Chapter 149: Double talents revealed, are you really a regular trainee?
Zhou Can remained very steady and carefully drained all the blood and fluid accumulated in the patient's brain.
With the help of the endoscope probe, he began to look for bleeding points.
Hematoma is formed because of ruptured blood vessels, which results in the inability of bleeding to be discharged from the body. Eventually, the blood is blocked in a certain area of the body, forming a hematoma.
Normally, hematomas on the limbs or body surface are not a serious problem.
If the amount of bleeding is small, you don't even need to go to the hospital, just apply ice on your own.
The purpose of ice compress is to constrict blood vessels, stop bleeding or further reduce bleeding.
Many people apply safflower oil or trauma medicine to the swollen area after spraining their ankle, but this is actually incorrect. Doing so may aggravate the condition.
This is especially not the case when a fracture occurs.
It is actually better to pour cold water on the swollen area.
With the help of water temperature, the ruptured blood vessels will shrink quickly and stop bleeding automatically. It cannot eliminate the hematoma, but it will not make the hematoma worse.
Which parts of the body are most dangerous when hematomas occur?
The brain and spine are the areas most vulnerable to hematoma infiltration or compression.
The patient being treated had a hematoma in his brain, which led to intracranial hypertension. It also compressed important brain tissues such as the brain stem, cerebral lobes, and nerves, which caused the patient to fall into a coma and even a rapid decline in various vital signs.
Now the accumulated blood is drawn out and the intracranial pressure is reduced, which has the same effect as intracranial puncture and drainage.
"Director Wen, I found two bleeding points. Should I use electrocoagulation to stop the bleeding?"
After Zhou Can's performances yesterday and today, Director Wen has already gained a very high level of trust in him.
Electrocoagulation of hemostasis carries little risk if performed on an insignificant area.
But it is inside the skull and close to the brainstem area.
The risk factor is very high.
Director Wen stared at Zhou Can and asked, "Have you ever participated in electrocoagulation hemostasis during surgery before?"
Zhou Can was immediately happy.
Among all his medical skills, he had the highest level in hemostasis.
At present, they have all reached the intermediate level of treatment.
"I have participated in many surgical hemostasis operations. I am about 80% sure that I can stop the bleeding in these two places without damaging other brain tissues."
To say that there is only an 80% chance of success is really very conservative.
It is a very good way to speak not to overstate the meaning of your words.
It’s just like eating until you’re 80% full and making tea until you’re 70% full.
"Okay, you try it!"
Director Wen recalled that his hands trembled when he was operating the endoscope before, so he decided to delegate the task. Because even if he were to do it himself, he might not be able to operate as well as Zhou Can.
Under normal circumstances, it is impossible for a surgeon to have shaking hands while performing any operation.
Only when you are extremely nervous can your hands tremble.
This is the body's loyal response.
Zhou Can manipulated the endoscope to perform electrocoagulation hemostasis. Compared with ordinary electrocoagulation knife, the usage is slightly different.
It mainly tests the long arm operation ability.
His hemostasis skills were already very good, and his insertion and grasping skills were at least level three. So the whole hemostasis process was extremely smooth and completed easily.
"Dr. Zhou's hemostasis skills are no worse than those of the senior attending physicians! And he has a very high talent for endoscopic operations. Wow, I am really enviable!"
Director Wen stared at the endoscope display screen and watched Zhou Can's entire hemostasis process clearly.
The movements were clean and neat, and the bleeding was stopped accurately, quickly and effectively.
Note that Director Wen used the word "envy" at the end.
That's because his own talent in endoscopic surgery is very ordinary.
I was inspired to see that Zhou Can had talent in both traditional and endoscopic surgery.
There are really only one person in a million who possesses both of these surgical talents.
At present, the training of endoscopic surgery talents in China first looks at the talent for traditional surgery. This is the foundation and a required course.
Especially the four basic surgical skills.
Then, after a certain foundation has been established in conventional surgery, we will select those who are proficient in endoscopic surgery and provide further training.
Therefore, major domestic hospitals and even some county-level tertiary hospitals are already able to perform some endoscopic surgery projects.
But to say that it is done particularly well is probably rare.
The most frightening thing is that some surgeons think that it is very simple to operate an endoscope. Maybe these doctors can indeed perform some simple operations by operating an endoscope.
For example, appendectomy, polypectomy, etc.
They start to show off when they see their success rate for these surgeries is over 80%.
Think you are so great.
Then if a tumor appears in the patient's body, we will strongly recommend the patient to undergo minimally invasive surgery.
Especially breast tumors, granulomas, etc. in women.
The incision is small and can maintain the beautiful figure of female patients to the greatest extent. Most female patients will choose the more expensive minimally invasive surgery.
As a result, the tumor was not completely removed and the operation was not done thoroughly, resulting in recurrence and pus discharge.
It even causes many patients to lose the opportunity for a second surgery.
This is the most unethical doctor.
For the sake of personal performance and so-called endoscopic surgery achievements, the serious consequences that patients need to bear are ignored.
Zhou Can operated the endoscope and checked carefully again, and finally found another bleeding point.
This time, I didn't ask for instructions and just used electrocoagulation to stop the bleeding.
Finally all done.
After draining the new blood, Zhou Can asked, "Director Wen, do you think we can remove the endoscope now?"
"Retreat!"
Director Wen readily agreed.
Zhou Can carefully withdrew the endoscope.
[Implantation experience +1.]
[Complete intracranial endoscopic surgery for the first time, implantation experience +100, grasping experience +100, hemostasis experience +100. ]
Wow, I got a whopping 300 experience points as a reward.
This is also the highest experience value reward Zhou Can has received since performing the surgery.
Risks and benefits coexist.
It seems that if there are opportunities to perform in the future, we must grab them.
[Congratulations on your grasping skill reaching level 4. Your current experience value is 60/10000, and you are at the lower level of attending physicians. You can complete endoscopic curved channel grasping, can complete the precise displacement of inserted coils, can complete the operation of built-in vascular clips, and can complete the auxiliary work of grasping the diseased tissue during endoscopic resection.]
Wow, they say misfortunes never come alone, but I didn’t expect that good fortunes would also come in a bunch!
Zhou Can felt the new fourth-level grasping technique and felt as happy as if he had drunk honey.
There is now an additional advanced medical skill at the attending physician level.
If this trend continues, it should no longer be a dream to upgrade all general medical skills to deputy director level and advanced medical skills to attending physician level within a year.
"Does the trepanation need repair?"
"unnecessary!"
Director Wen answered directly.
“Does the dura need suturing?”
Zhou Can is frantically trying to get opportunities to practice surgery.
"In theory, we just need to stop the bleeding and prevent infection after surgery. The dura mater actually has a certain ability to repair itself. It will grow together with the temporalis muscle."
Director Wen patiently guided Zhou Can.
The three graduate students were taking notes frantically.
Several residents were also taking notes. Surgical knowledge needs to be accumulated continuously.
Because there are too many problems encountered during the operation.
The best way for newcomers is to take more notes and review more when they have time to consolidate and deepen their memory.
This way, you will be able to master the technique and use it flexibly during future surgeries.
"Of course, if you want to repair it, it is possible. Usually tension-relieving sutures are performed." After examining the wound, Director Wen gave an additional conclusion.
After hearing this, Zhou Can immediately became interested.
"Can you let me sew it up? I promise I'll do my best."
Zhou Can has practiced sewing leather too many times.
This was the first time to suture the dura mater.
"How good are your suturing skills? If there are residents with above-average suturing skills, we can consider letting you do it." Director Wen would never dare to look down on Zhou Can again.
Because the surgical skills Zhou Can displayed were more impressive than the last.
Especially the endoscopic hemostasis ability just demonstrated was really shocking.
Even Dr. Zou, who had a lot of opinions about Zhou Can, had to admire him.
Because Zhou Can's ability to stop bleeding is no worse than that of this 40-year-old attending physician.
Now I wonder how this guy practiced?
"The suturing skills are OK, they should be at the level of a resident doctor." Of all the medical skills Zhou Can has, his experience in suturing and ligation is the highest. They are all at the level of an excellent attending physician.
Only a little over a thousand away from being promoted to deputy director level.
Any resident who compares himself with him will definitely be abused to the point of doubting his life.
"Okay, you try it!"
This suturing also requires endoscopic operation.
Because it is underneath the skull.
The hole is so small that even an ordinary sewing crochet needle cannot fit through it.
Zhou Can carefully manipulated the endoscope to perform endoscopic suturing. This was also his first time to perform endoscopic suturing.
His idea is simple.
While Director Xie has not yet implemented dimensionality reduction suppression on him, now is the time to grab the opportunity to undergo surgery and practice.
Especially this kind of endoscopic operation opportunity, it is difficult to get it by following other doctors.
It just so happened that Director Wen had no talent for advanced surgery, which gave Zhou Can a very good development opportunity.
Just as Zhou Can finished the first stitch, there was a gasp in the operating room.
Doctor Zou and Tang Li both stared with wide eyes, watching Zhou Can complete the endoscopic suturing in shock. They did not expect Zhou Can's suturing skills to be so excellent.
Leaving the two of them far behind.
"My God! Dr. Zhou's suturing skills are probably no different from those of an associate chief physician." Tang Li thought that her suturing skills were not bad, but compared with Zhou Can, the difference was really not even a little bit.
"This kid is really awesome!"
Doctor Zou muttered to himself.
As for the residents and graduate students behind them, let’s not even mention them.
Their skills are still very low and they can't see what's so good about Zhou Can's suture.
All I know is that the stitching was very neat and fast.
Director Wen stared at the screen without saying a word.
Maybe he was worried about interfering with Zhou Can's operations.
So I dare not disturb you at all.
He even reached down and pressed down to stop the other doctors from speaking.
Zhou Can showed everyone how amazing a resident trainee can be. In less than five minutes, he had completed all the sutures.
"Director Wen, please check."
After he finished suturing, he respectfully asked Director Wen to check it.
[You complete endoscopic suturing for the first time, and are rewarded with +100 suturing experience points and +100 ligation experience points. ]
So cool.
It was my first time operating an endoscope and the reward was really generous.
Experience points are added directly in hundreds.
"No, no!"
Director Wen shook his head repeatedly, his expression serious, his eyes fixed on Zhou Can.
These words were like a bucket of cold water poured over Zhou Can's head.
It gave him a chill.
All the excitement and joy turned into a sincere attitude of humbly accepting opinions.
"Ah... This is my first time suturing the dura mater. If there is anything I did not do well, please point it out and I will correct it immediately."
Zhou Can originally thought that he sewed well.
As a result, he received such a low evaluation from Director Wen, which was a big blow to him.
"No, no, no, I'm not saying that you didn't suture well. I'm doubting your identity. I've been working at Tuya for more than 30 years, and I've never seen a resident trainee as perverted as you. If you do well in implantation, it can be understood that you have outstanding talent in advanced surgery. But your level of hemostasis, suturing, and ligation surgery has reached the attending physician level. This is really rare."
Director Wen is not a fool either.
If a resident trainee is very good at a certain surgical procedure, it can be understood that he has practiced a lot.
However, to have such high level of skills in all surgical operations, it is only possible to achieve this level of skills if one practices from birth.
The training period for surgeons is extremely long, and it is difficult to achieve any success without more than ten years.
No matter how talented you are, it can’t be this good, right?
It's too exaggerated.
"Haha, you scared me. I thought it wasn't sewn properly."
Zhou Can breathed a sigh of relief, as long as the operation was not done well.
"Maybe it's because I like surgery so much and practice it so often, so my foundation is a little stronger than that of ordinary interns. That's all, it's not as exaggerated as you say!"
The explanation he gave was far-fetched.
But this matter is not important at all, and no one will delve into it.
There's nothing to be found.
Zhou Can is indeed very hardworking and practices surgery every day after work.
"I heard some directors talking about it a while ago. They said that our hospital has produced two monsters among the regular trainees this year. One has abnormal surgical skills. The other has theoretical knowledge that beats all the directors of other departments. Seeing is believing. I used to be skeptical, but now I believe it completely."
The other monster Director Wen mentioned should be Du Leng.
Overseas returnees with PhDs are really awesome.
However, the academic qualifications of overseas returnees with PhD degrees are sometimes quite exaggerated.
Judging from the powerful strength Du Leng has currently displayed, he should be the real deal.
"Doctor Zhou, don't just stand there, why don't you sew up the patient's scalp as well! Let me admire your superb suturing skills again. It's very much like Doctor Xu back then."
Director Wen inadvertently mentioned the death of Dr. Xu.
This shows that Dr. Xu had a huge influence in surgery back then.
"Thank you Director Wen for your trust."
Zhou Can didn't waste any time and directly took the needle holder and hook from the instrument nurse and started suturing.
He found that the instrument nurses who performed this kind of major surgery were all experienced and highly professional.
All kinds of cooperation are very good.
Zhou Can didn't need to say much about suturing different parts, what kind of thread to use, and how big the thread should be.
Everything was prepared early.
Just take it and use it.
And some details are also done very well.
Just now, when they were suturing under the endoscope, everyone didn't see Zhou Can's suturing technique clearly. Now that he was suturing the scalp, everyone was completely enlightened.
"His suturing skills are better than mine. Today is an eye-opener."
Doctor Zou was feeling a little depressed.
It was originally a level 4 operation.
It turned into Zhou Can's solo show.
This is a level 4 surgery! Who would have thought that a resident trainee could perform most of the key tasks of the surgery so naturally?
Zhou Can's surgical speed began to inherit Dr. Xu's "fast" style.
The head wound was sutured quickly.
"Not bad, not bad. This suture makes people happy just looking at it. The patient is in extremely weak physical condition right now, so let the orthopedics department do the knee surgery later."
The patient in the car accident not only suffered injuries to his head, but also to his knee joints and other parts.
The external injuries had been treated long ago.
"After the hematoma in the patient's brain was cleared, his vital signs have actually recovered quite well. It is a world of difference compared to when he first entered the operating room. In his current condition, I even suspect that he only needs to stay in the ICU for a day or two before being transferred back to the general ward."
The anesthesiologist has full confidence in the patient.
He should be the person who knows the patient's vital condition best.
"Haha, you can give such an optimistic evaluation. It seems that this operation was not bad. After waking up from general anesthesia, push him back to the ICU for observation!"
Director Wen successfully completed a difficult operation and was in a good mood.
I looked up at the clock on the wall.
"It seems like I can start doing research earlier today! Endoscopic surgery does have advantages over traditional surgery!"
According to his previous estimate, it would take at least four to eight hours to perform a traditional craniotomy on the patient.
The key is to avoid any unexpected situations along the way.
The patient's vital signs are dropping rapidly. If necessary, the operation must be stopped and emergency treatment must be carried out immediately.
That would take longer.
"Endoscopic surgery is indeed a major development trend. However, there are some diseases that cannot be effectively treated by endoscopic surgery or minimally invasive surgery. So I don't believe that traditional surgery will be completely eliminated."
Tang Li's talent for advanced surgery is very poor.
She must have thought deeply about the prospects of both surgeries.
After all, young people are most afraid of being suddenly eliminated by the times.
"You are right. Traditional surgery will still have room for survival for a long time. However, we must also see the rapid development of endoscopic surgery and its various advantages. Just like our Chinese traditional medicine, in just a hundred years, it was squeezed by Western medicine and was forced to survive in the cracks."
Director Wen remains pessimistic about the prospects of traditional surgery.
Even traditional Chinese medicine was used as an example.
"Chinese medicine is not bad in China, and my classmates who studied abroad told me a strange phenomenon. China currently does not attach importance to Chinese medicine and despises it. But foreign countries are just the opposite, and have begun to vigorously develop Chinese medicine. Not only have they quietly developed more than 10,000 varieties of Chinese medicine for planting, but they have also opened Chinese medicine research centers and recruited many powerful Chinese medicine practitioners from China."
When Dr. Zou talked about this , he seemed quite sad.
Traditional Chinese medicine has now become a permanent pain in the hearts of many medical professionals.
The market chooses everything.
It is an indisputable fact that the market for traditional Chinese medicine is very small.
Some far-sighted doctors and scholars have begun to call for the protection of traditional Chinese medicine, but with little success.
Zhou Can looked at Dr. Zou deeply, and his impression of him changed greatly after hearing what he just said.
To be honest, Zhou Can himself has always had a relatively neutral attitude towards traditional Chinese medicine.
Neither praise nor criticize.
Just look at it rationally and objectively.
