Zhou Can was still very steady, and carefully drained all the blood and water accumulated in the patient's brain.

With the help of the probe of the endoscope, he began to look for bleeding spots.

A hematoma is formed because a blood vessel ruptures, causing bleeding that cannot be drained from the body, and eventually the blood and water are closed in a certain area of the body, forming a hematoma.

Usually, hematomas in the limbs or epidermis of the body are not a big problem.

If the bleeding is small, you don't even need to go to the hospital, just apply ice yourself.

Ice compresses work to constrict blood vessels, stop bleeding or further reduce bleeding.

There are many people who rub safflower oil and bruise medicine on the swollen area after they break their feet, which is actually incorrect. Doing so may worsen the condition.

This is especially true in the case of fractures.

It is the right thing to do when you pour cold water over the swollen area.

With the help of the water temperature, the ruptured blood vessels are quickly constricted, automatically stopping the bleeding. The hematoma cannot be eliminated, but it does not make it more severe.

Which parts of the body are most harmful?

Intracranial and vertebral areas, which are infiltrated or compressed by hematoma, are the most harmful.

The patient being treated developed a hematoma in the skull, resulting in intracranial hypertension. And compress the brainstem, lobes, nerves and other important brain tissues, which will lead to the patient's coma, and even the rapid decline of various vital signs.

Now the blood is withdrawn and the intracranial pressure is reduced, which is actually the same as the effect of intracerebral puncture and drainage.

"Director Wen, I found two bleeding spots, do you want to do electrocoagulation to stop the bleeding?"

After Zhou Can's two performances yesterday and today, the trust in Director Wen's mind is already very high.

Electrocoagulation to stop haemostasis is risky if it is done at an insignificant site.

But within the skull, and close to the brainstem region.

This risk factor is very high.

Director Wen's eyes were fixed on Zhou Can: "Have you participated in electrocoagulation to stop bleeding during surgery before?" ”

Zhou Can was immediately happy.

Of all his medical skills, he has the highest level of hemostasis.

At present, they have reached the intermediate level of treatment.

"I have participated in many surgeries to stop bleeding, and I am about 80% sure that these two bleedings will be stopped without harming other brain tissues."

It's really very conservative to say that it's eighty percent sure.

It's a very good way to talk without talking full.

It's like eating eight points full, making tea seven points a truth.

"Okay, you try!"

Director Wen recalled that his hands trembled during the endoscope operation before, so he simply let his power go once. Because if he is in person, it may not be as good as Zhou Can's operation.

Under normal circumstances, it is impossible for the surgeon to shake his or her hands during any operation.

Only with a high degree of tension in the heart can the hands tremble.

This is the body's loyalty response.

Zhou Can manipulated the endoscope to electrocoagulate and stop bleeding. There is a slight difference in use compared to ordinary electrocoagulation knives.

It is mainly a test of the ability to operate the long arm.

His hemostatic technique was already very powerful, plus the implantation technique and the grasping technique were at least level three. So the whole process of hemostasis was unusually smooth and easily completed.

"Dr. Zhou's hemostasis is no worse than the senior treatment! And endoscopic operation has a very high talent, tsk, it's really enviable! ”

Director Wen stared at the endoscopic display screen and clearly watched Zhou Can's entire hemostasis process.

The movements are clean and neat, and the bleeding stops accurately, quickly and well.

Notice that Director Wen used the word envy at the end.

That's because he himself has a very ordinary talent in endoscopic surgery.

Seeing that Zhou Can has both traditional and endoscopic surgery talents, I was inspired by feelings.

People who have both surgical talents are really one in a million.

At present, the cultivation of endoscopic surgery talents in China first depends on the talent of traditional surgery. This is the basic, compulsory course.

In particular, there are four basic surgical skills in surgery.

Then, when the traditional surgery has a certain foundation, select people who are decent for endoscopic operation and further training.

Therefore, major hospitals in China, and even some county-level tertiary hospitals, have been able to do some endoscopic surgery projects.

But to say that it is particularly well done, it should be rare.

The most frightening thing is that some surgeons think that it is easy to manipulate the endoscope to do surgery. It may be that these doctors do manipulate the endoscope to do some simple surgery.

Such as appendectomy, polypectomy and so on.

They have a success rate of more than 80% for these surgeries, and they start to get nervous.

I thought I was so remarkable.

If a tumor develops in the patient's body, minimally invasive surgery will be highly recommended.

Especially in women, breast tumors, granulomas, and so on.

The incision is small, which can maintain the beautiful body shape of the female patient to the greatest extent. When most female patients hear this, they will choose the more expensive minimally invasive surgery.

As a result, the tumor was not cut clean, and the surgery was not clean, resulting in recurrence and pus.

It has even caused many patients to lose the opportunity for a second operation.

Such a doctor lacks the most virtue.

For the sake of personal performance and so-called endoscopic surgical achievements, ignoring the serious consequences that the patient needs to bear.

Zhou Can manipulated the endoscope and carefully examined it again, and finally found another bleeding spot.

This time, I didn't ask for any more instructions, and directly electrocoagulation stopped the bleeding.

It's all done.

After removing the new blood, Zhou Can asked, "Director Wen, do you see if the endoscope can be removed now?" ”

"Withdraw!"

Director Wen readily agreed.

Zhou Can carefully withdrew the endoscope.

[Implantation XP +1.]

[Complete the intracranial endoscopic surgery operation for the first time, the experience value of implantation is +100, the experience value of grasping surgery is +100, and the experience value of hemostasis is +100.]

Good guys, you've been rewarded with up to 300 XP at once.

This is also the highest experience point reward that Zhou Can has received since his surgery.

Risks and benefits coexist.

It seems that there will be a chance to perform in the future, and it should be robbed.

[Congratulations on your grasp technique has been upgraded to level 4, the current experience value is 60/10000, and the attending physician is at the next level.] It can complete the grasping of the endoscopic curved track, the precise displacement of the inserted coil, the built-in vascular clamp operation, and the auxiliary work of grasping the diseased tissue for endoscopic resection. 】

Good guys, they all say that misfortune doesn't go alone, but I didn't expect good fortune to come in a pile!

Zhou Can felt the new fourth-level grasping technique, and his heart was as happy as if he had drunk honey.

There is another senior medical skill at the attending level.

If this trend continues, it should no longer be a dream to upgrade all general medical skills to the level of deputy director and advanced medical skills to the level of attending within a year.

"Does the skull drill need to be repaired?"

"No, you don't!"

Director Wen replied directly.

"Does the dura mater need to be sutured?"

Zhou Can: This is the rhythm of crazy fishing for surgical exercise opportunities.

"Theoretically, as long as you pay attention to hemostasis and postoperative infection. The dura mater actually has a certain ability to repair itself. It will join with the temporalis muscle. ”

Director Wen patiently guided Zhou Can.

The three graduate students were frantically taking notes.

Several of the residents were also taking notes. Surgical knowledge needs to be built up over time.

Because there are so many problems encountered in the operation.

The best thing for newcomers is to take more notes and have time to review more to consolidate and deepen their memories.

In this way, you can be familiar with it in the future surgery process and use it flexibly.

"Of course, if you want to fix it, you can. Tension-reducing sutures are usually performed. After examining the wound, Director Wen gave a supplementary conclusion.

After Zhou Can heard this, he immediately became interested.

"Can you leave it to me to stitch it up? I promise to do my best. ”

Sewing skin, Zhou Can has practiced too many times.

It was the first time that the dura mater was sutured.

"How's your sutures? If you have a resident doctor with a medium or higher level of suturing, you can consider leaving it to you. "Director Wen will never dare to despise Zhou Can anymore.

Because Zhou Can's surgical ability is better than the other.

In particular, the ability of endoscopy to stop bleeding just now is really shocking.

Even Dr. Zou, who has a lot of opinions about Zhou Can, has to admire Zhou Can.

Because Zhou Can's ability to stop bleeding is no worse than that of him, a forty-year-old attending physician.

Now I wonder how this kid practiced?

"The level of sutures is okay, the level of residency should be." Among all the current medical skills, Zhou Can has the highest experience in suturing and ligation. All of them are at an excellent level.

He is only a little more than a thousand short of being promoted to the rank of deputy director.

Which resident doctor compares to him, he will definitely be abused to doubt his life.

"Okay, you can try it!"

This time, endoscopy was also required for the suture.

Because it's below the skull.

A hole so small that a normal stitched crochet needle can't get in.

Zhou Can manipulated the endoscope and carefully performed endoscopic sutures. This was also his first endoscopic suture.

His idea was simple.

Taking advantage of the fact that Director Xie has not yet suppressed him, it is now a chance to get a surgical exercise.

In particular, this kind of endoscopic operation opportunity is difficult to get with other doctors.

It just so happened that Director Wen did not have a talent for advanced surgery, which gave Zhou Can a very good development opportunity.

Zhou Can had just finished the first stitch, and there was an inhalation sound in the operating room.

Dr. Zou and Tang Li were all wide-eyed, and they watched in shock as Zhou Can completed the endoscopic sutures. They didn't expect Zhou Can's stitching level to be so good.

Leaving the two far behind.

"My God! Dr. Zhou's suturing level is probably no different from that of the deputy chief physician. Tang Li thinks that the level of suture is not bad, but compared with Zhou Can, it is really not half a star.

"This kid is good enough!"

Dr. Zou muttered to himself.

As for the next few residents and graduate students, don't mention it.

Their level is still very good, and they can't see where Zhou Can's stitching is good.

I only know that the stitching is neat and fast.

Director Wen's eyes were fixed on the screen and he didn't speak.

There may be concerns about interfering with Zhou Can's operation.

So don't dare to bother in any way.

He even reached out and pressed down to stop the other doctors from speaking out.

Zhou Can let everyone see how good Gui Peisheng can be. It took less than five minutes to complete the stitching.

"Director Wen, please check."

After he completed the stitching, he respectfully asked Director Wen to check it.

[The first time you complete endoscopic suturing, you will be rewarded with +100 suturing experience points and +100 ligation experience points.] 】

It's so cool.

The first time I operated the endoscope, the reward was really generous.

Experience points are directly added to the hundreds.

"No, no!"

Director Wen shook his head again and again, his expression was serious, and his eyes were fixed on Zhou Can.

These words were like a basin of cold water pouring down from Zhou Can's head.

Drenched him in the cold.

All the excitement and joy turned into an honest attitude of accepting opinions with an open mind.

"Ah...... The first time I sutured the dura, what was not done well, please point it out, and I will correct it immediately. ”

Zhou Can originally thought that he had sewn well.

As a result, he received such a low evaluation from Director Wen, which hit him quite hard.

"No, no, no, I don't say you didn't stitch it well. It's about doubting your identity. I've been working in Tuya for more than 30 years, and I've never seen a perverted trainee like you. If the implantation is done well, it can also be understood that the talent for advanced surgery is outstanding. However, your level of hemostasis, suturing, and ligation operations has reached the main level. That's a long time to see. ”

Director Wen is not a fool either.

A regular trainee, a certain level of surgery is very high, which can be understood as a lot of practice.

But the level of door surgery is so powerful, it is impossible to achieve it unless it is practiced in the womb.

The training cycle of surgeons is extremely long, and it is difficult to achieve small achievements without more than ten years.

No matter how good the talent is, it's not so good, right?

It's an exaggeration.

"Hehe, it scared me. I thought I didn't sew it well. ”

Zhou Can breathed a sigh of relief, as long as the operation was not done well.

"Maybe I usually like surgery very much, and I practice a lot, so my foundation is a little thicker than that of ordinary trainees. That's all, how can it be so exaggerated as you say! ”

The explanation he gave was far-fetched.

It's just that it's insignificant, and no one is going to dig into it.

If you want to look up, you can't find anything.

Zhou Can really worked very hard, and practiced surgery every day after work.

"A while ago, I heard some directors discussing, saying that the regulations recruited by our hospital this year have produced two demons, and one of them has a very perverted surgical ability. A theoretical knowledge hangs the directors of various departments. Seeing is believing, I used to be skeptical, but now I believe it completely. ”

The other demon that Director Wen said should be Du Leng.

Dr. returnees are really good.

However, the academic qualifications of returnees are sometimes quite large.

Judging from the strong strength that Du Leng is currently showing, it should be the real thing.

"Doctor Zhou, don't be stunned, just stitch up the patient's scalp! Let me appreciate your superb stitching skills again. It's very Dr. Xu's demeanor back then. ”

Director Wen inadvertently mentions the fallen Dr. Xu.

It shows that Dr. Xu had a huge influence in surgery back then.

"Thank you, Director Wen, for your trust."

Zhou Can didn't talk nonsense, and directly took the needle holder and crochet needle from the instrument nurse and sutured it.

He found that the instrument nurses equipped with this major surgery are all experienced and highly professional.

All kinds of coordination are very in place.

Stitching different parts, what thread to use, and how big thread to use, there is no need for Zhou Can to say more.

It's all about getting ready early.

Take it and use it.

And some details are also very well done.

was sutured under the endoscope just now, and everyone didn't see Zhou Can's suturing technique clearly. Now that the scalp is stitched, everyone is completely eye-opening.

"His level of stitching is above mine. Today is an eye-opener. ”

Dr. Zou was a little depressed.

It was supposed to be a fourth-level surgery.

It turned out to be Zhou Can's solo show.

This is a fourth-level surgery! Who would have thought that most of the key tasks of the operation would be completed by a regular trainee so naturally.

The speed of Zhou's surgery began to inherit Dr. Xu's 'fast' style.

The head wound was quickly sutured.

"Yes, yes, this stitch makes people feel good when they look at it. The patient's current physical condition is extremely weak, and the knee surgery will be done by the orthopaedic department in a later period. ”

The car accident patient injured not only the head, but also the knee joint.

The trauma had already been treated.

"After the patient's intracerebral hematoma was cleared, his vital signs had actually recovered quite well. Compared to when I first entered the operating room, it was a world of difference. In his current state, I even doubt that he will be able to return to the general ward with just a day or two in the ICU. ”

Anesthesiologists have confidence in their patients.

He should be the one who knows the patient's life condition best.

"Haha, you can give such an optimistic evaluation, it seems that this operation is not bad. After waking up from general anesthesia, push back to the ICU and observe! ”

Director Wen successfully completed a difficult operation and was in a good mood.

Glancing up at the wall clock.

"It seems that I can go to scientific research early today! Endoscopic surgery does have advantages over traditional surgery! ”

Originally, according to his previous estimates, it would take at least four to eight hours to perform a traditional craniotomy on a patient.

The key is to avoid accidents along the way.

The patient's vital signs are frenzied, and if necessary, the operation must be stopped and the rescue must be carried out immediately.

That will take longer.

"Endoscopic surgery is really a big trend. However, there are some diseases that cannot be solved well by endoscopic surgery and minimally invasive surgery. Therefore, I don't believe that traditional surgery has been 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, what everyone is most afraid of is that they will suddenly be eliminated by the times.

"You're right, traditional surgery is going to survive for a long time. However, it is also important to see the rapid development of endoscopic surgery, as well as the various advantages. Just like our Chinese traditional Chinese medicine, in just a hundred years, it has been directly squeezed into a state of survival by Western medicine. ”

Director Wen remains pessimistic about the prospects of traditional surgery.

He even took Chinese medicine as an example.

"Our Chinese medicine is not bad, and my classmates who studied abroad told me a strange phenomenon. At present, we do not attach importance to traditional Chinese medicine in China and despise traditional Chinese medicine. But abroad, on the contrary, began to vigorously develop traditional Chinese medicine. Not only has it quietly developed more than 10,000 varieties of traditional Chinese medicine, but also opened a traditional Chinese medicine research center, and dug up many powerful traditional Chinese medicine practitioners from our country. ”

When Dr. Zou talked about this, he was a little heartbroken.

Traditional Chinese medicine has now become an eternal pain in the hearts of many medical practitioners.

The market chooses everything.

It is an indisputable fact that the market for TCM is very small.

Some far-sighted doctors and scholars have begun to call for the protection of the heritage of traditional Chinese medicine. It's just that it has had little effect.

Zhou Can glanced at Dr. Zou deeply, and his impression of this also changed greatly with what he said just now.

To be honest, Zhou Can himself has always been relatively neutral towards Chinese medicine.

Neither praise nor depreciate.

It is to look at it rationally and objectively.

(End of chapter)