Come on, Dr. Wu

Chapter 239 Conjoined Infants

Simulated operating room!

On a weekend, all eighteen people had time. Under the leadership of Wu Xiaofu, everyone opened the simulated operating room directly with full curiosity.

Not to mention, it was Wu Xiaofu's first time here, and few others had been here before.

"This place was the same as the last time I came here."

Jia Mingjun, the chief physician of the nail and breast surgery department, said that he was thirty-four this year and it was the last time he participated in the national surgery competition. In fact, it was not only the last time, but also the first time.

"Didn't you say it was your first time to participate?"

"This is my first time to participate in the National Surgery Competition, but I have participated in the Donghai Surgery Competition before. About four years ago, our Donghai organization held the Donghai Surgery Competition. I was lucky enough to participate once. At that time The competition venue is here.

By the way, Dai Yu also participated. "

As he spoke, Jia Mingjun also looked at another female doctor in the nail and breast surgery department, Mao Daiyu. The youngest of the six people in the nail and breast surgery department this time was only thirty years old. Four years ago, he was twenty-six years old. I participated in the Donghai Surgery Competition, and it seemed that I was very talented at that time.

No wonder the doctors in the nail and breast surgery department all say that Mao Daiyu is their seed player.

"I'm participating too."

The speaker was Fan Xin, a doctor from the Department of Hepatobiliary Surgery. He is a genius in area A. He is thirty-two years old. I heard that he will be appointed as deputy chief physician this year. He is proficient in liver cancer resection surgery. Well, he is still a student of Wen Xinhan, and he is a key training target. .

"That's great. Since you've all been here before, it's easy. Come on, let's see how it's done. It's my first time to see this kind of thing. You guys can help those of us who have never been here get familiar with it. "

The simulated operating room is actually three rooms. Each room contains an operating bed with complete tools. The most important thing is the surgical model. For any operation you want to do, you must choose the corresponding surgical model and place it on the operating bed.

The most important thing is this surgical model. It simulates a real person. After being connected to the monitor, its entire body characteristics are the same as those of a normal person. If something goes wrong during the operation, the model will suffer from bleeding, cardiac arrest, electrolyte loss, etc. Disorders and other reasons can lead to patient death and surgical failure.

When performing surgery on a model, apart from not being able to communicate with the patient, everything else is basically very real, just like normal surgery. Of course, during normal surgery, they rarely communicate with the patient during the surgery.

A team member asked Wu Xiaofu before if he was competing against real people.

Wu Xiaofu quickly shook his head. Of course, it cannot be done on real people. If problems arise, it is absolutely against ethics. Patients are never tools for doctors to compete. If patients have problems because of competitions, they cannot afford it.

If someone exaggerates it again, they can be drowned by spittle and stars.

"Okay, let's get acquainted."

It was also the first time for Wu Xiaofu to perform surgery on a model, and he was very curious.

Fan Xin placed a model on the operating table. After the preparations were complete, Changsheng stood in the position of the chief surgeon, and Fan Xin took the initiative to stand in the position of the assistant. The others did not rush to start practicing, but Stand and watch.

Wu Xiaofu was not in a hurry to start. His eyes fell on the machine opposite the operating table. The magic of this model was not just that. On this model, there were countless sensing devices that Wu Xiaofu could not count, which were remotely connected to the opposite side. On the machine within sight.

After Wu Xiaofu starts, the machine will automatically time.

Time is a necessary criterion for surgery. Whether it is anesthesia or surgery, there is a tolerance limit of the human body. Just like a laparoscopic cholecystectomy, time is a very important item, usually two At the end of the hour, if you can advance early, you can get extra points. If you are accidentally late, you can only lose points.

Well, if you are really unskilled and just do it for five hours or something, then there is no need to compare, people may have problems.

For example, in the National Surgery Competition, the scores at various stages are broken down.

For example, there are detailed rules such as how long a hole punch cannot last, how long a gallbladder removal cannot last, etc.

Moreover, various important nerve and blood vessels in the standard model body have sensing devices.

If a blood vessel or nerve is accidentally cut off, the machine will have a corresponding alarm device. Points will be deducted for sure, and a timer will also start. If you cannot anastomose it in time, such as a blood vessel, after a certain period of time, the bleeding will be too much. Many, patients died and operations failed.

Nerves, how long the anastomosis is not performed, loses vitality, and leaves subsequent sequelae will also be taken into account.

Therefore, although it is just a competition and only models are used, the strict standards are no worse than actual actual combat, or even stricter than actual combat. After all, the human body is a highly adaptable individual.

During normal operations, some small blood vessels, nerves, and ligaments are cut off and left alone, and the deformity will recover or automatically degenerate, which will not affect your health. But with machine standards, it will be different. The slightest problem will affect you. Ratings and rankings.

"Captain, whatever surgery you want to choose, I'll give you some."

"Then let's remove the liver cancer."

When Mao Daiyu heard this, he gave a thumbs up. This was Wu Xiaofu's first time using a simulated operating room. He chose a high level of difficulty. His confidence was really scary. You know, this was Wu Xiaofu's first time as captain. I'm using a model to perform surgery in front of me, just in case something goes wrong.

It greatly affects your prestige, and can easily lead to loss of face.

However, they also knew about Wu Xiaofu's strength. Now that Wu Xiaofu had said it, they wanted to see Wu Xiaofu show off his skills for them.

"Okay, let's start with liver cancer resection. Carcinoma in situ in the right lobe of the liver. The diameter of the tumor is 7cm."

When Wu Xiaofu saw Mao Daiyu click to start, he stopped delaying.

After drilling, the pneumoperitoneum operation is all done by machine. The pneumoperitoneum is performed automatically, and Mao Daiyu can do it on your behalf.

The mirror enters the abdominal cavity. Not to mention, the view inside the abdominal cavity is really similar to that under normal circumstances. Even the colors of blood vessels, tissues, ligaments, nerves, and fat are the same.

However, in Wu Xiaofu's view, the model is simpler after all.

Because under normal circumstances, patients will have severe adhesions in the abdominal cavity, especially around the lesions, which will cause great obstacles whether it is freed or surgically removed.

But the model is much more layered.

After Wu Xiaofu was used to dissociating those adhesion tissues, doing so now was really like playing tricks.

"The standard operation time is five hours. How long do you think the captain can complete it?"

"Fortunately, this standard time is not customized according to the captain's standards. Otherwise, we would be in a miserable situation. You know, the captain's past record, the operation time for liver cancer resection never exceeds three hours."

"Wrong, the latest data, there is no more than two hours."

"What about this one?"

"I'll bet two hours."

"I bet for an hour and a half."

"I think the model is simpler. Can the operation be completed within an hour?"

Within an hour?
Everyone hurriedly shook their heads. No matter how fast it was, it couldn't be within an hour. It was too outrageous.

"Although the model looks simpler, it is the first time for the captain to operate it, so he may be a little unfamiliar."

"Does he look unfamiliar to you?"

Everyone looked at Wu Xiaofu's operation. Well, to say it was unfamiliar seemed a bit too much. The speed and proficiency of this operation didn't seem like it was his first time doing it.

"Captain, is this really your first time using this simulated operating room?"

Wu Xiaofu was not so involved this time. After all, he was a model, so Wu Xiaofu was still very relaxed.

"I wanted to use it before, but as you know, I used to study in the North District, and we didn't have a simulated operating room of this size."

Everyone also nodded, yes, some of them were not from top medical universities, so they naturally understood the conditions of ordinary medical universities.

"Forget it, time is definitely the captain's main point-earning item. I estimate that the boss's score must be the most in this item. Let's talk about the score. The full score is 100 points. I estimate that the captain must be in the 90s no matter what. above."

"Well, it's possible to score more than ninety-five points. With the captain's ability, it's probably very difficult to deduct more than five points."

"You look down on the captain too much. Don't forget, this kind of simulated surgery can give you extra points."

Yes, there are bonus points.

Everyone suddenly realized, yes, if it can be ended early, there will be extra points, and there will also be extra points based on the perfection of the operation.

For example, in liver cancer resection surgery, points will be added or deducted depending on how clean the resection is.

There are also other points plus or minus items.

Thinking of this, they all couldn't help but have some bold thoughts, "With a score above 100%, there must be hope. It can't be 120%."

"Good guy, I finally understand that sentence. With a perfect score of 100, I can pass the exam."

Although the operation time will not be too short, several people were discussing it enthusiastically, and it really didn't feel like the time passed so slowly.

In particular, it seemed that they didn't discuss it for long before Wu Xiaofu actually removed the cancerous lesion.

Another advantage of the model is that it does not need to be sent for inspection, and the machine itself can judge the cleanliness of the resection.

If it is a second resection, some points will be deducted.

"The removal of the cancerous lesions is complete and the cleanliness is 100%."

The sound came out from the machine, making the place clean, 100% clean!
"Is this 100% scientific?"

"It's really unscientific to put it on other people. It seems that after this simulated operating room was invented, no one can remove 100% of the cancer. Captain, this is a record-breaking one."

"No, it's a miracle. How many extra points do you get for this?" This 100% cleanliness means not only the complete removal of the cancer, but also the lymph node dissection. If you cut too much, you will have to remove more. Parts will also affect the percentage. The more parts you cut, the lower the percentage will be.

If there are cancerous lesions left, this percentage will be even lower.

This 100% means that Wu Xiaofu cut out the cancerous lesions almost exactly according to the safe distance. To be honest, if he usually cuts like this on patients, because there is no machine judgment, people still don’t feel it. But on the model, it is You can see how powerful it is.

These eyes are rulers.

No, even a ruler can't do this. It's amazing.

"Captain, are you still human?"

This sentence was actually said by Chu Jingming. Wu Xiaofu suddenly raised his head, and Chu Jingming felt that he had made a mistake, "No, I mean, you are too amazing."

Wu Xiaofu suddenly laughed, "It's not as exaggerated as you said. Practice makes perfect. The more you do it, the more you can do it."

Chu Jingming shook his head directly after hearing this. Although he had never used this simulated operating room before, he had eyes. This was obviously not as simple as he thought. What's more, it was not his first time to remove tumors. Cut.

Know what the concept of 100% is.

"Guess how long it has been now?"

Ah!
Everyone hurriedly looked at the time. Sure enough, it had been twenty minutes from the beginning to now.

At this moment, they were all silent. Is this Wu Xiaofu's reign of terror? They had heard before that Wu Xiaofu performed a liver cancer resection during pregnancy. They heard that it only took ten minutes. Although the cancer was very small, the operation was difficult, but Higher than this.

But that was just one case after all. Now, luckily, the cancerous tissue had been removed in twenty minutes.

Then this operation will not be completed in half an hour.

In fact, Wu Xiaofu lived up to their expectations. He processed the liver surface, flushed the abdominal cavity, removed the scope and closed the abdomen, all in less than ten minutes.

Twenty-seven minutes.

The time is fixed at twenty-seven minutes.

"The operation is over. The operation took twenty-seven minutes. The scores are being calculated and the final score is one hundred and forty-seven."

Ah!
When Wu Xiaofu heard the sound, he couldn't help scratching his head. Are the exams risking so much?

Everyone was stunned for a while. Those who had not participated in the competition looked at Fan Xin and the others, "When you participated in the surgery competition before, did anyone get this score?"

Fan Xin and the others all shook their heads in confusion.

"Stop making trouble, okay? We participate in surgeries. Although we all choose simpler surgeries, most of us are just attending. We have only done a lot of surgeries. Some of them can be completed within the standard surgery time, but the standard five hours , finished in twenty-seven minutes, who can do this?

What's more, the surgery was done so perfectly. The captain is a monster.

It's stable, this time it's stable for the first time. "

"And don't forget, this is the captain's first time using a simulated operating room. If he does it again, I'm afraid it will be even scarier than this. I don't know what those contestants who participated in the same period will think after seeing the captain's results. What an expression."

"I'm already shaking for them."

Wu Xiaofu waved his hand, "Basic operations, no six. Okay, you guys should practice it too. Once you are familiar with this model, it is indeed simpler than real-person surgery. Speaking of which, our advantages are still huge. You know, Most of the contestants are not familiar with the simulated operating room in advance, so we have to work harder. It would be a waste if we cannot get a ranking. "

Everyone nodded quickly. With Wu Xiaofu in front of them, they dared not work hard.

The only thought they have now is that they followed Wu Xiaofu. Wu Xiaofu's performance was too bright, they were too mediocre, but they lowered Wu Xiaofu's level too much, and they themselves felt bad about it.

Needless to say, Wu Xiaofu said they had to hurry up and get ranked no matter what.

Moreover, they were also wondering whether the model was really simple, but they thought it was complicated. However, they realized after they started practicing that it was not that the model was too simple, but that it was too simple for Wu Xiaofu.

There is not only this one simulated operating room in the First Affiliated Hospital of Donghai, but there are several more. However, the key Yu Shifu gave him can only open room 1. Needless to say, it means that this disaster will be enough, and the others will be enough. It won't be used anymore.

Stingy.

In the next period of time, Wu Xiaofu became familiar with the simulated operating room while going to work.

The scope of familiarity is not limited to hepatobiliary surgery, gastrointestinal surgery, and nail and breast surgery. Wu Xiaofu has also started to try it on the model. To be honest, this is also a good opportunity for Wu Xiaofu to boldly try some gastrointestinal surgery and surgery. Major surgery in thyroid and breast surgery.

Then it was time for Mao Daiyu and the others to suffer a big blow.

Forget about hepatobiliary surgery, but in gastrointestinal surgery and nail and breast surgery, Wu Xiaofu is much better than them. This is too unacceptable and shocking. Sure enough, geniuses are generally all-round geniuses?
"Xiao Fu, come here."

February 20th.

This day was Wu Xiaofu's surgery day. There were seven surgeries scheduled in one day. Wu Xiaofu had just finished the surgery. It was already past six o'clock and he was about to leave when he received a call from Yu Shifu.

Wu Xiaofu didn't ask any questions and went directly to the small conference room where Yu Shifu was talking about.

When he came over, Wu Xiaofu discovered that not only was he not off work, but doctors from several departments had also been called over and forced to work overtime.

"Xiao Fu, come and sit down first."

Seeing Wu Xiaofu coming in did not mean that Shi Fu greeted him, Rong Qiao had already greeted him first.

After scanning around, hepatobiliary surgery, not only Wu Xiaofu is here, but also Jingwei, and Wen Xinhan is also here. In addition to them, there are also pediatrics, cardiology, cardiothoracic surgery, neurosurgery, orthopedics, and anesthesiology. , Department of Critical Care Medicine and several other departments.

This is a big move. After Wu Xiaofu saw it, he couldn't help but think to himself. After all, he had been coming to the First Affiliated Hospital for so long, and this was the first time he had seen such a battle.

Facing Rongqiao, Wu Xiaofu nodded quickly. He originally planned to find an empty seat to sit down, but now he could only sit on the edge of Rongqiao.

"Xiao Fu, I asked you to come here because the hospital has just admitted a special patient. Please take a look at it first. Here is the medical record. Let's ask Director Lin of the Department of Pediatrics to tell you about the simple situation."

Director Lin of the Department of Pediatrics was a capable female doctor in her forties. When she heard Rong Qiao's words, she didn't hesitate and spoke directly to Wu Xiaofu.

"At three o'clock in the afternoon, a special patient came to my clinic..."

Conjoined babies!
Wu Xiaofu quickly gathered the key information and quickly captured the key to why so many doctors gathered here.

A pair of conjoined twins were delivered by cesarean section at the District Women's Hospital when their mother was 33+4 years pregnant. The doctors at the District Women's Hospital were immediately confused by the sight of the conjoined babies, and they did not dare to delay. The delivery doctor directly contacted them for help. Director Lin, the mother and the child were also rushed by the hospital in an ambulance.

After Director Lin saw it, he directly arranged to be admitted to the Neonatal Intensive Care Unit. Now they are gathered here just to discuss how to treat this conjoined baby.

Wu Xiaofu is no stranger to conjoined infants. Although he is not a pediatrician, when encountering such cases, almost all hospital departments jointly treat them. Although Wu Xiaofu has not participated in the treatment, he has seen many cases.

Conjoined twins are a rare congenital malformation. There are many types of conjoined twins, such as conjoined twins on the head, conjoined sternum, conjoined abdomen, conjoined ischium, etc. The prevalence rate is actually not low, about 1/5 ~10.

However, not many can be treated by doctors, because most conjoined twins die during embryonic life or immediately after birth.

It would be good to have about 20 in 1 births survive, but cases of conjoined twins who can undergo surgery are even rarer, and those who can successfully undergo separation surgery and survive are even rarer.

Therefore, from this point of view, the conjoined baby that Director Lin received was quite lucky. At least Director Lin gathered everyone here, which meant that the child still had the possibility of surgery.

Otherwise, Director Lin would not have admitted the conjoined twins.

Let’s talk about the situation of this conjoined baby first. Although the two children were born at the same time, one was bigger at birth, weighing 1950g, and naturally became the elder sister, while the other was smaller, only 1410g, so she became the younger sister.

Among them, the sister weighs less than 3 kilograms, which is an extremely low birth weight infant. The body organs of conjoined twins have many hidden dangers. Now that the sister weighs less than kilograms, it is even more dangerous.

You know, even babies who are not usually conjoined twins, if they are born less than three pounds, it means that they face more risks and challenges in the respiratory system, digestive system, circulatory system, etc.

The sisters' abdominal skin has been connected since birth and they share an umbilical cord.

After Director Lin admitted the conjoined infant, he conducted an examination and found that the elder sister was in good condition and her liver capsule was tightly attached to the other conjoined infant. No other obvious abnormalities were found. In addition to being closely attached to the liver capsule of another conjoined liver, my sister was also diagnosed with congenital heart disease.

"First consider complete transposition of the great arteries, accompanied by ventricular septal defect (10mm), pulmonary valve malformation with prolapse and stenosis, patent foramen ovale (2.6mm), patent ductus arteriosus (3mm) and mild tricuspid valve Reflux."

Speaking of my sister's congenital heart disease, Director Zheng of the Department of Cardiology also spoke directly. Everyone listening frowned. These are all congenital heart diseases that will affect life if they cannot be operated on as soon as possible. Now they are gathered in When it comes to a child, you can imagine how difficult it is.

In this case, they need to consider a situation, that is, whether this conjoined baby should abandon his sister to keep his sister safe.

After all, my sister's difficult and complicated congenital heart disease is very dangerous even if she is not a conjoined twin. At less than three pounds, there are almost no conditions for surgery. Even if they are successfully separated in the future, will they grow enough to be operated on? I don’t even know the time.

Fortunately, the sisters have their own internal organs and the adhesions are relatively thin. After evaluation, everyone felt that the sisters were ready for separation.

Therefore, if you want to save your sister, there is no chance. At the very least, you can separate the sisters first and then decide based on the development of the sister.

Doctors are also unwilling to take the initiative to give up the life of a child when a new life has been born. Whether it is professional ethics or softness of heart, they want to do their best to save the child.

With that topic out of the way, here's what they need to think about.

"When is the best time to have surgery?"

"How to ensure that my sister with complex congenital heart disease can successfully overcome the difficulties of separation?"

"Are the organs of conjoined twins independent? Is there a hidden metabolic coexistence?"

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(End of this chapter)