In the operating room of hand surgery, senior resident doctor Hou Kang introduced the situation to Ling Ran and his group in a low voice: "The patient is a skilled worker on the assembly line. During the maintenance of the equipment, the thumb of his right hand was crushed. The patient was originally sent to the local county. After the hospital was transferred to our hospital, the consultation in the department believed that thumb reconstruction was the most suitable for the patient, and it was also recognized by the patient and family members."
After Hou Kang introduced it here, he looked at Ling Ran again, and saw that he had no opinion, and continued: "I think the first toe of the right foot is the most suitable for thumb reconstruction surgery. Now the patient is being debrided in the operating room. Doctor Ling, your task is to amputate the first toe of the right foot..."
Ling Ran nodded. For such a major operation, two or three groups of people are often used. It is normal to assign him debridement or amputation.
For Ling Ran, who had never undergone thumb reconstruction surgery, as long as he could enter the operating table, he would be satisfied.
Wang Haiyang's thoughts are somewhat unpredictable.
To put it bluntly, thumb reconstruction surgery is quite rare for Yunhua Hand Surgery. It may only happen once in a few months. There should be many doctors who are willing to come on stage.
However, things in hospitals have always been complicated, and it is common for people to smell far and near.
After Wang Haiyang entered the operating room, he even ordered: "Ling Ran, check the operating room to see if there is anything missing, or what equipment you want, and let them fill it up as soon as possible."
This degree of recognition is relatively high, and several hand surgeons have come to see it.
Ling Ran didn't care about it, and asked first: "Generally, thumb reconstruction is done, and the second toe is usually amputated. What about this patient?"
"Small feet." Wang Haiyang, who was standing in the operating room waiting for the drape to be laid, gave an extremely simple and practical answer.
Ling Ran deliberately stood there for half a minute, and when the nurses finished spreading the drape and exposed the surgical surface, he saw the patient's tiny feet. Maybe it won't be the 37th, maybe it won't even be the 36th.
Comparing with his hands, they are the big hands of common rough blue-collar workers.
Lu Wenbin, who was also undergoing this operation for the first time, took advantage of being a junior, decisively stretched out his thumb, and compared it with the patient's thumb, then compared the second toe, and then compared the patient's hand, he couldn't help: "Small feet and big hands are quite rare."
"Perhaps wearing tight shoes since childhood." Wang Haiyang had seen so much that he didn't even bother to smile.
The itinerant nurse took the opportunity to joke, "I've worn a lot of small shoes since I was a child."
"The height is not bad, but the bare feet are 1.75 meters, and the stability is not good." The doctor who was debridement hurriedly said a few words when he had the opportunity.
Hou Kang became interested when he heard it, and immediately said to the nurse: "Don't you all say that you are lavish? What should you do if you encounter such a situation?"
No matter how vulgar words are spoken from the doctor's mouth, they will become very professional.
Lu Wenbin was about to shed tears when he heard that, damn, this is the operating room he knows well. In contrast, Ling Ran's operating room was too lonely. The chief surgeon didn't even chat, so how could the assistants chat easily? The patients were also anesthetized with a laryngeal mask, and they couldn't speak a word. What is the difference between shop
Look at the operating room of other people's hand surgery, the cheerful atmosphere, full of naughty words... If doctors can go to heaven, heaven must be an operating room, with a few cute little nurses, and a few knowledgeable and interesting little ones... Doctor, and a patient under general anesthesia.
"What is Xiao Lu thinking?" Hou Kang's voice interrupted Lu Wenbin's imagination.
Lu Wenbin showed a knowing smile reflexively: "I think we should focus on the tightness of the underwear."
Hou Kang was taken aback for a moment, and couldn't help laughing out loud.
The atmosphere in the operating room is happier.
cough cough.
Wang Haiyang stood up, as if he had suddenly pressed the pause button.
Wang Haiyang looked around for a week, smiled again, nodded to everyone, and said, "To be a doctor, you should sum up your experience more, and don't follow others' advice. Let me say something first, the big thenar (the raised part from the base of the thumb to the base of the palm) is big, b Blood type lasts a long time."
The little nurses were instantly shocked.
After a few seconds, they whispered:
"The blood type doesn't matter?"
"Thenar has a lot to do with the size of your hands."
"There is no way to test it now."
"Is there a way to test it later?"
"The size is not the same and you can't see it. Aren't you guessing happily?"
"Idiot, at least the size can be quantified. We can't see it. We can go to the urology department to ask. How do you find samples for the length of time? Do you do the statistics yourself?"
"Oh, it's disgusting."
"But... how did Director Wang sum it up?"
…
Ling Ran has always ignored the chats in the operating room.
According to Wang Haiyang's request, Ling Ran cleaned all the surgical instruments and medicines. This was originally the job of the first assistant, checking whether the things in the operating room were sufficient and suitable.
His current status is equivalent to that of a freshman.
Ling Ran was extremely serious in his work. Before the major surgery had officially started, he inspected the conventional instruments and medicines, then checked the microscopic instruments, and then looked at the electric drill and electric knife, and asked the nurse to fill up various types of Kirschner wires and The sutures, and finally the electric tourniquet and the sterile microscope cover just prepared were checked.
If it were an ordinary doctor who checked equipment so meticulously, he would curse at a nurse with a grumpy temper, but Ling Ran had never encountered a nurse with a grumpy temper, so he didn't have the corresponding consciousness.
"You can prepare a little more heparin saline." Ling Ran glanced at Yu Yuan who was waiting in the corner, and reminded him again.
He needed a second assistant today, and between Yu Yuan and Ma Yanlin, Ling Ran chose Yu Yuan without any surprise. Ma Yanlin is still a doctor trained in hand surgery, and there is always a risk of losing him when he is brought to the operating room of hand surgery. Before, he had no choice. When Yu Yuan came, he could be tied home first.
"In a while, after the debridement of the thumb stump is completed, I will make an S-shaped incision, and free the radial artery, radial nerve, and cephalic vein for backup. Ling Ran, you will make a V-shaped incision, free the arteriovenous and nerves to be used, and cut the bone , and then suture." Wang Haiyang paused, and said: "This is the first stage, and two groups of people will operate separately and cooperate to complete the work."
"good."
"yes."
The doctors are a little more serious.
"The second stage is the anastomosis of the first toe. The cephalic vein is anastomosed with the vein of the first toe, and the dorsal carpal branch of the radial artery is anastomosed with the dorsalis pedis artery..." Wang Haiyang introduced the plan carefully. There are also multiple paths for thumb reconstruction. Taking advantage of the time when the other group was doing debridement, he introduced his plan in detail.
At the end, Wang Haiyang said again: "In the second stage, I will be the main surgeon, Ling Ran will be the first assistant... Hou Kang will be the second assistant. Is there any problem?"
"Okay." Hou Kang answered with a little difficulty. He has been a resident doctor for several years, and he can be regarded as a senior doctor. He is ranked behind Ling Hou, and he is a little embarrassed. Just looking up, it seems that no one pays attention to this issue, so Hou Kang is relieved.
Ling Ran said, "I want to see the original MRI film."
"It's ready for you." Wang Haiyang answered very neatly. Everyone now knows that Ling Ran can understand MRI. Being able to understand and being able to see are naturally two concepts, and in hospitals, ordinary residents in the imaging department dare not say how well they understand MRI.
This advantage is also one of the reasons why Ling Ran has a good reputation in the surgery department. It may take several months of practice and hundreds of thousands of films to be able to watch MRI, and the requirements for understanding are higher.
Occasionally, when encountering problems with MRI, Ling Ran, who is well versed in hand surgery, can obviously provide more information, many of which the imaging department cannot provide. Such as blood vessels, tendons and other human tissues, the display under MRI is often not intuitive, and it also involves various choices when filming, and the requirements are extremely high.
Ling Ran, who has 3,000 times of hand dissection experience, master-level imaging (limbs) and perfect-level severed finger replantation, can make judgments that are often beyond the understanding of imaging professionals.
Perhaps it was because of the prerequisites of the first two that Ling Ran was able to obtain the latter technology.
"Open." Wang Haiyang twirled his fingers, and saw that one of the surgical walls was slowly lifted, revealing the big screen behind it.
Under the operation of the nurse, the patient's MRI film was quickly displayed on the big screen.
Ling Ran was a little surprised. The effect of watching movies on such a big screen is naturally better.
Wang Haiyang smiled and said, "How is it? This is our new watch... How should I say it..."
"An artifact for film reading." Hou Kang took a step forward, his tone aggravated.
Wang Haiyang nodded with satisfaction, and said, "Our hand surgery department is the core department of Yunyi. You have equipment like this, which costs one million yuan. You just need to ask, and it can be installed immediately. This is different from the emergency department." It’s the same, if you want to buy a 100,000-yuan instrument in the emergency department, you have to make a report. To be honest, if you really want it, if the time is right, it’s not impossible for us to buy an MRI machine alone.”
Ling Ran nodded while listening to the video, and asked curiously, "How did you tell Director Huo?"
When Huo Congjun was mentioned, Wang Haiyang's face turned green, he snorted again, and said, "I lent him another rehabilitation room for two months."
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