Zhang Fan no longer needs to worry about the situation outside the operating room. What he can do now is to perform the operation well and rescue Wang Weiping. Zhang Fan was not easy to give orders to the two chief directors. Lao Gao could tell, "Now is not the time to be polite. Hurry up. The two of us are now your subordinate doctors."
"Yes! Lao Gao is right." Lao Wang agreed.
"Both directors, I'm sorry! Director Gao washed his hands and disinfected, while Director Wang and I got into position, and asked the director in my heart to come for a surgical consultation. We might need joint treatment later." With the cooperation of the two, Zhang Fan starts commanding, and doing surgery is actually a bit similar to fighting a war. First of all, it is determined who is the general, and the general takes command, and then the subordinates take action. A general must think clearly and follow the orders and prohibitions of his subordinates.
A general must think clearly and give accurate orders. Otherwise, the subordinates will rebel. The same goes for surgeons. What you want to do must be clear and the instructions must be clear. Because there are several nurses and doctors waiting for your order. Waiting for the next step of the process.
Disinfection, laying out sheets, the two chief directors are doing the work of hospitalization. The surgeon has no right to think, and the assistants have to do these small tasks such as X-rays, CT scans, and RIs. Zhang Fan couldn't care about these trivial matters anymore and stared at the LED viewing light to think carefully.
The operation begins. The pelvis is actually a closed bony ring, a solid bony ring composed of the iliac, pubic, and ischial bones. Because the pelvis is relatively hard, it is generally not easily broken unless violently.
Wang Weiping's fracture was very serious. The pubic symphysis was separated, the sacrotuberculosis and sacrospinous ligament were ruptured, and the posterior sacroiliac joint was completely dislocated. The dislocated half of the pelvis has been displaced forward.
"Look for the bleeding point first. There must be relatively large blood vessel damage in the pelvic cavity." Zhang Fan said.
Opening the book and answering questions, the thinking is very clear. Lao Gao and Lao Wang were not surprised at all. Although this operation is very serious, for a doctor who excels in hip and knee replacements, the difficulty of this operation is not too difficult. Just hurry up and be fast!
When the surgeon has an idea, the assistant actively cooperates. The surgeon dominates everything on the operating table. Some surgeons with particularly bad tempers either curse people or throw things, which makes the doctors below unwilling to operate with them. There are quite a few doctors like this. I guess they were too oppressed in the past. After they became stronger, they started to imitate the same!
Zhang Fan chose the posterior approach. After cutting off the gluteus maximus fascia, he carefully performed subfascial separation inward to ensure that the gluteus maximus muscle tissue was separated from the subfascia without damage. Because the gluteus maximus fascia extends into the gluteus muscle at finger-like intervals every 5-10 seconds, special care must be taken to maintain an intact layer, protect the fascia from damage, and minimize damage to the muscle.
In order to completely restore its anatomical layers, Zhang Fan was particularly careful to separate the fascia and keep it intact. When you find the gluteus maximus on the sacrum, stop dissecting medially. The gluteus maximus was cut off from the aponeurosis of the thoracolumbar fascia, the iliac crest, the posterior superior iliac spine, and the multifidus fascia in sequence.
When cutting off the gluteus maximus, Zhang Fan kept the tendon long enough at the insertion point in order to facilitate repair of the gluteus maximus at the end of the operation. Then cut the gluteus maximus muscle at the crest of the gluteal muscle.
The operation was carried out step by step, and the three surgeons kept wiping the sweat from their heads. There was no conversation or communication between the three of them. The most they could see was that the two assistants exchanged their opinions through their eyes! Everyone knows what to do and what to do.
The skills of the three of them are not weak, and Zhang Fan's intentions are clear to the other two. However, Zhang Fansheng underwent a large amount of surgeries when he was young, and he performed them very quickly with his hands.
As soon as an expert takes action, he can tell whether there are blood vessels or nerves. Zhang Fan can quickly separate and cut them without thinking or stopping. The three-dimensional anatomical diagrams of various tissues seemed to be right in front of Zhang Fan's eyes. The two directors did not give it in vain. They were both masters. In order not to be underestimated by others, they cooperated fully.
The advantage of being focused is that the surgery goes very quickly. After entering the iliac area, bleeding was found. "Artery!" Zhang Fan said.
The other two people have also seen it! The arteries here are too troublesome to deal with! The possibility of docking is unlikely, but embolism will cause atrophy of lower limb muscles or buttock muscles.
Zhang Fan, who did not pause during the whole process, hesitated slightly, and the other two people also thought about what they would do if they were the surgeons today! "What's your blood pressure?" Zhang Fan asked.
The anesthesia director of the anesthesiology department is today's anesthesiologist, "Dr. Zhang, 85/50hg, heart rate 60."
"No!" Zhang Fan was still preparing to connect the artery, but the patient's vital signs did not support it, so he had to give up!
"Ligate!" Zhang Fan said. The first one failed. Both Lao Gao and Lao Wang understood what Zhang Fan meant. Lao Gao was about to persuade, but Zhang Fan immediately said ligation. It seemed that the young man was not enthusiastic and was still very calm. He was really a genius in surgery.
After this set, Wang Dehua was extremely jealous of Lao Gao. The two of them started competing and comparing each other since they entered the hospital. They fought until they reached the position of director, but there was no winner. But now Lao Gao has brought out a monster and directly crushed all the orthopedic surgeons below him.
Lao Wang was extremely jealous. If it weren't for the fact that the operation was still in progress, he would have wanted to curse! I have to be strong all my life, and getting older will definitely make Lao Gao proud.
The operation sounds quick, but it actually took three people four hours to do it. Damaged arteries and veins should be repaired as much as possible if they can be repaired, and those that cannot be repaired should be dealt with in the least damaging way. Zhang Fan's technique was too clever. Many places would have been damaged according to the methods of the two directors, but Zhang Fan cleverly avoided them. Lao Gao kept nodding. Although he didn't speak, his eyes looking at Lao Wang exuded an aura of pride.
Wang Weiping's vital signs were stable and the bleeding stopped. Lao Wang turned around and motioned to the circulating nurse to wipe away his sweat, and then said: "Dr. Zhang, your technique is not like ours. Lao Gao and I were both trained by the same master, so yours doesn't look like it!" Lao Gao's eyes were too disgusting, Lao Wang said unconvinced.
"When I was in Gu 1 and 2, I always watched you two directors perform the surgery. I thought about it carefully when I got back, and I gained a little bit of experience." Zhang Fan was no longer anxious now, and Wang Weiping survived.
"The philosophy of our Department of Orthopedics is to be brave in innovation. Dr. Zhang has done a good job in this regard, but you should not be proud and keep up your efforts. After you enter the department, every Tuesday will be designated as the department's study day. At that time, everyone can talk about themselves My experience!" Lao Gao said cheerfully.
After comparing the two people for a lifetime, there was no clear winner. As a result, in the generation of disciples, Lao Gao was already in the lead. If you don't show off or make Lao Wang angry, it won't be justified.
Lao Wang thought to himself: "That's nonsense! If I can get some insights after watching a few surgeries, then I can retire directly!" He rolled his eyes and glanced at Lao Gao, and then said: "Some people shouldn't be too complacent. If this situation continues, it is estimated that sooner or later this hospital will no longer be able to accommodate Dr. Zhang!"
"I'll make you proud. Let's see how you show off after Zhang Fan leaves!" Lao Wang thought in his mind and became much more balanced.
"No matter where he goes, his entry-level master will still be me, Lao Gao, and his surname will never be Wang. From now on, when people talk about Zhang Fan, they will mention me, and I can be considered a bit of a credit!"
The two kept bickering, and Zhang Fan was a little annoyed. They were talking too much, and the two directors were chattering like women. He doesn't understand how lucky he is to have such a lifelong professional enemy or rival! Pushing each other to make progress, without Lao Gao or Lao Wang, their careers would not have reached the current peak.
"The broken bones are not very severe, prepare to fix them!" Zhang Fan couldn't listen any more and spoke up to stop the bickering between the two! Today he is the chief surgeon and has this right.
The operation went smoothly, the patient's vital signs were stable, and the atmosphere in the operating room suddenly became relaxed.
The director of anesthesia said jokingly: "You two are not shy, hurry up and do the surgery. From now on, Dr. Zhang will rule. Our era has passed!" He and the two directors of the orthopedics department entered the hospital at the same time!
As soon as they said this, the two of them sighed at the same time and glanced at each other. They could vaguely see white hair from the temples. "Yes, it's over!" Lao Gao said softly.
Life, old age, illness and death are unavoidable for anyone, especially surgeons. They only have a few years of prime time. Once it passes, they start to rest on their laurels. As their eyesight and physical strength decline, they gradually become more and more unable to do their job.
The circulating nurse was the head nurse in the operating room. After several operations, she already knew Zhang Fan's status. She gently wiped the sweat from Zhang Fan's head and said, "Doctor Zhang, how much time do you think you have left?" It’s over, the meal is over, and the director asked me to ask you what you want to eat. The hospital will reimburse you today. We nurses will also benefit from you! "
"Haha, I'm free. I have to ask your leaders about this. I'm just a soldier. I'll eat whatever you eat." In the operating room, except for Zhang Fan and the operating nurse, everyone else was the leader. What Zhang Fan said is absolutely correct.
The operating nurse smiled quietly! She didn't dare to joke with the leaders. The head nurse looked kind, but she was ruthless in dealing with people!
"Finger? Steak?" the anesthesiologist asked.
"Okay! Let's eat steak as a kindness today. If you miss this moment and try to get the boss to be so generous, you probably won't have the chance. Now the boss is leaning more and more towards internal medicine resources, and our bonuses have also begun to decline. Well, let’s go talk to the boss that day.” Lao Wang said to Lao Gao.
"Okay, let's talk about it. The doctors below are all complaining now!"
This kind of thing is not Zhang Fan's concern. These words didn't even reach his ears, so they were blocked!
fixed! Stitch! Ligation, surgery completed! The anesthesiologist and nurse accompanied the patient to the ICU. Zhang Fan shook off his sore legs and turned around to see that Lao Gao and Lao Wang were already sitting on the ground floor of the operation room regardless of their status, leaning against the wall and taking a nap.
Really old!
