Chapter 92 Hand in Hand and Mouth to Mouth Teaching

Circuit surgery is different from conventional flying knife surgery. Flying knife surgery, the experts have a better character, and they will tell the local doctors on the operating table. If the doctor is more arrogant, he will not say a word, and the local doctor will not even let him tie a knot. They will do it by themselves. The whole process is covered, and the local doctor is also a human-shaped hook.

There is no way, after all, he has made money by pressing his reputation for half his life, not to promote technology.

But itinerant surgery requires detailed explanations, and even finds ways to make the doctors involved in the surgery understand clearly, just like watching a movie, there must be no mosaics. Whether it's natural or man-made, it doesn't work through the mosaic.

Therefore, at the beginning of the operation, Zhang Fan had to explain it. Zhang Fan was a little uncomfortable with this kind of operation.

Because Zhang Fan was known as the surgical dumb Zhang at the Chasu Hospital, after the operation, he could barely speak.

There is a reason for this, but everyone does not strictly abide by it. There is a rule in the surgical rules and regulations, which clearly stipulates that you should try not to speak during the operation, because talking will cause droplets, and there is a possibility of infection if there are droplets. sex.

When a man and a woman quarrel face to face, it is not unreasonable to describe them as kissing at the molecular level.

If it is necessary to speak in the operating room, you must speak in a low voice, but in reality, doctors and nurses drive like flying cars.

Back then, in Chasu Hospital, a patient went to the Commission for Discipline Inspection and sued the hospital after he was discharged from the hospital because the doctor and the nurse were chatting, because the patient was half numb and half awake, and heard such a sentence, "It's so big, you must have never seen it before." .”

The nurse didn't know whether it was true or not, so she immediately retorted, "Yes, I haven't seen it, anyway, yours is smaller than his."

This is the real thing, one can imagine how fast this car is.

"Zhang Yuan, the preparations for the operation are complete." The anesthesiologist said softly to Zhang Fan. The anesthetist was brought by old man Wu, who had worked with Zhang Fan before.

As soon as Zhang Fan heard this, he stood up, nodded to the camera, and then nodded to old man Wu.

He knew that the old man in his family was staring at the screen right now, and he probably was more nervous than himself. As for the uncle, at such an advanced age, he still has to go into the operating room to help Zhang Fan stand on the stage regardless of his troubles.

Zhang Fan couldn't say thank you, he could only be grateful from the bottom of his heart.

"Conventional median incision,

This incision cannot be saved, and it should be opened as large as possible. Although the damage is a little larger, it is more cost-effective than the second extension after an accident. "

Zhang Fan took the scalpel and used the back of the knife to make a simulated incision on the patient's stomach, just like the demonstration. This method is used in many operations, but other doctors are not demonstrating, but previewing.

Before cutting the skin, many doctors will do a drill with the handle or the back of the knife. Draw white marks on the skin.

The gallbladder is hidden on the edge of the liver. How to describe this thing? In fact, it is like a lady wearing a dress. When the wind blows, the skirt flutters violently, and the flickering makes many fat men excitedly say, White, black, Mickey Mouse!

The gallbladder is actually the same, it hides flickeringly. When most people enter the hospital, the doctor will let the patient lie down with their legs together and retract, and then the doctor's hand will be clasped on the edge of the ribs, and while the patient is inhaling, he will breathe again. Let the patient exhale, and touch the palm up and down with the breath.

This is like the wind. With this operation, you can feel whether it is white or black.

Before entering the abdomen, there is nothing special, routine operation, not to mention Zhang Fan, at Shanhua Hospital, just pull out a general surgeon, and he can make it clear for you.

When entering the abdominal cavity and holding up the liver, the cancerous gallbladder appeared.

A normal gallbladder is like a crystal clear purple grape that is covered with dew and hidden under the vine in the morning. With the wriggling of the body, the crystal clear bile slowly flows in the grapes. Under the sunlight, it really feels like sucking.

The organs of the body, to be honest, are quite beautiful when they are normal, definitely cuter than the organs on the surface of the body, the pink intestines, the fresh liver that exudes a sense of luxury, the white and clean bladder, and even the The lungs are like a pink and white jade.

But this patient’s gallbladder is not so cute. If you choose a word to describe it, it’s like a male toad meets a female toad. The pimples all over the body are full of scars, and they become bigger and more bloated as if filled with blood. , The yellow viscous viscous liquid occasionally secreted can make you spit out the half-boiled fried eggs you ate in the morning.

The purple gallbladder, which was originally in the shape of a drop, now looks like a toad huddled in place, and the gallbladder is slightly resembling due to swelling, which is really boring.

"It's late! It's late when the door opens, and it's not easy for Zhang Yuan to go."

In the observation room, many doctors whispered to each other. Everyone thought that maybe Shanhua would find a patient with an early stage cancer in the first round of surgery, but they didn't expect that it would be an advanced stage.

In fact, Shanhua's director of general surgery had talked with Zhang Fan at the beginning, meaning that for the first operation, it is best to choose patients in the early stage, and the operation is less difficult.

But Zhang Fan refused. Sometimes, the job of a doctor is very strange.

Valley Pork

Some doctors have a good reputation and cannot be better. Hua Tuo is not an opponent when he is alive, but he also follows a sentence, Zhuge is only cautious! Whether this habit is good or not is hard to say in the medical field.

This kind of caution will greatly reduce medical accidents, but the disadvantages are also obvious. This kind of doctor will hardly take risks in treatment.

Old man Wu is famous, how much old man Wu has done, what is the liver map of Asians, and what is the prescribed operation of Asian liver surgery, in fact, these are not as good as he took the risk of resection of a huge tumor on a young child. The old man's surgery is currently the world's youngest patient with the largest cancerous tumor.

According to the academic level, this resection is not as important as the above, and there is a taste of illegal operation regardless of surgical contraindications. But, can you say that the old man is wrong?

Therefore, the medical profession really cannot simply define a doctor as good or bad.

Zhang Fan is not as sentimental as old man Wu, and he hasn't cultivated to his level, but Zhang Fan is confident in his surgical skills.

Since he insisted so much, Shanhua's general foreign director also wanted to see the level of this future leader.

Therefore, the first operation was a very serious patient.

"Here must want to destroy the surrounding involved blood vessels and nerves, this is a difficult point, everyone please pay attention."

Zhang Fan said something softly, but after the sound was played, the eyes of a group of doctors in the observation room almost popped out.

The difficulty of this kind of operation is not to remove the gallbladder. The difficulty of removing the gallbladder is not much different from the difficulty of removing the gallbladder for gallstones. The real difficulty is to clean the nerves and blood vessels around the gallbladder.

Many cancer surgeries are very difficult. The difficulty is not the excision of the lesion. Removing a lesion is actually the same as removing a piece of rotten meat. It is not difficult.

The most difficult thing is to clean up. Many cancer surgeries cover seven or eight or even ten or more lymph nodes around the area. How to say this thing, let me put it briefly, for example, when surgery is performed on the navel, some surgeries require lymphatic dissection to be done under the armpits.

With such a large distance, it can be said that if one of them is accidentally missed, the end result is that all previous efforts will be wasted. Moreover, the scale of damage along the way was unimaginably large.

It is equivalent to almost destroying a person's defense organization.

Gallbladder cancer surgery is more troublesome. Look at the pancreas, liver, and colon next to it. These are not easy to mess with.

"Gauze wrapped!"

The director of the nursing department quickly handed Zhang Fan a piece of gauze soaked in saline.

Zhang Fan began to wrap the gallbladder. The moist white gauze wrapped and knotted the gallbladder lightly. In an instant, the disgusting gallbladder was wrapped in the gauze.

Zhang Fan started cleaning.

Vascular, terminal vessel resection, nerve descending neurectomy, lymphatic dissection.

Lymph like sesame seeds hangs near the hepatic portal vein, hangs on the side of the big brother's thigh like a bragging little brother, and keeps shouting, don't come here, my big brother is not easy to mess with.

Layers of sesame seed-like lymph lie around the thick hepatic portal vein, and with the fluctuation of the hepatic portal vein, the lymph also rises and falls.

Knife, replaced with a new sharp knife. Scalpels are particular. For example, the scalpel for skin opening is usually replaced with a new one after entering the abdominal cavity. It is not a waste of the doctor, because at this time, the blade must be kept sharp.

Zhang Fan held the handle of the knife and began to clean, swish, swish, swish, swish, swish, the blade slashed along the door vein system, like peeling a carrot. I don't know if Zhang Fan is nervous or not. He didn't dare to breathe.

At this time, if one is not careful, the blade penetrates a millimeter or two a little bit, and the cleaning can turn into bloody.

Outside the operating room, a group of people watched and shook their heads, "This is not possible, this requirement is too difficult. It can't be done! His blade is all along the adventitia of the blood vessel, this..."

Just when everyone thought that Nima was here to show off his skills, Zhang Fan began to speak, "The blade is attached to the outer membrane, you must feel the resistance of the outer membrane to the blade, along this layer of resistance, the blade is slightly inclined ten degrees , adduction and downward strength, don’t be careless, you must always feel the resistance of the outer membrane.”

"I'll go, this damn operation, can still talk, is this still a human?" A year old deputy Gao said fiercely. The old man Lu who was outside the operation smiled slightly and said: "This is the improvement of Qiu's knife technique. You can see that the tip of Zhang Fan's knife is not slanted, and he does not use the force of pushing down, but relies on joint tearing. of!"

Zhang Fan explained to Shanhua's director point by point the difficulties of the operation and how he performed the operation. It can be said that he just broke it up and explained it to Shanhua's director.

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