Back in 2002 as a doctor

Zhou Congwen didn't even dare to look at Liu Xiaobie, now he would think of the weird angle when the princess hugged her.

Alas, life, why is it like this, Zhou Congwen was a little depressed.

After changing clothes and entering the operating room, Zhou Congwen walked towards the emergency operating room while fastening his mask strap.

"Xiao Zhou, why are you in the hospital? Haven't you been referred to the doctor?" asked the nurse in the operating room.

"Something happened." Zhou Congwen said, "What's wrong with Brother Gao?"

The expression of the nurse in the operating room was indescribable, and it matched Li Ran's complicated expression.

Anxiety, dullness, hesitation to speak, and other emotions were written all over his face.

Zhou Congwen knew that something might have happened, but if Dr. Gao couldn't perform the operation, he should go to the superior doctor instead of himself.

strangeness.

Zhou Congwen walked into the operating room, "Brother Gao, what's wrong?"

He asked and watched, and saw that it was a laparoscopic operation, and the pneumoperitoneum had been established, but Dr. Gao did not perform the operation, but pressed sterile gauze near the incision.

"Xiao Zhou, I heard that you have done a lot of thoracoscopy recently?" Dr. Gao asked a strange topic.

Although it was a question, everyone knew that it was an affirmative sentence. Dr. Gao was a little embarrassed because he was tormenting Zhou Congwen, so he casually made an opening statement.

"Yeah, what's the matter?" Zhou Congwen responded.

"I... oh, unlucky." Dr. Gao sighed, "Finally, a patient underwent a laparoscopic appendectomy, but after going in, the abdomen continued to bleed. I suspect that the inferior epigastric artery was dried."

"..." Zhou Congwen was speechless.

He understood what the system meant, and it turned out that something went wrong with the laparoscope.

Dr. Gao has nothing to ask, he can only communicate with himself who has done a lot of thoracoscopy.

"Is there a titanium clip?" Zhou Congwen asked.

"Yes, I tried it, but it didn't work, I couldn't find where the bleeding came from." Dr. Gao said helplessly.

"Wait a minute, I'll go brush my hands." Zhou Congwen didn't show any pretense, and turned around to brush his hands.

Fortunately, this was 2002, when licenses had just started to appear, and almost all doctors did not have the concept of scope of practice, Zhou Congwen thought to himself.

If more than ten years later, I have to weigh whether I can and whether I have the qualifications to come up to support the stage and lead the knife.

The scope of practice, it seems that I need to find time to go to the provincial health department to add a few certificates.

In 2002, there were also benefits, Zhou Congwen thought with a smile.

"Old Gao, your brain circuit..." the anesthesiologist said, "Xiao Zhou is a chest specialist, can you do it?"

"I heard that their thoracoscopy is doing well, let's try it." Dr. Gao said dejectedly, "It's really difficult to develop a new technology."

"The new technology is fart. Originally, only one incision was made for the appendix. You have to incision three for the laparoscopy. I think this is a disaster." The anesthesiologist said contemptuously.

Dr. Gao didn't know how to explain it. He wanted to talk about what would happen after he became proficient, but Dr. Gao didn't know how.

He is also a little confused about the future.

For appendectomy, laparoscopy is indeed a bit large, not only the incision, but also the anesthesia.

Normally, appendectomy only requires continuous epidural anesthesia, but laparoscopic appendectomy requires general anesthesia.

But without the proficiency in basic surgery, even if you want to use laparoscopy to cut the gallbladder, you can't do it.

Dr. Gao was a little bit conflicted, especially after persuading a patient to undergo laparoscopic surgery, and ended up breaking the inferior epigastric artery because of his own operation...

For a while, he was a little discouraged, and cursed in a low voice, "Paralyzed, I won't do it in the future, let's have an operation, the 2cm incision is so simple."

"That's not what I said."

When Dr. Gao was complaining, Zhou Congwen came back after brushing his hands, squinting his eyes as if smiling.

Chapter 0343 surgery can do so!

"Originally." The anesthetist grumbled.

The operation that could have been completed in 20 minutes, Dr. Gao poked around for nearly an hour, and finally asked the chest department for help.

Today's class is not busy. It was originally a "good" class, but it was smashed by Dr. Gao.It would be strange if the anesthesiologist and the nurse in the operating room were out of breath.

"A new technology, it's the same at the beginning. Feeling it, you have to have confidence in the future." Zhou Congwen smiled slightly, sterilized and put on a sterile gown to go on stage.

"A new technology of fart, I admit that the thoracoscopic surgery in your thoracic department has less damage." The anesthesiologist said, "But is it necessary for general surgery? Major surgery can't be done, and minor surgery is still more traumatic. This is taking off your pants and farting." .”

Zhou Congwen didn't explain, but went directly to the stage, standing in the position of the performer.

"I'll take a look."

"Xiao Zhou, when you open the blood, it must be the inferior epigastric artery..." Dr. Gao said embarrassingly, "Try it, if it doesn't work, I will cut it to stop the bleeding. Sigh, I don't know how to talk to the patient if I go down." The family explained."

"Titanium clamp." Zhou Congwen whispered.

After receiving the titanium clip, Zhou Congwen patted Dr. Gao's hand, signaling him not to press it, and began to operate the camera to check the position.

"The director doesn't want to do laparoscopy, so I'm just free." Dr. Gao said helplessly, "I saw a new method and wanted to try it. Isn't it for removing the gallbladder. But looking at it now, I really can't do it."

"Old Gao, tell the truth, you are not doing it for money?" The anesthetist was not in a good mood, not at all used to Dr. Gao, and asked the essence of the question directly.

"Money? It's all in the hands of the director, and the manufacturer doesn't come to me." Dr. Gao said dejectedly, "What's my name? I didn't eat any meat and I got into trouble.

I just thought that laparoscopy is very good. If only three holes can be made in the gallbladder, isn't it better than a 20 cm incision. "

"Tch, if you don't have the money to figure out what to do with this stuff, you're free."

"Just idle." Dr. Gao sighed, looking at the anesthesiologist, "If I do laparoscopy again in the future, I will write the word Gao upside down."

"no need."

Suddenly, Zhou Congwen's voice interrupted Dr. Gao's complaints.

"Oh, Xiao Zhou, you don't know." Doctor Gao sighed, "How is it?"

When his gaze returned to the TV screen, he froze for a moment.

The two titanium clips appeared steadily in the field of vision, and no blood came out.

Uh... Zhou Congwen stopped the bleeding when he complained? !Dr. Gao's inexplicable astonishment was tinged with the excitement of escaping death.

Although the time to die is a bit too much, once the incision is made, how to explain it to the patient's family becomes a big problem.

“不怨你。”周从文淡淡说道，“腹壁下动脉的体表投影大致可分2种类型：腹股沟韧带中、内1/3交点与脐连线，约占70%。腹股沟钿带内2/5、外3/5交点与脐下上1/3、下2/3交点连线，约占30%。”

"Just pay more attention in the future. There is no need not to do laparoscopy just because of this trivial matter."

Dr. Gao was stunned for a moment, and Zhou Congwen explained the shape of the inferior epigastric artery like a textbook.

Can……

He shook his head, "I won't do it in the future, it's unnecessary to make a fuss."

"There are still benefits, such as this patient." Zhou Congwen smiled slightly, "Brother Gao, how about I help you?"

"Huh?" Dr. Gao was taken aback.

Zhou Congwen stood in the position of the surgeon and told himself that he would help him. What is the situation?

"Actually, you don't need to punch three eyes, one is enough." Zhou Congwen said while looking at the pressure of the pneumoperitoneum.

15 mm Hg, okay.

"One?!"

"Well, this patient won't open another mouth. For the next patient, you can make an incision at the navel." Zhou Congwen said while operating, "Many patients will accept this, especially young female patients."

"Uh..." Dr. Gao was taken aback, he didn't expect to have such an idea.

But with so many things, can they go in through one incision?

Zhou Congwen has already started the operation, and he explained with a smile, "Generally speaking, single-port laparoscopy makes a small arc-shaped incision about 2.5cm long in the patient's umbilicus, and places two 2mm and one 10mm Troca in an inverted triangle."

"One hole, so many things stuffed in?" Dr. Gao no longer complained, because he had seen Zhou Congwen put all the Troca (casing) in along his exploration port.

"No problem, Brother Gao, you made the first incision on the left side of the navel, 1cm. Just now the bleeding was extended by 1cm, which is barely enough. If the incision is on the navel, don't be so cautious, just 2.5cm will do. .”

"Uh uh uh..." Dr. Gao made a meaningless sound.

He could vaguely understand Zhou Congwen's meaning.

If there is only one mouth, if this mouth is still on the belly button... There will be many people who will undergo similar operations in the future!Dr. Gao seemed to have forgotten what he said just now that he would write Gao upside down, and became inexplicably excited.

The anesthetist and equipment nurse didn't really believe Zhou Congwen's words.

But Zhou Congwen was explaining while operating, and they were even more curious.

If an incision can be made, even on the belly button, then the significance of laparoscopic appendectomy will be reflected.

No scars, the girls must be happy.

Zhou Congwen used the toothless forceps to push the ileum to the left middle and upper abdomen, fully exposing the appendix.

"Well, here it is."

Dr. Gao saw that three cannulas went in one eye, which had no effect on the operation at all, and he forgot what he just said.

"Help me." Zhou Congwen handed the forceps to Dr. Gao, and then began to investigate.It can be seen that the surface of the appendix is ​​obviously congested, mildly edematous, the tension in the appendix cavity is high, there is no obvious adhesion with the surrounding tissues, and no abnormalities are found in other organs.

He used an electric coagulation hook to coagulate part of the mesentery of the appendix, poked a hole in the avascular area of ​​the mesentery at the root, cut the mesentery after clamping it with biological clamps.

Clamp the appendix at a distance of 0.5cm and 1.0cm from the cecum, respectively, with biological clips and titanium clamps, cut the appendix between the two clips, cauterize the stump mucous membrane, disinfect it with iodine and do not embed it, decompress the appendix to extract the pus, and then remove it from the abdominal cavity .

The whole operation was done in one go, without a single pause, like flowing water.

Dr. Gao was dumbfounded. He never thought that the demeaned and worthless laparoscopic appendectomy could do this!

"The cut is a bit awkward, that's probably what it means." Zhou Congwen said lightly, "Brother Gao, do you understand?"

"Uh..." Dr. Gao watched in a daze as Zhou Congwen took out his appendix and flushed his abdominal cavity, unable to utter a complete sentence.

"Aren't you counting? The surgery is over, and I can't close my abdomen without counting." Zhou Congwen said helplessly, looking at the equipment nurse and the itinerant nurse.

Chapter 0344 young and beautiful is the most important

"I'll go...Xiao Zhou, you are too good!" The anesthetist seemed to have forgotten the previous unhappiness, he said excitedly.

"It's not bad." Zhou Congwen smiled slightly, "The laparoscopy is very easy to use, really very easy to use."

"..."

The others in the operating room fell silent.

Laparoscopy is easy to use?Never saw it.Especially the anesthetist, who hated laparoscopic appendectomies.Although the ridicule of Dr. Gao just now sounded half-truth, it was from his heart.

"Count..." Zhou Congwen reminded again helplessly.

"Oh oh oh." The equipment nurse woke up like a dream, and hurriedly called Xun Xun to count together.

The two concentrated on checking the equipment, and the anesthesiologist asked, "Xiao Zhou, amazing, when did you learn to do laparoscopy? This operation is really smooth, Lao Gao, learn more. "

"The principles are similar, mainly the use of mirrors and long-handled instruments. Cutting the appendix? During my internship, the teacher let me do three."

"I'll go, awesome!" the anesthetist exclaimed.

Appendectomy is indeed one of the easiest operations, but it is no small matter.

Interns have the lowest status in the hospital, because they just come for an internship, that is, to take a look, connect reality with the knowledge in books, and have a general impression.

Generally speaking, it is very good for an intern to be able to pull the hook on stage, which proves that he has passed the level of aseptic operation.

No matter how good the student teacher is, he can allow him to make a few pickles.

Three appendectomies can be performed during the internship stage... This kind of intern is already close to a monster.

The anesthesiologist didn't expect Zhou Congwen to be so awesome when he was in school!

Actually... Zhou Congwen didn't expect him to be so awesome when he was in school.

"The appendix can be cut, and laparoscopic appendectomy is also very simple. It's not difficult to insert all the cannulas through one hole." Zhou Congwen felt a little embarrassed and brought the topic back to technology.

Dr. Gao listened to Zhou Congwen's nonsense in a daze, feeling a little dazed.

Is there no difficulty?

Do not!