medical simulator

Zhou Muyun said: "I found out that the reason why Teacher Lu is not well known is because basically no one brings juniors here."

"However, my master, the director of our ward, I heard from my master that there are some professors and experts from outside the province. If they know that Mr. Lu is giving lectures in China, they will come to become students not far away."

"This is really a big coffee."

Zhen Xing also shook the mole on his face, and replied in a Beijing accent, "Yes, I also asked my teacher more carefully. He only warned me that I must not learn badly from Teacher Lu."

"But I don't even know what he did, so how can I follow suit?"

What Zhen Xing and Zhou Muyun said was limited to the capital. They were from the capital, so they didn't know about it. Their instructors didn't even know that Lu Ganzhou had come to the capital.

However, after they went back and asked this person, their teacher only said, don't ask about this person.

Lu Ganzhou changed into a set of clothes today, but they were all in simple styles. He looked calm and looked at the students attending the small lecture very seriously. He didn't even look up at the so-called camera, nor did he pay attention to the so-called live broadcast.

He only paid attention to Gui Lao.

After Mr. Gui and others finished the process of handing over the class and handed over the task of lectures, Lu Qianzhou began to speak, and got straight to the point, saying: "I want to correct what Mr. Gui and Professor Pin said. This time they asked me to I'm just a junior when I give lectures."

"For the rounds later, everyone will go round with Gui Lao and Professor Pin and the others. Thank you."

After finishing speaking, Lu Ganzhou began his first novel.

After the first small lecture, Lu Ganzhou, as the teaching teacher, only took Zhou Cheng and other five students, plus Peng Peng, several doctors and professional masters in the department, and started the surgery that belongs to this small lecture. Arranged preoperative rounds for three people.

The surgery to be done today, and the content of the talk, are all about joints.

However, it is divided into three short stories.

The first lecture is the most classic hip joint, the second lecture is the slightly more difficult knee replacement, and the last is the rather rare ankle replacement.

Three novels, three locations, and nine patients.

Hip replacement is the most routine operation in joint surgery. It is not simple, but it is not difficult, nor complicated.

Especially diagnosis.

The process of ward rounds is the process of diagnosis.

Today's operations are all hip replacements, and they are all grade IV operations. Therefore, every operation will have a very standard preoperative discussion before the operation. Each patient's operation is performed by the surgeon. During the discussion, it is necessary to design all the surgical procedures and explain the reasons.

However, due to many operations and limited time, this process will be relatively omitted.And because it is not like sports medicine, it can be examined under the microscope first, and then the specific method of surgery can be determined.

Therefore, after confirming the diagnosis, everyone determined their own surgical methods.

Peng Peng, still serving as the chief surgeon of the teachers Zhen Xing and Zhou Muyun, said: "The diagnosis of my patient is osteoarthritis; hip joint dysplasia and subluxation. Therefore, it is planned to perform total hip joint replacement and titanium mesh cover surgery." .”

This is a very standard technique, and it is also relatively difficult, so after Peng Peng finished speaking, he asked, "What do you think, Teacher Lu?"

Peng Peng is much younger than Lu Qianzhou, so calling him Mr. Lu is out of seniority and admiration for Lu Qianzhou's strength.

"can."

"I'm in a bit of trouble. You see, the inner wall and inner column have collapsed, and the femoral head has almost fused."

After Lu Ganzhou finished speaking, he looked at Zhou Cheng and said, "Your surgery is the simplest osteoarthritis, can you get it?"

Yes, Zhou Cheng's patient was diagnosed as stage IV osteoarthritis, and it was the simplest operation. It only needed a simple hip replacement and it could be done.

This arrangement is naturally reasonable, Zhou Cheng's seniority is the youngest!

He does the simplest operation, as it should be.

Zhou Cheng blinked, and soon understood Lu Ganzhou's true thoughts!

Lu Ganzhou's patient arrangement today seems to have a lot of meaning.

You know, the more complicated the patient's condition is, the more complicated the operation is, and the more difficult it is to show off his strength!

Isn't Zhou Cheng taking the simplest patient to fight with Lu Ganzhou and Peng Peng just to set it off?

This has nothing to do with strength.

It's like, do all the questions, you do the elementary school questions, and others do the undergraduate questions, you get a perfect score, and the other party is [-], you just fail in a mess.

Although your upper limit is [-] and you can get [-], it still cannot compare to others' gold content.

It’s because the objects you perform surgery on are not at the same level.

Of course, Peng Peng’s is relatively simple. In fact, Zhou Cheng can also do it. After all, it’s just dysplasia. Compared with Lu Ganzhou’s, which has no inner walls and inner columns, it’s also easier to do pelvic reconstruction surgery. It's easy.

"Okay!" It was impossible for Zhou Cheng to snatch or refuse Lu Ganzhou's arrangement.

After all, Zhou Cheng's ability and identity are here. Although he was arranged as a patient who was the most unfavorable for him to perform, in fact, after Zhou Cheng discovered this arrangement, he immediately understood why in the simulated world, he was completely defeated. I have left Lu Ganzhou.

The moment Zhou Cheng saw the patient, he knew the truth in his heart.

But Peng Peng and Lu Ganzhou began to compete secretly.

Yesterday, Peng Peng took the initiative to take advantage of his unpreparedness and performed one of his best surgeries. As a result, he failed to defeat Lu Ganzhou, and was even hanged and beaten by Zhou Cheng.

Even Lu Ganzhou was better in the end, and was still above his own level.

This shocked Peng Peng very much. You must know that he was the one who started to study open reduction and internal fixation of small incision fractures.

Zhou Cheng didn't cheat by using the imitation ability to treat others in his own way, but by relying on hard power. However, Lu Ganzhou copied Zhou Cheng's surgical methods and ideas, and defeated him Peng Peng. Lost to Zhou Cheng.

Therefore, today, Peng Peng will remain invincible in the field of joint surgery.

Joint surgery is very mature now. Although his operation is not the most classic, similar to the joint replacement that Zhou Cheng diagnosed, but it can also be performed perfectly, so that no one can find anything to participate in the evaluation.

At least, from the current cognitive point of view, you can't do better than me!

A simple level IV surgery can be performed very quickly and perfectly when Peng Peng doesn't have to hide his clumsiness!

From incision of the skin, to exposure of the femoral head, to the placement of the femoral head with the oscillating saw, the acetabular cap, and the treatment of the femoral medullary cavity, every step Peng Peng made was very crisp and neat.

Perfect.

After about 10 or [-] minutes, a very standard, but the world's top teaching surgery video was born.

During Peng Peng's operation, even Lu Qianzhou observed the whole process very carefully, except that he felt that Peng Peng's simple operation was a bit worse than Zhou Cheng's absolute peak operation that he had seen yesterday.

Otherwise, it really couldn't be better.

So far, the best angle arrangement, the largest range of motion, the best fixed position, the most perfect stitching style and scheme.

The pressure came to him immediately.

He can't make a mistake, if there is a mistake, then it will definitely be seen, and then, Old Gui and the others will definitely use the words he said before to block his mouth and force himself to stay in the country.

The reason why I was able to go home to worship my ancestors was because of the support of Gui Lao and others.

Before you are ready for what you want to do, you must not make mistakes, make mistakes, or make mistakes.

However, Lu Ganzhou is also very confident in himself.

His surgical operation is equivalent to the combination of two super IV level surgeries, so it is very difficult.

But even so, Lu Ganzhou still perfectly performed two surgeries at the same time.

Total hip arthroplasty + acetabular plastic surgery + pelvic reconstruction + autologous bone grafting + allogeneic bone grafting + plate and screw internal fixation + joint debridement + skin and subcutaneous tissue suture.

No one can ignore the difficulty of a hip replacement without a unilateral acetabulum.

The moment Lu Ganzhou completed the operation, whether it was in the operating room or in a live broadcast venue where no one was giving a speech, thunderous applause erupted in an instant.

Including Peng Peng, Gui Lao and others, even if they think Lu Ganzhou is so annoying, they have to admit that Lu Ganzhou's strength is extraordinary and extraordinary, and he performed better than Peng Peng because of his difficulty and accumulation. higher.

Moreover, Peng Peng may not have enough experience as the surgeon now, so he would not make any mistakes in such a complicated operation.

And when the first lecture on the third day of the training class got here, everyone thought it was over.After all, Zhou Cheng's operation later on was just a small play of the younger generation.

Even if Zhou Cheng's talent is good, he can stand shoulder to shoulder with Peng Peng and Lu Ganzhou.

But the basic difficulty and size of the operation are there. Zhou Cheng is destined to be a soy saucer. He just went up, as a student, to participate in the role of the chief surgeon and assistant in the training class, and performed the operation in order to complete this operation.

No matter how beautiful Zhou Cheng did it, it is impossible for there to be too many accidents, just like, the difficulty of Peng Peng's surgery is just as difficult as that of Lu Ganzhou.

But, just when everyone thought so, an accident happened.

"Ms. Lu, this patient, I don't plan to do joint replacement, I'm going to do arthroscopic surgery." Zhou Cheng took his two friends and walked to the operating table. Both of them were ready for preoperative surgery. get ready.

Zhou Cheng took the initiative to tell Lu Ganzhou.

Lu Ganzhou was stunned!

Peng Peng was also taken aback.

Almost everyone was stunned.

What is Zhou Cheng doing?Osteoarthritis, you come for arthroscopic surgery?

"I think this patient's current condition meets the indications for hip-preserving surgery." Zhou Cheng continued, once again confirming the situation with one word!

Yes, the premise of all surgical operations is that they have to be operated on.

The purpose of all medicine is to reduce trauma.

Where is the ultimate direction and goal of surgery?A knowledgeable person may answer that it is a perfect operation, but a more knowledgeable person will say yes, there is no need for surgery, just kill the surgery directly!

Modern medicine that does not require surgery, and modern medicine that is increasingly simplified, is the ultimate goal of medicine.

Only before this goal can be achieved, surgery must exist.

As for Zhou Cheng, what he had to do was this kind of thing. It wasn't a question of whether the operation was done well or not, it was subversion!

Chapter 231 Huh?What are you telling me to watch!

Zhou Cheng's words, although everyone was very surprised, did not cause riots and shock.

Zhou Cheng's strength, in the past few days, has been obvious to all, from Mr. Gui as an academician, to graduate students and even interns.His clinical strength, without a doubt, can be said to be the strongest among all the young people present, and he can even break the age limit, even better than Peng Peng.

Peng Peng, as an introduced talent who is "privileged" to carry out pioneering operations alone, can carry out open reduction and internal fixation with small incisions that have never been seen before in the training course.

Zhou Cheng's strength is not weaker than Peng Peng's. Everyone has seen it. Naturally, no one thinks that there is something wrong with Zhou Cheng's suggestion that this patient is suitable for hip protection, or that there is something that should not be mentioned. .

However, it is definitely not enough to simply put forward this concept. Everyone is not a layman. You can say it, but you have to persuade and give your own reasons, not the kind of me that can say yes, or say, People in the past said it could be done.

Make it understandable, or at least logical!

Although there was no commotion, discussions with each other were inevitable. Many people started to turn on their mobile phones, or started to look up literature.

Because what Zhou Cheng said just now, although it is only a few simple words, has a lot of content, and it is very difficult to remember it clearly.

Maybe they feel that there is something missing.

Then, as the subject of Zhou Cheng's questioning, Lu Ganzhou took a deep breath, glanced at Zhou Cheng, and said, "You can choose to perform hip arthroscopy."

"Old Gui, I think that since Xiao Zhou thought of using arthroscopy for hip protection treatment, we should give him such a chance. After all, this training class is open."

"Xiao Zhou is capable and capable of expressing his own views and opinions, making his own innovations, and even creating a genre."

"what is your opinion?"

Although Lu Ganzhou was surprised by Zhou Cheng's words, he did not suppress Zhou Cheng at all because of Zhou Cheng's surprise, and, as Lu Ganzhou was at this level.

It is natural to know that the reason why all surgeries exist is because of non-surgical interventions that cannot be handled well.

The reason for the existence of grade IV surgery is that all surgeries under grade IV surgery cannot meet the requirements of surgery.

The fundamental purpose of all surgery is not how good-looking it is, but how beautiful it is performed.It's about healing.

However, whether Zhou Cheng is qualified to start the operation or not still depends on the organizer's opinion.

In fact, deep down in his heart, Lu Ganzhou didn't really hope that Zhou Cheng could use hip arthroscopy to perform the hip preservation surgery.

After all, although Zhou Cheng's surgery is currently the lowest in difficulty, if he can lower the level of surgery to achieve the therapeutic effect, then the corresponding difficulty will be completely different.

It's just that although there is currently a concept of hip protection.In fact, it is aimed at necrosis of the femoral head.

Osteonecrosis of the femoral head (ONFH), also known as avascular necrosis or aseptic necrosis, is one of the most common causes of hip joint disability in young adults.

There are three stages of femoral head necrosis, respectively 1. Ficat stage: also known as Ficat-Arlet stage, can be divided into I-IV stage.

2. Steinberg stage I-VI stage.

3. ARCO stage I-IV stage.

Each of these three stages has its corresponding scope of application of hip preservation surgery.

Hip preservation treatment, in terms of treatment methods, from the simplest, there are lifestyle changes, followed by drug treatment.

However, the indications for drug treatment and the drug treatment plan of the hip-preserving strategy involve a wide range of drugs, and no drug has been widely recognized at present.

At present, drug therapy is supported for hip preservation, which has a certain therapeutic effect on Ficat stage I/II or Steinberg stage I/II/III ONFH, and can also be used as a supplement to other hip preservation treatments.