Doctor’s Life Simulator

"As Director Pang said, traditional la requires the use of CO2 to form pneumoperitoneum for surgical operations under general anesthesia. CO2 easily diffuses subcutaneously to form emphysema, and diffuses into the blood through the omentum to cause hypercapnia, cardiopulmonary dysfunction, etc. Complications, for super-aged patients, their cardiopulmonary function is often in a compensated state, so the application of la is obviously limited. Suspension airless laparoscopic technology can complete minimally invasive surgery under continuous hard anesthesia, reducing the risk of complications. Cardiopulmonary function requirements and intraoperative anesthesia risk in very elderly patients.

As Qin Lang explained, he continued to slide the photos of the surgical design that he had drawn by hand.

No matter whether the technique is Qin Lang or Director Pang, Zhuang Tong thought of it, and looking at Qin Lang's hand-painted photos of the surgery, Zu Liang and Li Ming both became quiet.

They realized that this form of surgery had never been used before, that is to say, it was specially designed for this patient.

Zhuang Tong and Director Pang had a different idea. Originally, to establish a provincial key discipline of acute abdomen, there are requirements for the quantity and quality of the new surgery. If the surgery proposed by Qin Lang is successfully implemented, it will be an additional Increases the likelihood of success.

Zhuang Tong finally understood Wei Guoqiang's happiness.

This Qin Lang is really a baby bump. Wherever he goes, he takes the improved technique.

"Be sure to increase Qin Lang's time in the emergency department."

Zhuang Tong said something silently in his heart.

"Qin Lang, you will give a good introduction to the entire procedure."

Zhuang Tong rubbed his hands, his eyes were shining, and the suspended airless laparoscopic technique sounded very high. Although the application field was limited, it could solve the postoperative risks of super-aged patients, which is also a great thing. .

Zhuang Tong even thought that with this innovative technique, Qin Lang might be able to start a star-like medical career like those big names in the field of acute abdomen.

After all, a new technique was created during the hospitalization period. This kind of opportunity and talent is one in a hundred.

Although Zhuang Tong didn't fully understand Qin Lang's contribution to Wei Guoqiang's side, he still knew that Qin Lang proposed to improve several new techniques.

Although these few small improvements are not enough to shake the medical world, as the concert hall grows, this pioneering medical talent and potential.

Zhuang Tong's heart became hot, so let himself **** him well in the early stage of Qin Lang's growth stage.

After settling on this idea, Zhuang Tong looked at Qin Lang's technique again, and it was a different mood. If there is a chance, he must let Qin Lang go out, participate more in various academic exchanges, participate in medical forums, and of course participate more in various fields. experience in various surgeries.

Qin Gallery should not be limited to a burn department and wound treatment center.

As long as Qin Lang is still working in the emergency department for one day, he is a person in the emergency department.

[Ding, new task: live up to the ardent expectations of the director of the emergency department, become the subject leader in the field of acute abdomen in the first hospital of the city, and become a star doctor, task time limit: long-term, task reward: 1.3 life simulation points, 2.1 Item SCI paper results, with an impact factor of 10 or more. ]

"A subject leader in the field of acute abdomen? This is what it means to stick to the emergency department for a long time."

Qin Lang does not reject the long-term adherence to the emergency department. After all, the emergency department can contact a variety of patients, and at the same time, it can trigger tasks in various disciplines and learn the surgical techniques of various disciplines.

Qin Lang was a little surprised, and even glanced at Zhuang Tong. Of course, he would not disappoint Director Zhuang, and continued his analysis of the technique:

"First of all, epidural anesthesia is used. Then, the first incision is made 1.0cm below the umbilicus of the patient as an observation hole, and artificial pneumoperitoneum is established out of chapter, and the 1/2 of the normal pressure is controlled, and a laparoscope is placed.

The second step, which is also the core of this procedure, is to make an incision at the 3 fingers below the umbilicus as an operating hole. After exposing the appendix, the patient’s abdominal cavity is lifted and fixed on the stent through the external abdominal suture, and the pneumoperitoneum is relieved. Suspend the patient's abdomen to create an operating space. The average time of establishing a pneumoperitoneum was controlled at 3 min.

The last step is to establish another operating hole at McBurney's point, adjust the patient to a height of head down, lift the appendix, and perform routine free excision. Then follow the routine procedure until the intra-abdominal residual fluid is removed. During the operation, it was decided whether to indwell the abdominal drainage tube, withdraw the suspended purse string and laparoscopic instruments, and suture the abdominal incision.

above.

After Qin Lang finished speaking, he stood quietly, waiting to answer the questions and opinions of several directors and senior attending physicians about this technique.

Looking at Qin Lang's calm and calm demeanor, several directors and Li Ming fell into silence. “Clap clap clap!’

Zu Liang was the first to take the lead in applauding, and Li Ming naturally followed, applauding Qin Lang, or the person behind Qin Lang who designed such a technique.

To be able to present such an improved plan that has never been used before to a young man like Qin Lang, as the first shot of his debut, is really a lot of money.

Zu Liang put down his palm, looked at Zhuang Tong and Director Pang, and said meaningfully:

"From Qin Lang's analysis and introduction, this improved surgery can be promoted and applied to super-senior patients, and it is universal. It can be used as a landmark surgery in our city's first hospital. It is of great significance to carry out the subject of acute abdomen. Director Zhuang really opened our eyes at this consultation. "

As expected of Zu Liang, he saw the core of the matter at a glance, as well as the naked temptation.

"Director Zu is right, and I can't believe it. Qin Lang's improved technique is indeed of great significance for the city's first hospital to carry out the key disciplines of acute abdomen, but now we should solve this specific problem first. case."

Zhuang Tong directly prevented Zu Liang's derivation of the grand subject of discipline construction, as well as some malicious speculation.

"Still insisting that such a pioneering, feasible, and profound skill is the improvement of the memorial hall?"

Zu Liang was a little surprised in his heart. It seemed that Zhuang Tong was determined to support the gallery, but Zhuang Tong didn't seem to have a daughter.

If Qin Lang was the future son-in-law recognized by Zhuang Tong, then it would make sense to name such an important improvement technique in his name.

If this procedure is carried out smoothly, it will definitely be able to publish papers in core journals, which is self-evident for the future of doctors.

Zu Liang even thought about whether the director of "Farewell My Concubine" was Chen Kaige or his father, and whether Han Han's works were written by himself or written by his father.

After all, this kind of surgical improvement is just the icing on the cake for an old Jianghu like Zhuang Tong, but for a young doctor who is just starting out, it is a new genius born out of nowhere. After all, Eileen Chang has a famous saying: Be famous as soon as possible!

Zu Liang looked at Qin Lang's perfect appearance again, coupled with the improvement of the surgical technique conceived by such a genius, most female doctors would be fascinated by the charm of such male doctors.

After Zu Liang had a lot of inner drama, he continued to test Qin Lang's quality and asked directly and sharply:

"Qin Lang, I agree with the general framework concept of your surgery. If it is a long-term research topic, I will undoubtedly give you applause, but as a specific plan for an upcoming surgery, the details cannot be Ignored, so I still have a few questions."

Although Zu Liang's tone was soft, Li Ming on the side was used to his thorns.

Sure enough, Zu Liang was not polite at all:

"The subcutaneous tissue of the abdominal wall of super-aged patients is loose, and the subcutaneous suspension effect is poor, which may not form an effective surgical space, and there is also the risk of accidental injury to the inferior epigastric artery. How do you solve this problem?'

Listening to Zu Liang's question, several doctors were also curious about the details of this operation, especially the loose subcutaneous tissue and accidental injury to the inferior artery, which cannot be dealt with without actual experience.

Under the watchful eyes of several chief directors, he was not at all in a hurry, smiled slightly, and looked at Zu Liang:

"Just suspending the subcutaneous tissue of the abdominal wall is naturally risky, but I will use full-thickness suspension in the future, avoiding the abdominal wall blood vessels for puncture under direct vision, which is safe and reliable, and the relaxation of the abdominal wall of the elderly can form More efficient surgical space."

After Qin Lang answered, he was not impatient at all, but urged Zu Liang: "Director Zu has other questions, I will answer them one by one."

"This..

Seeing Qin Lang calm and calm, Li Ming is not calm, especially Qin Lang's sentence: I will be in surgery later...

How many meanings?

Zu Liang looked at Qin Lang's coping with ease, and took the initiative to ask himself to question, but he was a little unsure.

Just looking at such a young face, he really couldn't believe that Qin Lang's own improvement plan was made by himself.

Being able to become the director of general surgery, Zu Liang naturally has excellent patience and self-restraint. Zu Liang calmly raised a second question:

"According to your surgical design, it is foreseeable that the operative space exposure of the suspended pneumoperitoneum laparoscopic technique is poorer than that of the traditional pneumoperitoneum, and the exposed area is smaller, which means that the surgical operation will bring It is very difficult, so it must be operated by an operator with a higher level of laparoscopic operation. Since it is the first time to carry out, the uncertainty is actually no less than the risk of traditional laparoscopy.”

"Yes, Qin Lang, although your plan has improved the success rate of the operation, but due to the difficulty of the operation and the first deployment, it has increased the uncertainty of the operator. Therefore, after synthesis, for such an important patient, it is safe to do so. It’s better to go the traditional way.”

Li Ming took over Zu Liang's words on the side. The development of any new surgery requires full preparation, and the chief surgeon must have sufficient psychological quality before it can be launched.

"It is true that for the first time, there may be mistakes and great psychological pressure on the doctors themselves, but if it is done by myself, I have full confidence."

Qin Lang dared to say this, of course, had a reason.

A perfect appendectomy, plus hundreds of years of accumulation, if he can't, who can? Moreover, Qin Lang's new talent, the aura of the main knife, can increase the assistant's cooperation and success rate.

Whether it is for the patient's recovery or to complete the system's tasks, Qin Lang does his part.

So this time he chose to stand out, but, with a system and such accumulation, what is there to be afraid of?

With great power comes great responsibility.

Qin Lang looked around the crowd without any fear at all~www.readwn.com~ and finally looked at Zu Liang: "Director Zu, as long as I am the chief knife, the above will not be a problem."

Zu Liang didn't expect Qin Lang to speak so straight to the point that he was almost arrogant, his eyes widened and his mouth opened slightly.

"Nonsense, Director Pang doesn't dare to make a deal, how dare you say that you have full confidence? Do you think that laparoscopy is better than Director Pang?"

"I don't dare to say about other laparoscopic techniques, but I am competent enough for the suspended airless laparoscopic appendectomy! Director Zhuang, Director Pang, I want to be the chief surgeon for this operation."

Qin Lang ignored the doctors in general surgery and looked directly at Zhuang Tong and Director Pang, determined to win.

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