Ling Ran has recently done a lot of liver resections for liver cancer in the elderly, and he has developed some skills in it.

Today I tried my hand at cutting the liver. Instead of opening the liver to see the extent of cancer cell infiltration, I cut it in one go to test my judgment.

Facts have proved that the cutting is indeed accurate.

No more than 1 centimeter of liver should be cut off.

Comparatively speaking, in normal liver cancer resection, the surgeon's habit is to cut about 3 centimeters more. This is still bearable for patients with good physical condition, but for elderly patients with weak liver function,

The survival rate is too low. If you follow the usual procedures, you may not be able to revive.

The key to being able to cut accurately lies in both judgment and proficiency.

Ling Ran spent a few extra minutes to review the accuracy of his resection. According to his plan, he could try not to use a virtual person in the next surgery.

The virtual person's time is limited, and it is difficult to promote it to other hospitals. After all, the operation must be performed in the same way as normal people.

Clinical medicine is inherently empirical medicine. Too many things are learned through practice, and there is no need to really tell a truth. In other words, it is okay to tell a truth, but there is no need to tell the truth.

Take cardiopulmonary resuscitation, for example. The principles taught at the beginning are completely different from the principles taught now. Correspondingly, the strategies of cardiopulmonary resuscitation are constantly changing. Even in the 21st century, the guidelines for cardiopulmonary resuscitation are still 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 must be stopped immediately.

Similarly, the principles of defibrillators are constantly changing. Nitroglycerin has been used for more than 100 years and saved countless lives before someone summarized the principle and attributed it to endothelial cell relaxation factor, and thus obtained

Nobel Prize. Endothelial cell relaxing factor brought Viagra to the world.

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

For example, during liver resection, there has never been a definite statement on how long it takes to block blood in the liver. At first, surgical experts said that blocking for 15 minutes was okay, and then they said blocking for an hour was okay, and later, again,

It is recommended to relax for 5 minutes every 15 minutes... There is no principle, it is just a statistical result.

The reason why major surgeries have a very strict superior-subordinate relationship is often due to the mastery of experience. If lower-level doctors want to learn from superior doctors, they naturally have to be well-behaved.

Although the surgical techniques inherited from masters and apprentices are gradually being improved, the more advanced the techniques, the less rational they are.

Ling Ran was not going to talk about the rationale for liver resection, as long as the method was easy to use and the lives saved were real, patients never needed doctors to reason. Patients just wanted to be cured, survive, and live longer.

And surgeons are actually not that reasonable.

How many surgeons use methods that cannot explain the principles clearly and may not be the truth.

Ling Ran didn't have such entanglements.

He only needs to make sure that he can perform surgery without a virtual person. As for whether he needs to train dozens or hundreds of cases before he can perform surgery, it is not a problem. To learn a surgeon, he must first observe before assisting, and it takes two or three years to learn a technique.

The formula is very common.

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

The more people learn it, the more people use it, and the more experience they gain, the mortality rate will slowly decrease.

Liver cancer in the elderly is not an easy disease in itself. Ling Ran walked around to the operating table, glanced at the old lady on the operating table, signaled the anesthesiologist to continue pushing the medicine, then returned to the operating position and said: "Get ready for surgery."

The surgical team, who had been waiting inexplicably, finally came to life.

Compared with the surgery department of Jinghua Sixth Hospital, the surgical team sent by Donghuang District Hospital is obviously weaker, and their movements and organization are more sloppy. Although it is above the standard and quite active, it can be seen that

Daily surgical training is definitely not up to Yunhua standards.

However, it is a Class III hospital after all, and the lower limit is always controlled. Ling Ran slowed down a little, and then slowly increased the speed to allow the surgical team to adapt.

The doctors who came to visit the operation seemed quite relaxed.

"You did a pretty good job." Xu Jinyi, the director of the general surgery department, stood opposite Ling Ran. He and the vice president were both standing on a step stool, with their hands folded across their chests, and they had a clear view.

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

The deputy chief of general surgery next to him also smiled and nodded: "You did a good job."

Both of them had a sense of superiority that "I can do it too" in their compliments, and at the same time, their attitudes were quite friendly.

If you are at this level, if you can easily learn a new technique, it will naturally be "pretty good" and "pretty good".

The other deputy senior surgeons in the general surgery department also laughed and joked in low voices. Donghuang District Hospital does not have a specialized hepatobiliary surgery department, so everyone including the director and several deputy senior surgeons can perform liver surgery.

This is mainly because director Xu Jinyi can perform pancreatic surgery, so the pancreas has become the director's private area, regardless of the deputy high committee. If you don't know how to do it, you are not allowed to touch it. So everyone is fighting for it.

went.

In four or five years, when the director quits, these deputy chiefs will have a battle, and the winner will become the chief director of general surgery. The best one among the losers may even be able to split off into the hepatobiliary surgery department.

Generally speaking, the current atmosphere of Donghuang District Hospital is good, and several deputy senior officers also have the idea of ​​​​learning. Now they are in a good mood when they see Ling Ran doing simple and slow operations.

Ling Ran naturally ignored the thoughts of others and slowly freed the liver ligament. Then he looked at the time and started to speed up.

The entire surgical team was naturally led by him.

Cutting off the round ligament of the liver, the falciform ligament, the right triangular ligament, the left triangular ligament, and the coronary ligament... Ling Ran increased his speed a little at each step. When he reached the hepatoduodenal ligament,

The voices around him gradually became quieter.

A group of doctors who had been practicing surgery for more than 10 years all understood the reason for the change in speed when they looked at Ling Ran's still able operation.

"That's awesome." Director of General Surgery Xu Jinyi suddenly laughed out loud.

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

What he thought of in his mind was the suturing of peach-like blood vessels.

Now the old lady on the operating table is in much better physical condition. In fact, if the old lady's physical condition was not between ordinary and inoperable, Donghuang District Hospital would not dare to invite her to fly.

knife.

As he spoke, Ling Ran revealed the second porta of the liver, and then began to block the blood flow and expose the veins...

This series of actions, for other surgeons, should have been done more slowly, but Ling Ran was doing it faster and faster.

Because the difficulty is all on him, for the equipment nurse and nurse next to him, Ling Ran's equipment replacement speed may not be as fast as before. The anesthesiologist's job is easier because Ling Ran's surgery involves less blood loss and less violent cutting.

, the patient's physical signs are also relatively stable...

The doctors who were just watching the surgery were 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 his greasy gloves, and then washed his hands and changed his gloves again.

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

"I'm going!"

“Amazing!”

"The high mountains stand still and the scenery stops."

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

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

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

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