socalfunplaces Chapter 205
Chapter 205
In the operating room,
Lin Feng and several people have changed into sterile surgical gowns and are preparing surgical instruments.
Main knife: Lin Feng
· One assistant and two assistants: deputy chief physician of orthopedics, junior sister Qin Xiang
Tumor location: right upper lobe lung
Lin Feng is directing.
"Lie down 90 degrees on the healthy side!"
"Double-lumen threaded tube, general anesthesia!"
After anesthesia anesthesia the patient, he made an OK gesture to Lin Feng.
Lin Feng ascended the operating table.
"Let's go!"
Step 1,
Open your chest!
"One percent active iodine is disinfected three times, anteriorly and posteriorly past the midaxillary line and up to the subclavicle over the costal margin. "
This time, the surgery was not too difficult.
So Lin Feng took care of his junior sister Qin Xiang and made her the second assistant.
Qin Xiang took a deep breath to calm his emotions, and then carefully operated.
"Scalpel!"
Lin Feng took the scalpel, gestured with his palm on the back and outside of the patient, and then, close to the side of his hand, slashed down.
A knife of 20 centimeters, exposing the chest cavity to the eye.
The scalpel then cuts through the subcutaneous tissue, chest wall muscles, and intercostal muscles.
"Right lung ventilation!"
Lin Feng ordered.
The anesthesiologist hurriedly stepped forward and connected the surgical equipment.
"Wire saw!"
Lin Feng cut open the fifth and sixth ribs.
Bone wax stops bleeding in the bone marrow cavity.
Outside the operating room, a group of onlookers and students stared intently at Lin Feng's agile hands, for fear of missing a detail.
Knowledge and experience +100+100+100+100...
"Electric knife!"
Lin Feng took the electric knife and cut the patient's muscle tissue layer by layer.
"Bipolar electrocoagulation to stop bleeding!"
Zhang Yuan immediately cooperated, and Qin Xiang could only watch from the sidelines, without the slightest chance to intervene.
"The wet tourniquet protects the patient's incision. "
"Sternum brace!"
Qin Xiang finally found what he could do, and after attaching a hemostatic pad, he hurriedly handed the sternum brace to Lin Feng.
Lin Feng stretched the fifth and sixth ribs apart, fully exposing the surgical field of vision.
......
Step 2,
Clear vision, dissociation, excision...
Lin Feng put his hands into the patient's abdominal cavity and began to probe.
Hissing ~~~
"Dr. Lin is so strong, he actually inserted his hand into the patient's abdominal cavity!"
The onlookers said in disbelief.
"Dr. Lin is using the touch of his hand to probe the location of the mass in the patient's abdominal cavity and the location of blood vessels and trachea, right?"
"So strong!"
Soon, Lin Feng figured out the internal situation of his right chest cavity.
Consider the appropriate surgical approach.
"Scalpel!"
Lin Feng accurately cut an oblique crack on the patient's abdominal cavity.
The lingual artery is exposed to view.
(Lingual artery: It is a branch of the pulmonary artery that shoots posteriorly up and one anterior-descending vessel at the level of the posterior artery between lobes.) ）
"Silk thread number four!"
Lin Feng quickly ligated both ends of the lingual artery with both hands, and the surgical scissors were severed from the middle.
Pull the right upper lobe downward, open the mediastinal pleura, and swim with both hands away from the posterior apical artery and anterior artery.
Ligation!
Cut off!
Lin Feng again pulled the upper lobe backward, exposing the right upper pulmonary vein.
Then free out of the genus branch that flows into it to avoid affecting the surgical field of view.
Lin Feng's big hands seemed to have magic power, and ordinary doctors relied on surgical instruments, and it took a while to free tissue.
The free tongs in Lin Feng's hand were able to swim away with just a slight force.
Relaxed and cozy!
Many interns swallowed their saliva and felt that their worldview had collapsed.
They have seen the data on radical lung tumor resection, and generally by this stage, the operation time needs to be at least close to 3 hours.
And Lin Feng...
Looked at the time...
It only took 40 minutes!
Pervert!!
"No. 7 ligature!"
The right upper pulmonary vein of Lin Feng ligated patients is proximal to the heart.
"Clamps!"
Lin Feng is cut off at the predetermined cut-off, near and far behind.
"5*14 round needle, No. 4 surgical line!"
Sutures of the proximal and distal ends.
The right upper lobe lung (tumor location), which is now exposed to the field of view.
The forest wind begins to free the peribronchial tissues of the upper lobe.
Right upper lobe lung bronchial ligation ensures that the function of lung tissue in the lower right lobe is not affected after surgery.
The occluser directly cuts off the bronchi of the right upper lobe.
"Scalpel!"
Lin Feng cut off the patient's upper right lobe lung and removed it from the body.
The bronchial stump is intermittently sutured and the wound is covered with a mediastinal membrane.
Excision successful.
......
Next
Removal of tumor-degenerated lymph nodes in various tissues.
This is also the difficulty of this operation.
Lymph nodes are highly spread.
If it is not cleaned up, it will recur after a while.
The lymph nodes near the tumor are extremely hideous compared to normal lymph nodes.
The kind that looks disgusting.
"Scalpel!"
Lin Feng took a deep breath and began to remove the tumor into lymph node tissue.
is where the real test lies.
Just now, Lin Feng probed it, a total of twelve.
In each of the twelve, there can be no mistakes.
"Highest mediastinal lymph nodes!"
"Hilar lymph nodes!"
"Subcarina lymph nodes!"
"Paraesophageal lymph nodes!"
"Pulmonary ligament lymph nodes!"
The scalpel seemed to grow on Lin Feng's hand.
Every time the hand rises and falls, a whole piece of complete lymph node tissue is cut off.
It looks extremely smooth, without a hint of blockage, and it is natural.
After about 40 minutes,
All lesion lymph, excision successful!
......
Next
Finishing of surgery.
Lin Feng injected 1L of normal saline prepared in advance into the patient's abdominal cavity.
"Lung drum with ventilation!"
As the anesthesiologist controls the valve, the patient's lung tissue re-inflates.
Lin Feng pumped out the saline.
A drainage tube is placed through the midline of the 7th-8th intercostal and the second intercostal.
Bipolar electrocoagulation for complete hemostasis.
After Lin Feng fixed the ribs with bone nails, he manipulated the puller to close the patient's ribs.
The patient's muscular layer, subcutaneous tissue, and skin are sutured layer by layer.
So far
Completely close the chest and close the abdomen successfully!
The operation is complete!
......
All the doctors who watched and learned,
At this moment, his mind was already immersed in Lin Feng's surgical process.
Constantly flashing in my mind, a large number of fragments of information.
It is the clinical experience of this operation.
Experience +100+100+100+100...
After a long time, I finally woke up from the happiness gained from experience.
"The operation is over?"
"I'll go, it's only been more than 2 hours, so fast!"
"Doctor Lin, awesome!"
After the praise,
Look at other people.
The atmosphere froze suddenly.
"Ahem~~~"
"However, this operation is not very rewarding, and it will not come next time." "
"Yes, yes, not coming. "
"Whoever comes, whoever is a dog!"
"Well, whoever comes is the dog!"
One by one, the doctors shouted these words in an ironclad manner.
Heart: Next time I'll come, woof~~~
......
......
Afternoon
Five
Off-hours.
Lin Feng finished seeing several orthopedic patients and was about to pack up his things and go to eat.
"Lin Feng~~~"
Song Ziming, Huang Ziqian, and Wu Haoming hooked their shoulders and pushed open Lin Feng's clinic door.
"After work, let's get together a few brothers, how about the crayfish!" Huang Ziqian smiled cheekily.
For surgeons, three hundred and sixty-five days a year, the spirit is basically in a state of high tension, because you never know when the next operation will be.
Generally, during the period when there is no surgical schedule, eat a meal to relieve boredom.
"Okay. "
"Go!"
The four drove to the river.
By this time, in May, the weather had begun to get sweltering.
On the riverside, there are some supper stalls scattered.
"This shop is the most delicious, I always have this one!"
Wu Haoming took Lin Feng (wearing masks) and three people to one of the "really good crayfish" shops.
"Boss, ten pounds of crayfish!"
Wu Haoming sat down and shouted familiarly.
"The crayfish didn't have 10 pounds anymore, now it's only 5 pounds!"
The boss had a cigarette in his mouth and kept stir-frying the brightly colored crayfish in the pan.
"Do you think I have a problem with my eyes, or are there more than twenty pounds in your pot and in the basin on the ground?"
Wu Haoming shouted dissatisfied.
Boss: "See that person (pointing to a big fat man at the next table), this is my big customer today, the stall has covered dozens of pounds of lobster, this has already eaten more than a dozen pounds!"
Several people followed the line of sight and saw a table next door.
A fat man with a fat face,
How fat?
It is estimated that the big fat man is about 400 pounds!
The big fat man stepped on the stool with one foot and ate the shrimp tail in his hand with relish.
Crayfish shells have been piled up into mountains
The boss suggested: "There are only 5 pounds left, or 5 pounds of lobster, and add some barbecue?"
Wu Minghao nodded: "That's okay..."
The four found a corner and sat down.
Lin Feng was afraid of being recognized, so he wore masks.
Then the private person began to chat about the hospital gossip.
For example, a certain surgeon of the First City Hospital recently took care of the junior outside, and the mistress is a medical representative and is very beautiful.
This kind of gossip is the most exciting.
Surgeons, generally the target of medical representatives, are the purpose of selling medical devices, equipment, and drugs.
suddenly
Huang Ziqian looked at Lin Feng: "No, Lin Feng, why didn't a medical representative come to you?"
It stands to reason that Lin Feng has undergone surgery, seen so many patients, and is still young and handsome, which is the most coveted goal of medical representatives.
Lin Feng spread his hands: "I am also helpless~~~ I still want to be counted by people~~~"
It's been almost three years since I came to the city first house, and I'm still single.
Tragic!
(The Great God of Harmony passes by...) ）
At this time, Song Ziming said: "I heard that the brain department recently admitted a 77-year-old retired cadre, knocked, cerebral palsy, in addition to vital signs are still there, other basically no longer have any mobility, can not eat, are glucose and other nutrients to maintain life..."
Wu Haoming: "Ah? So miserable?"
Song Ziming shook his head: "The point is not here... Xiaoming, let me ask you, what if... What I'm talking about is if one of your elders looks like this, living in pain, and you decide whether to extubate or not, what would you choose?"
extubation,
It means to let the patient die.
Wu Haoming pondered: "It's all this level, it's quite painful to live, so let's simply extubate..."
Song Ziming shook his head: "Gee~~~"
Huang Ziqian chuckled: "Too young!"
Lin Feng smiled and said nothing.
Wu Haoming was stunned.
"What do you mean? Don't you still extubate?"
"That's right, the family of this retired old cadre, the choice is not to extubate..."
"Why?"
"Because of the money... Because he is a retired cadre, he does not need money for medical treatment, in addition, retired cadres have various welfare allowances, and this old man can receive at least six or seven thousand a month ... The family is for this money!"
Song Ziming told the truth!
"I'm going!!"
Wu Haoming was stunned!
It's just a collapse of the three views!
To be honest, patients with cerebral palsy, unable to move all over the body, are actually very painful, so Wu Haoming subconsciously feels that he should be extubated, which is more in line with human nature.
I didn't expect that...
For the sake of money, let the old man live in pain!
It's a wolf!
"This is not a special case. "
Huang Zi shares his experience next to him.
"Five years ago, I went to the provincial capital for further study..."
。