Gou is practicing medicine in the clinic

Chapter 317 Just a random knot, does the tumor have to be removed?
"It seems that Director Ru's most profitable job now is not her job as a doctor, but the wood carvings she carves. I heard that the cheapest one sells for 1199 yuan. I really doubt that one day she will make enough money to stop being a doctor and just change careers. Become a carver."

"You don't understand this! If she wasn't a doctor, no one would buy a wooden sculpture for 100 yuan. I've seen the instructions she posted online. It can be pre-ordered. It's a limited edition and has her autograph. It's for sale. In fact, it’s just a gimmick, at least if I have to spend that much money to buy a wood carving, I definitely won’t do it.”

……

When several doctors mentioned Director Ru Qingqing, they started a heated discussion.

"Xiao Li, I will do the next operation! I will ask you to take over when there is a training opportunity."

Director Zhang said to Li Jingsheng.

The next step is to dissect the lung hilum, which is difficult and risky and requires an experienced doctor.

No matter how much Director Zhang trusted Li Jingsheng, he would not dare to give him such an important job rashly.

Although other doctors were talking about Director Ru, their attention was focused on the patient's wound site.

When the atmosphere in the operating room is relaxed, the surgeon does not like to curse, and everyone is basically in this state.

We can talk about everything.

It is this that can enhance understanding among team members.

But when the patient develops a condition or the operation does not go smoothly, everyone is in a different state.

Everyone worked together to help the surgeon complete the operation.

Rescue when it's time to rescue.

When a serious situation occurs, the surgeon will definitely be in a bad mood.

The wisest thing to do at this time is to reduce the sense of presence.

Li Jingsheng stood aside and carefully watched Director Zhang dissect the patient's lung hilum. He had too much to learn.

When Director Zhang dissected the hilum of the lung, he did not cut the knife very quickly, but he was very steady.

Cardiovascular surgeons, especially those who perform surgeries, basically have this habit.

Seek stability.

Because cardiothoracic surgery includes heart surgery, sometimes just a shake of the hand or a slightly poor control of the force can rupture the aorta.

There is no need to talk about mitral valve and tricuspid valve repair surgery.

They must strive for excellence to ensure the success of the surgery.

"Xiao Li, this is the pericardium. You must not cross the boundary during the operation. I once had a student who caused cardiac arrest during a lung lobe surgery. Your incision has reached a very high level, which is equivalent to having I have a very good foundation. What I am lacking now is surgical experience. If you have time in the future, you can come and follow me more. As long as you are willing to develop in this area, I will try my best to teach you and give you opportunities to practice."

Director Zhang guided Li Jingsheng during the operation.

"Our Director Zhang is very partial to you! The training opportunity for today's surgery must have been given to several other doctors, but it was given to you first."

The equipment nurse is quite young and very beautiful.

Of course, she is now wearing a mask and a dust cap, revealing only her smooth forehead, eyebrows, and eyes.

Whether a woman is beautiful or not can be inferred just by looking at her facial features.

"Thank you, Director Zhang, and all the teachers for letting me go. I'm usually busy in the clinic and don't have time to come here to study. I feel very happy to be able to be let go by you as soon as I come here."

Li Jingsheng also tactfully reminded everyone that he would not come here every day to grab training opportunities.

At most, I only come here to grab it once in a while.

When it comes to interests, no one is easy to talk to.They can more or less accept it once in a while.

"Doctor Li, you don't have to be so polite. I think it's good to be able to operate on the same stage as an outstanding young doctor like you."

"Yes, yes, what Dr. He said is what I want to say. Welcome Dr. Li to the Cardiothoracic Surgery Department as a guest."

First and third assistants expressed their welcome.

The second assistant said nothing.

"Xiao Li, when dealing with the tip of the upper lobe and the anterior segment artery, you must first pull the upper lobe backward and downward. Doctor Tang, let Xiao Li temporarily take over your second assistant job,"

"Okay! Come on, it's easier to operate in this position."

Doctor Tang nodded kindly to Li Jingsheng.

It turns out that this boring doctor’s surname is Tang.

His voice is a little soft when he speaks, and he likes to be concise and to the point.

After Li Jingsheng took over, the work of exposing the field of vision and pulling the tissue that needed to be cut was left to him.

"Xiao Li, ligate this front artery!"

"Temporary sterilization?"

"Correct!"

Director Zhang confirmed.

Li Jingsheng gritted his teeth and directly promoted Sliding Knot from a minor achievement to a Dacheng.

After reaching this level, ligating this more important blood vessel can not only reduce damage, but also ensure that the slippery knot will not be suddenly opened.

Blood vessels are not only highly elastic, but also generate strong impulses as the heart contracts and relaxes.

Slip knots come loose very easily.

Especially if the knotting technique is not good, it is more likely to bleed, loosen or fall off.

With Dacheng-level slip knotting skills, Li Jingsheng easily tied two slip knots.

When operating, the movements are light and dexterous. Even if it is operated with tweezers, it is more flexible than a girl's hand.The location of the ligation chosen and the tightness of the ligation were impeccable.

"Young man's knot-tying skills aren't bad either! You can do that!"

Director Zhang couldn't help but look at him twice.

Knot tying may seem like a minor surgical operation, but it is often prone to various problems.

Especially for knots in some special parts, it is even more difficult to see the big difference in the small, and the requirements for the doctor's operation are frighteningly high.

Sometimes, if you sew some severely adhesions in the lumen, brain tissue, liver lobes, etc., you really need to use a little more force, but it will cause the sutured tissue to be broken directly.

Some people may not believe it, but when some surgeons practice knotting, they will put a piece of foam on the water and then practice knotting on the foam.

There are even more perverted ones, which require knotting on the tender tofu puffs.

The knot needs to be strong and tightly attached to the surface of the tofu.

In actual clinical operations, the difficulty will only be higher.Because sometimes it is necessary to complete the knotting deep in the thoracoabdominal and cranial cavities, the operating space is extremely cramped.The field of view may even be blocked and nothing can be seen.

As you can imagine, this level of difficulty is absolutely hellish.

But after successfully suturing this tissue as delicate as a bean curd, it is very likely that a life can be saved. This is the value and significance of a doctor.

Li Jingsheng's method of tying two sliding knots is also practiced by many more advanced surgeons.

But not many surgeons can tie knots that well.

His current knot-tying skills are not particularly good.

In the future, if you reach proficiency or even a higher level, you will have great potential.

The operation continues.

Director Zhang worked slowly and finally exposed the tumor.

"You all come and take a look at this tumor, mainly observe its location and shape, and then make a preliminary judgment on its nature and whether it has lymphatic metastasis or other metastases. I will also think carefully about the surgical plan to remove it. .”

The doctors came forward one by one to observe.

Li Jingsheng has seen a small number of tumors, both malignant and benign.

Generally, malignant tumors have distinctive features.

Just like some bad people, you can tell just by looking at their appearance.He looks fierce and evil.

"When resecting any lesion, you must consider multiple aspects and cannot blindly pursue a clean cut. If it is a benign tumor, some will not grow in size, or will not affect the patient's physical function, then you do not need to perform resection. If If it is malignant, or the possibility of malignant transformation is suspected, it is best to do an intraoperative pathology and then decide how to resect it.

Not all tumors suspected of being malignant require extended resection.

We have encountered a very special case before. The patient had a tumor in his lungs, but the nature could not be determined.After pathological biopsy, it can only be preliminarily concluded that the possibility of malignancy is high.After discussion, half of the patient's lung was finally removed.

Later, the patient recovered well after the operation, but developed sequelae such as wheezing and feeling depressed.

His life and work have been greatly affected.

He was originally engaged in manual labor, but after cutting off his right lung, he was no longer able to do heavy manual labor.Even climbing a hill or going up a few flights of stairs can make you out of breath.He lost his job, the family's finances were in trouble, and the quarrels with his wife became more and more frequent. Finally, his wife couldn't stand that kind of life and ran away.

The patient felt that he had no hope of life. Finally, when he was waiting for the bus on the roadside, he saw a large truck passing by. He rushed over and lay down in front of the wheel.Being crushed alive to death.

After receiving this news during a return visit, it caused us to reflect.

From the perspective of surgical treatment, we helped him completely remove his right lung to avoid the recurrence of malignant tumors.This was a successful operation.

However, after cutting off the right lung, the patient suffered major problems in his work and life, and finally chose to commit suicide.From this point of view, our operation was another failure.

To this end, a special discussion was held. If the right lung was not cut off, but only a small part was cut off, and most of the patient's respiratory function was retained, would this tragedy not have happened? "

When Director Zhang teaches his doctors, he doesn't just tell them rigidly what to do.

Instead, I will cite some real cases that have happened, so that everyone can think and understand from them.

I believe that the doctors trained in this way will be a group of doctors of flesh and blood.

Before surgery, the patient’s life after surgery will be considered.

Li Jingsheng and Director Zhang usually don't have much contact, but this time it was a deeper contact.

I couldn't help but feel a sense of admiration in my heart.

"Lymph is sometimes infiltrated by tumor cells. If it is not serious, it cannot be seen with the naked eye. It may not be found by performing an intraoperative pathological biopsy. This requires the surgeon to have a lot of experience. Whether metastasis occurs, Sometimes it is also a good idea to check the peripheral blood vessels..."

Director Zhang shared some of his surgical experience.

Teach you how to determine whether tumor cells have spread and metastasized.

In clinical medicine, the most commonly used method is to look at the size of the tumor.And explore surrounding blood vessels, lymph, and other tissues prone to tumors.

It may take five or even more than ten years for a malignant tumor to take root and grow.

This is a very long cancer process.

Many patients go to the hospital for examination and find tumors, but they are very small.

After comprehensive judgment, the doctor told the patient not to be nervous and only need to go to the hospital for a review every six months to observe whether it has grown.

Patients will feel particularly incomprehensible.

The tumor has obviously been found, why not perform surgery to remove it?
Do we have to raise tigers to cause trouble and wait until they grow up before cutting them?

What if it gets transferred?
　I wish all readers a Happy Mid-Autumn Festival in advance!Spend more time with your family, and single men can take the initiative!If you chase more, you will get it.

　　
　
(End of this chapter)