Chapter 391
Chapter 389: Chapter 183: Learning High Difficulty Complex Surgery Experience, Director Hu’s Praise
After entering the operating room, he found that the patient was already lying on the operating table.
Unlike the supine position he imagined, the patient adopted a left lateral 90-degree position.
This position is comprehensively considered based on the surgical field of view, location, and content of the surgery. It’s not the unchanging supine position. In fact, Zhou Can once saw a patient with manic disorder undergoing General Surgery, held down on the operating table by several doctors and forcibly anesthetized with a breathing mask.
Later, after the surgery, the patient was sent back to the ward and was tied to the bed with gauze on his hands and feet.
To prevent him from going berserk and injuring others.
Depending on the surgical requirements, the doctor will have the patient adopt different positions.
Inside the operating room, besides Zhou Can and Dr. Wu, there were three nurses and an anesthesiologist.
The anesthesiologist was administering anesthesia to the patient.
This preparation is generally done in advance. Nurses would enter the operating room early to organize items and check if all the trash was dealt with. Then they prepare the surgical instruments and medications needed.
“Is it for administering anesthesia and performing double-lumen intubation?”
Zhou Can hadn’t learned professional anesthesia techniques. He had just seen a lot, and he could guess the anesthesia method for various surgeries quite accurately.
Then, as a surgical resident, he needed to train in the anesthesiology department for a month.
At that time, he will definitely learn some more advanced anesthesia knowledge and specific operation methods.
“Right!”
The anesthesiologist was a man nearing fifty with a stone-faced expression, who never smiled when he spoke.
“May I assist you?”
Zhou Can was interested in gaining the Experience Points from the intubation.
As his residency rotations increased, his insights were also growing, and he had a clearer understanding of the future direction of medicine.
Minimally invasive and endoscopic surgeries were transitioning from a new trend to mainstream.
Forewarned is forearmed, unprepared spells ruin.
Besides mastering traditional surgery, Zhou Can would also spare no effort in improving his Advanced Medical Skill whenever possible.
“Go ahead!”
The anesthesiologist was indeed a man of few words. Coupled with his unsmiling face, he was quite unapproachable.
Dr. Guan was much more amicable than this person.
Zhou Can did not stand on ceremony, assisting with the intubation and fitting the breathing mask.
The anesthesiologist, seeing how Zhou Can handled the bronchial intubation as if it were a trifle, was slightly surprised and gave Zhou Can a few more glances.
Without saying anything, the two of them quietly completed all the anesthesia preparations for the patient.
Zhou Can stepped aside.
Before long, Director Xue and Deputy Director Lu arrived at the operating room with the surgical team.
“Not bad at all, the patient is already anesthetized!”
Director Xue had a rather cheerful personality and complimented them with a smile.
Then she began by having the scrub nurse help her put on sterile gloves, checked the surgical marks on the patient’s body, and examined the patient’s vital signs. After confirming there were no errors, the surgery began.
“Who prepared the conventional disinfection of the surgical field?”
“I did!”
The circulating nurse answered.
“Next time, remember to expand the scope a bit more. I think you must be a thrifty girl in everyday life.”
Though it was a criticism, coming from Director Xue, it was very acceptable.
The atmosphere turned very light.
The nurse blushed with embarrassment.
“It’s best to spread a drape before making the incision, then proceed with the incision from the posterior lateral right side.”
Director Xue patiently guided her subordinate doctors while performing the surgery.
Her movements were as steady as ever.
Zhou Can observed that most doctors in Cardiothoracic Surgery, especially those at a higher level, all continued the ‘steadiness’ trait of Director Hu’s surgical style.
In addition to steadiness, Director Xue also possessed the unique dexterity of a female doctor.
“Remember during incision, do not rush; it should be opened layer by layer. First, cut through the skin layer, then the subcutaneous tissue layer, and then the muscle layer. At this point, you can see the ribs. Then cut through the 5th rib from behind.”
After saying this, she signaled Deputy Director Lu to cut through the rib.
“Then enter the thoracic cavity through the intercostal space of the 4th rib.”
Thoracotomy is never a simple procedure.
Zhou Can stood below the operating table, watching and learning earnestly.
Having solid basic skills only provided a good foundation for surgery. To independently perform a major surgery like this, there’s still much to learn.
Especially the surgical techniques and precautions, all worthy of diligent study.
Even for the same pulmonary lobectomy, the surgical methods could vastly differ.
This demands the surgeon to be knowledgeable and adaptable, using knowledge flexibly depending on the situation.
“Have three main objectives for exploration: ensure there are no adhesions between the chest wall and lungs, no pleural effusion, and determine the exact position of the tumor on the lung lobe.”
Each of the three points is very important.
In the mid to late stages of lung cancer, the lungs and chest wall are likely to adhere. At that point, surgery must be performed very carefully to separate them.
In fact, for patients who develop to this stage, surgery is often no longer necessary.
Most of them have already undergone cancer metastasis.
Ethical doctors, upon diagnosing that a patient’s cancer cells have spread throughout the body or widely, involving multiple organs and tissues of the thoracic cavity, usually inform the patient. There’s no need to spend a lot of money on treatments; enjoy whatever food and drinks they like in the remaining time. If medications are to be used, the focus would mainly be on pain relief to improve the patient’s quality of life in the late stages of cancer.
Upon examination, this patient was considered very lucky.
There were no adhesions between the lungs and the chest wall, no pleural effusion, and the tumor was located on the posterior segment of the upper lobe of the right lung, approximately 4cm in diameter.
Not particularly large.
No tumors were found in the surrounding organs and tissues.
This was already a very ideal situation.
During the surgery, because of the pleural reflection. The tumor was close to the hilum, very near the upper lobe bronchus, making it impossible to perform a partial resection.