My Medical Skills Give Me Experiences
Chapter 196: Difficult end-to-end anastomosis. If you want to become a big tree, don't live wi
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Next, Director Jia explained and demonstrated the operation himself, separating and resecting the patient's diseased intestinal segment.
Watching Director Jia complete various operations with ease, the whole process of separation and excision was watertight, with delicate and stable movements, and his knife skills and techniques were extremely skilled, with precision exceeding that of robots.
This is the real master-level surgical skills.
Zhou Can stood by and watched, secretly absorbing the surgical advantages and experience skills.
"When resecting the diseased intestinal segment, we should not blindly pursue cleanliness. We should try our best to leave a longer intestinal segment for the patient. Otherwise, the patient will suffer from severe nutritional disorders after surgery."
Both the large intestine and the small intestine are the body's nutrient-absorbing organs.
Every piece of intestine has its purpose.
They constitute the entire nutrient absorption and excretion system of the human body.
If too much intestine is cut off, it will cause problems in the patient's nutrient absorption, and it may also cause frequent defecation, diarrhea and other troubles.
Some doctors have read a lot of books, lack of postoperative prediction in actual operation, and only blindly pursue the effect of surgery.
In the end, the patient died soon after the operation because the nutrients could not be absorbed, and the family members were angry and went to court.
"Who will do the next intestinal anastomosis?"
After Director Jia completed the part with the highest risk, the rest of the surgical work continued to be done by his doctors.
Such a doctor is a good doctor.
Great emphasis is placed on the cultivation of successors.
Just like Director Hu Kan of Cardiothoracic Surgery, he also pays attention to the cultivation of successors. The cardiothoracic surgeons love him from the bottom of their hearts.
"I'll do it!"
Zhou Can, an "invasive alien species", was unceremonious in grabbing the opportunity to practice surgery, which made other doctors look black.
They are all gentle and polite, and they are not opponents at all when they meet thick-skinned and quick strikers.
"Anastomosis is much more difficult than laparotomy. No one with more than ten years of surgical experience would dare to take on this job. It's a joy for you to grab it, can you do it?" The deputy chief physician scolded him with an unhappy face.
The other doctors also shared the same hatred and had great opinions on the new Dr. Zhou.
"You can let me try it first. If it doesn't work, please help me to end it. Of course, according to Director Jia's rules, if I mess up, I won't compete with you for the opportunity to practice surgery for the next three months."
Zhou Can replied with a smile.
This answer also blocked the mouths of others.
Zhou Can didn't say that he was capable from the beginning to the end, but told these people, you just wait and see me jump up.
As long as I make a mistake, I won't compete with you for the opportunity of surgery and exercise within three months.
Speaking of which, who would have the nerve to stop him?
So, Zhou Can once again stood on the chief surgeon's seat majestically.
He wasn't in a hurry to do the anastomosis, but carefully inspected the severed end of the intestine.
The cut is very flat.
Director Jia also thoughtfully separated the intestines, just enough to pull the two broken ends together.
Zhou Can only needs to match directly.
"Director Jia, can I choose end-to-end anastomosis?"
After seeing the incision, Zhou Can took the initiative to ask Director Jia for his opinion.
This approach is very clever.
It can greatly increase the trust of superior doctors in him.
If he grabs the opportunity to exercise, he will start to match directly. He will be judged as impetuous and eager for quick success. After the superior doctor has a bad impression of him, when he is entrusted with work in the future, he will have a lump in his heart.
"The end-to-end anastomosis is the most commonly used and the most physiological anastomosis method. The anastomosis method you have chosen is very good, hurry up and do the anastomosis!"
Director Jia is equivalent to giving him a reassurance.
According to different intestinal stumps, the selected anastomosis method will also be different.
In addition to end-to-end anastomosis, side-to-end anastomosis is also commonly used.
Zhou Can used absorbable sutures to bring the two severed ends together, and continuously sutured the entire thickness of the intestinal wall at the severed end of the intestine.
The outer seromuscular layer was closed with interrupted nonabsorbable sutures.
Director Jia
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Chapter 196 Difficult anastomosis of broken intestines. If you want to become a big tree, don't compete with grass Free reading: https://,!
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He didn't let it go, but guided him carefully.
Each chief physician has a different teaching method and each has its own style and characteristics.
When Director Jia taught him the operation, he was more concerned with instructing and not affecting Zhou Can's independent thinking. Equivalent to supportive teaching.
Director Hu Kan teaches by analogy, and likes to patiently teach all the surgical skills and experience involved, as well as various situations that may be encountered, to the subordinate doctors.
Director Shen's teaching in orthopedic surgery is simple, citing extensively, and paying more attention to theoretical explanations.
When Dr. Xu was teaching, he was extremely strict, with a sharp mouth and a tofu heart.
When mistakes are made during the operation, he will seriously criticize them, and then wipe your **** and tell you where the mistakes are and how to avoid them.
Zhou Can carefully and quickly kissed the end of the intestine.
Sweat could be seen dripping from his forehead.
There must be tension.
At the same time, this is still physical labor, and there are more elements of sweating and fatigue.
The patrolling nurse wiped his sweat intimately to keep the operation going smoothly.
Sweat dripping onto the patient's wound is not permitted.
After nearly an hour of anastomosis, Zhou Can finally successfully anastomosed the end of the intestine.
[Counting experience value +1.]
[Congratulations on completing the colon stump anastomosis for the first time, reward experience +100. 】
I have successfully earned 101 surgical experience points again, which is great.
There are many organs in the human body. For some difficult surgical tasks, as long as it is the first attempt and is successfully completed, you will be rewarded with 100 experience points.
Don't look at his anastomosis is now at the fourth level, which is a lower level of attending.
10,000 experience points are required to advance to level five.
If he could get a challenging and difficult anastomosis from time to time, it would probably take less than three months for his anastomosis to be promoted to the level of deputy director.
A reward of 100 experience points is quite impressive.
Under normal circumstances, he would need to complete a hundred ordinary anastomosis operations to earn this much experience.
"Jia Zhuquan, please check it for me! See what is not done well, and I will try to correct it next time."
He chooses his words carefully.
It did not say that it must be corrected, but used the elastic word of striving for it.
It's not that he is not modest enough, but because of some shortcomings in the operation, you can't change it if you want to.
Just like when we practice calligraphy, we clearly know that this stroke is not well written. I will definitely pay attention to it next time I write. But still not finished.
This is what is often said to be powerless.
Almost all technical movements need thousands of practice to get better and better.
It is impossible to spot a mistake and correct it right away.
It's almost impossible for a genius like that to exist.
The most is to do better and better.
"Overall, the anastomosis is not bad. There are many areas that can be improved. For example, the denser the better when continuous suturing is performed. Also, the selection of the initial position for anastomosis of the intestine should be carefully considered. With this Take the patient as an example, I personally think that choosing to start the anastomosis from here will reduce the difficulty of anastomosis and the probability of leakage..."
Director Jia's level is very high.
For all the flaws pointed out, Zhou Can was either incompetent, or it was the first match, and he was seriously inexperienced.
Others are mistakes that occurred during the matching process.
Being able to do this is almost his limit.
He kept in mind all the things he didn't do well, and then secretly concluded that he would definitely be able to do a better job next time when he did a similar intestinal end anastomosis.
In fact, as long as the many deficiencies pointed out by Director Jia can be corrected, the ability to improve is not only the intestinal anastomosis, but the entire anastomosis level.
"Who will do it?"
Director Jia asked.
Zhou Can didn't grab again this time, but silently stepped aside.
There is a measure in doing things, and a ruler in life.
All the benefits are taken by him alone, which is an absolute taboo.
On the first day of entering digestive surgery, he may become the deputy chief physician
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Chapter 196 Difficult anastomosis of broken intestines. If you want to become a big tree, don't compete with grass Free reading: https://,!
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, The "enemy" of the attending physician.
Sometimes, making enemies does not necessarily mean conflicts with others, or conflicts, it may also touch the interests of others.
The world of adults is dominated by interests.
Zhou Can snatched all the opportunities for surgery, and the others stood by and looked at him stupidly. He is just a newcomer, so what is he doing if he is not properly spreading hatred?
"I'm coming, I'm coming!"
A resident rushed to answer. Seeing his anxious appearance, he was afraid that Zhou Can would **** the exercise opportunity again and make others smile.
"Hehe, it seems that Zhou Can's arrival has played a certain positive role! At least grab the opportunity to practice surgery, you are no longer like a lady."
Director Jia is very happy about this.
In the past, when I asked these people who wanted the chance of surgery, everyone was hesitant, and it took a long time for someone to express their opinion.
It is undeniable that the punishment he set is indeed a bit harsh, but it is also for the good of everyone.
If something goes wrong, everyone will be unlucky.
The operation came to an end after more than forty minutes.
If it was Zhou Canlai who shut down the accent, it would have ended at least 20 minutes earlier.
This resident doctor's suture level is not bad, but he is too careful.
Every stitch is like a mouse coming out of a hole. It will never run out unless you carefully check the surrounding situation.
"Those who need to go to the toilet hurry up to use the toilet, and those who need to drink water go to drink water. After 20 minutes, continue to the second operation. It is still a partial intestinal resection operation, which will be more difficult."
After Director Jia finished speaking, he went out first.
The physical fitness and physical function of the elderly are much worse than that of the young.
There is still a tough battle to fight, he must hurry to make a convenience, and then replenish his body water.
"Junior Brother Zhou, I really didn't realize that you are so powerful!"
Qiu Hong smiled and took the initiative to talk to Zhou Can.
During the operation just now, Zhou Can's abilities really shocked her.
"I made my senior sister laugh. I'm only half-baked, with a lot of flaws. Thanks to Director Jia for pointing it out to me, I feel that I have gained a lot."
If Zhou Can admits that he is great, then his EQ is extremely low.
The first thing that makes others feel like a spring breeze is humility.
"Hehe, you still have some minor shortcomings. I can't even get started. Anastomosis is so difficult to practice, how do you practice it? When will you teach me!"
When Qiuhong laughed, her eyebrows and eyes were curved like a crescent moon.
Very charming.
Ask Zhou Can about the practice method of anastomosis, this is the purpose of her initiative to talk.
The two resident doctors also instinctively slowed down and listened with their ears up.
To be honest, they also really want to learn Zhou Can's anastomosis practice method. Because Zhou Can's matching level is quite good.
In terms of hard work, everyone is practicing surgery hard in private.
Buying mice to practice vascular anastomosis can cost most of their wages.
The price of mice for medical experiments is relatively expensive, and the better ones are basically more than two hundred yuan. They are not a concept at all with the pet mice sold in the market.
The mice for medical research are all strictly cultivated in the laboratory.
There are many inspection standards.
The small white mice in the market outside cost a few yuan a piece, not to mention other things, the bacteria and viruses they carry are terrible.
"The practice method may be the same as your usual practice. I usually anastomose the tail blood vessels and intestines of mice with a little more. As for other practice methods, there is really no one."
Zhou Can now buys fewer mice.
Because he doesn't gain much experience points by practicing with mice now, time and money are not worth it.
At the current level, practicing on patients is the fastest way to earn experience points.
He used to buy mice by the tens of ten.
It's only 2,000 yuan once.
The money for the cage is extra.
"mean!"
Qiu Hong didn't believe that he could improve so fast just by practicing with mice.
"I'm not lying to you."
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Chapter 196 Difficult anastomosis of broken intestines. If you want to become a big tree, don't compete with grass Free reading: https://,!
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Zhou Can was a little speechless.
It is absolutely impossible for him to tell outsiders about the medical experience value system.
That was his core secret.
"I don't care, whenever I come to you to ask for advice, you have to teach me. Who made you my junior!"
She gave full play to the ultimate privilege of being a beautiful woman, acting coquettishly and cutely.
If Zhou Can doesn't agree, he has to agree.
Looking at Dr. Qiu Hong, who has always been rather cold, coquettish and angry at Zhou Can, a new student from Gui Pei, he even brought out the relationship between senior sister and junior.
The other male doctors were envious for a while.
This kind of good thing is what many men dream of.
Zhou Can didn't feel much.
Because his girlfriend is younger and more beautiful than Qiuhong, and more importantly, the two already have a deep emotional foundation.
The upper body of a man is self-cultivation, and the lower body is instinct.
I have to add one more thing, a man who can restrain his desire is a real man.
Pink Tent, Hero Tomb.
How many heroes and heroes have been defeated by the love of beauty.
In particular, China has experienced a feudal society for thousands of years. Almost all great writers have a preference, that is romantic.
This has a great impact on future generations.
To this day, men still yearn for the life of landlords with wives and concubines in groups.
…
Twenty minutes later, Zhou Can and other doctors returned to the operating room one after another.
The patient was put on the operating table.
This is a patient with colon cancer, diagnosed after a colonoscopy biopsy.
After filming, Director Jia thought there was still a chance for surgery.
The age of the patient is not particularly old, only thirty-eight years old. She has two children, the eldest is only nine years old and the youngest is only six years old. So very reluctant to leave this world.
I want to grow up with my children.
I don't want my child to lose his mother when he is very young.
"Director Jia, doctors and nurses, please!"
The female patient's eyes were full of longing for life.
From her conversation and her calm performance in facing the serious illness, it can be seen that this is a highly cultivated female patient.
If it was an ordinary female patient, with no hair on their body, just a piece of cloth covered, it would be enough to make them feel embarrassed, and dare not look at people.
She can overcome the embarrassment in her heart, face it calmly, and politely ask the doctors and nurses to treat her illness, which is already very remarkable.
In fact, in the eyes of doctors, there is really no distinction between men and women.
During the operation, everyone thinks about how to do a good job for the patient. The whole process is full of risks, and everyone's spirits are tense, so they don't care about whether the patient is male or female.
The anesthesiologist for this operation is still the official doctor.
Zhou Can didn't even need his orders, and stepped forward to help.
As for the other doctors, choose to watch from the sidelines.
Put tubes or something, they will too.
However, he is not as proficient as Zhou Can in the operation and connection of various instruments, as well as the adjustment of ventilator parameters, etc.
There are even many doctors, even if they have reached the level of attending physician, they still only know how to use a ventilator.
The specific parameters are flexibly adjusted, and they will not at all.
This is because their training time in the Department of Critical Care Medicine is very short, and what they can learn is very limited.
But it doesn't matter, as long as they perform well in the future, they can definitely win the opportunity to study in the intensive care medicine department.
You can make up for what you didn't learn.
After successfully installing the breathing mask and the probe of the life monitoring instrument on the patient, the necessary tube placement and access construction were done, and then general anesthesia was implemented.
Taking advantage of the patient's general anesthesia, Zhou Can has already started to carefully check the patient's examination report.
He has come into contact with many cancer patients and has seen all kinds of cancers.
Colon cancer is a relatively common cancer.
Especially for some people who eat irregularly, are unhealthy, and do not like to exercise, this disease is more likely to occur.
The means of prevention, in addition to eating a healthy diet and exercising more, it is very necessary to do regular colonoscopy.
Especially if the immediate family members or family members are found to have similar cancers, they need to be more vigilant.
mind
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Chapter 196 Difficult anastomosis of broken intestines. If you want to become a big tree, don't compete with grass Free reading: https://,!
『』, update the latest chapter as soon as possible!
During the regular training of thoracic surgery, Zhou Can saw a family of five brothers and sisters, and three of them got liver cancer.
In many cases, cancer is like mice, especially easy to get together and form nests.
For example, some families like to eat bacon and fried food. If everyone lives together, they will definitely eat more. When one person develops cancer, the risk for others is greatly increased.
There is also the issue of genetic inheritance.
This remains unsolved.
"Who's going to open the stomach?"
Director Jia asked.
"I come!"
"me!"
This time it's interesting~www.readwn.com~ Whether it's the deputy chief physician who has always relied on his identity before, or several attending physicians, they are all rushing to do it.
On the contrary, Zhou Can didn't grab the opportunity to open his stomach.
For him, opening the abdomen is nothing more than adding a few incision experience points.
If you want to become a big tree, don't compete with grass.
When it's time to give up some small interests, you must give up decisively.
He is now targeting more difficult bowel segment separation, resection, anastomosis, or other newly added difficult surgical tasks.
Open the abdomen and close the cavity, leave it to these people to grab it.
It was the first time to compete with them, and the main thing was to find ways to show their strength and gain the trust and approval of Director Jia.
Now that this goal has been achieved, he will naturally stop robbing.
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Chapter 196 Difficult anastomosis of broken intestines. If you want to become a big tree, don't compete with grass Free reading: https://,!
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