Auto chess in the operating room

Chapter 100 Doctor Tang Accepts Apprentice

After Wang Daquan and Ma En left, Tian Linsheng rubbed his hands and looked at the tenement building with burning eyes.

Seeing that Tang Lou was going to write medical records in front of the computer, he quickly pulled out the chair and wiped it with his sleeve: "Doctor Tang, sit down."

"Doctor Tang, let me shut down my stomach tomorrow!"

Tian Linsheng was a little excited and a little nervous. After sitting down in Tang Lou, he quickly poured a cup of tea.

"Tian Linsheng, I found that you have the potential to be a dog lick."

Tang Lou took the tea. He was really thirsty after drinking the coffee in Director Cheng's office before, so he took a few sips and said, "Tea is still better, coffee is not bitter."

"Hey, Doctor Tang, I will hand over your medical records and reports to me from now on. I'm going to close my abdomen tomorrow, and I'm a little nervous. I want to buy a piece of pork to practice suturing. How about you give me some pointers."

Tian Linsheng also worked hard to prepare for the battle. After all, the second senior brother is too expensive now, and he is too poor.

"Yes, you can buy another section of pig large intestine and small intestine, and practice stump suture, figure-eight suture and purse-string suture. These are the most basic, and you will try it when you have the opportunity."

Tang Lou thought about it. After all, these are the most basic operations. Wouldn't it be too embarrassing to say that Tang Lou's assistants couldn't even suture well.

"The stump is stitched up. All right, then I'll go buy pork now."

Tian Linsheng was very excited, and became more and more grateful to Tang Lou. It took a long time for an intern to get a chance to stitch.

If it were a normal approach, he might have to wait until Wang Daquan left the army before he had the opportunity to suture and close the abdomen. But Tanglou would obviously let him try even the stump of the appendix and even turn his intestines?

Just thinking about it makes me a little excited!
"Thank you, Doctor Tang."

Tian Linsheng took a few steps, turned around again, and bowed seriously to the tenement building. After a surgeon performs his first operation, it will become smoother in the future, and the more he accumulates, the more natural he will grow. The faster it is, the more opportunities for surgery, a virtuous circle.

Following Tang Lou, he was completely on a ride.

After all, no one is willing to pull a hook for a lifetime.

Soon Tian Linsheng bought back pork, a section of pig large intestine more than ten centimeters long and a section of pig small intestine long more than ten centimeters.

I just don’t know why, but the aunt who sold the meat looked at him strangely, and even gave him a bottle of Nutritional Express.
In the practice room, Tang Lou specifically explained to Tian Linsheng the four common ways of holding a knife, as well as basic operations such as intermittent suture, simple continuous suture, and mattress suture.

Every method is naturally as smooth as mercury pouring down the ground. Under the three-star technique, there is no other hospital in the city that can match it.

Tian Linsheng was naturally dumbfounded. Only after such a close contact did he realize how great Tang Lou is!
Ma En is a piece of shit in front of Tanglou!
Tian Linsheng became more and more excited and thankful, under the opportunity of Tang Lou, he was able to control the needle, thread and force, such as enlightenment.

Tian Linsheng really felt that in just a few hours, he learned skills that he couldn't comprehend even if he worked in the operating room for three years.

Feeling grateful and ashamed at the same time, looking at the sutures demonstrated by Tanglou, Tian Linsheng spent five times as long and couldn't even achieve three successes.

But he is not discouraged, Tian Linsheng's biggest advantage is his good temper and good attitude.

After the explanation, Tang Lou left to see the information on patients who needed surgery tomorrow.
Tian Linsheng kept practicing, he didn't want to disappoint the opportunity Tang Lou gave him.

Tang Lou returned to the general surgery office, and looked at the patient information of tomorrow's surgeon:
Patient Gender: Female
Patient's age: 66 years old

Brief medical history: Due to "transferred right lower abdominal pain for more than 2 days", he was admitted to the hospital at noon today with "abdominal pain to be investigated (acute appendicitis?)".

Previously denied any special medical history; more than 2 days ago, there was no obvious inducement for pain around the umbilical cord, which was persistent dull pain, paroxysmal intensification, no radiating pain, the pain shifted and fixed in the right lower abdomen a few hours later, nausea, no vomiting, No diarrhea, frequent urination, urgency, dysuria, gross hematuria, cough and other symptoms.

Physical examination: T: 36.0℃, P: 84 beats/min, R: 21 beats/min, BP: 120/90mmHg;

The abdomen was obese and full, with no abdominal varicose veins, gastrointestinal pattern and peristaltic waves; McFarland point tenderness, rebound tenderness and muscle tension in the right lower abdomen.No mass was palpable, the liver and spleen were not palpable under the ribs, and Murphy's sign was negative; abdominal percussion showed tympanic sounds, no percussion pain in the liver and spleen areas, and no percussion pain in the kidney areas, negative shifting dullness, and bowel sounds 3 Times/minute, no sound of air passing through water was heard.

Auxiliary examination: Abdominal CT in the outpatient department of our hospital showed a tubular soft tissue density shadow of about 0.8cm in diameter in the ileocecal area, with fecal stones visible inside, exudative lesions around it, increased adjacent fat density, and thickened retroperitoneum on the right side. ;

Diagnosis: Acute suppurative appendicitis, appendectomy will be performed tomorrow morning.

After reading it, Tang Lou was also a little surprised. This patient is obese and plump. Compared with the normal body type, the operation will be more difficult. Moreover, due to the thick fat, sometimes the physical examination will be unclear than the normal body type.

However, with two-star appendectomy and one-star diagnosis, Tang Lou is still very sure.

Soon it was the morning of the second day.

Since Tang Lou was still an intern and had no qualifications to practice medicine, Qing Ping continued to enter the operating room with Tang Lou and Tian Linsheng in the name of the chief surgeon.

Of course, Qingping also has the consideration of escorting and dealing with accidents.

Chen Wenhao continued to be responsible for the anesthesia. He was already used to seeing the surgeon at Tanglou, and the anesthesia was quickly completed.

This time he was quite clever, when Qing Pingchou shamelessly sat on his stool, he secretly took out another one from the other side, and sat on it happily.

Surgery is like dating a partner. After one or two times, the novelty has disappeared, and the next step is routine. Looking at the tenement building, the posture remains unchanged... Chen Wenhao yawned.

After the Maxwellian incision was taken and the abdominal cavity was opened, many pus pools were seen. The fat pendant at the confluence of the colonic band was hypertrophic, congested, edematous, and stiff, with a little pus moss attached.

If it was Ma En, he might have panicked, but Tang Lou was still calm.

Qing Ping on the side naturally noticed the abnormality of the patient, but seeing that Tang Lou's operation didn't stop, he didn't stop either.

Tang Lou calmly and quickly dissociated the ileocecum, and then probed with his fingers, frowning slightly. In the normal position, the obvious shape of the appendix was not touched.

"The patient has a subserosal appendix, and it is easy to treat. The appendix is ​​wrapped by the intestinal fat hanging, and the fat hanging needs to be sharply dissected."

Naturally, Tang Lou wanted to let Qingping hear it, so as not to be stopped.

Qingping nodded: "Agree."

I was surprised in my heart. I felt that compared to the last time, this kid had made a lot of progress. Subserosal appendix was not uncommon, but it was considered a minority. Generally, when you encounter it for the first time, you would be nervous and panicked.

This tenement house is also very good-natured and knowledgeable. It seems that the past few days have not been wasted, and he is really reviewing various diseases of appendicitis surgery.

"Have you seen many cases?"

Qingping asked.

"Well, I read a lot of journals and studied dozens of appendicitis conditions and how to deal with them."

Tang Lou's eyes are not red and his heart is not beating. After all, it is not an exaggeration to call himself a senior expert in two-star appendicitis surgery.

"Not bad."

Qingping has always liked people who are serious and studious, and Tanglou is also very talented.

As Tanglou said, his hands were not idle, and he quickly dissected the fat hanging, revealing about 0.5*1.5cm of the appendix inside.
Consistent with the video data, Tang Lou continued to probe the appendix cavity with forceps to determine the root.

The more Qingping looked at it, the more frightened he became. Tang Lou's steps didn't make any mistakes, and his speed was much faster than ordinary people.

A few minutes later, Tang Lou completed the appendectomy.

"Tian Linsheng, take care, I'm doing purse-string suture on the stump of the appendix now, and I'll bury the stump after suturing."

Chen Wenhao on the bench suddenly woke up from his drowsiness. Isn't this Tanglou also an intern? Why is he still teaching?

Seeing Qingping's tacit attitude, he was even more surprised.

(End of this chapter)