My Medical Skills Give Me Experience Points Chapter 1282 - 505: Solution for Side Effects, Innovative Surgical Approach (Part 2)

The patient's duodenal ulcer is on the brink of perforation, explaining those painful groans.

Gastric acid's corrosive power surpasses all expectations.

It swiftly devastates the stomach, duodenum, and pylorus.

Its strength matches that of ordinary strong acids.

"Yang Zhi, Ding Dong, during this kind of surgery, stay alert. Sever the vagus nerve above the esophagus-stomach junction; failing that, the operation won't yield the intended results."

Zhou Can imparted the vital surgical details to them.

His knowledge stemmed from Deputy Director Liu's notes in the General Surgery Department.

With the spot confirmed, Zhou Can swiftly freed the left liver lobe.

He sliced through the triangular ligament directly, directing Yang Zhi to retract the left liver lobe upward and rightward, fully revealing the lower esophagus and esophageal cardia in the operative field.

Swiftly, he incised the serosa at the esophagus's lower end and cardia, dissected the upper hepatogastric ligament, and cut it clean.

His actions flowed with remarkable speed; observing his surgery felt like pure spectacle for the audience.

Next, he loosened the lower esophagus.

His fingers probed the esophagus's anterior wall, seeking the vagus nerve.

Medical texts color blood vessels red and nerves yellow.

Yet in live operations, nerves blend seamlessly with nearby tissues, demanding the surgeon's vast experience to detect by touch.

Zhou Can soon located a nerve on the esophagus's left front side.

That was the left vagus nerve.

He checked the right posterior esophagus too, verifying the right vagus nerve's location.

Now fully prepared mentally.

"Two vagus nerves exist here; always verify them in surgery."

He had them wash hands, don sterile gloves, then palpate the patient's esophagus and adjacent tissues for the vagus nerve.

Hands-on practice holds immense value.

Some chief surgeons avoid student involvement to prevent complications or delays, opting to just indicate anatomy verbally without allowing touch.

Can such training produce skilled surgeons?

Many residents after years still fumble like beginners in surgical anatomy—not from lack of study, but poor teaching.

Practice chances were scarce.

"I believe I've found it; it feels distinct, like a fibrous cord."

Yang Zhi first detected the vagus nerve.

Spotting the suspect spot, he sought Zhou Can's approval right away.

"Ding Dong, try to feel it now."

Zhou Can told Pu Dingdong.

Pu Dingdong matches in talent, yet proves more hands-on and precise than Yang Zhi.

Zhou Can felt content with his two assistants.

They shone consistently.

After probing, Pu Baodong pinpointed both left and right vagus nerves, even using sight to confirm.

"Good, now observe as I cut the vagus nerve."

Zhou Can meticulously isolated the vagus nerve from the esophagus.

Then he told Yang Zhi to elevate it with a nerve hook.

Scissors continued the separation.

Scissors, rather than scalpel.

Once five to six centimeters separated, the gastric vagus nerve trunk could be resected.

Resection length mustn't be too brief; typically two to three centimeters per trunk. The other follows suit.

Thus, gastric vagus nerve trunk excision finished.

"Xiao Zhou, post-vagus trunk severance, food often pools in the stomach. Got a solid fix?"

Dr. Xu watched quietly from aside, rarely interjecting.

Surgery almost done, he queried about handling postoperative retention.

"Pyloroplasty ought to resolve gastric stasis."

Zhou Can knew the fix well.

"You've delved deep into General Surgery—get on with it!"

Dr. Xu approved heartily.

Without pause, Zhou Can executed pyloroplasty.

Beyond that, post-vagus cut, he repaired diaphragmatic hernias on both diaphragm sides to avert future ones.

Diaphragm leg approximation and suturing pose high challenge.

Precision in suturing and ligation proves essential.

Here, he racked up plentiful suture and ligation experience points.

Each ligation granted generous experience rewards; he pushed extra for more.

Surgery's close saw ligation points exceed 94,000, nearing 100,000.

Normally, six thousand more ligations for upgrade.

Yet high-demand cases like peritoneum or dura sutures, or ligation-heavy ops, accelerate progress.

Ultimately, major complex surgeries yield the richest experience.

"Ding Dong, handle the abdominal closure!"

Yang Zhi excelled at cavity closure now.

His baseline skills solid, plus endless practice shadowing Zhou Can, boosted him swiftly.

Pu Dingdong lagged in surgery skill.

Zhou Can trained all subordinates evenly.

No favoritism or oversight.

Surgery winding down reassured Dr. Xu, who departed.

"Dr. Zhou, wait for Dr. Pu's sutures or prep next op?"

"You and Qiao Yu ready another OR; I'll supervise here."

"Got it!"

Ma Xiaolan and Qiao Yu prepped the next room.

Afternoons peak Zhou Can's emergency OR frenzy.

Dr. Xu paces steadily; elite surgeons claim the top-tier hundred-level rooms, lesser ones stuck in old facilities.

Thus, afternoons free up tables in the hundred-level OR.

Zhou Can oversaw Pu Dingdong's abdominal suturing—no concerns.

Pu Dingdong's sutures skilled, executed with utmost care.

Zhou Can's neat abdominal incision simplified the task.

Inner and outer layers sutured smoothly.

As he observed, mind wandered to the Shanghai patient seeking care.

That aortic dissection rip stretched too far.

Aorta replacement seemed the prime fix.

Yet recent vagus excision sparked ideas.

Vagus cuts demand upper severance for efficacy.

Pyloroplasty countered retention at stomach base.

Could distal aorta tweaks mirror this for dissection patient?

Blood vessels differ vastly from nerves.

Nerves transmit intricate bioelectric impulses.

Miswiring risks shorts or chaos.

Unique signals per nerve weave complex commands.

Blood vessels carry uniform blood.

Head-to-toe blood swaps freely.

Circulation flows nonstop.

Avoid artery-vein mixups, and issues stay nil.

A promising path emerged.

Distal aorta bypass, leveraging arterial universality.

Bypass—radical yet potent—echoes cardiac treatments.

Not novel entirely.

Yet distal-to-proximal aorta bypass innovates.

Diseased aorta spans four branches feeding vital organs.

Severing impossible, but distal reconnection forms fresh paths—a groundbreaking tactic.