Chapter 482: Director-level medical skills linkage, Dr. Pu's request
Surgery is mainly divided into three parts: anatomy, repair, and transplantation.
Dissection is easy to understand, including cutting open the skin, muscle layer and even the internal organs, and then removing or cleaning the lesion. The most important part of dissection is the incision.
The second is the separation technique and debridement technique which evolved from the incision technique.
Dissection is pure destruction of an intact human body. If you want to cure the patient, you must repair the damaged tissues and organs.
For example, if a blood vessel is cut, the bleeding must be stopped!
The nerves, blood vessels and tendons are broken, and they need to be sutured back together!
Therefore, the two main categories of surgery are anatomy and repair.
As for transplantation, it depends on actual needs.
Taking a piece of skin from the thigh and transplanting it to the face or neck is also called a transplant. Cutting off a head and transplanting it to a complete body is also called a transplant. The difficulty of the two is very different.
When practicing any kind of medical skill, you should start with the basics and simple learning and practice.
Zhou Can successfully mastered the incision technique to level six, which is considered a major breakthrough in the field of surgery.
This means that he already has the foundation to perform level 3 or 4 high-difficulty surgeries.
In the past, I had to use fast and steady knife techniques to barely complete the dissection part of some level 3 and 4 high-difficulty surgeries. Now, I have a higher level of surgical ability in various dissections and resections, and I can do it better.
Safety is the most important thing in major surgery.
When the incision technique reaches the junior level of a director, it means that the safety of the surgery has been improved by at least one level.
He tried to remove a cancerous lesion in a lymph node, and the feeling was completely different from a five-level incision. He could clearly feel what tissue was cut, the depth, and whether the edge of the lymph node had been cut.
Even some tiny tubes and nerve endings can have a vague perception when they are removed.
If one wants to be able to clearly feel when even tiny blood vessels and nerve endings are removed, one probably needs to improve the incision technique to the intermediate level of a chief physician, or even an advanced level.
You have to eat your meal one bite at a time.
Zhou Can feels very satisfied with the current level of surgery he has achieved.
To be frank, in the entire Tuya Hospital, there are probably no more than forty surgeons whose incision skills can reach the junior level of chief physician.
The level of a certain surgical skill actually has little to do with the level of professional title.
For example, Director Liu from the General Surgery Department.
Because of his lack of academic ability, he is still stuck at the title of associate chief physician at the age of nearly 60. However, his actual surgical ability is probably not worse than that of a chief physician, and may even be better than many chief physicians.
Of course, he has now been successfully promoted to senior professor, which is considered to be his wish come true.
Zhou Can is now a junior resident doctor, but his level of incision surgery has reached the level of a junior chief physician.
I believe there are many more examples where professional titles do not match medical skills.
It is not uncommon that some chief physicians with academic and research backgrounds may have worse surgical skills than an ordinary surgical resident.
"Six-level incision is so cool!"
After experiencing the director-level anatomical ability, Zhou Can accelerated the progress of the operation.
At this moment, his experience in incision and separation was still increasing rapidly.
Keep working hard and strive to upgrade the separation technique to level six as soon as possible.
Dissection is used in many difficult surgeries, and is a high-level medical skill that all surgeons have a headache with.
Some medical skills are easy to learn but difficult to master.
For example, suturing, ligation, and debridement.
Separation techniques are difficult to learn and even more difficult to master.
Even a strong doctor like Director Hu Kan had an accident when he was trying to separate the adhesion between the key diseased tissue and the large blood vessels. Since then, his health has been much worse than before.
It can be seen that if you want to become a true top surgical expert, you must improve your separation skills.
Otherwise there will be major shortcomings, leading to serious setbacks at critical moments.
Others find it difficult, but Zhou Can is not afraid.
As long as he continued to earn experience points for separation, he would be able to push this medical skill to level six.
…
After nearly three and a half hours, the operation was finally over.
Zhou Can gained a lot from this operation.
In addition to the incision surgery being promoted to level 6, the separation surgery is also very close to level 6. There is still more than 1,700 experience points missing. If he is lucky, maybe two or three major operations can help him successfully upgrade.
Anyway, these days, I have to go to the cardiothoracic surgery department almost every day to help with major surgeries.
Unlike before when he stood by and assisted Director Xueyan and Director Le, his current surgical mode basically requires him to perform the surgery as the main surgeon, with Director Xueyan or Director Le assisting him.
It is equivalent to standing by and 'guiding' him in performing the operation.
Risks at the legal and regulatory levels must be avoided.
He is not needed to be the main surgeon, but he is needed to provide backup and he only needs to stay in the same operating room.
The largest operating room in the cardiothoracic surgery department has three operating rooms and can perform three operations at the same time.
Taking advantage of this convenience, it is often the case that, as just now, Director Xueyan is in the operating room next door and leading the operation, while Zhou Can and Deputy Director He are performing the operation in the operating room next door.
If Director Xueyan needs support, Zhou Can can rush over to help immediately.
The benefits of doing so are enormous, as it can greatly increase the digestibility of high-difficulty surgeries.
In the past, a large number of people working overtime could only complete two major operations in one night. Now, we can double that.
This is extremely beneficial for the expansion of cardiothoracic surgery.
Zhou Can also gained a lot tonight. After his incision skills were promoted to level 6, when he was removing tumors or other tissues that might be cancerous, he found that there seemed to be a slight connection between debridement and incision.
This linkage is magical.
When removing the lesion, he could actually use debridement to vaguely sense whether there were any remnants of diseased tissue around the removed tissue.
For example, when he was removing a lymph node, he sensed that a larger blood vessel nearby had a lesion.
Since it was the first time he had experienced this strange feeling, he was a little confused.
With the attitude of being responsible for the patient, he carefully observed the blood vessel with the help of a magnifying glass. Then he found a small, inconspicuous spot. After repeated identification, and based on his surgical experience, he compared it with the cancerous blood vessels he had cut before.
It was finally determined that this section of blood vessel was likely to have undergone early-stage cancer.
After cutting it off, contact the pathology department immediately for testing.
It wasn't long before the news came back that the blood vessel had indeed turned into cancer.
At that time, Zhou Can felt particularly excited.
Because if his incision technique had not been promoted to level 6, and it happened to be linked with the debridement technique, he would have sensed that there was something wrong with the blood vessel. Even with the most advanced inspection equipment in the world, it would have been difficult to find this early cancerous blood vessel.
Don't underestimate such a cancerous blood vessel. If it is not removed completely during surgery, the patient will relapse in a short time.
You know, cancer is like a weed.
Even if there is only a piece of rhizome or even a leaf, it can sprout again and soon grow into a large piece.
Therefore, the ability that Zhou Can possesses now is of great significance.
It can ensure that during cancer surgery, the diseased cancerous tissue is removed as cleanly as possible.
Why do many patients with malignant tumors go to the hospital for examination and find that they are in the middle or late stage and the cancer cells have metastasized? Doctors will tell the patients that they have lost the opportunity for surgery.
This is because according to doctors' surgical experience, it is no longer meaningful to perform surgery after metastasis occurs.
If you cut off a large tumor, the small one will grow again quickly.
Apart from causing the patient to suffer more pain and draining the patient's family's money, it does not extend the patient's life much.
Rather than knowing that the disease cannot be cured and the patient’s family will be left penniless, it is better to let the patient go home, eat and drink well, and spend the last moments of his life with his family.
This is actually the doctor's kindness.
It’s just that family members and patients sometimes don’t understand and scold the doctor. Before leaving, they even curse him harshly, “You’re a quack. You can’t even do this kind of surgery. Let’s go find a skilled doctor who can do it.”
When faced with this kind of situation, doctors often endure it in silence.
When I came out of the operating room, it was already 11:42, which was much earlier than the expected time for the operation.
This is because Zhou Can's incision skills have been improved and the operation speed has been greatly accelerated.
"I hope the cancerous tissue in this patient's body has been completely cleared." Zhou Can could only pray silently like this.
This type of patient must undergo radiotherapy after surgery to consolidate the results of the surgery.
Radiotherapy and chemotherapy are still the two conventional methods for treating cancer.
Chemotherapy, in particular, has been basically demonized.
Many people believe that chemotherapy will kill them, is useless, and will ruin their bodies. This view is deeply rooted in the minds of many ordinary people. As soon as they hear the doctor say they need chemotherapy, they immediately shake their heads like rattles.
All I can say is that everything has two sides.
Every advantage has its disadvantages.
Chemotherapy, of course, is the use of chemical agents to kill cancer cells and prevent recurrence.
It is a double-edged sword. While killing cancer cells, chemotherapy drugs are also cytotoxic and directly destroy the cell structure. They cause the greatest damage to rapidly proliferating cells and are toxic to important organs of the body, such as the liver, kidneys, heart, and lungs. If the functions of these organs are damaged too much, the patient will suffer from organ failure or even die.
In addition, chemotherapy can suppress the immune system, which is an equally terrible side effect.
Patients who have just completed chemotherapy should be particularly careful about various infections.
Even a common cold can take your life.
Although chemotherapy has so many harms, it is also recognized that it can kill cancer cells.
At least it is a treatment method that can kill cancer cells without directly killing the person.
In addition, because cancer cells are extremely tenacious, chemotherapy cannot eliminate them all in one go.
Only part of them can be eliminated.
This means that patients need to undergo multiple courses of chemotherapy to achieve a more satisfactory treatment effect.
It is conceivable that patients with weaker bodies would hardly survive two or three more chemotherapy sessions.
This is one of the reasons why chemotherapy has become notorious.
Not everyone can endure a bloody fight where you kill 800 enemies but lose 1,000 of your own.
Fortunately, today's advanced drugs are on the market or have entered the research and development stage. For example, targeted drugs and immune-based cancer drugs. Drugs that create super T-cell warriors belong to this category.
Human immune cells can be divided into two categories, T and B. T cells are equivalent to scouts, and B cells are equivalent to missile soldiers.
As long as T cells can detect the enemy, B cells have a thousand ways to kill the enemy.
However, when encountering cunning enemies, such as the AIDS virus and cancer cells, T cells are unable to recognize their identities. At this time, B cells become blind and deaf, and are unable to attack at all.
In developed Western countries, using drugs to create super T cells and enhance their reconnaissance capabilities is indeed a good idea for treating cancer.
Speaking of which, this idea comes from our country's traditional Chinese medicine theory.
Many developed countries are paying more and more attention to traditional Chinese medicine and are learning it because they have tasted the benefits of it.
For example, the Japanese now have a wide variety of Chinese herbal decoctions, almost everything you need.
The price is beyond imagination.
The key is that the therapeutic effects of these decoctions are gradually recognized by the public.
Otherwise, it would not have been possible to develop to its current scale.
No one is willing to do something that is not profitable.
In contrast, in our country, traditional Chinese medicine is declining, and qualified practitioners are becoming fewer and fewer. It is really a pity and heartbreaking to watch.
All we can say is that there is still a long way to go and the revival of traditional Chinese medicine still has a long way to go.
The main thing is that young medical students must believe in Chinese medicine, be willing to spend time learning it, and be given opportunities to practice it.
It’s just too difficult to meet these market conditions.
Even if some people have learned Chinese medicine and have reached a certain level, not many people are willing to try Chinese medicine treatment when they are sick. Without a market, there is no motivation, which will form a vicious circle.
Only if a group of outstanding traditional Chinese medicine practitioners can emerge in the future and use their fame and real treatment effects to vigorously promote traditional Chinese medicine, will it be possible to change this unfavorable situation.
Therefore, there is still a long way to go to revive traditional Chinese medicine.
The mainstream thinking of doctors in China at present is that when they encounter patients who have no money, or difficult patients, or people who insist they are sick even though they are not, doctors will advise these people to see a Chinese medicine doctor.
I am not trying to belittle traditional Chinese medicine. This kind of thinking is indeed the mainstream among doctors today.
There are very few Chinese medicine practitioners like Mr. Chen Guoli.
"Doctor Zhou, I was shocked to see you perform the mediastinal lymph node dissection surgery today. You are younger than me, but you have such superb surgical skills. I admire you very much."
Dr. Pu caught up from behind.
On weekdays, Zhou Can rarely interacts with this person.
The other party was a newly recruited doctor into the cardiothoracic surgery department not long ago, so the two of them were not very familiar with each other.
However, Director Tingle and others all had good opinions about Dr. Pu.
Dr. Pu was able to enter the operating room this time as the attending physician, which gave him the opportunity to perform the surgery.
"Dr. Pu, you're too kind. Actually, my level is about the same as yours. I just have more opportunities to practice, so I'm a little more proficient."
Zhou Can answered modestly.
"You are always so humble. Whether it's your medical skills, medical ethics, or your personality, you are all worthy of learning. Can I... talk to you alone for a few minutes?"
Dr. Pu took the initiative to catch up with him and approached him to talk, and it seemed that he had some purpose.
"Well, no problem, if you have anything to say, please tell me!"
Zhou Can turned and looked at him.
"Uh... well, can we talk somewhere else? I'm afraid you won't agree to what I'm saying, and then I'll lose my job. It's really not easy to get into Tuya's cardiothoracic surgery department this time."
Doctor Pu looked as if he wanted to say something but hesitated.
"Sure! You lead the way!"
Zhou Can didn’t know what this person wanted to say?
