The road to the rise of great doctors

Chapter 88 Mysteries (Please collect and read)

"Liu Dong, our group depends on you. I heard Teacher Zhang Wei praise you several times, and I also heard your classmates talk about you when chatting. You have performed so well in other departments, so you can't relax when you come here. "

After checking the room, after the two senior professionals left, Zhao Gang smiled and said to Liu Dong.

"You have to learn more from Teacher Zhao. If you point to the east, I will never point to the west." When Liu Dong heard Zhao Gang's slightly joking words, he deliberately put on a funny look.

Not only was he not unhappy, he was actually a little happy.As an intern, his biggest worry is not that the workload is heavy, but that the teaching teacher will not let go, or that the medical team leader will take a vacation, which will almost shut down the team and waste one month of internship time, which will make him feel distressed.

How can we label our green years as boring and okay!
They returned to the office, and within a short while, Zhao Gang had finished giving all the medical orders.Liu Dong also read the key points of all the medical records of the group and took notes, clearly identifying the indicators that need attention at present and the next diagnosis and treatment plan.

Zhao Gang made a call to the outpatient surgery room and learned that the scheduled outpatient surgery patients had already reported at the nurse station.He called Liu Dong and arrived at the outpatient operating room of the general surgery department.

"The common outpatient surgeries in our department are mainly biopsies of body surface tumors or suspected cancer. Today's appointments are all for resection of body surface tumors."

Body surface tumors are common and frequently-occurring diseases in surgery.They are mainly tumors originating from superficial soft tissues such as skin, skin appendages, and subcutaneous tissue.

The main types of body surface tumors include: lipoma, seboma, fibroma, neurofibroma, hemangioma, nevus, etc.The main treatment method is surgical resection.The most common one is lipoma.

Both Zhao Gang and Liu Dong put on masks and surgical caps.

Lay a layer of clean disposable drapes on the operating bed, then prepare syringes, normal saline and local anesthetic lidocaine, take a few incision bags according to the number of patients planned for surgery, and then put the electrosurgical equipment and lights on All ready.

Zhao Gang walked to the door of the consulting room and called the first person's name several times.

After a while, a young man with a slightly green face walked over from the waiting area, knocked on the door, and then came in.

"What's your name?" Liu Dong took the initiative to pick up the list, asked the person's name first, and took the outpatient medical record from that person's hand.After hearing the reply, he turned to Zhao Gang and said, "The patient has been checked correctly. This is the first patient in the appointment."

I took out the informed consent form for the operation and briefly explained the operation process to the patient, as well as possible risks and treatment plans, as well as the approximate time for pathology to be taken over.After the patient signs, he is guided to lie down on the operating bed.

Why don't you lie down on your back instead of lying on the bed?

Because this tumor is on the back!
Instruct the patient to remove the top himself and place it on the side of his head.

The difficulty of this operation is similar to that of circumcision. Liu Dong had reviewed "General Surgery" and watched many videos before.Combined with the experience honed in surgery, he is confident for this level of surgery.

Therefore, while the patient was getting ready, Liu Dong opened the first layer of the incision bag by himself without waiting for Zhao Gang's instructions, and then used the long pliers next to him to open the inner layer of the incision bag.Next, open the syringe, gauze, sutures and other necessary items and pour them into the incision bag.

Use long pliers to take out the sterilization bowl, then open the amriodine for skin disinfection and pour it into the bowl.

At this time, Zhao Gang was writing outpatient medical records. He looked up at Liu Dong's operation, nodded, and said nothing.

After Liu Dong was ready, he said, "Dr. Zhao, I'm ready to disinfect."

"Okay, you need to disinfect and spread the towel first."

After Liu Dong heard this, he glanced at the patient's back. The swelling on the body surface was relatively obvious, slightly protruding from the body surface.But he still touched it with his hand and judged the approximate range.

Then, put on sterile gloves, use a cotton ball soaked with amriodine in the sterilization bowl, and perform sterilization 2-3 times according to the aseptic method. "It's a little cool, which is the temperature of the disinfectant. Don't worry, Normal operation." Before the operation, Liu Dong also said briefly to the patient.Seeing that the patient was relatively emotionally stable, he continued the operation.

After disinfection, a draping is placed around the tumor on the body surface to be operated on.

Then, use a syringe to draw physiological saline and lidocaine and dilute them in a certain ratio.Yes, saline and lidocaine, Liu Dong had already opened them before preparing for disinfection.

Yes, he can break open a glass ampoule containing lidocaine very skillfully.

In clinical practice, he often saw some nurses with band-aids wrapped around their hands. At that time, he began to pay attention to what caused the injury.After chatting and discussing, I learned that there are a lot of glass ampoules that need to be opened when dispensing liquids. Some of them are well set, and some cannot be opened due to manufacturing process problems and can only be opened with pliers. , and if you are inexperienced and use too much force, you will crush the glass and directly puncture your hand.

Therefore, he often brings some food, drinks, fruits and so on.Then when the faces became familiar, I went to ask for advice on how to break them apart quickly and accurately?After a few operations, I got the hang of it. Not only did I learn how to judge which items were basically impossible to break apart, but I also learned how to break apart standard items without hurting my hands.

After mastering it, I gained envious looks and private inquiries from my classmates, and gained a lot of reputation.

After he prepared the anesthetic, Zhao Gang also put on sterile gloves and went on stage.

Liu Dong saw that Zhao Gang didn't take over, and thought that this might be Zhao Gang's test. He was weighing his level.
Therefore, without any hesitation, I first made a skin pit on the surface of the skin, then inserted the needle and pulled it back first, showing that no blood vessels were tied, and then gradually carried out local infiltration anesthesia.After waiting for a few minutes for the medicine to take effect, the patient did not feel any obvious pain.

Just on the surface of the body surface mass, an incision was made along the long axis of the mass.Gradually cut until the capsule of the tumor is cut, and then use fingers and hemostats to alternately make blunt dissection along the outside of this capsule.

"When separating, the force must be controlled well, and the separation should be along the entire outside of the capsule without breaking it." Zhao Gang felt a little relieved when he saw that Liu Dong was still relatively skillful in the operation.But in the end, he still gave the instructions, and Quan Zhi stared closely at Liu Dong's operations. As long as there was the slightest sign of an accident, he planned to take over.

Liu Dong nodded after hearing this. He knew that Zhao Gang was doing it for his own good. "Most of the most common lipomas are lobulated and irregular in shape, so the separation should be done bluntly rather than sharply. The purpose is to remove it completely and not leave any residue to prevent it from getting bigger in the future. In addition, we are also worried that if it is malignant, If it is broken, it will grow and relapse." Liu Dong recalled the description he saw.

He separated it bit by bit, and after almost separating the surrounding areas, he used tissue forceps to lift the tumor and separate the base.This will completely cut it off.

Use gauze to soak it dry, find the bleeding point and tie it to stop the bleeding.The subcutaneous tissue and skin are then sutured layer by layer.

After disinfecting the skin with alcohol again, wrap it with sterile gauze.The operation is over.

Put the excised tissue into a specimen bag and soak it in formalin.

Liu Dong put these things and the filled-in pathology forms into a special cabinet in the operating room. After everything is done, the field staff will take them away and send them to the pathology department for examination.

After the patient got up, he expressed his gratitude to Liu Dong and Zhao Gang. Except for a slight pain during the anesthesia, he basically felt no pain afterwards.And I felt that the two doctors were more patient, and his nervousness became calmer.

At this time, a shiny dumpling appeared on the pathology bag. Liu Dong touched the dumpling lightly, and a system prompt flashed in front of his eyes:

Wang Yi's gift: Proficient swimming - In the small river in the village, Wang Yi learned to swim without any instruction from his friends, and he was very good at it. He even used his swimming skills to save another friend. .After entering college, he found that swimming, which he was best at, could obtain a national-level athlete certificate, and he could use this to coach and train children to earn tuition fees.His swimming skills were mainly based on the dog-cut style at first, but later he also learned various swimming styles, and now he is proficient in all kinds of swimming styles.This was his first surgery and his first time seeing a doctor by himself. He was originally very nervous after seeing the comments on the Internet, but after it was actually completed, it was successfully completed.Under the emotional turmoil, I felt a deep sense of gratitude to the surgeon, so I made this gift.

Liu Dong sighed deeply.

It turns out that I received so few gifts. Is it because I was an assistant most of the time? !If I can do more, let patients experience the warmth of medicine, which is also the essence of "great medicine".

(End of this chapter)