Back in 2002 as a doctor

"Holding the mirror is the basis, and we must pay attention to the angle. For example, the patient's lungs, the mirror has to be pressed down. Although the field of view is not as direct as 45°, the angle of entering the gun is within the field of vision."

"Yes, the angle of entry of the gun and the location of the small pulmonary nodules must be considered." Li Qinghua said like a student.

"The operation for small pulmonary nodules is very simple, and there is not much to know, but it is best to think of every operation as a sleeve resection." Zhou Congwen explained lightly, "For example, here."

As he spoke, he began to operate the long pliers.

Zhu Jun walked in at this time wondering, why is Li Qinghua so obediently listening to a little doctor explaining the operation?

"here."

Zhou Congwen clamped the lung lobes with long forceps, exposing the bronchial arteries and veins.

"When holding the mirror, we should try our best to make the surgical field clearer. Another detail is that we do not have electric burns, and there may be blood seeping down and contaminating the lens. Therefore, the lens should be close to the direction of the incision where bleeding is suspected, and hemostasis should be done by compression. .”

"You should also do this when there is an electric burn. Although it is only a small action, it can save a lot of things."

"For example here..."

Zhou Congwen explained lightly, and Li Qinghua tried hard to remember every word he said.

Zhu Jun disappeared with disdain in his heart, and was fascinated by what he heard.

Because of his high level, he knew that what Zhou Congwen said seemed insignificant, but every word was on the key point of the operation.

If you follow what he said, you will save some unnecessary troubles.

Although each trouble is not big, and the time it affects is not long, but if it accumulates, it will be extremely terrifying.

What is the background of this little doctor?Zhu Jun stared blankly at the screen of the TV thoracoscope, and suddenly such a thought appeared in his mind.

No matter who he serves as an assistant, he can bring the operation to a higher level.

Is there such a talent in the Third Academy?

"And here again..."

"Also, you have to be careful..."

There are not many points that Zhu Jun needs to pay attention to in his imagination, after all, it is just a very small operation.

but!

He stood behind and listened, Zhou Congwen talked endlessly, seemingly without end.

Every "knowledge point" is not big, and Zhu Jun has never even realized many problems.But when Zhou Congwen said it, Zhu Jun became more and more chilled the more he heard it.

It turns out that doing thoracoscopy by myself is so rough!

No wonder there has been no progress, and many details have not been noticed by myself.

However, Zhu Jun was still disdainful. Many of the details that Zhou Congwen said were the main points of thoracoscopic lung cuff resection.

In his view, this is just talking on paper.

If it is really an operation, it is really not certain what can be done.Thoracoscopy can also do sleeve resection?The whole country has never heard of it.It takes 9 hours to do esophageal cancer, which is causing harm to others.

"Congwen, we're coming down." Chen Houkun's voice came from behind.

"Brother Chen, it's ready, you can shoot." Zhou Congwen turned his head and narrowed his eyes, as if smiling.

"It's so fast."

"It's okay, you do it, we'll prescribe the next patient."

"Okay."

Zhu Jun subconsciously hid to the side, so as not to affect the operator.Out of the corner of his eye, he saw the time—it only took more than 40 minutes!

The surgery is really fast... No, the surgery is really rough, what the hell!Zhu Jun reversed his "wrong" understanding.

Chen Houkun and his assistant came to the stage, shot twice, knocked out the small nodules in the lungs, rinsed, and closed the chest.

The surgery was done quickly and was tedious and simply maddening.

Zhu Jun, who was used to opening and closing his chest for an hour, felt that this was irresponsible, and there was no reason for chest surgery to do so.

What a fool!

A small nodule was cut during the operation, and anesthesia and thoracotomy were performed during the other operation. Although the time did not coincide, they faintly became a whole.

Four patients are really not enough to see, just after ten o'clock, the four operations are over.

Zhu Jun was a little at a loss.

He has had surgery all his life, and since he graduated and came to Jianghai People's Hospital, he has to go to the operating table almost every day.Zhu Jun spent more time in the operating room than in his own living room.

Zhu Jun is well aware that three operations a day is the limit of his level, and to do four thoracotomy operations requires a lot of preconditions.

For example, the operation is simple, for example, my hands are smooth, for example, the assistants who cooperate with me are of high level, for example...

With many coincidences, I can also perform 4 operations a day, but at least six or seven o'clock in the evening when it ends.

however!

Chen Houkun opened the stage at eight o'clock, and less than four operations were completed at a quarter past ten.

The facts ruthlessly shattered all Zhu Junxian's guesses. He stared blankly at Chen Houkun finishing the final stitches, then turned and stepped off the stage.

The junior doctors of the third hospital began to carry the patients, and Zhu Jun lost his mind.

Can thoracoscopic surgery still do this?

This was done on the premise that the third hospital did not have electric burns, Chen Houkun opened the skin to stop the bleeding, and each operation had to "waste" 5-6 minutes.

If there is an electric burn...

Zhu Jun no longer dared to think about it.

He vaguely felt that the Third Academy, Chen Houkun, and Li Qinghua were right.

Do you want to...

When Zhu Jun began to recall the main points explained to Li Qinghua by Congwen on the operating table last week, he suddenly realized that he had forgotten most of them.

What I can remember are those points that I have realized, and I can't remember the rest at all.

Old man, Zhu Jun shook his head helplessly.

It's really old, it can't be compared with 20 years ago.

Thinking of his exuberant energy and excellent memory in the past, and comparing it to the present, Zhu Jun felt disgusted.He projected all his negative emotions on the video-assisted thoracoscopic surgery. This kind of surgery is a fucking heresy!

Chapter 0255 Appearing in reality

"Actually, you don't have to put the chest bottle down." Zhou Congwen's regretful voice made Zhu Jun hate this heretical technique even more.

There is no need for a chest bottle for lung surgery. This is like an ordinary person who has no basic common sense. It completely violates the principles of medicine. It doesn't look like a doctor said it!

Zhu Jun would have misunderstood him if he hadn't heard Zhou Congwen "teaching" Li Qinghua.

Did you say this to yourself?What's going on with the surgery!The lymph nodes are not cleaned, has anyone done this operation?

There were countless complaints in Zhu Jun's heart, and he couldn't figure out that several doctors under him seemed to be "bewitched" and insisted on coming to the Third Hospital to undergo such an extremely rough operation in his opinion.

Is it just to avoid using a big knife?

As a doctor, don't they understand that the opening is small, and the damage inside is actually not small...

Zhu Jun originally thought of a 15cm chest incision, which was actually a subcutaneous prolongation operation, but then thought of a wedge incision.

The linear cutting stapler clicks twice, and the operation is over.

Thinking of this, Zhu Jun scolded his mother, no surgery in the world did this!

But no matter what, Chen Houkun finished the operation, so he had no choice but to step down.

Glancing at the doctors under him, Zhu Jun left with disdain.

……

……

"Xiao Zhou, the operation was done too quickly." Chen Houkun pulled Zhou Congwen to go directly to the director's office.

But Zhou Congwen smiled, and pulled him into the doctor's duty room, "Brother Chen, are you guilty of doing it too quickly?"

"Oh, don't mention it." Chen Houkun said, "If one follows the other, I think it's okay if I can take a break in between. If two sets are running in succession, you just need to insert the linear cutter stapler in and let me shoot directly. It doesn’t feel like surgery at all.”

"The operation itself is not complicated, they are all the most basic pulmonary nodules." Zhou Congwen took out the white ganoderma and shook Chen Houkun.

"No." Chen Houkun directly refused, "Xiao Zhou, I originally thought that the egg grinder has been getting better and better recently, and the operation level has also improved, so I wanted to show you. The result..."

"Haha." Zhou Congwen smiled, "It's good to improve your level, don't worry, there will be no problems in today's operation. Brother Chen, what is the key point of the wedge resection operation for small pulmonary nodules?"

Zhou Congwen suddenly asked a question, Chen Houkun was slightly taken aback, his expression gradually became serious.

"Read the film before the operation, and locate it during the operation."

"Correct!"

As expected, Chen Houkun was very experienced, and he had thought about it very carefully, and explained the difficulties clearly at once.

In fact, the wedge surgery for small pulmonary nodules is not the focus of the two shots. Director Zhu Junzhu, who has been watching the operation, has no idea what the difficulty is.

Just like what Chen Houkun said, the first difficulty lies in watching the film before the operation.

Whether the patient needs surgery is a multiple-choice question.

There are many patients who can be observed temporarily, and will be reviewed every three months to six months.There are many issues to consider. Since Chen Houkun mentioned this point, he must have studied it.

If you choose to have surgery, how to find the small pulmonary nodules is a difficult point.

Nodules with a size of a few millimeters do not seem to be difficult to find, and with lung CT positioning, most people will never think that this is a difficult point.

However, after the lungs are deflated after one-lung ventilation, it is very difficult to find the nodules that are a few millimeters in size.

In the last life, I just started cutting small nodules with thoracoscopic surgery, and there was even an embarrassing and helpless situation where the small nodules were not cut after part of the surgical wedge cutting was completed.

Encountering this kind of thing is very... hard to describe, it is a medical accident, and it is a headache.

Some doctors encountered a similar situation and understood the difficulty. They simply cut the lung lobes and removed the lymph nodes according to the ancient surgical method.Although the operation was a bit slower, it was more stable.

Zhou Congwen is different. He has done thousands of similar operations, and he already knows the location of the small nodules like a cow, so he doesn't have to worry about the small nodules being missed by wedge cutting.

Chen Houkun's complaints are also here. Although Zhou Congwen paved the way for the operation in the Third Hospital, he can go up and directly use a linear cutting stapler to wedge incision, and there is no need to find small nodules at all.But I still have to worry about this when I go back. If I can’t find a small nodule after everything, I’m an idiot, right?

"Brother Chen, do you often think what to do if you can't find it?" Zhou Congwen smiled.

"Yes." Chen Houkun nodded, "Xiao Zhou, is there any good way?"

"Go back and study together." Zhou Congwen said.

Chen Houkun also didn't think that Zhou Congwen could have any secrets. This is not surgical training, it can only rely on countless times of practice and experience.

"However, such an operation really makes people feel guilty. The lung tissue I cut out can feel small nodules, and I dare not come down after opening it for a look. If the location of the small nodules can be determined, the operation can be faster." Chen Houkun said .

"Be careful."

"Xiao Zhou, why are you so anxious to pull out the chest bottle for the patient?"

"It's not necessary." Zhou Congwen said with a smile, "Brother Chen, if you put aside all your previous rich clinical experience...assuming that the patient has already been operated for 3 days, do you think you should pull out the chest bottle?"

Chen Houkun was taken aback, what Zhou Congwen said was indeed reasonable.

But it is not easy to put aside all the previous clinical experience.

At this moment, Chen Houkun didn't think about surgery, and his thoughts suddenly flew to a strange corner.

There is a famous bridge in Jin Yong's world, Zhang Sanfeng taught Zhang Wuji how to learn Tai Chi sword, and asked him how much he remembered three times.

Zhang Wuji didn't take the normal path, he kept forgetting and forgetting every time, and finally defeated his opponent with his sword intent without moves.

Does this little fellow Zhou Congwen also do these mysterious things?

Chen Houkun has always believed that novels are just novels, and Mr. Jin Yong found an exquisite gimmick to pretend to be coquettish. He never thought that this gimmick would appear in clinical work one day.

Forget the previous clinical experience... The more Chen Houkun thinks about this concept, the more confused he becomes.

The older the doctor, the more valuable he is. What is the most valuable thing?Definitely a clinical experience.

But Zhou Congwen, a bastard, let himself forget his previous experience!

Seeing that Chen Houkun was very confused, Zhou Congwen smiled and patted him on the shoulder, "Brother Chen, are you in a hurry to leave?"

"Not in a hurry."