven't paid attention to these things. How about the reform of the anesthesiology department?"

Zhou Can asked curiously.

"The reform of general surgery has achieved initial results, and the senior management of the hospital is already preparing to try it out in other departments." She stroked her loose hair.

The division of general surgery into multiple sub-departments has realized the subdivision of the medical field, which is indeed quite good.

Director Liu told Zhou Can that multiple sub-departments of general surgery have achieved all-round growth.Including the number of outpatient and emergency visits, surgeries, hospitalizations, the number of difficult cases conquered, and even the number of academic papers has also increased.

It also means that general surgery has become stronger than before.

So, that's a good thing.

The reform was considered a success.

It also borrowed from the management experience of advanced large hospitals such as the Imperial Capital and Shanghai Metropolis, and it is not surprising that it can achieve success.

"Doctors and nurses in the anesthesiology department may be further fixed in specific operating departments in the future."

She revealed the reform plan of the Department of Anesthesiology.

The current anesthesiologists are basically general practitioners.For example, Qu Zi may go to the emergency department today, the anorectal surgery tomorrow, and the cardiothoracic surgery the day after tomorrow.Wherever there is a need, she will go to any department.

This general practice model is actually not conducive to the growth of anesthesiologists.

Because anesthesiologists face different types of diseases, their understanding and understanding are different.

The general practice model will lower their professional level.

"I think the reform is very good. Last time I went to play with a classmate of mine, and I was lucky enough to meet the anesthesiologists of the Provincial People's Hospital. They have realized the subdivision of anesthesia. For example, those in charge of cardiovascular are only in charge of this field. Anesthesia for surgery. In many ways, the anesthetist was even more professional than the chief surgeon. I was particularly shocked at the time.”

Ma Xiaolan interjected from the side.

"It is indeed so. Now many large hospitals across the country have realized the subdivision of anesthesia specialties. Especially in the Imperial Capital and Modu, and a certain hospital in Zhengzhou, the professional level of their anesthesiologists has been in line with international standards. Our Tuya Hospital is very good. behind."

Qu Zi also pays close attention to the industry.

It's not that you don't hear what's going on outside the window.

Not even behind closed doors.

"Doctor Zhou, I mentioned this matter because I wanted to discuss it with you. If the anesthesiologist needs to fix a certain surgical team, do you think there is any chance for us to cooperate?"

After all, she is a deputy chief physician, and she must have been a little shy when she took the initiative to ask for cooperation with Zhou Can's team and asked for Zhou Can's opinion.

"I only perform two or three larger surgeries a day. If you tie my surgical team together, I'm afraid it will seriously affect your income."

Zhou Can has always been sober.

Despite the astonishing amount of surgeries performed in one day in the emergency department, there are not two major surgeries.

For ordinary first- and second-level surgeries, the chief surgeon or even the itinerant nurse can administer local anesthetic to the patient, and no special anesthesiologist is needed.

"I believe that the income is only temporarily low. I can see your surgical ability and growth rate. Just in the past few years, I need to get a high-level professional title, and the workload is less. I can have a lot of time to read and study."

Before Qu Zi asked for his opinion, he had obviously thought about it long ago.

"Thanks to Director Qu and Teacher Qin's great kindness, I can't wait to cooperate with such excellent anesthesiologists and nurses. I must remind you that the current situation in the emergency department is still not very good. Can we increase the number of third- and fourth-level surgeries in the future? , it’s really hard to say. You guys have to think about it.”

Zhou Can felt that it was quite good to be able to cooperate with Qu Zi.

Director Feng's rank is too high, it is impossible to be tied to his surgical team.

Even Director Feng is willing to tie him up because of his close relationship with Zhou Can.Neither will the hospital.

In terms of weight, Zhou Can's current surgery team probably won't even be in the top [-] at Tuya Hospital.

How is it possible to give him the top anesthesiologist in the hospital?

Also, Director Feng is a bit older after all, and he should retire in a few years.Now, Zhou Can's team is still weak, and the amount of major surgery is very small.In the future, as Zhou Can grows up, the number of major operations increases, but Director Feng is already facing retirement.

Therefore, his cooperation with the young Qu Zi is more beneficial to both parties.

"Then let's put it this way, when the time comes to fill in the wishes, I will directly fill in your emergency department."

Hearing Zhou Can's agreement, Qu Zi showed a rare smile on his face.

When she asked, she was probably afraid of being rejected.

After all, it will be embarrassing!

"Okay! Thank you Director Qu and Teacher Qin for your trust and love. We look forward to our regular cooperation model in the future."

Zhou Can stood up with a smile, walked up to the two of them sincerely, and shook hands with them respectively.

Made both of them laugh.

After eating, everyone went to the bathroom, drank water, took a short rest, and then continued with the operation without mentioning it.

During the second major operation, you can obviously feel that the atmosphere is more harmonious.

This has something to do with Zhou Can and Qu Zi's agreement to form a fixed partner during lunch.

In the future, it will be equivalent to a team of people.

When it was time to get off work, he swiped open the screen of his phone, and suddenly found that the police station in the area had sent him a notice.The case that he was almost hit by a flowerpot from the sky has been filed, and it is currently entering the criminal investigation process.

Seeing this news, Zhou Can was quite happy.

The filing of the case at least shows that the police will send professional criminal investigators to investigate.

He decided to call to inquire about the progress of the case.

"Hello Officer Hu, I'm Zhou Can, the doctor who was attacked by someone throwing a flower pot from the roof last night."

"Oh, hello Dr. Zhou! We have already filed a case."

"Excuse me, did you get fingerprints on those flower pots yesterday?"

"Well... the murderer was very cunning, and his fingerprints were not extracted. However, the cigarette butt we accidentally found on the roof has been sent to a technical appraisal. It may have been thrown by the suspect. In addition, we also extracted the cigarette butts at the scene. The shoe prints can be preliminarily identified as a male, probably in his 30s..."

(End of this chapter)