Doctor’s Life Simulator

In the operating room, Qin Lang, Liu Peichun, and the equipment nurse are ready.

After more than 50 surgeries, Qin Lang and Liu Peichun's cooperation has been extremely tacit. With the addition of the main knife's aura, Liu Peichun naturally does not need to be afraid of cooperation problems.

The anesthesiologist for this operation was naturally Chen Wenhao. Because of the new technique, Qin Lang asked Chen Wenhao to perform spinal anesthesia.

The patient was naturally emptied of the bladder before surgery without indwelling catheter.

After the anesthesia was completed, Chen Wenhao placed the patient in a supine position according to Qin Lang's request, with the head lowered and the feet high, and the left side tilted about 20 degrees. After doing all this, Chen Wenhao stepped aside.

Qin Lang and Liu Peichun stood on the left side of the patient, and the monitor was on the right side.

Because it is a single umbilical hole, the marking of the incision is naturally different from the McFarland incision, and it is also different from the conventional three-hole method of laparoscopy.

Qin Lang made a 1.5CM mark on the patient's umbilicus.

In the observation room, the expressions of the experts naturally changed. Although theoretically, the incision range is 1.5 cm, but in order to facilitate the operation, the senior surgeons will control the incision to 2.0 cm.

Those who dare to use the 1.5CM incision are either rookies or daring artists.

"interesting."

Among the expert group, a director had some appreciation for Qin Lang's choice.

Naturally, Qin Lang didn't think so much, nor did he show off his skills. His only thought was to reduce the incision as much as possible, be less invasive, and be more beautiful.

After all, the patient is a very young professional woman.

After the marking was completed, Qin Lang naturally took the scalpel from the instrument nurse.

Under the perfect level of incision, Qin Lang's pen-style incision was naturally extremely accurate, and he quickly opened his abdomen one by one.

"Cut Protector..."

After drinking a bottle of stamina potion beforehand, Qin Lang was completely immersed in the operation, and the airtight instructions followed one after another.

Having followed more than 50 units in Qin Gallery, Liu Peichun and the equipment nurse have naturally developed their instinctive reflexes.

"Kirschner wire, traction bow..."

Qin Lang's next instruction came out, and in the observation room, the experts were again puzzled.

Even Director Zhuang was a little at a loss.

"What the **** is this brat doing?"

Director Pang watched everyone's reactions and explained slowly:

"As all experts must know, conventional single-port laparoscopic channels (R-port, Triport, Uni-X) are very expensive and can only be used once, and must be equipped with a dedicated integrated 5.0mm laparoscopic device and Specialized flexible single-port laparoscopic manipulation instruments are expensive and unacceptable to ordinary patients.”

Director Pang said halfway through, unscrewed his teacup, Gudong Gudong took a sip, and then continued to add:

"Therefore, Qin Lang proposed a self-made abdominal wall suspension device using orthopedic traction arch and Kirschner wire."

When Director Pang was explaining, in the operating room, Qin Lang inserted the Kirschner wire through the skin up and down the extension line of Maxwell's incision in the right lower abdomen, then sneaked out under the skin, and passed through the subcutaneous distance of about 15.0cm.

After the two ends of the Kirschner wire are fixed with the traction bow, the traction bow is lifted up by the suspension rod and the horizontal bar, and the abdominal wall of the right lower abdomen is lifted up to establish the operation space.

"Fantastic, he's really a genius."

Han Hu's eyes lit up, looking at the homemade abdominal wall suspension device in the operating room.

Who would have thought that K-wires can be used in this way. K-wires are commonly used internal fixation materials in orthopaedics. The original specifications are generally fixed at about 20 cm, and there are several different specifications between 0.5-2 mm in diameter.

It is often used to fix short fractures or avulsion fractures and other fractures with little stress. It is also often used in the fixation of temporary fracture fragments in orthopaedic surgery. It is very cheap.

As for orthopaedic traction bows, they can naturally be used repeatedly.

"Director Cheng, how is it, is it okay?"

Han Hu moved the stool towards Kung-Fu, but Kung-Fu didn't talk to him, so he moved the stool to the side.

"Exploring Laparoscopic..."

Qin Lang gave the next order without stopping.

Liu Peichun naturally quickly inserted the laparoscope and began to investigate.

"Ultrasonic knife, grasping forceps..."

Only Qin Lang's calm voice remained in the operating room.

Qin Lang grasped the forceps with his left hand and the ultrasonic knife with his right. He very skillfully removed the greater omentum of the right lower abdomen and pulled the cecum at the same time.

At the same time, Liu Peichun's camera is also along the colon. The two cooperated very well, and soon they saw the appendix.

"Intraoperative findings: acute suppurative appendicitis, root perforation and gangrene, severe adhesions..."

Seeing the situation in the abdominal cavity, all the experts breathed a sigh of relief. Qin Lang only made such a small incision. Now encountering such a complex situation, the biggest difficulty of single-hole LA is at this moment. Due to the limitation of single-hole, for The delicate operation requirements of the surgeon are very high.

"Ultrasonic hemostatic knife..."

"He wants to?"

With Qin Lang's instructions, all the experts were stunned for a moment, and then reacted immediately.

"This Qin Lang is crazy!"

Obviously, Qin Lang was preparing to operate both hands at the same time, using an ultrasonic hemostatic knife to treat the mesentery.

The ultrasonic hemostatic knife has very high requirements for the operator, and the force and angle must be controlled well, and the tissue around the appendix must not be touched.

Otherwise, it will lead to electrical burns of the surrounding tissues and intestines. Dr. Huang once encountered a resident under his own management. Improper operation, the patient's wound surface was too large, and the patient suffered from right lower quadrant pain after surgery.

When the experts were nervous, Zhuang Tong and Director Pang were still there. After all, this was already the basic operation of Qin Lang.

Sure enough, in the next second, there was an exclamation in the observation room!

"Look at Qin Lang's hand controlling the gripper."

On one side of the screen is the surgical field in the patient's abdominal cavity, and the other camera angle is Qin Lang's hand.

I saw his hand micro-manipulating seven or eight times in a few seconds, constantly controlling the direction and angle of the grasping forceps.

At the same time, in the operative field, it can be seen that the grasping forceps are not always in one position of the appendix, but are constantly being finely adjusted.

At the same time, Qin Lang's other hand, controlling the ultrasonic hemostatic knife, also entered through the single umbilical hole.

This kind of picture is like Zhou Botong's left and right hand mutual knowledge, or the left hand draws a square and the right hand draws a circle.

Performing fine micro-manipulations with both hands simultaneously requires a very high degree of wrist flexibility for a person's concentration and finger strength.

"Slow Condensation Mode,,,"

While operating with both hands, Qin Lang issued further instructions at the same time, and the equipment nurse was no longer surprised, and immediately completed the debugging.

"Close up...Zoom out, panorama...Zoom in, close-up..."

Qin Lang controlled the forceps and the ultrasonic hemostatic knife with both hands, and at the same time directed Liu Peichun's trajectory, like a senior director directing the cameraman.

The picture is not only clear, but also beautiful!

After exactly 3 seconds, the mesenteric vessels have been clotted.

In the observation room, there was silence until Qin Lang was completely closed.

"This meso-appendix treatment is far better than an ordinary chief physician."

Although Dr. Huang had some prejudices before, after watching Qin Lang's operation, he had to say that it was really pleasing to the eye.

Director Han Hu took a sip of tea and did not speak, but he was more and more looking forward to the next operation.

Director Pang glanced around, the corner of his mouth raised slightly, and his heart was: where is this, the performance has just begun.

In the operating room, Qin Lang naturally remained focused.

The next step was the treatment of the appendix stump. Qin Lang observed it and found that the near edge of the gangrene at the root of the appendix was only 4mm away from the cecum.

"Absorbable thread, needle pliers..."

Qin Lang naturally chose the most suitable simple ligation + "8" cecal seromuscular suture treatment.

Looking at Qin Lang's light-heavy use of absorbable threads, in such a small operating space, various experts are naturally a little unbelievable.

In particular, the knots in the Qin Gallery are so beautiful, the spacing between the knots, the size, and the uniformity are beautiful.

"With such a solid basic skill, it seems that there is really not less practice on weekdays. Shu Ya, you have to take a good look, there is still a lot to learn."

Han Hu said to Ma Shuya next to him.

"Um."

Ma Shuya was convinced. Before, in the department, her basic skills were second only to Senior Brother Lu Min, but in front of Qin Lang's pervert, she was still not enough.

Of course, apart from the basic skills, what Ma Shuya admired the most was Qin Lang's grasp of the procedure and rhythm of the entire operation.

too mature.

"Irrigation of the abdominal cavity, placement of a drainage tube..."

Qin Lang continued to issue instructions, and this operation soon entered the final stage.

What everyone didn't expect was that after Qin Lang completed the operation of the main knife, he did not even let go of the final stitching.

"This?"

Han Hu watched Qin Lang enjoy the simplest stitching, and his heart was slightly touched.

"No wonder, his basic skills are so solid. Even if he has become the main knife, he is still doing the simplest stitching himself. This attitude is worth learning."

Ma Shuya also admired Qin Lang silently in her heart.

Only Director Pang was a little helpless, and they didn't know why Qin Lang had such a special habit of sewing.

Sure enough, after finishing the suture, Qin Lang changed his face and walked out of the operating room without looking back.

[Congratulations to the host for completing the task: 40 ERAT surgeries and 5 suspended pneumoperitoneum laparoscopic appendectomy were completed within one week. Obtained quest rewards: 1.1 life simulation points, 2. Talented super magic field: can see 10 times clearer magic field. 】

...

...

During the preparations for Qin Lang's surgery, Zhuang Tong returned to his office and quickly returned to the observation room with a few cups of freshly brewed coffee.

"Director Cheng, I really don't want to have a cup. It's mellow and rich, and it's warm and refreshing after drinking it."

"I'm used to drinking herbal tea."

With a cold rejection, he picked up the teacup in front of him, took a sip, and chewed a few pieces of tea leaves that he chewed into his mouth.

Han Hu and Ma Shuya thanked Zhuang Tong and took over the coffee.

Director Han took a light sip: "Not bad, really good. Director Zhuang, this visit to the First City Hospital is really worth it."

Zhuang Tong laughed.

"Qin Lang's surgical ability is really great. I also admit that he has certain attainments in suspended airless laparoscopic surgery.

Looking at Zhuang Tong and Han Hu's victorious gestures, they couldn't hold back after all, and said coldly.

"No hurry, we have time."

Zhuang Tong took a sip of strong coffee and leaned halfway on the back of the chair: "Director Cheng, be patient."

Seeing Zhuang Tong and the others drinking warm coffee, he picked up the tea cup again, and found that the bottom of the cup had reached the bottom. He was embarrassed to ask Director Pang to pour water, put down the tea cup, and sat sullenly with his brows furrowed.

...

...

ten minutes later.

In the operating room, it was ready, and a new patient appeared in the eyes of everyone.

What the experts did not expect was that the patient Qin Lang selected this time was a little boy who was less than ten years old.

"Director Zhuang, Qin Lang really knows how to select patients."

The extremely experienced Physician Huang said with some admiration and some worry:

"As we all know, acute appendicitis in children is more serious than that in adults, and children's omentum is not fully developed, and the inflammatory reaction is not easily limited, and it is prone to perforation, and may even lead to systemic poisoning, with a serious prognosis."

"So the main surgeon's understanding of the operation needs to be more in-depth, and the operation requirements for the surgeon are also higher."

"Moreover, appendicitis in children and appendicitis in adults are more difficult to diagnose in addition to the preoperative diagnosis during the operation. Because of the younger children, it is difficult to accurately describe the medical history of abdominal pain, and because of the fear of examination, the physical examination is not cooperative enough. It is easy to influence the judgment of clinicians.”

"Yes, I agree with Dr. Huang, or we can switch to an adult, the diagnosis of children is not so accurate."

"I suggest not to go to the difficulty for this observation, but to be more cautious, it is better to choose an adult."

The results finally found an opportunity to make up for it. In fact, even he dared not say that he could diagnose appendicitis in children 100% correctly, and there were more uncertainties.

As for Qin Lang, he admits his surgical talent, but the diagnosis is not only based on talent, but more on experience and experience.

"Director Cheng can rest assured that we have made sufficient preparations before the operation. If it is really impossible to perform ERAT, we will change to the conventional Stryke 30-degree laparoscopy and three-hole method."

Director Pang explained.

"Since Director Pang is so confident, let's start."

The effect snorted coldly and stopped talking.

In the operating room, in order to ensure the success rate of the operation, Qin Lang naturally used a single case simulation before the operation to confirm the patient's condition:

[Patient: Cao Xiaodou, male, 7 years old

Symptoms: due to persistent right lower quadrant pain, accompanied by nausea, vomiting, sanity, poor spirit, acutely ill face, no yellow staining of the skin and mucous membranes of the whole body, pathological murmur of superficial lymph nodes, abdominal tenderness, right lower quadrant tenderness, rebound tenderness Positive, localized muscle tension, no obvious abnormal mass, negative Murphy's sign,

Percussion drum sound ~www.readwn.com~ negative mobile dullness, physiological curvature of the vertebrae, free movement of the limbs, the existence of physiological reflexes, and the pathological reflexes are not elicited.

Blood routine: white blood cell count 12.3×109/L, neutrophil 0.81; B-ultrasound showed "enlarged appendix of right lower quadrant".

Diagnosis: acute appendicitis, enteric appendicitis

The main cause of appendicitis: caused by parasitic blockage.

Treatment plan: use ERAT to **** out the pus, because the inflammation is obvious, a plastic stent needs to be placed, and the worm body and eggs are completely removed using a stone extraction basket. 】

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