Chapter 663： sigh

Ling Ran has recently performed a lot of hepatectomy for advanced liver cancer, and he has developed some feelings.

Today, I did not try to cut the liver to see the invasion range of the cancer cells, but cut it across to test my judgment.

It turns out that the cut is indeed accurate.

More than one centimeter of the liver was excised.

In comparison, in normal liver cancer resection, the surgeon's habit is to cut about 3 cm more. For patients with better physical conditions, it is still affordable. For elderly patients with poor liver function, the survival rate is too low. If you follow the normal procedure, it is very possible to wake up.

The key to accuracy is judgement and proficiency.

It took Ling Ran a few minutes more to examine the accuracy of her resection. According to his plan, in the next operation, he can try not to use a virtual person.

Virtual humans have limited time, and it is not easy to promote them to other hospitals. After all, they need to perform operations in the way of normal people.

Clinical medicine is originally empirical medicine. Too many and too many things are practiced, and there is no need to really tell a truth. In other words, it is possible to talk about the truth, but it is not necessary to speak the truth.

For example, cardiopulmonary resuscitation, the doctrines at the beginning and the doctrines at present are completely different. Correspondingly, the strategy of cardiopulmonary resuscitation is constantly changing, that is, entering the 21st century, the guidelines for cardiopulmonary resuscitation are still ongoing 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 stopped immediately.

Similarly, the truth of the defibrillator is constantly changing. Nitroglycerin has been used for more than 100 years. After saving many lives, some people have summarized the principle and attributed it to the endothelial cell relaxation factor. Nobel Prize. Endothelial cell relaxation factor brings Viagra to the world.

Confined to the scope of surgery, more comes from experience.

For example, during liver resection, the timing of blocking the blood in the liver has never been confirmed. At the beginning, surgical experts said that blocking for 15 minutes was OK, and then said that blocking for 1 hour was okay. Later, it was suggested to let it go for 5 minutes every 15 minutes ... There is no principle in principle, it is the result of statistics That's it.

The reason why major surgeries have a strict relationship between superiors and subordinates is often the mastery of experience. It is natural that subordinate doctors have to be good to learn from higher doctors.

Although the master-student-style surgical technique is gradually being improved, the more advanced the technology, the less reasonable it is.

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

Surgeons, in fact, are not so reasonable.

The methods used by many surgeons are unclear and not necessarily truthful.

Ling Ran has no such tangles.

He only needs to make sure that he can cut without a virtual person. As for saying that he needs to train dozens or hundreds of cases to cut, it is not a problem. It is not uncommon for surgeons to learn first and then assist, and to accumulate two or three years of time to learn a technique.

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

There are more people learning, more people using it, and more lessons learned, and the mortality rate slowly decreases.

Old-aged liver cancer is not an easy disease in itself. Ling Ran walked to the operating table, looked at the old lady on the operating table, and signaled the anesthesiologist to continue to push the medicine, and then returned to the operating site, saying: "Preparing for surgery."

The inexplicable surgery group finally came alive.

Compared with the Department of Surgery of the Beijing No. 6 Hospital, the surgical team dispatched by Donghuang District Hospital is obviously weaker, and the movement and organization are more diffuse. Although it is above the standard and is quite positive, it can be seen. The daily surgical training is definitely not up to the Yunhua standard.

However, how to say it is also a Grade A hospital, the lower limit is always controlled, Ling Ran slowed down a bit, and then slowly increased the speed, so that the surgical team to adapt.

The doctors who came to see the operation were quite relaxed.

"Very well done." Xu Jinyi, director of general surgery, stood opposite Ling Ran, stepped on a step stool with the vice president, arms clasped in his chest, his vision was clear.

Donghuang District Hospital does not have a visitor room configuration, which means that the scene looks more comfortable.

The deputy high surgeon of the General Surgery also smiled and nodded: "Good job."

In both praises, there is a sense of superiority that “I can do it”. At the same time, the attitude is quite friendly.

If that's the level, learning a new technique easily will naturally be "very good" and "very good".

Several other deputy seniors in general also whispered and laughed. Donghuang District Hospital does not have a special hepatobiliary surgery, so including the director and several vice highs can perform liver surgery.

This is mainly because the director Xu Jinyi can perform pancreatic surgery. Therefore, the pancreas has become the retention area of ​​the director. So, everyone is fighting for me.

After another four or five years, the director retired. The deputies were in a big battle. The winner was the general director of the general. The leader among the losers might have the possibility of splitting out hepatobiliary surgery.

In general, the current atmosphere of Donghuang District Hospital is okay, and several deputy seniors also have the idea of ​​learning. Now looking at Ling Ran's simple and slow operation, I feel good.

Ling Ran naturally ignored the thoughts of others, slowly freeing the liver ligaments all the way, and then looked at the time, and began to speed up.

The entire operation group was naturally brought up by him.

Cut off the round ligament, hepatic sickle ligament, right triangular ligament, left triangular ligament, hepatic coronary ligament ... Every time you do one step, Ling Ran speeds up a little bit, and when the liver duodenal ligament is achieved, The voices around him had gradually subsided.

A group of doctors who have performed surgery for more than 10 years, looking at Ling Ran's easy operation, all understand the reason for the speed change.

"It's awesome." General Director Xu Jinyi suddenly laughed out loud.

Feng Zhixian and he knew each other ~ www.novelhall.com ~ and laughed out, "It's not time for Niubi."

In his mind, it was the suture of peach-like blood vessels.

Now the old lady on this operating table is in much better physical condition. In fact, if the old lady's physical condition is between ordinary surgery and non-surgery, Donghuang District Hospital would not dare to invite him to fly a knife.

While speaking, Ling Ran exposed the second hilum, and then began to block blood flow, exposing the veins ...

This series of movements, which should be done more slowly by other surgeons, however, Ling Ran is getting faster and faster.

Because the difficulty is all on him, Ling Ran's equipment replacement speed may not be as fast as the equipment nurses and nurses next to him. Anesthesiologist's job is simpler, because Ling Ran has less blood loss, less violent cutting, and the patient's signs are relatively stable ...

Just seeing the doctors at the surgery, there was some silence.

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

"Send it for inspection." When Ling Ran left the room, she took off the slippery gloves and washed her hands again to change the gloves.

In the operating room, this was the voice of discussion.

"I'm going!"

"Amazing!"

"Mountains stop at the top, Jingxing is at the end."

Xu, the inspection results were reported back: "The edges are clear."

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

Director Xu Jinyi quietly grabbed Feng Zhixian at this time, took him out of the operating room, and then whispered: "Professor Feng, I want to ask you something."

Feng Zhixian said with a smile: "You said."

Xu Jinyi: "I want to ask Dr. Ling to perform an operation on me."

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