My Medical Skills Give Me Experience Points

Chapter 1281: Chapter 505: Solution to Side Effects and Innovative Surgical Approach

Anesthesiologist Zi Qu and anesthetic nurse Qin Yue walked into the operating room together.

Although the reform in the anesthesiology department is still in its pilot phase, the two of them have essentially teamed up with Zhou Can.

Or rather, as long as there’s an anesthetic surgery in the Emergency Department, the two of them will prioritize it.

For the operating room in the Emergency Department, it’s basically Dr. Xu who calls the shots.

Dr. Xu treats Zhou Can as his successor, essentially making all affairs centered around Zhou Can.

Zhou Can and Zi Qu have reached a consensus and formed a partnership, and Dr. Xu approves and supports this tacitly. Whenever there is anesthetic surgery, he directly asks Zi Qu for assistance.

"What condition does this patient have?"

Zhou Can asked Zi Qu.

The anesthesiologist must have already thoroughly understood the patient’s condition, physical status, medication allergy history, and other information. Before the surgery, they still need to talk with the family and sign the anesthesia informed consent form.

Usually, the anesthesiologist and the chief surgeon discuss the patient’s condition to determine the surgical plan.

Zhou Can was really busy today.

It’s estimated that Dr. Xu replaced him in drafting the surgical plan with Zi Qu.

"The patient has a refractory duodenal ulcer with particularly high gastric acid. It’s likely causing her considerable discomfort. Additionally, she’s generally allergic to proton pump inhibitors, has a rather special constitution, and can only undergo surgery."

Excessive gastric acid can burn the mucosa and the stomach wall, the duodenal mucosa and the intestinal wall. The most common symptoms are heartburn, stomach pain, discomfort, nausea, and lack of appetite, among others.

If there are no special reasons, duodenal ulcers are often quite easy to cure.

However, there are a small number of patients who have recurring ulcers that are difficult to cure.

At this point, further investigation is needed to find the cause of the duodenal ulcer.

Western medicine is exceptional in this regard, wherever there’s a problem, it treats it.

High blood pressure? Use antihypertensive drugs and blood pressure quickly drops. Respiratory failure? Straight to a ventilator. A burst blood vessel? Immediate surgery to stop the bleeding and repair the vessel.

In short, as long as the cause is found, Western medicine can always find a solution.

Even with terminal illnesses like cancer, many types have already been conquered. And progress continues to be made.

With today’s technology, if cancer is detected in its early stages, the treatment results are typically very satisfactory.

"High gastric acid is often related to excessive secretion of gastric acid. Is it to reduce her gastric acid secretion through surgery now?"

"Precisely!"

Dr. Xu walked in.

"Which surgical plan do you think is best?"

Dr. Xu likely wasn’t only testing him but was also interested in hearing Zhou Can’s surgical opinion.

Currently, in many surgeries, Zhou Can can offer unique insights and even some novel surgical plans.

"Uh... If it’s a refractory duodenal ulcer and caused by high gastric acid, I think severing the vagus nerve is a good option."

After careful consideration and based on the patient’s actual condition, he gave his surgical opinion.

"Not bad, your surgical capabilities and thought process are getting better and better."

Dr. Xu expressed his appreciation.

His surgical plan is likely the same as Zhou Can’s.

This is also one of the most commonly used surgical plans for treating this disease.

Of course, it cannot be applied rigidly; it must be based on the patient’s actual condition.

The purpose of severing the vagus nerve trunk is to block the gastric acid secretion caused by the vagus nerve, thereby reducing the amount of gastric acid and curing the duodenal ulcer.

It must be stated that severing the vagus nerve trunk is a last-resort surgical option, as it will cause a range of side effects after being severed.

For example, the vagus nerve has an acid-regulating effect on the stomach wall muscle.

Once severed, it can no longer control the stomach wall muscle, resulting in the loss of functions such as contraction, expansion, and peristalsis of the stomach wall.

The stomach is an important digestive and food storage organ in the human body.

Its function is self-evident and can be referred to as the ’granary.’

When it loses the aforementioned functions, various adverse reactions can occur.

The patient may experience severe gastric emptying disorders and food retention.

Due to the high side effects of this surgery, it is rarely used clinically unless absolutely necessary.

Excess gastric acid is mainly treated clinically with gastric acid suppressants now. Proton pump inhibitors and H2 receptor blockers are the two most commonly used drug categories.

Omeprazole, Rabeprazole, Lansoprazole, etc., are all commonly used drugs.

They have quite a good effect on suppressing gastric acid secretion.

But when faced with patients who are allergic to these drugs or have unique poorly-absorbing constitutions, other methods must be considered.

Severing the gastric vagus nerve is very suitable for this patient.

After administering general anesthesia to the patient, inserting a urinary catheter, the surgery officially started.

Because it’s quite a major surgery, Dr. Xu was somewhat concerned and served as an assistant to Zhou Can.

He now rarely guides Zhou Can on specific surgical steps, just purely serves as support. He lets Zhou Can handle as much as possible on his own.

After opening the abdominal cavity, an automatic abdominal retractor was used to open the abdominal wall.

Then they explored the area with the ulcer.

Only after determining the location could they prepare for the next step of the severance surgery.

The patient’s duodenal ulcer was quite severe.

No wonder she kept moaning when brought in for surgery.

The pain and discomfort of the human body are not only unbearable when giving birth.

For example, trigeminal neuralgia is recognized in medicine as the highest level of pain. Or when more than a third of the airway is blocked, the suffocating feeling can bring significant suffering to the patient.