System Came When the Doctor was Thirty

”Xiao Lu, do you know the fundamental reason why I don’t continue teaching you the spleen preservation surgery?” Chen Song’s gaze flickered slightly before he changed the topic, his tone rather conflicted.

Chen Song certainly knew that Lu Cheng had a good learning efficiency, but Chen Song also knew that there were some surgeries that Lu Cheng could not master.

In the past, Lu Cheng might have really thought that Chen Song was ’lazy’ or had the mindset of ’teaching a student starves the master.’

But now, Lu Cheng’s spleen preservation surgery has reached a specialized level, and he can no longer add points to push forward, so Lu Cheng naturally understands the fundamental reason.

”I know, Teacher Chen, hold on a moment, let me look at my notes for you.” Lu Cheng quickly pulled out his notebook and turned to a fixed page as if showing off his treasures.

[Trunk; Splenic artery, celiac trunk → peripancreatic four segments → splenic hilum]

[Primary branch: Splenic lobe arteries, 2-7 branches divided at the splenic hilum (upper/middle/lower lobe)]

[Secondary branch: Splenic segment arteries, supplying independent spleen segments (wedge-shaped regions)]

[Tertiary branch: Terminal branch arteries, trabecular arteries → central arteries → penultimate arterioles]

[Variant branches: Splenic pole arteries, ectopic pancreatic branches/gastric branches, direct perforators not going through the splenic hilum]

To persuade others to study medicine is like asking for a bolt of lightning from the heavens!

Spleen removal surgery is very straightforward, considered a common secondary surgical technique in general surgery. However, the difficulty of performing spleen preservation surgery is a hundred times or even a thousand times more challenging than spleen removal surgery.

To perform splenectomy well, one must first be thoroughly familiar with the anatomy of the first, second, and third branch arteries of the splenic artery, and be agile and effective in hemostasis during spleen preservation.

The spleen is an organ, and injury to the spleen can occur at any location.

The diameter of the splenic artery is not very large, and the diameter of its secondary branches is even smaller, so when preserving the spleen or removing part of it, a slight error can cut into other spleen lobes and segments.

If the incision technique and hemostasis technique are not precise, attempting a highly complex spleen preservation surgery would be like a eunuch taking a bride.

”The core key lies in mastering the basics of the hemostasis technique, such as completing 80 precise electrocoagulation hemostasis actions within a minute, with an error tolerance of less than four times.”

”And the diameter of this hemostasis point should not exceed 1mm.”

”If the wound oozes blood, it will seep through the entire excised surface, and then, as the chief surgeon, you will have completely lost the opportunity to perform a spleen preservation surgery, and will have to transfer to a splenectomy.”

”The gap is too large at this step, and with your current ability, you can only complete 40 precision hemostasis actions within a minute. This also doesn’t require depth operations, only simulating hemostasis on the surface...”

”In reality, our organs are three-dimensional; they won’t allow you to lay them out flat.”

”So, you still need to practice the basics of hemostasis techniques for a long time, not only practicing surface hemostasis but also curved-surface hemostasis and deep hemostasis, and you need to increase your efficiency.” Chen Song pointed out specifically, then said.

”In general, mature surgeons wishing to specialize in a certain sub-specialty still need to study diligently for more than ten years after completing their doctorate to barely grasp most techniques in that sub-specialty.”

”This requires talent as well. The time invested is not squandered; instead, it’s solid, real investment of considerable effort into learning and practicing.”

”Being called a surgical technique, with just a word’s difference, there’s a world apart.”

Chen Song explained the learning background of many associate chief physicians at Xiangya Second Hospital to Lu Cheng.

Lu Cheng nodded his head: ”Thank you, Teacher Chen. I’ll gather some modules for practicing the basics of hemostasis techniques, then work on the methods and skills, and report my progress to you anytime...”

While Lu Cheng spoke, there was a knocking sound: ”Dr. Lu! The patient outside has come again, saying they still want to have surgery here.”

The voice sounded like Tian Duoduo from the nursing department.

Upon hearing this, Chen Song stretched lazily and mumbled, ”What’s going on?”

”Oh, Teacher Chen, previously there was a patient with a rupture in the A3 zone of the flexor tendon of the lower limb. The patient said I couldn’t guarantee the surgical outcome, what kind of doctor am I, what kind of surgery am I doing.”

Lu Cheng continued with a light laugh, ”He also said that doctors like me are a bane to the hospital, not taking responsibility, and putting all the blame on the ordinary people.”

”So I just advised him to seek out a more capable doctor...” Lu Cheng calmly replied.

Chen Song suddenly felt uninterested; he thought it was a surgery he must perform personally.

He waved his hand, ”Then go ahead and do your thing...”

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

On September 2nd, Lu Cheng was complained by a patient, whom he didn’t know, for improper attire. The medical department specifically called to order him to maintain proper attire, but didn’t really criticize him.

But once bitten, twice shy; Lu Cheng didn’t want to waste complaint resources on such trivial matters.

When Lu Cheng went out, he immediately saw the young man with tattooed arms sitting in a wheelchair, with a face full of apology. Upon seeing Lu Cheng, he extended his hand for a shake, ”Bro, I’m really sorry.”

”Your brother is a simple man, uneducated, and does indeed have a foul mouth, doesn’t know how to speak, please excuse my previous offenses.” The young burly man with an unknown tattoo on him smiled obsequiously at that moment.

”No offense taken, but the surgery is still the same one I mentioned earlier, the situation is still the same, and the risk remains unchanged.”

”Tendon suturing has a risk of rupture, secondary surgery risk, post-surgical functional healing risk.” Lu Cheng didn’t find anything wrong with the young man’s words. The A3 zone of the flexor tendon of the lower limb involves the gastrocnemius-soleus transition rupture, with the initial treatment choice being the Pulvertaft weaving method!

This suturing technique, even Tong Yuan’an hasn’t completely mastered, most of his techniques are prepared for high-end hand surgical techniques such as finger reattachment, tendon transposition, unlike the mixed batch of Lu Cheng.

Previously, Tong Yuan’an dealt with it using fascia embedding and reinforcement combined with the modified Tang method, which worked well post-surgery.

But Lu Cheng, having ’free time,’ pursued better patient treatment efficiency, so he ’practiced’ the Pulvertaft weaving method to try it on patients.

After all, it was the recommended treatment method, and the effect was indeed solid.

Moreover, the Pulvertaft weaving method has better treatment outcomes than the improved Tang method plus fascia embedding and reinforcement, with an average gain of about 0.2 more skill points.

Thus, with tendon rupture in this area, Tong Yuan’an no longer performs it routinely in orthopedics and refers it to Lu Cheng.

The young man criticized Lu Cheng then thought of seeking treatment elsewhere... the outcome was predictable.

Even if he went to the State People’s Hospital, they could only ’make do,’ and this guy’s demand for ’guaranteed results’ was certainly impossible to find any rash doctor in the county.

The young man’s expression was ’relaxed,’ layers of fat formed a smile, ”Risk is risk! Who says these risks were pointed out by you, Dr. Lu?”

”Dr. Lu, I’ll sign, I’ll pay, I’ll have the surgery, and I won’t run anymore.”

”If the surgical results aren’t good, it’ll just be my bad luck.”

The reason for the young man’s temper is mainly that he has a bit of a network.

After inquiring through various channels with his bit of a network, he found out, heavens, the person he labeled as a harmful figure is actually an ’expert’!

In fact, because Lu Cheng’s patient went to Ji City for work and then went to the State People’s Hospital for follow-up, many doctors there knew of Lu Cheng’s reputation...

”So you’re not going to the State People’s Hospital?” Lu Cheng asked to confirm once more.

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

It turns out the young brother is well-informed.