Chapter 420: The dawn of cardiothoracic surgery, fate has its own way
It was almost seven o'clock in the afternoon when Director Xueyan hurried over.
"I encountered some problems during my ward rounds just now, so I'm a little late. Director Le will be my first assistant, and Zhou Can will be my special assistant. He will replace me as the lead surgeon when necessary. Your arrangements remain unchanged."
Director Xueyan made the deployment of surgical posts in a swift and resolute manner.
In the past, she was gentle in her words and actions. But reality has forced her to become a tough girl!
It is difficult to be a human being without experiencing poverty; it is impossible to be innocent without experiencing setbacks.
She was able to make such great progress in just two months, from a gentle female director to an iron-blooded female general. I don't know how much suffering she had endured.
Only this kind of training can enable her management ability to truly grow.
Zhou Can had never seen any department director laughing.
Even if they are gentle to others at other times, when something happens, they will turn hostile immediately and be ruthless and show no mercy.
I believe that Director Xueyan will become a qualified department director in the near future.
The first operation began soon.
We can see that Director Xueyan has a solemn expression and focused eyes, and she is obviously more steady when she operates than before.
Zhou Can was on the side to help her, while Director Le was the first assistant. Deputy Director Lu, who was over 50 years old, was only qualified to be the second assistant.
Any surgical team will give priority to training young doctors.
At the age of Deputy Director Lu, he is already 54 years old, and he will retire in a few more years. On the one hand, as he ages, his learning ability deteriorates and his physical fitness seriously declines. On the other hand, it is not worthwhile to train him after he reaches retirement age.
Therefore, excellent young doctors in their thirties and forties are generally the most popular members of the surgical team.
This age group has lost the impetuosity and frivolity of youth and has acquired the calmness that middle-aged people should have. They have also acquired a certain foundation in medical knowledge and surgical skills. It is easier to train them.
And once they are trained, they can become an important backbone of the team.
Input is directly proportional to output.
Zhou Can was watching from the side, which was actually a good learning process. Even though he had performed lung lobectomy many times, each operation was different.
From the perspective of an observer, you can discover many problems that you cannot find during surgery.
It is a true saying that those who are involved are often confused, while those who are not involved can see clearly.
The first half of the operation went smoothly.
When it came to ligating the arteries of the dorsal and basal segments of the lower lobe, Director Xueyan seemed a little hesitant.
Zhou Can did not speak immediately, but waited patiently for Director Xueyan to make her own decision.
Zhou Can would only help her when she lost her own opinion and needed help.
The growth of every surgeon is inseparable from his own understanding through practice.
The knowledge in books or the skills taught by teachers can only become your own knowledge if you comprehend them. Otherwise, you will return them to the teacher soon after learning.
"I'm not sure about the artery ligation part!"
Xueyan was silent for three or four minutes, then looked up at Zhou Can.
She knew that Zhou Can had already mastered the surgical techniques for various situations to perform this left lower lobectomy surgery.
"Didn't you do a good job just now when you were handling the pulmonary vein?"
Whether she was directing an assistant to use a retractor to pull the diaphragm downward to expose the inferior pulmonary ligament, or using an electric knife to cut the ligament from bottom to top along the edge of the lung, she handled the situation very well.
Even in the unexpected situation where abnormal blood vessels in the pulmonary ligament were severed, she was still able to stop the bleeding calmly.
Now when it comes to dealing with the left lower lobe pulmonary artery, why do you back off?
"I'll direct and you operate, okay?"
Zhou Can asked calmly.
Fortunately, the people in the operating room were basically the trusted personnel of Director Hu Kan during his lifetime, and they knew Zhou Can's abilities. Otherwise, if a stranger came to the operating room, he would definitely be shocked.
Zhou Can is so young, a junior resident, but he actually made such a bold statement that he wanted to direct the chief physician of cardiothoracic surgery to perform a level 4 major operation.
This is too crazy.
"I……"
She still seemed a little unconfident.
The failed cardiac surgery the day before yesterday killed the patient, but the psychological trauma it brought to her has not been completely dispelled.
This takes time, and more importantly, it requires her to succeed in the operation in order to gradually dispel the shadow and regain her confidence.
"Don't worry. Even if something unexpected happens, I can help you deal with it. I believe you can accomplish it successfully."
Zhou Can encouraged her.
"Okay then! I'll try!"
Director Xueyan completely lacks the authority that a department director should have in front of Zhou Can.
“It’s not about trying, it’s about going all out.”
Zhou Can emphasized in a serious tone.
"good!"
She nodded vigorously.
"Cut the mediastinal pleura on the surface of the inferior pulmonary vein to expose the upper edge of the inferior pulmonary vein."
Zhou Can patiently guided her step by step.
In fact, she definitely knows the general operation methods, but there are some details or places that need to be adjusted, which she may not be able to master as flexibly as Zhou Can.
"Use your index finger to perform blunt separation between the lower lobe bronchus and the lower pulmonary vein to free the lower pulmonary vein. Be sure not to rush and be careful not to tear the tissues, as this will have an adverse effect on postoperative recovery..."
Both of them studied under Director Hu Kan, but Director Xueyan should have received more guidance.
But in actual practice, Zhou Can was obviously far better than her.
Especially in the flexible use of various techniques, as well as the judgment of various possible emergencies during the operation and the prediction of postoperative recovery, Zhou Can is far superior to her.
Under the guidance of Zhou Can, Director Xueyan worked closely with the entire surgical team to successfully complete the left lower lobectomy surgery, without Zhou Can even performing the surgery himself.
"It's done very well. As long as we take good care of her after she's sent back to the ward, there shouldn't be any major problems."
Zhou Can exclaimed sincerely.
"Doctor Zhou is our lucky star. I hope you can come and help us more often in the future. To be honest, after Director Hu passed away, I was always nervous every time I participated in a difficult level 4 operation. With your help, I feel really different and more at ease."
Director Le breathed a sigh of relief when he saw that the first operation was successfully completed.
He was really worried about the fate and safety of the department.
"There is strength in numbers. Our department really needs Dr. Zhou's help right now."
Deputy Director Lu is not good at speaking, and this was a rare time for him to speak.
He agreed with Director Le and both hoped that Zhou Can could come and help more often.
Not to mention the doctors and nurses below.
Something happened the day before yesterday, and they have been walking on thin ice for the past two days, feeling quite depressed.
The mood of the department's chief physicians, especially the department director, is basically the barometer of the entire department.
"Look, everyone is inviting you to come and help!"
Director Xueyan smiled for the first time in several days.
The success of this operation, which was performed entirely by her alone, greatly helped her restore her confidence.
"Haha, thank you all for thinking so highly of me. As long as I have time, I will definitely be there whenever you call."
Zhou Can agreed with a smile.
I had originally promised Director Hu Kan that I would do my best to help the cardiothoracic surgery department and prevent it from declining. Now I was just doing a favor.
"This operation took three hours. It's ten o'clock now. Can we still do the second operation?"
Director Xueyan asked for everyone’s opinions.
"There is absolutely no problem with my role as the second assistant. If necessary, these young guys can take my place." Deputy Director Lu was the first to express his opinion.
He is considered one of the older generation of medical staff in the department and has deep feelings for the department.
Knowing that he had no hope of promotion, his biggest wish was to retire smoothly as deputy director. Then he hoped that the department would develop well. Cardiothoracic surgery was like his home.
"The surgery has been scheduled. I will accompany you even if you have to work all night long." Director Le is even more amazing.
"That's fine with me, too."
Zhou Can also expressed his opinion.
In the operating room, they are the main personnel, and others, including circulating nurses and anesthesiologists, do not have much real say.
Just look at the high sudden death rate of anesthesiologists in major hospitals and you will know the status of anesthesiologists.
If people have the power to refuse, who would be willing to continue working overtime to perform surgery when they are extremely tired?
"What about you? Can you still hold on?"
"Can!"
"no problem!"
The three operating nurses agreed.
"I just hope it can be finished sooner. Some of the more time-consuming parts of the surgery can be done by Dr. Zhou Can, which may make it faster."
After all, the anesthesiologist is at the director level, so the opinions he expresses carry some weight.
Zhou Can touched his nose. He had performed so many major surgeries that almost all anesthesiologists knew him and knew that he was a quick surgeon.
"Sure. There's no problem with Zhou Can being the lead surgeon for the second surgery."
Director Xueyan also knows that slow speed is a major flaw.
"How can I perform a level 4 surgery with my skills? It would be great if Sister Yan could let me do the time-consuming parts of the surgery."
Zhou Can quickly refused.
Many of his surgical skills are only at the deputy director level, and he is still a little far from being able to perform level 4 surgery.
However, he has the ability to perform some key parts of the operation.
After all, his quick knife skills have reached the proficient level, and his steady knife skills have also reached the entry level.
By integrating these two knife techniques into surgical techniques that require surgery, such as incision and separation, it is entirely possible to reach the director-level level.
…
Nearing twelve o'clock in the evening, the second operation was successfully completed.
In order to shorten the operation time, Zhou Can performed many operations himself, including the final chest closure.
It was already very late, and if the two excellent residents were to close the chest, it would probably take until one or two in the morning.
It's not an exaggeration.
Residents are only considered novices in the surgical team.
Some junior residents can be happy for a whole month just by having their abdominal cavity closed.
Because they don't usually have these opportunities to practice.
"I've ordered midnight snacks for everyone. Everyone will get one. Take it home or to the dormitory to eat! Thank you for your hard work today." Director Xueyan said to everyone.
Both operations were completed successfully. This was the happiest moment for her in the past two months.
The invisible stone weighing on my heart seemed to have become much lighter.
Zhou Can participated in two major operations tonight and showed his absolute strength that amazed her and gave her hope.
In the past, she was too proud to bother Zhou Can. In addition, she thought she could do it, which made things worse.
It can be seen that all the medical staff involved in the operation were very happy.
No matter how hard it is, it doesn’t matter. The most frightening thing is not seeing the light at the end of the tunnel, no hope.
"Zhou Can, can you go to the ward and help take care of a post-operative patient?"
After the operation, Director Xueyan continued to ask him to help.
"What's wrong with that patient? Come on, I'll go with you to take a look. You're my sister, I'll definitely listen to you!"
Zhou Can said with a smile.
"Haha, thank you for being so kind to me! The patient had surgery two days ago. It was performed by the surgical team led by Deputy Director He. The patient had a lobectomy, and the postoperative drainage volume exceeded the standard..."
She gave a brief introduction to the patient's condition.
After lobectomy, a small amount of bleeding is normal. A daily drainage volume of less than 500 ml is generally within the normal range.
However, if the drainage volume is less than 200ml per day, it may not be a good thing.
Especially on the second day after surgery, if the drainage volume is too small, do not blindly believe that your surgery was done well and there is little bleeding or exudation. Instead, you need to be alert to whether it is blocked or there are other abnormal changes.
The risks of lobectomy surgery are always high.
The reason why many doctors think this operation is safe is that the technology is very mature.
However, if errors occur during the operation or if postoperative complications are serious, the probability of patient death is very high.
"Does Deputy Director He know about this?"
Zhou Can asked.
He had a very bad impression of Deputy Director He. The hospital implemented a first-visit system. Since it was Deputy Director He who performed the surgery on the patient, and now there are postoperative abnormalities and obvious complications, Deputy Director He must be asked to handle it.
There was no way he could lie down at home and sleep. Director Xue and Zhou Can got off work so late after performing surgery and still had to clean up his butt.
Zhou Can definitely doesn't qualify as such a pushover.
"I've notified him to come and handle it. He hasn't even left work yet. Just now when I was performing surgery, he sent me a message for help. The patient's condition is very bad. The key is that we haven't found the reason for the excessive drainage volume yet."
Director Xueyan gave a sly smile.
She must have been very happy that Deputy Director He would bow his head and ask her for help.
After all, Deputy Director He was unruly and always showed off his seniority in front of her.
Just this afternoon, Deputy Director He was asked to participate in the first left lower lobectomy operation, but he found a reason to refuse.
Everything goes around in circles.
Who would have thought that around seven o'clock in the evening, the patient who was undergoing surgery by Deputy Director He had a problem.
Now it was Deputy Director He's turn to get anxious and angry.
"I was worried that you wouldn't be able to make up your mind when you needed to do something! Just call him over to deal with it."
Zhou Can and she were as close as siblings, so there were some things they talked about without any hesitation.
This is all for her own good.
"I was indeed soft-hearted when I first became the department director for more than a month. I naively thought that if I was kind to others, they would be kind to me. Later, there were a few cases where I was considerate of Deputy Director He, but he schemed against me. That's when I saw his true face."
Director Xueyan is not stupid, she just uses her kindness on the wrong people.
"You can't command an army with kindness, and you can't do business with justice. Sister Yan, I think you must be ruthless when you need to be. If you want to manage such a large department, you can't manage it well without any means."
Zhou Can said to her seriously.
"Understood! The inpatient department is just ahead. Let's not talk about this anymore."
She was afraid that others would hear it.
The two came to the ward and saw that the patient was a man in his forties, with a pale face and a very bad mental state.
After Zhou Can looked at it carefully, his expression became solemn.
His extensive experience working in intensive care units made him realize that this patient's condition was extremely dangerous.
