My medical skills add experience

Chapter 652 Lowering the temperature and prolonging the tolerance limit, a new knife technique that combines the strengths of the three schools

Zhou Can has always respected Director Lou in his heart, even though Director Lou later turned to Dean Gao.He knew that Director Lou was serving the thief for the sake of the development of the emergency department.

At this moment, looking at Director Lou, who was full of anger and desperately trying to win the first prize, Zhou Can felt a little puzzled.

He went to arrange the manpower without mentioning it.

With the assistance of Dean Gao, coupled with Zhou Can's excellent connections among various clinical departments, a super elite surgical team was quickly organized.

It's a pity that Qiao Yu went abroad for further study.

Otherwise, it would definitely be better for her to be an instrument nurse for this operation.

She can also learn a lot of valuable surgical knowledge and experience from it.

The preoperative examination and preoperative preparations arranged for Mr. Song are in full swing.

The formulation of the surgical plan had been deduced countless times by Zhou Can.

After all, Mr. Song's status is noble, and nothing can go wrong.

……

When Zhou Can went into the operating room to change clothes, he found a chance to be alone with Director Lou.

"Director Lou, please forgive me for not reporting this matter to you in advance."

"Hmph, I think your wings are stiff, and you have made up your own mind on such a big matter. Give me a good operation, it's messed up, and I can't spare you."

Director Lou snorted angrily, and didn't give Zhou Can a chance to explain again.

This is the first time since Zhou Can entered the emergency department, Director Lou has been so unkind and angry towards him.

Zhou Can sighed slightly.

This matter was kept from Director Lou and Dr. Xu, in order not to give them a chance to stop it.

Dr. Xu is on vacation today, so he probably doesn't know about it yet.

Zhou Can's idea is very simple, if something goes wrong during the operation, he has to bear it alone.Dr. Xu is already miserable, but he can't be involved anymore.

As for Director Lou jumping out to grab credit this time, his behavior is confusing.

Out of respect, Zhou Can didn't think about it.

If everything goes well, Dr. Xu will have a surprise when he comes to work tomorrow.

If something goes wrong during the operation, Dr. Xu will be shocked before tomorrow.

In Shenwai’s best No. 1 [-]-level laminar flow operating room, Zhou Can and the ultra-luxury elite surgical team officially began to operate on patients.Director Liu of the Department of Critical Care Medicine personally led the team and the team of Director Feng of the Department of Anesthesiology to protect the lives of patients together.

In terms of nursing work, the chief commander of surgical nursing is the most experienced itinerary teacher in the surgical operating room.

Jiang Wei served as Zhou Can's equipment nurse and deputy commander.

Ma Xiaolan is not very lucky, the due date is coming soon, so she can only take maternity leave at home.

Missed this gilded opportunity.

Of course, the risk is also very high. If the operation fails, it is possible that the gold plating will not be successful but will become suffering.

Then again, the housekeeper Bian has already signed the pre-operative signatures that should be signed.

If something really happened, even if Mr. Song died on the operating table, at most it would be the few people who took the lead.The other participants in the operation will be implicated a little at most, and there is no risk of too much.

"Director Feng, can the operation begin?"

"Vital signs are stable, general anesthesia has been successfully implemented, let's have a craniotomy!"

Since the reform of the Department of Anesthesiology, Director Feng seldom appears in the operating room of the emergency department, and he is only seen in the fourth-level major operations of neurosurgery and cardiothoracic surgery.

Tuya's strongest anesthesiologist should be him.

Seniority, experience, and professionalism are top-notch.

Although there is no name of master and apprentice between him and Zhou Can, there is a relationship between master and apprentice.Following him, Zhou Can learned a lot of valuable anesthesia knowledge and life-saving methods in anesthesia science.

This life-saving refers to saving the patient's life.

Accidents happen during surgery, which is a common occurrence. At this time, every second counts, and life-saving means are extremely important.

Zhou Can was the one who performed the surgery himself, and it had to be him.

The Song family didn't value those flashy names, but only valued the real strength of the chief surgeon.

They conducted a very detailed investigation on Zhou Can, and felt that Zhou Can had this ability, so they were willing to let Zhou Can perform this operation on Mr. Song.

At this time, the door of the operating room opened automatically, and a figure walked in.

Despite wearing a mask and headgear, Zhou Can can still recognize Dr. Xu at a glance.

His heart trembled slightly, but he didn't expect the teacher to know about it.

Dr. Xu's arrival did not attract much attention from others.

Because there are quite a lot of medical staff in the operating room.

And they are basically top elites in various fields, each with a high vision.

What everyone cares about now is their own work, and do their best to cooperate with Zhou Can to make this operation a success.

As for the rest, no one cares.

After Dr. Xu came in, he just stood behind Zhou Can and did not speak.

But Zhou Can could feel that the teacher's eyes were very soft.

Every movement of the craniotomy, Zhou Can is meticulous and careful.

Because Mr. Song is very fragile now, the fire of life has been extremely dimmed, and any rude action may bring disaster.

Even Director Feng, who is extremely experienced, watched Zhou Can cut the patient's scalp and subcutaneous tissue, then drill a hole in the skull, and then cut the skull flap along the hole with an electric saw...

Every step made him tremble with fear.

Not just him, but everyone else.

Seeing Mr. Song's heart rate drop suddenly, even everyone held their breath.

"Director Feng, do you want to strengthen your heart?"

"Observe first, Zhou Can's technique is already very good, and it should not affect the patient's vital signs to fluctuate too much. It is likely to be related to the skull flap just cut, and it will return to stability after a while."

Director Feng sat calmly at the back and escorted the patient's life.

His eyes are extremely sharp, sometimes staring at the dial and screen of the monitoring instrument, and sometimes watching the progress of the patient's operation.

Zhou Can dissected it step by step, and finally he could see the brainstem area.

Even after so many years, you can still see the surgical traces left after the tumor was removed.

Ordinary people can't see it, but Zhou Can, who has rich experience in brain surgery, can see those defective parts at a glance.

"Teacher, is this the nerve that was severed back then?"

Zhou Can pointed to the side of the trigeminal nerve extending from the brainstem and asked.

"Yes, the pons were cut. At that time, the tumor was very large and infiltrated into the brainstem area. If the operation was not done thoroughly, it would definitely recur. At that time, there were only two options. Either try your best to take a risk, Either close the cranial cavity, sew it up, and tell the family members that the operation is too difficult to operate.”

Dr. Xu didn't say any more.

He chose the former.

Take a chance.

As a result, the second half of his life was ruined, his future was lost, and he fell directly into the abyss.

It is not easy to be a surgeon, and it is even more difficult to be a benevolent surgeon.

If Dr. Xu had to choose again, he might choose the latter.

The cranial cavity was closed again and it was declared inoperable.

This kind of thing happened from time to time in the hospital. Although it was a bit embarrassing, it was better than an accident.

"After it was cut open, it was sewn up again?"

"It has been repaired, but the effect is not satisfactory."

Dr. Xu admitted it frankly.

"Looking at the situation, the part that was repaired back then must be cut open, debrided, and then reattached."

After careful inspection, Zhou Can said so.

Neural anastomosis is extremely difficult.

And nerve cells are the only non-renewable cells.

It cannot repair and heal itself like other body tissues.

When the nerves are anastomosed, there are tens of thousands of guide wires inside, each of which must be aligned to ensure the best effect after the nerve anastomosis.

Some guide wires are wrongly set up and fail, that is, the wrong nerve is often called by cursers.

The consequences can be imagined.

"Director Feng, Director Liu, I'm going to use my brain, and the patient's vital signs may disappear by then. How long can you give me?"

Zhou Can took a deep breath, but his eyes remained firm.

"The safest time is within 3 minutes, and the shorter the time, the better."

Director Feng said directly.

The brainstem is known as the restricted area of ​​life, not to mention cutting it, even in the peripheral area, few doctors dare to move it.

At present, there are only a few courtyards in China who dare to claim that the brain stem is no longer a restricted area of ​​life.

Tuya also barely possesses the strength in this area.

But to be honest, Wu Baihe never bets on his future and tomorrow, as long as the risk is too high, he will give up.

Unless the family members are willing to sign the waiver, and Tuya's legal counsel will sign the document.

Out of ten cases of brainstem surgery, it is already very good to be able to succeed in two cases.

Zhou Can's current incision is only a little short of level seven, and debridement, anastomosis, suture, knotting, and pathological diagnosis are all level seven.It can only be said that I have the ability to try it, but I am not fully sure.

His steady knife technique and fast knife technique have been stuck in the second level, but failed to break through to the third level, which also caused his incision technique to also be stuck in the sixth level.

Debridement and incision are closely related.

Especially Mr. Song's brainstem repair part, it is difficult to incision and then debridement.

"3 minutes is definitely not enough, I'm not sure at all."

Zhou Can shook his head.

Incision, debridement, and quick anastomosis, let alone 3 minutes, even if it can be done in 10 to [-] minutes, it is the top level in the field of Shenwai.

"Then how long do you want?"

Director Liu of the Department of Critical Care Medicine asked.

"Conservatively, it will take at least 10 minutes."

If Zhou Can's fast knife technique and steady knife technique can break through, this time may be shortened a lot.

Because the incision is good or bad, it is directly related to the difficulty of debridement later.

At the same time, it is also related to the difficulty and effect of suture.

After Director Liu finished listening, he turned to look at Director Feng.

"Old Feng, why don't we try the cooling method? Other than that, I'm afraid there is no better way to extend the time to 10 minutes."

"That's a good idea."

Director Feng's eyes lit up slightly, and he nodded in agreement.

Under low temperature and normal temperature environment, the consumption of human body is two concepts.

Now the technology is relatively mature to freeze and seal life, and in science fiction, someone is unfortunately frozen in a snow mountain avalanche.Then after N years, through the thawing technology, that person came back to life.

The operating room temperature is generally controlled at around 25 degrees.

Because the patient is performing the operation naked, this temperature is the most friendly to the patient.

In winter, the temperature of the operating room is generally adjusted to above 20 degrees, and 22 degrees is the most suitable.In summer, it is appropriate to control the temperature below 26 degrees.

Human wisdom is infinite.

For routine surgery, the operating room temperature is controlled within this range, but in case of special surgery, the temperature can be lowered to cooperate with the smooth implementation of the operation.

The most common is to turn down the temperature to around 15 degrees.

At this time, the blood circulation and metabolic rate of the human body will be slowed down accordingly, which is extremely beneficial to the control of bleeding and the prolongation of the operation.

"By lowering the room temperature, we can extend the time by about three times, and it should be safer within 9 minutes. Are you sure?"

"Okay! But I have to go out and put on a jacket first."

Zhou Can heard that the time could be extended three times to 9 minutes, and he knew that this was already the limit.

Lowering the temperature in the operating room can certainly prolong the patient's limit tolerance time, but it is extremely unfriendly to the operator.

In a low temperature environment, the operator's movements will become slow and their movements will become clumsy.

This significantly prolongs the operating time.

For example, Zhou Can could sew three stitches in one second, which is the fastest speed.At low temperatures, it may not be possible to sew a stitch in a second.

Calculated in this way, the patient's operation tolerance time has been improved, but the total operation time has also been extended several times.

The only way is for the surgeon to wear a warm jacket.

……

Ten minutes later, the main surgical staff had all put on thermal underwear.

Zhou Can even put on a padded jacket.

It must be explained that when going out to change clothes on the spot, the sterile clothes on the body must be replaced with new ones.Including headgear, gloves, etc., must be replaced with new ones.

This is a waste of behavior.

But in order to ensure the smooth implementation of the operation, let alone a few sets of sterile isolation gowns, no matter how much it costs, it is worth it.

The family is absolutely happy to pay the money.

As long as they are reasonable family members, they will not care.

The temperature in the operating room has already started to drop, and both Director Liu and Director Feng are on the verge of a formidable enemy.

When the temperature drops, the patient's vital signs will be seriously affected.

Frogs can hibernate, and so can bears, but humans do not have this ability.

Patients in critical condition are even more unable to tolerate the damage caused by low temperature.

Every winter, many elderly people, as well as critically ill patients who are bedridden, have a particularly hard time.

Low temperature itself represents the withering of life.

"Hurry up!"

Director Feng said to Zhou Can after the patient's signs stabilized.

"it is good!"

Zhou Can held the scalpel, his eyes became firm and focused, and everyone in the entire surgical team cooperated with him.The Song family is also looking forward to his successful operation. Whether Dr. Xu can stand up and get rid of the shackles of guilt on his body also depends on this operation.

That invisible pressure turned into a heavy burden and weighed on him.

After taking a few deep breaths, he held the knife and cut down.

No hesitation, no timidity.

Some are just a responsibility, a benevolence.

As his knife cut down, the clear feeling of the knife was transmitted back to the brain through the fingers and palm.

In this extremely high-pressure state, Zhou Can only had patients in his eyes.

As if, he could see the beating life.

"Beep beep..."

The alarms of the monitoring instruments rang together.

All the medical staff were already busy, and the god of death hovered over the operating room.

In Zhou Can's mind, he was comprehending the sword technique naturally.

Because he has to cut it across the board.

"The ultimate of the fast knife is to be as fast as lightning, ignore all the difficulties, cut the mess quickly, and accomplish it overnight. The essence of the steady knife method is to win steadily, strive for stability, durability, and no imbalance...The precise knife law is only the pursuit of precision, without Any deviation, the force is just right, the position of the knife is just right, the knife is just right, the lesion is just cut off, or the corresponding tissue is cut just right..."

The three true meanings of fast knife technique, steady knife technique and fine knife technique kept appearing in his mind.

The fine knife technique was learned from Wu Baihe in the operation room of Shenshou.

The three are intertwined and all melt into the scalpel in his hand.

The cut is the pontine part of the brainstem.

This place was once cut open by Dr. Xu, so it was cut by mistake.

The later repair was not ideal, and now it must be cut and repaired.

Zhou Can knew very well that Mr. Song's life was already hanging on this knife.

When it was cut, the effect did not reach the ideal state, and it was far from the perfection he expected.

"Oops!"

Zhou Can's mind went blank for an instant.

At this moment, he already felt that the disaster of extinction was coming, or in other words, it had already come.

The teacher's kindness, the majestic Song family like a king, his own career, the expectations of so many medical staff...they turned into whips and lashed Zhou Can hard.

The more dangerous the situation, the more calm you need to be.

Zhou Can remembered Director Hu Kan's exhortation.

I saw that his hand holding the knife gradually relaxed a lot, and it was no longer tightly holding the scalpel.

Instead, it became a 'toy', and the scalpel was no longer a life-saving straw that he held tightly.This is a kind of mental sublimation.

In the past, it was the sword controlling people, but now, he seems to have touched a trace of the real essence, people controlling the sword.

The scalpel was held in his hand so casually, it was not smashed, let alone smashed, but he gave the scalpel life and soul.Let it come alive, let it dance on your fingertips and palms, and obey Zhou Can's command as you like.

Where to hit.

At this moment, he seemed to be in a daze, disregarding everything in the outside world.

Only surgery that has long been integrated into his life.

It was true that the incision did not achieve the desired effect, but after the subsequent debridement, he obviously had the strength to make up for it.

Dr. Xu standing behind him, and Wu Baihe on the opposite side, saw Zhou Can's scalpel being swiped rapidly to debride the wound.

Their eyes widened in disbelief.

What kind of sword technique is this evildoer using?
Why is it a bit like four different things, the steady sword method is not like the steady sword method, the fast sword method is not like the fast sword method, and the precise sword method is not the same, but it seems to combine the strengths of the three schools, and perfectly blend these three contradictions into one Together.

The incision made by debridement, Dr. Xu still can't see any tricks.

On the other hand, Wu Baihe showed extremely envious, even jealous eyes.This level of nerve incision is the perfect incision he has been pursuing so hard, but he has never achieved it after pursuing it all his life.

Zhou Can has reached it at this moment.

(End of this chapter)