Chapter 158 155. Keep the program

Since the theater moved to the Municipal General Hospital and Kawei has the authority to take the lead in surgery, the Q&A session during the operation has become his retention program.

Before crossing, Kawei is a surgeon who loves to ask questions. He mainly helps point out where the minefield is during the operation, and also helps young doctors deepen the memory of relevant anatomical locations.

The surgical anatomy structure is complex, and even if you have super strong memory, you need to practice frequently to ensure the accuracy of memory.

Young doctors usually need to watch the anatomical map repeatedly and participate in surgery to maintain this level of proficiency, but people are always lazy and will slack off and get along. At this time, old doctors need to "promote" at critical moments.

In Vienna, the question was painted with a layer of commercial elements, which also allowed Kawei to master the true level of other surgeons.

Of course, if you have to go into it in depth, the question itself also reveals some of Kawei's evil taste.

The question I just asked was indeed difficult, and even in modern times, there were not many young doctors who could answer this question. So after asking the question, the venue was silent and there were very few discussions.

In fact, for most viewers, answering the right questions is as difficult as winning the lottery. They come to visit and learn and appreciate more. As for asking questions, they can only focus on participating.

Compared to them, the ones who really feel embarrassed are the big guys sitting on the VIP seats in the four corners.

It is so embarrassing that no one can answer the question raised by a young man.

"Don't look at me, I'm already thinking about it."

In Corrigo's mind was a picture of a chest cavity with the blood vessels drawn. The answer seemed to have reached the throat, and the lips were almost touching each other, saying them: "It's so fast, I think the answer is almost at the mouth."

Watman is old and he prefers practical exercises for memory.

I saw the old man closed his eyes and touching his left upper arm with his right hand all the way to the torso: "Well, if I remember correctly, the blood supply in the chest should come from the subclavian artery. As a part of the head, the blood supply naturally comes from the subclavian artery."

"It's not bad, Dean Watman is indeed awesome, but it's still too simple to just say the subclavian artery."

Kawei quickly cleared the fascia around the left breast gland, then turned on Ru's head and quickly cut off the degenerated breast duct and other tissues: "The second most difficult point in the operation is here. When doing free cutting under Ru's head, you must pay attention to the thickness and strength of the cutting. If it is too thick, it will easily not be clean. If it is too thin, it will affect the blood supply, causing necrosis of Ru's head after the operation."

The operation process is beautiful, and the explanation can make people shine. Every word is the key point and there is no nonsense.

Just the experience of cutting under the dizziness of your head, it is enough to pay the fare.

But Watman felt uncomfortable: "Since the blood vessels come from the branch of the subclavian artery, the blood supply naturally comes from above the body, so it is definitely not appropriate to make an incision on your head. I think this sentence is enough to answer your question, how can it be considered simple?"

It's okay to explain this, but it didn't achieve the purpose of Kavi's question: "Can the dean talk about which branches of the arteries it is?"

The problem is a bit beyond the scope, and Watman seems very embarrassed, but the tickets that should be exempted cannot be left behind: "This should be the second problem, right?"

"Yes, that's how I understand it."

"That's the question just now."

"It's okay, even if Dean Watman answered correctly."

Kawei smiled and separated the breasts from the pectoralis major muscle, and then slowly lifted the hyperplastic breasts into the incision just like taking out a box of tissues, and threw them into the metal plate handed over by Herman: "I will ask them to refund you after the operation."

"It's almost the same." Watman stood up and looked at the whole process, nodding constantly, "It seems that small incisions do make sense."

"That is, male breast hyperplasia is not obvious, so this can be done. If it is a female, an enlarged incision must be made."

The small incision under Kavi’s head is not just a simple small incision, but also gives many doctors a new idea of ​​incision approach.

Can breast cancer resection, which originally cut off the entire Ru Atrium, have a more beautiful operation method?

Even if breast cancer is not removed, what about the simple breast tumor? Especially for the tumors near Rutou and Dizziness, is it too inhuman to cut off Rutou and Dizziness directly? And can patients who give up the surgery because they want to cut Rutou and Dizziness off by relying on a beautiful new incision to retain it?

At this point when the surgery is carried out, the really important incision has been displayed and there is not much to see.

Watman's idea had long been floating out, thinking about how to improve the breast cancer resection that has been going on for many years.

However, Kavey suddenly shouted and pulled him back to the operation site: "Director Watman, what about the second question I asked just now?"

".Hmm? The second question?"

"Which branches of the subclavian artery are from the blood supply of the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness of the head and the dizziness

"I've already waived the ticket for today, so why don't I give it to others?"

Watman didn't have much breast surgery and knew the shape of the blood vessels, but he really forgot his specific name. For his reputation, he couldn't say that, so all he could do was delay time.

What he was waiting for was Kawei who chose to give up, or.

"I remember it! I remember it! I remember it all! Hahaha!!!" Suddenly, Corrigo on the other side screamed, his face filled with excitement of perfect answers, "I definitely can't be wrong this time, the answer is the lateral thoracic artery and the internal thoracic artery." [1]

Both blood vessels are sub-branches, so it is not difficult to know the name. The anatomy book will also mark and introduce it.

Even if the memory of the textbook has faded, I will often encounter it when doing autopsy. If it were Professor Lange, director of the Anatomy Teaching and Research Department, the response time for answering this question would not exceed half a minute.

But even if there is no division of the subject, it is somewhat inclined to be a clinical surgeon.

Breast surgery is rare, mainly abscess aspiration and tumor resection, which are not their expertise. The plastic surgery that Corigo focuses on is not related to the breast. After all, it is very difficult to reconstruct the entire Ru Atrium after resection.

It is really not easy to think of these two blood vessels in this case.

"Dr. Corigo's answer was quite good." Kavey didn't dare to ask further and briefly explained this answer. "The arterial blood supply here is mainly supplied by the branches of the lateral thoracic artery and the perforation of the internal thoracic artery.

These small branches all come from the slightest part of the inner and outer part through the gland lobes to reach the base, so the incision must be made below the slight head. If the incision is on top, it is easy to damage the arterial network below, which will lead to postoperative necrosis."

The two paragraphs basically explain the shape of blood vessels and the direction of blood supply, which is much more detailed than simply listing certain blood vessels.

Many sounds of writing and taking notes were heard in the audience. Most of the people's heads were buried in the notes, and they tried their best to record, and they did not dare to miss a word. For Amor and Herman standing on the operating table, the only disadvantage of being Kawi assistants was probably that they could not take notes on the spot.

After 15 minutes, Fernan's right breast gland was also removed by the same method.

"Leave it to me next." Herman had already taken the needle and thread and was ready to start sewing.

But this time Kawei did not let go: "I'm really sorry, the patient's requirements this time are relatively high. Ordinary skin sutures will leave scars. Not only will it not be beautiful after the operation, but the scar after healing will also cause contractures, which will further pull the head."

“What should I do?”

"We can do a subcutaneous suture [2]." Kavey took the needle and thread, "Just do intermittent subcutaneous suture of the fat layer, and let the epidermis heal on its own. After all, a large area of ​​breast gland was cut off, and the skin was not tense."

The operation came to an end, and Koch, who was doing the pathology side, brought the news of the section examination: "I did a simple fixed staining section, which should be a tumor."

"Well, record it on the medical record and wait until the subsequent paraffin specimens are completed for review."

"I see."

Kavi completed the suture easily and announced the end of the operation.

Because the area of ​​the surgical theater of the Municipal General Hospital is limited, the postoperative interview and inquiry process are carried out in the audience. Except for the four VIP seats, all non-surgical personnel are not allowed to enter the central area of ​​the surgery.

People can't get in, but the audience's enthusiasm is very high.

"Congratulations to Dr. Kawi for continuing to maintain the record of 100% successful surgery." Although Greg had some suggestions during the operation, he still sent his blessings after the operation. "I hope you can continue to maintain it and bring health to the people of Vienna."

“I will work hard.”

"Although this surgery is not that complicated, it should be a reference in the field of Ru Atriectomy." Greg asked. "Although Dr. Kavey is very young, I still want to ask more, have you ever had a breast cancer resection?"

Kavi was a little hesitant.

Is there a answer or no?

In fact, there are some. It is not uncommon for severe contusion and laceration to cut off the entire Ru room. Kawei helped him. The basic operation of the surgery is very similar to breast cancer resection. The only thing missing is the dissection of the surrounding lymph nodes.

However, there was no clear concept of lymphatic metastasis in the 19th century, and lymphatic dissection was not common. Simple resection of Ru'an is similar to breast cancer resection.

So it is not an exaggeration to say "has been done" here.

But breast cancer removal is not easy in everyone's eyes, and not many people can complete this surgery.

Kavi has now exhibited a cesarean section, intraperitoneal liver resection, spleen repair, hysterectomy, and ureteral repair.

If you add another breast cancer resection, will there be too many? If you go to a logistics hospital in the future, you will have to face battlefield trauma every day. If you say that you have done everything and you will succeed, isn’t it a bit too much?

With this in mind, Kavey was humble: "I just saw it and didn't participate in it."

"With Dr. Kavi's surgical talent, can you see it be equivalent to participating in it?" Greg did not avoid this, but instead exaggerated Kavi's ability. "Doctor Kavi is already a genius in the Austrian surgical field. Even your teacher, Dr. Ignaz, the owner of the genius title, has admitted this."

"I can only say that I learned faster."

"Doctor Kavey, you're really too modest."

This is true. In everyone's eyes, Kawei is the overly modest genius surgeon.

However, out of disgust with the newspaper media, Kawei always felt that the other party was looking for and creating new topics in normal surgical news. So he quickly pulled back the direction of the inquiry, hoping to make the postoperative discussion more pure and professional: "Does other people have any other problems related to surgery?"

"I have a problem." Masimov was silent for the entire operation and finally spoke, "Should we have a pathological examination of the bilateral resection?"

"Doctor Masimov is worried about the tumor?"

“There are factors in this regard.”

"You can try it, but" Kawei conducted another examination of the removed breast glands. "From the color, texture and blood supply structure, this should be the breast glands after simple hyperplasia. There are hyperplasia on both sides, and the degree of hyperplasia is basically the same. I personally think the probability of tumors is very low."

“.Makes.”

Masimov nodded and added two more strokes to his notebook.

Orgi, who was standing beside him, said: "I would like to ask if there is any possibility of non-surgical treatment? After all, surgery and anesthesia are both risks, and it is too risky to waste your life for two burdens."

"If the patient is not worried about the appearance of the body, there is no need for surgery," Kavey explained. "But many patients will feel pain, which will affect their daily life. If the patient is willing, I think the surgery is fine."

"What if something happens?"

"Surgery accidents are very rare because there is almost no bleeding." Kavey took out a few pieces of compression and stop bleeding that he was used today. "These five pieces were used for gao pill removal, and only three pieces of gauze were used for double mastectomy, and the amount of bleeding was very small."

"anaesthetization."

"As for anesthesia, it is entirely caused by irregular anesthesia operations," said Kawei. "Since diethyl ether entered the surgery department and became a necessity for surgery, we have been lacking in exploration of the use of diethyl ether. Recently, I will publish a paper specifically elaborating on the use of diethyl ether to minimize the chance of anesthesia accidents."

"I see."

Kavi answered two questions in succession, looked back at Herman and Amor who were bandaging, and was still a little worried: "Be careful, don't wrap it too tightly. Excessive bandages can also cause necrosis. Be careful."

"Yes, I got it!"

"Is there any other question?"

At this time, Watman, who had been thinking about breast cancer resection and late plastic surgery, suddenly spoke: "If Kavi, you are interested in breast cancer resection, I have a surgery to need your help."

"On Microorganisms" and "New Understanding of Ether Anesthesia", there are two extras.
Chapter completed!