Chapter 991 Nanqiao Li Yidao

Soon, Li Min repaired the aorta and the inferior vena cava, and the speed was fast and good.

In fact, if the level of the surgical institute is ranked, Li Min's level is the worst, and his speed is also the slowest. He is the tail of the crane among the training doctors, but the fish in the Pacific Ocean may be much larger than the largest fish in the pond.

The blood vessels were repaired, the large blood vessel clamp was loosened, and the aorta began to pulsate. Li Min carefully checked each suture to see if there were any weak links. This kind of suture cannot have weak links. Weak links are very easy to gather the impact of blood pressure, and eventually tear again, causing life-threatening.

After careful inspection, Li Min found that there were no weak links, but for safety reasons, he still waited for more than ten minutes before doing the next work.

Li Min performed very steadily throughout the operation. After all, he was an apprentice taught by the world's top doctors. He would not omit any surgical steps and pushed forward step by step. Although he was a little nervous, he didn't feel nervous at all after doing it.

The level shown by Li Min completely crushed Director Peng and Director Zhang. The two were stunned and couldn't believe their eyes. This was a doctor in a township hospital.

The doctors of Guandu Town Hospital next door were also completely confused. When did Li Min become so powerful? In the past, because he was diligent and studious, his level was above everyone else, but no matter how hard he tried, he never exceeded the level of doctors in township hospitals. Now Li Min's every move is completely an expert image. He can actually do the operation that Director Peng and Director Zhang can't do steadily.

"It would be more reliable if there were artificial blood vessels, but the objective conditions do not allow it. It shouldn't be a big problem after repairing it this way. Control your blood pressure well in the next few days. It can't be too high. There will basically be no problem in two weeks." Li Min instructed the doctor in charge.

The doctor in charge nodded continuously, and the old dean said to the doctor in charge of the bed dissatisfiedly: "Don't just listen, take a notebook and write it down. A good memory is not as good as a bad pen. What if you forget it?"

The doctor in charge of the bed immediately went to find a small notebook in a panic. The circulating nurse handed him a piece of paper and a pen, and the doctor in charge of the bed quickly wrote down what Li Min had just said on this piece of paper.

"Vital signs?" Li Min asked while looking at the data on the monitor. The blood pressure was a little low Hg, and the heart rate was fast at 108 beats/minute. The rest was still within the normal range.

This shows that the patient's blood volume and hemoglobin were obviously insufficient due to blood loss, but the situation was controlled in time to avoid further deterioration.

"Transfuse all the remaining blood, old dean, can you find a way to get more blood?" Li Min could only make the best choice based on objective conditions.

Director Zhang immediately said: "Take my phone, Director He in the address book, that's Director He from the blood station, I'll say a few words to him and ask him to send blood quickly."

Not to mention in the medical community of the county, even in various fields of the county, Director Zhang is an informed person. The heads of various major bureaus are all friends of Director Zhang, and Director He of the blood station is even a good brother. Asking him to help with emergency blood delivery is just a matter of a phone call.

Sure enough, Director He on the other end of the phone immediately agreed to send blood to Guandu Hospital by special car without hesitation, and asked if it was enough for twelve units of suspended red and twelve units of plasma.

Director Zhang turned around and asked Li Min if it was enough. Li Min nodded. It was enough. This time, Director Zhang found the confidence and style of Zhang Yidao in Nanqiao again from the matter of getting blood.

In fact, being a department director in the medical industry is not just a matter of technology. It involves a lot of human relations. Even if your technology is good, without good interpersonal relationships, at this moment, if a blood station director sends you blood according to the rules and regulations, others don’t have to send so much blood so quickly, or even refuse your request. There is only so much blood in the whole county, why should they send it to you?

Human relations are even more important in small counties. For example, if Director Zhang encounters difficulties in the operation and can’t get off the stage, he must be able to find someone who is willing to save the stage. If there is a mistake in the operation and the patient’s family makes trouble, he must be able to find someone to help speak up. If there is any inspection from above, he must be able to find someone to help guide and cover the bottom.

Without human relations and only skills, it is far from enough to be a department director. Some department directors are not good at performing surgery, and some simply do not perform surgery. Their main job is to deal with human relations and ensure the normal operation of the department.

Generally, those who can prepare blood have already done cross-matching and other tests. The blood station only needs to send blood according to the original test. The township hospital is far away from the county town. If a large amount of blood is needed for rescue, it is really inconvenient.

However, given the patient's current condition, it can be waited. Li Min then instructed the anesthesiologist to add some colloid fluid to the patient, so that the volume can be maintained for a longer time. In fact, fluid replenishment is very particular.

"Let's continue to remove the tumor!" Li Min did not intend to stop.

There are still four units of blood to be transfused, which is enough to support him to complete the removal of this tumor. If this tumor is not removed and the abdomen is closed now, it is actually not good for the patient, because Director Zhang has already operated on the tumor, and the tumor itself is still bleeding. Although it is not as violent as the blood bursting from the large blood vessels, long-term bleeding will accumulate and eventually cause blood loss shock.

It is difficult to stop bleeding from a tumor, so it is better to remove the tumor to stop the bleeding completely and avoid future troubles. Otherwise, you may have to return to the ward and undergo a second laparotomy in the middle of the night to stop the bleeding.

"The tumor is still being removed?" Not only Director Zhang, but also Director Peng was terrified, and had just planned to give up tumor removal.

Li Min explained the reason for the removal, and at the same time stated that with the patient's current condition and four units of blood as support, it was feasible to remove the tumor.

The old dean was also surprised, and suddenly felt that Li Min was so unfamiliar. Is this completely the level of an expert in a big city? How can he improve so fast, so fast that it's a bit scary.

Everyone doesn't know that Li Min was taught by Yang Ping in the Surgical Research Institute, and with the resources of the Surgical Research Institute, Li Min's one-month training can completely match the training of an ordinary doctor for several years. The long time of practicing medicine eventually accumulates cases. For example, in the county hospital, some cases can't be seen for several years, but when he went to Tiantan Hospital, he saw more cases in one day than the county hospital saw in more than ten years.

The types of operations that Li Min performed during his time at the Surgical Research Institute far exceeded those that Director Zhang had performed for decades. Director Zhang often repeated some cases for decades, but Li Min was different and could come into contact with various cases.

Yang Ping's training for Li Min was also the most scientific. First, he made the theory very solid and proficient, then practiced with a large number of experimental pigs, and finally followed Yang Ping and other professors on stage, and finally performed some operations under Yang Ping's guidance. The whole process was very strict and advanced step by step.

"Do you have large blood vessel surgery in your training?"

Director Peng asked in surprise. Their hospital currently does not carry out large blood vessel surgery at all. For such a large blood vessel tear just now, Director Peng can only help to block the blood vessel urgently, and then send it to the provincial capital by ambulance. Blood transfusions are constantly given on the way. In the end, whether it can be rescued depends entirely on luck. Last year, a patient with aortic dissection tear died in the emergency department.

Li Min did not stop his movements and said, "Many patients with Marfan syndrome go to Sanbo Hospital for surgery. Professor Yang generally does not perform large blood vessel surgery now. It is done by doctors below. It is not very difficult. The team leader does not do much. It is done by the attending doctors below. Professor Yang is more caring for me, so I have many opportunities to practice. I probably performed 50 to 60 surgeries independently during this period."

I have been doing surgery for decades and have never touched large blood vessel surgery. He actually performed 50 to 60 surgeries. The two directors were very surprised.

"Are there many surgeries there?"

"I can't finish it. I can't finish it at all. As long as I want to do it, I can do it 24 hours a day. I work from 8 am to 11 pm every day. If I hadn't taken a vacation these few days, I would definitely be in the operating room every day."

"If he doesn't do large blood vessel surgery, what surgery does Professor Yang do? ”

'Brainstem tumors, coronary artery bypass grafting, heart-lung transplants, extremely severe scoliosis, upper cervical spine surgery, etc., and sometimes complex liver and pancreas tumors, such as ex vivo tumor resection and autologous liver, pancreas and duodenum transplantation.”

These operations are not usually performed by the two directors. They are general surgeons and are very familiar with ex vivo tumor resection and autologous organ transplantation of liver, gallbladder and pancreas. Not to mention this hospital, there are only two or three hospitals in the country that can perform this operation.

"Have you seen this operation?"

'I have been the first assistant many times. "

Director Zhang and Director Peng felt dizzy at the same time. Damn, I have never seen this operation. Director Peng has seen this operation in a paper. Director Zhang usually does not read journal papers and has never heard of this operation.

"How is ex vivo resection performed?" Director Zhang was quite curious.

"It is to remove the liver, pancreas, duodenum and tumor together, and sometimes other organs together, all at once, cut out the tumor on the table, and then transplant these organs back. "

Director Peng explained to Director Zhang and showed his own knowledge. Otherwise, Li Min had performed many operations as the first assistant, but he could not explain why, which was very embarrassing.

"!!!"

Director Zhang smacked his lips. This operation cut out the liver, pancreas and duodenum together. This was bigger and more difficult than the combined pancreaticoduodenectomy, not to mention the subsequent autologous organ transplantation. It was scary to think about it. At this time, Director Zhang felt like a fish king in a pond running into the sea and seeing a small shark.

For high-difficulty operations, Yang Ping required Li Min to be proficient in only some emergency operations. For non-emergency operations, there was a possibility of transfer, and they could be transferred to higher-level hospitals. Yang Ping's training for Li Min was tailored to his current grassroots nature, so as long as it was an emergency, such as large blood vessel surgery, Li Min must be able to complete it independently and skillfully. Once this type of patient is encountered, there is not much chance of transfer.

Times are changing so fast, Director Zhang remembers When I was doing further studies, I was very happy to be able to perform appendicitis. I would brag about it among my classmates for a long time. Now, trainees can even perform large blood vessel surgery. It's really a different era.

Isn't it said that the medical environment is poor now, and trainees are just doing odd jobs and have no chance to get started? It seems that rumors are just rumors and cannot be trusted.

Li Min was not impatient or impatient about the separation of the tumor. He completely followed the knowledge and skills learned in the usual training. Perhaps many things have become a habit. There is theory and practice. Li Min is still very confident.

"This kind of tumor has rich blood vessels. The blood vessels connected to it must be cut and ligated one by one to completely remove the tumor. Because of the invasive adhesion, this operation is not easy to do. A plan must be made based on the CT images before the operation, otherwise it will be very passive." Li Min said while doing it.

Director Peng and Director Zhang kept nodding. When it comes to reading CT and MRI images, they only have a little basic knowledge. They usually read them in conjunction with reports. It is difficult for them to make a perfect and accurate judgment independently without reports.

''Is there a chance to operate on a tumor?" Director Zhang was very curious.

Li Min said frankly: "Generally, this kind of not very complicated tumor surgery research institute does not encounter it, but general surgery can encounter it a lot. They are more caring for me and are willing to give me the opportunity to practice. General surgery is also willing to give me the opportunity to learn when there is surgery."

Just after he finished speaking, Li Min felt that his words were inappropriate and might be a bit hurtful, but he definitely did not intend to hurt others' dignity. He just answered the questions truthfully, answering questions while performing surgery, naturally without thinking, and every sentence was his true expression.

"How is your level in Sanbo Hospital? I guess it's better than those doctors, right? "Director Zhang has always looked down on those young doctors with high academic qualifications, thinking that they are late in practice and are only good at theory.

Li Min shook his head: "The doctors in the Surgical Research Institute are all doctors. How can I compare with them? I don't know how many levels I am behind them. If they hadn't been patient to teach me, I wouldn't be able to do these operations."

Those doctors are so good. Li Min's current level is already good enough. Those doctors are better than Li Min. Professor Yang is better than those doctors. He is the teacher of those doctors. What level is Professor Yang? Is he a god?

If they hadn't seen Li Min's operation with their own eyes, the two directors would have thought that Li Min was bragging. Now Li Min's level is here, and they have to believe it.

"What other operations can you do?" Director Zhang asked.

Li Min thought for a while: "I can do the basic operations of general surgery. I can't do pancreaticoduodenectomy and organ transplantation now, but other problems are not big. "

The old dean was very happy to see Li Min's current level. Hey, it's worthwhile to send him out for further study. No wonder Li insisted on going to Sanbo Hospital for further study. This hospital is a low-key treasure hospital.

"Doctor Li, old dean! Let's go eat fish together later. The fish I caught in the reservoir are fresh. The chefs of the farmhouses near the reservoir are very good at cooking fish." Director Peng invited Li Min.

Director Zhang also said: "Yes, let's go eat fish together and have a good chat later. Doctor Li, when you come back from further study, you will be Nanqiao Li Yidao."

It seems that the name Zhang Yidao may not be kept. The Yangtze River's back waves push the front waves. In the future, Nanqiao will be Li Yidao's world. Director Zhang can't help but feel a little sad that the hero is old and the overlord has changed hands.