Chapter 485 Rectal Repair, Director Qu Asks to Join
"What do you mean?" Qiao Yu asked Ma Xiaolan with his head tilted.
"You'd better stop asking and focus on the operation!"
As the surgeon in charge, Zhou Can had to control the atmosphere and style of the operating room. Some topics should not be discussed too much.
"Look at the weird expressions on your faces, the smirks on your faces, and the mystery. You must know the cause of the patient's anal prolapse. Doctor Zhou, tell me the answer!"
Qiao Yu usually made requests to Zhou Can and was almost never rejected.
Now seeing that Ma Xiaolan was unwilling to speak, she asked Zhou Can to speak.
"Ah... it's better not to discuss things that are not suitable for children. The patient will need to be suspended with a Teflon mesh in a while. Are you ready?"
Zhou Can directly changed the subject.
"I've been ready for a long time."
Qiao Yu saw that they were all mysterious and refused to tell the reason.
She looked at Yang Zhi without giving up.
"Doctor Yang, you must know this too, right?"
"Uh - I really don't know. The patient is already under anesthesia, let's do the surgery quickly!"
Yang Zhi is an honest man, but not stupid.
He would never say anything he shouldn't say, even if you kill him.
"Give me the catheter!"
Before this operation, a urinary catheter needs to be inserted. This is Zhou Can's favorite job, if for no other reason, just to gain experience points in the insertion operation.
The operation began quickly.
Zhou Can made an incision about 20 cm long from the patient's private part through the left midline.
Then cut the skin and subcutaneous layers to enter the abdominal cavity.
"Soak the gauze in warm saline and give it to me." Zhou Can had already told Qiao Yu some of the items that needed to be prepared for the operation before the operation.
"Give!"
Qiao Yu handed him the gauze.
After receiving it, use gauze soaked in warm salt water to make a cushion and push the entire small intestine toward the upper abdomen.
"Yang Zhi, there are dozens of surgical procedures for the treatment of rectal prolapse. There are about eleven that are still in use. For example, anal ring reduction, mucosal resection, transvaginal rectal sigmoid resection, combined rectal fixation, and reinforcement of the presacral fascia with synthetic mesh... These surgical methods can treat rectal prolapse. The one I am using now is the most commonly used, and the treatment effect is excellent. There are relatively few postoperative complications, and there is almost no recurrence."
Zhou Can was performing surgery on the patient while guiding Yang Zhi.
The master leads you to the door, but the practice depends on yourself.
After learning many surgical methods, you need to study them flexibly on your own and gain more insights through practice.
The surgical methods chosen for different cases of rectal prolapse are also different .
"Look, the next step is the most critical step in the operation."
Zhou Can was seen carefully freeing the posterior wall of the rectum, stopping at the tip of the coccyx, and then lifting the rectum.
After completing the freeing of the posterior rectal wall, his experience points for separation were rewarded with 100 points, which made him very happy.
Another step closer to level six separation.
"Qiao Yu, prepare the Teflon mesh sling."
Zhou Can greeted her in advance.
Because it was the first time that this surgical procedure was used to repair a prolapsed rectum.
"Use a wide Teflon mesh sling around the upper rectum. That's how it's done."
Zhou Can taught by example, trying his best to teach Yang Zhi in one go.
"Remember, the best length for a mesh sling is 5 cm. Then use thin non-absorbable sutures to fix it to the presacral fascia and periosteum under the sacral protuberance, and sew the edges of the sling to the anterior and lateral walls of the rectum."
It is actually not easy to teach and operate at the same time.
Because you cannot be distracted during the operation, it is definitely safer to operate with full concentration.
“Does the pelvic floor need repair?”
"No need to fix it."
Zhou Can replied.
Many of Yang Zhi's questions during the operation were to the point, which showed that he had a strong comprehension ability and had really learned the surgical knowledge Zhou Can taught him.
After learning it, he can immediately raise questions that he doesn’t understand through thinking.
"You take care of the rest of the stitching!"
Zhou Can left the suturing opportunity to Yang Zhi.
The fastest way for a surgeon to grow is to practice surgery.
If you just watch from the sidelines, you may still be a novice for your entire life.
It is easy to see things, but difficult to do things. This is an eternal law.
For Zhou Can, suturing the peritoneal incisions on both sides of the rectum and the various layers of the abdominal wall is just a very simple matter. After all, his suturing skills have been promoted to level six, and his ligation skills are still a little short of that, but they will soon be promoted.
In his eyes, this ordinary surgical operation no longer has much appeal.
The high-difficulty operation that could earn him 100 experience points was the most tempting to him. Performing such an operation could be equivalent to the experience points gained from dozens or even hundreds of ordinary operations.
Rectal repair is a level 3 surgery, and Yang Zhi rarely has the opportunity to perform this risky operation.
He was so excited that he put all his efforts into carefully suturing the patient.
Zhou Can stood by and gave instructions and supervised the process.
"Director Qu, it's already past noon. How about you two just have a meal in the operating room?"
Zhou Can looked up at the clock on the wall. It was past twenty.
Time flies.
It would take at least 12:50 for Yang Zhi to finish suturing. Not everyone can perform surgery as fast as Zhou Can.
Under normal circumstances, an ordinary surgeon can only perform 11 or 12 simple level 1 and 2 surgeries a day, which is about the limit. As for level 3 major surgeries, even a veteran with the ability of a deputy director can only perform about two a day at most.
As long as they are not particularly complicated, Zhou Can, with his simple surgical team, can perform five or six level three and four major surgeries a day, which is two to three times as much as others.
In terms of surgical speed, only Xu Yidao could surpass him.
Today, Dr. Xu is carrying on his work with a heavy burden, and what he pursues is no longer speed, but safety and stability.
I am old now and can no longer output as crazily as young guys like Zhou Can.
“No need for that!”
Qu Zi glanced at the anesthesia nurse before answering Zhou Can.
The instrument nurses and circulating nurses are assistants to the surgeon, while the anesthesia nurses are assistants to the anesthesiologist.
Like surgical nurses, anesthesia nurses are also a special type of nurse .
The professional requirements are very high.
They can become the right-hand man of the anesthesiologist and help with many things.
"There is another major surgery this afternoon, so why don't you just eat here? I can discuss the surgical plan with you while we eat."
In fact, everything that needed to be discussed has already been discussed.
Zhou Can said this just to give her and the anesthesia nurse a reason to stay for dinner.
"Okay then! Qin Yue doesn't eat spicy food."
Qu Zi nodded in agreement.
Zhou Can signaled Ma Xiaolan to make a phone call to order food.
One thing must be said, in the past, the operating room management was strict and doctors were not allowed to bring mobile phones into the operating room.
As for watches, rings, earrings and other decorations, they are not allowed to be brought into the operating room.
You can stay in the dressing room.
Tuya's current management is relatively humane. Even interns can bring their cell phones into the operating room, provided they are set to silent mode.
If your cell phone rings when your senior doctor is performing surgery, you will most likely be scolded.
As for the patient who reported to the media that a doctor was playing with his mobile phone in the operating room, this is basically impossible. The area above the waist can be considered a relatively sterile area. During surgery, both hands must be cleaned and disposable sterile gloves must be worn.
Sometimes you even need to wear double gloves.
For example, when performing a digital examination on a pregnant woman, an experienced midwife will wear two layers of gloves on her right hand.
Throw away the outer layer after the prenatal check-up to reduce the risk of infection during the operation.
After more than half an hour, the operation was over.
In fact, when Zhou Can handed over the finishing work of the operation to Yang Zhi, the operation was basically successful.
"After sending the patient to the recovery room, everyone went to the lounge to eat and rest for a while. We are preparing to perform the second major operation in a row."
Zhou Can is now performing general level 3 major surgeries, and Dr. Xu would just come over occasionally to take a look and then leave.
He was quite confident in Zhou Can.
Zhou Can would only ask Dr. Xu to come and help if the operation was high-risk and extremely difficult.
With the addition of Yang Zhi and the rapid growth of Ma Xiaolan, their team now no longer needs to call for extra help when performing ordinary level tertiary surgeries.
If Dr. Pu from the cardiothoracic surgery department can join his surgical team in the next few days , the team will be expanded again and his surgical team will become complete.
…
In the rest room, everyone was already hungry, so everyone had a fast food meal.
Even a ladylike girl like Qiao Yu was eating like crazy.
"Doctor Zhou, have you heard about the reforms in the anesthesiology department?"
Qu Zi took the initiative to talk to Zhou Can.
She is nearly 40 years old and is currently a deputy chief physician. Her professional ability is quite impressive.
Moreover, Zhou Can believes that her potential is much greater than that of Chief Physician Dongfang Xueluo.
"I've been so busy lately that I haven't really paid attention to these things. How is the Department of Anesthesiology being reformed?"
Zhou Can asked curiously.
"The reform of general surgery has begun to show results, and the hospital's top management is already preparing to gradually implement it in other departments." She smoothed her scattered hair.
General surgery is divided into several sub-departments, which realizes the segmentation of the medical field, which is indeed quite good.
According to Director Liu, several sub-departments of the General Surgery Department have achieved all-round growth, including outpatient and emergency visits, surgeries, hospitalizations, the number of difficult cases solved, and even the number of academic papers.
This also means that general surgery has become stronger than before.
So, that's a good thing.
The reform was considered a success.
It has also drawn on the management experience of advanced large hospitals in Beijing, Shanghai and other places, so it is not surprising that it has been successful.
"Doctors and nurses in the anesthesiology department may be further assigned to specific surgical departments in the future."
She revealed the reform plan for the Department of Anesthesiology.
Currently, anesthesiologists basically run all departments. For example, Qu Zi may go to the emergency department today, the anorectal surgery department tomorrow, and the cardiothoracic surgery department the day after tomorrow. She will go to whichever department is needed.
This general practice model is actually not conducive to the growth of anesthesiologists.
Because anesthesiologists have different understandings and perceptions of different types of diseases.
The general practice model will lower their professional level.
"I think the reform is good. Last time I went to visit a classmate of mine, I had the opportunity to meet an anesthesiologist from the Provincial People's Hospital. They have already achieved the subdivision of anesthesia. For example, the one responsible for cardiovascular surgery is only responsible for surgical anesthesia in this field. In many aspects, that anesthesiologist is even more professional than the surgeon in charge. I was very shocked at the time."
Ma Xiaolan interrupted.
"That's true. Now, many large hospitals across the country have realized the subdivision of anesthesia. Especially in the capital, Shanghai, and Zhengzhou, the professional level of their anesthesiologists is already in line with international standards. Our Tuya Hospital is very backward."
Qu Zi also pays close attention to the industry.
It's not that I turn a deaf ear to what's happening outside.
There is no such thing as working in isolation.
"Doctor Zhou, I mentioned this matter because I want to discuss it with you. If the anesthesiologist needs to have a fixed surgical team at that time, do you think there is any opportunity for us to cooperate?"
After all, she was an associate chief physician, and she was definitely a little shy when she took the initiative to request to cooperate with Zhou Can's team and sought Zhou Can's opinion.
"I only perform two or three major surgeries a day. If you are tied to my surgical team, I'm afraid it will seriously affect your income."
Zhou Can has always been very sober.
Although the emergency department performs an astonishing number of surgeries a day, there are only two major surgeries.
For ordinary first and second level surgeries, the surgeon in charge or even the circulating nurse can simply inject the patient with local anesthetics; there is no need for a specialized anesthesiologist.
"I believe your income is only temporarily low. I can see your surgical ability and growth rate. It just so happens that you need to strive for a senior professional title in the next few years. With less workload, I can have plenty of time to read and study."
Qu Zi had obviously thought about it before asking for his opinion.
"I am grateful to Director Qu and Teacher Qin for their kindness. I am very grateful to be able to work with such excellent anesthesia doctors and nurses like you. I must remind you of one thing. The current situation of the emergency department is still not very good. It is hard to say whether the number of level 3 and 4 surgeries can be increased in the future. You must consider it carefully."
Zhou Can felt that it was great to be able to work with Qu Zi.
Director Feng's rank is too high, and it is impossible for him to be tied together with his surgical team.
Even if Director Feng was willing to be tied to Zhou Can because of his close relationship with him, the hospital would not agree.
In terms of weight, Zhou Can’s current surgical team probably wouldn’t even be in the top 20 at Tuya Hospital.
How is it possible to give him the hospital's best anesthesiologist?
In addition, Director Feng is getting a bit old after all, and will retire in a few years. Right now, Zhou Can's team is still weak, and the number of major surgeries is very small. In the future, when Zhou Can grows up, the number of major surgeries will increase, but Director Feng will already be facing retirement.
Therefore, it is more beneficial for both parties for him to cooperate with the young Qu Zi.
"Then let's put it this way. When I fill out my application form, I will directly fill in your emergency department."
When Qu Zi heard Zhou Can's agreement, a rare smile appeared on her face.
When she asked, she was probably afraid of being rejected.
After all, it would be embarrassing!
"Okay! Thank you Director Qu and Teacher Qin for your trust and kindness. I look forward to our future regular cooperation model."
Zhou Can actually stood up with a smile, walked up to the two of them sincerely, and shook hands with them respectively.
It made both of them laugh.
After the meal, everyone went to the toilet, drank water, took a short rest, and then continued with the operation.
When performing the second major operation, I could clearly feel that the atmosphere was more harmonious.
This has something to do with the agreement between Zhou Can and Qu Zi to become a fixed partnership during lunch.
From now on, we will be part of a team.
When he got off work, he opened his phone screen and found that the local police station had sent him a notice. The incident of him being almost hit by a falling flowerpot had been filed and was currently entering the criminal investigation process.
Zhou Can was very happy to see this news.
The filing of a case at least means that the police will send professional criminal investigators to investigate.
He decided to call and inquire about the progress of the case.
"Hello, Officer Hu. I'm Zhou Can, the doctor who was attacked by a flower pot thrown from the roof ."
"Oh, hello, Dr. Zhou! We have already opened a case."
"Excuse me, were any fingerprints extracted from those flower pots yesterday?"
"Well... the murderer was very cunning, and we were unable to extract fingerprints. However, the discarded cigarette butts we accidentally found on the roof have been sent for technical identification. It is possible that they were thrown by the suspect. In addition, shoe prints were also extracted from the scene. It can be preliminarily determined that it was a male, probably in his thirties..."
