The urethral dilator patient was sent to the recovery room, where he waited for the anesthesia to wake up, and a new patient was quickly brought in.

It was a female patient in her 40s, with a yellow complexion and a very slow walk.

Zhou Can has already read her information, and the main symptoms of this patient when he was admitted to the hospital were jaundice, weight loss, nausea, and vomiting. Upon examination, the duodenal head had a tumor.

This surgery requires the removal of the tumor, which is a tertiary major surgery.

Duodenal surgery is basically a third- or fourth-level operation, which is difficult and risky.

The evaluation of Zhou Can in the emergency department, the previous urethral dilation was just an appetizer. Now is the real event.

Dr. Xu is a senior attending physician who is qualified to perform tertiary surgery according to the surgical safety access system. The junior deputy chief physician can preside over the tertiary surgery, and the fourth-level surgery will be carried out gradually under the guidance of the senior physician.

Therefore, this duodenal head tumor resection is already the limit that Dr. Xu can assess Zhou Can.

No matter how high the operation is, he will not be able to preside over it.

If Zhou Can successfully completes this operation, he will be supplied with sufficient amounts of surgeries within the third level of the emergency department in the future.

The anesthesiologist, who is still the same as the previous operation, guides the patient to lie down on the operating table and begins to anesthetize it step by step.

"Call me again when it's okay here!"

Dr. Xu went to the operating room outside for surgery.

In order to maintain the total number of surgeries per month, surgeons in the emergency department work hard. Even so, because of the lack of a master surgeon like Zhou Can, Dr. Xu could only go into battle in person.

He worked very hard every day.

In fact, Dr. Xu is quite old, and people in their fifties are far from being able to compare with the physical strength and energy of young men.

Even so, he is still working hard to make the operating room in the emergency department grow little by little.

The hospital will only look at the performance of the department and the quality of the operation.

If the number of surgeries in the department is small, the number of surgeons will be small. At the same time, various resources in terms of hardware will also shrink significantly.

Take a look at the 10,000-level operating rooms of cardiothoracic surgery, neurosurgery, and general surgery, with top-level configurations, endoscopes, laser scalpels, high-frequency radiofrequency radiofrequency blades, and so on. I even heard that the neurosurgery department is building a top-of-the-line hybrid operating room.

Looking at the emergency department, there is only one dedicated operating room that truly belongs to you.

The instruments and equipment are also quite backward.

If you want to get a better surgical environment and high-tech equipment, you can only rely on your own hard work.

What is the method of fighting?

Help the hospital make enough money to perform more surgeries and improve the quality and quantity of surgeries.

"Qiao Yu, you make preparations first, and I'll carefully study the patient's examination data!"

"Okay!"

Qiao Yu readily agreed.

She has to take on multiple responsibilities by herself, and she's a hard nurse.

Typically, a tertiary surgery will have at least two nurses.

If it's a flashy surgical team, all three nurses are normal.

Zhou Can's surgical team has just started, strictly speaking, there are only two people, she and Zhou Can, and hard work is inevitable.

More than 40 minutes later, the preoperative preparations here were completed, and Zhou Can also had a deep understanding of the patient's condition. I have already worked out the most suitable surgical plan in my mind.

"I'm going to ask Dr. Xu to come over!" Qiao Yu took the initiative to go outside to ask Dr. Xu, and waited until Dr. Xu finished the operation in his hand, and then informed him that it was ready.

From these details, it can be seen that Qiao Yu is very measured.

It is a blessing to have such a good nurse on the surgical team. In the future, in the coordination process of the surgical team, she can become Zhou Can's virtuous assistant and help him coordinate the cooperation of the entire surgical team.

This can save Zhou Can a lot of unnecessary trouble, and to a certain extent, enhance the unity and tacit understanding of the surgical team.

Before the operation officially began, Zhou Can first placed a nasogastric tube on the patient.

Originally, according to the requirements of the operation, the patient should be placed with a nasogastric tube at seven or eight o'clock in the morning when the ward rounds were made.

In addition, endoscopic surgery is now mostly used for duodenal head tumor resection surgery when conditions permit, especially in type B cases.

The operating conditions in the emergency department are rudimentary, there is no endoscope, and there is a lack of advanced examination equipment in some operating rooms.

This will undoubtedly add some difficulty and trouble to the surgery.

Zhou Can returned to the emergency department this time, just to bring the surgical team up, and then fight for surgical resources step by step, and directly make the operating room of the emergency department bigger and stronger.

As long as the operating room becomes bigger and stronger, other departments of the emergency department will also be pulled and develop together.

After Zhou Can finished examining the patient, he stood on the main knife position and started the operation.

After careful consideration, he did not opt for a straight incision.

Instead, an oblique incision is made from the patient's right upper quadrant costal margin, lateral to the anterior axillary line, medially beyond the midline.

Dr. Xu, who was working as an assistant next to him, couldn't help but nod his head when he saw the incision method he chose.

The advantage of this incision is that it is well exposed, and although it is necessary to cut the muscles of the abdominal wall, the incision dehiscence rarely occurs after surgery. There is no small bowel under this incision, so complications such as postoperative adhesive intestinal obstruction are rare.

From this point, it can also be seen that Zhou Can's surgical experience is extremely rich.

Three years of experience has made him reborn, improving not only medical skills, but also medical knowledge, clinical operation experience, comprehensive prediction ability and so on.

At the same time, Dr. Hui was shocked to see his new style of knife technique, which combines the quick knife method and the steady knife method.

It also gave him a new direction of thinking about the fast knife method and the stable knife method.

In the past, I always thought that the fast knife method and the steady knife method were incompatible, but now I see that the apprentice has successfully fused these two knife techniques. They checked and balanced each other, but instead of conflicting, they made the scalpel more stable.

He was pleasantly surprised.

After opening the thoracic and abdominal cavity, Zhou Can first did a comprehensive exploration of the patient.

He found a metastatic nodule in the liver, and along the duodenal ligament of the liver, he found swollen lymph nodes. It seems that this is an uphill battle.

If the patient's tumor metastases and is not removed, the postoperative survival will definitely not be long.

It's easy to relapse.

After knowing the size and extent of the duodenal nipple with his hand, he made sure that he was aware of the size and extent of the duodenal nipple during the operation.

Next, he makes a Kocher incision on the outside of the duodenum.

Kocher's method, also known as the Kochis method, is a reduction technique for shoulder dislocation.

The incision requirements here are similar to those of the Coriolis method.

[Quick knife experience +1, stable knife experience +1.] 】

[Congratulations on advancing to proficiency level for your quick knife technique.] 】

After completing the Kocher incision, Zhou Can clearly felt that his knife skills seemed to have made a major breakthrough and improvement.

His quick knife technique has always been an entry-level level, but now he has been upgraded to a level, but it is really not easy.

It should have been promoted to proficiency level a long time ago.

Mainly because he has been training in internal medicine for a year and a half, and rarely has surgery. Then the time to go back to the dormitory every day to practice the fast knife technique is also extremely limited, and the accumulation of experience points naturally slows down a lot.

Fortunately, he followed Director Hu Kan to study in cardiothoracic surgery for nearly a year, and he was able to get one or two surgeries every day. He can even be used as a master knife occasionally. Only then did I gradually accumulate the experience value of the fast knife method.

[Quick knife method, current experience value: proficiency level 1/100000, win quickly, correct other surgical shortcomings quickly, and be proficient in the use of fast knife method in various complex surgical processes. It can be integrated into all surgical procedures with a knife. 】

He calmed down, suppressed his excitement, and proceeded to the next surgical step, which was to cut the posterior peritoneum.

After cutting with this knife, I immediately felt the benefits brought by the upgrade of the fast knife method.

I can't say it, but I feel very relaxed.

It's a bit of a weightlift.

At the same time, he also noticed that after the quick knife method was upgraded, the stable knife method was significantly weakened. The scalpel suffered some damage in terms of stability.

If I had to describe it specifically, I felt that the invisible mountain pressed on the scalpel had become lighter.

If the steady knife method is regarded as a means of counterbalancing the fast knife method, the fast knife method is promoted, but the stable knife method is not promoted, this will definitely have some adverse effects. It increases the risk of mistakes during surgery.

To put it bluntly, the road is one foot high, and the magic is one foot high.

The magic of the quick knife method is extremely strong, and there is no steady knife method to restrain it, which will make it easy for Zhou Can to follow the old path of Dr. Xu in the operation.

For a surgeon, having a medical malpractice is a very scary thing.

"Huh?"

Dr. Xu's eyes lit up, and there was a hint of surprise on his face, and his eyes showed appreciation and relief.

With his level, he naturally discovered that Zhou Can's fast knife technique had been greatly improved for the first time.

However, he did not interfere with Zhou Can's operation, but silently served Zhou Can as an assistant.

After the posterior peritoneum was incised, Zhou Can began to detach the descending duodenum.

The small scalpel seemed to be alive in his hand, with a degree of depth and agility. The whole process of dissociation is like an art.

……

Nearly an hour and a half later, Zhou Can looked at the cut nodules, lymph nodes, and duodenal head tumors, and his heart was full of a sense of accomplishment.

The patient has successfully completed the surgery, the cavity has been closed, and the signs are in good condition.

"Nice, pretty good! It seems that in the past three years, you have not been wasted, and your surgical ability, diagnostic ability, medical knowledge, judgment level, and all aspects of ability have been improved. Did you make a major breakthrough and improvement in the quick knife method just now? ”

It was only after the operation that Dr. Xu asked about it.

"Well, I do have some insights, and I have more experience and deeper understanding of the knife skills and knife handling techniques."

Zhou Can admitted frankly.

He knew that the quick knife technique was the most important thing for Dr. Xu, and he always hoped that he would inherit the mantle.

"Just now I watched you during the operation, fast and steady, which is very good. It shows that the knife stabilization method taught by Director Hu Kan can indeed be mutually beneficial with the fast knife method. Now that Director Hu is no longer there, among his descendants, you have the best talent, and you can practice more stable sword techniques when you have time. ”

Zhou Can almost thought that he had misheard, and for the first time in history, Dr. Xu asked him to practice more knife stabilization.

It's really unexpected.

Is this an alternative mourning for the death of Director Hu Kan, or a recognition of Director Hu Kan's bold innovation in medical skills?

The concept of the integration of the stable knife method and the fast knife method was first put forward by Director Hu Kan. It's just Zhou Can to practice.

At this point, whether Dr. Xu admits it or not, Director Hu Kan must have outperformed him.

"Seeing that your surgical skills have been raised to such heights, there is not much I can teach you. The master led the way in, and the cultivation depended on the individual. In the future, during the operation, you can boldly explore on your own, and if you encounter something that you can't decide, you can ask me at any time. However, I recommend that you ask me as little as possible. Each surgeon's surgical ideas, diagnosis methods, and treatment plans may be different. What's right for you is the best. ”

Dr. Xu was even more relieved to see this apprentice grow so fast, and his heart was filled with joy.

"Teacher, I still have a lot to learn......

Zhou Can disagreed.

He didn't want to leave the school so soon.

As soon as he spoke, Dr. Xu raised his hand to stop him from continuing.

"Don't worry, I'll teach you what I need to teach you. You're my only heir, could it be that I'll bring those medical skills into the coffin? ”

Choked by Dr. Xu, Zhou Can was speechless.

"Three thousand avenues, all leading to Rome. Everyone has their own surgical path and surgical style. I only need to teach you the basic methods and some important surgical experience and skills, and you can understand and explore the rest on your own, which will be more beneficial to you. When educating children, if we ask children to blindly follow their parents' thinking, children will definitely grow up to be inferior to their parents. Only by letting them go can they go far and fly higher. ”

Dr. Xu really has good intentions for Zhou Can.

Just so that he can have higher achievements in the future and not be trapped in the shadow of the teacher.

"Understood! Thank you for being so thoughtful about me. ”

Zhou Can nodded vigorously, with a relieved expression on his face.

"I'll call an intern to come in and be your assistant, and then you can use as much force as you want, as long as you make sure that the operation is safe, you can do it. If you don't understand or are not sure, you can call me at any time, and I'm outside. ”

Dr. Xu completely delegated authority to him.

It means that the assessment has passed.

And it has achieved extremely high scores.

This is normal. Not to mention anything else, just because Zhou Can made a breakthrough in the quick knife technique during the operation and was promoted to the proficiency level, it was enough for Dr. Xu to take a few high looks at him.

The master and apprentice have been dealing with each other for a long time, and Dr. Xu has a deep understanding of his personality, surgical style, and personality.

Naturally, you can rest assured.

After Dr. Xu went out, he quickly called an intern doctor in.

He was a twenty-two-year-old man.

Because he was wearing a hood and a mask, he could only roughly see the appearance of this young man.

"Hello Mr. Zhou, my name is Luo Shishen, clinical major, general practice, I have been interning in Tuya for almost half a year, please give me more advice." The young man has a lot of respect for Zhou Can.

Unknowingly, Zhou Can has gone from an intern to a regular trainee, becoming a full-fledged resident, and a teacher in the eyes of interns.

Of course, that's a polite name.

"Do you know how to pull a hook or something?"

"I have basically learned the simplicity of hooking and sewing skin. You have something to do, just command. ”

"Okay! I'll tell you what you need to do later. ”

Zhou Can nodded, Qiao Yu had already taken the third surgical patient in at this time.

Good guys, came straight to an acute appendicitis patient.

There is no endoscope in the emergency department, and laparoscopic surgery cannot be done. Then you have to do traditional surgery.

The preoperative conversation or something, it must have been done.

Otherwise, it would be impossible to enter the operating room.

Zhou Can didn't ask too much, such as why the patient didn't go to the specialist for laparoscopic surgery, but chose to go to the emergency department for traditional surgery. He just looked at the patient's examination data carefully to make sure there was nothing wrong, and then waited for the anesthesiologist to administer anesthesia to the patient.

The new young man named Luo Shishen is quite diligent, and he is busy before and after, and he doesn't need to take the initiative to do many things, and he will help.

This made Zhou Can feel quite satisfied.

During the operation, Luo Shishen seemed to talk a little too much, and kept asking this and that.

At the beginning, Zhou Can was afraid of face, so he patiently answered him one by one. But this guy doesn't have any eyesight, even when Zhou Can is performing some extremely high-risk surgical steps, he still keeps asking.

(End of chapter)