Chapter 488 Sixth level separation, the operating nurses are all very good looking
Based on his surgical experience, it was almost impossible to repair the patient's finger tendon, and the only way was to transplant a tendon.
Under normal circumstances, a person's finger will have the superficial flexor tendon, the deep flexor tendon, and the extensor tendon.
By contracting or relaxing them, they help the fingers to flex or extend.
Medical anatomy may seem simple, but in cases like this where adhesions occur, the difficulty of surgery will be frighteningly high. This is a delicate surgery that tests the surgeon's skills and experience.
No matter how confident Zhou Can was, he was still frightened when faced with this type of secondary surgery.
Seeing Zhou Can's hesitation, the patient begged Zhou Can to try his best to help him think of a solution. Even if the treatment failed, he would not cause any trouble to the hospital.
At this time, the patient's father told Zhou Can that they came to see him too early and they stayed in the hotel for four days.
Since he has so few numbers, it’s impossible to get one.
In the end, I spent two hundred yuan to buy an number from a scalper.
The only child in the family, who was about to turn 25, was disabled in his right hand due to an accident. This seriously affected his job search, marriage, and life. In order to treat his son, the patient's father contracted 17 acres of land and found a logging job in the forest farm in his hometown.
He also told Zhou Can that he was not afraid no matter how hard or tiring it was.
I am willing to spend any amount of money as long as it can cure my son's hand.
Then he told Zhou Can that after his son’s hand was injured and disabled, he had been studying hard and enduring a lot of pain that ordinary people could hardly imagine.
In the end, Zhou Can was moved by the father and son.
We invited Dr. Xu to consult and develop a surgical plan.
The patient was admitted to the hospital yesterday and underwent all the necessary examinations. Then the nurse and the attending physician shaved the hair on the patient's hands and feet and trimmed his nails. All preparations were made for the operation.
Regarding the source of transplanted tendons, there are three options. The first is allogeneic, which requires donation from a deceased person.
The procedures are complicated and there is a certain waiting period.
But in general, tendons are not as scarce and sought-after as organs such as corneas, kidneys, and hearts , so the waiting period is generally not very long, and the cost is not high.
However, there is a risk of rejection in allogeneic tendon transplantation.
For such a poor family, the cost is still not low.
The second type is artificial tendon.
With the continuous advancement of human technology, artificial tendons have been developed and the technology is relatively mature.
The cost is also not low, and there may be rejection reactions, inflammatory reactions, etc.
All allogeneic transplants, whether artificial or from other people, carry the risk of rejection. Many people who have received organ transplants need to take medication for life to prevent rejection.
It can be seen that neither of the above two transplantation methods is suitable for this patient.
Plus the fact that the patient had already undergone two corrective surgeries only made the transplant more difficult.
After discussing with Dr. Xu and based on the patient's comprehensive condition, Zhou Can finally decided to obtain the plantar tendon or common digitorum tendon from the patient's foot to complete the autologous transplant.
This operation is very risky.
If things go wrong, the patient's right hand function may not recover, and his toes may also lose their flexion and extension function.
After many discussions with the family and the patient himself and obtaining their consent, today's operation was carried out.
"Watch carefully, both of you. The most commonly used incision is a Brunner's serrated incision on the palm side of the finger."
While operating, Zhou Can taught the two some of the surgical techniques.
The advantage of tilting the serrated incision on the finger to one side is that the scar will not fall on the tendon, and it will also be easier to sew when the finger is flexed.
After dissecting the patient's finger, you can see the marks left by the previous doctor's operation.
The doctor's surgical skills were not bad and he performed the operation very delicately.
It’s just that the doctor’s correction method is a bit confusing.
Zhou Can naturally would not comment on the previous doctor's poor performance. Instead, he quickly completed the dissection of the finger and began to remove the tendon from the patient's foot.
At present, Yang Zhi and Pu Dingdong are unable to help Zhou Can perform this difficult surgical project.
If the medical assistant's surgical skills are strong enough, he or she can even perform surgery simultaneously with Zhou Can.
When Zhou Can completed the preparation for the hand transplant, the medical assistant was also removing the plantar tendon.
[Experience points for incision +1, experience points for separation +1, completing the more difficult plantar tendon separation will reward you with +100 experience points. ]
Zhou Can was overjoyed when he saw his experience points in separation technique suddenly surge.
As for the incision, now he has been promoted to the director level. If he wants to be promoted to the next level, he needs a full million experience points. If he can only earn 1 point at a time, he probably won't be able to be promoted in his lifetime.
Even if you are awarded 10 or 100 points occasionally, the difficulty of getting promoted is still frighteningly high.
However, Zhou Can was confident that he could upgrade several major surgical skills to level seven within five to ten years.
Because as his surgical team continued to expand, some simple operations would be handed over to other doctors in the team, while he continued to challenge more difficult operations.
For example, this hand tendon transplant surgery.
Although it was only a Level 2 surgery, it was extremely difficult. The level of precision and surgical skills involved were no less than those of a Level 4 major surgery.
Relatively speaking, secondary surgery has lower risks and the procedure is less complicated.
That's all.
If you simply think that level 1 surgery is very simple and can be performed by any surgeon, while level 4 surgery is very difficult and can only be performed by a chief physician, this is too narrow-minded and superficial.
There are also extremely difficult surgeries among the first-level surgeries.
There may be some standard level 4 surgeries, but level 3 and above surgeries cannot be said to be simple.
When Zhou Can completed the separation of the finger tendons just now, he had already received a lot of separation technique rewards.
After all, the adhesion was very serious, and Zhou Can took great effort to preserve the patient's superficial flexor tendon.
This is even more difficult than removing the plantar tendon just now.
After separating the plantar tendon, he continued to separate a blood vessel nearby.
This blood vessel is quite small, but it cannot be cut directly because it is responsible for part of the blood supply to the foot.
There is an old saying that goes, "A moving man lives, a moving tree dies."
Why do trees die easily after being transplanted?
Because it is easy to damage the roots.
The same is true for performing surgery on patients. We should try to preserve blood vessels, nerves, tendons, and even subcutaneous tissues, etc. This will reduce the harm to the patient's body.
Some irresponsible doctors, in order to save trouble, just leave everything alone.
This is extremely unethical.
The patient may suffer many inconveniences in life or even lifelong physical pain for the rest of his life because of what the doctor does.
[Separation skill experience points +1, +1... Reward separation skill experience points +100. ]
[Congratulations on your successful promotion to level 6 in separation skills. Your current experience value is 1/1000000, which is the junior level of chief physician.]
Thanks to his unremitting efforts, the separation technique that he had been dreaming of was finally promoted to the sixth level.
Zhou Can discovered that after his medical skills were upgraded, he had a new experience in separating and freeing human organs and tissues. At this moment, he had basically separated the main trunk of the blood vessel, leaving only a few branches connected to it.
This is already considered the terminal blood vessel.
It can’t be considered a capillary, but it is equivalent to the level above the capillaries.
Originally, according to Zhou Can's previous surgical skills, it would not only be time-consuming and labor-intensive to successfully separate such a small blood vessel, but it might not be successful. This was not a question of whether to wear magnifying glasses or not.
This is because the smaller the blood vessels, the thinner their blood vessel walls will be, and the more delicate they will appear.
It can easily break if you're not careful.
In medicine, even Wu Baihe, a neurosurgeon known as the top scalpel, would be able to cut through all the tiny blood vessels.
At most, pick out one or two important ones and separate them by the roots. Don't even think about going any further.
Zhou Can's separation technique has been promoted to level six, but he wants to take this opportunity to challenge himself.
It’s a good opportunity to experience how powerful the sixth-level separation technique is.
He didn't dare use the word 'cow'.
Because the sixth-level medical skills are only at the director level, only the seventh level is qualified to be called "awesome".
"Give me a No. 27 surgical blade!"
Zhou Can said to Qiao Yu.
"Ah... I didn't know you needed such a small blade. Xiaolan, could you please go get it from the equipment room for me?"
"OK!"
Ma Xiaolan ran to get the razor blade in a hurry.
There is a common instrument and consumables room in the operating room, which stocks all kinds of commonly used surgical consumables and blades.
When performing surgery in the old operating room, Dr. Xu once got angry because the packaging bags of consumables in the equipment room were opened but not used.
"With such a small blade, you don't want to separate the peripheral nerves, do you?"
Qiao Yu didn't know why Zhou Can suddenly wanted such a small blade when he was almost done separating the plantar tendon.
Normally, a No. 11 blade is sufficient for separating blood vessels, while a No. 10 blade is more commonly used for skin incision.
"I want to preserve as many of his tiny blood vessels as possible so that it can reduce damage to his feet."
Zhou Can smiled.
Soon, Ma Xiaolan ran over with blade No. 27.
In fact, there are also No. 34 and No. 36 blades.
But for now, No. 27 should be enough.
After changing to a tiny blade, Zhou Can thought he would feel a little uncomfortable holding it in his hand. Unexpectedly, after the separation technique was upgraded to level six, he felt no discomfort when holding it in his hand.
And there is a sense of familiarity of 'old friend'.
It seemed as if I had often used such a small blade to separate blood vessels and nerves before.
He tried to separate the first tiny branch of the blood vessel, and the knife was surprisingly smooth as if it was assisted by God. With each cut, his hand was as steady as a mountain, and the cut was as fast as lightning.
The quick knife technique and the steady knife technique are a perfect combination at this moment.
As his surgical skills of incision and separation were both promoted to level six, it seemed that his quick and steady knife skills also had new breakthroughs and improvements.
I can’t explain it, it feels so good.
This was something Zhou Can had never experienced before.
Finally, thanks to his efforts, the first thin branch blood vessel was successfully separated.
I had already prepared myself mentally for the possibility of cutting the blood vessel wall, but in the end it was successful.
It's just far from perfect.
When doing surgery, there is no need to pursue perfection. It is enough to make the surgery successful and ensure that the patient recovers well after the surgery.
Of course, once you have a very good surgical foundation, it will be no problem to move to the next level and pursue greater excellence.
Zhou Can is very self-aware. He has just been promoted to level six, which is only the junior level of chief physician. It is absolutely not advisable to blindly pursue perfection.
First of all, this will greatly prolong the operation time.
Secondly, if your technology is not up to that level, and you insist on pursuing perfection, you might end up causing trouble.
In the words of the elderly, you eat what you can afford.
If you don't have the ability but still want to eat delicacies from land and sea and a banquet, you are destined to have high aspirations but a fragile life.
[Separation skill experience +1, you successfully separated a tiny blood vessel, experience reward +100. ]
Zhou Can's eyes suddenly lit up, as if he had discovered a new way to earn a large amount of separation experience points!
In the future, as long as conditions permit, you can separate a few more small branch blood vessels for the patient. Not only can you earn 100 separation experience points, but you can also reduce the damage caused by the operation to the patient.
Kill two birds with one stone.
…
After the plantar tendon is successfully removed, the next step is to transplant it into the patient's finger.
This surgical procedure is an extremely delicate process.
It also tests the operator's experience and planning.
"Doctor Zhou, why do we need to reserve some surrounding tissue when harvesting the plantar tendon?"
Dr. Pu Dingdong was confused and asked Zhou Can for advice.
Normally, during the operation, it is best for the assistants not to ask questions, because sometimes the operation is too difficult, the patient's condition is not good, and the surgeon is under great pressure.
It is conceivable that the surgeon was in a very , as if there was a powder keg pressing on his heart.
You may be scolded even if you don't look for trouble. If you dare to ask questions at this time, you will most likely be scolded.
When Zhou Can was doing an internship, he followed an operation where the chief surgeon was a bad-tempered deputy chief physician who scolded the instrument nurse from the beginning to the end of the operation.
At that time, the instrument nurse was also a 30-year-old woman, and she was scolded so hard that her eyes were filled with tears.
Even so, she still insisted on completing the operation.
Then I ran out and hid in the toilet and cried.
Sometimes, it is a blessing for medical assistants and surgical nurses to meet a surgeon with a good .
Speaking of this, let me reveal another very interesting phenomenon.
Basically, no matter whether it is a large hospital or a small hospital, the nurses in the operating room are often the most beautiful among the nurses.
There are probably many reasons why this phenomenon occurs.
First of all, the status of the surgeon is often very high. In any clinical department, the doctor who performs well in surgery will have a high status.
There is no dispute about this.
Because they do have the capital, which is not only the guarantee of the department's "box office", but also the core of the department's revenue generation.
Even in the internal medicine department, doctors who are good at interventional procedures are also ranked higher.
The second reason is that surgeons are usually male doctors.
Among ten men, some are lustful. It has nothing to do with their character. It's just the nature of men.
I believe that no surgeon would be willing to work with a female nurse who is not very pretty during surgery. Surgery itself is a nerve-wracking, physically demanding, and stressful job. In order to complete a difficult surgical task, you need to stare at a bloody part for one or two hours, or even several hours.
How tired the eyes must be!
During surgery, looking at the good-looking female nurses can not only relieve visual fatigue of the eyes, but also make you feel better.
As for those hypocrites who insist on putting doctors on the temple of morality and defining them as being out of touch with the world, I can only say, young man, you are still a little too young.
Whether he is a male leader or a surgeon, as long as he is a man, he hopes that the woman around him is good-looking.
In order to avoid making certain mistakes, some business owners hire male secretaries, which in itself is actually a manifestation of lack of confidence.
