Surgical skills are really just one step at a time.
Each level has different abilities.
It is an entry-level incision method, and it is scary to cut it with one knife. In fact, they don't dare to use it on patients at all, unless they are very brave and don't take human life seriously.
Skilled-level incisions can be stronger and can make incisions in non-vital parts such as limbs, but the wounds produced are uneven and the edges of the wounds are difficult to describe.
Sometimes if it is not done well, it is easy to make a wavy wound.
Because the dissection is performed layer by layer, if the incision is not made properly when cutting the first layer, it will definitely affect the subsequent incisions.
And suturing requires debridement before suturing.
Otherwise the patient's wound may heal very poorly.
"Not bad, not bad, the cut is really beautiful! There is no need to mention the bleeding control. Don't be stunned by the retractor, and work quickly."
Director Hua was very satisfied with Li Jingsheng's performance.
The second and third assistants had cleverly used flat hooks to open the opening, exposing the spinous processes of the lumbar vertebrae.
At this time, you can see many muscle groups on both sides of the spinous process.
Including the spinalis dorsalis, multifidus, interspinalis, etc.
Therefore, it makes sense that everyone likes to eat tenderloin when buying pork. The lean meat in this part is rich and the meat quality is also very good.
"Jingsheng, the myofascia needs to be incised along both sides of the spinous process. The venous plexus below is extremely rich, so be careful."
Director Hua still asked Li Jingsheng to continue the operation.
"OK!"
Li Jingsheng was secretly glad that he had just upgraded the incision method to Dacheng, otherwise it would be easy to miss when facing the rich venous plexus.
It is difficult to stop bleeding in this area, and it will be troublesome to cut the blood vessels.
Now, he was exactly like a experienced deputy chief physician, incising the myofascia next to the spinous process bit by bit.
The whole process is done with care.
During the separation, his scalpel is always close to the bone surface and performs subperiosteal dissection.
By the time everything is completed, the patient's vertebrae can be clearly seen.
He couldn't help sweating on his forehead.
Although the traveling nurse was a bit fierce, her eyes were sharp and she took the initiative to help him wipe away his sweat.
No greeting is even needed.
He felt that his separation technique seemed to have improved a lot.
I took a moment to look at the properties.
Proficient in sharp traditional scalpel separation method 375/500.
The speed of this proficiency improvement is simply terrifying.
It feels like one stabbing blow has at least added five points of proficiency to him.
However, the tension of walking on thin ice, as well as the feeling of using incision and separation together and fusing them together, gave Li Jingsheng a new understanding of these two surgical skills.
He took a look at his health and was equally surprised, it had increased by more than two hundred.
Two hundred of them will definitely be prizes.
The operation continues.
The next task will be more difficult, requiring separation of the muscles next to the spinous process.
It is more difficult than incising myofascia.
Moreover, this patient had a tough tendon attachment due to surgery, which made it even more difficult.
"Bone Knife!"
Li Jingsheng saw that Director Hua didn't stop him, so he was ready to challenge again.
In fact, with the Dacheng-level cutting method, there is no problem in cutting this piece. It's just that the sharp separation method is a little behind, and the mastery level is still a little weak.
It's okay to deal with ordinary surgical separation tasks, but it's quite risky to deal with such difficult tasks.
He very carefully cut open bit by bit with a bone knife and peeled off the spinous processes one by one.
As soon as the knife went down, blood came out.
"Did I get into trouble?"
Li Jingsheng looked up at Director Hua with a guilty conscience.
When it was separated just now, it was obvious that the attached tendon was very tough. If you apply just a little force, you won't be able to separate them at all.
So he increased his strength.
The result is the current situation.
He could feel the blood vessels being broken through the feedback from the bone knife.
"Don't panic, it will be the same for anyone else. You have almost no experience in this area, so it is normal for some bleeding to occur."
Director Hua comforted Li Jingsheng and personally stepped forward to help Yan Jian stop the bleeding.
"Go on! Once you've peeled it all off, you can then use gauze to pack it to stop the bleeding."
Li Jingsheng was relieved by Director Hua and immediately operated on the patient again.
My mood was somewhat affected.
But his progress is also very obvious.
In order to avoid getting into trouble again, he quietly upgraded the sharp separation method from mastery to master level.
After spending more than 700 points of life, the life points that were finally accumulated were used up to only more than 200 points.
His health balance rarely seems to exceed one thousand for a long time.
It gets used every time.
I have to admit that after the sharp separation method was improved, the entire peeling process was significantly smoother.
For some parts that are difficult to peel off, he can feel much more relaxed when operating.
The control of strength, depth, and handiness have all been greatly improved.
After peeling off all five spinous processes, he breathed a sigh of relief.
I have never experienced such a difficult surgical procedure.
Fortunately, my life was fulfilled. Except for breaking the blood vessel when the tough tendon attachment was separated, the bleeding afterwards was very small.
"Jingsheng, thank you for your hard work! You performed very well. Especially after the patient's blood vessels between the spinous process and the lamina suffered a large bleeding, you were able to quickly stay calm from the panic and complete the subsequent surgical tasks calmly. This is very good. I believe it. It is also a very good training and improvement for your character.”
Director Hua spoke highly of his surgical performance.
When young doctors go to the operating table, lack of technical proficiency is only one aspect. Mental training is also very important.
Don't panic when something happens, you need to deal with it calmly.
"Now you carefully watch my steps to stop bleeding. Use gauze to fill the space between the muscles and bones. It must be tightly packed, otherwise the hemostatic effect will not be achieved at all."
As Director Hua stuffed the gauze in, the bleeding stopped quickly.
This principle is actually to apply pressure to stop bleeding.
Li Jingsheng has mastered compression and hemostasis, but his level is not yet high.
Standing by and studying at this moment has gained a lot.
"Director Hu, come and bite off the spinous process!"
For some surgical procedures that are too high-risk and difficult for novice doctors to master, Director Hua will not easily let his doctors take risks.
Because some surgical steps have the opportunity for trial and error, and some do not.
As long as it is damaged, it will immediately become a surgical accident and there is no room for recovery.
Li Jingsheng was also asked to study beside the laminectomy after removing the spinous process, and gave some detailed guidance and explanations.
Those who can participate in this operation are all excellent orthopedic surgeons.
It can be regarded as integrating the cutting-edge power of orthopedic surgery.
However, it is limited to the two levels of deputy director and attending.
As for the resident doctors, only Li Jingsheng has this honor.
Other senior residents can only observe and learn under the operating table.
…
When the operation ended, it was already around 6:40 in the evening.
Li Jingsheng gained more from this operation than he imagined, especially the epidural and intradural exploration after laminectomy, which gave him a deeper understanding of the vertebrae.
A lot of practical knowledge cannot be learned from books.
Because the understanding of words is certainly not as clear as seeing, touching, or even participating in it.
Human language has evolved for at least thousands of years, but there are still many things that language cannot fully express.
Practical teaching through words and deeds is the best way to improve surgical skills.
In this operation, he obtained a very important suturing opportunity.
After the laminectomy, the dura mater was also cut.
After the operation, the dura mater needed to be sutured, and Li Jingsheng succeeded in suturing it.
Continuous sutures are used.
Because he earned a lot of health points during the operation, after getting this suturing task, he directly upgraded the continuous suturing to the level of Xiaocheng without even thinking about it.
As a result, when he finished sewing, he unexpectedly received a 500-point health bonus.
Although the highest health reward he has ever received is one thousand. But he still felt very excited and happy to get the five hundred health points reward.
There are too many medical skills to improve.
For example, the level of square knots, surgical knots, and slip knots can no longer keep up with the surgical tasks that Li Jingsheng can get.
There are only two things he has to do now, make money desperately, gain health points, and then upgrade his medical skills.
Try to master surgical skills as soon as possible.
"Jingsheng, I see that your suturing skills are quite good. There will be another surgery at half past seven, which requires anastomosis of tendons, blood vessels, and nerves. Will you participate?"
Director Hua loves talents very much. Seeing that Li Jingsheng has performed so well, he can't help but want to train him more.
"Okay! I'm going to eat first and use the toilet. I'll come to you in the operating room later."
Li Jingsheng readily agreed.
Anastomosis is an advanced surgical technique that he has long wanted to master.
But the previous suturing and knotting techniques were very poor. Even the skin was not sutured well, and the anastomosis was unthinkable.
The conditions now seem ripe.
Besides, I just earned 500 health points as a reward. If necessary, I can upgrade the corresponding sewing skills or knotting skills.
I guess I need to upgrade my knotting skills.
Anastomosis is not only very demanding on suturing, but also very demanding on knotting techniques.
For example, if the anastomosis of blood vessels is not tightly knotted, it will directly lead to internal bleeding or thrombosis after blood flow, which can easily lead to the death of the patient.
Therefore, superb knotting skills are very important.
He currently masters the square knot, slip knot, and surgical knot, which is enough.
The only thing required is to increase their skill proficiency. Only the knotting skills at the proficiency or proficiency level are still a bit weak.
"The operation is not performed here, but in the laminar flow operating room No. 5 of the General Department of Surgery. This is a joint operation between two departments. It should be a good experience for you to gain knowledge and gain opportunities for anastomosis training."
In many surgical rooms, when patients undergo surgery, they need to ask orthopedic surgeons to join them for joint surgery.
For example, if you want to open the chest, you would ask an orthopedic surgeon to saw the sternum or ribs.
Director Hua also saw Li Jingsheng showing his strong surgical ability, so he took him there to gain more knowledge.
Otherwise, I would definitely not dare to take him there easily.
Otherwise, it is easy to be laughed at by doctors in other departments.
General surgery is a versatile department in the surgical department.
It can basically open the abdomen, reconnect amputated limbs, cut out tumors... everything can be done.
Including anal surgery is also a sub-department under general surgery.
In fact, in many smaller hospitals, hemorrhoidectomy and anal fissure repair are completed directly by the general surgery department. There is no too detailed division.
After Li Jingsheng came out of the operating room, he finally had a chance to look at his mobile phone.
He was a little worried about Ou Qinglan asking to work with him.
But she should have known that Li Jingsheng went into the operating room for surgery, because she was in the office when Hu Jia invited Li Jingsheng.
He took out his phone and saw that Ou Qinglan had sent him a message.
"Waiting for you in the hospital cafeteria."
His heart felt warm.
He immediately called her and walked quickly to the hospital cafeteria.
It's a bit late now, the cafeteria is probably about to close.
"Are you having surgery?"
Her soft voice came over.
"Well, I just came out of the operating room. Where are you?"
"I'm waiting for you in the cafeteria! I asked the cafeteria aunt to make the stir-fried pork you like and put it in a box. It's still hot. Come here quickly."
"good!"
After Li Jingsheng hung up the phone, he felt moved and warm.
It feels so good to have a girlfriend.
In terms of care and consideration, Ou Qinglan is really impeccable. Li Jingsheng had never experienced this feeling with his ex-girlfriend.
Maybe every woman is different.
In contrast, Ou Qinglan is very selfless in love, and only has Li Jingsheng in her heart and eyes.
The ex-girlfriend seemed a lot more selfish. Li Jingsheng basically cared about her and loved her.
This also makes Li Jingsheng willing to risk his life to protect this love.
He rushed all the way to the cafeteria, and when he saw Ou Qinglan, he couldn't tell what he felt in his heart.
Anyway, it’s very warm.
There was no one in the cafeteria, and Ou Qinglan was sitting there playing with her mobile phone.
"Qinglan!"
"Our Dr. Li is finally off work! I'm going to get the food for you. If it hadn't been prepared and put there in advance, it would have been snatched away by others."
Ou Qinglan stood up with a smile and walked towards the window.
"Auntie, please give me my food."
The aunt who prepared the meal took it out from the thermal cabinet and handed it to her.
Then he glanced at Li Jingsheng.
"Young man, your girlfriend really cares about you. She only ate two vegetarian dishes, but she gave you so much stir-fried meat and cucumber and ham sausage. She also specially asked me to put it in the incubator because she was worried about getting cold. .When you meet a girl like this, you should cherish her, and don’t hurt her heart."
The aunt who was cooking said to Li Jingsheng with a smile.
"Okay, I will cherish it."
Li Jingsheng couldn't describe how he felt. He really wanted to hold her tightly and let time last forever.
This silly girl.
Posted two minutes late, sorry.
(End of chapter)
