Back to 1999: From operating surgeon to becoming a top doctor

"I am Dr. Xiao from the Department of General Surgery. I am sorry to bother you all tonight."

"Today we are doing emergency laparoscopic exploration. Director Wang is pushing the instrument over. Since pneumoperitoneum needs to be established during the operation, please pay more attention to the patient's ventilator parameters and arterial blood gas analysis, anesthesia teacher."

After a brief self-introduction, Xiao Chenguang went straight to the point.

Laparoscopic surgery is different from previous open surgery. It uses a tiny lens to penetrate into the patient's body, and then combines with an imaging system to finally present the picture on TV for the operator to observe.

However, due to the limitations of the human body's physiological structure, the peritoneal cavity is not large enough for the lens to explore deeply, so it is necessary to establish artificial pneumoperitoneum to stretch the peritoneum from the tightly attached internal organs to obtain sufficient vision.

This is the first step of laparoscopic surgery and the key to the success of laparoscopic surgery.

Otherwise, the operation will not even be able to see the field of view clearly, and no matter how much effort is made, it will be useless.

When Xiao Chenguang introduced the patient's current condition to everyone in a concise and concise manner, there was silence in the operating room.

"Laparoscopy again..."

Liu Tie was stunned, and then showed a bitter smile.

No wonder the director called him personally and asked him to go on stage.

At that time, because the situation was urgent, Liu Tie only knew that it was an abdominal exploration operation. Because the patient was old and seriously ill, the director asked him to rush over from home to ensure the safety of the operation.

But who would have thought that this was actually a laparoscopic operation.

Damn it.

The director asked someone to take the blame, but he couldn't just take it on himself.

Liu Tie's face was hopeless, and his heart was full of regret.

If he had known this would happen, he shouldn't have volunteered to go to the provincial capital operating room to study anesthesia management for laparoscopic surgery.

So that he was the designated anesthesiologist for the first laparoscopic operation after returning to the hospital, and later he was punished for the failure of the operation.

I thought I would never touch this kind of operation in the hospital in my life, but who knew that it had only been a short time, and I had to go on stage again, and it was an emergency laparoscopic operation in the middle of the night.

How can this be justified?

Liu Tie's heart was filled with sorrow.

But the patient had already been pushed into the operating room, eagerly waiting for the operation. He couldn't just not have the operation because of himself.

Liu Tie thought he was not that kind of person, so he gritted his teeth and prepared the patient for the operation according to the anesthesia process.

He moved the bed, placed the patient in the surgical position, and prepared the medication before general anesthesia.

When everything was going on in an orderly manner, Wang Jingang pushed the instrument to the operating room.

"Oh? Xiao Liu, you're here?"

As soon as Wang Jingang entered the door, he saw Liu Tie preparing anesthetics, and he felt relieved.

After all, Xiao Liu was the only anesthesiologist in Shengli Hospital who had gone out to study laparoscopic surgery, and his experience and skills were much better than other anesthesiologists in the operating room.

"Hi, Director Wang, what a coincidence."

Liu Tie greeted awkwardly, revealing a smile that was uglier than crying.

As the director of the department, Wang Jingang understood Liu Tie's thoughts at once.

It seemed that Xiao Liu had no confidence in the laparoscopic surgery that was about to be performed.

"Xiao Chenguang, I asked the director of the operating room to invite the anesthesiologists who know the most about laparoscopic surgery in the hospital. The rest is our turn."

"Director, no problem." Xiao Chenguang said with a smile.

Seeing Xiao Chenguang's relaxed face, Liu Tie next to him almost cried.

No problem?

Is it really no problem?

If he remembered correctly, this seemed to be the second laparoscopic surgery in the hospital.

As for the situation of the first one, they must know it better than himself.

Now they are still in the mood to chat, where do they get the confidence from?

However, compared with Liu Tie's sad face, the instrument nurse who was checking and installing the laparoscope handle did not think so.

In her cognition, if the operating room is always full of laughter, it means that the patient is basically fine.

But once the atmosphere becomes weird, everyone is silent, I am afraid that the patient on the stage will suffer.

Just like when she passed by the No. 1 operating room next door just now, it was full of people, but no one spoke.

The scene was even more terrifyingly quiet, everyone was like a piece of wood, motionless.

The nurse thought about it now, and her hair stood on end.

"Director Wang, the patient has been anesthetized, and the operation can start at any time."

Liu Tie slowly injected the anesthesia induction agent into the patient's body, watched him close his eyes little by little, waited for the muscle relaxant to take effect, and inserted the prepared tracheal tube along the corner of the patient's mouth.

Then Liu Tie connected the opened anesthesia ventilator pipeline to the patient, selected the machine control, and watched the folding bag in the bellows begin to float up and down in an orderly manner, indicating that the patient's condition was normal.

"Thank you for your hard work."

Looking at his skilled operation, Wang Jingang nodded with satisfaction. It was really wise to ask Liu Tie to follow the stage.

With such an experienced anesthesiologist on stage, at least the patient's anesthesia risk will be greatly reduced.

But at this time, Liu Tie was worried and looked a little listless.

Just as he adjusted the patient's tidal volume according to the patient's condition, Xiao Chenguang's voice came over like a spring breeze.

"Brother Liu, the patient will have pneumoperitoneum soon. Please change the ventilator to pressure control and increase the respiratory rate a little bit."

"Hmm?" Liu Tie was startled and stopped turning the button.

He frowned and looked at Xiao Chenguang in displeasure: "Do you have any comments on my operation?"

Liu Tie was already upset, and at this moment, someone was actually pointing fingers in his professional field, which made him a little angry.

"Of course not."

Hearing this, Liu Tie's mood eased, but Xiao Chenguang's next words made him stunned.

Xiao Chenguang pointed to the ventilation mode on the anesthesia machine screen and said: "Generally, artificial pneumoperitoneum uses carbon dioxide gas. Its stay in the peritoneum will cause an increase in carbon dioxide in the blood, resulting in temporary hypercapnia."

"While artificial pneumoperitoneum opens the abdominal surgical field, it will increase the abdominal pressure, causing the patient's diaphragm to move up, squeezing the lungs, and causing high airway pressure."

"So when general anesthesia adjusts the ventilator parameters, it will choose pressure control according to the patient's condition to ensure that the patient's lungs will not suffer from barotrauma."

"As for why the respiratory rate is increased, it is also through gas exchange in the lungs, so that the increased carbon dioxide in the blood can be discharged from the body with breathing, improving the patient's hypercapnia."

Xiao Chenguang's words not only confused Liu Tie, but also the instrument nurse next to him.

This is solid knowledge in the field of anesthesiology. How can he, a surgeon, be more professional than an anesthesiologist?

Looking at their confused expressions, Wang Jingang could hardly suppress the smile on his face.

But he immediately recalled that he seemed to have the same expression not long ago.

Wang Jingang shook his head helplessly and began to connect the laparoscopic equipment silently.

As for Xiao Chenguang's performance at the moment, it further strengthened his determination.

This operation will definitely work!

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