Chinese medicine: When you do things to the extreme

Chapter 144 What on earth was lost?
Professor Teng Qinghe then took several deep breaths to calm himself down.

Then he began to explain to Zhou Yanqing: "To be honest, Yanqing, the reason why I didn't let you do too much today is mainly because I'm afraid your skill pool is limited."

"Including my last question, I just wanted to give it a try."

"So, I hope you can understand."

How old is Zhou Yanqing?

It would be a pleasure to be able to experience the replantation of severed limbs.

After all, the discipline of medicine is a discipline that has been accumulated through the experience of countless predecessors.

Everyone's learning curve and the learning trajectory of people with different qualifications have already been determined.

China is a huge country, and has accumulated countless geniuses over the course of time.

The development of modern medicine in China has only lasted for a few decades. China's current medical level is close to the international level, which is the result of the hard work of these predecessors.

Who dares to say that one is better than another?

Referring to the learning curve of people who have come here, and looking a little higher at Zhou Yanqing, he has already reached the upper limit of Teng Qinghe's vision over the past thirty years since he became an adult.

Zhou Yanqing smiled and said, "Teacher Teng, I can only sew a few stitches. I dare not operate alone..."

Zhou Yanqing replied honestly.

The main reason is that this is Jishuitan. If this was the First Affiliated High School of Hengda University, Zhou Yanqing could say that he could perform the transposition technique. Even if he was only an entry-level transposition operator, he might be more "skilled" than his teacher.

There are thresholds for surgery.

Many surgeries that cannot be performed in tertiary hospitals are not because of the hospital’s level, but because the doctors in the hospital are unable to perform them because they cannot meet the threshold.

Compared to Zhou Yanqing's former senior brother who was the leader in "Hand Surgery" in the county hospital.

If Zhou Yanqing went to a city-level hospital now, he would also be the leader in "neurotendon and vascular bridging transposition surgery."

"I'll sew a few stitches if you dare!"

"Really?" Teng Qinghe looked at Gong Zixi and others and asked.

Gong Zixi was the first to nod: "Yan Qing dared to say in front of you, Professor Teng, that he could sew a few stitches, so he must have a certain level of skills."

"Is this a pond?"

The orthopedic strength of Kyoto Third Hospital is not worse than Jishuitan, but Gong Zixi is far worse than Teng Qinghe, so Gong Zixi doesn't dare to show off here.

After all, the hospital is a place where human lives are at stake, and strength is respected.

He Zhu nodded upon hearing this.

Teng Qinghe made way and carefully completed the position rotation with Zhou Yanqing back to back, then he said carefully: "It's okay, Yanqing, you sew first, if it's not sewn well, I will take over..."

Upon hearing this, Zhou Yanqing took a closer look without hesitation.

Why is nerve transfer difficult?

NeurosuturingTM is the process of suturing the end to end of the same nerve, which is basically a simple nerve suture.

Nerve transposition is to connect the ends of two nerves to replace their functions. If the position is not handled properly, it will definitely be a tangled state.

The blood vessels are tangled and blood circulation is poor.

The result of the nerves being tangled and rotated and compressed is definitely necrosis, which makes suturing them difficult.

Not only do you have to sew, you have to sew with design.

The basic skill of suturing has evolved to this point and has almost reached perfection.

Even a point more or less may bring unpredictable consequences to the patient.

Zhou Yanqing looked at it for a long time before he finally sat down, picked up the microscope needle holder and microscope forceps, and carefully pulled open the epineurium at both ends.

The brachial plexus nerve transposition surgery is so straightforward, because there is no perivascular membrane at the proximal end of the brachial plexus nerve, so it is a one-time deal.

There can be no mistakes.

Although Zhou Yanqing did not have much experience in transposition surgery, he still had the basic skills of nerve suturing.

Moreover, Zhou Yanqing also had some understanding of the transposition technique. It was not that he did not know how to do it at all. When he was following Professor Tan Zhongyu, Zhou Yanqing also tried to suture it several times, so he had some experience.

Therefore, Zhou Yanqing followed the instructions of his former master, Professor Tan Zhongyu, chose a point that was easier to correct, and sewed two stitches carefully and properly.

After Zhou Yanqing finished suturing, the surgical field showed that the two nerves were somewhat pulled, and it looked as if they were sutured by an intern.

However, no one on the stage laughed at Zhou Yanqing.

Just because you haven't done it doesn't mean you haven't seen it. Zhou Yanqing sutures with the simplest two stitches, which are equivalent to locators.

The transposition technique will cause a transposition and twisting, and then naturally the superiors will make corrections. If they can practice to the point where they can correct such pulling, they will have reached the level of their superiors.

Every professor has gone through this, including the first professor who performed nerve transposition, who also crossed the river by feeling the stones.

Zhou Yanqing tilted his head to look at Professor Teng Qinghe and asked cautiously, "Teacher Teng, is this okay?"

Zhou Yanqing was not being humble, but he was not aware of Teng Qinghe's usual operating habits. This was his first time working with Teng Qinghe.

As a student, it’s never wrong to be low-key and humble.

"Yes!~"

"Very good! It seems your teacher has given you a lot of guidance." Teng Qinghe nodded.

Zhou Yanqing heaved a sigh of relief when he heard that. Just as he was about to stand up, Teng Qinghe said, "Then sew two stitches on the other nerve as well. I'll see how you understand the location point."

Teng Qinghe still had the intention of testing the teacher. The first time was an accident, but if he could operate it well twice, it would definitely not be a coincidence.

As Teng Qinghe spoke, he loosened the nerve stump that was pulled aside.

Zhou Yanqing did as he was told and sutured the other two nerve stumps with two stitches carefully, and he found the positioning points quite well.

According to Professor Tan Zhongyu's description, the beginning of the transposition operation is to find such a positioning point, and then to find the correction point. Finally, if you can find a suitable release point, then for this operation, you have really entered the door.

It sounds mysterious, but there are no other good words to describe it.

This is like a chef's control of the heat, which is sometimes difficult to define clearly. After all, peripheral nerve injury is a relatively new field and many things are unknown.

Zhou Yanqing did not respond, but continued to watch Teng Qinghe's operation intently.

At this time, watch as much as you can.

The masters in the outer courtyard are no better than your own master. You can observe them whenever you want. If you want to observe them again in the future, you may have to wait for the opportunity for further study.

Professor Teng Qinghe began to explain: "The two points that Yanqing just sutured, the upper stitch could actually be a little further inward."

"Why? This has something to do with the angle of the transposition technique..."

“The difficulty of transposition surgery is to find the correction point after finding the transposition point.”

"The two stitches have been sutured, and the style of the surgery has been finalized. No matter how the first two stitches were, it is difficult to remove them and suture them again. The most we can do is to make corrections..." "Nerve transposition is derived from nerve suture and is higher than nerve suture. So no matter how things change, they still remain essentially the same. The suture of nerve transposition essentially follows the concept of nerve suture."

“But there is a difference…”

Professor Teng Qinghe explained and demonstrated while performing the operation. He then asked Zhou Yanqing to complete the suture of a tendon transposition.

Compared to the extremely high precision of suturing in nerve transposition surgery, the suturing in tendon transposition surgery does not require such precision, as long as you have a general idea of ​​what is going on.

After watching Zhou Yanqing sew a few stitches, Professor Teng Qinghe felt that it was not too bad, so he said, "Yanqing, why don't you just sew up this muscle."

"I just happened to tell you more."

"This peripheral nerve treatment sounds mysterious, but it can actually be broken down into many key basic skills."

"Anatomy is a big deal. Why did Director Lin give you that anatomy class? The main purpose was to make you aware of the potential gaps in the body."

“I can design and innovate through my own understanding, and think about which muscles can be transferred and which cannot be transferred.”

"Transposition can be manifested in many forms, including transposition between two tendons and reconstruction of tendon insertion points..."

"I won't go into detail about this. There will be a special teacher to explain it to you in detail later. What I'm talking about today is actually the outline."

"There are several key points in peripheral nerve treatment. The first is nerve relaxation."

"The second is the transposition of the nerves and muscles, and the third is the reconstruction and re-relaxation of the anatomical structure..."

"The third point is very important, because after the transfer and release operations are completed and the normal tissue structure is reconstructed, if the patient's limb function is to be restored, the anatomical structure must be reconstructed."

"This creates a gap so that the transposed nerves have a place to fit and the muscles have a place to slide."

"Understand that nerves are part of the body, and they just need to exist in the body without being compressed."

"Muscles slide, and sliding requires gaps. We also need to rebuild these gaps. How to rebuild is related to reconstruction."

"us……"

"Oh, Yanqing, have you finished stitching?" Teng Qinghe had just finished talking about the key points while Zhou Yanqing had finished stitching.

This time Zhou Yanqing stood up and said, "Teacher Teng, thank you for checking it."

Teng Qing and a professor from Jishuitan Hospital endorsed themselves and asked themselves to perform the operation. This is the behavior of a teacher.

Not only your mentor is a teacher. Anyone who has taught you something is a teacher and deserves respect.

Zhou Yanqing's failure in getting a master's and doctoral degree at Jishuitan was not caused by Teng Qinghe alone, so it was impossible for Zhou Yanqing to hold a grudge.

Seeing that Zhou Yanqing had a calm temper but his martial arts skills were extremely impressive, Teng Qinghe became angrier and angrier the more he thought about it, and the more he loved him.

But I feel more and more regretful.

No one will target a genius unless he is a fool.

"Okay, very good." Teng Qinghe praised, half true and half false.

If compared with his ideal quality, it would not pass the test. But if compared with this operation, it is definitely good enough.

Afterwards, Professor Teng Qinghe performed a high-standard tendon transfer surgery for Zhou Yanqing and others!

It’s a feast for the eyes for everyone!

It turns out that the operation can be done so delicately, and a small tendon suture can be done so smoothly...

However, Teng Qinghe no longer let Zhou Yanqing intervene in the subsequent reconstruction techniques, and did not spend more time explaining them.

He just said: "You don't need to learn reconstruction yet. There will still be special courses to teach it later."

"This training course lasts for five days. The first day is the general outline, the second, third and fourth days are the transposition and bridging techniques respectively, and the last day is for review."

“Then the class will officially end.”

Several people nodded and quickly reviewed the content they were going to learn next.

In fact, time has passed unknowingly and it is already six o'clock in the evening.

By the time Professor Teng Qinghe finished the operation, it was almost 7:20. The operation lasted about four hours.

Moreover, there are still some finishing operations to be done, which will probably take about an hour.

After Teng Qinghe stepped down from the stage, he said, "Okay, it's getting late now, you should all go back and rest first, as you still have lessons to do tomorrow."

"Eat well and recover well. Don't let your spirits run low, or you'll miss out on important content tomorrow."

After Teng Qinghe finished speaking, he looked at Zhou Yanqing with a complicated look, but in the end he did not say, "Yanqing, come with me."

Jealousy can only make people angry. Desire but not being able to get something is one of the sources of jealousy. Teng Qinghe was afraid that he would regret it in the future, so he simply decided not to have any more entanglements with Zhou Yanqing.

Zhou Yanqing and others thanked Professor Teng and said goodbye.

After the event, the host, Associate Professor Gong Zixi, invited us to go out for a midnight snack.

Since everyone else agreed, Zhou Yanqing stopped saying anything unsociable.

So he listened to the arrangements obediently and followed everyone like a devout little brother.

……

After Professor Teng Qinghe left the operating room, he walked towards the parking lot. After hesitating for a long time, he finally called Liu Guowei.

"Professor Teng, is the get out of class over? Thank you for your hard work." Liu Guowei's voice was very casual and respectful.

Liu Guowei and Teng Qinghe are both deputy directors of hand surgery. Their abilities are comparable, but they specialize in slightly different specialized branches.

"Guowei, I personally saw this Yanqing on the operating table today. I also tried it myself."

"I don't know how to tell you." Teng Qinghe said hesitantly.

I don’t know how to describe it, either it’s too bad or too good.

Zhou Yanqing can’t be too new. If Zhou Yanqing was too new, he wouldn’t be able to get to this point.

Liu Guowei's breathing quickened after he understood what he meant. "Brother Teng, do you mean to say that this kid has improved so much from September of the year before last to January of this year?"

"Is it because of Xiangya Hospital's intervention?"

Liu Guowei was the supervisor Zhou Yanqing chose when he applied for his doctorate, and the events at that time can actually be traced back to the year before last.

Therefore, Liu Guowei studied all the results of Dr. Zhou Yanqing's re-examination.

Including assessment results of professional special channels!

Based on Liu Guowei's performance record, he did not find any outstanding aspects. He was not much different from many others. Every year there were a few who were better than Zhou Yanqing at that time.

But, after the training at Xiangya Hospital?

Only a year and a half?
Is this ascension?

(End of this chapter)