My medical skills add experience

Chapter 488 Six-level separation surgery, the nurses are all good-looking

Based on his surgical experience, it is almost impossible to repair the patient's finger tendon. The only way is to transplant a tendon.

Under normal circumstances, a person's fingers have superficial flexor tendons, deep flexor tendons, and extensor tendons.

By their contraction or relaxation, they help the fingers to flex or straighten.

The medical anatomy may seem simple, but in the case of adhesions like this, the difficulty of surgery will be frighteningly high.It is a delicate operation, and it is a test of the skill and experience of the surgeon.

No matter how confident Zhou Can was, he would feel apprehensive when encountering this kind of secondary surgery.

Seeing Zhou Can's hesitant face, the patient couldn't help begging Zhou Can to try his best to help him find a way.Even if the treatment fails, he will not cause any trouble to the hospital.

At this time, the patient's father told Zhou Can that he came early when he came to see a doctor, and they stayed in the hotel for four days.

Since his number is very small, it is impossible to grab it.

In the end, I spent two hundred yuan to buy an account from scalpers.

There is only one child in the family, who seems to be 25 years old, but because of an accident, his right hand is disabled.Seriously affected job hunting, marriage, and life.In order to treat his son, the patient's father contracted [-] mu of land and found a job as a logger at the forest farm in his hometown.

He also told Zhou Can that no matter how hard or tired he is, he is not afraid.

As long as the son's hand can be cured, he is willing to spend more money.

Then he told Zhou Can that after his son's hand was injured and disabled, he has been studying hard and endured a lot of pain that ordinary people can't imagine.

In the end, Zhou Can was moved by the father and son.

Dr. Xu was invited to consult together to formulate a surgical plan.

The patient was admitted to the hospital yesterday, and all the examinations that should be done have been done. Then the nurse and the bed doctor shaved the hair on the patient's hands and feet, and cut off the nails.Get ready for surgery.

Regarding the source of tendon transplantation, there are three options. The first is allogeneic, which requires donation from the deceased.

The procedure is complicated and there is a certain waiting period.

But in general, tendons are not as scarce and sought-after as organs such as corneas, kidneys, and hearts, and the waiting period is generally not very long.The cost is not high.

Only the allogeneic tendon transplantation has the risk of rejection.

For such difficult families, the cost is still not low.

The second type is artificial tendon.

With the continuous advancement of human technology, artificial tendons have been developed, and the technology is relatively mature.

The cost is also not low, and there may be rejection reactions, inflammatory reactions, etc.

All allogeneic transplants, whether artificial or from organs or tissues taken from other people, carry a risk of rejection.Many people who have received organ transplants need to take anti-rejection drugs for life.

It can be seen that the above two transplantation methods are not suitable for this patient.

Coupled with the fact that this patient had already had two corrective surgeries, this only made the transplant more difficult.

After discussing with Dr. Xu, Zhou Can finally decided to take the plantar tendon or common toe extensor tendon from the patient's foot to complete the autograft according to the patient's comprehensive condition.

This operation is very risky.

If not, the function of the patient's right hand has not recovered, and the function of flexion and extension of the toes has also been lost.

I discussed a lot with the family members and the patient himself, and got their consent, which led to today's operation.

"Both of you are optimistic. The incision is usually made from the Brunner on the palm side of the finger. The most common way is to make a zigzag incision."

While operating, Zhou Can taught the two of them the surgical skills.

The advantage of turning the jagged incision on the finger to one side is that the scar will not fall on the tendon, and it will be more convenient to suture when the finger is flexed.

After dissecting the patient's finger, you can see the marks left by the previous doctor's operation.

The doctor's surgical ability is not bad, and the operation is very delicate.

It's just that the doctor's correction method is a bit puzzling.

Naturally, Zhou Can would not comment on what was wrong with the previous doctor's operation.Instead, after dissection of the fingers was quickly completed, the tendon was taken from the patient's foot.

At present, Yang Zhi and Pu Dingdong are unable to help Zhou Can perform such a difficult operation.

If the doctor's assistant's surgical ability is strong enough, he can even operate simultaneously with Zhou Can.

When Zhou Can completed the preparations for the hand transplant, the medical assistant just happened to remove the plantar tendon.

[Incision experience +1, separation experience +1, complete the more difficult plantar tendon separation, reward experience +100. 】

Zhou Can was overjoyed seeing the experience value of the separation technique skyrocketed.

As for the incision technique, he has now been promoted to the director level, and he needs a full 100 million experience points to advance to the next level.If you can only earn 1 point at a time, you probably won't be able to level up for a lifetime.

Even if you occasionally award 10 or 100 points, the difficulty of promotion is still frighteningly high.

But Zhou Can is confident that it will take five to ten years to upgrade all the major surgical skills to the seventh level.

Because as his surgical team continues to expand, some simple operations will be left to other doctors in the team.And he is constantly challenging more difficult operations.

For example, the current hand tendon transplantation.

Although it is only a second-level operation, the difficulty is extremely high.The degree of sophistication and surgical skills are not inferior to those of the fourth-level major surgery.

Relatively speaking, the risk of secondary surgery is lower, and the surgical process is not so complicated.

That's it.

If you simply think that the first-level surgery is particularly simple, a surgeon can do it.Level [-] surgery is particularly difficult, and it is too narrow and superficial for the chief physician to perform the surgery.

There are also extremely difficult ones in the first-level surgery.

Level [-] surgeries may also have some moderate surgeries.However, it is impossible to simply say that there is no operation above the third level.

When Zhou Can completed the tendon separation of his fingers just now, he had already received a lot of rewards for the separation technique.

After all, the adhesion is very serious, Zhou Can spent a lot of effort in order to preserve the patient's superficial flexor tendon.

The difficulty is even higher than taking the plantar tendon just now.

After separating the plantar tendon, he continued to separate a blood vessel next to it.

This blood vessel is quite small, but it cannot be cut directly.Because it is responsible for part of the blood supply to the foot.

There is an old saying that a man moves to live, but a tree moves to die.

Why is it easy to die when a tree is transplanted?

Because it is easy to damage the roots.

It is also the same reason to perform surgery on patients. The blood vessels, nerves, tendons, and even subcutaneous tissue that can be preserved should be preserved as much as possible.Only in this way can the physical injury to the patient be reduced.

Some irresponsible doctors, in order to save trouble, just do everything.

This is extremely immoral.

The patient may be left with a lot of inconvenience in life and even cause lifelong pain to the body because of everything the doctor has done for the rest of his life.

[Separation experience +1, +1... Reward +100 separation experience. 】

[Congratulations on your successful promotion to the sixth level of the separation technique, the current experience value is 1/1000000, and the primary level of the chief physician. 】

With his unremitting efforts, the separation technique that he had been thinking of was finally promoted to the sixth level.

After Zhou Can discovered that this medical skill was advanced, he obviously had a new experience in separating and dissociating the organs and tissues of the human body.At this moment, the main trunk of this blood vessel has been basically separated by him, leaving only a few branches connected to it.

This is already a terminal vessel.

Not counting capillaries, it is equivalent to the upper level of capillaries.

Originally, according to Zhou Can's previous surgical ability, it would not only take time and effort to successfully separate such a small blood vessel, but it might not be successful.It's not a matter of wearing magnifying glasses or not at all.

But because the smaller the blood vessel, the thinner its blood vessel wall will be, and it will appear more delicate.

It broke by accident.

In medicine, even the supernatural Wu Baihe, known as the peak scalpel, would be fine with such tiny blood vessels.

Pick at most one or two important ones and separate them from the root, and then don’t even think about it.

Zhou Can's separation technique has been promoted to level six, but he wants to take this opportunity to challenge.

Just in time, you can also experience how powerful the six-level separation technique is.

He dared not use the word 'cow'.

Because the sixth level of medical skills is only at the director level, only the seventh level is eligible to be called a "cow B".

"Give me a No. 27 surgical blade and try!"

Zhou Can said to Qiao Yu.

"Ah... I didn't even know you wanted such a small blade. Xiaolan, could you please go to the equipment room and get it for me?"

"OK!"

Ma Xiaolan hurriedly ran to get the blade.

There are commonly used instruments and consumables room in the operating room, where all kinds of commonly used surgical consumables and blades are stored.

When performing surgery in the old operating room, Dr. Xu once lost his temper because the packaging bag of consumables in the equipment room was opened but not used.

"With such a small blade, you don't want to separate the peripheral nerves, do you?"

Qiao Yu didn't know why Zhou Canmingming was about to separate the plantar tendon, why he suddenly needed such a small blade.

Under normal circumstances, a No. 11 blade is sufficient for separating blood vessels.For skin cutting, more than 10 blades are used.

"I want to keep as many small blood vessels as possible for him, so as to reduce the damage to the feet."

Zhou Can smiled.

Soon, Ma Xiaolan ran over with the No. 27 blade.

In fact, there are also No. 34 blades and No. 36 blades.

For now, however, the number 27 should be sufficient.

After replacing the thin blade, Zhou Can held it in his hand, thinking that he would feel a little uncomfortable.I didn't expect that after the separation technique was promoted to the sixth level, there would be no sense of disobedience in holding it in my hand.

And there's an 'old buddy' familiarity to it.

It seems that I used to use such a small blade to separate blood vessels and nerves.

Trying to separate the first tiny branch blood vessel, the knife is surprisingly smooth.With each knife, his hand was as steady as Mount Tai, but when he cut it, it was as lightning-like.

The fast knife method and the steady knife method are a perfect combination at this moment.

As his two surgical skills of incision and separation have all been promoted to the sixth level, it seems that he has also made new breakthroughs and improvements in his fast knife technique and steady knife technique.

I can't put it into words, it feels great.

It was something Zhou Can had never done before.

Finally, with his efforts, the first thin branch vessel was successfully separated.

They were already mentally prepared for the possibility of cutting the blood vessel wall, but in the end they succeeded.

It's just far from perfect.

In surgery, there is no need to pursue so-called perfection.It is enough to be able to perform the operation successfully and ensure that the patient recovers well after the operation.

Of course, after having a very good surgical foundation, it is no problem to go to the next level and pursue more excellence.

Zhou Can is very self-aware. He has just been promoted to the sixth level, and he is only at the junior level of chief physician. If he blindly pursues perfection, it is absolutely not advisable.

First of all, this will greatly prolong the operation time.

Secondly, if the technology is not up to that level, if we insist on pursuing perfection, it may cause accidents.

In the words of the old man, you can eat whatever you can.

If you don't have that ability, you have to think about eating delicacies from mountains and seas. If you have a full banquet, you are doomed to have a heart higher than the sky and a life thinner than paper.

[Separation experience +1, if you successfully separate a tiny blood vessel, experience reward +100. 】

Zhou Can's eyes lit up immediately, as if he had discovered a new way to earn a large amount of separation experience points!

In the future, as long as conditions permit, several small branch vessels can be separated from the patient.Not only can you earn 100 experience point rewards for the separation operation, but you can also reduce the damage caused by the operation to the patient.

Kill two birds with one stone.

……

After successfully removing the plantar tendon, the next step is to transplant it into the patient's finger.

This surgical process is also an extremely delicate process.

And it is a test of the operator's experience and planning.

"Doctor Zhou, why do we reserve some surrounding tissue when removing the plantar tendon?"

Dr. Pu Dingdong was puzzled and asked Zhou Can for advice.

Under normal circumstances, it is best for the medical assistants not to ask questions during the operation of the main surgeon.Because sometimes the operation is too difficult and the patient's condition is not very good, the pressure on the surgeon is very high.

It is conceivable that the chief surgeon was very irritable at this time, as if a powder keg was pressed in his heart.

You may be scolded if you don't ask for trouble. If you dare to ask questions at this time, you will probably be scolded.

When Zhou Can was an intern before, he had a surgery with a bad-tempered deputy chief physician.In a daze, he scolded the equipment nurse from the beginning of the operation to the end of the operation.

At that time, the equipment nurse was also a 30-year-old woman, and she was so scolded that her eyes filled with tears.

Even so, she still insisted on finishing the operation.

Then I ran out to hide in the toilet and cried.

Sometimes, it is also a kind of happiness for medical assistants and surgical nurses to meet a good-tempered surgeon.

Having said that, let me reveal another very interesting phenomenon.

Basically, whether it is a large hospital or a small hospital, the nurses in the operating room are often the most beautiful among the nurses.

Why this phenomenon occurs, there should be many reasons.

First of all, the status of the chief surgeon is often very high.In any clinical department, a doctor who does a good job in surgery will have a high status.

This is not in dispute.

Because people do have this capital, it is not only the "box office" guarantee of the department, but also the core of the department's income generation.

Even in the internal medicine department, doctors who do a good job of intervention are also at a higher level.

The second reason is that the chief surgeons are generally male doctors.

It has nothing to do with the character of ten men, it's just the nature of men.

I believe that no surgeon is willing to cooperate with a female nurse with a particularly low-value appearance during the operation.The operation itself is a tense, physically exhausting, and stressful job.In order to complete a difficult surgical task, it is necessary to stare at a bloody part for an hour or two, or even several hours.

How tired the eyes must be!

After the operation, looking at the good-looking female nurse can not only relieve the visual fatigue of the eyes, but also make the mood better.

As for those hypocrites who insist on taking doctors to the temple of morality and defining them as inhumane, it can only be said, young man, you are a little too young.

Whether it is a male leader or a doctor, as long as he is a man, he hopes that the women around him are good-looking.

Some business owners, in order not to make certain mistakes, hire a male secretary, which itself is actually a sign of lack of self-confidence.

(End of this chapter)