The road to the rise of great doctors

Chapter 39 New Skills

Liu Dong sat on the chair and savored his newly acquired skills.

Ultrasound diagnosis is different from suturing, which is a basic skill that almost every surgeon must master.Even some physicians are more or less skilled in suturing techniques.However, this basic skill has a characteristic, that is, it is quick to learn, but easy to learn and difficult to master. Once you dig into the details, the difficulty and requirements increase exponentially.

For example, ordinary surgeons must master the suturing skills. The commonly used suture objects are surgical incisions, and the suturing method is simple suturing.For facial suturing or the kind of suturing where you want the scars left after suturing to be less obvious, plastic surgeons are the specialty, in addition to doctors who have specialized in it.Also, for complex situations, suturing that requires tension reduction also requires certain skills and experience.In addition to learning, it also requires a lot of practice and thinking about how to apply it flexibly during clinical work.

The difference between ultrasonic diagnosis and suturing is that this is a basic skill in the imaging department or ultrasonic department, and it is not something that surgeons must learn.However, when surgeons learn to use ultrasound, it is like having an extra pair of eyes, which is even more powerful when performing operations or surgeries on dangerous parts that require image guidance.

While others are still fearfully performing blind punctures, with the assistance of ultrasound, surgeons can become more targeted.When others are worried about penetrating blood vessels or damaging certain organs, and cautiously call and beg the sonographer to come to the bedside to assist, if the surgeon knows how to perform ultrasound, these troubles can be saved, and even disagreements between the two can be avoided. If there is a discrepancy or different understanding, one person will have the effect of "2 (a surgeon who understands ultrasound, possessing two skills) > 1 + 1 (1 surgeon + 1 ultrasound doctor)".

Of course, routine diagnostic ultrasound examinations still need to be performed by the ultrasonography department.

Therefore, at work, sometimes when the east is not bright, maybe if you expand horizontally, the west may be bright.

In clinical practice, when the improvement of certain skills has temporarily reached a bottleneck, or when it is necessary to rely on proficiency to improve weakly, appropriately broadening parallel skills can be a matter of small investment and large benefits.

Liu Dong used to be a clinical medical student, and his imaging examinations were all at the textbook level. He also read some X-rays and computed tomography films during class and internship. However, for ultrasound, he only stayed at the level of being able to interpret reports. Entry level.

During his internship in the Department of Urology, Liu Dong was limited in what he could do for some surgeries, and he was stuck at the stage of preparing and handing things over.

The newly acquired skills gave Liu Dong great confidence.

"What are you thinking about?" Doctor Zhou touched Liu Dong for a while, and then said: "At this point, it is generally relatively peaceful. I can just continue on duty alone. Why don't you go back and rest? You can also rest in the duty room. …”

"Well, thank you for your hard work. I have to continue working tomorrow, so I'll just take a nap in the duty room. If you need anything, you can call me." Liu Dong stood up, said something, and walked out.

The little nurse said with emotion: "Dr. Liu is really hardworking. There are not many young people who are so hardworking, and they are so handsome!"

Dr. Zhou rolled his eyes and said with an affirmative tone: "Yes, Xiao Liu is really rare. Now some graduate students are still complaining about insufficient subsidies and not many opportunities, so they are just waiting to teach them, but they don't even think about it. If he doesn’t perform well and doesn’t work hard, who will let him go and take responsibility for him.”

Early the next morning, Liu Dong woke up and looked at the time. It was exactly 6 o'clock.I slept in the duty room. Although I fell asleep quickly, the duty room and the observation room were right next to each other. There were always different sounds coming to my ears when I was sleeping, as if someone was talking in my ears. I didn't sleep well. .In addition, the bed was a bit soft, and my waist felt sore when I woke up.When I walked to the emergency surgery clinic, I saw that Dr. Zhou had just seen a patient.Liu Dong walked up to him and said hello, and then prepared to leave. He planned to buy some breakfast and go home to simply wash up.

When he got home, Li Xiao was already awake.

The two of them had breakfast quietly together, and then hurried back to the hospital. When Liu Dong arrived at the department, his shift was almost over.Fortunately, there is nothing special to deal with.

After taking a quick look at the patients in charge, he returned to the shift room. Seeing that other students also looked tired, he was still a little curious.But time was limited and it was too late to ask.

Through today's shift, he learned that there are two types of surgeries that require ultrasound assistance.He was also a little excited after acquiring new skills.Although the limited area is the abdomen, the principle of ultrasound is the same. Other parts are also rough and have not reached the proficiency level.

The first urology surgery that requires ultrasound is for complex renal stones, which is required during percutaneous nephrolithotomy.To perform this operation, you need to have adequate hydrops in the renal pelvis. Then, after ultrasonic positioning, you can gradually puncture from the skin to the hydrophilic renal pelvis. Then, after expanding the channel, insert the nephroscope and other operating equipment, and then break the stones and flush them out.Ultrasound is very important for localization.

The second type of surgery in urology that requires ultrasound is needle biopsy to collect pathological tissue. Among them, prostate needle biopsy is the most commonly used.Under the guidance of ultrasound, the organ or tissue where the tumor is suspected is punctured, and then the tissue is obtained through the puncture needle, and then sent to the pathology department for examination to confirm the diagnosis.Once the diagnosis is made, a treatment plan will be formulated.

Today, Deputy Chief Physician Wang Peng received four new patients suspected of prostate cancer in the outpatient clinic, all of whom are men over 4 years old and will undergo needle biopsy operations.

Liu Dong was very familiar with their medical histories, but he had not acquired ultrasound examination skills before, so he expected to have to watch the surgeon do it, but to be honest, he couldn't understand it.

Now that he has acquired the skills of ultrasound examination, he feels very motivated and wants to do it quickly and verify the practical results of the new skills.

After finishing his shift, Liu Dong began to bring patients scheduled for prostate biopsy to the operating room.At present, due to the development of sub-specialties, such surgeries are all performed by Professor Zhang, who specializes in urological ultrasound. He performs calculus and prostate cancer biopsy.

This kind of surgery is not very difficult and can be performed by doctors with a little training, even without ultrasound. However, there are still certain methods to achieve the goal of not missing anything and causing less damage.

Prostate cancer is one of the most common malignant tumors of the male urinary system, and its incidence rate ranks second among male malignant tumors.As mentioned before, this disease has a certain relationship with genetics, and it is one of the diseases for early screening of cancer in male physical examinations.

Under what circumstances is it suspected to have this disease?There are several main situations, all of which are related to early cancer screening.For men with difficulty urinating, if they are over 50 years old, it is generally recommended to do an ultrasound of the urinary system, a serum test for prostate-specific antigen, and a digital anal examination. If any of these items is suspicious, prostate cancer should be suspected. of.If cancer is suspected, further confirmation is needed.

(End of this chapter)