Auto chess in the operating room

Chapter 297 Why Don't Let Dr. Tang Try?
Soon Sun Danfeng found Qian Gang. Seeing Director Qian, Sun Danfeng was a little embarrassed and anxious: "Director Qian, Dr. Tang and I were doing a pericardiotomy and drainage. Unexpectedly, something happened after the incision. There are omissions in the preoperative data, and there may be problems with the conventional surgery, so please check and guide me."

Hearing what Sun Danfeng said, Qian Gang nodded and was about to set off, but then he thought that the little guy Tang Lou was also there, so he asked casually: "Does Doctor Tang have any opinions?"

Sun Danfeng did not expect that Qian Gang would ask Tang Lou for his opinion, so he chuckled lightly: "Doctor Tang, just a resident doctor can give you any useful advice, but he said during the operation that he has an improved method that can solve the problem of patients. question, but I scolded him directly. Director Qian, let's go over quickly."

Qian Gang took a direct look at Sun Danfeng, and his sharp eyes made him startled: "What's wrong, Director Qian?"

Director Qian pondered for a few seconds, with a serious tone: "Since Dr. Tang has proposed improvements, why don't you let him try?"

Director Qian knew Tang Lou's level, especially the City First Hospital, who didn't know that Tang Lou's talent for improving techniques was unimaginable.

"Director Qian, are you kidding? Tang Lou is so young. Do you really want him to try?"

Sun Danfeng swallowed his saliva, a little puzzled, when did the resident doctor have such a status.

When they were in the Third Hospital of Shanghai, even a doctor like him didn't dare to speak casually when studying the operation plan.

Qian Gang waved his hand: "Okay, since Dr. Tang has an improvement plan, you should go back quickly and follow his technique. I'm going to come over after a while."

"Ok."

Sun Danfeng frowned, but since the director said so, it can't be said, is that resident doctor really good?

However, Sun Danfeng was still a little unconvinced.

Soon Sun Danfeng rushed back to the operating room. Seeing Tang Lou who was still in front of the operating table, he said with a sullen tone, "Tang Lou, just now you said that there is an improved technique, are you sure it can solve the problem?"

Seeing that things turned around, Tang Lou immediately explained: "That's right, I just observed the visceral and parietal lesions of the patient's pericardium, bit the parietal and pericardial tissue at the suspicious lesion, placed a drainage tube in parallel, and sutured the pericardium in place. , and at the same time cooperate with the application of antiviral and nutritional myocardial drugs, and add glucocorticoids."

Tang Lou explained the idea of ​​the improvement plan very succinctly.

"Misplaced suture drainage?"

Hearing Tang Lou's plan, Sun Danfeng was slightly taken aback. He had never heard of this method even though he had seen so many directors' surgeries in the Third Hospital of Shanghai. Has anyone used it before?

"Tang Lou, where did you learn this technique improvement? Did Director Qian think about it?"

Sun Danfeng is a rigorous academic school. He likes to quote scriptures and textual research on the sources of techniques.

"No, I just thought about it myself."

"What? You thought of it yourself!"

Sun Danfeng was shocked. What he thought was not clinically proven. A resident doctor is so confident. Suddenly, Dr. Sun regretted coming to the city's first hospital. This is too wild.

What a nonsense!

Tang Lou said something lightly, and then directly gave instructions to start the operation.

"Hey, wait a minute, I haven't agreed yet."

Sun Danfeng's heart jumped out, why is this tenement house so out of control, he hasn't finished asking yet!
Moreover, the difficulty of suturing in the pericardium is very high, especially for misplaced suturing, which may be self-defeating.

Even his suturing skills dare not suture the pericardial dislocation.

Just as Sun Danfeng was about to stop him, Director Qian had already entered the operating room.

Seeing Director Qian, Sun Danfeng hesitated for a moment, then looked at the director and complained: "Director Qian, Tang Lou proposed a plan, but he improved it himself, the risk is too great, I think it is better not to take the risk. "

As soon as he heard that Tang Lou proposed a new improved surgical method, Director Qian's eyes lit up. He knew how Cheng Jian in the General Surgery Department managed to get down the key disciplines in the field of abdominal external hernia. Look at the several powerful improvement plans of the tenement building.

"Tang Lou, there is another improved technique so soon, is it your original creation?"

Director Qian ignored Sun Danfeng, walked to the edge, and licked his lips, full of anticipation.

Seeing Director Qian's reaction, Sun Danfeng opened his mouth slightly, what is this all about?
Does this mean that Tang Lou often improves his spells?

Tang Lou nodded, and said directly: "Director Qian, Dr. Sun, if the operation is not performed, the patient's condition will be very dangerous. I will start."

"of course."

Qian Gang agreed without even thinking about it, and told Sun Danfeng at the side: "You should also pay attention. If this technique can be promoted, then this subject will be handed over to you and Tang Lou."

Sun Danfeng listened to Director Qian's words in disbelief, why did he still want to popularize this technique that the resident doctor came up with on a whim, and do research?
When Sun Danfeng couldn't understand, Tang Lou directly started to operate.

"Hemostat. Slender needle."

When the equipment nurse heard Tang Lou's voice, she became energetic and cooperated immediately.

In the meantime, Tang Lou pulled out the pericardium on the basis of Sun Danfeng before, and then used a long and thin needle to try to draw out the fluid for the second time.

"First assistant, routine pericardial examination."

As soon as he stood at the position of the chief surgeon, under the concentration of Tang Lou's talent, he directly denied his relatives and gave the order directly.

Director Qian was not dissatisfied at all, and cooperated directly.

Sun Danfeng who was watching was stunned. This is the first time he has seen a big director assisting a resident doctor?
After completing the routine inspection, Tang Lou began to suture the misalignment.

I saw that Tang Lou lifted the pericardium on one side of the incision, pulled one side outward, and sutured from the subcutaneous tissue, and fixed the pericardium on the other side in place, so that the incision could not be aligned due to dislocation, leaving a 2mm gap.

Looking at Tang Lou's sutures, Sun Danfeng's eyes protruded slightly, and he suddenly understood why Director Qian valued this resident doctor so much, and his basic skills were too solid.

Even in the Third Hospital of Shanghai, the sutures of the chief directors were not as smooth and beautiful as Tang Lou.

Sun Danfeng was also a little helpless from being the main swordsman to a spectator, and asked weakly:

"Little one, Dr. Tang, what is the use of this misplaced suture?"

While Tang Lou placed a drainage tube at the pericardial incision, he sutured the subcutaneous tissue and skin one at a time.

"Sterile Bottle"

Tang Lou continued to issue instructions, "Take out the drainage tube when the daily drainage is less than 2ml, and check regularly."

After completing these operations, Tang Lou said:

"In the traditional incision under the xiphoid process, the pericardium is incised at the lowest position of the pericardium and sutured in a misplaced position, and a drainage tube is placed at the same time. This will not only avoid complications of pericardiocentesis, but also achieve long-term drainage to relieve cardiac tamponade."

"The principle is to make an incision at the lowest part of the pericardium, which is conducive to the complete drainage of the effusion. At the same time, the pericardial incision and misplaced suture destroy the function of the pericardial airtight cavity. In the early postoperative stage, more pericardial effusion is discharged by the drainage tube. When the daily drainage fluid is less than 2ml, the drainage tube is removed, so that the newly formed fluid leaks into the loose subcutaneous tissue of the abdomen along the gap of the misplaced suture, and is absorbed by the subcutaneous tissue with a strong absorption capacity, establishing an "internal drainage" It can maintain a relatively dynamic balance between the exudation and absorption of fluid, and play a long-term role in relieving cardiac tamponade.”

"At the same time, with the application of related drugs, the inflammatory lesions of the pericardium can be gradually controlled, and the generation of pericardial effusion is gradually reduced, and finally the purpose of curing non-specific pericardial effusion is achieved. And the use of entering the pericardium at the xiphoid process, that is, not entering the pericardium Abdominal cavity, without entering the chest cavity, can reduce complications such as thoracic and abdominal infection.”

After Tang Lou explained the principle of the whole operation, the last step was also completed.

Tang Lou looked at Sun Danfeng: "Doctor Sun, is there anything else you don't understand?"

(End of this chapter)