From that day on, He Shengcai studied even harder as if he had been given a shot of blood.
At the same time, he is also practicing more surgical procedures, such as endoscopic bile duct stent implantation, endoscopic duodenal polypectomy, pediatric endoscopic surgery, etc.
From the inside out, from the outside to the inside, from organic to functional, as long as the endoscope can touch it, he is eager to learn.
Among them, level 4 gastrointestinal endoscopic surgery is his focus.
Digestive endoscopic surgery is divided into four levels. According to the surgical grading management system of tertiary hospitals, doctors with different seniority and levels can perform different surgeries.
Level one is the simplest, and appendectomy is a level one surgery.
Second-level surgeries include enterostomy, perforated gastric ulcer repair, splenectomy, and rectal mass biopsy.
These two levels of surgery are not very difficult, and can be performed by any junior attending physician, or even by an excellent resident doctor.
Tertiary surgeries include cholecystectomy, intestinal polypectomy, gastrectomy and other partial organ resection surgeries, which are the battlefield of senior attending physicians.
As for level four surgeries, a mandatory requirement for associate senior doctors is that they can perform most level four surgeries.
In addition to performing severe and difficult surgeries, senior associate senior doctors are also required to introduce new surgeries or newly designed procedures.
When you become a chief physician, in addition to various difficult surgeries, you also need to perform organ transplant surgeries, which also puts forward higher requirements for innovation capabilities and requires you to develop and design new surgical procedures yourself.
Therefore, the profession of doctor is extremely technical, and the conditions for upgrading at each level are very clear. There are exact requirements for what level of surgery, whether it can be performed, and to what extent it can be performed. The promotion process is also a journey of fighting monsters and upgrading along the way.
Before He Shengcai came to study, he was very proficient in level 3 surgeries and a little bit better in level 4 surgeries. However, due to limited conditions, he did not have many opportunities to practice.
Because most of the difficult surgeries in the department are controlled by Director Zhu, he usually performs mostly second- and third-level surgeries.
Only when Director Zhu is on a business trip for a meeting or flying a knife, he can pick up leaks and perform some level 4 surgeries.
As for operations such as organ transplantation, unfortunately, Director Zhu does not know how to do it, and Kunshi is a small place after all, so close to Haishi. Whenever a patient needs a transplant, the first choice is to go to a top-level hospital in Haishi.
He also taught himself difficult level four surgeries such as ESD surgery and G-POEM technology, and then he had the opportunity to practice them after meeting several patients whose symptoms were not too serious.
After several beautiful surgeries, he gained a bit of fame, but it also made him a thorn in Director Zhu's side.
If nothing else, he should either take the path of retiring after being in charge of Buddhism for ten thousand years, or be squeezed out by Director Zhu.
Fortunately, the accident happened, and the hospital received strong support from above to support key departments.
As a disadvantaged subject with the largest number of patients and the weakest capabilities, general surgery is naturally the first to be targeted by the hospital and is called the highlight of reform and innovation.
"A person's destiny and personal struggle are important, but the process of history must also be considered."
There had never been such a moment when He Shengcai had an extremely profound understanding of those familiar words.
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On this day, he received a notice as soon as he arrived at the hospital in the morning.
"An elderly patient was diagnosed with a circumferential early-stage esophageal cancer that is extremely rare in China and required ESD surgery."
"Preoperative endoscopic iodine staining revealed that the diseased mucosa was 14 centimeters long. It was extremely difficult to completely peel off the entire diseased mucosa."
"I'm actually not a first aid, but the chief surgeon."
He Shengcai looked at the surgery arrangements and was stunned.
ESD surgery is inherently a technically difficult level 4 surgery. The thickness of the esophageal wall of an average person is only 4 mm, and the mucosal layer is at most 1.5 mm. ESD surgery requires completely peeling off lesions within 1.5 mm, so the difficulty can be imagined.
Although there are medicines to treat cancer now, anti-cancer drugs are very expensive and are generally used to treat middle- and late-stage cancers. For early-stage cancers like this, surgery is required to eradicate them, which not only speeds up recovery, but also greatly reduces the financial burden.
After all, a minimally invasive surgery costs 10,000 to 20,000 yuan, and is cheaper than a few thousand yuan, which is much more cost-effective than anti-cancer drug treatment that costs more than 100,000 yuan.
However, He Shengcai was a little surprised that difficult ESD surgeries were usually performed by the chief physician and were handed over to an attending surgeon.
He looked at the patient's case and frowned.
Elderly patients, underlying diseases, peripheral lesions, intraoperative bleeding, endoscopic dissection treatment, all kinds of information seem to challenge the treatment limits of endoscopists.
You must know that in endoscopic operations, the slightest difference can make a huge difference. If the incision is not thorough, it means that it is not done. If the incision is too much, the risk of bleeding and perforation will also increase sharply. In addition, the degree of esophageal stenosis after surgery will also increase. It cannot be ignored.
He quickly became excited. The greater the difficulty, the greater the challenge. This was an excellent opportunity to verify what he had learned. Professor Zhou must have thought of this before making such an arrangement.
Therefore, there is no room for rejection and we can only face the difficulties.
In the afternoon, He Sheng was ready and entered the operating room.
In addition to anesthesiologists, second assistants, nurses, and some young doctors observing.
Standing on the operating table, looking around, he couldn't help but smile when he saw everyone's surprised looks.
"From this moment on, prove yourself."
"I know you still have doubts about my strength, but after this surgery, you won't have any doubts anymore."
He picked up the endoscope and looked at it, and was suddenly surprised.
This equipment was very familiar, and he recognized it at a glance. It was a Sanqing endoscope, and it was also equipped with an ultrasonic scalpel that could adjust the angle.
In the hospital in Kunming before, when Sanqing was first sent here for trial use, he had used it many times.
"It seems to be the prototype sent by Sanqing. It's great. Sanqing's ultrasonic scalpel is much easier to use than the electric knife. It causes less trauma to the tissue and there is almost no bleeding."
The thought flashed through his mind.
Soon, everything was ready and the operation began.
"The intubation was successful under anesthesia. During the operation, it was found that the mucosa of the esophagus 23-35 cm away from the front teeth was rough and eroded."
"Mark the area around the lesion under gastroscopy, and inject epinephrine-melan injection around the lesion."
"The lesion was not raised well, so we used an ultrasonic scalpel to gradually separate it in the tunnel and remove the entire lesion."
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He silently recited the surgical procedures in his mind, and his mood gradually became as calm as water, without any disturbance.
He lowered his head and operated skillfully, relying on his solid technical skills and rich surgical experience to avoid blood vessels, carefully build tunnels, and then gradually peel off the mucosa.
The expected bleeding from the wound surface did not appear. Under the ultrasonic scalpel, the mucosal tissue was cut and peeled off smoothly like a hot knife cutting into butter, without any trauma to the nearby blood vessels.
If I had to use one word to describe the entire surgery, it would be clean.
In two words, it is smooth + clean.
The operation lasted two hours, and the patient's blood pressure was stable during the operation without any errors.
In the end, the 14 cm long cancerous mucosa buried deep in the esophagus was successfully peeled off completely.
After the operation was over, the patient was quickly sent away, and thunderous applause erupted from all around.
This is a recognition of his strength and a compliment to his skills.
"Dr. He, your skills are really amazing."
"I heard that you are still the attending doctor? This time you are here to study for promotion. To be honest, at your level, you are more than enough to be the deputy director of a tertiary hospital."
"Your skills can only be used as a primary care physician in your hospital? This is too complicated."
"Oh my God, China is indeed a great country. With your skills, you can even become the director of a national hospital in our country."
Everyone was talking congratulations, including some foreign doctors who were amazed.
He Shengcai showed a smile and said humbly as usual: "No, no, everyone deserves the praise. I only have the skills I have now after coming here for further training. If I want to praise him, I'd better praise Professor Zhou for his teachings."
"Haha, this is all the result of your own efforts. I don't dare to be greedy for credit." A laugh sounded behind him.
He Shengcai looked back and saw Zhou Ruping standing behind him, looking at him with a smile.
"Teacher, how long have you been here?"
"Not long after your operation started, I came here and have been watching until now. As I expected, you have completely mastered the ESD operation."
He Shengcai was suddenly surprised and happy: "Teacher, thank you, you taught me well."
Zhou Ruping laughed: "Let's go and talk to me in the office."
He Shengcai's head was dizzy and his heart was numb. He came to the office and drank a glass of water to calm down.
"How's it going? Have you selected the surgical video for the competition?" Zhou Ruping got straight to the point and asked directly.
He Shengcai shook his head and was about to say something.
Zhou Ruping clicked his finger on the mouse and said, "I recorded your surgery just now and made it into a surgery video. What do you think?"
He Sheng took two steps forward and watched his smooth operation on the surgery video. There was no bleeding or fireworks at all. It was extremely pleasing to the eye.
He has also watched some videos of past award-winners, and his surgical performance was extraordinary, not inferior to those of the finalists.
"This," he was so moved that he blurted out: "Teacher, have you been prepared for this?"
"That's right," Zhou Ruping said with a smile: "Don't blame me for not telling you in advance. I don't want to put too much pressure on you and want you to express yourself freely."
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"Actually, I was the one to do this surgery, but full-esophageal ESD surgery cases are very rare. This surgery is not that difficult. I think you just need a case to make a video of the surgery, so I'll leave it to you."
"Originally, I thought that if you can do it, you can record it and compete even if you are a master. If you can't do it, you can continue to study. I can watch from the side and tell the truth."
"I didn't expect that," he said with a look of approval in his eyes: "You did a better job than I thought. There wasn't even any bleeding from the wound. You just missed a step. If it were other students, they might have to use hot pliers to stop the bleeding. It doesn’t look so pretty.”
"The most important thing about minimally invasive surgery is the word minimally invasive. The smaller the trauma, the better, and the less bleeding the better. If it can be done without blood and trauma, it is the best surgery for the patient."
He Shengcai scratched his head and said with some embarrassment: "That's the result of using the ultrasonic scalpel. If others use the ultrasonic scalpel instead of the electrosurgical scalpel, they can definitely do it as cleanly as me."
Zhou Ruping waved his hand: "I called you here just for this reason. According to your opinion, how is the ultrasonic scalpel under the hose used? Compared with the electrosurgical scalpel? Is it difficult?"
He Shengcai pondered for a moment and said sternly: "Of course there are difficulties. This is a new thing. The doctors are familiar with using the electrosurgical scalpel. They may not be used to it when they suddenly switch to the ultrasonic scalpel. But as soon as they get started, they will definitely like it. Ultrasound."
"After all, electrosurgery relies on heat to stop bleeding, and damage to surrounding tissues during cutting is inevitable. If ultrasonic scalpel is used, intraoperative bleeding and hemostasis will be much more convenient, and the trauma to the patient will be less."
"Of course, mastering any new technique requires a lot of practice. This is inevitable."
Zhou Ruping nodded: "You are right. Sanqing's trustee sent me a message before, saying that he wanted to sponsor the Endoscopy World Cup and compete with Olympus. I was a little dissatisfied. Now it seems that my thinking is too narrow. ”
He Shengcai smiled apologetically and said, "I can't blame you for thinking so. After all, Olympus endoscopes have been a monopoly for decades, and everyone is used to it."
Zhou Ruping sighed with emotion: "Yes, I am used to using foreign equipment and have formed a fixed mindset. In addition, other domestic manufacturers have not been able to live up to their expectations and have not been able to break the monopoly of Olympus. Who would have thought that domestic endoscopes can actually so smart."
"The prototypes sent by Sanqing are not only no worse than Olympus, but the flexible and hard tube ultrasonic scalpels they are equipped with are even more powerful than Johnson & Johnson's. I am really impressed."
He slapped his thigh, excitement showing on his face.
"Following the rise of China's endoscopic surgery, China's endoscopic equipment has also risen."
"Twenty years ago, I wanted an Olympus endoscope but couldn't get one, so I had to modify it myself, using a crochet hook to make a simple instrument."
"Twenty years later, domestic endoscopes have actually outperformed the previous ones, with their own technologies and breakthroughs."
“It’s really gratifying and congratulatory, what a great blessing for the country!”
"It's decided, this time I will risk my old face. I won't let go of the face I have gained over the past ten years, and I must send Sanqing's equipment into the endoscopic surgery room."
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After Zhou Ruping said these words, he suddenly reached out to straighten his hair, smoothed the messy hair, and sat upright.
“Chinese endoscopic surgery became internationally famous for the first time, and it started with me.”
“Now, for the first time, China’s endoscopic equipment has become internationally famous, and it’s only me who started it.”
"The great nation serves the country and its people, and the dignity of the country consists of honor and disgrace. The honors received by doctors are not only based on their own strength, but also cannot be separated from the development of the country."
He Shengcai was immediately in awe. What he admired most about Professor Zhou was that he always kept the country and the people in his heart and always worked hard for the patients.
Ask yourself carefully, I am just a layman, learning technology is not just for fun, but mainly for promotion, but I don't have such a profound consciousness.
If he had been in the teacher's position, would he have been able to achieve the same results? He could only shake his head with regret.
At this moment, he thought of the "Artisan of the Great Country" program filmed by the TV station. Zhou Ruping became the only doctor selected because he brought great honor to the country on the international stage and single-handedly transformed China's endoscopic surgery. Brought to the forefront of the world, it has been recognized by people all over the world.
I thought that I actually had the opportunity to take over this glorious and great task from my teacher and make a name for myself on the international stage.
He couldn't help but feel his heart tremble, his limbs trembled, and his eyes became moist.
"Teacher, don't worry, I won't let you down."
He Shengcai clenched his fists and said these words resolutely.
