Six Hundred and Sixtieth Chapters Sigh

Ling Ran has recently performed a lot of liver resections for advanced liver cancer, and he has cultivated some hand skills.

Today, I did a small test. I didn't break the liver to see the extent of the cancer cell infiltration, but cut it across the board to test my own judgment.

Facts have proved that the cut is indeed accurate.

The extra part of the liver cut off should not exceed 1 cm.

In comparison, in the normal resection of liver cancer, it is the habit of surgeons to cut about 3 centimeters more. For patients with relatively good physical conditions, it is still affordable. For elderly patients with weakened liver function, the survival rate is too low. If you follow the usual procedures, it is very likely that you will not wake up.

The key to being accurate lies in both judgment and proficiency.

Ling Ran spent a few more minutes, all used to examine the accuracy of his resection. According to his plan, in the next operation, he can try not to use the virtual human.

The time of the virtual person is limited, and it is not easy to promote it to other hospitals. After all, the operation must be performed in the way of normal people.

Clinical medicine is inherently empirical medicine. Too many things are learned through practice, and there is no need to really explain a truth. In other words, it is okay to speak the truth, but it is not necessary to speak the truth.

Take cardiopulmonary resuscitation, for example, the reasoning at the beginning is completely different from what is being said now. Correspondingly, the strategy of cardiopulmonary resuscitation is constantly changing. Even in the 21st century, the guidelines for cardiopulmonary resuscitation are still constantly changing. Variety.

The latest evidence-based medicine is trying to continuously improve empirical medicine, but this does not mean that the use of empirical medicine should be discontinued immediately.

Similarly, the principles of defibrillators are constantly changing. Nitroglycerin has been used for more than 100 years, and after saving an unknown number of lives, someone summed up the principle and attributed it to endothelial cell relaxation factor, and thus obtained nobel prize. Endothelial relaxant factor brought Viagra to the world again.

Confined to the scope of surgery, there are more things that come from experience.

For example, in liver resection, there has never been a definite statement about the time to block the liver blood. At the beginning, the surgical experts said that blocking for 15 minutes was fine, and later they said that it was okay to block for 1 hour, and later, they suggested letting go for 5 minutes every 15 minutes...the principle is that there is no principle, it is the result of statistics That's all.

The reason why major surgeries have a strict subordinate-subordinate relationship often lies in the mastery of experience. If a subordinate doctor wants to learn something from a superior doctor, he naturally has to be nice.

Although the master-apprentice-style surgical techniques are being gradually perfected, the more advanced the techniques, the less reasonable they are.

Ling Ran is not going to talk about the principle of liver resection, as long as the method is easy to use, the life saved is real, and the patient never needs a doctor to reason. The patient just wants to cure the disease, survive, and live longer.

And surgeons, in fact, are not so reasonable.

The methods used by many surgeons cannot explain the principles clearly, and they are not necessarily true.

Ling Ran didn't have such entanglements.

He just needs to be sure that he can cut without a virtual human. As for the need to train dozens or hundreds of cases to cut, it is not a problem. It is very common for surgeons to study first and then help them. It is very common to accumulate two or three years to learn a technique.

Ordinary liver resection is not an easy task, and for a long time, it is known for its high mortality rate.

More people learn it, more people use it, and more experience is summed up, and the death rate will gradually drop.

Elderly liver cancer itself is not an easy disease. Ling Ran walked around to the operating table, glanced at the old lady on the operating table, and signaled the anesthesiologist to continue pushing the medicine, and then returned to the operating position, saying, "Prepare for the operation."

The inexplicably waiting surgery team finally came alive.

Compared with the surgery department of Jinghua No. 6 Hospital, the surgery team sent by Donghuang District Hospital is obviously weaker, and its movements and organization are more sloppy. Although it is above the standard and quite active,

But it can be seen that the daily surgical training is definitely not up to Yunhua's standard.

However, in any case, it is a third-level hospital, and the lower limit is always controlled. Ling Ran slowed down a little, and then slowly increased the speed, so as to let the surgery team get used to it.

The doctors who came to visit the operation also looked at it quite relaxed.

"It's done pretty well." Xu Jinyi, the director of the general surgery department, stood opposite Ling Ran, stepping on a step stool with the vice president, arms crossed, with a clear view.

Donghuang District Hospital does not have a viewing room configuration, which means the site looks more comfortable.

The deputy head of general surgery next to him also nodded with a smile: "It's a good job."

In the compliments of the two, there is a sense of superiority of "I can too", and at the same time, their attitudes are quite friendly.

If it is at this level, learning a new technique easily is naturally "very good", "very good".

Several other vice-presidents outside the general public also giggled and laughed in a low voice. Donghuang District Hospital does not have a specialized hepatobiliary surgery department, so the director and several deputy senior officials can perform liver surgery.

This is mainly because the director Xu Jinyi can perform pancreas surgery, so the pancreas has become the director's private land, no matter whether the deputy high-ranking officer can do it or not, he is not allowed to touch it. So, everyone went to fight for it.

After another four or five years, the director will retire, and these deputy seniors will have a battle, the winner will be the chief director of general surgery, and the best of the losers may have the possibility of splitting into hepatobiliary surgery.

Generally speaking, the current atmosphere in the Donghuang District Hospital is good, and several deputy senior managers also have the idea of ​​learning. Now seeing Ling Ran's simple and slow operations, they are all in a good mood.

Naturally, Ling Ran ignored other people's thoughts, and slowly freed the hepatic ligament along the way, then checked the time, and started to speed up instead.

The entire surgical team was naturally brought up by him.

Cut off the round ligament of the liver, the falciform ligament of the liver, the right triangular ligament, the left triangular ligament, the coronary ligament of the liver... Every time a step is done, Ling Ran will increase the speed a little bit, and when the hepatoduodenal ligament is done, The surrounding voices have gradually decreased.

A group of doctors who have been in surgery for more than 10 years, seeing Ling Ran's operations with ease, all understood the reason for the speed change.

"It's awesome." Xu Jinyi, director of general foreign affairs, suddenly laughed.

Feng Zhixiang knew him well, and he laughed when he heard it: "It's not the time to be awesome."

In his mind, what he thought of was the stitching of peach-like blood vessels.

Now the old lady on the operating table is in much better physical condition. In fact, Donghuang District Hospital would not have dared to invite him to throw a knife if the old lady's physical condition was not between those who could be operated on and those who could not be operated on.

While speaking, Ling Ran revealed the second portal of the liver, and then began to block the blood flow, exposing the veins respectively...

This series of actions, for other surgeons, should be done slower and slower, but Ling Ran is doing it faster and faster.

Because the difficulty was all on his body, for the equipment nurses and nurses beside him, Ling Ran's equipment replacement speed may not be as fast as the front. The anesthesiologist's job is easier, because Ling Ran's surgery has less blood loss, less violent cutting, and the patient's physical signs are relatively stable...

It's just that the doctors who saw the operation were a little speechless.

In just a few minutes, Ling Ran completed the pre-cut line and sharply separated the liver.

"Send it for examination." Ling Ran waited for the nurse to leave the room, took off the slippery gloves, washed his hands and changed gloves again.

In the operating room, there was a lot of discussion.

"I'm going!"

"Stunning!"

"Mountains look up and stop, scenery travels and stops."

After a while, the inspection result came back: "The edges are clear."

The doctors in the operating room had another brainstorming poetry conference.

Director Xu Jinyi quietly grabbed Feng Zhixiang at this time, led him out of the operating room, and said in a low voice, "Professor Feng, I want to ask you something."

Feng Zhixiang said with a smile: "You tell me."

Xu Jinyi: "I want to ask Dr. Ling to operate on me."

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