godfather of surgery

Professor Shi also has a very bad temper. In his hospital, junior doctors are sometimes scolded to bits.

The moment when conflict is on the verge of breaking out.

"Professor Yang asked me to come on stage, right, Professor Yang!"

Director Fang was so anxious that he immediately turned to Professor Yang for help. Especially Zhang Lin, a pretentious boy who doesn't recognize his relatives. It's best not to mess with him, otherwise he will become a victim of his pretentiousness. If he scolds him in the operating room here, Lao Fang will be in trouble in the future. How can Sanbo Hospital survive with several general surgery doctors watching?

Yang Ping looked up and saw that the person who had just been introduced was Professor Shi from the Cancer Hospital of Nandu Medical University, so he nodded: "Yes, I just asked Director Shi to come on stage."

When the boss spoke, the pretentious boy had nothing to say, so he had to give up the idea of ​​pretentiousness.

Director Fang breathed a sigh of relief. Zhang Lin had such a good reputation that no one dared to mess with him. Even the director of the medical department was afraid of him. Not to mention other people, he would fall out whenever he wanted. He had no feelings to talk about. I still remember that in the past, the patient's family members beat his wife. He ignored everything and just fought hard with them. No one could stop him. In the end, the arrogant and domineering patient's family members had to bow their heads and admit their mistakes and beg for mercy. Director Fang felt that it was best to stay away from such people.

"There's not enough room for so many people on the stage, so don't come up again. Crowding can easily contaminate the surgery." Zhang Lin said coldly.

In fact, this is indeed the case. The operating table is such a big place, and it will definitely not work if there are too many people crowded in. If you move casually and touch arms, it is easy to contaminate the surgical area and disturb others.

There was no other way. Director Fang had no choice but to reluctantly put down the hands he raised in front of his chest. He helplessly watched his senior brother having fun on the stage. Director Fang regretted inviting his senior brother over. It was so good for him to be alone. If he hadn't taken care of his senior brother, he would have done it long ago. Stand on the stage and be a helper.

Director Shi adjusted the sterile gloves and immediately entered the first assistant state. He picked up two vascular forceps, gently clamped a bit of connective tissue and lifted it up so that the surgeon could separate the tumor and normal tissue.

"Come on, Professor Yang, continue!" Director Shi urged.

Yang Ping picked up a sharp knife and continued the operation.

"This vascular clamp should be raised a little higher."

"Oh! Here?"

''The one over there next to the portal blood vessels. "

"is it here?"

"Correct!"

"Relax the other one a little, and then a little more."

"The clamp slipped, wait."

Just now, when the two vascular forceps were adjusted, one of them was not operated properly and slipped directly from the soft tissue of the forceps.

Director Shi has not been an assistant for many years, and he is very unaccustomed to it now. He has no sense of cooperation at all, and he and Yang Ping have never worked together on stage. He must be confused and confused.

Now Yang Ping is preparing to separate a tumor in the porta hepatis area. The tumor here is growing around blood vessels. The blood vessels cannot be saved, so both the blood vessels and the tumor must be removed. During the resection process, hemostasis must be done, and the blood vessels must be protected and marked. The remaining healthy blood vessels can be used for subsequent vascular reconstruction.

"Don't shake your hands randomly. This is a sharp knife. If you are not careful, you will accidentally injure yourself."

"Oh oh oh-"

"Stop shaking!"

"I didn't—"

The more he talked, the more Director Shi's hands shook, and he couldn't control them at all. Sweat was already oozing out from his forehead. Yang Ping was so fast. Director Shi was unfamiliar with the work of assistants, and he usually used tissue scissors to separate. Now Yang Ping has a sharp knife in his hand. Director Shi feels scared when he looks at it. This assistant can't do it.

"I guess I haven't recovered from the cold in the past two days. I'm feeling dizzy now. Director Fang, come here!"

Director Shi finally couldn't hold it any longer. If he continued like this, he would definitely get into trouble.

"Good!"

Director Fang responded immediately. He had been waiting for such an opportunity for a long time. He regretted that he should not have put down his hands just now, and now he had to brush his hands again.

Without stopping for a moment, Director Fang immediately prepared to go out and wash his hands. The door of the operating room opened and Song Zimo walked in with both hands raised. He had finished eating, and now it was Xu Zhiliang's turn to go out to eat.

Director Fang finished washing his hands, got dressed and went on stage: "Dr. Song, take a breath, I will help you for a while."

"Oh!" Seeing that Director Fang was so active, Song Zimo didn't say anything and made room for him. Director Fang excitedly stood at Yishu's position, ready to fight.

A pile of organs were laid out on a special sterile operating table. Yang Ping continued to separate tumors. Director Shi couldn't keep up. How could Director Fang keep up?

The human tissue was spread on the sterile table. It was so soft that Director Fang was a little at a loss. In the past, surgeries were done inside the human body, but now this pile of things was separated from the body. He didn't even think of it, so he acted like it. The assistant's performance is not much better than that of the senior brother. The main difference is in basic skills.

After all, the training methods of the people at the Institute of Surgery are different. They have a scientific basic skills training system, and they train one or two hours of basic skills every day, and then a lot of surgical training.

Director Fang followed the traditional surgical training. Traditional surgical training lacked a systematic and scientific training system. It was just sporadic and non-continuous training. Many hospitals even did not have basic skills training at all. They just tried to explore and conduct self-training. Most of them It is to learn from each other on the operating table and explore from practice.

This backward training method directly leads to the lack of basic skills training for surgeons. Many orthopedic surgeons do not recognize all professional orthopedic instruments. Slightly newer instruments require the guidance of engineers from the manufacturers. Without engineers to follow the stage, the operation cannot be performed.

Many neurosurgeons do not have formal training in microsurgery, and even some short-term training is very sloppy. Only a few hospitals have systematic and formal microsurgery training. Most doctors go to the battlefield after a little training.

There is no basic laparoscopic training in general surgery, resulting in laparoscopy becoming a special skill for some doctors, rather than a basic skill mastered by all general surgeons.

From school to hospital, there is no awareness of skills training, let alone a department specifically responsible for skills training and evaluation. The so-called model of experienced people leading novices is in name only. It is much better in some top large hospitals. In ordinary hospitals, doctors basically grow wildly. Completely self-taught on my own.

Therefore, many doctors have graduated a few years ago and are already deputy chief doctors, but they cannot even tie knots and cut threads proficiently and standardly. They have published a lot of papers and performed many surgeries. They can speak eloquently for an hour at academic conferences, but they are not qualified to do so. Professional surgical instruments are not fully recognized yet. "We are going to remove the left lobe of the liver, Director Fang, please pick out the round ligament!"

Yang Ping reminded Director Fang.

But Director Fang was completely confused. In this pile of soft things, tumors and organs were mixed together. Where was the liver? Where the round ligament is is not clear at the moment.

"Professor Yang, I'm here to experience it -" Director Fang couldn't keep up with the rhythm, so he explained honestly.

When Yang Ping heard this, he realized that Director Fang was here to experience life. He had no choice but to slow down and take care of Director Fang. This patient was admitted by Director Fang, and they had already communicated with him before the operation and asked him to be an assistant. , everyone forgot about this when the operation started. Now that he has finally come to the stage, no matter what, we must take care of him and let him experience it. The dignified surgical institute cannot break its promise.

Anyway, there is no rush. When Xu Zhiliang comes back, Yang Ping is going to have dinner.

Yang Ping said to Director Fang: "Come on, Lao Fang, let's experience what it's like to be a surgeon."

Chief surgeon?

Director Fang shook his head. How could he dare to perform this kind of surgery? His senior brother is a nationally renowned expert in pancreatic tumor surgery and he didn't dare to say this. How could he, Old Fang, dare to perform this kind of surgery? He still knew how much he weighed.

Yang Ping gave up his position as the surgeon: "Old Fang, come here and experience it. This patient is still yours. It's okay. I'll be your assistant."

Director Fang saw that Yang Ping was not joking, but was serious. Hearing that Yang Ping would be the first assistant, he felt a little eager to try, and stood up to the position of the chief surgeon. Anyway, if it didn't work, he would leave it to Yang Ping, and nothing would happen.

Director Fang would definitely not dare to play with sharp knives. It is still possible to try it with tissue scissors. Director Fang adjusted the tissue scissors in his hand to find the feel.

Yang Ping's vascular forceps gently lifted a bit of tissue, and the other tissue forceps pointed at a part: move slowly, start the scissors from here, use the tips of the scissors, open and close as small as possible, don't rush.

Director Fang followed Yang Ping's guidance and cut it bit by bit. After all, he was a senior doctor who had been working for more than ten years. His skills were still good and not bad. However, it was difficult for anyone else to keep up with Yang Ping, a non-human being. Rhythm.

Under Yang Ping's guidance and protection, Director Fang followed Yang Ping's guidance and cut wherever Yang Ping's vascular forceps lifted the tissue in that area. As soon as Yang Ping's vascular forceps blocked it, he immediately stopped.

Whenever a blood vessel is encountered, Yang Ping will use the tip of a vascular forceps to separate the blood vessel, and then hand it over to Director Fang for electrocoagulation or ligation.

In this way, Director Fang advanced the operation bit by bit, and at a good speed.

Can you do it yourself? Director Fang had never performed such a smooth operation before. The surgical area was clean and there was almost no blood.

The assistant helped him prepare every step in advance, and did a good job of guidance and presentation. He only had to follow the assistant's guidance. This surgery was really a miracle, and Director Fang worked more and more vigorously.

Director Shi watched with envy in the audience. The junior surgeons were doing so smoothly. Why couldn't I keep up with the rhythm just now? Maybe I wasn't used to it. I'll try it again when I have the opportunity.

Director Fang's operation became smoother and smoother, and he felt great. The metastases had been mixed with part of the left liver. If the tumor was to be completely removed, the only way to remove the tumor was to remove the left liver lobe, and some blood vessels in the porta hepatis also had to be cut off. So the difficulty of the operation is still very high.

Director Fang wears fluorescent glasses, is serious, and makes steady progress with Yang Ping's strong cooperation, which is very typical of everyone.

"Xiao Chen, help me take some photos, take a few more photos from different angles, and videotape them, hurry up!"

Director Fang suddenly remembered about taking pictures and immediately ordered his graduate students to take pictures immediately. Now that he was the chief surgeon, he would take out these photos to brag in the future. How could he miss such a rare opportunity?

Yang Ping used two pairs of vascular forceps to gently lift the tissue on both sides, so that the tissue in the middle of the two vascular forceps was exactly where the scissors could be inserted. Director Fang's scissors cut shallowly every time, so it was very safe.

Now it was time to incise the liver parenchyma and perform liver lobectomy. Director Fang became more and more confident as he did so.

Cutting the liver parenchyma will cut off some small blood vessels, but the vascular forceps in the assistant's hands are too powerful and do not give these blood vessels the slightest chance. As long as the blood vessels are cut, the assistant's vascular forceps will immediately clamp the broken ends of the blood vessels. Director Fang Simply touch the electrosurgical tip to the tip of the vascular forceps easily to perform electrocoagulation on the severed end of the blood vessel.

Even if the blood vessels are slightly thicker, it doesn't matter. At worst, Director Fang will ligate them.

Moreover, there seems to be an endless supply of vascular forceps in the assistant's hands, one by one appearing in time without any hesitation.

Yang Ping's vascular forceps clamped the severed round ligament of the liver and gently lifted it. Another blood vessel guided Director Fang forward. Using the round ligament of the liver as a symbol, Director Fang carefully cut the front lobe of the left coronary ligament. , Yang Ping pulled away the left outer lobe of the liver, exposing the posterior lobe of the left coronary ligament for Director Fang to remove. Under the guidance of Director Fang, he gradually separated it laterally and separated the left triangular ligament.

Director Fang usually performs ordinary liver lobectomy and is experienced and confident. However, this case is too special and the tumor is very tricky to grow. Now Yang Ping has prepared everything for him. To Director Fang, this operation is a fool's errand. For surgery, as long as you don't want to die, just take the scissors and cut randomly.

Many general surgeons in the operating room were staring at the screen at this time. Director Fang puffed up his chest and looked like a real boss. Everyone has a pretentious heart, and Director Fang was no exception.

The tissue scissors continue to separate. In addition to blood vessels, some small intrahepatic bile ducts will also be cut when the liver parenchyma is cut, and their broken ends will retract.

But don't worry, the assistant is very powerful. The vascular clamp will clamp their stump in time and firmly. No matter it is a blood vessel or intrahepatic bile duct, none of them will be let go. When the assistant lifts the stump, the clamp wire has been sent When it comes into his hands, Director Fang just needs to wind the thread and tie it generously.

Finally, the left lobe of the liver and the tumor that invaded it were completely separated, and the whole process was clear and clean.

"Anesthesiologist, I need to remove the left lobe of the liver!"

Director Fang announced loudly that at every critical point in the operation, the surgeon should remind the anesthetist to report vital signs. This was also Director Fang's declaration of his status as surgeon.

Although it is removed from the body, each organ is still connected to the patient's blood circulation, so it is actually only separated from the body in a spatial position, but not physiologically. After removing the left lobe of the liver, if the bleeding fails to stop somewhere, Once this is done, if massive bleeding occurs, the anesthesiologist will be caught off guard if he is not mentally prepared, so it is necessary to alert the anesthesiologist.

The doctors, masters, doctors, and graduate students in the general surgery department all focused their eyes on Director Fang from the screen. They were all in awe of Director Fang. Director Fang performed such a major operation in a decent manner, and there was no accidental injury so far. One blood vessel, the surgical area is clean. When did Director Fang become so powerful? He also mastered the "bloodless surgery" of the Institute of Surgery without revealing his real face.

"How's it going? Director Fang, are you tired? Do you want to take a break?"

By this time Xu Zhiliang had finished eating, and it was Yang Ping's turn to eat. Yang Ping asked with concern.

Director Fang has been immersed in it and can't extricate himself: "It's okay, continue, I will cut out all the tumors and then let you do autologous transplantation, so that you can take a breather."