Chapter 511 Anesthesia is a dangerous road, a long wait
At first, he felt that following Zhou Can had more prospects, so he tried every means to switch from cardiothoracic surgery to the emergency department.
This move was the right one.
At least his surgical skills have improved significantly and his future is bright.
But every time he met the head of the cardiothoracic surgery department, he would feel embarrassed. At this moment, he lowered his head, looking as if he was too embarrassed to see anyone.
"Doctor Pu, you will know what to do in the emergency department, right?"
Director Xueyan asked with concern.
“Adapt, adapt!”
Pu Dingdong's face turned red and he didn't dare to look Director Xueyan in the eye.
"Thank you Director Xue for your concern."
After a while, he uttered another sentence.
"Learn and work hard from Dr. Zhou. Tuya Hospital is a big stage. As long as you have the ability, you will definitely shine one day." Director Xueyan nodded and encouraged him.
"Let's go to the hybrid operating room."
This operation is very special. It requires both vascular bypass and interventional surgery, as well as the placement of vascular stents.
There are very high requirements for the hardware facilities and instruments and equipment in the operating room.
Even with the financial resources and scale of Tuya Hospital, there are only two such high-end surgeries available.
It is used more frequently in cardiothoracic surgery and neurosurgery.
When other departments need to use it, they must apply to the hospital and then arrange shifts.
When I arrived at the compound operating room, I saw an old man with extraordinary aura standing outside the door, followed by a young man carrying a briefcase and dressed very formally. He stood respectfully behind the old man.
"That person is a family member, who came here on a special chartered flight."
Director Xueyan introduced Zhou Can.
The old man looked like an entrepreneur. Zhou Can could easily sense from his invisible aura that he was not an official but a businessman.
However, Chen Zhongzhi exudes a mixed aura of the second generation of rich people and the second generation of officials.
It is estimated that some members of the Chen family are officials.
Some large families, as long as there are people of high moral character and prestige in the family, will be able to form cohesion among the family members and integrate the resources of the entire family together, so that they can develop better.
"Director Xue, when can my son finish the surgery?"
The old man raised his wrist to look at his watch and asked.
"I'm not sure about that for now, but I estimate it will take at least three hours! The exact duration will depend on the operation."
Director Xueyan was very polite to the old man.
Doctors have a relatively high social status, but that is only for ordinary people. When encountering some business tycoons and officials, the status of doctors immediately becomes somewhat low.
“I’m counting on you!”
The old man glanced at the medical staff and bowed to them all.
"You're welcome, Mr. Cai. This is what we should do. If you have been waiting outside the operating room, you can sit on the bench over there and rest for a while."
Director Xueyan pointed to a bench not far away.
The family members sitting here waiting are all waiting for their relatives or friends in the operating room to come out after surgery.
Some people seemed calm, while others looked anxious.
Zhou Can couldn't help but feel confused when he heard Director Xueyan call the old man Mr. Cai.
The patient's name is Chen Zhonghui, but his father's surname is Cai. Does that mean the patient took his mother's surname?
This family is a bit complicated!
Generally, children take their mother's surname, which means that the son is a live-in son-in-law.
After entering the operating room, Zhou Can changed his clothes and went into the operating room, where he saw the patient already lying on the table.
The person who gave the patient anesthesia was Director Feng, who was accompanied by an anesthesia nurse and two students.
Zhou Can was also a student of Director Feng, and he walked up to him and greeted him familiarly.
"Boy, that's great! You've already been able to innovate in major surgery!"
Director Feng rarely praises people and is not very smiling.
But Zhou Can, Shangguan Xueluo, and Qu Zi were exceptions. Director Feng liked all doctors in the Department of Anesthesiology who studied hard and had some ability.
Dr. Guan was almost trained by Director Feng as his successor.
Unfortunately, his growth was not as good as Director Feng expected. Zhou Can could clearly feel that Dr. Guan’s status in the Department of Anesthesiology was no longer as good as before.
This is true for any department, only those with ability will be promoted.
If you don't advance, you will retreat.
Dr. Guan is quite hardworking, but after an incident, he became much more timid. He is very conservative when handling many high-risk surgeries.
Nowadays, when cardiothoracic surgery is performing some major surgeries above level three, as long as the risks are a little higher, almost no surgeon is willing to cooperate with Dr. Guan.
Because the probability of the surgical plan being rejected is too high.
If the anesthesiologist is too adventurous, accidents are likely to happen. If he is too conservative, the patient and the surgeon will miss many surgical opportunities.
There is a degree here that needs to be struck.
If Dr. Guan cannot break free from the influence of being overly cautious, he will not be able to grow quickly.
They will be ruthlessly eliminated little by little by the general trend of development.
In terms of personal relationship, Zhou Can and Dr. Guan are like old friends.
Zhou Can also found opportunities to talk to Dr. Guan three or four times, either explicitly or implicitly, asking Dr. Guan to relax the standards for surgeries with reasonable risks. However, Dr. Guan only agreed verbally and did not put it into action.
Later, Zhou Can never mentioned it again.
Adults are stubborn.
Never try to wake up someone who is pretending to be asleep, otherwise you may easily become enemies with him.
Zhou Can understood these principles of life very early on. After trying to persuade them several times without success, he naturally stopped trying.
The development of anesthesiology is quite good now.
People like Qu Zi and Shangguan Xueluo are growing rapidly.
The entire anesthesiology department, from bottom to top, is full of talented people, and the development momentum is quite encouraging.
Director Xie of the Department of General Surgery has made great contributions to the development of the Department of Anesthesiology. He has provided a lot of support and help to the Department of Anesthesiology.
On this point, we must admire Director Xie's foresight.
He may have realized long ago that the Department of Anesthesiology and the Department of Surgery form a symbiotic relationship. Only when the Department of Anesthesiology develops well can the Department of Surgery have a strong comrade-in-arms.
Then other major departments also maintain good relations with the Department of Anesthesiology because they all have the need for anesthesia support.
As a result, except for the difficulty in recruiting people, the Department of Anesthesiology is doing well in the hospital.
The reform of the anesthesiology department, which has been put on the agenda, will be a huge test for people like Dr. Guan, because the current model of the anesthesiology department is to eat from the same pot, and when the orders are received, they will be distributed fairly to various anesthesiologists.
If the department has special requirements and designates someone, it will generally be agreed as long as it can be arranged.
Dr. Guan is now facing the embarrassing situation that few departments have designated him to perform anesthesia surgery. It would be better if there was no reform, as he could eat from the same big pot.
After the reform, if you can’t get any orders, it will be difficult to survive.
Either you transfer to the critical care medicine department, or find out which department's intensive care unit is short of staff and transfer there to work as a ward physician.
From the moment an anesthesiologist chooses the path of anesthesiology, his or her career is destined to be filled with thorns and endless adventures.
Whether you are an anesthesiologist or a doctor who has switched to become a critical care physician, you need to take risks for all kinds of patients all the time.
"Do you need a cardiac arrest?"
Director Feng asked Zhou Can.
He already knew that the entire surgical plan was designed by Zhou Can, and he would definitely have to ask Zhou Can again in person about some key issues during the operation.
"As long as there is no major accident, the heart does not need to be stopped. But extracorporeal circulation needs to be prepared, which is needed for vascular bypass. In case of unpredictable events such as severe atrial fibrillation and cardiac arrest, extracorporeal circulation can also buy time to rescue patients at critical moments."
Zhou Can replied.
"Then there's no problem. The patient has entered anesthesia. Except for his unstable blood pressure, other signs are relatively stable. Let's get started."
Director Feng is efficient in doing things.
Never nag or talk nonsense.
…
The operation began quickly.
This operation needs to be carried out in two steps. First, a vascular bypass is performed to ensure the blood supply to the patient's aortic branches. Then a stent is placed.
It may seem like a simple bypass surgery, but it actually tests the doctor's skills and the cooperation of the entire team.
For any major surgery, the medical assistants, nurses, and anesthesiologists must all work in harmony. It is simply not something that can be accomplished by one person.
Zhou Can brought Qiao Yu and others to watch this time, intending to let them understand how an excellent surgical team should cooperate with the chief surgeon to complete the entire operation.
He has an invisible leadership position in the cardiothoracic surgery operating room.
After the operation started, everyone, including Director Xueyan, took him as the core and started to operate like a precision machine.
The division of labor is clear and the team works well together during the operation.
Everyone is the owner of this operation and needs to maintain a sense of ownership at all times.
If someone is cunning, or is afraid of heavy work, or shirks responsibility when faced with a risky surgical task, or ignores a crisis and acts indifferently, as if it is none of my business.
All of these may lead to problems with the surgery or even failure.
After Director Hu Kan passed away, Zhou Can also established this invisible leadership position bit by bit through his own efforts.
It must be pointed out that this leadership position is not fixed.
If Director Xueyan is the lead surgeon, Zhou Can and the others will revolve around Director Xueyan.
Whoever performs the surgery is the core of the surgical team.
However, whenever problems occurred during major surgeries, Zhou Can was always the main rescue force as long as he was on the scene. He tackled tough problems and overcame difficulties to complete some extremely difficult surgeries. All these made Zhou Can's image gradually become taller, and he eventually became a rock in everyone's mind.
This kind of invisible leadership is not possessed by other cardiothoracic surgeons.
Only Director Hu Kan has ever had such a status.
After performing an autopsy on the patient, Zhou Can was deeply frightened when he saw the dissection band in the chest and abdominal cavity.
The patient is very lucky to be alive today.
"Director Le, please help me block the blood flow to this branch."
"no problem."
Zhou Can quickly cut open the branch blood vessels and then performed anastomosis.
His surgery was fast.
Anastomosis of artificial blood vessels with the patient's blood vessels is a test of the doctor's skills.
If the fit is not good, various problems may easily occur.
In particular, the central pressure of the aorta is very high, and the impact force after blood flow is quite terrifying.
If the fit is not perfect, it will break through directly.
His experience in suturing, ligation, and anastomosis is increasing rapidly.
Ligation is rapidly approaching level six.
One, two...five branch blood vessels were all anastomosed with the artificial blood vessels.
The next step is to evacuate the air and then perform aortic bypass surgery.
Sometimes, the anastomosed intestines and blood vessels are checked, and if necessary, a water injection test can be performed.
Especially for some surgeons whose skills are not particularly good, water injection tests can help detect problems in advance when performing anastomosis on key parts.
If leakage occurs after the intestines and blood vessels are anastomosed, it will have catastrophic consequences.
Some patients also have hardened and brittle blood vessels, or severe intestinal adhesions that make them as fragile as tofu, which requires special caution.
After the anastomosis, it is easy to break.
It is necessary to take various measures in advance to ensure the safety of the anastomosis.
An hour and a half later, Zhou Can finally completed the aortic bypass. Looking at the newly established blood pathway, he was full of anticipation.
Just waiting for the blood circulation test.
His ligation skills are very close to level six. As long as he performs another difficult major operation, he should be able to advance to the next level.
The benefits this innovative surgery brought him were unimaginable.
Especially the self-confidence and deeper understanding of life.
"Success or failure depends on this one move, I hope everything is OK. Let's circulate the blood!"
The ligated blood vessels are loosened, and the blocked blood flows into the artificial blood vessels like a surging tide, quickly forming a secondary pathway.
The test lasted for more than five minutes and remained stable without any problems.
Cheers rang out in the operating room.
A successful bypass means the operation is more than half successful.
The next step is to place a vascular stent.
Zhou Can was not in a hurry to close the abdomen, mainly because he was worried about the rupture of the aortic dissection.
If it really breaks, you can rescue it and stop the bleeding manually at any time.
Placing a vascular stent was much more difficult than expected.
However, his insertion and injection skills have now reached level six, so he was able to escape without any major problems.
Finally, the longest cardiovascular stent ever was successfully placed.
At this point, the operation was a success.
The patient's risk of aortic dissection was completely eliminated.
Next, there is the most crucial step.
After the cardiovascular stent is placed, the blood inlet of the branch blood vessels is also blocked. At this time, the patient needs to rely on the vascular bypass performed by Zhou Can to provide blood supply.
Everyone held their breath and stared at the patient.
The newly built secondary blood circuit has been tested and is unobstructed. However, after the blood inlet of the branch blood circuit is blocked by the stent, it is still unknown whether the blood supply of the bypass can meet the needs of the organs.
Theoretically, because the human body walks upright, the lower the blood vessels go, the more difficult it is to circulate blood.
For example, one of the most common problems is that when you are cold, your feet usually get cold first.
Because the feet are the lowest point in the human body for blood circulation.
This is true whether you are sitting or standing.
Only when lying flat can the blood return to the feet be maintained in a relatively relaxed state.
Ten minutes passed and there seemed to be no adverse changes in the patient's body.
"Director Feng, how is the patient's condition?"
Director Xueyan is even more anxious than Zhou Can.
No one could understand the pressure she was under as the department director. This innovative surgery was too important for the department.
"The patient's vital signs are stable and he should have passed the first wave of tests. This means Xiao Zhou's surgical plan is completely feasible." Director Feng was also nervous.
As long as the patient has any physical problems, he will provide appropriate rescue immediately.
"Can you sew up the wound?"
"Wait a moment. Only ten minutes have passed. Wait another twenty minutes while I test the patient's limb nerves. Then I'll observe the discharge of urine to determine whether the operation was successful."
Director Feng did not relax his vigilance, but continued to observe the patient's condition.
Time passes by every second.
While waiting, everyone had already started discussing some key points and clever ideas of this operation.
