Chapter 506: Old Stories, Swift Sword is King
Once this idea came up, I couldn't stop it.
Zhou Can continued to improve and refine this new surgical plan.
Once the blood supply problem of the branch vessels is solved, the treatment of this section of the aorta will be easy. Just put a special vascular stent in it, and the extremely long aortic dissection can be solved.
Because a new blood pathway was created through bypass surgery, the connection between the branch blood vessels and the aorta has been blocked by the stent and no longer has any impact.
There are many benefits to doing this.
The surgical incision is much smaller than that of a vascular replacement.
At the same time, the heart does not need to be stopped, and there is no need to worry about risks such as paraplegia caused by interruption of blood supply during aortic replacement.
The only operational difficulty may be building the bridge.
It is necessary to anastomose the blood inlets of multiple vascular branches.
This was no problem for Zhou Can, who had level 6 anastomosis and level 6 suture. Level 5 ligation was barely enough.
Because anastomosis of these branch blood vessels mainly tests the anastomosis skill. Although suturing and ligation are also very important, the level of associate chief physician is sufficient.
A vascular stent this long probably has to be custom-made.
Because under normal circumstances, no interventional surgery would ever place such a long stent.
Zhou Can was very excited after having a complete surgical plan.
Fortunately, the patient was not sent away. Perhaps I can talk to the patient after the operation.
However, because it is an innovative surgery, there is no mature surgical experience to draw on, and the potential risks are also very high.
…
Zhou Can worked in the operating room until about 6:20 in the evening and completed the last emergency surgery.
According to his usual work routine, after leaving the operating room, he would go to the inpatient ward for rounds, have dinner, go to the cardiothoracic surgery department to work until late at night, and then go home.
The volume of business in the Department of Cardiothoracic Surgery has increased rapidly recently. We often receive difficult cases and patients who need high-level surgeries. Many of them require the concerted efforts of the chief physicians in the department to tackle them.
Zhou Can is the leader of this assault team.
He is excellent in both surgical and diagnostic abilities.
Take yesterday's heart stent surgery for example. There was no one else in the entire department who could perform it.
Zhou Canleng was able to successfully complete the operation by relying on his perseverance, strength, and talent for interventional surgery.
"Teacher, today I met a patient with aortic dissection. The tear zone was very long. I thought of a surgical plan that has never been tried before. Can I discuss it with you?"
Zhou Can stopped Dr. Xu who was taking off his mask and preparing to go home after get off work.
Since he returned to the emergency department and officially became a resident physician, Dr. Xu's job has become significantly easier.
A lot of work was taken care of by Zhou Can.
For example, when it comes to ward rounds, as long as Zhou Can checks it once, Dr. Xu doesn’t have to worry about it at all.
Zhou Can could promptly identify the potential risks before and after the operation and deal with them accordingly. He would only bother Dr. Xu and report to him if they were beyond his ability.
As for performing surgery in the operating room, Zhou Can can replace several attending surgeons.
Even higher than the level of associate chief physician.
Now, even if it is a level 3 surgery, as long as Zhou Can has done it several times and the patient does not have a serious underlying disease, Dr. Xu basically does not enter Zhou Can's operating room. Zhou Can presides over the entire process.
All this trust is built on Zhou Can's long-term stability.
Whether it was ward rounds, surgery, or diagnosis, he never let Dr. Xu down.
It is not easy to do this.
You need to have a very high sense of responsibility and treat every patient carefully and seriously.
"Let's talk in the lounge!"
Dr. Xu called Zhou Can into the lounge of the operating room.
Discussions on intraoperative issues are usually held here.
In the lounge, Zhou Can first gave a brief introduction to the patient's condition, and then talked about the surgical plan he had envisioned.
Dr. Xu just listened silently.
After he finished speaking, there was silence for seven or eight minutes. Doctor Xu then said meaningfully, "You are very similar to me back then. In order to save patients, we can devote ourselves to it and die for it. We can take great risks to challenge various surgeries just to cure patients. But the world does not seem to be so fair. Good people may not necessarily be rewarded. Of course, I am not saying this to discourage your enthusiasm for surgery."
"A few years ago, when I was performing the surgery where the accident happened, I was also full of confidence and enthusiasm. In order to solve the patient's problem, I looked up a lot of information and practiced privately countless times. Later, even though the knife was moving too fast during the operation, and my hands were faster than my brain, and I cut the patient's nerves, I still insisted on completing the operation. It was because I gritted my teeth and helped the patient remove the lesion that the patient had such a long survival period."
From what Dr. Xu said, it is not difficult to hear that when he was halfway through the operation on the patient, he cut off an important nerve of the patient because the knife was moving too fast during the operation.
By then he already knew he was in big trouble.
If it were an ordinary doctor, he would probably have a mental breakdown and give up the operation.
Especially when we know that the patient's status is extremely noble, the psychological pressure they endure will only be greater.
Not to mention the distant past, even during the Republic of China period, some great Chinese medicine practitioners were equally cautious when treating famous patients.
If anything goes wrong, the patient will turn hostile at any time.
Doctors are actually the weaker party in front of those powerful people.
Dr. Xu knew that something was wrong, but he still gritted his teeth and completed the operation, and did his best to help the patient completely remove the lesion.
This is a doctor's sense of responsibility and commitment.
Zhou Can's anastomosis skills have now been upgraded to level six, so he may be able to resolve the medical accident that happened to Dr. Xu back then.
It is usually not easy to ask Dr. Xu in person.
Now that the topic was brought up, he immediately asked, "Teacher, can you tell me about the patient's condition and the specific part that was cut wrong?"
Asking this question is equivalent to uncovering Dr. Xu's scars.
He was somewhat nervous.
Normally, Dr. Xu is an extremely serious person and almost never smiles.
Zhou Can was worried that he would suddenly turn hostile and scold Zhou Can.
"Why are you asking that?"
Doctor Xu stared at him with a look that made people feel a little uneasy, but there was no sign of anger.
"I... I'm just curious." Zhou Can wanted to tell the truth and tell Dr. Xu that he wanted to help Dr. Xu get rid of the shackles on his body.
Because he was not sure at all, he did not dare to make any promises too early.
I didn't even dare to say anything that could bring .
The cruelest thing in the world is to give others hope and then extinguish that hope with your own hands.
Dr. Xu has been carrying shackles for so many years, and he must be extremely eager to one day be able to take off the shackles and become a normal person again.
Over the years, he has been working hard to improve his surgical skills and correct defects in surgery.
Isn't it just for the purpose of making a comeback one day?
People who have successfully climbed to the top and accidentally fell to the bottom of the valley from the top want to climb back to the top more than anyone else.
As long as Dr. Xu is given a chance to make a comeback, I believe that after years of hard work, he will definitely show stronger surgical skills than before.
"It's better for you to stay out of this matter. I've said before that the patient's identity is extremely special. If you want to help me, it's more likely that you will be implicated as well. Do you understand?"
Dr. Xu is an experienced man, so how could he not see Zhou Can's true intention?
But he didn't want to implicate his apprentice.
"Teacher, I have been studying and working with you for several years, right? Do you think I am steady in my work?"
"Yeah, quite steady. Especially after learning from Lao Hu, he has adopted Lao Hu's style in his work."
Doctor Xu nodded.
The Old Hu he was referring to was naturally the late Director Hu Kan of the Cardiothoracic Surgery Department.
"Don't worry. I won't take risks easily if I'm not sure. I believe you are the only one who knows the patient's condition best. Even if you tell me, it will definitely do more good than harm. I can learn a lesson from it. Maybe when I have enough ability in the future, I can think of a solution. If you don't tell me, I will definitely ask others, but the information I get may be biased."
Zhou Can seized the opportunity today, persevered, and was determined to get to the bottom of it.
After his strength improved, Zhou Can was obviously more confident in asking this question.
"Alas! These are all old stories. Since you want to ask, I'll tell you! But I have to tell you in advance, you must not try to take any risks."
Doctor Xu sighed with a complicated expression.
He likes this apprentice from the bottom of his heart.
In addition to his excellent surgical talent, Zhou Can knows how to be grateful and respect his teachers, which is also an important reason why Dr. Xu loves him so much.
No one wants to raise a wolf for nothing.
"That patient was diagnosed with multiple tumors in his body. They were the kind of tumors that surgeons shudder at, and they grew near important nerves, almost touching each other. At the time, no one, including Hu Kan, Wu Baihe, or the retired top surgeons, dared to the operation because I saw the patient's wife kneeling in the general surgery office holding her young baby. I felt sorry for the widow and orphan, so I took the risk and took on the operation."
When Dr. Xu talked about the past, a look of .
"To borrow a phrase from the Internet, I couldn't bear to see the suffering of the world even though I was not doing well myself. I was young and frivolous at that time, and it was the peak of my career. I was so popular that I was even featured in many medical journals in the world. In one issue, the scene of me performing surgery on a patient became the cover of a magazine. At that time, the General Surgery Department of Tuya Hospital was almost the best in the industry. At least that's what I thought. Later I realized that I was just looking at the world from a narrow perspective."
Everyone has a time when they are young and frivolous.
More than ten years ago, Dr. Xu was still very young, in his prime forties.
At that time, he had achieved many major achievements, even setting the world record for the fastest surgery time. He was also in charge of Tuya's top comprehensive surgery department and had an elite team under him.
You can imagine how high-spirited he was.
No one expected that they would see his house building collapse just as they saw it being built.
Overnight, Dr. Xu fell from the altar and lost his luster because of a medical accident.
Even the general surgery department of Tuya Hospital was directly disbanded.
The medical staff of this department at that time, especially those who participated in the operation with Dr. Xu, either changed their careers or, like Dr. Xu, changed their identities and worked in some small hospitals or poor departments.
It can be said to be very miserable.
"The patient's malignant tumor was in this location. After medical examination, no obvious signs of nerve infiltration were found. I repeatedly read the films, checked the pathology reports, and looked through the materials. I felt that as long as the tumor was removed completely, the patient could be saved. Of course, because the tumor and the nerves are adjacent, if you want to remove them completely, you must remove all the tissue on the surface of the nerves. This separation difficulty is still the ceiling in the field of surgery. Even at Renhe Hospital in the capital and a certain affiliated university in the southwest, no doctor dares to challenge such an operation."
More than ten years have passed, and this type of surgery is still the ceiling in the industry, which shows how great Dr. Xu was back then.
Who would have thought that such a great surgical expert is now just an attending physician in the emergency department?
Zhou Can's heart was filled with emotion when he heard this.
It turns out that among Tuya's three famous surgical knives, Dr. Xu's is the best one .
"At that time, because I was fast at performing surgeries, especially cutting lesions that others didn't dare to cut, I dared to cut, and my knife was as fast as lightning, full of magic. So, some people secretly called me the magic knife Xu Chen."
When Dr. Xu talked about the glory days back then, a gleam of light flashed in his eyes.
"Xiao Zhou, you have to remember that although the quick knife has the major flaw of the hand being faster than the brain and is difficult to control, its advantages are also very obvious. Not only is the operation fast, but sometimes it can also cut through the Gordian knot. My quick knife can easily remove lesions that cannot be cured by either the steady knife method or the precise knife method. I have always insisted that you use the quick knife as the main method, not entirely out of selfishness, but because the quick knife has advantages that other knife methods cannot match."
Zhou Can deeply agrees with this view.
And as his surgical skills became more advanced, his understanding of quick and steady knife techniques became more profound.
He had never practiced or learned precise knife techniques, so he didn't understand them.
He has now reached a relatively high level in steady knife skills, and has gained a certain say.
Its biggest advantage is stability.
To put it bluntly, it is like adding multiple safety layers to a scalpel, which in itself is a kind of restriction on the scalpel.
The quick knife method is full of magic, but it can better solve problems in actual combat.
"Let's continue talking about the patient's condition! I removed all of his tumor, but unfortunately an important nerve was cut, causing him to be paralyzed and unable to take care of himself. However, this patient comes from an extremely wealthy and powerful family, and the medical treatment he enjoys is far beyond imagination. He receives the best physical therapy, massage, assisted exercise, and nutritional support every day. So he is in very good condition."
It can be imagined that even if the patient's important nerves are damaged and the body is paralyzed, he should not suffer any pain except being unable to take care of himself.
It feels good to have power.
It has been like this since ancient times.
The life enjoyed by the powerful and wealthy is simply beyond the imagination of ordinary people.
Nerve cells are the only cells in the body that cannot regenerate.
Once cut off, it is a disaster for the patient.
No matter how rich or powerful you are, it is difficult to recover.
Dr. Xu’s fate serves as a warning to us. I believe no doctor would dare to take any risk to treat this patient again.
