Vol 2 Chapter 1640: Hand to mouth teaching

   Chapter 1640 Hand-to-mouth teaching
   Itinerary surgery is not the same as conventional flying knife surgery. In the flying knife surgery, the experts are better, and they will tell the local doctor on the operating table. If the doctor is more arrogant, he will not say a word, and even the local doctor will not even tie a knot, and they will do it themselves. The whole process is covered, and the local doctor is also a personal-shaped retractor.
   This is also no way, after all, he is pressing his reputation for half his life to make money, not to promote technology.
But the tour operation requires detailed explanations, and even find a way to make the doctors involved in the operation understand clearly. Just like watching a movie, there must be no mosaics. Although many bigwigs can do it in their hearts, they are in the end. Whether it’s natural or man-made, it’s still impossible to see through mosaics.
   Therefore, Zhang Fan had to explain at the beginning of the operation. Zhang Fan was a little uncomfortable with this kind of operation.
  Because Zhang Fan was known as a surgical mute at Chasu Hospital, he had surgery and he could hardly speak.
This makes sense, but everyone is not strict. There is a rule in the operation rules and regulations, which clearly stipulates that you should not speak as much as possible during the operation, because speaking, there will be droplets, and if there are droplets, there is a possibility of infection. sex.
  A man and a woman quarreling face to face, in fact, it is not unreasonable to describe them kissing at the molecular level.
   If it is necessary to speak in the operating room, it must be whispered, but in reality, the doctors and nurses are flying in their cars.
Back then, at Chasu Hospital, a patient went to the Disciplinary Committee to sue the hospital because of a chat between the surgeon and the nurse, because the patient was half anesthetized and half awake when he heard this sentence, "It's so big, you must have never seen it before. ."
  The nurse didn't know if it was true or not, so she immediately retorted, "Yes, I haven't seen it before, anyway, yours is smaller than his."
   This is the real thing, you can imagine how fast this car is.
   "Zhangyuan, the operation is ready." The anesthesiologist said to Zhang Fan gently. The anesthesiologist was brought by Old Man Wu and worked with Zhang Fan at the beginning.
   Zhang Fan stood up, nodded at the camera, and then at Old Man Wu.
   He knew that the old man in his family would be staring at the display screen right now, and he probably was more nervous than himself. And the uncle, at such an old age, has to enter the operating room regardless of the hard work to help Zhang Fan stand on the platform.
  Zhang Fan can't say thank you, he can only be grateful from the bottom of his heart.
   "Conventional median incision, this incision cannot be saved, and it should be opened as large as possible. Although the damage is a little bigger, it is more cost-effective than the secondary extension after an accident."
   Zhang Fan took the scalpel and used the back of the knife to make a simulated incision on the patient's stomach. This method is used in many operations, but other doctors are not demonstrations, but previews.
  Many doctors use the handle or back of the knife to do a drill before cutting the skin. White marks are drawn on the skin.
The gallbladder is hidden at the edge of the liver. How can I describe this thing? In fact, it is like a lady wearing a dress. As soon as the wind blows, the skirt flutters violently. White, black, Mickey Mouse!
The gallbladder is actually the same. It hides and disappears. When ordinary people enter the hospital, the doctor will make the patient lie down, with the legs together and retracted, and then the doctor's hand will be buckled on the edge of the rib cage. Ask the patient to exhale and touch the palms deeply and shallowly as they breathe.
   This is just like the wind. With this operation, you can feel whether it is white or black.
   Before entering the abdomen, there is no special, routine operation, not to mention Zhang Fan, in Shanhua Hospital, just pull out a general treatment, and it will be clear to you.
   When entering the abdominal cavity and holding up the liver, the cancerous gallbladder appeared.
   A normal gallbladder is like a crystal clear purple grape hidden under the vine in the morning and stained with dew. With the peristalsis of the body, the crystal clear bile slowly flows in the grapes. Under the illumination of the fluorescent lamp, it really makes people feel the most to suck.
The organs of the body, to be honest, in normal times, are quite beautiful, definitely cuter than the organs on the surface of the body, the pink intestines, the lively liver exuding an extravagance, the white and smooth bladder, and even the The lungs are like a pink and white jade.
But this patient's gallbladder is not difficult to be cute. If you choose a description, it is like a male toad meets a female toad. It is covered with scarred pimples, and it becomes bigger and bloated as if it was congested with blood. , The yellow sticky viscous liquid secreted occasionally can make the half-boiled eggs eaten in the morning spit out.
   The purple gallbladder, which was originally a droplet, was like a toad shrinking where it was at this time, and the gallbladder was slightly swollen because of the swelling, which was really boring.
   "It's late! It's too late to open the door. It's not easy for Zhang Yuan to go."
   In the observation room, many doctors came to whisper, and everyone thought that perhaps in the first round of surgery, Shanhua would find a patient in the early stage of cancer.
  Actually, the general director of Shanhua had talked to Zhang Fan at the beginning, which meant that for the first session, it was better to choose patients in the early stage, as the operation was less difficult.
   But Zhang Fan refused. Sometimes, the profession of a doctor is very strange.
  Some doctors can't have a good reputation. Hua Tuo is no match in this world, but they also follow a sentence, Zhuge is only cautious! Whether this habit is good or not is hard to say in the medical world.
  This kind of caution will greatly reduce medical errors, but the disadvantages are also obvious. Such doctors will hardly risk treatment.
   Old Man Wu is famous, how much Old Man Wu has done, what liver Asian atlas, and what surgery is done for Asian liver surgery. In fact, these are not as good as he took the risk of performing a huge tumor resection on a young child. This operation of the old man is currently the youngest patient in the world and the largest operation for cancer.
  According to the academic level, this excision is not as important as the above, and there is an illegal taste of performing surgery regardless of the contraindication of surgery. But, can you say that the old man was wrong?
   Therefore, the medical profession really cannot define a doctor simply as good or bad.
   Zhang Fan is not as high-spirited as Old Man Wu, and he has not practiced to the level of others, but Zhang Fan is confident in his surgical skills.
  Since people are so insistent, Shanhua's general foreign director also wants to see the level of this future leader.
   Therefore, the first operation was a very serious patient.
   "We must destroy the surrounding blood vessels and nerves. This is a difficult point, please pay attention."
  Zhang Fan said softly, but the sound of the sound made the eyes of a group of doctors bulge out in the observation room.
   The difficulty of this kind of surgery is not the removal of the gallbladder. The difficulty of removing the gallbladder is actually not much different from the difficulty of removing the gallbladder with gallstones. The real difficulty is to clean the nerves and blood vessels around the gallbladder.
   Many cancer surgeries are very difficult. The difficulty is not the removal of the lesion. Removing a lesion is actually the same as removing a piece of rotten meat, and it is not difficult.
  The difficult part is the dissection. In many cancer operations, the dissection range extends to seven, eight or even more than ten lymph nodes around it. How do you say this thing? To put it simply, for example, when you perform an operation on the navel, some operations require lymphatic dissection to be done under the armpit.
   With such a large distance, it can be said that if one of them is accidentally missed, the end result is that all previous efforts will be lost. And the scale of damage along the way is unimaginable.
   is equivalent to almost destroying a person's defense organization.
   The operation of gallbladder cancer is more troublesome. Look at the pancreas, liver, and colon next to it. These are not easy to mess with.
   "Gauze Wrap!"
   The director of the Nursing Department quickly handed Zhang Fan a piece of gauze soaked in physiological saline.
  Zhang Fan began to wrap the gallbladder, the moist white gauze was gently wrapped and knotted around the gallbladder, and the instantly disgusting gallbladder was wrapped in the gauze.
   Zhang Fan started cleaning.
   Vascular, terminal vascular resection, nerve descending nerve resection, lymphatic dissection.
  Lymph like sesame seeds hangs near the hepatic portal vein, like a flamboyant little brother hanging on the side of the elder brother's thigh, constantly shouting, don't come here, come here, my elder brother is not easy to mess with.
  There are layers of sesame-like lymph around the thick hepatic portal vein, and with the fluctuation of the hepatic portal vein, the lymph also rises and falls.
   Knife, replaced with a new sharp knife. Scalpels are exquisite. For example, scalpels are usually replaced after entering the abdominal cavity. It is not a waste of doctors, because at this time, the blade must be kept sharp.
Zhang Fan held the handle of the knife and began to clean, swish, swish, and swish the blade along the door system, like peeling a carrot, whether Zhang Fan is nervous or not, I don't know, Zhao Jingjin and Shanhua's general foreign affairs director, even Not even breathing.
   At this time, if you accidentally push the blade a little deeper into one millimeter or two millimeters, the cleaning can turn into a big blood.
   Outside the operating room, a group of people kept shaking their heads as they watched, "This can't be done, this requirement is too difficult. It can't be done! His blade is all along the adventitia of the blood vessel, this..."
Just when everyone thought that Nima was here to show off his skills, Zhang Fan began to speak, "The blade is attached to the outer membrane, you must feel the resistance of the outer membrane to the blade, along this layer of resistance, the blade is slightly inclined ten degrees. , Don’t be careless about the strength of adducting and descending, you must always feel the resistance of the adventitia.

   "I'm going, this Nima can still speak with this kind of operation, is this still a human?" The one-year-old deputy said fiercely. The old man Lu, who was outside the operation, smiled slightly and said, "This is the improvement of the Qiu-style knife technique. You can see that Zhang Fan's knife tip is not oblique, he is not using the force of pushing down, but relying on joint tearing. of!"
  Zhang Fan explained to the director of Shanhua the difficulties of the operation little by little, and how he performed the operation himself. It can be said that he broke it apart and smashed it to explain to the director of Shanhua.
   (end of this chapter)