My Medical Skills Give Me Experience Points Chapter 1399 - 556: Preoperative Assessment—The Two Most Easily Overlooked Malignant Transformations

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Previously on My Medical Skills Give Me Experience Points...
Zhou Can arranges for Director Zhong Ming to accompany him on a surgery, asking him to keep his identity secret. Jiang Wei joins Zhou Can for ward rounds and then they head to First Hospital. At the hospital, they are met by Song Qian, who seems impressed by Zhou Can. Jiang Wei uses her connection to secure Zhou Can's agreement to the surgery, highlighting her role in bringing him there.
“This is Director Tan Shengli from our Digestive Department!” Song Qian was the first to introduce a middle-aged man leading the group. “This is Dr. Zhou Can from Tu Ya, this is his surgical nurse Jiang Wei, a returnee with a doctoral degree. This is his colleague, who has come to learn.” When introducing the three people, Zhong Ming was placed last. Throughout the process, Zhong Ming’s name wasn’t asked. If it weren’t for Zhou Can’s presence, Zhong Ming might not have been allowed into the operating room. “I’ve long heard of Dr. Zhou’s reputation. Thank you for your efforts!” Tan Shengli didn’t shake hands with Zhou Can but nodded and smiled in greeting. In the operating room, people can talk, but physical contact is very rare. Theoretically, the area above the waist needs to be kept sterile. The gloves, surgical gowns, masks, and head caps used in each surgery are paid for by the patient. Every penny should be spent wisely. Wasting arbitrarily, even though patients and their families might not pursue it due to ignorance, there will be some oversight within the hospital. Of course, the operating room has always been the core of the hospital, so oversight is relatively lax. It’s rare for leaders from the Medical Department, Quality Control, or Hospital Administration to enter the operating room and watch doctors perform surgery. After all, if it makes doctors nervous and causes a surgical accident, who would be responsible? Furthermore, the status of lead surgeons is not low; they are often the technical backbone of the hospital. With a little more experience, they may also hold some administrative positions in the hospital. No department administrators would want to offend them. At most, after the surgery ends, people from infection control would occasionally enter the operating room for spot checks. They check whether infection control measures in the operating room are implemented and whether trash is properly disposed of. In the operating room, medical and household waste must be separated. If caught mixing them, expect reprimands and fines. Some doctors, for convenience, throw medical waste into black plastic trash bins. A more responsible circulating nurse would usually correct it face-to-face if noticed. But even she can have ’drowsy’ moments. Especially if an incident occurs with the patient mid-operation, everyone is busy saving the patient, leaving no time to attend to these minor matters. “Director Tan, you’re too kind!” After greeting, Zhou Can consciously eyed the patient on the operating table. “That is our anesthetist, Director Hei.” “Hello, Director Hei, I’m pleased to collaborate with you.” Zhou Can clearly showed more regard for the anesthetist, greeting them very humbly. Surgeons and anesthetists need to cooperate closely and work together during surgery. This person is equivalent to Zhou Can’s comrade in this operation. Naturally, building a good relationship is necessary. The lead surgeon holds a very high position in the operating room, akin to a captain, but cannot work alone. To successfully complete a surgery, collaboration from anesthetists, surgical nurses, and assistants is needed. Missing any party would be detrimental. Especially in relatively larger surgeries like this. “A good hero needs three helpers,” as the saying goes, is certainly applicable. “Looking forward to a pleasant collaboration!” Director Hei was a female doctor, appearing to be in her early forties, wearing black-framed glasses, and looking quite serious. When greeting Zhou Can, her face was devoid of any smile. The vast majority of anesthetists maintain this demeanor. It’s not entirely because they are inherently aloof or prideful, but because of the ever-changing nature of surgeries. Out of professional habit, they maintain a stiff face, always on high alert. Over time, they’ve developed the habit of remaining serious during work. “Is the patient now under general anesthesia?” Zhou Can noticed the patient was unconscious upon entering. The patient showed no response while he was talking to other doctors. “Yes, the patient is successfully under general anesthesia and stable; we can proceed with the operation at any time.” Seeing Zhou Can inquire about the patient’s condition, Director Hei responded in detail. “Earlier, I noticed an incision on the left posterior lateral side of the patient’s chest; is that from the previous surgery?” Zhou Can closely observed the patient’s surgical incisions, including the shape, length, whether they were red or pus-filled, how well they were sutured, etc. These could largely deduce the previous surgeon’s skill level. However, considering that Level 3 and Level 4 surgeries in large hospitals are often completed by multiple doctors together, poorly made or poorly sutured incisions don’t necessarily reflect the lead surgeon’s subpar skills.It's conceivable that an assistant was responsible for opening the patient's chest. Closing the thoracic cavity afterward is a task that some more skilled resident doctors can indeed manage. In the context of a major surgical procedure, the number of participating individuals is strictly limited. Many resident doctors are afforded only the chance to observe and gain knowledge from the sidelines, which itself is considered a significant opportunity. Even within the sterile environment of a Level 100 laminar flow surgical suite, the number of medical personnel entering is reduced to the absolute minimum. If their presence isn't essential, they are frequently subject to stringent controls. For example, during a Level 3 surgery, the anesthesia team might be allocated a maximum of three positions. In reality, this often comprises a seasoned anesthetist and an anesthetic nurse, amounting to two individuals. Occasionally, they might include a trainee, bringing the total to three. Regarding surgical nurses, there are typically one or two instrument nurses and one circulating nurse. This circulating nurse functions much like a vital housekeeper during the operation, proving indispensable. There tends to be greater flexibility with the surgical team. Usually, a single lead surgeon is present, though in exceptional circumstances, surgeons working in tandem might occur. Should the patient necessitate simultaneous surgeries in both the abdominal and thoracic regions, dual lead surgeons could be involved.