My Medical Skills Give Me Experiences
Chapter 246: The inch is shorter and the ruler is longer. Amazing volume of endoscopic procedures
【My medical skills can add experience points】【】
The two were walking side by side in the corridor at the moment. Hearing this, Luo Shengsheng stopped and turned to look at Zhou Can.
"Isn't the 73-bed patient under the management of Yu Xin? Doctor Zhou is a hero who is sad and beautiful. Want to help her?"
"Hey, that's right! But if I have the idea of pursuing her, I really don't. It's because we all belong to the same medical group, and I think the couple in bed 73 is not in a good family. It's all suffering haha The bottom of the society. When the patient's condition is really serious, the cost of treatment will be terrible. The key is not necessarily life-saving."
Zhou Can has his own ideas.
To say that he is interested in a beautiful woman is really wronging him.
Yu Xin's appearance is not bad, but compared with Su Qianqian, the gap is not a little bit.
In Zhou Can's eyes, she is at best a vulgar fan type.
"So that's the case. Doctor Zhou has a benevolent heart, which is admirable!"
He gave Zhou Can a thumbs up.
"I didn't need you to specifically ask about this matter, and I would handle it easily. The main reason is that Yu Xin, that woman, is too aloof. She rarely greets her when they meet each other. Just ask whoever owes her twenty-five It’s like 80,000, it’s unpleasant to see.”
Yu Xin's character is indeed a bit too cold, it's perfectly normal for others to criticize her.
There are always some women who don't know where their confidence and confidence come from. They pull their faces all day long, thinking that everyone will revolve around them.
As a result, it is conceivable that the relationship between this kind of woman and her colleagues in the unit can maintain a superficial harmony, which is considered very good.
When they really encountered something, there was no one to help.
Compared with Yu Xin, Qiao Yu is much better than her.
Qiao Yu is not only more beautiful than Yu Xin, but also has a much higher EQ.
Even if Dr. Lu pestered her so much, even if she hated Dr. Lu so much, she never broke her face.
"Doctor Zhou opened his mouth. I will definitely deal with this matter. It is actually a trivial matter. There are many ways to deal with this kind of family members. I will go and deal with her now."
After seeing Zhou Can's piercing skills, Luo Shengsheng's attitude towards Zhou Can became more enthusiastic and friendly.
Zhou Can returned to the office.
Yu Xin sat there with a sad expression on her face. It seems that she went to persuade the aunt again, but the effect was not satisfactory.
Not long after, Luo Shengsheng came back with a relaxed smile on his face.
"The family members of bed 73 have obediently registered for treatment! The patient's younger sister will rush to the hospital to take care of her later."
Luo Shengsheng said to Zhou Can.
"Mr. Luo is amazing! Such a hard-to-persuade aunt, I didn't expect you to take care of it easily. She is so sick that if she doesn't go to the doctor, she will turn into typhoid fever or sepsis and can't escape. Mr. Luo also saved her life. According to Buddhism According to the family, this is a seven-level pagoda!"
Zhou Can was shocked when he heard that Luo Shengsheng persuaded the aunt so quickly.
"Haha, it's not that big of a merit! But good deeds can definitely be judged."
Luo Shengsheng laughed happily, not without complacency.
The inch is shorter and the ruler is longer.
Everyone has their own special skills. Luo Shengsheng's puncture skills may be far inferior to Zhou Can's, but his ability to persuade his family members is simply at its peak and has reached the realm of perfection.
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【My medical skills can add experience points】【】
Anyway, let Zhou Can persuade that aunt, he is the first and the second eldest.
Not far away, Yu Jie was originally frowning, but his eyebrows were tightly furrowed.
Now when she heard that Luo Shengsheng persuaded the family members in bed 73, she was both surprised and happy.
After thinking about it for a while, it became clear that Zhou Can must have secretly asked Luo Shengsheng to help her. Otherwise, Luo Shengsheng would not ask Zhou Can for credit as soon as he came in.
"Thank you Mr. Luo, thank you Dr. Zhou!"
Yu Xin still couldn't believe it, so she hurried to the ward to check.
She came back soon.
But the sadness on his face was gone.
"That aunt really went to see a doctor, and she was really persuaded by President Luo to leave."
"Otherwise can it be fake?"
Luo Shengsheng raised his eyebrows in dissatisfaction and asked back.
"Dr. Yu definitely didn't mean to distrust you. She just felt unbelievable like me. How can such a difficult family member be so obedient in front of you, Mr. Luo? Mr. Luo taught us newcomers!"
Zhou Can quickly smoothed things over for her.
Otherwise, with her cold face, Luo Shengsheng might be angered before she even opened her mouth.
After hearing Zhou Can's explanation, Luo Shengsheng's expression softened a lot.
He did a really good job on this one.
"It's nothing to say, I just moved out of the hospital's infection prevention and control regulations, and said some harsh words to her. I told her that if she didn't leave the ward immediately, the consequences would be extremely serious. As a result, before I finished speaking, her husband died Urging her to register for treatment as soon as possible."
Luo Shengsheng did not elaborate on the harsh words he had said to the aunt.
But it is certain that those words can bring enormous psychological pressure to the patients and their families in the 73rd bed.
The person who can decide this matter is actually her husband.
As long as her husband's vital interests may be seriously affected, there is no need for the doctor to say anything more, her husband will be the first to be anxious.
"It seems that you can't just be polite to family members! Today, I learned another trick from Mr. Luo. When dealing with difficult family members, you must pay equal attention to kindness and dignity. When you should be serious, you must never be polite to him."
Zhou Can has always been the worst at dealing with difficult family members.
This has something to do with his upbringing.
Since he was a child, the people he has dealt with are basically of high quality. Even if you encounter unreasonable people, you can still deal with them with your fists.
But being a doctor in a hospital is considered a service industry.
You must not use your fists against family members or patients!
If there is anything, I can only persuade patiently.
Luo Shengsheng's handling of this difficult aunt gave Zhou Can a lot of inspiration.
While chatting, Director Shang appeared at the door of the office.
He didn't mean to come in, but stood at the door and shouted at Zhou Can, "Doctor Zhou, remember to send the patient with esophageal anastomotic leakage in bed 71 to the interventional operating room on time."
This case is a highly difficult surgical case.
Endoscopic surgery in gastroenterology has been done a lot, but it is still full of challenges.
"OK!"
Zhou Can also hoped that this patient could undergo surgery as soon as possible.
The patient's body has become very weak due to long-term inability to eat.
The sooner you have surgery, the better.
…
In the interventional operating room, the 71-bed patient was sent into the interventional operating room by Zhou Can and the nurses.
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【My medical skills can add experience points】【】
Both the family and the patient expressed their willingness to take the risk of doing this operation.
Because the patient is in so much pain.
The anastomotic stoma between the esophagus and the jejunum was blocked, making it impossible for the patient to swallow saliva, so a spittoon was always needed to be placed by the bedside. The degree of pain is unimaginable to ordinary people.
After the anesthesia was administered, Director Shang performed the surgery himself.
With the cooperation of the nurse, a thin needle less than 1mm was inserted through the patient's esophageal anastomosis into the opposite intestinal cavity by using an endoscopic ultrasound. The whole process requires the aid of XX-ray images.
Zhou Can stood by and stared at it for a while.
Pity.
What a great opportunity for surgery, if he can get started with the operation, he can earn at least 100 points of advanced medical experience rewards.
The whole endoscopic puncture process went smoothly, and the selected nurses were also the best endoscopic surgery nurses in the department.
Director Shang also specially called a deputy director to come over as an assistant to avoid any mistakes.
The covered metal stent is placed next.
Although the placement was successful in the end, Director Shang's placement technique was not very good in terms of the proficiency of the operation technique and technique.
If you are exhausted, you will be at the level of attending, which is about the same as Zhou Can.
But this is already very powerful.
There is no pure gold in gold, and no one is perfect.
The endoscopic surgery ability of many chief physicians is not satisfactory. Director Shang is already considered a high-ranking dwarf and a master of endoscopic surgery.
"Okay! The blocked jejunum-esophageal interface has finally been opened for him."
Director Shang was very happy.
The whole operation process was extremely smooth and took only one hour and five minutes.
However, this is only to help patients solve the problem of anastomotic segment occlusion, and the problem of esophageal anastomotic leakage still exists.
"Okay, the operation was a success, we are going to remove the endoscope and wake up from the anesthesia!"
Director Shang directly announced the end of the operation.
Zhou Can was stunned for a moment, he clearly proposed to Director Shang to repair the fistula before!
Seeing the joy of the doctors and nurses, Zhou Can hesitated for a while, and decided to mention this matter.
In order to repair the fistula, he also did a lot of homework.
The surgery ended like this, and the patient still couldn't eat in the future.
"Director Shang, the patient's fistula has not been resolved yet, can you take this opportunity to resolve it together?"
Zhou Can really bit the bullet and made this suggestion.
He is just a regular trainee, and his relationship with Director Shang is still very strange. It is far from being a friendship or even a deep relationship.
If it was Mr. Liu or Dr. Xu, Zhou Can would give his opinion casually.
As long as it is reasonable, they will readily agree.
Director Shang was in high spirits at the moment, and Zhou Can mentioned that there was still one problem that had not been resolved, which was tantamount to spoiling his spirits.
"It is extremely difficult to solve the anastomotic leakage of the esophagus. The second hospital where the patient underwent surgery is the same as our Tuya, which is also a top-tier provincial hospital. As a result, the problem not only failed to be solved, but caused the anastomotic occlusion. We want to solve the esophageal anastomosis. The anastomotic leakage problem must be cut off and re-anastomized. This operation is very risky, so it is not recommended.”
Director Shang was a little unhappy, but because of Zhou Can's outstanding performance yesterday, he patiently explained it to Zhou Can.
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【My medical skills can add experience points】【】
There are many reasons for esophageal anastomotic leakage.
Some are due to insufficient suturing, poor local blood supply, anastomotic errors, and so on. Some are due to postoperative infection, or cut tissue necrosis, or pleural effusion.
The last situation is local infection and suppuration, or the anastomosis is too small.
It can be seen from this that doctors with poor surgical skills kill people.
The above-mentioned reasons are almost all caused by the poor level of surgery. If the first surgery is done for this patient, nothing will happen afterwards.
As a result, because the first anastomosis was not in place, I suffered so much for life.
"Can I try it? I might be able to pinpoint the fistula and close it."
Zhou Can dare to say this based on the five-level suture and ligation technique.
"Repair the fistula with the help of an endoscope in a narrow lumen? Zhou Can, it's really not that I've broken your confidence. There is no such doctor in the world who can do it successfully."
Director Shang himself is a master of endoscopic surgery, and has a very deep understanding of endoscopic surgery.
"I didn't say that the repair of the fistula should be completed in the esophagus or jejunum! My idea is to find the fistula, then open two small windows from the outside, and use the endoscope to complete the repair work."
Zhou Canqi persevered and continued to fight for the opportunity to repair the fistula for the patient.
"Open two small windows in the chest? How high is the risk, do you know?"
Director Shang raised his voice a lot.
This young regular trainee is really messing around. Do you think surgery is a child's play house?
If only esophageal anastomotic leaks were so easy to repair.
"What if the fistula is in this position?"
Zhou Can pointed to the upper left abdomen of the patient.
"Do you think the fistula is in this position?" Director Shang's expression became much more serious.
"It's not clear yet, and it's only inferred based on the patient's examination in another hospital and some current symptoms. At present, the patient's anastomotic stoma has been successfully dredged by you, and you can check it with angiography."
Zhou Can said calmly.
Even when facing a department director, he was neither humble nor overbearing. Not to mention any fear.
Just normal communication.
"Okay, I'll follow your opinion and check the fistula opening and fistula channel with angiography. The ugly thing is, if you want to open the chest, I will never agree. Even if you just open two small windows, it will never work. The patient's age With such a large size, coupled with long-term malnutrition, it is difficult to withstand open chest surgery. Moreover, his chest organs are likely to be severely adhered."
Director Shang has his own worries and concerns.
The patient has undergone two surgeries, and the viscera and tissues of the thoracic and abdominal cavities will definitely adhere to a certain degree.
This will undoubtedly increase the risk and difficulty of surgery.
When multiple risks increase, the risk level of surgery will increase exponentially.
For the sake of safety, neither the surgeon nor the anesthetist will agree to perform such an operation.
"Thank you for agreeing!"
Zhou Can successfully persuaded Director Shang and heaved a sigh of relief.
Next, an esophagogram was performed, and it was found that the fistula was right where Zhou Can had pointed.
The fistula is easier to find, as it is directly connected to the drainage tube.
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【My medical skills can add experience points】【】
"Even if the fistula is in this position, the difficulty of repairing it is still frighteningly high. Are you sure you can complete it?" Director Shang secretly evaluated, and he is not sure at all if he is asked to do this repairing.
"If you agree to delegate power to me to do it, I'm at least 80% sure of success."
Zhou Can didn't dare to speak too harshly.
80% certainty is already very high.
Because doctors tend to use extremely conservative estimates.
Director Shang did not immediately agree, but lowered his head to consider the risks involved.
"I heard that you have performed many endoscopic operations in other departments, is it true?"
Director Shang stared firmly at Zhou Can's eyes when he was asking.
His gaze was breathtaking, it was to prevent Zhou Can from lying.
"it is true."
Zhou Can gave an affirmative answer.
"How many cases did you fail in total?"
Director Shang asked again.
"Zero cases!"
Zhou Can's answer shocked everyone.
The failure rate of surgery is not low, even in a large hospital like Tuya, the failure rate of surgery is still quite high.
Any surgery has risks.
Director Shang was also full of suspicion.
"To be precise, there were zero cases of failure during the operation. The postoperative treatment effect did not meet expectations, and there were eleven cases in total."
Zhou Can explained.
"Then how many endoscopic operations have you performed in total?"
According to ordinary people's thinking, the failure rate is zero, and the total number of operations performed must be very small.
It is even possible that only eleven cases were done in total.
Although none of the eleven cases of endoscopic surgery had any problems during the operation, the postoperative results were not good, which can explain Zhou Can's poor surgical ability in disguise.
"There may be more than 500 endoscopic operations completed in total! I haven't counted the specific number of cases."
Zhou Can was really stumped by this question.
For surgery, he can at most calculate the total number of surgeries for the day. As for the total number of surgeries performed since the training, how can he have the time to calculate this!
If you have that time, you might as well read two more books.
"Oh my god, there are more than 500 endoscopic operations in total! Is this really something that a regular trainer can do?"
After hearing this, the deputy chief physician couldn't help exclaiming.
Others are also strongly skeptical of authenticity.
Zhou Can's general training time is less than two years.
"Well, just wait a moment, I'll make a call to find out."
Director Shang went to the side to make a phone call.
The matter is so important that he dare not be careless. Only after confirming that Zhou Can had really completed a large number of endoscopic surgeries would he consider asking Zhou Can to repair the fistula.
"Is it the old bear? I'm Shang Feng from the Department of Gastroenterology. Can you check for me how many endoscopic surgeries Dr. Guipei Zhou Can has participated in?"
"Yes, yes, I want to know the result immediately."
…
After waiting for about a minute, the result was found on the other end of the phone.
"What... You said that Zhou Can has participated in more than 800 endoscopic surgeries?" This number really scared Director Shang~www.readwn.com~ It seems that Zhou Can only reported 500 surgeries, which is already very conservative .
"Understood! I just want to know about his endoscopic surgery ability and experience. This result really scared me. Okay, thank you old friend for your help. I'm currently undergoing surgery here, so I won't tell you!"
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【My medical skills can add experience points】【】
After finishing speaking, Director Shang hung up the phone.
I don't know which department of the hospital this call is from? The other party probably has some power, otherwise it would be impossible to find out Zhou Can's total number of surgeries he participated in so quickly.
After the phone call, Director Shang already looked relaxed, with a very rare smile on his face.
"Dr. Zhou really didn't lie. To be honest, I'm really shocked that you participated in so many endoscopic surgeries." Participating in surgeries, if you just observe and learn, usually won't be recorded in the surgical records.
At least one has to be in the role of a third assistant to be eligible to be named.
Don't even think about being an intern doing miscellaneous hooks.
"It is also the superior doctors in various departments who have vigorously trained me to participate in so many endoscopic operations."
If Zhou Can told Director Shang that he was not only involved in many endoscopic operations, but also the chief surgeon, he wondered if he would scare Director Shang into a heart attack.
"Okay! The repair of the fistula is up to you! Director Shi and I will be your assistants." Director Shang personally served as Zhou Can's assistant, just because he was worried about any accidents during the operation.
Just escorting Zhou Can by the side.
(/novel/)
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