"What do you mean?" Qiao Yu tilted his head and asked Ma Xiaolan.

"Don't ask, concentrate on the operation!"

Zhou Can, as the main knife, must control the atmosphere and atmosphere of the operating room. There are some topics that should not be discussed too much.

"Seeing that you all have strange expressions, evil smiles on your faces, and mysterious expressions, you must know the cause of the patient's anal prolapse. Dr. Chow, tell me the answer! ”

Qiao Yu usually made requests to Zhou Can, but he was almost never refused.

Now seeing that Ma Xiaolan refused to speak out, she asked Zhou Can to speak.

"Ah...... It's better not to discuss things that are not suitable for children. The patient will need to use the Teflon net suspension in a moment, are you ready? ”

Zhou Can directly changed the topic.

"It's been ready for a long time."

Qiao Yu saw that they were all mysterious, and refused to say the reason.

She looked at Yang Zhi without giving up.

"Doctor Yang, you must know that, right?"

"Uh- I really don't know. The patient is already under anesthesia, so let's hurry up and do the surgery! ”

Yang Zhi is an honest man, but he is not stupid.

If you shouldn't say it, you won't say it if you kill him.

"Give me the urinary tube!"

A urinary catheter will need to be inserted before this procedure can be performed. This is Zhou Can's favorite job, if not for anything else, just to earn experience points for the placement technique.

The operation soon began.

Zhou Can made an incision from the patient's private part through the left midline, about 20cm long.

Then the skin and subcutaneous layers are cut into the abdominal cavity.

"Soak the gauze in warm salt water and bring it to me." Zhou Can had already told Qiao Yu about some items that needed to be prepared for the operation before the operation.

"Give!"

Qiao Yu handed him the gauze.

After that, make a cushion out of gauze soaked in warm salt water and push the entire small intestine towards the upper abdomen.

"Yang Zhi, there are dozens of surgeries to treat rectal prolapse. There are about eleven of them that are still in use. For example, anal ring reduction, mucosal resection, rectosigmoidectomy through the female intimate area, combined rectopexy, and presacral fascia reinforcement with synthetic mesh...... All of these surgical methods can treat rectal prolapse. The one I use now is the most commonly used and has excellent results. Postoperative complications are relatively rare, and recurrence is almost unlikely. ”

Zhou Can operated on the patient while guiding Yang Zhi.

The master led the way in, and the cultivation depended on the individual.

After learning many surgical methods, you need to study the specific flexible application by yourself and understand it more in practice.

In the face of different rectal prolapse, the surgical method chosen is also different.

"Well, the next step is the most critical step in the operation."

I saw Zhou Can carefully free the posterior wall of the rectum, until the tip of the coccyx stopped, and then raised the rectum.

After completing the free work on the posterior wall of the rectum, he is rewarded with 100 dissection experience. It made him so happy.

It's one step closer to the sixth-level separation.

"Qiao Yu, prepare the Teflon net suspension."

Zhou Can greeted her in advance.

This is the first time that a prolapsed rectum has been repaired using this procedure.

"Use a wide Teflon mesh suspension to surround the upper rectum. Well, that's how it works. ”

Zhou Canyan taught by example, and strived to teach Yang Zhi at one time.

"Remember, 5 cm is the best choice for the mesh suspension. It is then fixed to the presacral fascia and periosteum under the sacral eminence with thin non-absorbent threads, and the edges of the suspensory are sewn to the anterior and lateral walls of the rectum. ”

It's not easy to teach and operate at the same time.

Because there is no distraction during the operation, it is definitely safer to concentrate on the operation.

"Does the pelvic floor need to be repaired?"

"No need to tinker."

Zhou Can replied.

Many of Yang Zhi's questions during the operation can be asked to the point. It shows that his comprehension ability is very strong, and he really learned the surgical knowledge taught by Zhou Can.

After learning it, he can immediately ask some questions that he doesn't understand through thinking.

"The rest of the stitching, come on!"

Zhou Can left the opportunity for stitching to Yang Zhi.

The quickest way for a surgeon to grow is to get started with surgery.

Just a bystander, you may still be a novice for the rest of your life.

It is easy to see things, but difficult to do things, it is the law of the ages.

For Zhou Can, suturing the peritoneal incisions on both sides of the rectum and the layers of the abdominal wall is just a very simple and small thing. After all, his suture technique has been promoted to level six, and the ligation technique is still a little bit closer, but he is about to be promoted.

In his eyes, this ordinary surgical operation is no longer very attractive.

The difficulty of earning 100 XP points is the most tempting for him. Doing one kind of surgery can withstand the experience value of dozens or hundreds of ordinary surgeries.

Rectal repair is a tertiary operation, and Yang Zhi rarely has the opportunity to get started with this risky operation.

He excitedly gave his all to the patient and carefully sutured it.

Zhou Can stood next to him to point out and check.

"Director Qu, it's past twelve o'clock at noon, how about you two have a meal in the operating room?"

Zhou Can looked up at the wall clock on the wall, it was more than twelve twenty.

Time flies.

It is estimated that by the time Yang Zhi is stitched, it will be at least after 12:50. Not everyone has Zhou Can's surgical speed.

Under normal circumstances, ordinary surgeons do eleven or two simple primary and secondary surgeries a day, which is almost the limit. As for the tertiary major surgery, even if the strength of the veteran reaches the deputy director level, there are about two at most a day.

Purely doing third- and fourth-level major surgery, as long as it is not particularly complicated, Zhou Can can do five or six units a day with a simple surgical team, which is two or three times that of others.

In terms of the speed of surgery, only Xu Yidao could press him head.

Today's Dr. Xu is no longer pursuing speed, but safety and stability.

is also older, and there is no way to be a young man like Zhou Can and output like crazy.

"No need!"

Qu Zi glanced at the anesthetist nurse, and then answered Zhou Can.

Instrument nurses and itinerant nurses are the helpers of the surgeon. A nurse anesthetist is the anesthesiologist's helper.

Like surgical nurses, nurse anesthetists are a special type of nurse.

The professional requirements are high.

They can be the right hand of the anesthesiologist and help with many things.

"There's a major surgery in the afternoon, so you just eat it here! I can also discuss the surgery plan with you during the meal. ”

In fact, what should have been discussed has already been discussed.

Zhou Can said this just for a reason for her and the anesthetist to stay and eat.

"Oh well! Qin Yue doesn't eat spicy food. ”

Qu Zi nodded in agreement.

Zhou Can motioned for Ma Xiaolan to call and order food.

One thing that must be said is that in the past, the operating room was strictly managed, and doctors were not allowed to bring mobile phones into the operating room.

As for watches, rings, earrings and other accessories, they are not allowed in the operating room.

It is possible to leave it in the changing room.

Tuya's current management is relatively humane, even if he is an intern, it is okay to bring a mobile phone into the operating room. The premise is that it must be muted.

If your phone rings while the senior doctor is performing surgery, there is a good chance that you will be scolded.

As for some patients reporting to media reporters, some doctors are playing with their mobile phones in the operating room. This is basically impossible to happen. Above the waist can be considered as a relatively sterile area, and hands must be cleaned during surgery and disposable sterile gloves must be worn.

Sometimes you even need to wear two layers of gloves.

For example, for a digital examination of a pregnant woman, an experienced midwife will wear two layers of gloves on her right hand.

Throw away the outer layer after the prenatal check-up, which can reduce the infection of the mother during the operation.

More than half an hour later, the operation was over.

In fact, when Zhou Can handed over the tail sweeping work to Yang Zhi, the operation was basically successful.

"After sending the patient to the recovery room, everyone went to the rest room to eat and rest for a while. Preparing for a second major surgery in a row. ”

Zhou Can is now undergoing general tertiary major surgery, and Dr. Xu will only occasionally come over and take a look before going out.

He was quite relieved of Zhou Canna.

Unless he encounters a high-risk and particularly difficult operation, Zhou Can will take the initiative to ask Dr. Xu to come and help.

With the addition of Yang Zhi and Ma Xiaolan's rapid growth, their team is now doing ordinary tertiary surgery, and there is no need to call additional people to help.

If Dr. Pu from the Department of Cardiothoracic Surgery can join his surgical team these days, the camp will expand again, and his surgical team can become perfect.

……

In the rest room, everyone was already hungry, and each person had a fast food.

Even a ladylike girl like Qiao Yu is crazy about cooking.

"Doctor Zhou, I don't know if you have heard about the preparation of the anesthesiology department?"

Qu Zi took the initiative to talk to Zhou Can.

She is close to 40 years old and is currently the deputy chief physician. The professional strength is quite powerful.

And Zhou Can thinks that her potential is much stronger than that of the chief physician Dongfang Xueluo.

"I've been so busy lately that I haven't really paid attention to these things. How to reform the anesthesiology department? ”

Zhou Can asked curiously.

"The reform of general surgery has achieved initial results, and the hospital's senior management is ready to implement it in other departments one after another." She stroked her loose hair.

The division of general surgery into subdepartments and the subdivision of the medical field have been realized, which is indeed quite good.

According to Director Liu, Zhou Can told that many subdepartments of general surgery have achieved all-round growth. Including the number of outpatient and emergency visits, surgeries, hospitalizations, the number of difficult cases conquered, and even the number of academic papers has also increased.

It also means that general surgery has become more powerful than before.

So, that's a good thing.

The reform was a success.

It is also a reference to the management experience of advanced hospitals such as the Imperial Capital and the Magic Capital, and it is not surprising that it can succeed.

"Doctors and nurses in the anesthesiology department may be further fixed to specific operating departments in the future."

She revealed the reform plan of the anesthesiology department.

At present, anesthesiologists are basically general practitioners. For example, Qu Zi may go to the emergency department today, to the anorectal surgery tomorrow, and to the cardiothoracic surgery the day after tomorrow. Wherever there is a need, she goes to which department.

This general practice model is actually not conducive to the growth of anesthesiologists.

Because anesthesiologists have different understandings and perceptions of different types of diseases.

The general practice model will lower their professional level.

"I think the reform is good. Last time, I went to play with one of my classmates, and I was fortunate to meet the anesthesiologists of the Provincial People's Hospital, and they have realized the subdivision of anesthesiology. For example, those who are in charge of cardiovascular work are only responsible for surgical anesthesia in this field. In many ways, the anesthesiologist was even more professional than the surgeon. I was particularly blown away. ”

Ma Xiaolan interjected beside her.

"That's true. At present, there are many large hospitals across the country that have realized the subdivision of anesthesiology. In particular, the professional standards of anesthesiologists in the imperial capital, magic capital and a hospital in Zhengzhou have been in line with international standards. Our Tuya Hospital is very backward. ”

Qu Zi also has a high degree of concern for the industry.

It's not that you can't ignore what's going on outside the window.

Not even behind closed doors.

"Doctor Zhou, I mentioned this matter to discuss it with you. If the anesthesiologist needs to fix a certain surgical team at that time, do you think there is a chance for the two of us to cooperate? ”

She is a deputy chief physician, and she must have been a little shy when she took the initiative to ask for Zhou Can's team and ask for Zhou Can's opinion.

"I only have two or three big surgeries a day, and if you are tied to my surgical team, I am afraid that it will seriously affect your income."

Zhou Can has always been very sober.

Don't look at the emergency department, the number of surgeries in a day is staggering, but there are not two major surgeries.

For ordinary primary and secondary surgeries, the chief surgeon or even a roving nurse can administer local anesthetics to the patient, and there is no need for a special anesthesiologist.

"I believe the income is only a little lower temporarily. I can see your surgical ability and growth rate. In recent years, I need to hit the senior professional title, and the workload is a little less, so I can have a lot of time to read and study. ”

Qu Zi had obviously thought about it before asking for his opinion.

"Thanks to the love of Director Qu and Teacher Qin, I naturally can't ask for it to cooperate with such excellent anesthesiologists as you. It is important to remind both of you that the current situation in the emergency department is still not very good, and it is really difficult to say whether the volume of tertiary and fourth-level surgeries will be increased in the future. You have to think about it. ”

Zhou Can felt that it was quite good to be able to cooperate with Qu Zi.

Director Xu's rank is too high for it to be tied to his surgical team.

Even if Director Yu sees his close relationship with Zhou Can, he is willing to be tied to him. The hospital won't say yes either.

In terms of weight, Zhou Can's current surgical team is estimated to not even be in the top 20 in Tuya Hospital.

How is it possible to give him the top anesthesiologist in the hospital?

Also, Director Yu is a little older after all, and he should retire in a few years. Now, Zhou Can's team is still weak, and the amount of major surgery is very small. In the future, Zhou Can will grow up and the number of major surgeries will increase, but Director Yu is already facing retirement.

Therefore, it is more beneficial for both parties for him to cooperate with the young Qu Zi.

"Then let's say so, when the time comes to fill in the will, I will fill in your emergency department directly."

Qu Zi heard Zhou Can's agreement, and a rare smile appeared on his face.

When she asked, she was probably afraid of rejection.

After all, it will be embarrassing!

"Good! Thank you Director Qu and Mr. Qin for your trust and love, and look forward to our fixed cooperation model in the future. ”

Zhou Can actually stood up with a smile, walked in front of the two very sincerely, and shook hands with them separately.

It made both of them laugh.

After eating, everyone went to the toilet, drank water, took a short rest, and then continued the operation.

When the second major surgery is performed, the atmosphere is noticeably more harmonious.

This has something to do with the fact that Zhou Can and Qu Zi agreed to form a fixed partner at lunchtime.

In the future, it will be equivalent to a team of people.

When he got off work, he swiped the screen of his mobile phone and found that the police station in the area had sent him a notice. The case of him almost being hit by a flower pot falling from the sky has been filed and is currently in the criminal investigation process.

Seeing this news, Zhou Can was still very happy.

If the case is filed, it at least means that the police will send a professional criminal investigator to investigate.

He decided to call to check on the progress of the case.

"Hello Officer Hu, I'm Zhou Can, the doctor who was attacked by someone throwing flower pots from the roof last night."

"Oh, hello Dr. Zhou! At present, we have filed a case. ”

"Did you get your fingerprints on those pots yesterday?"

"Hmm...... The killer was cunning and failed to extract fingerprints. However, the discarded cigarette butts that we accidentally found on the roof of the building have now been sent for technical appraisal. It is possible that the suspect threw it. In addition, shoe prints from the scene were also extracted, which can be preliminarily identified as a male in his thirties......"

(End of chapter)