godfather of surgery
Chapter 30
Chapter 30
Yang Ping thought a lot about the meeting with Huang Jiacai.
In fact, he does not doubt that the annual salary of one million yuan, the current skills in the system are increasing, and the single skill of severed finger replantation will soon break through the perfect level and advance to the master level.
At this level, it will not be low in any hand surgery hospital, not to mention the annual salary of one million, and the annual salary of 60 million is very common.
But once he leaves the platform of a large tertiary hospital such as Sanbo, and misses the meritorious Bole of Director Han, he may stop at a hand surgeon in a small hospital, which is not what Yang Ping wants.
He should do more, and his goals can be higher and farther. As for economic income, Yang Ping believes that it is a matter of course.
Through some analysis and thinking, Yang Ping became more firm in his thoughts.
The five-stage replantation made the orthopedics department of Sanbo Hospital famous.
A large number of patients with severed fingers go to Sanbo Hospital almost every day.
Yang Ping, Tian Yuan, and Song Zimo took turns to replant the severed fingers. Doctors such as Zhang Lin and Xiaowu were also brought along by Song Zimo to train microsurgery operations. Director Han asked the attending doctors and below to train each of them in microsurgery. , and ultimately to be able to independently complete the replantation of severed fingers.
Yang Ping entered the system and checked the completion of the task: the progress bar was at 30%.
Now he was relieved, and according to this trend, completing the task was not a problem.
Yang Ping only has more than 9000 points left over from last time, so he dare not spend them carelessly for the time being.
Now that he is good at it, he can squander a lot of points, and he can only use it as an emergency backup if he has less points.
Living within your means is the basic financial management principle.
Yang Ping has just arrived. Although he is the attending physician, he was used as a resident physician before, and now he has performed well in several consecutive surgeries.Director Han immediately straightened him and designated him as the chief physician.
Director Han has his own plans. The development of orthopedics has completed the initial accumulation, and now he plans to enter a period of rapid expansion.
The construction of the talent team is the most important. Although there are several great directors, they are all quite satisfactory.
The pastoral garden is very good. He is only in his thirties, and he is already able to take charge of himself. Song Zimo is extremely talented, and with a little training, he will be able to stand out.
However, I feel that the talents are still not enough. Now there is a Yang Ping. Looking at these operations, he completely surpasses Song Zimo.
This gave him a little more confidence, and it was time to start the strategy of rapid expansion.
He decided to help Yang Ping apply for the permission of the third-level surgery, so that he could run faster.With the application form, he knocked on the office of Professor Zhang Zongshun of the hospital expert group.
The old man took off his presbyopic glasses, pointed the words with his fingers, read it once, and said slowly: "Master's degree, I just entered the clinic, and the replantation of amputated limbs is a bit good. Replantation of amputated limbs is not a rare thing now, and surgery is widely used. "
He was right. Replantation of severed fingers is a very popular operation. Hand surgery hospitals are blooming everywhere, and any hospital does not do it every day.
The expert group is a feature of Sanbo Hospital. A group of retired domestic well-known experts and professors were hired to Sanbo Hospital. Because of their old age, they no longer perform surgery and usually go out of the outpatient clinic.
In addition to going out of the clinic, there are also some tasks, most of which are of the nature of teaching and supervision. For things like evaluating the authority of surgery, the power is in their hands, and it is also when they have the most sense of existence.
"Let's go through the procedure and go through all the operations above, second child Han, if it wasn't for your highly recommended, newcomer, no special education background, we would not start the procedure, this is going through the special talent channel, so he The surgery score is not only passing, but an average of over [-]." The old man put on his glasses.
"He did a great job for the hospital last time." Old Han defended himself and wanted to say a few more words to Yang Ping, at least lower the rating of the operation, which would be less difficult.
The old man looked up, his eyes showing from the upper edge of his glasses: "This is not good, it's a different matter, haven't we already taken him through a special passage?"
These old and stubborn people were also characters when they were young, and they all looked like bull-nosed ones. Old Han didn't want to compete any more, so he had to agree.
"That's it, we'll go into the process. According to the list above, we will send the video of the operation before every Friday, and we will meet each other on Friday to give a score. Second Han, you are a little biased, Ke. There are so many majors here, I haven't seen you apply for tertiary surgery, it's not too long ago, right?" The old man is also a shrewd person.
"Now that the trauma emergency center is listed, and the number of orthopedic surgeries has skyrocketed, I am short of people and capable people." Lao Han said helplessly.
After bargaining like this, things are done, at least they agree to start the process, and the rest is for Yang Ping to complete the operation.
Old Han has never seen how Yang Ping's other operations are done. Many doctors will only perform replantation of severed fingers, and it is very common that they cannot even take a simple fracture.
Well, I just took this opportunity to see how Yang Ping's other operations are doing. If it is as good as the replantation of a severed finger, I will directly put a burden on his shoulders.
Whether the knife is a bull's knife, it depends on whether it can be used directly or needs to be sharpened.
Returning to the office from the administrative building, Song Zimo was waiting for Lao Han. Song Zimo handed over the next week's teaching operation to Lao Han for a look.
"Next week's teaching operation, I don't need to watch it, just report it to me." Lao Han took a sip of tea.
Song Zimo flipped through the textbook: "Clavicle fracture, Director Tian did it."
There are several teaching operations every week, so that the young residents and attending physicians can learn and master the practical steps of the operation. Generally, Director Tian will perform the surgery, and a few will also perform the surgery by Song Zimo.
In addition to following the national doctor training system, Sanbo Hospital also has its own system. Three years of regular training plus five years of specialist training can be regarded as an entry-level specialist.
"Tell Yang Ping, he will do it next week, is the case ready?" Lao Han asked with concern.
"Get ready, the three are all fractured collarbone, simple, smashed, and those requiring neurovascular exploration are typical cases, and the patients are all young people with no underlying diseases.
Song Zimo is the secretary of the Department of Orthopedics, and these teaching cases are selected and determined by him.
Clavicle surgery is simple, so let’s try the water first. After talking with Song Zimo, Director Han called Yang Ping over and closed the door of the office.
"Xiao Yang, I want to help you expand your surgical authority to include fractures of the limbs and pelvis. Do you think it will work? Yes! The hospital will start investigating you. No, it doesn't matter. You are with me for a while, and I will familiarize you. "
This is an undisguised truth from Lao Han. Yang Ping knew in his heart that it was Lao Han who was helping him fight for greater surgical authority from the hospital. He was very moved: "Don't worry, I will definitely live up to my high expectations."
"With your words, I am relieved. I have submitted the application form, and the expert group leader Zhang Lao also agrees. From next week, you will do all the teaching operations, and the teaching operations will be scheduled on Thursday, next week's surgery. The operation is a fracture of the clavicle, so I have prepared three, one of which is to probe the blood vessels and nerves under the clavicle, which is more troublesome, but don’t be afraid, I will be in the audience at that time, and I will be there at any time.” Lao Han encouraged him.
In any industry, encountering a good teacher is very precious and avoids many detours.A good teacher will not only point you in the right direction, but will also carry you on a journey at a critical time.
"The road ahead is still very long, keep in shape, keep going, remember, your goal is farther away, don't give up easily." Lao Han's torch-like eyes cast.
Yang Ping nodded: "Well, thank you Director!"
"You are ready to review the operation of clavicle fracture. Although it is the simplest operation in orthopaedics, it is not so easy to do well. Every step must be in place. Also, your operation score, on average, is [-] points. access to surgery.”
"Understood!" Yang Ping was very confident.
Fortunately, Yang Ping left some points and came out of Director Han's office.
Yang Ping entered the system and spent [-] points to purchase [-] cases of clavicle fracture surgery.
In one breath, five hundred cases of various clavicle fractures were performed in the system, and I felt nauseous.
On Thursday, after the shift and rounds, the young residents and attending physicians gathered in the orthopaedic operating room, which is the operating room next to the classroom.
Everyone sat early in the next classroom and waited, and the interns were not arranged to come, because at this stage, the interns had not yet formed a concept for specialized surgery.
The patient takes the beach chair, and Xiao Wu is the assistant. He washes his hands regularly, disinfects the sheets, and wears a surgical gown.
Su Yixuan is an instrument nurse. Because there are many operations, in order to improve the tacit understanding of the operation, the operating room specially arranges Su Yixuan to provide a table for Yang Ping.
After the preoperative check, open the stage!
Many people are curious about a doctor who has done a perfect replantation of a severed finger, and how about other operations, and there is no shortage of people who want to see him capsize in order to achieve psychological balance.
Song Zimo longed for this day for a long time, of course, not to see him capsize, but to see how his operations other than replantation of his severed fingers would go?
Knife!
Needless to say, just reach out.
He gently patted his palm.
First vertically, then at a 45-degree inclination, then stand upright and retract the knife.
The beautiful incision along the dermis is called a machete incision!Once formed, the skin is just cut, neither opaque nor too forceful, and the deep fascia is cut.
Clavicle epithelial nerves are avoided!
Pull the hook, put it in, Xiao Wu and two hands, pull the hook up and down, and pull the incised skin away.
"Be gentle!" Yang Ping reminded Xiao Wu.
The force of the hook was too great, and Xiao Wu immediately lowered the force on his hand.
Electric knife!
With the electric knife incising the deep fascia and platysma, the smoke came out, but it was all sucked away by the suction device in the left hand, and the unpleasant fried burnt smell only spread out a little.
The spotting hemorrhages had not yet had time to form a scale, and they were wiped out one by one like a gopher with an electric knife.
Pushing forward layer by layer, there is almost no blood on the gauze, only a faint, faint light.
The periosteum was cut, and the electrocautery was shaped again.The Periosteal Stripper gently performs subperiosteal stripping, revealing the limited bone surface.
Needless to say, the reduction forceps have been delivered to her hands. This is the first time Su Yixuan has performed an operation other than replantation of Yang Ping's severed finger.
Is tacit understanding also natural?
Point reduction forceps, two, clamp both ends of the fracture, gently pull the fracture, and use the stability of the fracture itself.
Another reduction forceps quickly clamped the fracture end, a 1.5 mm Kirschner wire, drilled into the vertical fracture line, just penetrated, and stopped.
The temporary fixation was firm and stable, and the reduction forceps were withdrawn.
The template of the steel plate is pasted, pre-bent and shaped, and then the steel plate is shaped according to the template.
The six-hole steel plate fits perfectly on the collarbone. Drilling, sounding and tapping, each step has a clear rhythm, without omitting, without rushing or delaying, and steadily advancing.
Six screws are placed.
rinse!
Layered suture with absorbable sutures inside.
Finally, the skin is sutured continuously with thin nylon thread intradermally, which is the so-called cosmetic suture.
6 minutes, from incision to suture, it only took 6 minutes.
Song Zimo's wish was fulfilled, but his curiosity did not weaken because of this. Instead, it became stronger. What about other surgeries?
Although it was a simple operation, it was done so perfectly that it was just like a textbook.
There was a smile on Lao Han's face, this kid did not embarrass himself.
This operation is just a small test, it seems that the knife is good!
(End of this chapter)
Yang Ping thought a lot about the meeting with Huang Jiacai.
In fact, he does not doubt that the annual salary of one million yuan, the current skills in the system are increasing, and the single skill of severed finger replantation will soon break through the perfect level and advance to the master level.
At this level, it will not be low in any hand surgery hospital, not to mention the annual salary of one million, and the annual salary of 60 million is very common.
But once he leaves the platform of a large tertiary hospital such as Sanbo, and misses the meritorious Bole of Director Han, he may stop at a hand surgeon in a small hospital, which is not what Yang Ping wants.
He should do more, and his goals can be higher and farther. As for economic income, Yang Ping believes that it is a matter of course.
Through some analysis and thinking, Yang Ping became more firm in his thoughts.
The five-stage replantation made the orthopedics department of Sanbo Hospital famous.
A large number of patients with severed fingers go to Sanbo Hospital almost every day.
Yang Ping, Tian Yuan, and Song Zimo took turns to replant the severed fingers. Doctors such as Zhang Lin and Xiaowu were also brought along by Song Zimo to train microsurgery operations. Director Han asked the attending doctors and below to train each of them in microsurgery. , and ultimately to be able to independently complete the replantation of severed fingers.
Yang Ping entered the system and checked the completion of the task: the progress bar was at 30%.
Now he was relieved, and according to this trend, completing the task was not a problem.
Yang Ping only has more than 9000 points left over from last time, so he dare not spend them carelessly for the time being.
Now that he is good at it, he can squander a lot of points, and he can only use it as an emergency backup if he has less points.
Living within your means is the basic financial management principle.
Yang Ping has just arrived. Although he is the attending physician, he was used as a resident physician before, and now he has performed well in several consecutive surgeries.Director Han immediately straightened him and designated him as the chief physician.
Director Han has his own plans. The development of orthopedics has completed the initial accumulation, and now he plans to enter a period of rapid expansion.
The construction of the talent team is the most important. Although there are several great directors, they are all quite satisfactory.
The pastoral garden is very good. He is only in his thirties, and he is already able to take charge of himself. Song Zimo is extremely talented, and with a little training, he will be able to stand out.
However, I feel that the talents are still not enough. Now there is a Yang Ping. Looking at these operations, he completely surpasses Song Zimo.
This gave him a little more confidence, and it was time to start the strategy of rapid expansion.
He decided to help Yang Ping apply for the permission of the third-level surgery, so that he could run faster.With the application form, he knocked on the office of Professor Zhang Zongshun of the hospital expert group.
The old man took off his presbyopic glasses, pointed the words with his fingers, read it once, and said slowly: "Master's degree, I just entered the clinic, and the replantation of amputated limbs is a bit good. Replantation of amputated limbs is not a rare thing now, and surgery is widely used. "
He was right. Replantation of severed fingers is a very popular operation. Hand surgery hospitals are blooming everywhere, and any hospital does not do it every day.
The expert group is a feature of Sanbo Hospital. A group of retired domestic well-known experts and professors were hired to Sanbo Hospital. Because of their old age, they no longer perform surgery and usually go out of the outpatient clinic.
In addition to going out of the clinic, there are also some tasks, most of which are of the nature of teaching and supervision. For things like evaluating the authority of surgery, the power is in their hands, and it is also when they have the most sense of existence.
"Let's go through the procedure and go through all the operations above, second child Han, if it wasn't for your highly recommended, newcomer, no special education background, we would not start the procedure, this is going through the special talent channel, so he The surgery score is not only passing, but an average of over [-]." The old man put on his glasses.
"He did a great job for the hospital last time." Old Han defended himself and wanted to say a few more words to Yang Ping, at least lower the rating of the operation, which would be less difficult.
The old man looked up, his eyes showing from the upper edge of his glasses: "This is not good, it's a different matter, haven't we already taken him through a special passage?"
These old and stubborn people were also characters when they were young, and they all looked like bull-nosed ones. Old Han didn't want to compete any more, so he had to agree.
"That's it, we'll go into the process. According to the list above, we will send the video of the operation before every Friday, and we will meet each other on Friday to give a score. Second Han, you are a little biased, Ke. There are so many majors here, I haven't seen you apply for tertiary surgery, it's not too long ago, right?" The old man is also a shrewd person.
"Now that the trauma emergency center is listed, and the number of orthopedic surgeries has skyrocketed, I am short of people and capable people." Lao Han said helplessly.
After bargaining like this, things are done, at least they agree to start the process, and the rest is for Yang Ping to complete the operation.
Old Han has never seen how Yang Ping's other operations are done. Many doctors will only perform replantation of severed fingers, and it is very common that they cannot even take a simple fracture.
Well, I just took this opportunity to see how Yang Ping's other operations are doing. If it is as good as the replantation of a severed finger, I will directly put a burden on his shoulders.
Whether the knife is a bull's knife, it depends on whether it can be used directly or needs to be sharpened.
Returning to the office from the administrative building, Song Zimo was waiting for Lao Han. Song Zimo handed over the next week's teaching operation to Lao Han for a look.
"Next week's teaching operation, I don't need to watch it, just report it to me." Lao Han took a sip of tea.
Song Zimo flipped through the textbook: "Clavicle fracture, Director Tian did it."
There are several teaching operations every week, so that the young residents and attending physicians can learn and master the practical steps of the operation. Generally, Director Tian will perform the surgery, and a few will also perform the surgery by Song Zimo.
In addition to following the national doctor training system, Sanbo Hospital also has its own system. Three years of regular training plus five years of specialist training can be regarded as an entry-level specialist.
"Tell Yang Ping, he will do it next week, is the case ready?" Lao Han asked with concern.
"Get ready, the three are all fractured collarbone, simple, smashed, and those requiring neurovascular exploration are typical cases, and the patients are all young people with no underlying diseases.
Song Zimo is the secretary of the Department of Orthopedics, and these teaching cases are selected and determined by him.
Clavicle surgery is simple, so let’s try the water first. After talking with Song Zimo, Director Han called Yang Ping over and closed the door of the office.
"Xiao Yang, I want to help you expand your surgical authority to include fractures of the limbs and pelvis. Do you think it will work? Yes! The hospital will start investigating you. No, it doesn't matter. You are with me for a while, and I will familiarize you. "
This is an undisguised truth from Lao Han. Yang Ping knew in his heart that it was Lao Han who was helping him fight for greater surgical authority from the hospital. He was very moved: "Don't worry, I will definitely live up to my high expectations."
"With your words, I am relieved. I have submitted the application form, and the expert group leader Zhang Lao also agrees. From next week, you will do all the teaching operations, and the teaching operations will be scheduled on Thursday, next week's surgery. The operation is a fracture of the clavicle, so I have prepared three, one of which is to probe the blood vessels and nerves under the clavicle, which is more troublesome, but don’t be afraid, I will be in the audience at that time, and I will be there at any time.” Lao Han encouraged him.
In any industry, encountering a good teacher is very precious and avoids many detours.A good teacher will not only point you in the right direction, but will also carry you on a journey at a critical time.
"The road ahead is still very long, keep in shape, keep going, remember, your goal is farther away, don't give up easily." Lao Han's torch-like eyes cast.
Yang Ping nodded: "Well, thank you Director!"
"You are ready to review the operation of clavicle fracture. Although it is the simplest operation in orthopaedics, it is not so easy to do well. Every step must be in place. Also, your operation score, on average, is [-] points. access to surgery.”
"Understood!" Yang Ping was very confident.
Fortunately, Yang Ping left some points and came out of Director Han's office.
Yang Ping entered the system and spent [-] points to purchase [-] cases of clavicle fracture surgery.
In one breath, five hundred cases of various clavicle fractures were performed in the system, and I felt nauseous.
On Thursday, after the shift and rounds, the young residents and attending physicians gathered in the orthopaedic operating room, which is the operating room next to the classroom.
Everyone sat early in the next classroom and waited, and the interns were not arranged to come, because at this stage, the interns had not yet formed a concept for specialized surgery.
The patient takes the beach chair, and Xiao Wu is the assistant. He washes his hands regularly, disinfects the sheets, and wears a surgical gown.
Su Yixuan is an instrument nurse. Because there are many operations, in order to improve the tacit understanding of the operation, the operating room specially arranges Su Yixuan to provide a table for Yang Ping.
After the preoperative check, open the stage!
Many people are curious about a doctor who has done a perfect replantation of a severed finger, and how about other operations, and there is no shortage of people who want to see him capsize in order to achieve psychological balance.
Song Zimo longed for this day for a long time, of course, not to see him capsize, but to see how his operations other than replantation of his severed fingers would go?
Knife!
Needless to say, just reach out.
He gently patted his palm.
First vertically, then at a 45-degree inclination, then stand upright and retract the knife.
The beautiful incision along the dermis is called a machete incision!Once formed, the skin is just cut, neither opaque nor too forceful, and the deep fascia is cut.
Clavicle epithelial nerves are avoided!
Pull the hook, put it in, Xiao Wu and two hands, pull the hook up and down, and pull the incised skin away.
"Be gentle!" Yang Ping reminded Xiao Wu.
The force of the hook was too great, and Xiao Wu immediately lowered the force on his hand.
Electric knife!
With the electric knife incising the deep fascia and platysma, the smoke came out, but it was all sucked away by the suction device in the left hand, and the unpleasant fried burnt smell only spread out a little.
The spotting hemorrhages had not yet had time to form a scale, and they were wiped out one by one like a gopher with an electric knife.
Pushing forward layer by layer, there is almost no blood on the gauze, only a faint, faint light.
The periosteum was cut, and the electrocautery was shaped again.The Periosteal Stripper gently performs subperiosteal stripping, revealing the limited bone surface.
Needless to say, the reduction forceps have been delivered to her hands. This is the first time Su Yixuan has performed an operation other than replantation of Yang Ping's severed finger.
Is tacit understanding also natural?
Point reduction forceps, two, clamp both ends of the fracture, gently pull the fracture, and use the stability of the fracture itself.
Another reduction forceps quickly clamped the fracture end, a 1.5 mm Kirschner wire, drilled into the vertical fracture line, just penetrated, and stopped.
The temporary fixation was firm and stable, and the reduction forceps were withdrawn.
The template of the steel plate is pasted, pre-bent and shaped, and then the steel plate is shaped according to the template.
The six-hole steel plate fits perfectly on the collarbone. Drilling, sounding and tapping, each step has a clear rhythm, without omitting, without rushing or delaying, and steadily advancing.
Six screws are placed.
rinse!
Layered suture with absorbable sutures inside.
Finally, the skin is sutured continuously with thin nylon thread intradermally, which is the so-called cosmetic suture.
6 minutes, from incision to suture, it only took 6 minutes.
Song Zimo's wish was fulfilled, but his curiosity did not weaken because of this. Instead, it became stronger. What about other surgeries?
Although it was a simple operation, it was done so perfectly that it was just like a textbook.
There was a smile on Lao Han's face, this kid did not embarrass himself.
This operation is just a small test, it seems that the knife is good!
(End of this chapter)
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