Chapter 4 Breaking the tail
In the big room, Lei Beisha carried out the concept of playing eight sticks and giving a sweet date, and comforted: "At the beginning of the internship, everyone mainly focused on observation, paying attention to the learning of methods, studying hard and practicing hard, and working hard.
Yihehe. Today, I mainly give you a demonstration. From now on, you will have plenty of time to spend in the practice room. When the time comes, you don’t have to come if you don’t want to."
Seeing that Lei Beisha's attitude had improved, Wang Zhuangyong quickly raised his white-gloved hand and asked: "Director Lei, how difficult is it to splice the tail of this white mouse? What are the difficulties?"
"How difficult is it? How can I describe this?" Lei Beisha thought for a moment and said: "Let me describe it. In addition to having students from your medical school as interns, the hand surgery department of our Yunhua Hospital also accepts nearly a hundred provincial students every year.
Doctors from other hospitals in the country come to practice and learn. When these doctors leave, only single digits can complete the required blood flow rate of 95%."
The students all exclaimed.
Doctors who can come back to Yunhua to recuperate, no matter how weak they are, are still better than medical students who have never been on the operating table. With this judgment, when they see the tail of the white mouse being docked and spliced, the students will be even more in awe.
A few minutes later, Kang Jiuliang and Ling Ran sat on both sides of the table. The objective lens of the two-person binocular microscope faced the tail of the white rat. The two ends of the machine above each provided a pair of eyepieces for Kang Jiuliang and Ling Ran.
"When we normally practice, we will cut the tail of the white rat into 60 to 80 pieces. Our situation today is special, so we will cut it a little less." Kang Jiuliang turned on the microphone on the side of the table to speak, and picked up the scalpel.
"The white rat is so cute, don't cut off its tail." A girl hidden in the crowd shouted.
Although he guessed she was joking, Kang Jiuliang still explained seriously: "Experimental animals are the unsung heroes of our medical school. Everyone uses experimental animals for training to improve technology and better improve human welfare. And within the scope of ability,
Everyone should also try their best to make good use of every experimental opportunity and reduce the suffering of experimental animals within their capabilities. Therefore, when doing exercises, you must be serious... This student, what are you doing?"
While Kang Jiuliang was talking, he saw that Ling Ran had cut the anesthetized white rat tail into dozens of pieces...
"You said you should cut less sections today, but I cut 42 sections. Is it too little?" Ling Ran's scalpel shone with silver light.
The students below were even more excited to see it, including the girl who just said, "The white rat is so cute." She was also so excited that she wished she was the one who had been stabbed just now.
"Just cut it, then you have to follow the instructions." Kang Jiuliang looked at the pile of broken tails and couldn't let him put them back together again.
No, they are preparing to fight now.
"I'll give you a demonstration first." Kang Jiuliang held the tweezers in his left hand and the needle holder in his right hand and said, "What we are using now is called microscopic medical equipment. Many students may not have been exposed to it. Its main feature is that it is compact, such as the one we use now.
The thickness of the suture is only one-tenth of a human hair... This classmate, by the way, what is your name?"
"Ling Ran." Ling Ran replied.
"Don't like talking?"
"good."
"I will be talkative in the future. Surgeons are always talkative when performing operations." Kang Jiuliang's appearance changed obviously during the operation and before the operation.
Ling Ran said "Oh".
Kang Jiuliang couldn't hold it back and said, "Aren't you curious why?"
"Because it's boring." Ling Ran replied.
The interns laughed softly.
Kang Jiuliang was stunned for a moment and asked: "Is the question I asked too boring?"
"It's because the surgeon is so bored when he's operating."
"Indeed, surgery takes a long time and is really boring. When we do a hand surgery, it often lasts ten or twenty hours. Even if you don't want to talk, the people next to you also want to talk." Kang Jiuliang said.
Again struggling with Ling Ran's pun, he was talking and operating at the same time, as if the two of them were not interfering.
At least in the eyes of the interns, the rhythm in Kang Jiuliang's hands is completely different from the rhythm in his mouth.
The saying goes that practice makes perfect, or so it goes.
Ling Ran was also familiar with the details of Kang Jiuliang's operation in his mind.
The docking and rejoining of the tail of a white rat is, in the final analysis, a vascular anastomosis.
To suture the disconnected blood vessels, six to eight stitches are needed on the small blood vessel cross-sections to ensure smooth blood flow without obstruction or leakage.
During the suturing process, care must be taken not to create any cavities or dead spaces.
To say how skilled a surgeon is, it actually depends on these specific and subtle concerns.
For example, after two or three years of training, surgeons in hand surgery can always reattach the tail. However, whether it can be used as usual after surgery, whether there is dull pain or even complications, depends not only on the condition of the rat itself, but also on whether it can be used as usual after the operation.
Surgeon's operations.
In short, it is not easy to sew, and even more difficult to sew well.
"Do you recognize the suture method I used?" Kang Jiuliang said to himself out of boredom and asked Ling Ran directly.
"It's just interrupted suturing." Ling Ran didn't say much.
"Are you familiar with it?" Kang Jiuliang asked, but he answered the question by himself: "You should be familiar with it. This is the most commonly used and simplest suture method, also called nodule suture, right? Just one stitch for each stitch.
Jie, when I was practicing in school, this is what I practiced most, what about you?"
"Almost." Ling Ran still answered concisely and concisely. He looked at Kang Jiuliang's operation, his mind was full of information, and he didn't want to chat at all.
"Okay, I'll give you a try." Kang Jiuliang suddenly felt a little unhappy. I'm very busy, sir. I worked so hard to demonstrate to you, but I can't even chat with you.
He originally wanted to perform a few more anastomoses to familiarize Ling Ran, but now that he had finished one vascular anastomosis, he simply let it go.
Ling Ran was stunned for a moment, but without thinking much, he said "Okay" and grabbed the needle holder.
Kang Jiuliang's eyes never left the eyepiece, but at this moment he couldn't help but raise his head and glance at Ling Ran.
As the saying goes, an expert will know if something is wrong as soon as he makes a move. For microsurgery, picking up the needle holder and keeping your hands steady is the basis for getting started.
In order to sew eight stitches on a blood vessel with a diameter of 0.5 centimeters, the suture needle they used was only one-fifth of the thickness of a hair. When an ordinary person holds the needle holder, the needle tip at the front will tremble continuously.
Its amplitude is so large that under a microscope, it looks like it is dancing.
In fact, any doctor who has not specially practiced microsurgery will feel dizzy when he picks up the needle holder used under the microscope, and has to hold it for a long time to practice.
Some doctors even lift and swell their arms in order to practice acupuncture.
As for medical students…
Kang Jiuliang couldn't help but ask: "You, Yunhua University School of Medicine, are still practicing microsurgery?"
"I run a small clinic at home." Ling Ran told the lie he had made up, and the needle under the microscope pointed at the small blood vessels in the tail of the white mouse.
Kang Jiuliang quickly focused his attention, but saw that the blood vessels in the tail of the white rat were motionless under the microscope.
Kang Jiuliang couldn't help but raise his eyebrows.
Under the microscope, the blood vessels did not tremble at all, indicating that they were not stretched at all. This is not a basic requirement, but a very advanced level.
In order to practice this technique, some doctors will put foam in a basin and then sew and tie knots on the foam. The goal is to prevent the foam from moving at all.
The same is true for suturing a severed finger. If the suturing is done at this level, both the recovery ability and the future function of the finger will be much stronger.
Suddenly, the suturing of an anastomotic point was completed.
Kang Jiuliang didn't even notice the specific time. His only judgment was that he was at least faster than himself.
Thinking of this, Kang Jiuliang quickly looked at the vascular anastomoses under the microscope. He saw that the exposed knots were quite consistent. From the appearance alone, they were pleasing to the eye, and there was no possibility of false knots.
class error.
This is textbook suturing and knotting of blood vessels, and there is absolutely no fault at all.
Chapter completed!