My medical skills add experience

Chapter 218 Excision of Huge Lipoma, Dr. Feng's Reminder
During the operation, gloves are contaminated and need to be replaced immediately to avoid infection to the patient.

This is really not because the doctor is extravagant and wasteful, but for the safety of the operation.

In ancient times, even the simplest amputation operation may cause infection and death of the patient.In ancient times when medicine was backward, hands and feet were cut off, and the death rate was very high.

There must be a wave of Huaxia Chinese medicine here.

The earliest surgical operation under general anesthesia began with Hua Tuo in the Eastern Han Dynasty.At that time, the laparotomy could be performed to remove the tumor from the patient.There are relevant records in both unofficial and official history, and there should be nothing to doubt about this.

In fact, some methods of surgical hemostasis and infection prevention invented by the ancients in China were earlier than the Eastern Han Dynasty.

Qin Shihuang was called a tyrant, and his policies such as unifying the currency and building the Great Wall made the first emperor's merits outweigh his demerits, and historians have always praised him.

As everyone knows, the ancient methods of stopping bleeding and preventing infection were also discovered during the reign of this tyrant.

At that time, all kinds of severe punishments were imposed on the prisoners.

For example, the tattoo punishment of tattooing on the face of the prisoner, as well as the more cruel punishments such as cutting, palace, cutting, and killing.

Most of the people who were executed brutally at the beginning would die quickly due to blood loss and infection.Until a jailer named Zhang Shou accidentally discovered that although the wounds scalded on prisoners with red-hot irons were serious, they did not bleed.

Later, he took money from the prisoner's family, and several prisoners, including the prisoner, had three fingers chopped off during interrogation.The prisoners were bleeding profusely and howling continuously.

This jailer named Zhang Shou took money from his family, so he couldn't watch that prisoner die.So with an idea, he took a red-hot soldering iron and burned it hard on the patient's severed finger.

The pain caused the prisoner to curse Zhang Shou to die.

In the end, the prisoner fainted from the pain.

A total of eleven prisoners had their fingers cut off afterwards, but only the prisoner who was burned with a branding iron by Zhang Shou survived.

At this time, the prisoner also came to his senses, knowing that Zhang Shou was secretly saving him.

After being released from prison alive, the family members sent a sum of money to Zhang Shou again to express their gratitude, but they didn't mention it.

This incident also made Zhang Shou, a small prison guard, see a huge "business opportunity".Since then, he has continued to study how the red-hot iron can stop the bleeding of the prisoner and help the prisoner survive.

He was even more merciless when it came to the benefits from his family members.

Later, Zhang Shou made a lot of money through this matter, bought fertile land and houses in his hometown, married many beautiful wives, and gave birth to a lot of children.

In order to avoid going to the battlefield, his sons entered the prison system under Zhang Shou's arrangement.

At this time, Zhang Shou used money to clear the way, but in fact he was no longer that unknown little jailer.

Instead, he had a certain power and got to know many officials.

Using his contacts, he got his sons into many prisons as jailers.At the same time, he also told his sons the secret that burning the wound with a red-hot iron can stop the bleeding, so that they can also make a fortune along with it.

His youngest son later carried forward this craft, and developed the use of red-hot knives for execution, and the survival rate of prisoners is higher.The wound was not infected, not purulent, and had less bleeding.

In that age of scientific backwardness, it is very remarkable to have these discoveries.

It is estimated that it was this discovery that later laid the foundation for surgery in the Eastern Han Dynasty.

Zhou Can put on sterile gloves, held a scalpel and began to operate on patients.

I saw that the cold and sharp scalpel seemed to be alive in his hand, easily cutting the surface skin of the lipoma along the skin lines.

The tumor was then separated along the tumor capsule using curved hemostatic forceps.

All visible vessels were clamped and ligated.

The fifth-level hemostasis technique is cool, combined with the fifth-level ligation technique to ligate the blood vessels involved in the tumor, his movements are dexterous, precise and quick.During the ligation, not only did not tear the surrounding tissues, but also the ligation was firm and just right.

Surgical skills at the deputy director level are only four words, smooth and silky.

Up to now, Zhou Can's four major surgical basic medical skills are only incision and have not been upgraded to level five.

At present, his incision is almost close to the middle level of attending.

There is still a long way to go before being promoted to level five.

He found that after the medical skill was promoted to the fourth level, if he wanted to upgrade quickly, he couldn't just do routine surgery.Instead, it is necessary to constantly challenge those difficult surgical parts.

The first time of every operation is as valuable as a girl's first time.

100 experience points will be rewarded almost every time.

If a girl can clean herself and love herself, and leave the first time to her husband, it will be beneficial to the stability and happiness of marriage, as well as her status after marriage.

After Zhou Can carefully separated the huge tumor, he was also greatly relieved.

[Separation experience value +1.]

[For the first time you successfully separated a huge subcutaneous tumor on the face, you will be rewarded with +100 separation experience. 】

So cool.

101 separation experience points were successfully credited to the account.

It is equivalent to doing more than 100 ordinary separation operations.

Earning the system's high experience value rewards is a technical job.Zhou Can never tires of the huge gains after completing each challenge.

The lipoma has been separated and the blood vessels have been ligated. The next step is to cut it off.

It is more difficult to remove this huge lipoma, but he is sure to do it well.

"Strange, where does this lingering sense of danger come from?"

Zhou Can couldn't help wondering secretly.

I thought that the crisis must be hidden in the process of separating the tumor from the surrounding tissue.Because this difficulty is the highest.

Even though Zhou Can used the quick knife technique to control the fourth-level separation technique, he still encountered many difficulties.

Fortunately, they all went through smoothly.

Now that the separation of the lipoma has been completed, the feeling of danger has not disappeared, but has aggravated a lot.

Where does this sense of crisis come from?
Is it dangerous to remove this lipoma?
The difficulty of resection is not as high as that of separation, so it cannot be dangerous.

Zhou Can even wondered if the more he knew, the more timid he became.

Many older doctors are cautious when performing operations or taking medicines for patients.It looks very timid.

Now, Zhou Can seems to have the same "cowardice" as those old doctors.

"Old Liu, do you think there will be great potential risks in removing this tumor?"

Zhou Can had no choice but to ask Mr. Liu for help.

"Given your level of anatomy, I am fully capable of cutting out this lipoma safely. Don't think too much, we surgeons must be bold and careful. Where did Zhou Can, who was full of confidence and dared to challenge, go? Show your courage. I, the senior doctor in charge, are not afraid, what are you afraid of?"

Liu Lao gave him the greatest encouragement.

The two have cooperated to perform various large and small surgeries up to [-] to [-], and Mr. Liu is very clear about Zhou Can's surgical prowess.It was also out of his high trust in Zhou Can that he still insisted on allowing Zhou Can to operate when Zhou Can raised questions and showed timidity.

The purpose is to train Zhou Can.

Help him improve his surgical ability.

Many difficult operations, let alone Gui Peisheng with a very short working life like Zhou Can, even a chief physician who has worked for decades may never have experienced it.

Just try to challenge.

There are too many hurdles to overcome in life.

"Then I'll cut it open!"

Zhou Can stabilized his mood, and then began to remove the patient's huge tumor.

Brush brush!
The monopolar electric knife cut off the lipoma easily.

In order to prevent recurrence, some adjacent normal tissues were deliberately removed.

All tumors, whether benign or malignant, are prone to recurrence if they are not cut clean.This point is most likely to be overlooked by many novice surgeons.

Even some attending physicians who have been engaged in surgical work for more than ten years, due to various reasons, will lead to unclean and incomplete tumor resection.

Compared with ordinary scalpels, electric knife has several advantages.

The cutting speed is fast, the hemostatic effect is good, the operation is simple, and the complications can be effectively reduced.

When resecting or cutting various organs and tissues in the subcutaneous tissue, abdominal cavity, and thoracic cavity, doctors often choose to use electric knife.

However, there are some old doctors who will stick to ordinary scalpels.

Because they think that ordinary scalpels are easier to handle and hold.It is said that the best hospital in the imperial capital has Beidou Taishan-level experts in the field of surgery, who never use electric knife when operating on patients.

He has successfully completed many ultra-difficult operations that are extremely delicate.

Have to say that this is a miracle.

Zhou Can's current level of knife skills and anatomy can only be regarded as a medium level.Far beyond comprehension is why the top surgeon insisted on using a common scalpel.

One thing is for sure, even the current Tuya Hospital, including many top hospitals in other provinces, still cannot achieve a true intracranial surgery-free restricted area.

The brainstem is still considered contraindicated by most surgeons.

Even with the robot surgery that has been blown up abroad, I haven't heard of anyone who dares to do brainstem surgery.

But the top surgical expert in the imperial capital dared to do it. The key is that he succeeded, and more than one case succeeded.But multiple instances.

Therefore, the debate on who is stronger and who is weaker about ordinary scalpels and electric scalpels, LEEP scalpels, low-temperature plasma ablation scalpels and other high-tech scalpels has never stopped.

It is an indisputable fact that ordinary scalpels have not been eliminated so far and are still widely used in operations.

Zhou Can neither rejects the traditional "cold weapons", nor favors the electric knife and other scalpels invented by later generations.

Anyway, whichever is convenient to use.

For example, the saphenous vein rotary cutter is also a high-tech product.Using it, multiple incisions can be avoided, and the trauma to the patient is small.

Another example is the phacoemulsification suction knife, which can not only reduce the amount of blood loss during the operation, reduce postoperative complications, but also speed up postoperative recovery.It also has the functions of phacoemulsification, suction, flushing, ultrasonic cutting for hemostasis, and ultrasonic debridement.

It is simply not comparable to ordinary scalpels.

It is safe and accurate to separate blood vessels and bile ducts.One of the necessary surgical artifacts in hepatobiliary surgery.

Especially for those doctors who are not good at separation technology, it is a lifesaver.

Originally, there was only a low-level separation technique for residents, but after using it, it can immediately be upgraded to the excellent level of residents.

The medical progress brought about by science and technology cannot be ignored.

Zhou Can used the electric knife until the lipoma was completely cut off without any accident.

[Incision experience +1.]

[For the first time you successfully removed a huge subcutaneous tumor on the face, you will be rewarded with an incision experience value of +100.]

It's really cool to do this difficult major surgery.

Earned another 101 incision experience points.

The experience points of this medical skill are not easy to earn.

Zhou Can was extremely happy to earn so much at one time.

At the same time, he also felt that his anatomy level seemed to have improved a lot.

After a brief inspection, it was found that the incision had been successfully promoted to the middle level of attending.

This level is roughly equivalent to the strength of senior surgeons in charge.

"Wow, this is the first time I've seen such a big lipoma!"

Seeing that Zhou Can successfully cut off the lipoma, Wu Ziyu immediately lifted it out with tissue forceps and put it in a basin.

Lipomas are mostly multi-lobed and irregular in shape.

This lipoma is irregular in shape, but not lobular.

Zhou Can didn't have much joy, because the sense of crisis was more urgent.

Ever since he cut this lipoma, he felt inexplicable anxiety.

Careful inspection of the wound showed that the base of the tumor was removed cleanly without residue.It didn't cause massive bleeding or hurt important nerves.

This operation should be regarded as very well done.

After checking several times and finding no hidden dangers, Zhou Can looked up at Old Liu.

"Old Liu, do you think you can sew up now?"

"Let's suture! The operation was done very well!"

Mr. Liu is not easy to praise others.

He said it was good, so it was really good.

Zhou Can no longer hesitated, and immediately sutured the patient's wound and performed some flap repairs.

Because the wound suture involving the head and face requires high suture level, it is necessary to avoid ugly and hideous facial scars after surgery.

It is definitely a blessing for this patient that Zhou Can personally sewed up the wound for this patient.

Director-level surgeons basically don't care about such things as skin sewing.At most, it is handed over to the attending doctor for suturing.

I'm afraid there is no attending doctor whose suturing skills are as good as Zhou Can's.

Except for special attending doctors like Dr. Xu who have been promoted from chief physicians.

After the stitches were completed, the patient's vital signs were stable, and no accidents occurred.

Zhou Can's hanging heart fell to the ground temporarily.

It's really strange, it's a good thing to upgrade to the third level of anesthesia, but why does it appear inexplicably dangerous.

This made Zhou Can nervous for several hours in vain.

"Xiao Zhou, the operation was done very well! Why is your condition a little bit wrong today? You seem to be preoccupied."

Liu Lao noticed some subtle changes in Zhou Can's expression.

Can't help asking why.

"I can't tell. When I operated on this patient just now, I felt an inexplicable sense of danger."

Zhou Can expressed his doubts.

"Hi, I've had this experience too. Everyone's nerves are tense during any major surgery. It's perfectly normal to feel nervous and worry about accidents. Now the surgery has been done and everything is going well. There is no need for you to worry about this anymore! Relax and go on to the next operation! There are still many operations waiting for you!"

Mr. Liu didn't want to see anything wrong with Zhou Can, a general.

Do ideological work for Zhou Can on the spot.

comfort him.

"Okay! Maybe I'm worrying too much!"

Zhou Can packed up his mood and was ready for the next operation.

The anesthesiologist, Dr. Feng, had already packed his things. Before leaving, he said to Zhou Can, "If your intuition is correct, the sense of crisis may come from the patient's postoperative complications. It is necessary to closely monitor the patient's postoperative recovery."

After speaking, Doctor Feng left.

Postoperative complications?
Zhou Can was startled, but at the same time had a glimmer of understanding.

No wonder I was always restless. It turns out that the risks of surgery not only come from the operation process, but also may appear after the operation.

It ignores this.

"Tell the doctor in charge of the bed to focus on monitoring this surgical patient."

Zhou Can said to the nurse.

"Mmm Good!"

The patrolling nurse agreed and pushed the patient to the recovery room for anesthesia.

Zhou Can's hidden status in the department is quite high, let alone the attending doctor and resident doctor in charge of the bed, even the chief physician and deputy chief physician are very polite to Zhou Can.

As long as the brain has not been kicked by a donkey, the doctor in charge of the bed will take this matter seriously.

What Zhou Can explained was no different from what Liu Lao explained in person.

After the patient was sent away, the next surgical patient was brought in by the trainee doctor.

The follow-up operation by the intern is to insert the urinary catheter, prepare the skin, make various preparations for the patient before the operation, and check the routine blood pressure, heart rate, body temperature and other items.

After everything was ready, I received the notification from the operating room and sent the surgical patients there on time.

Sometimes, the chief surgeon just does the operation and doesn't necessarily check the patient's information.The interns who follow up the operation are obliged to ensure that the wrong patient is not sent.If the chief surgeon performs the wrong operation on the patient, the intern will definitely be finished.

The main knife also has to be unlucky.

Suspension of surgical authority is the lightest punishment.

Although the odds of this happening are low, it is still possible.

From these aspects, interns who have no sense of presence actually have important responsibilities.

　Thank you book friends, you are testless, for your support!

　　
　
(End of this chapter)