Chapter 364: The capable ones will take the lead, will it fail at the last moment?
"It's not even eight o'clock yet, and we've already completed two operations. It seems that if we work hard, we don't have to stay up late!" Director Xueyan looked up at the wall clock and a smile appeared on her face.
Because she was wearing a mask, the only thing you could tell was her eyes.
"If we were to perform these two operations, it would be good if we could finish them before ten o'clock!"
Deputy Chief Physician Lu is in his fifties, with a head full of white hair. He is an expert in both surgery and academics. Unfortunately, he is too straightforward and often dies in conversation.
Isn't this a disguised way of saying that they are slow in performing surgery?
Everyone felt somewhat awkward, but Director Hu Kan remained silent.
"Well... Actually, it's not a bad thing to be slow! Slow work makes fine work!"
Deputy Director Lu is Director Xueyan's deputy, and she is often given the role of assistant, which is equivalent to her partner. She can only try her best to help Deputy Director Lu smooth things over and try to make amends.
"Haha, Director Xue is right. I am a fast person, but I am a little careless! Operation safety is above all else. It is safer to go slower and more steadily."
Zhou Can also quickly made fun of himself to avoid making the atmosphere awkward.
He didn't want to stand against all the cardiothoracic surgeons.
"There is only one operation left. Let's take a short break and prepare to complete it in one go!"
Director Hu Kan ended the topic.
Although Director Hu is usually quite gentle, these chief physicians are very concerned about their reputation. Steady surgery is his lifelong pursuit and honor. Deputy Director Lu is not careful with his words and criticized the slow steady surgery in public, which will definitely make Director Hu Kan unhappy.
This is because Deputy Director Lu is in his fifties and has a high position, so he was not scolded.
If a young doctor spoke nonsense, he would most likely be scolded.
Everyone who needed to go to the toilet went to the toilet, and those who needed to drink water drank water.
Surgery is a physically demanding job. Whether it is doctors or nurses, when performing a long operation, they usually drink water, milk, Nutri-Express, etc. during the breaks.
If the doctor prepares a Red Bull drink, there is probably a tough battle to fight.
Sometimes, a complex operation lasts for more than ten hours, which is definitely a difficult challenge for doctors and nurses who have been tired all day. However, in order to save the patient's life, they can only grit their teeth and persevere.
Drinking some refreshing drinks became their helpless choice.
In the early years, many doctors and nurses drank a medicinal drink called brain tonic juice.
This drink can refresh you, but it has strong side effects.
Keeping people's spirits in an excited state for a long time will overdraw their life essence, which will accelerate the aging of doctors and nurses.
Zhou Can also went to the toilet, drank some water, and returned to the operating room with high morale.
Other surgical staff also returned to the operating room one after another.
The patient was lying on the operating table. The anesthesiologist was not Dr. Feng, but another chief physician of the Anesthesiology Department, Dongfang Luoxue.
As her name suggests, she is as cold and beautiful as snow, as if everyone in the world owes her a debt.
Like Director Xueyan, she is a truly talented woman.
Dongfang Luoxue was in her early forties and was quite beautiful, with fair and smooth skin. She did not look like a forty-year-old woman, but rather had the tender and fresh look of a twenty-year-old girl.
According to Zhou Can, she is the only female chief physician in the Department of Anesthesiology.
He is also the youngest one ever.
It must be mentioned here that in most people's impressions, anesthesiologists are male doctors, but in fact there are quite a few female anesthesiologists.
The proportion of female anesthesiologists abroad is even much higher than that of male anesthesiologists.
"Can I help you?"
Zhou Can and Dongfang Luoxue were not familiar with each other, but they knew each other.
She also knew that Zhou Can was half-apprentice of Doctor Feng.
"good!"
He just gave a cold one-word answer.
"I haven't seen Doctor Guan for some time. Is he okay?" Zhou Can tried to chat with her while working efficiently.
It wasn't that he wanted to win over this cold-hearted female anesthesiologist, but it was a job requirement.
Only by maintaining good communication can we ensure that the work is completed more smoothly.
When encountering emergencies , cooperation can be more tacit.
If everyone is like her, cold and silent, and unable to communicate in time when there are problems, then something serious will happen.
She lowered her head and carefully installed the probe of the life monitoring device for the patient, but did not speak.
"Doctor Guan almost had an accident last time, and I'm a little worried that he might be affected, so I wanted to ask." Zhou Can glanced at her and spoke to her this time.
“Work!”
There were only two words to answer him.
This lady is really cold. Zhou Can has met female doctors and nurses with cold personalities, but it is rare to find one as cold as her.
She is not aloof, but icy.
"I heard that most anesthesiologists have weird personalities, and it's true."
Zhou Can muttered softly.
Of course, this is intentional.
Just wanted to see her reaction.
As a result, she pretended not to hear and was not affected at all.
Zhou Can did not dare to say anything excessive to provoke her, but just helped her to anesthetize the patient.
"The patient's electrocardiogram is slightly abnormal. Do we need to make any special preparations?"
After the patient passed out after inhaling the anesthetic, Zhou Can finally mentioned the matter.
Every anesthesiologist has a different approach.
Doctor Feng is the most rigorous of all the anesthesiologists Zhou Can has ever met. Although Doctor Guan is also very rigorous, his clinical experience is still a little lacking in comparison.
Dongfang Luoxue is very meticulous in her work, but Zhou Can feels that she lacks foresight.
The preoperative preparations were relatively sufficient, but there was a clear lack of necessary preventive measures for some accidents that might occur during the operation.
“No need!”
She just answered with two words coldly.
Since she said so, Zhou Can naturally couldn't say anything more.
To be honest, his skills in the field of anesthesia are also limited, and he still has a lot to learn. During this operation, he was able to find some subtle abnormalities when checking the patient's electrocardiogram.
However, it is impossible to diagnose the causes of these subtle abnormalities.
Because the patient already had a serious heart disease, it was normal for the electrocardiogram to be abnormal.
Director Hu Kan didn't say anything, so there's no need to worry too much.
However, this is a minor hidden danger after all. The anesthesiologist plays the role of the patient's life guardian during the entire perioperative period. Zhou Can felt obligated to remind Dongfang Luoxue.
After being reminded, she said it was okay, and Director Hu Kan and others didn't say anything, so Zhou Can naturally wouldn't interfere.
"Xueyan, you will be the lead surgeon for this operation, and Director Le will be the first assistant. Xiao Zhou and Deputy Director Lu will also be the second assistants. The rest of you must fully cooperate and assist to ensure the smooth completion of the operation."
Director Hu Kan made the task deployment.
"Please help me complete the operation, thank you!"
Director Xueyan was in charge of this difficult level 4 surgery, and she was a little nervous. Before the operation began, her eyebrows were tightly knitted and her eyes were extremely sharp.
"Director Xue, you're welcome!"
"The department needs this operation to maintain its reputation. It is related to the success or failure of the department. We will definitely do our best!"
Everyone expressed their opinions.
At this critical juncture, we are all in the same boat, and the entire cardiothoracic surgery department is more united than ever before.
"Director Dongfang, can we perform the operation now?"
Director Xueyan turned her head and looked at Dongfang Luoxue.
"The patient's vital signs are stable and he can be operated on!"
She is cold to men and has the same attitude towards women.
The operation began. An arterial perfusion tube was inserted through the ascending aorta through a midline incision in the chest, a right-angle tube was inserted through the superior and inferior vena cava tubes, and a left heart decompression tube was inserted through the right superior pulmonary vein. After extracorporeal circulation and cooling and cardiac arrest, atrial folding surgery was performed.
Almost all level 4 major surgeries are extremely risky.
This kind of surgery, which requires stopping the heart, is even more horrifying.
When the operation reached the stage of cardiac arrest, Director Xueyan's forehead was already covered with beads of sweat.
The nurse wiped her sweat from time to time.
Opening the chest is not only a technical job, but also a physical job.
It was very strenuous for the female doctor to perform the thoracotomy even with a male doctor assisting her.
Director Xue was half nervous and half tired.
Next, Director Xue held the knife and made an incision parallel to the right atrioventricular groove.
"Hold on for a moment! Everyone, take a close look at the patient's right atrium and see if there is anything wrong?"
Director Hu Kan teaches on-site.
"The patient's right atrium seems to have grown significantly larger." Deputy Director Lu has extensive surgical experience and gave the answer after a quick look.
"Well, Deputy Director Lu's observation is very accurate! What should we do if we encounter this phenomenon during surgery? Does anyone know?"
Director Hu Kan is very patient when teaching students and always guides them step by step.
Try your best to let students learn fully through practice.
Everyone shook their heads. Perhaps the two chief physicians knew something and were afraid of being slapped in the face, so they didn't dare to speak carelessly.
"Patients with significantly enlarged right atria should undergo partial right atrium resection. This patient needs to have this portion of the right atrium removed."
Director Hu Kan gave guidance.
But he did not explain the purpose of doing so.
This is intentionally left for everyone to think about.
It was Zhou Can's first time to participate in such a difficult level 4 heart surgery. At the moment, he was helping to pull the hook and doing miscellaneous work.
Even so, it is still an honor.
Because even a chief physician like Dr. Long couldn't even get the qualification to pull the hook in this operation. Not to mention Jin Mingxi, who could only stand in the audience and watch.
This is also thanks to Director Hu Kan's special training of him.
Jin Mingxi's talent is not bad, he is very serious about his work, he works hard enough, and his steady knife skills are pretty good. These are the reasons why Director Hu Kan values him.
Director Xueyan followed Director Hu Kan's instructions and carefully removed part of the right atrium.
There are a lot of blood vessels here, and even though she was very careful when cutting, the wound still bled severely.
Director Le was busy helping to stop the bleeding.
Some of it even splashed onto the surgical gown and mask.
"Doctor Zhou, Doctor Zhou, you should do it! My operation speed is far slower than yours, and it is easy to make mistakes."
Director Le took the initiative to give up his position as first assistant.
The first assistant has a heavy responsibility. If he or she is not capable enough or does not work well with the chief surgeon, the efficiency of the operation will be seriously affected.
"I...have too little experience. Isn't that a bad idea?"
Although Zhou Can was polite in his words, he actually wanted to take over the assistant role.
Compared with the second and third assistants, the first assistant is the one who is close to the water and gets the moon first, and the harvest will be greater.
The surgical access rules clearly state that only by performing assisting tasks in level three or four surgeries can one be considered to have experience.
"Xiao Zhou, don't hesitate, hurry up and help stop the bleeding! Remember, during the operation, the most capable ones should go first, and there is no need to be shy or polite. Our mission is to ensure the smooth and safe completion of the operation."
Director Hu Kan started swearing.
What else is there to say? Zhou Can decisively took the position of assistant and took over Director Le's job.
His hemostasis skills are currently at level five, not inferior to Director Le's.
In fact, most of the young chief surgeons do not necessarily have all of their surgical skills up to the chief physician level, and may have only one or two major surgical skills that have reached this level.
Director Le and Director Xueyan are both very young chief physicians.
A chief physician in his forties can definitely be considered young in a provincial tertiary hospital like Tuya.
Even many people who are lucky enough to be promoted to chief physicians at the age of 48 or 50 still feel young.
After Zhou Can took over, stopping the bleeding became much more efficient.
Needless to say, his speed in electrocoagulation to stop bleeding was unmatched. The key was to ligate some thicker blood vessels, which he also did very quickly.
In just a moment, the heart bleeding was completely stopped.
After the accumulated blood is drained, the next surgical procedure can begin.
"Xueyan, first check the tricuspid valve and its subvalvular structure!"
Director Hu Kan gave orders again.
Every step has its profound meaning.
"Teacher, I have found out the tricuspid valve and its subvalvular structure!"
Director Xue reports.
Thanks to Ichijo's excellent perspective, Zhou Can also saw it clearly.
"Well, let's start the atrial ventricular folding procedure!"
Director Hu Kan nodded slightly and began to instruct her to continue the operation.
…
After more than two hours, the operation was basically completed.
"Teacher, what should we do next?"
The further Director Xueyan got to the end, the more nervous she became.
For fear of mistakes.
"Let's inject water to test the opening and closing of the tricuspid valve first!"
Director Hu Kan was in command the entire time and had the entire operation under control.
"If a few small holes are found on the anterior valve during water injection testing, they can be sutured with 5-0 polypropylene thread. At this time, after the gas in the left heart is exhausted, the aortic clamp is opened. When the tricuspid valve opens and closes well and there is no insufficiency under heart beating, the right atrial incision is sutured."
Zhou Can kept all these advanced practical surgical knowledge firmly in mind.
After the heartbeat was restored, it was normal at first, but less than five seconds later, the heartbeat suddenly stalled and became much faster than normal.
This ventricular tachycardia phenomenon has very serious consequences.
Zhou Can's uncle suffers from ventricular tachycardia.
It can cause heart rhythm disturbances.
"What happened? Did the operation fail?"
Everyone was stunned.
Many people were participating in this ventricular folding surgery for the first time.
Clinical experience is very limited.
"Don't panic yet. As long as we find out the cause and correct it, we can ensure the success of this operation."
At this last moment, something unusual occurred, making everyone feel a sense of loss as if they had failed at the last minute.
Director Hu Kan worked hard to stabilize the morale of the troops.
Judging from his behavior, this should be the first time he has encountered such a thing.
