Chapter 207 Another one is gone and goes to war in times of crisis

Author: Jiangbian Yuweng

Chapter 207 Another one is gone and goes to war in times of crisis

This incident at least made Du Leng feel that the situation was very good.

There was no expression on Zhou Can's face. The removal of Song Ze would not have much impact on the surgical capabilities of Deputy Director Liu's team.

Because Song Ze usually plays the role of second assistant during major surgeries, pulling hooks, doing odd jobs and so on.

As for the ability to perform independent surgeries, Song Ze is the attending physician with relatively low qualifications and can preside over some simple first- and second-level general surgeries on his own.

Now that he is gone, Zhou Can happens to take over all Song Ze's surgeries.

Watching the doctors from Yang Qing's team leave, Zhou Can and Song Ze didn't say a word.

When Song Ze passed by him, he even deliberately turned his head and pretended not to see Zhou Can.

"Is Yang Qing's team really that good?"

I really don’t know what Song Ze is thinking?

I always feel that Song Ze has no dignity at all in Yang Qing's team.

Zhou Can ignored these people and took the biliary stone patient into the operating room with the intern.

Not long after, He Hansheng, Deputy Director Liu and others entered the operating room one after another.

Zhou Can's eyes flashed, and he discovered that one more person was missing from the team.

"Director Liu, I have something to tell you. Resident doctor Cheng Gang has gone to another group to develop."

He Hansheng bit the bullet and told Deputy Director Liu about the incident.

"Did another one leave?"

Mr. Liu was stunned for a moment, his tone was full of loneliness, and there was sadness deep in his eyes.

One after another, his doctors left his group and joined other groups at this critical moment. For this nearly sixty-year-old man, it was tantamount to being severely traumatized again and again.

Up to now, the entire surgical team only has the first assistant He Hansheng and the third assistant Wan Sanyi.

After all, Zhou Can was just a regular trainee. After his rotation in this department, he left.

So he is not a permanent member of this team.

The other trainees and interns are of no use. They can only help with less technical and less risky tasks. And they also have to leave.

An intern still has a long way to go if he wants to become a resident physician under Deputy Director Liu.

There are also many variables.

At least 90% of Tuya's interns will eventually be eliminated.

Less than one out of ten can stay.

Anyone who has done an internship knows this. When I first interned in a provincial tertiary hospital, I felt extremely proud and full of good vision for the future. When the internship was over, I realized that not to mention staying in the hospital and becoming a full-time employee, I even obtained the training required to stay in the hospital.

The qualifications are extremely difficult.

The competition among large hospitals is really cruel.

Thousands of troops cross the single-plank bridge, but very few people cross it. Everyone who successfully crosses it is an outstanding person.

Mr. Liu's doctors lost three of them in just one day, each of whom he had carefully trained for at least two years.

These people didn't even say hello when they left, they just left.

The coldness of human nature is most truly reflected in the face of interests.

"If you want to leave, you can't stay. Let's start the operation!"

Mr. Liu sighed and said with some loss of interest.

"Dr. Zhou, you are better at endoscopic surgery. Let's work together to complete this surgery and let Director Liu rest."

He Hansheng asked Zhou Can for his opinion.

Mr. Liu was so shocked at this moment that his hands were shaking. He didn't know whether it was because he was so angry or because he was feeling seriously unwell.

After all, I am older.

The current situation is definitely not suitable for in-person surgery.

"I have no problem at all. As long as Mr. Liu is there to give instructions on the key operations of the surgery, I am confident that I can do this surgery well."

Zhou Can had already studied this patient's examination report.

If there are many stones in the bile duct, endoscopy, cholecystectomy, and common bile duct stone removal are required.

He already had surgical experience in endoscopic gallbladder removal.

Even if you don't have the guidance of a superior doctor to perform this surgery, you can still complete it successfully.

"Xiao Zhou, the previous steps are the same as laparoscopic cholecystectomy, you can just do it directly."

Mr. Liu is quite confident about Zhou Can's endoscopic surgery capabilities.

"okay!"

Zhou Can follows the steps of laparoscopic cholecystectomy.

"To perform this kind of laparoscopic surgery, two surgical methods can be adopted: transcystic duct exploration or transcommon bile duct incision exploration according to whether the cystic duct is widened. The former is suitable for cases where the cystic duct is relatively short and thick, and generally the diameter is greater than 5mm.

Consider this method. For this patient, if the stones in the bile duct are small and few in number, common bile duct incision can be used to explore and remove the stones, followed by T-tube drainage."

Mr. Liu was standing by to guide Zhou Can during the surgery.

"clear!"

Zhou Can answered as he carefully dissected out the upper section of the common bile duct along the cystic duct.

After processing the cystic artery, free the cystic duct and dissect the anterior lobe of the hepatoduodenal ligament toward the junction of the common bile duct and the common hepatic duct.

Until the blue-green bile duct is clearly exposed.

These operations require extremely advanced endoscopic surgical skills.

Among Mr. Liu's surgical team, even if Mr. Liu does it himself, he may not be as good as Zhou Can.

Everyone else stood aside and watched quietly.

Some people stared at the endoscope screen, while others stared at Zhou Can's hands.

Zhou Can carefully incised the front wall of the common bile duct.

Blood vessels appeared on the anterior wall of the exposed upper segment of the common bile duct.

He calmly used curved forceps to lift off the front wall of the bile duct, and then performed electrocoagulation.

Immediately afterwards, place a small piece of gauze with barium sulfate thread in Wen's hole and use curved micro-scissors to cut the front wall of the common bile duct about 1cm longitudinally or diagonally.

In these operations, the placement and clamping techniques that he usually practiced hard came in handy.

After a successful operation, the experience value is directly rewarded to one hundred and one hundred.

Because it is the first time to operate, and it is quite difficult.

It was of great benefit to him in terms of his own surgical experience and improvement in endoscopic surgery capabilities.

The system rewards 100 experience points, usually when Zhou Can has made great progress in surgery or diagnosis, or has made major gains.

"That's right, you must keep it up!"

Deputy Director Liu watched from the side as Zhou Can steadily progressed the operation process, and he felt very pleased.

Next, fiberoptic choledochoscopy is performed to explore the bile duct and remove stones.

Zhou Can controlled the endoscope to explore upward to the left and right hepatic ducts. After discovering the stone, he used a stone removal mesh to remove it. Then he should explore downward to the lower end of the bile duct and remove the stone using the same method.

During the exploration, he found that there were many stones in the bile duct.

"Mr. Liu, is it possible to directly remove the stone using the laparoscopic rotating joint grasping forceps?"

Zhou Can asked Mr. Liu for his opinion.

"Can!"

Mr. Liu nodded in agreement.

This method of removing stones is very convenient and practical.

After catching almost all the stones, Zhou Can used a choledochoscope to explore and remove the remaining stones.

There are still several key surgical steps to be done next.

Place a T-tube and suture the bile duct incision.

This step tests the suturing technique very much. If bile leaks around the T-tube, the suturing is not in place.

Fortunately, Zhou Can's suturing and ligation techniques all reached the level of deputy director.

The whole operation process was almost a success.

At this point, the gallbladder can be removed directly.

After the gallbladder is removed, the surgical field is flushed, and an abdominal drainage tube is placed.

During the operation, the abdominal drainage tube is inserted into the abdominal cavity through the right anterior axillary port and placed around the T-tube and in the liver-kidney space. This step is far more difficult than imagined.

Fortunately, after Zhou Can's hard work, he finally lived up to his high expectations and successfully completed the entire operation.

"Mr. Liu, I would like to ask you, during the process of removing the gallbladder just now, I found that the patient's gallbladder showed signs of malignant transformation. In this case, do I need to submit it for pathology examination?"

Zhou Can asked Mr. Liu for his opinion.
To be continued...