Chapter 246: Every inch has its own shortcomings and every foot has its own strengths. Astonishing amount of endoscopic surgery
The two were walking side by side in the corridor at this moment. Upon hearing this, Luo Shengsheng stopped and turned to look at Zhou Can.
"Isn't the patient in bed 73 under Yu Xin's care? Doctor Zhou, you are a hero and you want to help her?"
"Hehe, I guess so! But I don't really have any intention of pursuing her. It's just that we are in the same medical team. Plus, the couple in bed 73 are not from a well-off family. They are both at the bottom of society. If the patient's condition really gets worse, the cost of treatment will be terrifying. The key is that they may not be able to save him."
Zhou Can has his own ideas.
To say that he is interested in beautiful women is really unfair to him.
Yu Xin’s appearance is not bad, but compared with Su Qianqian, the gap is quite big.
In Zhou Can's eyes, she was at most a vulgar woman.
"So that's how it is. Dr. Zhou has a kind heart. I admire him!"
He gave Zhou Can a thumbs up.
"You don't need to ask for this specifically. I would have done it. The main reason is that Yu Xin is too cold. She rarely greets me when we meet. It's like someone owes her 2.58 million yuan. It's not pleasant to see her."
Yu Xin's personality is indeed a little too cold, so it's normal that others complain about her.
There are always some women who don’t know where they get their confidence and courage from. They look stern all day long and think that everyone has to revolve around them.
The result is predictable. For such a woman, it is considered good enough if she can maintain superficial harmony with her colleagues at work.
When they really get into trouble, there is no one to help them.
Compared with Yu Xin, Qiao Yu is much better than her.
Qiao Yu is not only more beautiful than Yu Xin, but also has a much higher emotional intelligence.
Even though Dr. Lu pestered her so much and even though she hated Dr. Lu so much, she never quarreled with him.
"Now that Dr. Zhou has spoken, I will definitely handle this matter. It's just a small matter. There are many ways to deal with such family members. I will go and deal with her now."
After seeing Zhou Can's puncture skills, Luo Shengsheng's attitude towards Zhou Can became more enthusiastic and friendly.
Zhou Can returned to the office.
Yu Xin sat there with a sad face. It seemed that she had tried to persuade the old lady again, but the effect was not satisfactory.
Not long after, Luo Shengsheng was seen coming back with a relaxed smile on his face.
"The family of bed 73 has already registered for treatment! The patient's sister will arrive at the hospital later to take care of him."
Luo Shengsheng said to Zhou Can.
"Mr. Luo is amazing! I didn't expect you to be able to easily persuade such a difficult aunt. She was so sick, if she didn't seek medical treatment, she would have developed typhoid fever or sepsis. Mr. Luo saved her life. According to Buddhism, this is like building a seven-story pagoda!"
Zhou Can was shocked when he heard that Luo Shengsheng persuaded the old lady so quickly.
"Haha, it's not that great a merit! But it's definitely worth mentioning for its good deeds."
Luo Shengsheng laughed happily, not without pride.
Every inch has its own shortness, and every foot has its own strength.
Everyone has their own specialties. Luo Shengsheng's puncture skills may not be as good as Zhou Can's, but his ability to persuade family members is simply the pinnacle and has reached the pinnacle.
Anyway, Zhou Can was overwhelmed if he was asked to persuade the old lady.
Yu Qing, who was not far away, had a worried look on his face with his brows furrowed.
When she heard that Luo Shengsheng had persuaded the family of bed 73, she was surprised and happy.
After a little thought, she realized that Zhou Can must have secretly asked Luo Shengsheng to help her. Otherwise, Luo Shengsheng would not have asked Zhou Can for credit as soon as he came in.
"Thank you, Mr. Luo, thank you, Dr. Zhou!"
Yu Xin was still a little bit unbelievable and quickly ran to the ward to check.
She soon came back.
But the sadness on his face had disappeared.
"That lady really went to see a doctor, and was really persuaded to leave by Mr. Luo."
"How else could it be fake?"
Luo Shengsheng raised his eyebrows with some dissatisfaction and asked back.
"Doctor Yu definitely doesn't mean to distrust you. She just feels the same as I do. How come such a difficult family member is so obedient in front of you, Mr. Luo? Mr. Luo, please teach us newcomers!"
Zhou Can quickly smoothed things over for her.
Otherwise, with her cold face, she might make Luo Shengsheng angry before she even opens her mouth.
After listening to Zhou Can's explanation, Luo Shengsheng's expression eased a lot.
He really did a great job on this matter.
"It's nothing. I just cited the hospital's infection prevention and control regulations and said some harsh words to her. I told her that if she didn't leave the ward immediately, the consequences would be extremely serious. But before I finished speaking, her husband was already urging her to register for treatment."
Luo Shengsheng did not elaborate on what harsh words he said to the old lady.
However, it is certain that those words can bring tremendous psychological pressure to the patient in bed 73 and his family.
The person who can make the decision on this matter is actually her husband.
As long as it may seriously affect her husband's vital interests, her husband will be the first to get anxious without the doctor saying anything more.
"It seems that we can't just be polite to family members all the time! Today I learned another trick from Mr. Luo. When dealing with difficult family members, we must use both kindness and severity. When it's time to be serious, we must never be polite to them."
What Zhou Can has always been worst at is dealing with difficult family members.
This has to do with his upbringing.
Since he was a child, the people he had dealt with were basically of high quality. Even if he met unreasonable people, he would deal with them with fists.
But being a doctor in a hospital is considered a service industry.
You definitely can’t use your fists against family members or patients!
If there is anything, you can only persuade them patiently.
The way Luo Shengsheng dealt with this difficult-to-persuade old lady gave Zhou Can a lot of inspiration.
As they were chatting, Director Shang appeared at the office door.
He had no intention of coming in, but just stood at the door and shouted to Zhou Can, "Doctor Zhou, remember to send the patient with esophageal anastomotic fistula in bed 71 to the interventional operating room on time."
This case is a highly difficult surgical case.
Although endoscopic surgery is performed frequently in gastroenterology, it is still challenging.
"OK!"
Zhou Can also hopes that the patient can undergo surgery as soon as possible.
The patient's body has become very weak due to long-term inability to eat.
The sooner the surgery is performed, the better.
…
In the interventional operating room, the patient in bed 71 was sent to the interventional operating room by Zhou Can and the nurse.
Both the family and the patient expressed their willingness to take the risk of undergoing the operation.
Because the patient is in so much pain.
The anastomosis between the esophagus and the jejunum is blocked, so the patient cannot even swallow his saliva, and a spittoon must be prepared at all times by the bed. This level of pain is unimaginable for ordinary people.
After anesthesia was administered, Director Shang performed the operation himself.
With the help of the nurse, an ultrasound endoscope was used to insert a thin needle less than 1 mm from the patient's esophageal anastomosis into the intestinal cavity on the opposite side. The whole process required the assistance of XX-ray imaging.
Zhou Can stood nearby and watched with envy.
What a pity.
What a great opportunity to perform surgery! If he can do it himself, he can earn at least 100 points of advanced medical experience points as a reward.
The entire endoscopic puncture process went smoothly, and the nurse selected was the best endoscopic surgery nurse in the department.
Director Shang also specially called a deputy director to serve as an assistant to avoid any mistakes.
Next, a covered metal stent is placed.
Although the placement was successful in the end, judging from the proficiency of the operation technique and skills, Director Shang's placement skills were not very good.
At best, he is just an attending physician, about the same level as Zhou Can.
But this is already very impressive.
There is no pure gold, and no one is perfect.
The endoscopic surgery capabilities of many chief physicians are unsatisfactory. Chief Shang is considered a tall man among short ones and is already an expert in endoscopic surgery.
"Good! The blocked junction between his jejunum and esophagus has finally been cleared."
Director Shang was very happy.
The entire operation went extremely smoothly and took only one hour and five minutes.
However, this only helps patients solve the problem of anastomotic segment occlusion, and the problem of esophageal anastomotic fistula still exists.
"Okay, the operation was successful. Prepare to remove the endoscope and wake up from anesthesia!"
Director Shang immediately announced the end of the operation.
Zhou Can was stunned. He had clearly suggested to Director Shang that the fistula should be repaired!
Seeing that all the doctors and nurses were so excited, Zhou Can hesitated for a moment and decided to mention the matter.
In order to repair the fistula, he also did a lot of work.
The operation ended like this, and the patient still couldn't eat afterwards.
"Director Shang, the patient's fistula has not been resolved yet. Do you think we can take this opportunity to resolve it?"
Zhou Can really made this suggestion out of necessity.
I am just a trainee and I am still a stranger to Director Shang. It is far from saying that they have established a friendship or even a deep affection for each other.
If it was people like Mr. Liu or Doctor Xu, Zhou Can would give his opinions freely.
As long as it is reasonable, they will gladly agree.
Director Shang was in high spirits at the moment, and Zhou Can ruined his mood by pointing out that there was still a problem that had not been solved.
"It is extremely difficult to solve the esophageal anastomotic fistula. The second hospital where the patient underwent surgery is also a provincial tertiary hospital like our Tuya. As a result, not only was the problem not solved, but the anastomosis was blocked. If we want to solve the problem of esophageal anastomotic fistula, we must cut it off and re-anastomose it. This operation is very risky, so it is not recommended."
Director Shang was a little unhappy, but considering Zhou Can's outstanding performance yesterday, he still patiently explained to Zhou Can.
There are many causes of esophageal anastomotic fistula.
Some are due to insufficient suture, poor local blood supply, anastomosis errors, etc. Some are due to postoperative infection, or necrosis of cut tissue, or pleural effusion.
The last situation is local infection and suppuration, or the anastomosis is too small.
From this we can see that doctors with poor surgical skills can kill people.
The above reasons are almost all caused by poor surgical skills. If the patient had done a good job in the first surgery, nothing would have happened to him afterwards.
As a result, I suffered so much because the first anastomosis was not perfect.
"Can you let me try? I might be able to find the fistula accurately and close it."
Zhou Can dared to say this based on the five-level suturing and ligation technique.
"In a narrow lumen, using an endoscope to repair the fistula? Zhou Can, I really don't mean to undermine your confidence. There is no doctor in the world who can do this successfully."
Director Shang is an expert in endoscopic surgery and has a very deep understanding of it.
"I didn't say that the fistula should be repaired in the esophagus or jejunum! My idea is to find the fistula, open two small windows from the outside, and use an endoscope to complete the repair work."
Zhou Can continued to fight for the opportunity to repair the fistula for the patient.
"Open two small windows in the chest? Do you know how risky this is?"
Director Shang's voice became much higher.
This young intern is really too naughty. Does he think surgery is just a child's game?
If only esophageal anastomotic leaks were that easy to repair.
"What if the fistula is located in this position?"
Zhou Can pointed to the patient's left upper abdomen.
"Do you think the fistula is located at this position?" Director Shang's expression became much more serious.
"It's not clear yet. I can only infer it based on the patient's examination in other hospitals and some of his current symptoms. At present, the patient's anastomosis has been successfully cleared by you. You can check it with angiography."
Zhou Can said in a calm tone.
Even when facing a department director, he remained neither humble nor overbearing, not to mention showing any fear.
Just normal communication.
"Okay, I'll follow your advice and take angiography to check the fistula opening and the fistula tract. Let me be frank, if you want to open the chest, I will never agree. Even if it's just two small windows, it's absolutely not possible. The patient is so old and has been malnourished for a long time, it's difficult for him to withstand open-chest surgery. And his chest organs are likely to be severely adhered."
Director Shang has his own concerns and worries.
The patient has undergone two operations, and there will definitely be a certain degree of adhesion between the organs and tissues in the chest and abdominal cavities.
This will undoubtedly increase the risk and difficulty of the operation.
When multiple risks increase, the risk level of surgery will increase exponentially.
For safety reasons, neither the surgeon nor the anesthesiologist would agree to perform such an operation.
"Thank you for agreeing to do so!"
Zhou Can successfully persuaded Director Shang and breathed a sigh of relief.
Next, they performed esophagecography and found that the fistula was indeed at the location Zhou Can had pointed out before.
The fistula tract is easier to find as it is directly connected to the drainage tube.
"Even if the fistula is in this position, the difficulty of repairing it is still frighteningly high. Are you really sure you can complete it?" Director Shang evaluated himself secretly. He had no confidence at all in doing the repair.
"If you agree to let me do it, I have at least an 80% chance of success."
Zhou Can didn't dare to say anything too decisive.
An 80% chance of success is actually very high.
Because doctors tend to use extremely conservative estimates.
Director Shang did not agree immediately, but lowered his head to consider the risks involved.
"I heard that you have performed many endoscopic surgeries in other departments. Is that true?"
When Director Shang asked the question, he stared into Zhou Can's eyes.
His gaze was intimidating, which was to prevent Zhou Can from lying.
"It's true."
Zhou Can answered in the affirmative.
“How many cases have failed in total?”
Director Shang asked again.
“Zero cases!”
Zhou Can's answer shocked everyone.
The failure rate of surgery is not low. Even in a large hospital like Tuya, the failure rate of surgery is still quite high.
Any surgery has risks.
Director Shang also had a look of suspicion on his face.
"To be precise, there were zero cases of intraoperative failure. There were eleven cases where the postoperative treatment effect did not meet expectations."
Zhou Can explained.
“So how many endoscopic surgeries have you performed in total?”
According to common sense, if the failure rate is zero, the total number of surgeries performed must be very small.
It is even possible that only eleven cases were performed in total.
Although there were no problems during the eleven endoscopic surgeries, the postoperative results were not good, which indirectly proves that Zhou Can's surgical ability was poor.
"I've probably completed more than 500 endoscopic surgeries in total! I haven't counted the exact number."
This question really stumped Zhou Can.
When performing surgeries, he would at most calculate the total number of surgeries performed that day. As for the total number of surgeries he had performed since his regular training, he did not have the time to calculate this!
If you have that much time, you might as well read a few more books.
"Oh my god, more than 500 endoscopic surgeries in total! Is this really something a resident trainee can accomplish?"
After hearing this, the deputy chief physician couldn't help but exclaimed.
Others also strongly doubted its authenticity.
Zhou Can’s total training time is less than two years.
"Well, wait a moment, I'll make a phone call and find out."
Director Shang went to the side to make a phone call.
The matter was of great importance, so he dared not be careless. Only after confirming that Zhou Can had really completed a large number of endoscopic surgeries would he consider letting Zhou Can perform fistula repair.
"Is this Lao Xiong? I'm Shang Feng from the Department of Gastroenterology. Can you help me find out how many endoscopic surgeries the resident doctor Zhou Can has participated in?"
"Yes, yes, I want to know the result immediately."
…
After waiting for about a minute, the result came out on the other end of the phone.
"What...you said Zhou Can has participated in more than 800 endoscopic surgeries?" This number really shocked Director Shang. It seems that Zhou Can's report of only 500 surgeries is already very conservative.
"I understand! I just wanted to learn more about his endoscopic surgery skills and experience. This result really scared me. Okay, thank you for your help, old friend. I'm performing surgery right now, so I won't talk to you anymore!"
After saying that, Director Shang hung up the phone.
I don't know which department of the hospital the call was made to. The other party may have some power, otherwise they would not have been able to find out the total number of surgeries Zhou Can participated in so quickly.
After finishing the call, Director Shang looked relaxed, with a very rare smile on his face.
"Dr. Zhou really didn't lie. To be honest, I'm really shocked that you've participated in so many endoscopic surgeries." If you participate in an operation just to observe and learn, it usually won't be written into the surgical record.
You have to at least get a role as a third assistant to be eligible to leave your name.
Don’t even think about being an intern who does odd jobs like hook pulling.
“It is also because of the great efforts of senior doctors in various departments to train me that I can participate in so many endoscopic surgeries.”
If Zhou Can told Director Shang that he not only participated in many endoscopic surgeries but also performed them as the main surgeon, I wonder if Director Shang would be scared to have a heart attack.
"Okay! You can perform the fistula repair! Director Shi and I will be your assistants." Director Shang personally assisted Zhou Can because he was worried that something unexpected might happen during the operation.
Just guarding Zhou Can from the side.
