I run a clinic in the United States

Chapter 58 "Mount Everest" in General Surgery

On the hillside of Mission Peak, a luxurious manor, and an equestrian training ground.

Luo Ya was wearing a black sportswear and was holding a "pearl white" horse that was very sweaty.

She was originally going to go horse riding, but she immediately called Zhou Qiao after receiving the news!
Hearing that Zhou Qiao was full of confidence at this time, he felt a little relieved.

After all, she had seen Zhou Qiao's medical skills before, and they were extremely miraculous. She couldn't even see her serious injuries now!
And after recovering, it didn't affect the flexibility of her hands at all!Shooting a gun, pulling the reins, or even playing the piano, all feel nothing out of the ordinary.

"If it's really difficult, it's probably something on the license."

Loya pondered for a while, then called several familiar members of the California Senate one by one, mentioned the incident a little bit, and the other party said that they would go to ask.And let her rest assured that such a small matter, don't worry about it.

After Luo Ya hung up the phone, she couldn't help but smile wryly. She was not so powerful in her previous status, and she never thought that even a member of parliament could do whatever she wanted now.It's a bit hard to want to go back!

After making the call, looking at the green pasture and the clear sky, Luo Ya couldn't help but feel happy and waved to the distance. Black Scorpion immediately ran over on horseback and shouted: "Head!" Son, what are your orders?"

He is riding a bay red horse, which is also a tall and handsome horse, but it is far worse than Luo Ya's "pearl white"!

If Zhou Qiao was here, he would definitely exclaim: "Fuck, Zhaoye Jade Lion!"

In the Tang Dynasty, there was a painter named Han Gan who painted a picture of "White Night Illumination". The two Dawan horses are all white, without any variegation. They run at night and can reflect the surroundings as brightly as snow.

Of course, this kind of horse is not suitable for fighting, but only for acting.If you ride on the battlefield, you will only become a target.

Roya got on the horse and said, "Let the people below keep an eye on that Kainzi, and report immediately if there is any situation."

"Got it!" Black Scorpion thought for a while, and couldn't help but make a gesture to wipe his throat, and asked, "Boss, do you want to kill that bald man?"

Roya waved her hand, killing him now is too obvious, and it is easy for people to connect the two things.

"Look at it first!" Luo Ya waved her hand lightly, but she was very helpless in her heart. These gangsters know how to fight and kill all day long.

She doesn't have any psychological burden to kill gangsters, black people eat black people, but wanton killing civilians?It may affect her in the future, unless it is made airtight.

However, you can't kill them, but you can teach them a lesson.

……

At one o'clock in the afternoon, the community hospital, operating room No. 1, is ready for work.

In the corner of the operating room, the Bose sound system hanging on the wall started playing soothing music, Insecurity by Scars On 45.

This song was chosen by Ava to ease the tension during the operation.

There are hundreds of music to choose from in the music library, including passionate rock music, but Ava prefers this ballad.

The surgery was naturally performed by Zhou Qiao, instrument nurse Elena, traveling nurse Ava, and anesthesiologist Nancy. In addition, there were two experts from the medical committee, Professor Eric Pasent and Dr. Sam.

Of course, Professor Parsons and Dr. Sam will only watch and will not intervene.

In other words, the operation was basically completed by Zhou Qiao alone!
For such a major operation, it is not allowed to have four, five, or even more surgical assistants in China, but in the United States, due to the high cost of labor, no matter how major the operation is, there are at most one or two assistants.

Zhou Qiao is more miserable and doesn’t have an assistant!

However, it didn't bother him.

Another reason is that Americans have invented many auxiliary devices that are convenient for one person to operate, such as retractors.

A super complicated hook, the kind with seven or eight "claws" on one pole!

After all, it is a foreign country, so it is very different from China. For example, when you first enter the door, there is usually an aunt in the domestic operating room (the intern students call it the "door god") who is responsible for delivering clothes, but in the United States, taking The hand washing clothes are fully automatic, just like a vending machine. You can swipe your card and choose the size that suits you. The size of the jacket and pants can be combined in different ways, and then it will pop out by itself.

All because there are few Americans.

Its effective land area and arable land area are both larger than those of China, but its population is only over 3 million!Therefore, the United States is a big agricultural country, and China imports a large amount of grain from the United States every year.

Many people think that China is a big agricultural country. We are not as good as the United States in terms of science and technology. Can't we be crushed in agriculture?
However, the real situation is not the case, just look at the annual Sino-US trade surplus.

The United States not only has a superior geographical location, but its homeland is also relatively safe. It was almost unaffected by World War I and World War II, unlike China, which was surrounded by wolves.

Of course, this kind of geography can be bullied when it is weak, but in its heyday, when all nations come to court, all the younger brothers gather around, and various interests are projected, it is easy to form a powerful alliance!

This is not comparable to the "isolation overseas" of the United States.

Several other members of the medical committee, as well as Kainz, the owner of the Red-headed Gull Clinic, were watching the "live broadcast" in a monitoring room outside. The main reason was that the operating room was too small. pollute.

Kainds was acquainted with a member of the investigation team and was also a whistleblower. He had the cheek to follow, and everyone did not chase him away.Anyway, it won't affect the investigation.

Mr. Clark was holding a cup of coffee in the waiting area, and there was also music playing.

This is similar to the airport waiting area. The coffee is free and you can refill it at will.

Mr. Clark was so nervous that he drank several cups of coffee within a few minutes of sitting down.

Normally, he can drink a cup for ten minutes, and no more than five cups a day, but today, from morning to now, he has already had seventeen cups!I guess I won't be able to sleep well at night.

It doesn't matter if you can't sleep. Anyway, Mrs. Clark needs someone to take care of her after the operation.

Pancreatic cancer is a very dangerous malignant tumor, and its treatment is different from that of benign tumors.

If it is located at the tail of the pancreas, the body and tail of the pancreas, the invaded blood vessels, and the spleen need to be removed. If it is located at the head of the pancreas, pancreatoduodenectomy is required.

Mrs. Clark belongs to the latter category.

What Zhou Qiao is going to do today is "Total Laparoscopic Pancreatoduodenectomy", which can be called "Mount Everest" in general surgery.

The operation is difficult and risky. It requires not only dissection and resection of multiple organs around the important blood vessels of the internal organs, but also high-quality reconstruction of the digestive tract, such as pancreaticojejunostomy, bile duct jejunostomy, gastrojejunostomy...

Especially "pancreaticojejunostomy", which is called "the kiss of death" by surgeons, is the main source of surgical complications.

Compared with conventional pancreaticoduodenectomy, radical resection of pancreatic head cancer is more difficult.

Aseptic inflammation or vascular invasion around the tumor leads to the disappearance of vascular anatomical gaps, and a little carelessness will lead to fatal hemorrhage, which requires higher surgical skills and teamwork.

Due to the large trauma of pancreas and duodenectomy, long operation time, and more bleeding in the operative field, anesthetist Nancy chose general anesthesia combined with epidural spinal nerve interference block.

In order to improve the patient's tolerance to anesthesia and surgery, a high-protein, high-sugar, and low-fat diet was also given before the operation, and water, electrolyte disorders, and acid-base imbalances were corrected.

Of course, for such a difficult operation, muscle relaxants and endotracheal intubation were naturally applied.

As for intraoperative monitoring of blood pressure, heart rate (law), SPO2, PETCO2, CVP, invasive arterial pressure, urine output, body temperature, etc., they are all due meanings and will not be detailed one by one.

In addition, because the pancreatic enzyme in the patient's body can decompose fat into fatty acids and react with calcium ions in the blood to saponify, it may lead to hypocalcemia, so calcium supplements need to be supplemented during the operation according to the situation.

"Dr. Zhou, the anesthesia is ready!" Nancy glanced at Zhou Qiao and said loudly.

She never expected that Zhou Qiao, at such a young age, would be able to perform such a difficult operation by himself.

Regardless of whether it can be done or not, she feels that Zhou Qiao's courage is very good!

Moreover, she observed Zhou Qiao secretly, and only felt that Zhou Qiao was calm and confident, and most likely he was competent!
What's more, there are two "big bosses" from the University of California School of Medicine and Stanford University Health Care who are "observing" and "supervising"!
Nancy felt that if she changed herself, she would probably be so nervous by now that her heart would jump like a deer!

Zhou Qiao nodded and called out "Ava, Time Out!"

Ava immediately cheered up and reported the patient's basic information, name, planned operation, position, etc., with a crisp voice like pearls falling into the plate.

After she finished speaking, Nancy the anesthetist immediately picked up.

Afterwards, Elena picked up, her voice was exactly the same as Ava's. If they weren't in different positions, they would have thought it was the same person reporting.

Finally, Zhou Qiao came again!
The information said by several people was exactly the same, and the operation officially started!
(End of this chapter)