Doctor's Life Simulator

Chapter 85 Crisis!Variation of vagus nerve found during operation
Soon Wei Guoqiang brought Qin Lang to Zijingang First Hospital.

After the two of them parked their cars, they rushed to the base of the ward building. Deputy Director Shen Jiachen and one of his subordinate doctors were already waiting early.

The girl beside Shen Jiachen was 1.7 meters tall, with straight and slender legs, wearing a white coat, and a delicate and beautiful face.

The girl is 27 years old this year, she is Shen Jiachen's graduate student, she is considered his favorite student.

"Director Wei, Doctor Qin, you have worked hard."

Shen Jiachen thanked Wei Guoqiang and Qin Lang, and then introduced the little follower beside him.

"This is my student Tang Yue, who is my graduate student. She is also an intern at my burn and plastic surgery center. This time, let her observe this operation together and learn from Director Wei and Dr. Qin."

Tang Yue brushed her soft hair with her right hand, and nodded to Wei Guoqiang and Qin Lang with a delicate and cute face, saying hello:

"Director Wei, hello Dr. Qin, I will learn more from you next time."

Tang Yue, as a graduate student of Zijingang No. [-] Hospital, and a top doctor like Deputy Director Shen Jiachen under the tutelage, has no airs or arrogance at all.

In his tone, he was very respectful and curious about Qin Lang and Wei Guoqiang.

In particular, looking at Qin Lang, who is just like her and has a perfect appearance, he added:
"Doctor Qin, Director Shen asked me to learn more basic surgical skills from you. In return, if you need to revise your paper in the future, or submit an article to a foreign journal, you can come to me. And this is my best field, and I can help you when the time comes. You can modify it together."

Speaking of her scientific research ability and foreign language attainments, Tang Yue straightened her back, full of confidence and pride.

Shen Jiachen also added a sentence like an old father:
"Doctor Qin, your clinical talent is overflowing, and Tang Yue's scientific research talent is also not bad. In the future, you can communicate more and promote each other."

Hearing Director Shen's praise of Qin Lang, Tang Yue became more and more curious about the length of this young man who was three years younger than herself.

And Qin Lang is also observing Tang Yue's depth, probably because he has stayed in Shuguang Beauty Hospital for a long time today, so he instinctively starts from the forehead, eyebrow arch, orbicularis muscle, eyelid, nose bridge, nose wing, nose tip, lips, chin, neck , collarbone all the way down.

This ratio is simply a template for plastic surgery, especially the facial features, the shapely body, even through the clothes, can be accurately distinguished, perfect symmetry, the body size is suitable for the body shape, and the soft waist is underneath, the size of the opening and closing Just right pelvis, upper and lower body in golden ratio.

Seeing Qin Lang's focused and meticulous line of sight scanning, Tang Yue was slightly puzzled, but Qin Lang's appearance was just like hers, so it should just be a sympathy for seeing girls of the same level of beauty, right?

Tang Yue was not at all ashamed, and responded with a generous gaze. After all, beauty is justice!

And when the two little doctors met each other's eyes for the first time, deputy director Shen Jiachen had already led Wei Guoqiang to open the way ahead.

"Okay, then Dr. Tang will have to be troubled a lot."

Qin Lang really didn't know anything about writing papers. Although there was a free labor force from Cheng Yunfeng in the city's first hospital, Qin Lang really didn't believe in his level.

But now Tang Yue, who was so slim and tall, was standing in front of him, no matter whether it was out of politeness or instinct to appreciate her perfect plastic template figure, he had no reason to refuse.

"For this operation, our Zijingang No. [-] Hospital is considered to be the top lineup. Our two little doctors are really lucky."

Tang Yue and Qin Lang communicated, and when they talked about the operation that will be carried out in a while, they were looking forward to it.

She naturally thought that Qin Lang was the proud disciple of Wei Guoqiang who was like her and brought him to see the world.

After all, this kind of opportunity is once in a lifetime!
Of course, this arrangement is also the carefulness of Deputy Director Shen Jiachen. After a while, he will let Tang Yue and Qin Langwei Guoqiang enter the operating room together. It's not clear who is who.

Shen Jiachen has seen Qin Lang's operation and technology with his own eyes, so he is naturally sure, but the rest of the directors don't necessarily think so.

In fact, Qin Lang is too young. In order to avoid unnecessary disputes, he and Qin Lang stood at the end during the operation, waiting for Director Yu and Director Yang to complete the extended resection of the primary tumor and neck dissection. After that, he directly took over the repair of the external carotid artery.

Deputy Director Shen Jiachen led Wei Guoqiang, Qin Lang, and Tang Yue to prepare for the operation. After learning about the patient's condition and the subsequent operation plan, they entered the operating room.

In the operating room, Director Yu and Director Yang are already ready to go.

The director of the anesthesiology department personally administered general anesthesia to the patient.

"Director Wei, Doctor Qin, you have worked hard."

In the operating room, the focus was on the patients, and everyone was fully armed, so Director Yang and the two turned their heads, unable to tell who was who, and greeted them.

"Now that the staff is here, I'll start first."

Director Yang was the first to start neck lymph node dissection.

Radical neck dissection, also known as total neck dissection, requires resection of cervical lymphatic tissue in zone Ⅴ in front of the prevertebral fascia on one side. Due to the special circumstances of the patient, even the cervical lymphatic tissue in zone Ⅵ and Ⅶ can be wiped out. .

Director Yang is worthy of being the director of oral and maxillary surgery in the First Hospital of Zijingang. The posture of holding the knife is completely at the textbook level, and the strength with which he uses it is even more consummate.

Even Qin Lang couldn't pick out any flaws.

Director Yang soon completed the incision of the skin and separated the skin flap on the superficial surface of the deep cervical fascia under the platysma.

The entire exposure position is controlled very precisely, from the upper edge of the rudimentary process and the mandible, the lower boundary to the upper edge of the clavicle, and the posterior boundary to the front edge of the trapezius muscle.

The action is clean and neat, and the speed is also very fast.

Wei Guoqiang and Qin Lang on the side were eye-opening.

"No loss, it is the top hospital in Zhejiang Province."

Qin Lang also felt yearning in his heart, what a place where Crouching Tiger Hidden Dragon, Director Yang's incision and separation skills have reached [-]% of his own skill, really amazing.

Next, Director Yang dealt with the lower end of the internal jugular vein, directly cut off the sternocleidomastoid muscle and the end of the clavicle with an electric knife, found the internal jugular vein, and began to separate the common carotid artery and vagus nerve.

The vagus nerve is the tenth pair of cranial nerves, and it is a mixed nerve. It is the cranial nerve with the longest journey and the widest range of divisions.

Under normal circumstances, the direction of the vagus nerve in the neck is relatively constant, but this patient has a rare variation.

Director Yang is very familiar with the normal branch of the vagus nerve, but during the neck dissection this time, he found that the left vagus nerve descends from the anterolateral side of the internal carotid artery about 3 cm above the branch of the carotid artery. Deviated.

When the internal jugular vein is separated and ligated during neck lymphadenectomy, it is very important to protect the vagus nerve. Generally, the vagus nerve runs behind the common carotid artery and the internal jugular vein. When it is separated from the neck, the nerve will be in the The deep surface of the internal jugular vein is easy to protect.

However, even if this variation of vagus nerve walking is carefully distinguished, it is still possible to ligate the vagus nerve and the internal jugular vein together and damage the nerve.

The patient's current serious condition, if there is more vagus nerve damage and repair, it will undoubtedly make the situation worse.

Director Yang's previous fast pace came to an abrupt end, and cold sweat broke out on his forehead and back.

After all, this kind of vagus nerve mutation is really rare, and the extent of the mutation can only be known by cutting it open. However, once it is damaged, it is irreversible.

If it was an ordinary patient, Director Yang would have boldly tried it. If it was really damaged, it would take more time to repair it. But this patient has a special status, and in the observation room, Vice President Lin was watching.

Director Yang's heart thumped and he was in a dilemma.

"What happened to Director Yang?"

Director Yu, who was the closest, saw Director Yang's abnormality, and asked nervously.

Director Yang's mouth was bitter, and he said helplessly:
"The course of the cervical vagus nerve varies in patients. Conventional experience is no longer effective, and it is very likely that there will be mistakes in the operation. To achieve a non-destructive separation, the surgeon needs to be very familiar with neck anatomy, far beyond ordinary people's care and precision. Separation technology."

Director Yang didn't say a word in his heart, this is still after the incision and autopsy, to find out the trend, and to be wise after the fact.

How to do!
(End of this chapter)