Bu Songming can see it, here.

A professor like him is not as good as a dog, but he walks all over the ground about the same. Basically, who can walk in and be the main surgeon, who is not a professor?

But how many professors are there in the Shonan University Hospital?

A subspecialty has at least three to four specialties, a major specialty has one or twenty, and the Shonan University Affiliated Hospital has at least fifty or even sixty or seventy specialties.

One or two thousand professors.

If you throw a brick down from the upper floor, you may hit a well-known professor in a subspecialty who is a well-known figure in the province.

A professor like him came here for surgery, and it was really inconspicuous.

And above the professors, there are also subject leaders, from the academy and from the outer courtyard......

The food chain is very complete.

Even, if you can enter the operating room, the bystanders are very talented interns, and ordinary people will not let you in.

However, it seems that Fang Xian, the former student of his school, is still at a relatively high level in the food chain.

Bu Songming is very pragmatic.

I was pretended not to speak, but I was honest, and my basic skills were solid. Level 4 incision, level 4 debridement, basic specialist skills, specialist skills, and even specialty-related difficult surgeries are all very firmly mastered.

This kind of operation is naturally extraordinarily smooth, and of course, it can only be said to be smooth.

He usually likes to teach in his own hospital, but he doesn't say a word at the moment.

Because Professor Lin Jiemo's operation is not worse than him, and he is much younger than him.

It's just that as the operation progressed, Bu Songming found that hey, this Fang Xian seemed to be slowly moving closer to his side, and he gave up the opportunity to assist Professor Lin Jiemo in the operation.

Bu Songming just glanced at Fang Xian at first, thinking that Fang Xian could choose his location at will.

However, after an hour had passed, Fang Xian was still standing on the opposite side conscientiously, and when he cooperated with him, Bu Chunming glanced at Fang Xian unexpectedly again, and still did not speak.

……

Four o'clock in the afternoon.

After the whole operation, Fang Xian still followed him, and Bu Songming walked to the way to the dining room and asked, "Xiao Fang, what have you been following me for?" ”

"Professor Bu, did you mainly do colon-related tumor resection before?"

"I look at the excision technique, it seems to be different from what I usually see." Fang Xian's current vision is naturally not ordinary.

The reason why he approached Professor Bu Songming was naturally not to look down on Lin Jiemo, nor to deliberately curry favor, but because Fang Xian felt that Professor Bu Songming's colonectomy techniques and suturing techniques were different from the professors he had seen before.

When Bu Songming heard this, he first took a rice plate, made some food, and after sitting down in the corner, he said: "Xiaofang, in fact, it's not worth talking, I just made a slight adjustment to the 4-level resection concept of tumor resection for tumor resection of the lower colon." ”

"The prognosis of patients after surgery has not improved much, but it has been reluctantly recognized by the medical association, so I have been promoted to the senior title of research, otherwise, I am only an associate researcher."

Professor is a teaching title, which is related to the number of students and the level of teaching. Director is a professional title that is related to an individual's abilities. Researcher, is a research title, related to scientific research.

Hearing this, Fang Xian's brows furrowed slightly, and he asked: "Professor Bu, if I remember correctly, the tumor resection of the lower colon is a fourth-level operation and a fifth-level operation, right?" ”

The complexity of the medical society and the difficulty of operation are divided into six categories and six levels.

Colon cancer is one of the five types of diseases, and although the mortality rate is not high, the prognosis is not good.

The difficulty of operation is also divided into six categories and six levels, and the resection of colon cancer is at least a four-level difficult operation, which is cumbersome, time-sensitive, and requires a very solid professional advanced operation that may not even be enough to be able to control.

For example, the specialized skills of gastrointestinal surgery are not enough for intestinal segment transplantation, and real specialized skills such as intestinal segment revision.

The level 1 difficulty is the basic medical skills, which interns can do.

The second level of difficulty is the basic skill of the specialty, which can be routinely done by senior residents and attending physicians.

Level 3 operation difficulty is a specialist skill, which requires senior level 2 physicians, that is, attending physicians and associate professors, which can be done routinely.

The fourth-level operation difficulty is the advanced skills of the specialty, which requires senior level 3 physicians, associate professors and professors to do it routinely.

As for the level 5 operation difficulty, it can only be routinely performed by a senior level 4 physician.

"There are grades four and five, and occasionally the smaller ones are also defined as grade III, which is mainly related to the location and size of colon cancer."

"Xiao Fang, my little skill is just decent in the professor, and it's not surprising." Bu Chung replied clearly, looking quite honest.

At this moment, Fang Xian could see his appearance, his lips were thick, the whole person looked quite honest, and there was a little handsomeness in his outline, but it was obvious that it was the traces that had been carved by the years.

"Professor Bu, in fact, what I want to ask is, is the new concept of grade 4 colectomy that you have developed related to functional reconstruction?" Fang Xian didn't check this information in depth.

Tumor resection of the colon is too high-end, and it is difficult for ordinary people to think that such a procedure will be associated with the reconstruction of damaged colon function.

After all, tumor resection of the colon requires too wide a range of incisions, and it is not a reference for other diseases.

However, Fang Xian saw a little hope in him.

"Yes, my new definition of colon tumor resection is to reserve the function of a small part of the nerve, and then reconstruct it through the transplantation of the intestine, hoping to recreate the function of self-relieving."

"But the progress is limited, and as you know, the colon is relatively fixed, and if it is removed, it is very difficult to rebuild. The current understanding is still that it is a fistula. ”

"You also know that only some patients in colon cancer surgery need to be completely resected, and only a very small number of patients will choose not to conserve anus." Bu Songming said.

Compared with the damage, the impact of colon cancer surgery on stool function is relatively small.

Ostomy is an alternative solution that connects the intestine to the abdominal wall so that stool can be expelled manually, alleviating problems in stool control.

But who wants to carry a dung bag with them?

"Professor Bu, have you ever thought about expanding this technique to non-colon cancer diseases, for example, you can make the concept of such resection completely clear, we can find a better plan to expand the remaining functions."

"For example, can we preserve the function of the toothed comb, or transplant it through muscle transplantation, muscle morphological reconstruction, etc.?" Fang Xian lowered his voice, hoping that Professor Bu Songming could join his team.

As an expert in colon cancer treatment, he should be able to understand the pain of patients better, and Professor Bu Songming also has deep basic skills.

For example, Professor Gong Ziye, who is mainly engaged in trauma-related diseases in general surgery, may not be in the reconstruction of his own technical strengths.

Bu Songming said: "I must have thought about it, but at present, the surgical methods of anal reconstruction surgery are actually relatively limited, and the applicability is relatively narrow." ”

"For example, the perineal route, such as the abdominal route, such as the ostomy fistula."

"It's an improvement at the purely surgical level."

However, there are also researchers who are exploring the use of biomaterials or artificial implants to improve anal reconstructive surgery. But progress is not progressing well so far. ”

"It was previously expected that 3D printing technology would create customized implants based on the patient's anatomy, thereby improving the precision and success rate of the surgery. But it didn't end in a hurry. ”

"Unless it's a valve that's like a pacemaker and has regular bowel movements."

"But this is also very painful for patients, often waking up at night, or just pulling in the crotch of their pants...... Bu Songming is worthy of being a person who does colon cancer, and he is not shy about it at all, even if it is eating."

"If you want to make a difference in this area, either you have direct progress in biomaterials, or you can do it with 3D printing technology, which allows implants to do whatever you want, otherwise it's more difficult."

"However, some scholars are currently building a similar trigger for the trigger, which is to use the residual muscle contraction to guide the active release of the takeover function. Replace the initiative to take over. ”

"But there's a problem, that is, the corresponding muscles can't contract unconsciously, otherwise?" Bu Chung Ming explained the difficulty.

Bu Songming's understanding of the depth and difficulty of this disease is still relatively professional.

Fang Xianyan nodded: "Simple surgical reconstruction and implant reconstruction are two hot topics in surgery, and basically all surgeries are based on foreign implants. ”

"At least until xenoprosthetics are developed, that's basically the case."

"However, non-biological prostheses, which are difficult to be directly compatible with the human body and controlled by the human body, are also a major limitation of the current implant replacement function, and if we can find a balance in this, then there is a silver lining."

"Professor Bu, when you remove the colon, you will retain blood vessels and nerves to a greater extent, and I think you can also use this kind of resection."

"If the trigger you are talking about cannot be replaced by muscle function, then can it be replaced by a postural position?" Fang Xian asked a similar question again.

If the muscle function is contracted to trigger the trigger, it will happen unintentionally, but what about the change of position?

"Position?"

"What about a change of position? It's not good news for gay women either. However, the change of position you mentioned as a trigger is also a way of thinking. ”

"But if you touch your thighs to your front abdomen as a trigger, you have to consider the problem of intercourse...... Bu Songming's understanding is still relatively comprehensive and profound.

When Fang Xian heard this, he was stunned.

Well, I'm just an adult, but my thinking is not an adult.

……

Discussions with professionals are very beneficial.

Previously, Fang Xian had been seeking the possibility of functional reconstruction under the emergency surgery of general surgery, and he had never thought about seeking ideas from the surgery of cancer patients, but it was indeed his own cognition that was too narrow.

The main reason is that the understanding of professional specialties and diseases is not deep enough.

But it's already good, at least for now, he's got a possible solution.

The trigger is triggered, similar to a firearm. It's good to have enough time for the patient to prepare, if it can be triggered.

Of course, before that, there was still one problem to solve, and that was the generation of convenience.

You can't accumulate there, can you?

In fact, it is okay to go to the toilet regularly, that is, if you have diarrhea, it will make people more uncomfortable, and without corresponding feedback on feelings, the damage to the human body is still fatal.

How nice it would be to not get hurt and not get sick.

When Fang Xian was in the lounge, he let out such a sigh.

However, when Fang Xian was curious about Bu Xianming, Bu Xiangming also became curious about Fang Xian.

After dinner, because he was a newcomer, Professor Bu Songming, who was more active in his work, took another general surgery operation and brought Fang Xian up.

Professor Bu Songming found that, hey, it is no wonder that this party dares to covet the reconstruction of damaged stool function, which is full of uncontrollable surgical research and development.

It turns out that Fang Xian's kung fu is still deep enough.

Professor Bu Songming is more delegated in the prefecture-level city hospital, so he instructed Fang Xian all the way to operate this entire large section of intestinal obstruction.

In the end, the whole operation was completed in a decent manner, and the operation time was not long, and it was only at 10:40 in the evening, and the operation that he expected to take eight or nine hours to complete was ended ahead of schedule.

"Xiao Fang, your basic skills are too solid."

"It's a pity, tomorrow I won't be on duty, I can only be on duty, otherwise, I'm very happy to have surgery with you and communicate together." Professor Bu Chung Ming found that some of the ideas of colon cancer resection may be useful.

I am also very happy to work with Fang Xian.

When he reached Bu Songming's position, he was not short of money, so he wanted to make a name for himself and make more achievements professionally.

……

Another village.

Fang Xian felt that in fact, there were still a lot of talents in Huaguo, the techniques were complicated, and the medical knowledge was vast, and sometimes the eyes might not always be on the most awesome people.

Maybe some professors in prefecture-level city hospitals also have their own insights, but their contributions, research, are not so prominent and not so important, so they are buried.

But in fact, their research results are also of great significance for the development of the discipline.

While his cognition was improved, Fang Xian found that his specialist skills, intestinal segment suturing and intestinal segment reconstruction, seemed to have something more in the process of increasing points to level 4.

"Wait a minute! ~"Fang Xian hadn't studied his panel properly for a long time.

But at this moment, Fang Xian found another change in the panel.

That is, the different concepts of level 4 skills, only if you are exposed to it, it will appear, you are aware of it, and you can recognize it, you can add points to fill it, otherwise.

Even if you have a level 5 Ruyi level skill, you still won't be able to master all the operating concepts.

The premise of wishful thinking is that you have to have this awareness, at least know? Right?

Seeing this, Fang Xian smiled lightly at the corner of his mouth.

If you can't do the prototype at level 4, then you will be at level 5.

Add points –

(End of chapter)