Gou is practicing medicine in the clinic

Chapter 229 Difficult Separation, Heart-warming Moment

Surgical skills are really one step at a time.

Each level has different abilities.

The entry-level incision method is terrifying.In fact, I dare not use it on patients at all, unless I am very courageous and don't take human life seriously.

The incision at the proficient level can be stronger, and it can be incisions on some non-critical parts such as limbs, but the incisions are uneven, and the margins of the incisions are hard to describe.

Sometimes it is not done well, and it is easy to cut a wavy wound.

Because it is dissected layer by layer, the incision of the first layer is not cut well, which will definitely affect the incision below.

And suturing requires debridement to suture.

Otherwise the patient's wound may heal poorly.

"Not bad, not bad, the cut is really beautiful! There is nothing to say about bleeding control, don't stand still for the hook, hurry up and work."

Director Hua is very satisfied with Li Jingsheng's performance.

The second assistant and the third assistant have cleverly opened the opening with the flat hook, exposing the spinous process of the lumbar spine.

At this time, you can see that there are many muscle groups on both sides of the spinous process.

Including spinous dorsi, multifidus, interspinous muscles, etc.

Therefore, it makes sense that everyone likes to eat tenderloin when buying pork.The lean meat in this part is very rich and the meat quality is also very good.

"Jingsheng, the myofascia needs to be incised along both sides of the spinous process below. The venous plexus below is extremely rich, so be careful."

Director Hua still asked Li Jingsheng to continue the operation.

"Ok!"

Li Jingsheng secretly rejoiced that he upgraded the incision method to Dacheng just now, otherwise he would easily miss in the face of abundant venous plexus.

It is difficult to stop bleeding at this part, and it is troublesome to cut the blood vessel.

Now, he is completely like a senior deputy chief physician who has experienced many battles, cutting open the myofascia next to the spinous process little by little.

The whole process is done with care.

During the separation, his scalpel was always close to the bone surface for subperiosteal dissection.

By the time everything was done, the patient's vertebrae could be clearly seen.

Some sweat broke out on his forehead.

Although the itinerant nurse was a bit fierce, she had sharp eyes and came over to help him wipe his sweat.

Didn't even need a hello.

He felt that his separation technique seemed to have improved a lot.

Take the time to check the properties.

Sharp traditional scalpel separation proficiency 375/500.

This rate of proficiency improvement is simply terrifying.

It felt like a single blow would at least add five points to his proficiency.

However, the nervousness of walking on thin ice, and the feeling of combining the incision and separation techniques together, gave Li Jingsheng a new understanding of these two surgical skills.

He glanced at the life value by the way, and was also pleasantly surprised, it had increased by more than 200.

Two hundred of them must be prizes.

Surgery continues.

The next task will be more difficult, requiring separation of the muscles surrounding the spinous process.

It is even more difficult than cutting myofascia.

Moreover, because this patient has undergone surgery, there is a tough tendon attachment, which makes it more difficult.

"Bone knife!"

Seeing that Director Hua didn't stop him, Li Jingsheng was ready to challenge again.

In fact, with the Dacheng-level incision method, there is no problem in cutting this piece.It's just that the sharp separation method is a little behind, and the proficiency level is still a little weaker.

It's okay to deal with ordinary surgical separation tasks, but it's quite risky to deal with this kind of high difficulty.

He carefully incised with a bone knife and peeled off each spinous process one by one.

As soon as the knife went down, blood came out.

"Did I get into trouble?"

Li Jingsheng looked up at Director Hua with a guilty conscience.

When it was separated just now, it was obvious that the attached tendon was very tough.If you only use a little force, you can't separate it at all.

So he increased his strength.

The result is the current situation.

Through the feedback of the knife feeling of the bone knife, he could feel that a blood vessel was broken.

"Don't panic, it's the result of whoever is doing the operation. You have almost no experience in this field, and it's normal to bleed a little."

Director Hua comforted Li Jingsheng, and personally stepped forward to help Simple stop the bleeding.

"Go on! After you peel off everything, it's convenient to use gauze to stop the bleeding."

Li Jingsheng was relieved by Director Hua, and immediately operated on the patient again.

The mood is still somewhat affected.

But his progress is also very obvious.

In order to avoid getting into trouble again, he quietly upgraded the sharp separation method from proficiency to Dacheng level.

It took more than 700 life points, and the life points accumulated with great difficulty were used up to only 200 points left.

His life balance seems to rarely exceed [-] for a long time.

will be used every time.

I have to admit that after the sharp separation method is improved, the whole peeling process is much smoother.

For some parts that are difficult to peel off, he can feel a lot easier when operating.

The control of strength, depth, and chirality has all been improved by leaps and bounds.

After peeling off all five spinous processes, he breathed a sigh of relief.

I have never experienced such a difficult surgical procedure.

Fortunately, fortunately, except for breaking the blood vessel when separating the tough tendon attachment, the bleeding behind was very small.

"Jingsheng, you have worked hard! Your performance is very good, especially after the patient's blood vessels between the spinous process and the lamina have a large hemorrhage, you can quickly keep calm from the panic and complete the follow-up operation tasks calmly. This is very good. I believe It is also a very good tempering and improvement for your xinxing."

Director Hua highly affirmed his surgical performance.

When young doctors go to the operating table, it is only one aspect that they are not skilled. The exercise of mind is also very important.

Don't panic when things happen, you need to deal with them calmly.

"Next, carefully watch my hemostasis steps. Use gauze to fill the gap between the muscle and the bone surface. It must be tightly packed, otherwise the hemostatic effect will not be achieved at all."

As Director Hua stuffed the gauze in forcefully, the bleeding really stopped quickly.

This principle is actually oppression to stop bleeding.

Li Jingsheng has already mastered the compression and hemostasis, but the level is not high.

Standing by the side to study at this moment has a lot of gains.

"Director Hu, come and bite off the spines!"

For some surgical procedures that are too risky and difficult for novice doctors to master, Director Hua will not easily let his doctors take risks.

Because some surgical steps have opportunities for trial and error, and some do not.

As long as it is broken, it will be an operation accident immediately, and there is no room for recovery.

For the laminectomy after the spinous process was bitten off, Li Jingsheng also let Li Jingsheng study beside him, and gave some detailed guidance and explanations.

Those who can participate in this operation are all excellent orthopedic surgeons.

It can be regarded as integrating the cutting-edge strength of orthopedic surgery.

However, it is limited to the two levels of deputy director and attending.

As for the resident doctor, Li Jingsheng is the only one who can be on stage.

Other senior residents can only observe and study under the operating table.

……

It was already past 40:[-] in the evening when the operation was over.

What Li Jingsheng gained from this operation was beyond imagination, especially the epidural exploration and intradural exploration after laminectomy, which gave him a deeper understanding of the vertebrae.

A lot of practical knowledge cannot be learned in books.

Because the understanding of words is definitely not as clear as seeing, touching, or even participating.

Human language has evolved for at least thousands of years, but there are still many things that cannot be fully expressed by language.

Actual combat by precept and deed is the best way to improve surgical skills.

In this operation, he got a very important suture opportunity.

After the laminectomy, the dura mater was also cut.

After the operation, the dura needed to be sutured, and Li Jingsheng managed to get it.

A running suture is used.

Because he earned a lot of life points during the operation, after getting this suture task, he directly upgraded the continuous suture to the Xiaocheng level without even thinking about it.

As a result, when he finished stitching, he unexpectedly received a reward of 500 health points.

Although the highest life reward he ever received was [-].But he still felt very excited and happy to get the [-] life point reward.

There are too many medical skills to improve.

Such as square knots, surgical knots, and slippery knots. Now their level can't keep up with the surgical tasks that Li Jingsheng can get.

There are only two things he has to do now, make money desperately, earn life points, and upgrade his medical skills.

Strive to practice surgical techniques as soon as possible.

"Jingsheng, I see that your suturing skills are quite good. There will be another operation at 07:30, which requires anastomosis of tendons, blood vessels, and nerves. Will you participate?"

Director Hua loves talent very much. Seeing Li Jingsheng's outstanding performance, he can't help but want to train him more.

"Okay! I'll go eat first, go to the toilet, and come to the operating room to find you later."

Li Jingsheng readily agreed.

Anastomosis is an advanced surgical technique that he has long wanted to master.

But the previous suturing and knotting were very poor, even the cortex could not be sutured well, and the anastomosis was even more unnecessary.

The conditions now appear to be ripe.

Besides, I earned 500 points of health reward just now, and I can upgrade the corresponding sewing skills or knotting skills if necessary.

Estimated to upgrade knotting skills.

In addition to the high requirements for suture, anastomosis also has strict requirements for knotting technology.

For example, the anastomosis of blood vessels, because the knot is not firm, directly leads to internal bleeding after blood drainage, or thrombosis, which can easily lead to the death of the patient.

Therefore, superb knotting technique is very important.

He has mastered the square knot, slip knot, and surgical knot so far, which is enough.

The only thing needed is to upgrade their skill proficiency.Only proficient or mastery-level knotting skills are still a little weaker.

"The operation is not performed here. It is in the Laminar Flow Operating Room No. [-] of the General Surgery Department. This is a joint operation of two departments. It should be very good for you to gain knowledge and gain anastomotic training opportunities along the way."

When many patients in the operating room undergo surgery, they need to invite doctors from the orthopedic surgery department to perform combined operations.

For example, to open the chest, the orthopedic surgeon is invited to saw the sternum or ribs.

Director Hua also saw that Li Jingsheng showed strong surgical skills, so he took him there to gain knowledge.

Otherwise, I would not dare to take it easily.

Otherwise, it is easy to be laughed at by doctors in other departments.

General surgery can be regarded as a universal department in the surgical room.

It basically cuts open the abdomen, connects severed limbs, cuts tumors... everything can be done.

Including anal surgery is also a sub-department under general surgery.

In fact, in many smaller hospitals, hemorrhoid cutting and anal fissure repair are all done directly by the general surgery department.There are no subdivisions.

After Li Jingsheng came out of the operating room, he finally had a chance to look at his phone.

He was a little worried that Ou Qinglan would work with him.

But she should know that Li Jingsheng was in the operating room for surgery, because she was in the office when Hu Jia invited Li Jingsheng.

Taking out her phone, Ou Qinglan sent him a message.

"Waiting for you in the hospital cafeteria."

His heart warmed up.

Immediately while calling her, he walked quickly to the hospital cafeteria.

It's a little late now, and the cafeteria is probably about to close.

"Under surgery?"

Her soft voice came over.

"Well, just out of the operating room. Where are you?"

"I'll be waiting for you in the cafeteria! I asked the auntie in the cafeteria to make your favorite fried pork. It's still hot in a box. Come here quickly."

"it is good!"

After Li Jingsheng hung up the phone, his heart was touched and warm.

It's great to have a girlfriend.

In terms of caring and consideration, Ou Qinglan is really impeccable.Li Jingsheng had never experienced this feeling with his ex-girlfriend.

Maybe every woman is different.

In contrast, Ou Qinglan is very selfless towards love, she only has Li Jingsheng in her heart and eyes.

But the ex-girlfriend seemed a lot more selfish, basically Li Jingsheng cared about her and loved her.

This also made Li Jingsheng willing to take care of this love with his life.

He rushed all the way to the cafeteria, and when he saw Ou Qinglan, he couldn't tell what it was like.

Anyway, it's very warm.

There was no one in the cafeteria, Ou Qinglan was sitting there playing with her mobile phone.

"Qing Lan!"

"Our Dr. Li is finally off work! I'll go get you the food. If it hadn't been packed and put there in advance, it would have been snatched away by others."

Ou Qinglan smiled and stood up, walking towards the window.

"Auntie, please give me my meal."

The aunt who was cooking took it out of the insulated cabinet and handed it to her.

Then he glanced at Li Jingsheng.

"Boy, your girlfriend really cares about you. She only ate two vegetarian dishes, but she made you so many fried pork and cucumber ham sausage. She also specially asked me to put it in the warmer, worried that it would be cold When you meet such a girl, you should cherish it, and don't hurt her heart."

The aunt who was cooking rice said to Li Jingsheng with a smile.

"Okay, I will cherish it."

Li Jingsheng couldn't tell what it was like, but he really wanted to hug her tightly and make time last forever.

This silly girl.

　I'm 2 minutes late, sorry.

　　
　
(End of this chapter)