The genius doctor starts from the game

Chapter 153
It's really inappropriate for the four emergency departments to be completed so quickly.

Zhou Ziyu said: "Is there any more later? Didn't you go to eat together?"

"Brother Ziyu, please don't bury me. Here comes a replantation machine for five broken fingers. Professor Hong from the Department of Orthopedics is doing it on the stage."

"If the chief hospital hadn't followed the stage, I guess Professor Hong would scold her on stage." Lu Cheng refused,

In fact, this is also true. Except for the first one that Zheng Liu gave up on purpose, the others were all due to Zheng Liu's inability to separate himself, so Lu Cheng was allowed to be on the stage. Otherwise, Zheng Liu would definitely not let him come to try work. Lu Cheng performed such intensive surgery.

Professor Hong of the Department of Orthopedics is the current leader of microsurgery in trauma, and almost everyone in the hospital knows him.

Zhou Ziyu nodded: "That's right, it's not a happy thing to call out the professor on stage. There are no familiar people on stage, and a good temper is just cursing."

"Then do you go back directly later or go to the operating room to have a look?"

Lu Cheng's surgery is over. It's two o'clock in the morning, and Lu Cheng has also completed three emergency surgeries. No one will say anything when he goes back at this point.
Lu Cheng replied: "Let's go to the operating room to have a look. The operation of amputated fingers and replantation has never been on stage before. Today should be a chance to take the stage."

"There are few people at night, maybe you can play with the microsurgery mirror."

Lu Cheng generously admitted that it was nothing.

There is no shame in admitting one's inadequacies, and besides, he has never been on stage before with replanted limbs.

Zhou Ziyu was not surprised by Lu Cheng's answer. Lu Cheng is so young and has such powerful skills. Talent is part of it, but hard work is absolutely essential:
"Then I'll go first, I wish you to step down early."

"Good night dreams."

"Thank you Brother Ziyu, you also have a sweet dream." Lu Cheng replied.

Chief resident physicians, you can tell their nature just by hearing their names. They are always doctors who live in the hospital. If you want to have good dreams, you must have no emergency.

Zhou Ziyu chewed betel nuts, smoked a cigarette, and went to change clothes. He probably went back to the department to rest at this point...

The operating room was brightly lit, the anesthetist dozed off, and the vital signs on the anesthesia machine were very stable.

The difficulty in replanting severed fingers is the technology, which poses little threat to the patient, and because the severed finger has a tourniquet or blood drive belt, there will not be much bleeding during the operation.

On the operating table, Zheng Liu, Professor Hong, and another operating team were concentrating on the operation.
Three people gathered around one hand, only two mirrors were divided by Zheng Liu and Professor Hong, so Lu Cheng basically had no chance to look at it, so he simply watched from the audience.

No one noticed his arrival.

While watching, Lu Cheng recalled the operation process of the replantation of the severed limb.

Whether it will happen or not has nothing to do with remembering the procedure of the operation. The operation must be done by hand in order to know whether it will work or not, rather than just knowing how to do it.

Unless you reach a certain level, you can quickly become familiar with it.

The replantation of a severed finger is a little easier than the replantation of a severed limb because of the size of the operation.

But the operation is not simple.

But as with all trauma surgery, first principles never change,
Rinse, debride, rinse again, rinse thoroughly, debride thoroughly, remove necrotic tissue and foreign objects in the severed finger!
If there is no thorough debridement and foreign body removal, no matter how good the suture and butt joint are, it will be fake, the final effect will definitely not be good, and wound necrosis and infection will easily occur.

But unfortunately, this step has already been completed, and the process of connecting the bones has already been completed. Professor Hong is already suturing the blood vessels and nerves of the third finger, and is now finishing the process.

But through those few Kirschner needles that are a little bit thin!

Lu Cheng also knew the second step of replanting the severed finger,

The second principle for the replantation of severed fingers is to harden first and then soften. It must first connect the bone and then connect the soft tissue. The soft tissue includes blood vessels, nerves and tendons; the priority of blood vessels is the highest.

Because only after the blood vessels are unblocked, can we talk about whether the nerves can live.Whether the tendon can live is a big topic.

If the nerves and tendons are all necrotic in the end, no matter how good the suture is, it will be a failure.

The broken ends of the fracture are all cross-fixed with Kirschner wires to form four semi-open triangles to fix the broken ends of the fracture.

The microscope was pushed, adjusted, the eyes were facing the eyepiece, and the adjustment, focal length, and interpupillary distance were started. After the adjustment, the field of view was finally seen clearly.

After the bones have been connected, it is time to anastomose the blood vessels and nerves.

For the severed finger stumps that Professor Hong is doing now, the blood vessel stumps have been sorted out and trimmed, and the blood vessel stumps have already become clean and tidy.

Moreover, Professor Hong has sutured more than half of the proper digital artery in a circle, and now he is doing the proper digital artery on the ulnar side of the middle finger.

The palmar proper artery is divided into two sides of the ulnar and radial sides in each finger, and the popular point is the inner and outer sides.

The proper palmar artery of the middle finger originates from the common digital palmar artery. Professor Hong holds the needle thread and tweezers for fiber suture, but Zheng Liu is also required to use a microscope at the other end to assist and cut the thread.

The diameter of the proper palmar artery is very small, maybe even a little more than one millimeter, but it is obviously not an easy task to sew at least six stitches around such a small blood vessel.

Microscopic sutures, which are much thinner than a hair, are constantly pierced in and out under the microscope and in the hands of Professor Hong. This process is not very smooth, but it is not sloppy. But in the process of knotting, it is very slow.

Because such a small blood vessel is very fragile, as long as the force is a little stronger, it may directly tear the blood vessel. In this way, most of the previous suturing operations can definitely be performed.

Therefore Professor Hong is cautious.

The surgery has lasted for two hours so far.
Under the full attention of the surgery class, they were a little absent-minded. Zheng Liu saw his hands trembling slightly, but he didn't blame him. The surgery class was just students, and they couldn't be expected to have the same energy and ability as those who had experienced battle.

With just such a glance, he saw Lu Cheng who was watching the operation under the stage, and immediately asked, "Xiao Cheng, how many sets have you finished?"

Chen Ding naturally thought that Lu Cheng came here to take a look, after all, that's all.

"It's all over, come and study." Lu Cheng didn't hide anything.

Chen Ding was stunned for two seconds, and upon hearing this, Professor Hong couldn't help but raised his head, frowned slightly and said, "Have you finished all three emergency procedures?"

The tone was a little unhappy.

As a professor of microsurgery, he doesn't think that the speed of the operation is something to be proud of. On the contrary, the effect of the operation is the ultimate goal he pursues.

After listening, Lu Cheng continued to nod his head.

Zheng Liu hurriedly said: "Professor Hong, this is the Lu Cheng I told you about, he is a very good doctor."

Professor Hong is an expert in trauma surgery, if it caused his displeasure, it would not be a good thing, and we will not be happy to get along with each other at work in the future.

Hearing the word Lu Cheng, Professor Hong always felt that he had heard it somewhere, and it seemed familiar. A young man could make him feel familiar, and he should have worked in orthopedics before.

So his face softened a lot and asked: "Do you still have the strength? Can you still go on stage?"

"If you can get on stage, you can change with this little brother."

Professor Hong naturally saw the hand tremors in the surgery class, but it was an emergency surgery and it was late at night, so no one was looking for him, so he had to make do with it.

Lu Chengcheng said, "Then I'll wash my hands right away."

When the surgery team heard this, their eyes lit up. Originally, such amputated limbs were replanted, but he was not able to see too many things with the naked eye like this.

He hurriedly said to Lu Cheng: "Then brother Cheng will work hard."

Lu Cheng smiled and said it was all right.

Washed hands and dressed quickly, and then took over the position of the operation class.

Although Zheng Liu and Professor Hong each had a mirror occupying most of the field of view of the operating table, there were not many assistants blocking the view at the moment, so Lu Cheng could still see very clearly how Professor Hong was suturing.

Professor Hong continued to sew the next stitch, while Zheng Liu continued to help him cut and pass the thread, occasionally holding the needle to fix it.

Lu Cheng helped them fix their fingers and position them.

Because the proper palmar artery is on both sides of the finger, when suturing the radial side, the index finger will block the line of sight and operation,
And at this moment, the index finger has just been replanted, so it is not suitable for breaking it apart forcefully.

However, Lu Cheng still slightly pressed the patient's index finger and thumb with his hand, and his field of vision was much wider than before. Moreover, he also called Xun Xun to open another pair of gloves, and then used the gloves to cover the ring. The first knuckles of the finger and little finger are stretched on the surgical drapes.

The operating space can be exposed most perfectly.

Just such a hand, Professor Hong suddenly felt a shock, the movement of the hand was at least three points faster, and he asked, "Where did you learn these things?"

The layman looks at the excitement and the insider looks at the doorway.

Professor Hong himself has been replanting amputated fingers for so many years, but rarely has such a broad field of vision, and the stump of the patient's amputated finger is not written in the textbook, so there is no exposure during the operation. Strict standards,

Lu Chengcheng said: "Professor Hong, during the undergraduate internship, our professor over there used to be so fixed. I think it is very practical, so I wrote it down."

"Thinking that it might be useful in the future, it just happened to be used today."

Professor Hong kept nodding, and praised without hesitation: "Knowing how to pay attention to details is very good."

"The ability to apply flexibly is also very strong."

"Which school did you go to?"

"Seoul University." Lu Cheng replied without looking up.

As soon as Seoul University contacted Lu Cheng with a few words, a series of memories flooded into Professor Hong's mind instantly.

It also includes some rumors, as well as the vigorous purge in the medical field five years ago, and the No. [-] Hospital of Hunan University also suffered a lot...

Hearing rumors that this Lu Cheng jumped from undergraduate to Ph.D., and then he didn't know where he went or what he did for five years, but at least Lu Cheng is a very talented person, so Professor Hong took a little test: " The replantation of the amputated finger we are doing now is a relatively standard severed end, not the kind of severed interphalangeal joint. Even the severed end of the palm."

"Will the principle of replantation be memorized?"

In fact, professors are not stingy with teaching, but it is also necessary to distinguish whether the people who follow are worth teaching.

If he tells you about the replantation of severed limbs, and you ask him where the blood vessels and nerves are deformed, he will naturally scold you MMP in his heart.Still teaching shit?Then it's not on a channel at all.

"Yes!" Lu Cheng pricked up his ears, without saying a word.Waste of Professor Hong's time explaining.

Professor Hong also believed it. Seeing Lu Cheng's earnest expression with ears pricked up, he felt even more satisfied. He thought to himself that it was not without reason that Lu Cheng was able to enter the field of vision of himself and others so quickly. Academics were one of them. , just this attitude of learning is enough to make any professor feel good.

"Vascular anastomosis is a top priority."

"Actually, replanting a severed finger is the same principle as resuscitating it. First save the life, and then save the function!"

"As for the life of the severed finger, there are two."

"The first, the most basic one, is the blood supply."

"The second is the nerve. If the nerve is necrotic, then the finger is just a decoration. However, with this decoration, as long as the finger is not dead, it is better than nothing!"

"Because there is still a certain function under his severed end, at least it can allow him to maintain a certain holding function."

"There is also the suture of the nerve..."

Professor Hong spoke seriously, and both Lu Cheng and Zheng Liu listened carefully.

In fact, this opportunity was not won by Lu Cheng's eagerness to learn, but because Lu Cheng helped Professor Hong broaden his horizons, which reduced the difficulty of the operation to a certain extent, so that he didn't have to concentrate as before. Professor Hong only had the time to explain to Lu Cheng.

Otherwise, no matter how eager to learn, it is definitely not as important as the purpose of stepping down in the heart of the chief surgeon.

Lu Cheng nodded frequently while listening, and the experience of amputated limb replantation and trauma surgery experience on the panel is increasing crazily. With this explanation, the increased experience is fully two times the increase of the three surgeries he did before. times more.

In clinical practice, we must do more, learn more, listen more, and watch more.

Sometimes, just a random word of advice from the professor can reach you and make you improve quickly.Lu Cheng knew this when he followed Professor Min.

Because after Lu Cheng came to power, the speed of the operation has obviously accelerated...

This change can be felt by both the anesthetist and the itinerant nurse.

In the middle of the process, Chen Yusheng had already rushed to the operating room, but he only watched from the audience and did not disturb Lu Cheng because he wanted to give Lu Cheng Assam.

After about an hour, finally only the proper artery and nerve on the ulnar side of the little finger remained without suturing.

Professor Hong said: "Zheng Liu, do you want to try to sew a few stitches? This is the opportunity Lu Cheng has won for you."

Of course Zheng Liu was eager to try, but he also heard the meaning in Professor Hong's words, so he said, "Then I will sew two-thirds, and leave the remaining third to Lu Cheng."

That's what Professor Hong originally meant, but after all, Zheng Liu is the real chief inpatient, and you should try to stick to him as much as possible when you have any chance to get started.

It is naturally the best thing for Zheng Liu to think about it.

Zheng Liu took the suturing equipment and needle and thread, and then Professor Hong moved to Lu Ben's original position and turned his palm over, completely exposing himself.

The ulnar proper artery of the little finger is on the outermost side and is very well exposed. This is the main reason why Professor Hong dared to let Lu Cheng and Zheng flow up.

It is also necessary to pay attention to the opportunity for surgery.

Zheng Liu's hands trembled slightly. This was the first time he had sutured a blood vessel by himself, and it was such a small proper digital artery.
"Professor Hong, you have to watch carefully, I'm afraid my hands will shake." Zheng Liu suddenly became nervous.

One injection may destroy the artery on one side.

Professor Hong said very solemnly: "Then don't shake."

Zheng Liu took a deep breath, then slowly inserted the needle in and out. Lu Cheng quickly clamped the needle that was not long, and then pulled the needle out through the curvature of the needle, without causing any damage to the blood vessels. of shear force.

Professor Hong captured this movement very keenly.

For him, these details are the key steps that determine whether the replantation of severed limbs will survive or not. It took at least a dozen stitches for Liu to realize that it was much stronger.

Sure enough, surgery is also very talented.

Professor Hong didn't bother Zheng Liu, because at this time, the most taboo thing was to interfere with the chief surgeon.

Zheng Liu stretched and knotted very slowly, and he didn't dare to use force, but he couldn't achieve the purpose of tightening without force. In the end, he had to pull tremblingly seven or eight times before he could barely suture.

With the experience of the first needle, the speed of the subsequent needles will gradually increase.

Finally, after two-thirds of the stitches were finally done, Zheng Liu let out a long sigh of relief, and handed the equipment to Lu Cheng. His forehead was covered with sweat stains, and he said, "Yu Sheng, wipe it off for me." sweat."

Professor Hong looked at Zheng Liu and didn't say much. In fact, he was quite satisfied with Zheng Liu's performance. After all, he was able to sew it up just after touching it. This is a manifestation of solid basic skills.

Next, it’s up to Lu Cheng. I hope he won’t let Zheng Liu’s work go to waste.

Lu Cheng took the equipment in his hands, closed his eyes and rested for a while, and did not start sewing until Chen Yusheng wiped Zheng Liu's sweat.

Insert the needle perpendicular to the single wall of the blood vessel, push the needle along the arc of the needle, and then exit the needle smoothly. The whole process is extremely smooth!
After just one injection, Professor Hong immediately said, "Xiao Lu, why don't you come with me? Your hands are simply natural microsurgery hands, and it's the patriarch who wants to reward you with this meal."

"In the future, you will definitely be able to perform nerve transposition surgery."

Hearing Professor Hong's words, Zheng Liu, who was pulling the needle, immediately became nervous, and hurriedly said: "Professor Hong, Lu Cheng is only on trial work, not from this hospital for the time being."

If Lu Cheng had been with the boss on the first day, he would have taken him to the Department of Orthopedics, and Professor Huang might mess with him later.

And it's not easy for Lu Cheng himself to refuse this kind of thing.

Professor Hong said: "Lu Cheng hasn't been admitted yet, everyone knows this. What are you talking about here, Zheng Liu?"

If Lu Chengruo is a student, it's really hard to grab where he goes to Professor Hong, but Lu Cheng has already worked, so whoever can keep him in their own group depends on their own skills and courage.

(End of this chapter)