Soon, Li Min repaired the aorta and inferior vena cava quickly and effectively.
In fact, if ranked by the level of surgical institutes, Li Min's level is the worst, and his speed is also the slowest. Among training doctors, he is the tail of a crane. But in the Pacific Ocean, any fish you can find is much bigger than the biggest fish in the pond.
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The blood vessel was repaired, the large blood vessel blocking clamp was loosened, and the aorta began to pulsate. Li Min carefully checked every suture opening to see if there were any weak links. There should be no weak links in this type of suture, as weak links can easily accumulate blood pressure.
The impact force will eventually tear it apart again, causing life-threatening consequences.
After careful inspection, Li Min found that there was no weak link, but for safety reasons, he still waited for more than ten minutes before doing the following work.
Li Min performed very steadily during the entire operation. After all, he was an apprentice taught by the world's top doctors. He would not omit every surgical step and advance step by step. Although he was a little nervous, he did not feel nervous at all afterward.
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Li Min's performance completely overwhelmed Director Peng and Director Zhang. The two of them were stunned for a moment and couldn't believe their eyes. This was a doctor from a rural hospital.
The doctor at the hospital in Guandu Town next to him is also completely confused. When did Li Min become so powerful? In the past, because he was diligent and studious, his level was higher than everyone else, but he never exceeded the level of doctors in rural hospitals. Now
Li Min behaves like an expert in every move he makes. He can actually successfully perform operations that Director Peng and Director Zhang couldn't perform.
"It would be more reliable if there is an artificial blood vessel, but the objective conditions do not allow it. After repairing it, there should be no big problems. If you control your blood pressure well these days and don't make it too high, there will basically be no problems after two weeks." Li
The people ordered the doctor in charge.
The doctor in charge kept nodding, and the old director said dissatisfiedly to the doctor in charge: "Don't just listen, take a notebook and write it down. A good memory is not as good as a bad pen. What if you forget?"
The doctor in charge of the bed immediately hurriedly went to find a small book. The circulating nurse handed over a piece of paper and pen. The doctor in charge of the bed quickly recorded what Li Min said just now on this piece of paper.
"Vital signs?" Li Min asked as he glanced at the monitor to see the data. His blood pressure was a bit low, 90/54mmHg, and his heart rate was 108 beats/min. The rest was within the normal range.
This shows that the patient was obviously deficient in both blood volume and hemoglobin due to blood loss, but he just controlled the situation in time to avoid further deterioration.
"Transfuse all the remaining blood, old dean, can you think of a way to get some more blood?" Li Min could only make the best choice based on objective conditions.
Director Zhang immediately said: "Take my phone. Director He in the address book is Director He from the blood station. I'll say a few words to him and ask him to send blood quickly."
Not to mention in the medical field of the county, but also in all fields of the county, Director Zhang is a well-informed figure. He is the leader of all major bureaus. Who is not a friend of Director Zhang? Director He of the blood station is even more a good brother. Let him help rescue and deliver blood.
That was a matter of phone calls.
Sure enough, without any hesitation, Director He on the other side of the phone immediately agreed to send a special car to send blood to Guandu Hospital immediately. He also asked the man if twelve units of suspended red and twelve units of plasma were enough.
Director Zhang turned around and asked Li Min if it was enough. Li Min nodded, enough. This time, Director Zhang found the confidence and style of Nanqiao Zhang Yidao again from the matter of taking blood.
In fact, being a department director in the medical industry is not just a technical matter, it also involves a lot of human experience. No matter how good your skills are, but you don’t have good interpersonal relationships, at this moment, if a blood station director is sending blood to you, if you follow the rules,
Come on, others don't have to be so quick, don't have to send so much, and can even refuse your request. The whole county only has so much blood, so why should it be given to you here?
Humanity and sophistication are even more important in small counties. For example, if Director Zhang encounters difficulties during the operation and cannot get off the stage, he must be able to find someone who is willing and able to come to the rescue. If something goes wrong during the operation and the patient's family members make trouble, he must be able to find someone who can help him.
The person who speaks to me needs to be able to find someone who can help guide me if there is any inspection.
There is no human sophistication, only technology, which is far from enough to be a department director. Some department directors are even not very good at performing surgeries, and some do not perform surgery at all. Their main job is to deal with the human world and ensure the normal operation of the department.
Generally, blood can be prepared, and cross-matching and other tests have been done. The blood station only needs to send blood according to the original test. Township hospitals are far away from the county seat, and it is really inconvenient if a large amount of blood is needed for rescue.
However, given the patient's current condition, he could afford to wait. Li Min then ordered the anesthetist to add some colloid fluid to the patient, so that the volume could be maintained for a longer time. Fluid replenishment was actually very particular.
"Let's continue to remove the tumor!" Li Min had no intention of stopping.
There are still four units of blood that can be transfused, which is enough to support him to complete the resection of the tumor. If the tumor is not removed and the abdomen is closed now, it will actually be detrimental to the patient, because Director Zhang has already opened the surgery and the tumor itself is still bleeding.
, although the blood is not as violent as the burst of blood from a large blood vessel, but bleeding for a long time will accumulate, and eventually hemorrhage shock will occur.
It is difficult to stop bleeding from a tumor. It is better to remove the tumor to completely stop the bleeding and avoid future problems. Otherwise, you will probably go back to the ward in the middle of the night and go to the uterus for a laparotomy to stop the bleeding.
"Can the tumor be removed?" Not only Director Zhang, but Director Peng was also frightened and had just planned to give up on tumor removal.
Li Min explained the reasons for the resection, and also stated that given the patient's current condition and four units of blood support, it is feasible to remove the tumor.
The old dean was also surprised beside him. He suddenly felt that Li Min was so unfamiliar. Is this completely at the level of an expert in a big city? Why did he progress so fast? It was a bit scary.
This chapter is not over yet, please click on the next page to continue reading! You don’t know that Li Min was taught by Yang Ping personally at the Institute of Surgery, and with the resources of the Institute of Surgery, Li Min could study for a month and be able to compete with ordinary students.
A doctor's years of practice and long practice will eventually accumulate cases. For example, in a county hospital, some cases cannot be seen for several years, but when I go to Tiantan Hospital, I can see more cases in one day than the county hospital has seen in more than ten years.
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The surgeries performed by Li Min during his time at the Institute of Surgery far exceeded the types of surgeries performed by Director Zhang in the past decades. Director Zhang often repeated some cases over the decades, but Li Min was different and could be exposed to various cases.
Yang Ping's training for Li Min was also the most scientific. First, he made the theory very solid and proficient, then used a large number of experimental pigs to practice, and finally followed Yang Ping and other professors on stage. Finally, he performed some operations under Yang Ping's guidance.
The process requirements are very strict and should be advanced step by step.
"Do you have major vascular surgery for further training?"
Director Peng asked in surprise. Their hospital currently does not perform major vascular surgeries at all. With the tear of a large blood vessel just like this, the best Director Peng can do is help block the blood vessel urgently, and then use an ambulance to send it to the provincial capital, with constant blood transfusions on the way.
Whether he can be rescued in the end depends on luck. Last year, a patient with aortic dissection and tear died in the emergency department.
Li Min continued to move his hands and said: "Many patients with Marfan syndrome go to Sanbo Hospital for surgery. Professor Yang generally doesn't do large blood vessel surgeries now. They are all done by doctors below. It is not very difficult.
The team leader who leads the team doesn’t do much, it’s all the attending doctors below who do it. Professor Yang takes good care of me, so there are many opportunities for practical operations. During this period, he performed probably fifty or sixty surgeries independently.”
I have been doing surgery for decades and have never touched a major blood vessel. He actually performed fifty or sixty cases. The two directors were in awe.
"Are there many surgeries over there?"
"I can't finish it, I can't finish it at all. As long as I want to do it, I can do it 24 hours a day. I do it from 8 a.m. to 11 p.m., every day. If I hadn't been on vacation these days, I would have done it.
I will definitely be in the operating room every day now."
''If you don't perform major vascular surgery, what kind of surgery will Professor Yang do?"
''Brainstem tumors, coronary artery bypass grafting, heart and lung transplantation, extremely severe scoliosis, upper cervical spine surgery, etc. Sometimes we also perform complex tumors of the liver and pancreas, such as extracorporeal tumor resection and liver, pancreas and duodenum autotransplantation.
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These surgeries are something that the two directors would never encounter on a daily basis. They are majoring in general surgery and are very familiar with extracorporeal tumor resection and autologous organ transplantation of the liver, biliary and pancreas. Not to mention in this kind of hospital, there are only so many surgeries that can be done in the country.
Two or three.
"Have you ever seen this kind of surgery?"
''I've been a helper many times."
Director Zhang and Director Peng felt dizzy at the same time. Damn it, I have never seen this kind of surgery. Director Peng has seen this kind of surgery in papers. Director Zhang usually doesn't read journal papers. This kind of surgery is unheard of.
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"How does extracorporeal resection work?" Director Zhang was very curious.
"It means cutting out the liver, pancreas, duodenum together with the tumor, and sometimes other organs as well, cutting out the tumor completely on the stage, and then transplanting these organs back."
Director Peng explained to Director Zhang and also showed his own knowledge. Otherwise, Li Min had been the first assistant in many surgeries and he would not be able to explain it, which would be very embarrassing.
"!!!"
Director Zhang smacked his tongue. This operation removes the liver, pancreas and duodenum together. Isn’t this bigger and more difficult than combined pancreaticoduodenal resection? Not counting the autologous organ transplant later, it’s scary to think about it.
At that time, Director Zhang's mood was like that of a fish king in a pond who ran into the sea and saw a small shark.
For difficult surgeries, Yang Ping only required Li Min to be proficient in some emergency operations. Those that were not emergency operations could be transferred to higher-level hospitals. Yang Ping's training for Li Min was tailored based on his current grassroots level.
It is custom-made, so as long as it is emergency, such as major vascular surgery, Li Min must complete it independently and skillfully. Once such patients are encountered, there is not much chance of transportation.
Times are changing so fast. Director Zhang remembers that he was secretly happy when he was able to treat appendicitis when he was a trainee. He had to show off for a while among his classmates. Nowadays, trainees are even required to undergo major vascular surgery. This is really not the same era.
Isn't it said that the current medical environment is poor, and all the trainees are just doing odd jobs, with little opportunity to get started? It seems that the rumors are just rumors and cannot be believed.
Li Min is not impatient or impatient about the separation of tumors. He completely follows the knowledge and skills he has learned in daily training, or many things have become a habit. He must have theory and practice, and he is still very confident in his heart.
"This kind of tumor is rich in blood vessels. The blood vessels connected to it must be cut off and ligated one by one to completely remove the tumor. Because of the invasive adhesions, this kind of surgery is difficult to do. You must make a plan based on the CT pictures before the surgery, otherwise
Very passive." Li Min said while doing it.
Director Peng and Director Zhang kept nodding. When it comes to reading CT and MRI pictures, they only know a little bit about the basic skills. They usually read them in conjunction with the report. It is difficult for them to make complete and accurate judgments independently without the report.
"Is it possible to perform surgery on tumors?" Director Zhang was very curious.
Li Min said frankly: "Generally, you can't come across this kind of oncology surgery institute that is not very complicated, but you can come across many in the general surgery department. They take good care of me and are willing to give me opportunities to practice. The general surgery department is also willing to let me learn from operations.
Chance."
After just speaking, Li Min felt that his words were inappropriate and might be a bit hurtful. However, he definitely did not intend to hurt other people's dignity. He just answered the questions truthfully and answered the questions while performing the operation. Naturally, every word was not thought through.
It is your true expression.
This chapter is not finished yet, please click on the next page to continue reading the exciting content! "How is your level at Sanbo Hospital? You are probably better than those doctors, right?" Director Zhang has always looked down on those young doctors with high academic qualifications.
They think that they started late and are just good at theory.
Li Min shook his head: "The doctors at the Institute of Surgery are all Ph.D.s. How can I compare with them? I don't know how far behind they are. If they hadn't been patient enough to teach me, I wouldn't have been able to perform these surgeries."
Those doctors are so powerful. Li Min's current level is already good enough. Those doctors are better than Li Min. Professor Yang is even better than those doctors. He is the teacher of those doctors. So what level is Professor Yang, the level of a god?
If they hadn't witnessed Li Min's surgery with their own eyes, the two directors would have thought that Li Min was bragging. Now that Li Min's level is here, you have to believe it even if you don't believe it.
"What other surgeries can you perform?" Director Zhang asked.
Li Min thought for a while: "I know all the basic operations of general surgery. I can't do combined pancreaticoduodenectomy, organ transplantation, etc. right now. The other problems are not big."
When the old director saw that Li Min was at this level, he was very happy. Oh, sending him out for further study is still rewarding. No wonder Xiao Lizi insisted on going to Sanbo Hospital for further study. This hospital is a low-key treasure hospital.
"Doctor Li, old director! Let's go eat fish together later. The fish I caught that grazed in the reservoir are fresh. The chefs at the farmhouse next to the reservoir are very good at cooking fish." Director Peng invited Li Min.
Director Zhang also said: "Yes, let's go eat fish together and have a good chat later. Doctor Li, when you come back from further studies, you will be Nanqiao Li Yidao."
It seems that the name Zhang Yidao may not be saved. The waves behind the Yangtze River push the waves ahead. From now on, the territory of Nanqiao will be Li Yidao's world. Director Zhang can't help but feel a bit sad like a hero changing hands at the end of his life.