Gou is practicing medicine in the clinic

Chapter 184 You Are Not an Outsider, Electrocoagulation to Stop the Bleeding
"it is good."

Li Jingsheng was extremely straightforward, and went directly to the stage to take over the job.

This kind of practical exercise opportunity is extremely rare, and it is of great benefit to the improvement of medical skills, the improvement of surgical experience, and the tempering of courage and character.

Doctor Qin and Ruan Xiaoqin, the two "two generals" could only watch enviously.

What surgery requires is real skills, without that skill, no matter how powerful the flattery is, it is useless.

In Chinese medicine, if you don't read the twelve meridians, you will make a mistake if you open your mouth and do it.

The surgery of western medicine is not at that level, and people will die if they do it.

It may be a bit exaggerated to say this, but without that technical level, it is inevitable to screw up the operation.

No senior doctor's brain was burnt out, and he dared to let a young doctor with no strength start using a knife on a patient.

Ganglion cysts are not a common condition.

It is prone to occur in the navicular bone, lunate bone, triangular bone, and skull, especially in the metaphysis of long bones.

The tumor in this female patient was on the palm side, which is quite rare.

Under normal circumstances, ganglion cysts in the carpal bones are mostly on the back of the hand.

The ligamentous anatomy of the dorsum of the wrist is not complicated, and the carpal bone is superficial, so the approach from the dorsal side of the wrist is the first choice.This patient had a special tumor location, so Professor Wu chose to approach from the palm side.

At this point, the volar joint capsule can be seen after retracting the neuromuscular tendon.

Locate the scaphol-yue gap, and then cut the joint capsule here, and the tumor in the shou-yue joint also revealed the true face of Lushan.

The cyst is small and the wall looks very thin.

What Li Jingsheng has to do now is to remove the cyst completely.

Although it is a technical task, in Li Jingsheng's view, it is not difficult.A proficient separation technique is completely sufficient.

Professor Wu may have suffered a setback in separation during the previous operation, and has already had a psychological shadow. He was worried that he would make a fool of himself in front of his doctors again, so he simply handed over this job to Li Jingsheng.

Without much effort, the cyst was successfully removed by Li Jingsheng.

Complete and complete.

Proficiency of sharp separation technique +1, HP +101.

Good guy, he was rewarded with 100 health points.

This one hundred life points should be the easiest time to earn.

It should be related to the intraosseous cyst he separated for the first time.

Earning so many life points all at once made him feel elated.Originally, only 59 points of life were left, but it rose to 160 in one fell swoop.

"Oh, it turns out that there are some transparent jelly liquids inside!"

An intern made a fuss and looked curiously at the cysts on the plate.

"It's not like you haven't had this kind of surgery before. Don't act like you haven't seen the world before, making people laugh."

Professor Wu gave him a dissatisfied look.

The intern was so frightened that he fell silent.

"Dr. Li, you have worked hard. You can watch and study the next steps of the operation!"

After Professor Wu took over, he took a miniature hand drill and began to polish the cyst wall.Until the fresh cancellous bone is exposed, the bone graft is filled inside.

This was the first time Li Jingsheng saw bone grafting.

Much simpler than imagined.

The whole operation process is not complicated.

He secretly kept the operation points of each step in his heart.However, this kind of memory is generally not long-term, and it will be forgotten or confused soon.

To really keep the deep memory of the doctor, you must do it yourself.

The teaching steps in large hospitals are basically to let novice doctors observe and learn first. After seeing it a few times, the superior doctors give some simple tasks for them to practice.Then gradually increase the difficulty of the task until the entire operation process and technical points are fully learned.

"Okay, Dr. Ruan, let's repair the cut ligament and joint capsule!"

After Professor Wu completed the high-risk steps in the operation, he left the finishing work to his doctors.

"no problem."

Ruan Xiaoqin had been waiting for a long time.

Immediately took over the finishing work.

Dr. Qin stared at the side with greedy eyes.After all, he is the number three person in the second group, and he will soon be promoted to the attending doctor. He can't accompany the two operations tonight, can he?
Always get some benefits!

"Professor Wu, can I suture the wound?"

Dr. Qin saw that Li Jingsheng was so excited, he was really anxious in his heart.

"Row!"

Professor Wu's only two generals must have been vigorously cultivated.

Dr. Qin, who successfully got a skin sewing job, was overjoyed.

Just wait for a while to perform well.

Ruan Xiaoqin has already started repairing the cut ligaments for patients.

I thought this sycophant had no real skills, but I didn't expect that Ruan Xiaoqin's suture level was quite good when he sutured the ligament for the patient.He used continuous sutures.

This suture method has many advantages, it can make the wound fit perfectly, and it has hemostatic effect.

The sewing speed is fast, saving stitches and time, and less knotting.

It also reduces foreign body irritation.

It is more commonly used in internal suturing.

I saw that Ruan Xiaoqin's movements were skillful, the suturing process was quite smooth, the sutures were neat, and the ligaments fit tightly.

This level has reached the proficient level.

You really can't underestimate anyone.

In the last operation, Professor Wu also said that Ruan Xiaoqin's suturing was a weak point, but now it seems, how weak is it?

It is clearly very strong!

However, there are many techniques for suturing, and it is also possible that Ruan Xiaoqin is good at continuous suturing.It's also possible that the interrupted sutures, other advanced suturing techniques, are rubbish.

After the ligament is sewn, tie a knot to fix it.

At this time, I saw Ruan Xiaoqin clumsily operating the tweezers, as if he was still biting his cheek.Even through the mask, you can see the swelling.

Could it be...he couldn't tie the knot?

In order to practice surgical skills, many doctors take toothpicks when eating, or use tweezers to pick up beans, or practice suturing with grapes and sausage.

Knotting should be a basic skill that is easier to practice.

Unlike sewing, sometimes in order to simulate the feel of human skin as much as possible, pigskin must be practiced.

If it's just a beginner's knot, you can practice with just a piece of cloth.

More advanced ones need to use props such as tofu and sponges.

Ruan Xiaoqin worked hard and finally tied a square knot.

It was this knot that ruined all his previous efforts.

Because the knot was not tied properly, the sutures became loose, and the ligament that had been sutured was torn apart again.

His face flushed, and the stitches were cut and re-stitched.

If he had worked out his slippery knot, he would not need to cut off the sewn thread at this moment.

Li Jingsheng's current knot-tying level is not very good, only proficient level, which is equivalent to the level of a senior resident doctor.

Unexpectedly, Ruan Xiaoqin was already the attending doctor, but the knot was still so unbearable.

Not to mention the proficient level, look at this clumsy appearance, I am afraid it is enough for the entry level.

Appropriate standard training level.

This is really a knot that ruins 'life'.

"Why don't you get a basin of water when you go home, put a sponge in the water, and then practice more knot-tying skills on the sponge?" Professor Wu scolded him in a tone of hatred.

"Practice is practice, but this hand is not very easy to control. I will practice hard when I get home."

Ruan Xiaoqin's face was dull after being laughed at by so many people.

Nodding, he re-sewed the ligament again, more carefully this time.

It's just that the technology is not at home, and it is of no great use to be careful.

Should screw up or will screw up.

"Let Dr. Li tie a knot for you! Otherwise, it will be messed up again later. This suture can't be so cheap."

Professor Wu's distress should not be the sutures, but the impatient waiting.

He looked up at the clock on the wall from time to time, obviously something urgent.

I was working overtime today, and it was almost nine o'clock in the evening after two surgeries.

This is a bit interesting, Professor Wu didn't go off in person but asked Li Jingsheng to help.

It's just that his suturing skills are not very good. After scolding the doctor under him later, he will make a joke in person. Where is his old face going?

Let Li Jingsheng save the game, at least he still has a way out.

Received a knot-tying job on the spot, but Li Jingsheng didn't refuse.

Instead, he silently upgraded Fang Jie from the proficient level to the proficient level, spending a total of 85 health points.

This time, with the proficient level of square knot technology, let alone ligament suture knotting, even blood vessel anastomosis knotting, he is completely competent.

"I'm not good at tying either, but I've been doing square knots with tweezers, and I've been practicing for a while. If you mess up, just don't blame me."

Those who should be humble have to be humble.

Li Jingsheng said politely, and after taking it with his hands, he helped Dr. Ruan finish the final knot.

His square knot is now at the proficient level, not very good, but it is obviously more than one level higher than Dr. Ruan's.

It's easy to type, and it takes less than a second.

Moreover, the knot is very firm and fits closely on the surface of the ligament.

In the eyes of this group of doctors with poor surgical skills, the square knot he tied is already perfect.

"Square knot proficiency +1, health +101."

Looking at the soaring HP on the attribute panel, he just felt like a big pie fell from the sky.

After thinking about it for a while, I understood what was going on.

Tying this square knot can only get 1 point of health, but it is the first time for him to repair the ligament.

Probably this one gave him the 100 health bonus.

He had just spent 85 points of health, and only 75 were left at the end of the book, and now it has risen back to 176 in an instant.

The operating room is simply his paradise, and earning life points in it is like picking up money.

There is no easiest, only easier.

Separating an intraosseous cyst earned 101, but now tying a knot in the ligament also earned 101.

Isn't this picking up life points?
Moreover, several of his surgical skills have been upgraded to the proficient level without knowing it.

This progress is faster than riding a rocket.

As his surgical skills reach more and more proficient levels, the jobs he can earn will continue to increase.At that time, the speed of earning life points may be further accelerated.

This is completely a virtuous circle!

I used to think that the speed of earning life points in the manual reset clinic was exaggerated enough, but I didn't expect it to be even more exaggerated when I entered the operating room.

It's a big win tonight.

"Well, Dr. Li's knot-tying technique is really good. You all have to learn from him."

Professor Wu's knot-tying level is average, and he can't say too advanced content if he wants to comment.

Where is the knot?

What details are well done?
These, he couldn't say one, two, three at all.

As a leader, you don't need to know everything in detail, just a good word can sum it up.

"Doctor Ruan, don't be dazed, continue. Hurry up and finish the operation."

Professor Wu urged.

Ruan Xiaoqin speeded up.

After the joint capsule is cut, some do not need to be repaired.

Especially the hip capsule.

At present, even in the top tertiary hospitals, patients are basically not sutured and repaired after undergoing hip capsulotomy.

Ruan Xiaoqin is not good at knotting, but there are only two kinds of stitching skills: intermittent stitching and continuous stitching.

This is just Li Jingsheng's preliminary understanding of him.

After repairing the incised ligaments and joint capsules, all that remains is to suture the cortex.

Doctor Qin has been following this job for 800 years.

At this moment, he took it without mercy.

Ruan Xiaoqin happily gave up his position.After all, suturing is not his strong point. Let Dr. Qin do it, and he can avoid making a fool of himself.

Although doctors like to rob practice opportunities, it does not mean that they rob all practice opportunities.

When encountering something that you are not good at, you will instinctively develop your strengths and avoid weaknesses.

"Xiao Qin, what kind of suture are you going to do?"

Professor Wu raised his eyes and looked at the clock when he asked the question.

"Can interrupted sutures be used?"

Doctor Qin replied.

"Interrupted sutures work, but are too slow."

Professor Wu gave a veto.

The wound was sutured, which is located on the palm side, which is not a good angle for suturing.

Using intermittent sutures, with Qin Fei's suture level, it would be considered a high incense if he could suture it in half an hour.

"Then... can you suture continuously? This is fast."

"Certainly not. If the palm is sutured with this method, the wound will not be stable, and it will easily form unsightly scars. The patient is so young and female, so it's okay to give us a bad review."

Professor Wu vetoed it again.

"Then I'm afraid the only thing left is intradermal suture. But my technique is not very good, and I'm a little worried about messing up." Dr. Qin thinks that his suture ability is relatively strong, at least compared with the interns and residents present. It's the best.

It's just that intradermal suture is difficult to learn and improve. Although he has been practicing very hard, his level is still not good.

Seeing that Dr. Qin was not up to the task of suturing, and neither was Dr. Ruan, Professor Wu suddenly felt that there was no one under his command.

Thinking of Li Jingsheng's stitching performance is very good.

The square knot tied just now is even more eye-catching, a proper master level.

"Doctor Li, how is your intradermal suture technique?"

If Li Jingsheng is not good enough, I am afraid that Professor Wu can only end up "showing his ugly face".

At that time, Professor Wu will show everyone the intradermal suture technique of his three-legged cat.

"My intradermal suture technique is not excellent, but it should be no problem to deal with this wound."

Li Jingsheng replied confidently.

"It's up to you, hurry up and sew up the patient, and then everyone should get off work early."

Professor Wu ordered troops on the spot, and once again arrested Li Jingsheng to be used as a capable general in the group.

He was thinking in his heart that the next time he had an operation, as long as there was a chance, it would be best to call the kid surnamed Li.At that time, it will be a free 'handy helper'.

"Doctor Qin, I'm really sorry, I'm afraid you will have to find a chance to exercise next time."

Li Jingsheng said with a smile.

"Hmph, don't be complacent, isn't it just intradermal sutures? I'll practice hard for a while, and I'm sure I can surpass you."

Dr. Qin's family is rich, so he can buy a lot of pigskin and squander it.

But he seems to have forgotten one thing.

He is currently working as the general hospitalization, so he probably doesn't have much time to go home.There is even less time available to practice surgery.

Li Jingsheng didn't play tricks with him, and spoke directly with his strength.

After taking over, a certain degree of simple debridement is first performed on the patient's wound.

His body surface debridement has reached the proficient level, and some trimming of the patient's wound can make the suture effect better.

Professor Wu watched from the side, with a slight fever on his face.

The incision was made by him, not to mention great, at least at a qualified level.

But Li Jingsheng's wound after debridement was obviously more beautiful and tidy.

The level is not good, but there is still some vision.

"Give me the electric coagulation knife."

Li Jingsheng saw that a capillary was broken during the debridement process and was bleeding out.

Just in time, take this opportunity to practice electrocoagulation to stop bleeding.

With the previous display of skills, no one doubts his surgical skills.

Ruan Xiaoqin handed him the electric coagulation knife very naturally.

After receiving it, burn it down against the bleeding site.

laugh!
White smoke came out.

The strike is a bit heavy, and the strength, angle, and position are not well grasped.

The bleeding has stopped.

When Ruan Xiaoqin saw that his electrocoagulation hemostasis level was so rubbish, a smile appeared in his eyes.

People are like this. When they see a particularly good opponent, they will always try to find some flaws in the opponent and regain some psychological balance.

Professor Wu's eyes flickered, but he didn't say anything.

Nobody is perfect.

It is normal for Li Jingsheng to have one or two surgical shortcomings at such a young age.

Doctor Qin, on the other hand, smiled, feeling relieved for a while.He likes to see Li Jingsheng deflated most.

"Dr. Li's electrocoagulation hemostasis still needs to be practiced! Fortunately, it is a superficial capillary. If it is a chest and abdominal organ, it will cause an accident if you do it like this."

Doctor Qin did not miss this opportunity to attack his rival.

Speaking directly and publicly is tantamount to pouring a pot of manure down Li Jingsheng's head.

Li Jingsheng has used electrocoagulation before, but he has never practiced it on patients.

No superior doctor dared to let him do it.

At this moment, he tried it. Although his performance was not good, he gained a lot.

Trying to check the properties panel, a smile appeared in his eyes.

It only takes one time to let the electrocoagulation stop bleeding reach the entry level. Apart from him, I am afraid that there is no other person.

At first, I thought, this time I have some money, buy an electrocoagulation knife and go back to the clinic, and then buy white mice and rabbits to go back to the clinic to practice techniques such as electrocoagulation for hemostasis and vascular anastomosis.

It seems that there is no need to be so troublesome.

Now electrocoagulation hemostasis has reached the entry level, even if you just come in by groping, that's enough.

Being able to learn electrocoagulation to stop bleeding so quickly may have something to do with the fact that he has already mastered two hemostasis skills, and has systematically studied electrocoagulation and hemostasis knowledge and operating points before that.

No nonsense, decisively spend 100 health points to directly upgrade electrocoagulation hemostasis from beginner to proficient level.

It is equivalent to the level of electrocoagulation and hemostasis directly rising from the level of junior residents to the level of junior attending physicians in an instant.

This level is already quite powerful.

Many weaker deputy chief physicians may have this level of operation.

(End of this chapter)