Practicing Medical Skills in a Small Clinic

"It’s okay, we still have a chance in the second round. The first batch was all top hospitals; in the second batch, the competition for surgical qualifications will be much lower."

Hu Jia comforted Professor Chen Anchen.

Soon, the second batch of ten cases was released.

This time, Chen Anchen and Hu Jia did not choose a low-risk case but selected a medium one.

In fact, the surgical difficulty wasn’t particularly high; the main focus was on evaluating the comprehensive scores in four aspects: preoperative, intraoperative, postoperative, and prognosis.

True expertise can shine through while treating even a simple case.

Rather than tackling an exceptionally difficult case that others have already managed to handle.

This time, they chose the fourth case.

The number 4 is considered unlucky, but their team had already lost the first-round surgical qualification. If they lost again, they would be out of the race for the trophy.

The results came out quickly again.

A total of eleven hospitals answered the fourth question; fortunately, the strength of the second hospital was enough.

With the narrowest of margins, thanks to the 1 point bonus earned by Li Jingsheng, they edged out the second place by one point and successfully obtained the surgical qualification.

Chen Anchen was extremely excited.

Hu Jia appeared much calmer, and Li Jingsheng was arguably the calmest in the team.

He was only a guest participant.

Winning a prize didn’t concern him much.

For Chen Anchen, winning a prize was very important.

This is why, among the three members of the team, he was the most excited.

When something doesn’t concern you, your attitude is generally detached.

The patient they selected actually had a surgery of considerable difficulty.

Although it was only a secondary surgery, it required a high standard from the doctor.

The two surgical nurses were brought over by the second hospital.

It was unlikely any team would dare use the surgical nurses from Qiaobang Hospital.

Due to the competitive interest relationship, who knows if the nurses from Qiaobang would pull some tricks?

Even a small mistake could lead to lower scores.

"Foot joint fusion surgery, both Director Hu and I have performed many such cases, so we have plenty of experience. For the parts of the surgery that we aren’t proficient in, we’ll have Dr. Li handle them."

Chen Anchen made a simple arrangement.

"No problem."

Li Jingsheng readily agreed.

Chen Anchen’s surgical skills were strong in every aspect, and Hu Jia was the same. The areas where they might need Li Jingsheng’s help were likely minimal.

Mainly just assisting them, holding retractors, and such.

Whether he would need to do the stitching was still uncertain.

The patient had traumatic arthritis, combined with a degree of avascular necrosis of the talus, causing severe instability in the ankle joint.

It was currently in a state of equinovarus deformity.

The inversion angle exceeded 170 degrees.

It fully met the surgical indications.

Although it didn’t seem difficult, there were indeed many challenging details.

After the team entered the operating room, they got right to the procedure.

Anyway, Vice Dean Jin was quite pleased that Chen Anchen’s team won the surgical qualification.

Because there were only twenty surgical qualifications in total.

A total of at least one hundred and thirty or forty hospitals sent orthopedic representatives.

Orthopedic trauma itself is a very popular medical field.

The revenue-generating capability goes without saying.

Which hospital’s orthopedic department isn’t lucrative?

If the business is slightly better developed, the revenue-generating capability could be even stronger than in major departments like cardiac surgery and neurosurgery.

Even if the second hospital’s orthopedic department relied entirely on manual bone setting drainage, its revenue capacity remained very strong.

This is evident if you look at Director Hua’s status in the hospital.

When Li Jingsheng first showed his talent in manual bone setting, Director Hua directly convinced the hospital higher-ups to specially recruit him. The conditions offered were extremely favorable.

Because orthopedics is so popular, any hospital with a little strength would engage in this project.

This also led each hospital to wish to showcase itself in the skills competition, to expand or enhance its reputation.

The competition was intensely fierce, which was understandable.

The patient had already been sent to the operating room, lying quietly on the operating table, waiting for the surgery.

The examination report was extremely detailed.

The organizers were worried about unexpected events during surgery and had done all the necessary tests.

With the condition of this patient, staged surgery was an option.

First, do a triple joint surgery, then three months later, proceed through the posterior heel approach to do the ankle joint fusion surgery.

The specific surgical plan choice was primarily discussed between Chen Anchen and Hu Jia, with Li Jingsheng having little to add.

There was no way around it since it wasn’t his strength.

He needed to keep accumulating surgical case treatment experience.

"The foot and ankle deformity is very severe!"

Standing at the lead surgeon’s position, Chen Anchen hesitated to make the first cut, holding the scalpel.

Judging by the situation, he didn’t seem very confident.

Incision is a fundamental skill every surgeon needs to master.

But not many can really practice it to perfection and precision.

Watching from the side, Li Jingsheng assessed silently, knowing that the cut had to extend along the patient’s ankle all the way forward to the position below the outer edge of the extensor tendon.

The presence of deformity meant uncontrollable vessels and an uncontrollable incision line.

The risks were substantial.

If this were a surgery room at our own hospital, we could think of some alternative solutions.

We could even invite other surgeons with strong incision skills for support, but now we can only cut with gritted teeth.

Because giving up is equivalent to forfeiting.

Don’t even think about winning a prize.

Clearly, this is a surgery we could do, yet this unexpected incident has left Chen Anchen in a dilemma.

Forcing the surgery carries a very high risk of causing trouble.

At that time, if a medical accident occurs, it would be more severe than forfeiting. It would not only tarnish the hospital and the department but also cause significant impact on Chen Anchen’s medical career.

Causing a medical accident is a major taboo for doctors.

A doctor spends their lifetime working diligently and cautiously, hoping to retire at chief physician. This is the most ideal state.

One or two minor incidents are unavoidable.

But if a major incident occurs and is taken to court by the family or investigated by the authorities, the problem becomes very serious.

"Director Hu, come have a look at his incision site."

Chen Anchen considered all options but ultimately decided not to take this enormous risk.

Compared to causing an incident, he’d rather forfeit.

At least he could maintain some dignity; if an accident occurs, it would really be terrible.

In front of the patient, he couldn’t outright tell Hu Anchen, "Director Hu, this patient’s foot deformity is severe, I can’t cut it, can you?"

Saying that might scare the patient into climbing off the operating table right away.

Hu Jia had already been observing the patient’s foot.

At this moment, he leaned in closer, took a look, and also shook his head slightly.

"The deformity is indeed severe. You should have come to the hospital for treatment earlier!"

He turned to scold the patient.

Letting it get this severe before treatment only unnecessarily increases the difficulty of the surgery for the doctors, doesn’t it?

"The conditions in our town are limited, we’ve been doing conservative treatment, dragging it on until it became like this. Can it still be treated now?"

The patient looked innocent but was also worried.

Judging by his age, he seemed to be only forty-seven or forty-eight, not very old.

If he lives a bit longer, he might have only lived half his life.

With the continuous improvement of living standards, people’s average life expectancy is getting longer and longer.

Many people can live to eighty-five or eighty-six, even beyond ninety years old.

"We will research it first, you lie there and don’t move."

Chen Anchen spoke formally to the patient.

Li Jingsheng watched from the side as both directors were hesitant to make an incision, and after weighing the options, he also lacked confidence.

But if he could elevate the skin incision method by one level, the assurance would increase greatly.

"Director Chen, for cases with severe deformation like this, I actually have some experience."

Li Jingsheng’s remark was more of a probe.

If Chen Anchen agreed to let him try, he would elevate the incision method by one level.

After all, it would cost nearly eight hundred points of life value, and he was indeed a bit reluctant.

His incision method was currently quite advanced, and he hardly hesitated to make incisions.

But wanting to ensure no mistakes, that’s relatively challenging.

In a competition, merely guaranteeing no problems is not enough. Cutting crookedly wouldn’t earn you a place, would it?

Knowing well that a place couldn’t be won, there is no need to perform this surgery.

Because there are no benefits to gain, and there’s significant risk.

Better to directly forfeit.

"Then take a look!"

After a brief exchange of eye contact with Li Jingsheng, Chen Anchen finally agreed to let Li Jingsheng try.

"Alright!"

Li Jingsheng didn’t hesitate this time, he directly spent 814 life points to level up the incision method.

Skin incision method perfect 2000/5000.

After upgrading, upon observing the incision site drawn on the patient’s foot, he had at least three different incision plans in his mind. All could ensure high scores.

"Due to severe deformity in both the ankle and dorsum of the foot, a single cut from the ankle to the base could easily go wrong. Depth is also hard to control. So I propose cutting in two stages for possibly satisfactory results."

Li Jingsheng proposed his incision plan.

Under normal circumstances, the common practice in surgeries is to make a single cut.

Even in classes, teachers teach this.

This time, Li Jingsheng proposed breaking the rigid rules set by teachers, and instead cleverly adapting to the patient’s actual situation by cutting twice.

"Dr. Li, the incision is entrusted to you, the subsequent joint fusion surgery will be executed by Director Hu and me."

Chen Anchen had collaborated with Li Jingsheng multiple times.

Knowing Li Jingsheng never spoke boastfully or recklessly.

Seeing Li Jingsheng proclaiming with certainty his striking incision plan, Chen Anchen decided to take the gamble.

Take a chance, turn a bicycle into a motorcycle.

This case is absolutely worth the gamble.

According to fair principles, the incision difficulty of this case is very high, hence, if it is executed well, definitely some extra points can be earned.

Or perhaps every surgery case has a challenging aspect.

This is an intentional test for them.

After all, the examiners have their tradition; unless they stump many contestants, their advanced setting level is not shown.

"Alright!"

Li Jingsheng responded concisely and forcefully.

Taking the lead surgeon position, he said to the instrument nurse "Just give me the traditional surgical blade."

The feeling of using the traditional surgical blade is more distinct, while the electric knife is convenient, for such a high-difficulty incision, choosing traditional surgical blades, cold weapons, is more prudent.