Zhou Can realized that reading more books usually has many benefits, especially when you can apply what you've learned during critical moments.
Reading books is beneficial, a golden and jade-worthy saying left by the ancients.
"Um, very good answer. The surgery we are going to perform on this patient today is to use a vascularized bone flap transplant, aiming to save the patient's necrotic femoral head."
Doctor Shan announced this surgical plan with a strong sense of pride on her face.
Just by hearing the name, you know the surgery is highly technical.
For a newly promoted attending physician to be able to complete such a difficult surgery, pride and honor are indeed appropriate.
The patient was quickly wheeled into the operating room.
The anesthesiologist also hurried over.
In orthopedics, the frequency of using anesthesiologists is very high.
No choice, many of their surgeries are major ones.
Both spinal and general anesthesia must be conducted by professional anesthesiologists.
At this level of surgery, the risk is also very high.
The patient isn't particularly old, only about thirty-five or thirty-six years old. She is a rather petite woman.
Her lower body is covered with a blanket.
In the eyes of doctors, patients have no gender distinction. For this patient, even underwear can't be retained during surgery, she must be feeling somewhat embarrassed.
But when compared to relieving her pain, such minor discomforts seem less important.
The anesthesiologist proficiently examined the patient and then performed general anesthesia directly on her.
Perhaps also considering the feelings of the patient, they decided to use general anesthesia.
Normally speaking, it'd also be feasible to perform this surgery under epidural anesthesia.
"Anesthesia successful, patient's vital signs are stable, surgery can proceed."
The anesthesiologist reported routinely.
Doctor Shan, having performed many surgeries, usually seemed quite relaxed.
At this moment, however, her expression was very solemn.
"This surgery is divided into two major steps. First is to assess the extent of necrosis in the recipient area's femoral head. If the necrosis is mild, direct bone drilling and grafting can be done. But for this patient, the necrosis of the femoral head is severe, relying solely on reducing intraosseous pressure by grafting is unlikely to be effective. We need to help establish a new blood supply."
She taught while operating.
This complex surgery not only attracted the six resident trainees, but even Tang and another resident doctor were seriously watching and learning.
Being the first assistant, Zhou Can had a clear advantage and could learn conveniently.
He could understand every surgical step more clearly.
"First, determine the size of the femoral head needed for implantation. Then separate out one to two sets of blood vessels."
She picked up the scalpel and directly cut through the patient's skin and fat layer.
Zhou Can quickly acted to stop the bleeding beside her.
After revealing the somewhat collapsed femoral head, Doctor Tang stepped forward to help by pulling retractors, providing a better view for the surgery.
This step, the trickiest part was freeing the two sets of blood vessels.
She operated very cautiously.
When freeing the first arterial blood vessel, it went relatively smoothly.
However, Zhou Can, who was helping with retraction, noticed that her separation technique was somewhat weak. It was only at the level of resident doctor, not quite at the attending level.
The Separation Skill, after all, is an Advanced Medical Skill, difficult to practice and slow to progress.
Her current level was actually pretty remarkable.
Probably even many attending physicians' separation skill couldn't match hers.
When she moved on to separate the second venous vessel, due to the complex situation and femoral collapse, greatly increased the difficulty of freeing the venous blood vessels.
Time was passing by the minute and second.
Her sweat continually flowed from her forehead. The circulating nurse kept wiping it off for her.
It was noticeable, despite Doctor Shan wearing a head cover, that the hair at her temples was soaked with sweat.
"It's no good, this blood vessel is too difficult to free. I'm afraid we need to have Director Shen personally come and take over the surgery."
After trying multiple times and making slow progress,
and the freed blood vessels were quite rough, even nearly rupturing the vessel wall a few times.
"Please contact Director Shen for me!"
She said this to the circulating nurse.
She temporarily halted the surgery.
The call was promptly made.
"Teacher, I've encountered a tough situation. The necrosis of the patient's femoral head is unimaginably severe, and the difficulty of freeing the recipient blood vessels is too high for my skills. I may need you to personally take over."
This highlighted the importance of having a highly competent mentor.
In critical moments, seeking help from your own mentor costs the least and is most reliable.
Asking other senior doctors for help might embarrass you due to hospital rules.
You're likely to get scolded,
and even possibly demoted, restricting your future surgery privileges.
Like Zhou Can, his teacher is Dr. Xu.
He gave him his direct phone number and even told him that he can call him at three in the morning to help him out in a crisis.
Try calling another director in the middle of the night and see?
"Alright, I'll wait for you!"
She ended the call somewhat helplessly.
Zhou Can, who was listening on the side, heard clearly that Director Shen seemed to be conducting an important major surgery and couldn't get away.
This made things difficult.
If Director Shen couldn't make it soon, the patient lay bare-bottomed, with an open incision.
The surgery was stuck due to the lead surgeon, Doctor Shan, having limited skills and unable to proceed, forcing the patient to just wait.
Time continued to pass by the minute and second.
It was still unknown when Director Shen would be able to arrive, and Director Shan's face was filled with worry.
She truly hadn't expected the surgery would be so challenging.