godfather of surgery

Chapter 991 Nanqiao Li Yidao
Soon, Li Min repaired the aorta and inferior vena cava quickly and well.

In fact, if we rank the surgical institutes by level, Li Min's level is the worst and his speed is also the slowest. He is at the tail end among the doctors in training. However, any fish in the Pacific Ocean may be much bigger than the biggest fish in the pond.

The blood vessels were repaired, the large blood vessel blocking clamp was released, and the aorta began to pulsate. Li Min carefully checked each suture to see if there were any weak links. This kind of suture cannot have weak links. Weak links can easily gather the impact force of blood pressure and eventually tear again, causing life-threatening danger.

After careful inspection, Li Min found that there were no weak links, but for safety reasons, he waited for more than ten minutes before doing the next work.

Li Min was very steady throughout the entire operation. After all, he was an apprentice of one of the world's top doctors. He did not skip any surgical steps and proceeded step by step. Although he was a little nervous, he didn't feel nervous at all towards the end.

The level of performance displayed by Li Min completely crushed Director Peng and Director Zhang. The two were stunned and could not believe their eyes. This was a doctor from a township hospital.

The doctors at the Guandu Town Hospital nearby were also completely confused. When did Li Min become so powerful? In the past, he was diligent and studious, and his level was better than everyone else, but it was never beyond the scope of doctors in township hospitals. Now, Li Min's every move completely shows the image of an expert. He can actually perform the operations that Director Peng and Director Zhang cannot perform.

"It would be more reliable if we had artificial blood vessels, but objective conditions do not allow it. There shouldn't be any major problems after repair. Control your blood pressure well in the next few days. It can't be too high. There will basically be no problem after two weeks." Li Min instructed the doctor in charge.

The doctor in charge kept nodding his head, and the old dean said to the doctor in charge in dissatisfaction: "Don't just listen, take a notebook and write it down. A good memory is not as good as a bad pen. What if you forget?"

The attending physician immediately went to look for the notebook in a panic. The circulating nurse handed him a piece of paper and a pen. The attending physician quickly wrote down what Li Min had just said on the paper.

"Vital signs?" Li Min asked while looking at the data on the monitor. His blood pressure was a little low, 90/54 mmHg, and his heart rate was a fast 108 beats/minute. The rest was still within the normal range.

This shows that the patient was obviously deficient in blood volume and hemoglobin due to blood loss, but the situation was controlled in time to avoid further deterioration.

"Let's transfuse all the remaining blood, old dean. Can you find a way to get some more blood?" Li Min could only make the best choice based on objective conditions.

Director Zhang immediately said, "Give me the phone number. Director He in the address book, that's Director He from the blood station. I'll talk to him and ask him to send the blood as soon as possible."

Not to mention the medical community in the county, Director Zhang is an well-informed person in all fields of the county. The heads of all major bureaus are all friends of Director Zhang. Director He of the blood station is even a good brother. Asking him for emergency blood delivery is just a matter of a phone call.

Sure enough, Director He on the other end of the phone agreed without hesitation to send a special car to Guandu Hospital immediately, and he asked for twelve units of suspended red blood cells and twelve units of plasma, and asked if it was enough.

Director Zhang turned around and asked Li Min if it was enough. Li Min nodded and said it was enough. This time, Director Zhang found the confidence and style of Nanqiao Zhang Yidao again from the matter of taking blood.

In fact, being a department director in the medical industry is not just a technical matter, it involves a wealth of human relationships. No matter how good your skills are, if you don't have good interpersonal relationships, at this moment, if a blood station director sends you blood according to the rules and regulations, others don't have to send so much so quickly, or even refuse your request. There is only so much blood in the whole county, why should they send it to you.

Social etiquette is even more important in a small county. For example, if Director Zhang encounters difficulties during an operation and cannot leave, he must be able to find someone who is willing and able to save the situation. If there are some mistakes during the operation and the patient's family makes trouble, he must be able to find someone to help speak up. If there is any inspection from above, he must be able to find someone to help guide and cover the situation.

Having only technical skills but no social skills is far from enough to be a department director. Some department directors are not even very good at performing surgery, and some simply don't perform surgery. Their main job is to deal with social skills and ensure the normal operation of the department.

Generally, blood can be prepared and cross-matching and other tests have been done. The blood station only needs to deliver the blood according to the original tests. The township hospital is far from the county seat, which is really inconvenient if a large amount of blood is needed for rescue.

However, considering the patient's current condition, he can afford to wait. Li Min then instructed the anesthesiologist to give the patient some colloidal fluid, so that the volume can be maintained longer. Fluid replacement actually requires a lot of attention.

"Let's continue to remove the tumor!" Li Min had no intention of stopping.

There are still four units of blood that can be transfused, which is enough to support him to complete the removal of the tumor. If the tumor is not removed and the abdomen is closed now, it will actually be disadvantageous to the patient, because Director Zhang has already performed surgery and the tumor itself is still bleeding. Although it is not as severe as the bursting of large blood vessels, long-term bleeding will accumulate and eventually cause blood loss shock.

It is difficult to stop bleeding from a tumor, so it is better to remove the tumor to stop the bleeding completely and avoid future troubles. Otherwise, you may have to return to the ward and undergo a second laparotomy in the middle of the night to stop the bleeding.

"Still want to remove the tumor?" Not only Director Zhang, but Director Peng was also trembling with fear and had just planned to give up on removing the tumor.

Li Min explained the reason for the resection and indicated that with the patient's current condition and four units of blood as support, it was feasible to remove the tumor.

The old dean standing by was also very surprised. He suddenly felt that Li Min was a strange person. Was his level completely that of an expert from a big city? How could he have improved so fast? It was so fast that it was a bit scary.

What everyone doesn't know is that Li Min was taught by Yang Ping himself at the Surgical Research Institute, and with the resources of the Surgical Research Institute, Li Min's training for one month was completely equivalent to that of an ordinary doctor in several years. Practicing medicine for a long time eventually accumulates cases. For example, in the county hospital, some cases may not be seen for several years, but when he went to Tiantan Hospital, he saw more cases in one day than the county hospital had seen in more than ten years.

During his time at the Institute of Surgery, Li Min performed far more types of surgeries than Director Zhang had performed over the past few decades. Director Zhang often repeated some cases over the past few decades, but Li Min was different. He had access to a variety of cases.

Yang Ping's training for Li Min was also the most scientific. He first made the theory very solid and proficient, then practiced with a large number of experimental pigs, and finally followed Yang Ping and other professors on stage. Finally, he performed some operations under the guidance of Yang Ping. The whole process was very strict and advanced step by step.

"Do you perform major vascular surgery during your postgraduate training?"

Director Peng asked in surprise. Their hospital currently does not perform any large blood vessel surgery. For this kind of large blood vessel tear just now, the most Director Peng can do is to help block the blood vessel urgently, and then send the patient to the provincial capital by ambulance, with blood transfusions on the way. In the end, whether the patient can be rescued depends entirely on luck. Last year, a patient with aortic dissection died in the emergency department.

Li Min did not stop moving his hands and said, "Many patients with Marfan syndrome go to Sanbo Hospital for surgery. Professor Yang generally does not perform large blood vessel surgery now. It is done by doctors below. It is not very difficult. The team leader does not do much. It is done by the attending doctors below. Professor Yang is more considerate of me, so I have many opportunities to practice. I probably performed 50 to 60 surgeries independently during this period."

I have been doing surgery for decades and have never performed major blood vessel surgery, but he actually performed fifty or sixty surgeries. The two directors were amazed. "Are there many surgeries over there?"

"I can't finish it. I can't finish it at all. As long as I want to do it, I can do it 24 hours a day. I work from am to pm, every day. If I hadn't taken a few days off, I would definitely be in the operating room every day."

"If you don't even do major vascular surgery, what kind of surgery can Professor Yang do?"

"We treat brain stem tumors, coronary artery bypass grafting, heart and lung transplants, extremely severe scoliosis, upper cervical spine surgery, etc. Sometimes we also treat complex liver and pancreatic tumors, such as in vitro tumor resection and liver, pancreas and duodenum autotransplantation."

These operations are something the two directors would never normally perform. They are general surgeons and are very familiar with extracorporeal tumor resection and autologous organ transplantation of the liver, gallbladder and pancreas. Not to mention this hospital, there are only two or three hospitals in the country that can perform this type of operation.

"Have you ever seen this kind of surgery?"

"I have served as the first assistant many times."

Director Zhang and Director Peng felt dizzy at the same time. Damn, I have never seen this kind of operation. Director Peng has seen this kind of operation in a paper. Director Zhang usually doesn’t read journal papers, so he has never heard of this kind of operation.

"How is extracorporeal resection performed?" Director Zhang was quite curious.

"We remove the liver, pancreas, duodenum, and tumor together with other organs at once. We remove the tumor on the operating table and then transplant the organs back."

Director Peng explained to Director Zhang and also showed his own knowledge. Otherwise, it would be embarrassing for him not to be able to explain why Li Min had performed many surgeries as the first assistant.

"!!!"

Director Zhang smacked his lips. This operation involved removing the liver, pancreas and duodenum together. This was even more complicated and difficult than a combined pancreaticoduodenectomy, not to mention the subsequent autologous organ transplant. It was scary to think about it. At this moment, Director Zhang felt like the king of fish in a pond who ran into the sea and saw a small shark.

As for the high-difficulty surgeries, Yang Ping only required Li Min to be proficient in emergency surgeries. For non-emergency surgeries, the patients could be transferred to higher-level hospitals. Yang Ping's training for Li Min was tailored to his current grassroots level, so as long as it was an emergency, such as large blood vessel surgery, Li Min had to be able to perform it independently and skillfully. Once such patients were encountered, there was not much chance of transfer.

Times are changing so fast. Director Zhang remembers that he was so happy when he could perform an appendectomy surgery during his further studies that he showed off to his classmates for a long time. Now, trainees can even perform large blood vessel surgeries. It's really a different era.

Isn't it said that the current medical environment is poor and trainees are just doing odd jobs and have few opportunities to get started? It seems that rumors are just rumors and cannot be trusted.

Li Min was neither anxious nor impatient about separating the tumor. He completely followed the knowledge and skills learned in the usual training. Perhaps many things had become habits for him. He had both theory and practice, so Li Min was very confident.

"This type of tumor is rich in blood vessels, and the blood vessels connected to it must be cut and ligated one by one to completely remove the tumor. Because of the invasive adhesions, this type of surgery is not easy to perform. A good plan must be made based on the CT images before the operation, otherwise it will be very passive." Li Min said as he did it.

Director Peng and Director Zhang kept nodding their heads. When it came to reading CT and MRI images, they only had a basic understanding and usually read them in conjunction with reports. It was difficult for them to make complete and accurate judgments independently without the reports.

"Is there a chance that I can perform surgery on a tumor?" Director Zhang was very curious.

Li Min admitted: "Generally, this kind of not very complicated tumor surgery is not encountered in the research institute, but it is encountered a lot in the general surgery department. They are more caring towards me and are willing to give me opportunities to practice. They are also willing to give me opportunities to learn when there are surgeries in the general surgery department."

Just after he finished speaking, Li Min felt that his words were inappropriate and might be a bit hurtful, but he definitely did not intend to hurt others' dignity. He just answered the questions truthfully while performing the operation, so naturally he did not think about them, and every sentence was his true expression.

"How is your level in Sanbo Hospital? I guess you are better than those PhDs, right?" Director Zhang has always looked down on those young PhDs with high academic qualifications, thinking that they are slow in taking action and are only good in theory.

Li Min shook his head. "The doctors at the Institute of Surgery are all PhDs. How can I compare to them? I don't know how far behind them there is. If they hadn't been patient enough to teach me, I wouldn't have been able to perform these surgeries."

Those doctors are so good. Li Min’s current level is already good enough. Those doctors are better than Li Min. Professor Yang is better than those doctors. He is the teacher of those doctors. Then what is Professor Yang’s level? Is he a god?

If the two directors had not seen Li Min's surgery with their own eyes, they would have thought that Li Min was bragging. But now that Li Min's level is there, they have to believe it even if they don't want to.

"What other surgeries can you perform?" Director Zhang asked.

Li Min thought for a moment and said, "I know all the basic surgeries in general surgery. I can't do pancreaticoduodenectomy and organ transplantation right now, but the other operations are not a big problem."

The old dean was very happy to see Li Min's current level. Hey, it seems that sending him abroad for further studies is beneficial. No wonder little Li insisted on going to Sanbo Hospital for further studies. This hospital is a low-key treasure hospital.

"Doctor Li, old dean! Let's go eat fish together later. These are grass-eating fish that I caught in the reservoir. They are very fresh. The chefs at the farmhouses near the reservoir are very good at cooking fish." Director Peng invited Li Min.

Director Zhang also said, "Yes, let's go eat fish together and have a good chat later. Doctor Li, when you come back from further studies, you will be Nanqiao Li Yidao."

It seems that the name Zhang Yidao may not be able to be kept anymore. The new generation will replace the old generation. From now on, Nanqiao will be the world of Li Yidao. Director Zhang can't help feeling a little sad that the hero is getting old and the overlord has changed hands.