medical simulator

"That might really be impossible."

"The collateral circulation of the organs downstream of the abdominal aorta is not rich, but it won't take long, and there is not much time left for the patient."

"Lan Lu, get on stage and continue the operation!" Dewey confessed without discussing with Zhou Cheng at all.

But after saying this, he still explained to Cai Dongfan: "Professor Cai, it's okay to lend me Xiao Zhou, right?"

Zhou Cheng also looked at Cai Dongfan first.

Now Zhou Cheng's place of practice is not in Shashi, but in Changshi. When he came to the stage, he followed Cai Dongfan on the stage. He must not appear in the chief surgeon team, unless the Affiliated Hospital of Shonan University temporarily went through the corresponding multi-site practice procedures.

So now Zhou Cheng needs to listen to Cai Dongfan's orders.

"Xiao Zhou, you can go." Cai Dongfan smiled.

Hearing this, Zhou Cheng walked to the operating table again, and Dewey and Lan Lu untied the sutured place again.

Vascular suturing requires very delicate operation, otherwise the vessel wall is easy to tear, and the abdominal aorta is not allowed to have a breach!

"Xiao Zhou, can you handle this situation?" Dewey asked like a dead horse treating a living horse doctor. A person who can stand up to Yang Yifeng shouldn't be too bad.

"It should be possible to give it a try." Zhou Cheng doesn't need to be too careful now, all the procedures are in compliance with the rules, and now Dewey is the chief surgeon, he doesn't need to take responsibility, he is just an assistant.

But the assistant can also do the work of the chief surgeon, but the name can be changed slightly.

Now the rupture of the abdominal aorta in this patient is not complicated. After a little trimming of the inner and outer membranes, it can be sutured.

"That's just right, Xiao Zhou, come over and try." Dewey quickly moved away from the seat.

Zhou Cheng didn't refuse either, and after Dewey got out of the way, Zhou Cheng took the surgical instruments of vascular surgery into his hands, and directly operated the perfect vascular suture with his hands like flowers.

Trimmed tissue scissors closed, stitched in and out, knotted...

Soon, in less than five or six minutes, Zhou Chengcheng managed to finish the treatment of the arterial injury that Dewey and others had failed to deal with several times.

It seemed that Dewey and the others were sweating profusely just as a joke.

Or the current Zhou Cheng is just joking, like playing house.

Is this thing too difficult to operate?Or is Zhou Cheng too powerful?Not all are well evaluated.

Everyone looked dull and complicated.

Seeing this, Cai Dongfan, Professor Ning and the others quickly approached, and then each returned to their positions, ready to operate their respective fields.

"Professor Du, I'm almost done here, why don't you let go of the proximal end first? Look at the permeability and extravasation of the blood supply?" Zhou Cheng suggested asking.

"Yes!" Dewey nodded, not daring to say no, but his tone was a bit embarrassed, and he didn't quite understand whether the person he temporarily pulled onto the stage to save the field was here to save the field or to kick the field.

I obviously sewed it up several times, but I couldn't sew it up well, so Zhou Cheng dealt with it when he came up. The contrast between before and after is sharp, as if he did everything specifically to promote Zhou Cheng.

……

Zhou Cheng did not do anything other than orthopedics. Professor Dewey only asked him to help with the suture of the abdominal aorta first. Limb replantation.

Oh no, this surgery is no longer simply replantation of severed limbs.

The home field of the operation is Guang Yanhu.

Cai Dongfan and Guang Yanhu were divided into two groups, each dealing with a section of lower limbs.Guangyanhu was operating within the normal process, but Cai Dongfan seemed a little confused and couldn't find a clue, as if he didn't know how to start after finishing the debridement.

Debridement is the basic operation of trauma, but replantation of amputated limbs is not something ordinary doctors dare to do directly.

The junior doctors are not surprised.

However, when Zhou Cheng moved over to help, Na Zhupei, who was doing surgery with Cai Dongfan and was an assistant, looked at Zhou Cheng in astonishment, and quickly moved out of the room.

Zhou Cheng's strength this week was not blown out. At least, he helped Professor Dewey just now and easily dealt with the abdominal aorta that Professor Dewey failed to deal with.

There may be elements of exaggeration, but it must be capable.

And Zhou Cheng is an orthopedic surgeon.

After Zhou Cheng stood next to Cai Dongfan, he took over the surgical instruments and said, "Master, let me help you."

When Cai Dongfan heard the words, he glanced at Zhou Cheng, and his mood immediately relaxed: "Okay, Xiao Zhou!"

While speaking, Cai Dongfan saw that Zhou Cheng had adjusted the direction of the hook at some point in order to expose the opening better and obtain a better surgical field.

At the same time, Cai Dongfan also saw that Zhou Cheng had almost pieced together the shattered bone fragments like a ghost by means of techniques.

Then he said: "Master, I think the patient's current bone condition is not bad, should I prescribe a titanium mesh for auxiliary fixation?"

Cai Dongfan nodded, and shouted confidently: "Okay, Xun Xun, open a titanium net."

Hearing Cai Dongfan's words, Guang Yanhu, who was doing the surgery on the opposite leg, glanced at it, and then his whole body went numb, his eyes widened instantly, and he stood on tiptoe carefully to see Zhou Cheng's reset fracture and his own. Comparison of fracture reduction.

I can't say that my own is not good enough, but I can only say that the reset made by Zhou Cheng will be more perfect!

After the titanium mesh came out, Cai Dongfan subconsciously wrapped it directly on the outside of the femur.Then he said, "Xiao Zhou, come and twist it."

This tone sounded like an orderly tone, and it was a little floating.

Zhou Cheng touched Cai Dongfan's hand silently, then folded the shape of the titanium mesh into a cylindrical shape with a smaller diameter, and inserted them into the bone marrow cavity of the femur respectively, and then stretched the outer periphery of the titanium mesh to cover the fractured bone. Quality pieces!

On the periphery, a piece of cut titanium mesh was added, and then I raised my head and asked, "Master, would this be better?"

Cai Dongfan blushed slightly, and nodded solemnly.

"This is not bad, this will be even better." Shamelessly expressing that Zhou Cheng is excellent, at the same time, Cai Dongfan seemed to realize that after Zhou Cheng returned, he should not be careless.

Otherwise, the embarrassment just now will be even more embarrassing.

Guang Yanhu on the opposite side was still suturing the muscles and tendons of his lower limbs, but occasionally he couldn't help but glance at Zhou Cheng who was doing the operation.

Then, every time he took a look, he would find that at Zhou Cheng's place, he found a very strange, unexpected, but unexpectedly better surgical method than what he knew, and it was displayed in front of him.

This is a large-scale damage, spanning the knee joint.Including the patella, lower femur, and proximal tibial plateau.

At present, except for the patella, which Zhou Cheng has not been able to restore, the others such as the femur and tibia have all been restored by Zhou Cheng's various weird surgical procedures!

And this is not even the severed limb replantation that Zhou Cheng cooperated with Qin Tianzhu before!

This TM is a step further than the replantation of severed limbs. This should be called limb reconstruction!

The replantation of severed limbs, at least there are still severed limbs that can be used, and the reconstruction of severed limbs is basically to create something out of nothing, to get out something that should have died, just like rebuilding!

Then, Guang Yanhu also saw that Zhou Cheng started to make a show again.

The bone surface can be rebuilt by Zhou Cheng, but soft tissues such as muscles cannot be created out of nothing, and if all the soft tissues are replaced with instruments, the cost will be too high.

However, Lu Cheng still used local materials from the previous damage, and reused a lot of materials in his own body. For example, when rebuilding and transplanting muscles, Zhou Cheng rested the muscles that were already thin and took out the tendons. After coming down, the tendons were transplanted, and the muscles were left alone, and then some places with richer muscles were found, and they were split horizontally to perform muscle transplantation.

Then there are blood vessels and nerves. Zhou Cheng found a suitable blood vessel replacement either from the proximal end or from the far end!

In this way, the blood supply was finally resolved.

And when Zhou Cheng did this, Guangyanhu unilaterally stopped his own surgery and left it to Guipei to continue debridement.

Because his follow-up surgery can only improve some details at most, and what he needs to do now is to observe Zhou Cheng's surgical thinking, which is a major improvement to his own skills.

Which is more important, Guang Yanhu still understands.

It's just that Guang Yanhu's mood is very tangled at this time.

First, it can be seen that Zhou Cheng's strength is absolutely extraordinary, even more legendary than the legend, this is absolute!

Even though he was already high enough, because of Ding Changle, because of Lei Zhong, because of Qin Tianzhu, he had enough respect for Zhou Cheng, but this heart was still not enough. Zhou Cheng's height was even higher than this!

This is also the reason why Professor Ding Changle and others were willing to grant Zhou Cheng the authority to perform three types of surgery a year ago!

Second, after Zhou Cheng came back, his current position was a bit embarrassing.It was not easy to enjoy the treatment of leading the group several months in advance, and Professor Cai was very cooperative.

If Zhou Cheng came back again, wouldn't it mean that he would return to the previous situation where he was behind others and controlled by others?

From extravagance to frugality is difficult!

Third, I can learn a lot, but the premise is, do I want to let go of my face?

Chapter 365 Not Everyone Serves!

Lu Cheng is still scrupulously continuing to operate. Although his professional title is only as an attending doctor now, he has already passed various surgical authorizations, including new operations, and can be performed routinely, as long as there are suitable diseases. exist.

Replantation of amputated limbs is generally for amputated limbs with relatively smooth stumps.

The severed limb transplantation in Chang City is aimed at people who must undergo amputation due to life-saving reasons, and then undergo transplantation of severed limbs. The target is the kind of severe ischemia for a period of time after amputation sick.

This, if successfully developed, could reduce disability for many patients.

Lower-level hospitals may not be able to save limbs, but they can amputate limbs to save their lives. After the vital signs are stabilized, the amputated limbs will be sent to higher-level hospitals, which is equivalent to dismantling the operation!

The time window in which surgery can be performed is delayed.

However, what Lu Cheng is doing now is the reconstruction of severed limbs after damage. This is another level of theory. It is more applicable to segmental damage, other positions other than staged damage, or OK.

In such cases, it is necessary to reconstruct the tissue of the damaged segment and restore the normal length of the patient's limb.

This kind of operation will be more difficult. It can be regarded as waste recycling, and it can also be dismantled and repaired, and the original normal muscle tissue can be extended in length through various methods such as thinning and splitting!

The more difficult thing to deal with is the blood vessel and nerve. The blood vessel and nerve tissue cannot be divided into bundles, so they can only be replaced by nerve branches of muscle tissue that pass through other normal nerves, but the relative role and nutrition are not important...

It sounds simple, but it actually involves a lot of high-end surgeries.

For example, just one muscle, there are muscle transplantation, muscle replantation, muscle repair, muscle plastic surgery, tendon transplantation, tendon replantation, tendon formation, tendon transposition, tendon repair, tendon suture...

Among them, the difficulty of tendon suture is relatively the easiest!

In addition to muscles, there are transposition of blood vessels, suturing of blood vessels, repair and cutting of blood vessels, and grafting of blood vessels...

Guang Yanhu was already a little fascinated.

When this patient came, the instinctive reaction of all doctors, especially those in trauma surgery, was how to save the limbs. Is it too risky?

After Guang Yanhu saw it, he just decided to keep one side of the foot, and the other side, it is best to amputate it, the possibility of keeping it is too small.

But, in fact, Guang Yanhu also knows that it is theoretically feasible to save this leg, but it will cost a lot of money. For example, Ding Changle and other orthopedic professors all appeared in the surgery. between.

It can be guaranteed, but the timing is not a coincidence.

Not to mention other professors, even those from trauma surgery must be spared.

In the 22nd room next door, Cai Dongfan forcibly sent Jinping to deal with it temporarily, and then he stayed with Guang Yanhu, giving priority to this young man.

But ah, after this young man's luck was utterly unlucky, he ushered in the biggest turning point again!

It happened to be New Year's Day, and Zhou Cheng came to Shashi for the holidays. The skills Zhou Cheng showed now could be used by at least three professors.This is not bragging.

Of course, it’s not that Zhou Cheng has three professors who are good, but that Zhou Chenghui’s skills are simply too comprehensive. You say that the stitching of bones is so good, so forget it. You are so good at stitching, and the stitching is so high-quality , forget it.

Why can you suture muscles and blood vessels so well when you have no place to place microscopic instruments?

……

two hours later.

Guangyanhu's debridement has almost come to an end.

According to the previous arrangement, Guang Yanhu had to go to Room 22 to see the situation first.

However, Guang Yanhu, who had finished his surgery, didn't go to the next door, but sent Zhu Pei who followed him first, and went to the 22nd room next door to take a look first. He, on the other hand, got closer to Zhou Cheng. The opposite of Cheng, personally participated in the operation, and watched and learned.

From a distance, you can only see the process, and when you look closely at the details, you will know that Zhou Cheng's detailed operations are unimaginable by ordinary people, and his fingers are tactfully flying like a swimming dragon.

However, Guang Yanhu still noticed that Zhou Cheng's fingers seemed to be trembling slightly stiffly. It should be that he moved too fast in a short period of time, resulting in muscle fatigue and lactic acid accumulation!

Looking at the progress of the operation, Zhou Cheng has already completed most of the operations. The only thing left is the suturing of the outermost muscle layer. Zhou Cheng has even layered and paved the muscle tissue.

Guangyanhu stretched out his hand and said in a low voice: "Xiao Zhou, let me sew up the rest. You can take a rest for a while? Stare at the side?"

It has been four hours since Zhou Cheng woke up. After such a long time, the machine should be rubbed red, let alone a human?

Guang Yanhu's operation time is the same as Zhou Cheng's, but the degree of fatigue is completely different when doing different things.

Zhou Cheng glanced at Guang Yanhu, hesitated for a while, and handed the equipment in his hand to Guang Yanhu, and he had already prepared Guang Yanhu to replace him, and changed positions back to back.

When making a fist, Zhou Cheng clearly felt that the flexor tendons in his hand were constantly trembling. The pain caused by the fibrillation made it difficult to use force, but Zhou Cheng still insisted on holding it, but the left and right hands were constantly rotating, and then another One hand stretched and stretched continuously, doing relief movements.

Only then did Cai Dongfan notice Zhou Cheng's situation, his mind froze a little, and he said, "Xiao Zhou, you can do the rest of the operation with Professor Guang, and you can step down and go back when you're done, I'll go and see what's going on next door first." .”

Zhou Cheng looked up at Cai Dongfan again, and said in a low voice, "Master, I'll just rest for a while. I'll go back after the operation in the next room is over. Anyway, it's about time."

The surgical patients in the 22 rooms were specially greeted by the general surgeon, and Cai Dongfan ignored them. If there were any problems later, it would not be conducive to Cai Dongfan's unity with his colleagues in the hospital.

"Alright." Cai Dongfan continued to walk to the next operating room while taking off his clothes.

After leaving the operating room, on the operating table, several professors from other departments spoke one after another: "Xiao Zhou, add a WeChat later, and I can introduce you to some girls."