Doctor’s Life Simulator

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When Physician Yan was surprised, Han Hu on the side was also a little surprised. After all, in terms of experience and eyesight, he was much better than Physician Yan.

"Qin Lang did not choose a conventional anterior cervical pedicle flap, but chose an anterior cervical fascia flap for repair?"

Han Hu quickly understood Qin Lang's thinking. The patient's tumor was only confined to one part of the vocal cords, and the laryngeal chamber was not involved. Therefore, as long as an appropriate prosthesis was selected, the recovery of laryngeal functions such as voice after surgery was highly likely. of.

In contrast, the appearance and function of the anterior cervical pedicle flap are not satisfactory, and it also increases the potential danger of the laryngeal cavity communicating with the outside world from the neck. The structure is close to the original anatomical structure, which greatly reduces the risk factor of the laryngeal cavity communicating with the outside world from the neck.

The vocal cords of the larynx are the vibrating organs for sound production. The vocal cords are a layered vibrating body. From the functional anatomy level, from the outside to the inside, the vocal cords are divided into the capsule layer, the transition layer and the body layer, which is similar to the anterior cervical fascia. The **** are very similar.

The only problem is that the free transplantation of the anterior cervical fascia flap is much more complicated than the anterior cervical pedicle flap, and the requirements for subsequent suturing are also very high.

This reflects Qin Lang's accomplishments in flap transplantation.

After all, Yan Zhengqi's skills are limited, and he has only mastered the repair of the anterior neck pedicle flap before, so he is somewhat vague about Qin Lang's operation.

On the operating table, before the prosthesis was sutured, Qin Lang removed the corresponding part of the residual vocal cord tissue near the anterior joint and at the place to avoid mutual interference between the prostheses.

After that, the size, length, and tension of the prosthesis are properly controlled.

"...3-0 gutters..."

After completing the previous step, Qin Lang chose the most suitable catgut. If it is too thin, it will easily come off and break, while if it is too thick, there will be foreign objects that cause phlegm and cough.

Looking at Qin Lang's perfect suture, Yan Zhengqi also felt admiration in his heart. Although Qin Lang has little experience in tumor resection for laryngeal dehiscence, he is indeed far superior to ordinary people in some basic skills.

After the cervical fascia flap was sutured to the defect margin formed by the excision of the vocal cord tumor, Qin Lang, depending on the size of the pedicle, was located on the same side of the myofascial flap as the median thyroid cartilage dehiscence margin, at the same height as the vocal cord on the healthy side. A little cartilage is removed in a "c" shape, and the corresponding part of the residual vocal cord tissue at the proximal and anterior joints of the affected side is removed to accommodate the pedicle components that make up the fascia flap.

Looking at Qin Lang's operation, Yan Zhengqi changed color slightly:

"This Qin Lang has a very meticulous operation and an old-fashioned way of dealing with it. It is so jerky in the operation of laryngeal dehiscence tumor resection, but in terms of skin flap transplantation and repair, he is like a senior old director. It seems that he was in burn plastic surgery before. The accumulation of the department is really deep.”

Yan Zhengqi had a slight sense of urgency, but fortunately, he was able to stabilize Qin Lang with his years of experience in the tumor resection of the laryngeal dehiscence.

Thinking of this, Dr. Yan breathed a sigh of relief. After all, the refinement of an operation requires a lot of time and the accumulation of the amount of surgery.

After calming down, the next step was to perform some operations of the laryngeal dehiscence tumor resection. Sure enough, Qin Lang lost power again.

The whole operation became jerky, and Yan Zhengqi also found some opportunities to give Qin Lang some guidance and tips.

After a while, Yan Zhengqi also handcrafted a soft latex supporter for Qin Lang, which was filled with iodoform gauze. After Qin Lang took it, it was placed in the throat cavity to prevent postoperative adhesions.

Fix the 10-gauge silk thread at the upper and lower ends of the finger cuff hanging in the throat cavity, and the upper part is drawn through the pharynx from one nostril, and fixed on the same side of the face with medical tape.

The silk thread below is drawn from the tracheal incision and tied to the ear hole of the tracheal cannula.

The whole set of operations is quite satisfactory.

The next step is to suture the thyroid cartilage and various layers of soft tissue, and apply a moderate pressure bandage.

Five minutes later, Qin Lang's first laryngeal dehiscence tumor resection was completed.

[Ding, complete the five laryngeal dehiscence tumor resections through your own abilities, the task progress is 1/5]

After watching Qin Lang's entire operation, Yan Zhengqi didn't have much deep understanding, so he encouraged him:

"Doctor Qin, although you are not familiar with laryngeal dehiscence tumor resection, and some of the operations are a bit jerky, but in general, your flaws do not hide your flaws, especially your basic skills are still very good. Next, as long as there are suitable patients, I will I will assist you and continue to be the main surgeon, and I believe that after the accumulation of some operations, you will be able to master this technique as soon as possible."

Qin Lang professionally smiled, but he was calculating the progress in his heart. After completing five sets, he directly simulated it to the perfect level:

"Okay, I will try my best to get Asahi to master laryngeal dehiscence tumor resection."

Yan Zhengqi finally regained some of the majesty of the old doctor, but before he could continue to instruct him, Han Hu, who was beside him, interrupted him.

"Qin Lang, your surgery was done very well."

Han Hu looked at Yan Zhengqi again, slightly disappointed in his tone: "Doctor Yan, you need to study more with Dr. Qin. After returning, reflect on Qin Lang's surgical operation. There are many bright spots and flashes in it. place."

Han Hu looked at the problem differently from Yan Zhengqi. Standing at a higher level, many of Qin Lang's operations, especially the choice of flaps, were far beyond conventional operations.

As for the experience and skills, Qin Lang is just a newcomer and not yet proficient, but this operation has fully demonstrated his potential. The ideas and concepts of the operation are much more important than the actual operation.

Moreover, with Qin Lang's learning ability, it won't take long for him to master this technique.

On the contrary, Yan Zhengqi, who has been training for so many years, has fallen into the rut with the idea and concept of surgery, and the upper limit is limited, but he is still complacent.

Han Hu looked at Qin Lang, who was humble and motivated, and suddenly had the urge to change students with Shen Xi. Yan Zhengqi's practice has been abandoned.

Yan Zhengqi was also taken aback by his teacher's revelation, but he didn't understand that Qin Lang's operation was obviously a novice, and he had strong basic skills. Is it really that good?

Yan Zhengqi recalled the operation process. I'm afraid that it was not Director Han who wanted to save face for Professor Shen. It must be like this.

Oral dissatisfied with a perfunctory sentence: "I see, Director Han, after I go back, I will definitely review Qin Lang's surgery."

"Um."

Han Hu retracted his gaze from his apprentice with a little disgust, and looked at Qin Lang again:

"Qin Lang, Professor Shen and I will continue to arrange suitable patients for you. I hope you will master laryngeal dehiscence tumor resection soon."

Han Hu encouraged Qin Lang again.

Shen Xi was on the side and was quite satisfied with Qin Lang's performance, but after all, Qin Lang was indeed a bit clumsy in some operations: "Qin Lang, although Director Han praised you, you still need to know your own shortcomings, many In terms of the operation, you are still very jerky, you should communicate and learn more with Dr. Yan."

Hearing Shen Xi's words, Yan Zhengqi felt a little more comfortable in his heart. This is a fair evaluation.

"Qin Lang, looking forward to the second operation we cooperate with."

Yan Zhengqi is also ready to see if Qin Lang's next surgery progresses and his learning ability is as powerful as the legend.

Shenxi also encouraged Xia Qinlang: "Step by step, don't be too eager for quick success. Doctors need a lot of time to accumulate."

...

...

After Qin Lang said goodbye to Professor Shen, Director Han and others, they encountered a familiar figure when they passed through the general surgery department.

It was Wang Heng, the deputy director of the Department of General Surgery of Zijingang No.1 Hospital who was introduced in the past.

After such a short period of time, Wang Heng had already established a firm foothold in general surgery with his medical skills. Although he was young, all the attending physicians and the deputy director admired him unceasingly.

Wang Heng brought a few doctors to carry out a routine for a case, and behind him, followed by several attending physicians, as well as several junior doctors, Lu Min, who had a good relationship with Qin Lang before, and Ma Shuya also followed Behind Wang Heng.

The group of people was mighty and mighty, with Wang Heng's horse head in sight.

"Director Wang, we have conducted a preliminary physical examination and diagnosis of the patient, but we cannot determine the real cause of the patient."

Lu Min is now convinced of Wang Heng, and he may be able to fight for some surgical operations, but in more comprehensive diagnosis, scientific research, management, and all aspects, Wang Heng is completely worthy of his current deputy director.

As Lu Min walked, he continued to report the patient information they had previously sorted out:

"The patient, female, 61 years old, was admitted to the hospital due to cough, expectoration of sputum for a month with fatigue and sweating, and the symptoms did not improve after 5 days of anti-infective treatment."

"Physical examination: decreased left thoracic tremor, solid percussion sound in the left middle and upper lungs, and thick breath sounds in both lungs."

At the same time, the patient's chest X-ray and CT impact data were also handed to Wang Heng.

Wang Heng also looked at it carefully:

"Blocky high-density shadows in the middle and upper fields of the left lung with clear borders and slight right shift of the trachea...ct: Encapsulated lesions are seen in the left thoracic cavity. The CT value of the unenhanced scan is 34hu, and there is no obvious enhancement..."

Looking at the patient's condition, Wang Heng also frowned, the cause was really difficult to diagnose.

Looking at Wang Heng, his face was a little embarrassed, and Lu Min, Ma Shuya and others around him were even more clueless.

When a group of people was about to go to the conference room for a consultation, Lu Min immediately found Qin Lang walking:

"Qin Lang, why are you in our general surgery department?"

Hearing Qin Lang's name, several people looked over, and even Wang Heng took the initiative to say hello.

Ever since, knowing that Lu Yu had been taught a lesson by Qin Lang, Wang Heng paid more and more attention to Qin Lang.

"Doctor Qin!"

Wang Heng also greeted very politely.

"Director Wang, UU reading www.uukanshu.com Physician Lu, Physician Ma."

Qin Lang also didn't expect such a coincidence. He happened to meet Wang Heng and his group. They were all young people, and they had been in contact with each other a few times.

Wang Heng thought about it, and also invited Qin Lang to participate in the consultation:

"Doctor Qin, if you have time, join us in our consultation."

Qin Lang was of course disrespectful to Wang Heng's invitation.

Soon, several people came to the conference room. Lu Min also introduced the patient's situation to Qin Lang while he was preparing.

"We have done radiographic examinations on the patient, and we have also done CT enhancement and MRI enhancement. However, it is still impossible to distinguish the specific symptoms of the patient."

Lu Ming was a little helpless, but also a little depressed.

[Ding, new task: propose a new diagnostic plan for Wang Heng's team, using CT virtual tracheal endoscopy technology to assist CT enhancement and MRI enhancement, to find the real cause for the patient. At the same time, work with Wang Heng to specify the best treatment plan. Mission reward: 1.1 life simulation points, 2. Handling skills for massive bleeding during chest tumor surgery: master level. 】