Coming out of the four courtyards.

Xiao Mao said sincerely: "Teacher Zhang, you know a lot. ”

Zhang Gu smiled: "It's okay, Teacher Zhou Dongfeng knows more." ”

It's not that he's deliberately modest.

He seems to be in the limelight recently, as if he has robbed Zhou Dongfeng of the limelight, but in fact, he is more specialized in anastomosis.

Really count it out.

Zhang Gu can independently perform the surgery, and he doesn't even have five surgeries.

And Zhou Dongfeng will have at least more than ten units.

Xiao Mao was greatly encouraged: "I will follow you and Director Zhou to learn hard!"

Zhang Gu sighed: "I also have to come to a big improvement. ”

We have already started to teach students, and our surgical skill pool is still so shallow, how can this work?

Anyway, it's useless to save up a lot of cards.

When we go back, we will expand the scope of our surgery and improve the clinical level!

Back to the Third Courtyard.

Shen Wenting looked at Zhang Gu with a blank eye: "Brother Zhang, tell the director, let you go to him when you come back." ”

"Did you say anything?"

Shen Wenting flattened her mouth and said: "There is a difficult patient, the director is studying the treatment plan, saying that you are needed for the anastomosis part, it may be this matter." ”

Zhang Gu was happy in his heart, Director Xiang is really my guiding light!

I was looking to expand the scope of surgery, so I came to the door with the opportunity.

Shen Wenting was envious: "You are going to join Director Xiang's team again, Brother Zhang, when can you take me again, I can do anything, dirty work and hard work!"

Zhang Gu comforted her and said, "Don't worry, there is a chance." ”

"Okay. ”

Shen Wenting also knew that Zhang Gu's treatment today did not depend on anything else, but on his ability.

She also had to improve her abilities.

She picked up a thick book, read it, and as long as she was free, she would seize the time to improve her abilities, and she would always improve.

......

When Zhang Gu took Xiao Mao to the office of the chief of major surgery.

Xiang Jianhua and his royal deputy, Donnie Yen, are studying the patient's condition.

"Xiao Zhang is here, let's sit down first!"

Xiang Jianhua glanced at Mao Junliang behind Zhang Gu, knowing that it was Zhang Gu's recent student, and after nodding slightly, he didn't pay much attention.

Xiao Mao was glanced at by Xiang Jianhua, the surgical boss, and he trembled a little.

He has only been in the company for a few days, and he has come into contact with this famous leader, and he is very nervous!

Xiao Mao glanced at Zhang Gu quietly......

I saw Zhang Gu's calm demeanor, and he even leaned his head over, "Director Xiang, what's the situation with the patient?"

Xiang Jianhua said: "The patient is overly obese and takes medicine for useless type 2 diabetes. ”

"We are considering gastric bypass surgery, or gastric reduction and resection. ”

"You may need to be in charge of the anastomosis later, you have to be mentally prepared, we will study the surgical plan first, and you can rest for a while. ”

"Good. Zhang Gu agreed.

But instead of leaving, he stood in the corner of the table and looked through the patient's medical records.

Xiang Jianhua glanced at Zhang Gu, ignored it, and discussed the plan with Donnie Yen.

Donnie Yen said: "Director Xiang, I think it is better to use sleeve gastrectomy to reduce the stomach capacity, reduce appetite, and reduce food intake by removing the greater curvature of the stomach, so that the obesity can be reduced, and type 2 diabetes should be relieved to a certain extent." ”

Xiang Jianhua was a little hesitant: "It's just that it can't be relieved, this patient's type 2 diabetes is ineffective by taking medicine, and it must be completely cured by surgery." ”

"From the perspective of radical treatment of type 2 diabetes, gastric bypass surgery to rearrange the small intestine is more appropriate. ”

The two of them discussed for a while, but they couldn't make up their minds.

At this time, Zhang Gu also read the patient's medical records.

I've been listening to the two of them for a while.

The key point that made the two hesitate and entangle is-

Gastrectomy and gastric bypass are two types of surgery that only partially solve the patient's problem.

Either it mainly cures obesity, but it has little effect on type 2 diabetes.

Either it mainly inhibits the secretion of insulin resistance factor, thereby treating type 2 diabetes, but the side effects of surgery are large, the function of the gastric pylorus is sacrificed, and the weight loss effect is average.

Both surgeries have their own advantages and disadvantages, which made Director Xiang, who pursues perfection, very hesitant for a while.

After discussing with his deputy Donnie Yen for so long, he has never decided on a surgical plan.

Xiao Mao stood next to him and didn't dare to say a word, for fear that making a little noise would affect the thinking of the two big guys.

At this time, Zhang Gu suddenly spoke, startling Xiao Mao.

"Director Xiang, Doctor Zhen, why don't we try the advantages of combining the two surgeries?"

Xiang Jianhua thought about it and shook his head slightly.

"I've thought about it too, but it's not good to synthesize. ”

"You see, these two surgeries, either remove part of the stomach, or redirect the stomach and intestines, turning the stomach into two parts, how to learn from each other's strengths?"

Donnie Yen also looked at the case and was puzzled.

In Zhang Gu's mind, he consumed a blank skill card and specified it to be exchanged for "sleeve gastric bypass surgery".

It costs three more beginner cards to upgrade to the intermediate, municipal level itself.

Zhang Gu stepped forward and took the medical record.

"Director Xiang, do you think this will work?"

Zhang Gu said: "First do sleeve gastrectomy to shrink the stomach and reduce food intake. However, the pyloric stump is retained. ”

"This preserves the function of the pylorus and makes it less likely to cause dumping syndrome. ”

Xiang Jianhua was thoughtful, but also wondered: "How to deal with the pyloric stump?"

Zhang Gu smiled: "Have you forgotten that I am the best at anastomosis?"

"I intend to divide the jejunum into proximal and distal jejunum with a 150 cm boundary, tranverse incisions proximal and distal respectively, and at the same time, perform end-to-side anastomosis with the reduced sleeve gastric inferior pyloric end and distal jejunum. ”

"In this way, it slows down the rate of gastric emptying, shortens the small intestine, reduces absorption, and inhibits the secretion of insulin resistance factor, so as to achieve the purpose of treating type 2 diabetes. ”

Donnie Yen's mouth opened wide as he listened.

Isn't this equivalent to using anastomosis to combine sleeve gastrectomy and gastric bypass surgery into one?

How did this Dr. Gu's brain grow?

He was really allowed to combine the advantages of the two surgeries in a consistent way!

After thinking and analyzing for a while, Xiang Jianhua's brows gradually relaxed.

In the end, the whole person was in good spirits!

"You kid, you really do anastomosis superbly! I even thought of using anastomosis to solve gastric bypass surgery!"

At this moment, Xiang Jianhua looked at Zhang Gu with a little admiration in his eyes.

He has also seen many doctors who can specialize in a surgical technique.

However, it can skillfully use anastomosis in gastric bypass diversion surgery, and also combine the two surgeries into one, take the essence of it, and remove its dross......

This is enough to show that Zhang Gu has practiced the anastomosis technique to the extreme, and he can start a sect!

Zhang Gu smiled: "Director Xiang, is this method okay?"