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

The operation was so casual that it seemed insignificant to Xiao Chenguang.

But everyone in the operating room was stunned.

The steel needle inserted into the patient's abdominal cavity was like a magic needle that stabilized the sea, motionless on the surface.

The puncture hole was set up and the needle and thread were fixed.

Xiao Chenguang's forearm was as steady as a mountain, and his fingers swayed up and down quickly, hooking or stretching. The black thread as thin as a hair began to turn into a residual image in his hand, like a dancing butterfly, pleasing to the eye.

The button of the pneumoperitoneum machine lit up, and the machine body hummed, driving the light blue carbon dioxide cylinder as tall as a person, and began to inflate the patient's abdominal cavity in an orderly manner.

After a while, the skin around the umbilicus bulged, and the peritoneum close to the internal organs began to separate.

"Brother Liu, check the blood gas and see the partial pressure of carbon dioxide in the patient's blood."

Xiao Chenguang saw that the artificial pneumoperitoneum was established. For safety reasons, he chose to let Liu Tie draw arterial blood gas for the patient.

The so-called arterial blood gas is an indicator of the patient's ventilation and ventilation, which is measured by inserting a needle with heparin anticoagulant into the patient's artery.

"Okay, right away."

Liu Tie moved quickly and immediately inserted the prepared heparin needle into the radial artery on the thumb of the patient's right wrist to draw blood.

The radial artery is also the place where the pulse fluctuates.

Old Chinese medicine practitioners like to take the pulse here. If the pulse slips, then it is likely that you are pregnant.

Of course, the patient in front of him is an elderly man with a smooth pulse. Liu Tie tried several times but failed.

Seeing that everyone was waiting for him, he was sweating profusely, and even his hand for drawing blood was shaking. The dark green wash clothes were mostly wet, and white sweat stains were soaked.

But the needle in his palm seemed to be upset with him. No matter how he tried, he could not accurately locate the puncture point.

"Try the two-point fixation method. Use the index and ring fingers to fix the two sides of the puncture point, tighten the skin, and at the same time, insert the needle at a 45° angle 1cm above the first striated muscle of the patient's palm, with a depth of 0.5cm."

Xiao Chenguang's words sounded like a ray of sunshine in the dark, and rang in the operating room.

"Okay, I'll try."

Liu Tie seemed to have grabbed a life-saving straw, and hurriedly began to puncture according to Xiao Chenguang's instructions.

After the needle tip penetrated the patient's epidermis, Liu Tie vaguely felt a slight breakthrough from his finger.

It was like walking through the snowy ice and snow, and suddenly found the way home.

The bright red blood flowed into Liu Tie's needle tube.

"It's arterial blood!"

Liu Tie's tense nerves relaxed a lot instantly.

Human blood is divided into arterial blood and venous blood according to the different oxygen content.

Generally, the bright red is arterial blood, while the blood drawn during physical examination is dark red or even a little purple, which is venous blood.

After all, Liu Tie has been doing this for so many years, so he can still tell the difference between blood.

"Doctor Xiao, it has to be you."

Liu Tie looked ashamed, after all, he actually relied on Xiao Chenguang to guide him in his professional matters.

It's okay if you say that the theoretical knowledge is not as good, but now even the operation is not as good as it should be.

Xiao Chenguang is a surgeon, how much theoretical experience does he have to master so many things.

Liu Tie even wanted to knock open his head at this moment to see whether it was a human brain or a supercomputer that took up the size of two basketball courts.

"Wow, Doctor Xiao, you are simply amazing."

The instrument nurse flashed her big eyes and instantly turned into a little fan girl, looking at Xiao Chenguang with admiration.

As a nurse, one of her daily tasks is to give injections and infusions.

Therefore, she is more aware of the difficulty of arterial blood.

This is different from venous blood drawing, which only needs to be squeezed with a tourniquet to reveal the blood vessels. The arterial blood vessels can only be touched but not seen.

The radial artery is one of the thinnest blood vessels among the arterial blood vessels, hidden under the surface of the body, and is even more difficult to detect.

Like the patient on the stage, his blood pressure was originally low, and because of his old age, his epidermis was loose and his blood vessels slipped, making it even more difficult to draw blood.

But Xiao Chenguang could accurately tell the location of the patient's blood vessels with just a glance, and even the depth was clear.

If this is not amazing, she doesn't know what is amazing.

"I didn't expect that Xiao Xiao not only operates superbly, but also diagnoses and anesthetizes with ease. Now he even has such luck in vascular anatomy, it's really..."

Wang Jingang didn't know what words to use to express his feelings at this moment.

But one thing is certain.

Xiao Chenguang can tell the depth and direction of the blood vessels at a glance, not because he is amazing, but because he applies theory and practice to the extreme.

Looking at the changes in their eyes, Xiao Chenguang didn't think it was strange.

If he hadn't washed his hands before going on stage, afraid of contaminating the sterile area, the operation just now would be calculated in seconds.

After all, this kind of examination is not even the most basic operation in the operating room in the future, and it is not worth mentioning at all.

Soon, the results of arterial blood gas analysis were sent back to the operating room.

"PH 7.31, CO2 56mmHg, O2 188mmHg, Na 140mmol/L, K 4.0mmol/L, Ca 1.30mmol/L, GluL, Lac 2.2mmol/L, Hct 22%, HCO3 19mmol/L, BE -3.5mmol/L."

On a piece of paper, there were numbers and letters everywhere. The nurse stretched her neck to take a look and felt dizzy. She felt that it knew her, but she didn't know it.

"Doctor Xiao, you are really amazing. The patient does have hypercapnia."

Liu Tie took the blood gas analysis and looked at it for a long time, and found that the carbon dioxide content in the patient's blood was higher than the normal range.

This was exactly the same result as Xiao Chenguang said before, which was amazing.

"Yes, it is true." Xiao Chenguang glanced at the blood gas analysis sheet and said, "The patient's blood is acidic, and the pH value is 0.04 lower than the normal minimum line of 7.35, and the bicarbonate and residual alkali are also ten percentage points lower than the normal value. The most critical lactic acid has risen, which is related to the establishment of artificial pneumoperitoneum."

"Brother Liu, according to the parameters I mentioned before, change the ventilator to pressure control mode."

"Okay, okay, I'll change it now."

At this time, Xiao Chenguang's words were like an imperial decree in Liu Tie's heart, making him instinctively execute.

If there was a trace of hesitation before, the blood gas analysis in his hand at this moment is the proof of Xiao Chenguang's strength.

He has a solid knowledge of anesthesiology theory and is familiar with the use of ventilators. Even for blood gas, which is an uncommon monitoring method, Xiao Chenguang can analyze the results from the dense values ​​at a glance.

If he were to question him again, he would probably think that his IQ is problematic.

Liu Tie began to adjust the ventilator parameters according to Xiao Chenguang's instructions.

"Xiao Xiao, make five holes?"

Wang Jingang saw that the ventilator adjustment was completed and the patient's vital signs on the monitor were also stable, so he prepared to proceed to the next step.

"No, just make three."

Xiao Chenguang shook his head. The five-hole method was the earliest standard for laparoscopic surgery.

With the advancement of medical technology, the most popular and commonly used is the three-hole method, and the five-hole method used in the early days was only used for the most complex level 4 laparoscopic surgery.

As for the current operation, the three-hole method was chosen because the patient was old and the condition was urgent. For the sake of insurance, let everyone rest assured.

Otherwise, with Xiao Chenguang's ability, as long as the equipment is suitable, he can go a step further and use the one-hole method, which is the most difficult to operate and the least traumatic to the patient.

"Okay, okay, then make three holes."

Wang Jingang was secretly amazed, and couldn't help but sigh, thinking that Xiao Chenguang was really amazing.

He felt that the operation was too difficult with the five-hole method, but Xiao Chenguang actually said that only three holes were needed.

And looking at his calm expression, and thinking about his previous stable operation, it seems that Xiao Chenguang still has some strength left.

This gap, this ability.

The young are awesome!

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