While the people in the previous group were doing debridement, Ling Ran stood in front of the screen reading the pictures with his arms folded and his arms folded.
Lu Wenbin was doing work like disinfecting patients' toes, and Yu Yuan accompanied Ling Ran, acting as a humanoid remote control for him.
Ling Ran was watching the MRI film, and Yu Yuan was also silently.
She had studied imaging seriously, and her level of magnetic resonance is not weak. At this time, she couldn't help but want to make some suggestions.
Yu Yuan paid attention to Ling Ran's expression, guessed his opinion, then let out a light breath, and was about to speak...
"Okay, turn it off." Ling Ran finished watching the film and returned to the operating position.
Yu Yuan froze for a moment, then turned off the big screen helplessly, then put the remote control back to its original place, and walked to Ling Ran's side by herself.
"Go and wash your hands." Ling Ran's tone was tepid, but Yu Yuan was so frightened that she almost fell down.
Several doctors in the operating room looked at Yu Yuan strangely.
As far as today's operation is concerned, senior resident doctor Hou Kang was lucky to come in. No one would have thought that someone would need to be reminded to wash their hands.
Yu Yuan blushed and left the operating room to wash her hands. The hands that touched the remote control must be washed again. She remembered it at the beginning, but then forgot.
After Ling Ran had drawn the line and picked up the scalpel, Yu Yuan returned in a hurry.
"Doctor Ling is so nice. He is willing to bring students to see the world for such an operation." The nurse chatted quietly, the voice was so loud that the operating room could be heard.
Yu Yuan became more and more embarrassed.
It's not that she doesn't understand these things. Her master's thesis even said that she was infected in the hospital, and she even published the SCI of the first district.
However, her practical experience is really little, and she didn't get many opportunities after arriving in the hospital. Speaking of it, she is not as good as other residents who have been in the hospital for three years and stayed in the same group...
"Gauze." Ling Ran's order came from beside his ears, which woke up the second assistant, Yu Yuan.
"Stop the bleeding."
"Give me another piece of gauze."
"Sucked."
Ling Ran's orders came one after another. Amputation is a super weakened version of replantation of severed fingers. Although the most troublesome anastomosis of blood vessels and nerves is no longer necessary, the blood and nerves must be managed and dealt with one by one.
For Ling Ran at this time, amputation was an easy task. Lu Wenbin could already cooperate with ease, so the demands on Yu Yuan were even lower.
Yu Yuan lowered her head to do things, and slowly regained a little confidence.
"What do you think?" Ling Ran glanced at Yu Yuan during the operation.
Yu Yuan thought about it for a few seconds before blurting out, "The patient's first toe is already deformed. According to the MRI, it would be better to perform some joint release after the osteotomy."
This word has been held back in her heart since she watched the MRI film.
At this time, I took the risk to say it, and suddenly felt a burst of relief.
Lu Wenbin looked at Yu Yuan in surprise, and thought: You are quite courageous.
The joint release mentioned by Yu Yuan is a separate step, which means that it puts forward further requirements for the operation method, increases the complexity of the operation method, and also increases the risk of the operation in a disguised form. Most importantly, the operation The steps have already been drawn up by Director Wang Haiyang, and adding them rashly is tantamount to challenging the authority.
When encountering a doctor with authority over the parents, with just one word, a small resident doctor may be classified as a separate book.
Of course, Wang Haiyang is not the chief physician of the department, and Yu Yuan's behavior is just bold.
Ling Ran gave an "en" without agreeing or disapproving.
He also arrived at the information displayed by the MRI. From this point of view, Yu Yuan does have the ability to read images, which can be said to be commendable.
However, Ling Ran is already a skilled surgeon. Now that he encounters such incomplete cases with certain indications for surgery, he no longer makes judgments based only on the image data. He will first think like a surgeon: Be good, let me open it and have a look.
Therefore, Ling Ran completed the amputation first, and then observed the exposed joints to confirm that the MRI scans were correct, before saying, "Director Wang, I'm going to loosen the soft tissue around the first toe extensively."
"Okay." Wang Haiyang hurriedly searched for the blood vessel without raising his head, and he answered straight away. His trust in Ling Ran can be said to be extremely high.
Ling Ran followed the amputation wound and performed arthrodesis.
Compared with the surgical procedures sent directly by the system, such as the tang method and the replantation of severed fingers, Ling Ran did not directly obtain joint release surgery. However, the joint release book is only a first-level surgery in orthopedics, and it is the lowest in terms of difficulty and complexity. Ling Ran can play according to the operation instructions in the most common books, plus 3000 times of dissection experience. with ease.
Surgeons are like this. It is normal to continue to perform a certain operation. However, when a surgeon inadvertently encounters an inexperienced situation, previous experience begins to play a role. Countless theoretical experiences learned from university , also burst out in an instant, and began to provide detailed and unspeakable information.
For an intern who has never been on the operating table, it may take an hour or two to perform joint release for the first time, with countless sweats.
But for Ling Ran, he has too many resources for reference.
Except for the different positions of the steps, he has done every movement used in the mere arthrodesis.
With a little proficiency, you can do it with ease.
"Director Wang, I'm done here." Ling Ran sewed up the amputation site, checked both sides at last, and then withdrew from the operating position.
According to the usual practice, Lu Wenbin also checked up and down and confirmed that there was no bleeding or other problems before starting to bandage.
Wang Haiyang looked up at the time, sighed secretly, and said again: "Ling Ran is not tired, come and help me if you are not tired."
"Okay." Ling Ran was very interested in this.
After taking off his gloves and changing a pair, he stood in the position of the first assistant, and squeezed Hou Kang into the position of the second assistant.
No matter how senior Hou Kang is, he is still a resident doctor. He can come to participate in the operation today, which means that Wang Haiyang does not want to find an overly strong attending doctor. Therefore, seeing Ling Ran in the queue, Hou Kang had to step aside obediently.
When he stood at the second assistant's position and turned his head, he saw the equipment nurse slapping the tweezers heavily into Ling Ran's hand with a smile on his face, and wiped his fingers seemingly.
"The blood vessels can be connected." Ling Ran operated under the two-person microscope, and the speed was obviously accelerated.
Wang Haiyang was inexplicably used to this state, and felt quite comfortable being pushed away by Ling Ran.
The artery of the finger was connected to the corresponding artery of the toe, and then a vein and nerve were connected. After about an hour, the patient's right big toe of size 35 was connected to the position of the right hand.
The palms are rough, the toes are wrinkled, and the proportions are even more out of balance.
The equipment nurse, who participated in this type of operation for the first time, stretched her head to take a look, and couldn't help but comment: "It looks fine at first glance, but it's a bit shocking to look carefully."
Wang Haiyang said lightly: "If you don't think it looks good, you can ask someone from the plastic surgery department to do it and adjust it to make it look better. Our work is complete."
"Going for plastic surgery will cost a lot of money." The nurse clicked her tongue twice: "I think it's expensive to get false eyelashes."
Wang Haiyang sneered: "Since you have no money, don't worry about whether it looks good or not. If you connect your thumb, it's still a labor force. If you can't connect your thumb, can it look good?"
The little nurse was speechless, she pouted and said, "If it's not good-looking, it's not good-looking. The director can point at a deer as a horse."
Even if a young and beautiful nurse retorts unreasonably, it is considered coquettish.
Wang Haiyang laughed, but he became proud instead: "Today's operation was really good, let's stop here, Xiaohou, finish it off, Ling Ran add me a WeChat, and I'll send you some photos."
"Oh, good." Ling Ran dragged his gloves and surgical gown, took out his phone, and asked, "What photo?"
"The new C-arm camera we bought is quite easy to use. I'll send it to you for a look." Said Wang Haiyang, while actively opening the photo album, and sent over a dozen photos in one go.
After sending Ling Ran all the way to the elevator, Director Wang Haiyang reluctantly left.
Lu Wenbin followed Ling Ran, and Yu Yuan was even more surprised.
During the few years in Yunyi, the three groups that Yu Yuan followed were the chief physician and the deputy chief physician, who were on the same level as Wang Haiyang, but she had never been treated so kindly.
Thinking of this, Yu Yuan couldn't help feeling physically and mentally exhausted.
"Ten minutes... rest for a quarter of an hour. I'll ask when the next patient will enter the operating room." When Ling Ran was about to arrive at the emergency department, he began to arrange the next operation, with an excited expression on his face. .
Rather than cooperating with Director Wang, he still prefers to be the surgeon himself.
"Doctor Ling..." Yu Yuan called out in a low voice, "Can I not participate in the next operation?"
"kindness?"
"I... I think I can sort out the operation process just now and write a medical report." After Yu Yuan finished speaking, she hurriedly said: "You and Director Wang performed the operation, and the first authors must be you and Director Wang. Ranked third."
A case report is a type of paper, and it is also the most common type of medical paper. Many medical journals, including the New England Journal of Medicine, have a case report column. The more famous case reports, such as AIDS and Legionnaires' disease, were discovered through case reports.
Of course, the case reports written by general doctors do not have so many new diseases to report. Therefore, the most common case reports are the special clinical manifestations of known diseases, or new findings in imaging and laboratory studies, and special cases. lessons learned, etc.
Easier said than done, short case reports often require vivid descriptions, multi-angle research and in-depth elaboration, which is actually not easy to write.
Ling Ran pondered for a few seconds, and asked, "Where do you want to publish it?"
"At least the core periodicals." Yu Yuan chatted with Su Jiafu, and felt Ling Ran's pulse.
"Okay." Ling Ran really couldn't refuse the blessing of a core journal, so he turned to Lu Wenbin and said, "Call Ma Yanlin to get up, and let him have the next surgery."