This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 73 After all, the eldest brother knows more!
"Xiao Lu, do you know the real reason why I'm not continuing to teach you the spleen-preserving technique?" Chen Song's eyes flickered slightly before he changed the subject, his tone quite conflicted.

Chen Song knew that Lu Cheng was a good learner, but he also knew that there were some surgeries that Lu Cheng couldn't learn.

If it were before, Lu Cheng really thought that Chen Song was 'lazy' or had the idea of ​​'teaching students to starve their masters'.

But now, Lu Cheng's spleen preservation technique has reached the expert level, and he can no longer add any more points to improve it. Lu Cheng naturally understands the root cause.

"I know, Teacher Chen, wait a moment, let me show you my notes." Lu Cheng deftly pulled out his notebook and flipped to a specific page as if reciting a familiar story.

[Main trunk; splenic artery, celiac trunk → four segments of pancreas → splenic hilum]

[First-level branch: Splenic lobe artery, dividing into 2-7 branches at the splenic hilum (upper/middle/lower lobe)]

Secondary branch: Splenic segmental artery, supplying an independent splenic segment (wedge-shaped region)

[Third-order branches: terminal arteries, trabecular arteries → central arteries → capillary arteries]

[Variant branches: splenic polar artery, ectopic pancreatic/gastric branch, direct perforators that do not pass through the splenic hilum]

Advising someone to study medicine is a sin that will be struck by lightning!
Splenectomy is a very simple procedure, belonging to the second level of common general surgery. However, spleen-preserving surgery is hundreds or even thousands of times more difficult than splenectomy.

To perform a splenectomy well, one must first have a thorough understanding of the anatomy of the first, second, and third-order branches of the splenic artery, and be flexible and effective in preserving the spleen and stopping bleeding.

The spleen is an organ, and spleen damage can occur in any location.

The diameter of the splenic artery is not very large, and the diameter of its secondary branches is even smaller. When preserving the spleen or performing partial splenectomy, there is a slight risk of cutting other splenic lobes or segments.

If incision and hemostasis cannot be done in a specific and detailed way, then trying to perform a very complex spleen-preserving procedure is like a eunuch getting married.

"The key point is to master the basics of hemostasis. For example, if you cannot perform 80 precise electrocoagulation hemostasis operations within one minute and the hemostasis error tolerance is less than 4 times."

"Furthermore, the diameter of this hemostatic point must not exceed 1mm."

“If the bleeding from the wound penetrates the entire resection area, then as the surgeon, you will completely lose the opportunity to perform a spleen-preserving surgery and will have to be referred for a splenectomy.”

"This step is too big. With your current ability, you can only complete 40 precision hemostasis procedures per minute at most, and it doesn't require in-depth operation, it's just a simulated hemostasis operation on the surface..."

"In fact, our organs are three-dimensional; they cannot be laid out flat."

"Therefore, you still need to practice the basics of hemostasis for a long time. You need to practice not only planar hemostasis, but also curved hemostasis and deep hemostasis, and you need to improve the efficiency." Chen Song gave specific and targeted instructions, and then added.

“Generally speaking, for a seasoned surgeon to specialize in a particular subspecialty, even after graduating with a doctorate, it still takes more than ten years of diligent and serious study to barely master most of the surgical techniques in that subspecialty.”

"You also need talent. The time you invest is not wasted, but a real and solid investment of a lot of energy in learning and practicing."

"Although both are called surgical procedures, the difference of just one word makes a world of difference."

Chen Song explained to Lu Cheng the learning experiences of many associate chief physicians at Xiangya No. 2 Hospital.

Lu Cheng nodded: "Thank you, Teacher Chen. I will collect some practice modules on the basics of hemostasis and then practice the techniques and skills. I will report my progress to you, Teacher Chen, as soon as possible..."

As Lu Cheng was speaking, there was a knock on the door: "Dr. Lu! The patient outside is here again, saying he still wants to have the surgery here."

The voice sounds like Tian Duoduo from the nursing department.

After hearing this, Chen Song immediately stretched and asked, his words slightly slurred, "What happened?"

“Oh, Dr. Chen, a patient with a ruptured A3 flexor tendon in the lower limb came in recently. The patient said, ‘If I can’t guarantee the effectiveness of the surgery, what kind of doctor am I, and what kind of surgery do I perform?’” Lu Cheng then chuckled, “He also said that doctors like me have become the black sheep of the hospital, shirking responsibility and pushing all the blame onto the people.”

"So I told him to go and find someone more capable..." Lu Cheng replied calmly.

Chen Song suddenly felt bored; he had thought it was a surgery he was required to perform.

He waved his hand and said, "Then go do your thing..."

Lu Cheng stood up and straightened his white coat in front of the mirror.

On September 2nd, Lu Cheng was complained about by a patient because his attire was not neat. The medical affairs department called him and ordered him to straighten his clothes in the future, but they did not criticize him.

But once you've learned your lesson, you'll be wiser, and Lu Cheng didn't want to waste complaint resources on such trivial matters.

As Lu Cheng stepped outside, he spotted the young man with the tattooed arms sitting in a wheelchair, his face full of apology. Upon seeing Lu Cheng, the man reached out to shake his hand, saying, "Brother, I'm so sorry."

"Your brother here is a rough fellow, not very educated, and I do have a foul mouth. I'm not good at speaking, and I've offended you before." The burly young man with some kind of tattoo was smiling obsequiously.

"There's no offense involved, but the surgery is still the same one I just mentioned, the situation is still the same, and the risks are still the same."

"Tendon suturing carries the risk of rupture, the risk of a second surgery, and the risk of poor postoperative functional healing." Lu Cheng didn't think there was anything wrong with what the young man said. The A3 area of ​​the lower limb flexor tendon is a rupture at the transition between the gastrocnemius and soleus muscles, and the first choice for treatment is the Pulvertaft weaving technique!
Even Professor Tong Yuan'an hadn't fully mastered this suturing technique. Most of his procedures were prepared for advanced hand surgery procedures such as finger replantation and tendon transfer, unlike Lu Cheng's eclectic approach.

Previously, Tong Yuan'an used fascia embedding reinforcement combined with the modified Tang method to treat the condition, and the postoperative results were acceptable.

But Lu Cheng had nothing better to do, so in order to pursue better treatment efficiency for patients, he also practiced the Pulvertaft weaving method and tried it on the patients.

After all, it's the preferred treatment method, and its effects are truly remarkable.

Moreover, the Pulvertaft weaving technique is more effective than the modified Tang technique with fascia embedding reinforcement, and on average, it yields about 0.2 more skill points.

Therefore, for tendon ruptures in this area, Tong Yuan'an no longer routinely performs the procedure in the orthopedics department; he will refer the case to Lu Cheng instead.

The young man berated Lu Cheng and then tried to seek medical treatment elsewhere... the outcome was predictable.

Even if he went to the state hospital, he could only "cope" with it, but this guy demanded "guaranteed results," and it was absolutely impossible to find such a hothead in the county.

The young, burly man laughed heartily, his fat bulging as he said, "Risk is risk! But who told you to be a doctor like Dr. Lu?"

"Dr. Lu, I'll sign the papers, I'll pay, I want the surgery, and I'll never run away again."

"If the surgery doesn't work out, I'll just consider it bad luck."

The reason why the young, strong man had a bad temper was mainly because he had some connections.

After gaining a little bit of connections and making inquiries from various sources, I found out, oh my god, the person he was referring to as a "harmful figure" was actually an "expert"!
Even after Lu Cheng's patients went to work in Jilin City and went for follow-up examinations at the State People's Hospital, many doctors there became aware of Lu Cheng's name...

"You're not going to the state hospital anymore?" Lu Cheng asked again to confirm.

Patients have the right to informed consent and the right to refuse informed consent, as well as the right to be referred to a higher-level hospital for further treatment.

After all, the older brother knows a lot.

(End of this chapter)