Women like their delicate skin, pretty face, protruding forward and backward, sexy figure, and pursue sweet and lovely beautiful appearance by any means; What's more, not satisfied with cosmetic whitewashing, they went overseas for cosmetic surgery and sought the transformation from cocoon to butterfly.
What surgeons like is that every knife is accurate, every ligation and suture is just right, the operation process is as smooth as running water, and the surgical specimens are as perfect as works of art.
There is nothing wrong with pursuing perfection.
Just as women's pursuit of beauty improves men's taste and promotes fashion trends; Surgeons' pursuit of perfection has also improved their own level and promoted the progress of medicine.
? However, the pursuit of perfection often requires a price.
If a woman's pursuit of beauty is nothing more than painting, wiping, fiddling and sorting, and most of the time it is only a man's wallet that is injured, then the surgeon's pursuit of perfection is full of traps, bumpy and sometimes even expensive.
Because the perfection of the operation depends on the handling of some details, some of which are related to the surgical effect, and some of which have no obvious relationship with the surgical effect.
For example, when colon cancer is operated on the right colon, theoretically, as long as the fatty lymph tissue at the root of the blood supply vessel is cleaned up, the D3 radical effect can be achieved, but some people will peel off the adventitia of the superior mesenteric vein and even the artery without leaving a trace of fat.
There is nothing wrong with this, of course, because the perfect operation should be like this. Lymphatic dissection, not only lymph nodes, lymphatic vessels, adipose tissue and any tissue that may hide cancer cells are completely removed, achieving the most thorough radical cure, visually beautiful and maximizing the effect. However, the handling of details is often the most technical and level, and sometimes it is related to the mood and mentality of the surgeon.
The heart should be flat, the hands should be steady, the movements should be bold and accurate, and strive for one step in place, slowly and steadily; If you are impetuous, emotional, rude and not in place, causing bleeding or collateral damage, and then rework to remedy it, it will often make you embarrassed and dangerous.
? To experts, danger means safety. The closer to the blood vessels, the clearer it will be, the clearer it will be when walking, the clearer the tissue gap, and the more comfortable it will be when you are free. For ordinary people, danger is a real threat, just like walking a tightrope on a cliff. If you are not careful, once you miss, you will be in danger and flustered, making yourself in a hurry and endangering the safety of patients.
? Once, I had laparoscopic right colon surgery for ascending colon cancer. The exposure of superior mesenteric vein, the disconnection of ileocolic artery and vein, the disconnection of right colon artery, the exposure of surgical trunk, the exposure of Henle trunk, the exposure of the root of the artery and vein in colon, and the dissection of lymph nodes have all been successfully completed, only waiting for the disconnection of the artery and vein in the root colon.
When the arteries and veins in the colon were exposed, I noticed that the vein was next to the artery with a small gap in the middle, and the vein was hidden behind the artery. After it emanates from superior mesenteric vein, it immediately branches into left and right branches, and the trunk is very short.
Carefully separate the middle colon artery from the vein. When cutting the middle colon artery from the root, put a blood-locked vascular clamp at the proximal end of the vein. Because the trunk is too short and the gap is not enough, the titanium clamp is only placed at the distal end.
When I put on the titanium clip, I was a little worried, because the clip was just at the bifurcation of the blood vessel, and the titanium clip might not be long enough to completely clamp the branch blood vessel. Of course, for the sake of safety, I installed two titanium clips.
In fact, I thought at that time that the safest way was to separate the left and right branches of the vein, so that the risk of bleeding would be much smaller; Although this is not a vein cut from the root, it will not affect the effect of radical surgery because the root lymph nodes have been cleared.
It's much safer to break from a branch than from a root, but it doesn't always feel so perfect. In the pursuit of perfect surgery, I think, since it is free, it is better to cut off the middle colon vein from the root. Anyway, the vein near the heart has been blocked very accurately. Even if there is bleeding, it is far from the heart and there is not much movement. (meditation, an opportunity given by the surgeon)
Of course, as feared, there is no suspense in the bleeding of distal blood vessels. Fortunately, I am prepared in my heart, but I am not too flustered. It's just that there was an episode in the operation for no reason, and I always felt very unhappy.
I sometimes ask myself, is this a blind pursuit of norms? What is the meaning and value? We talk about norms every day and implement them. Have we become slaves to norms, forgetting that we are the main body of surgery and that we can actually think and be flexible?
I think, the so-called perfect surgery should be to understand the meaning of the standard and learn to be flexible, improvise according to the actual situation of the patient, properly handle every detail with just the right means, and sometimes even ignore (unimportant) details.
The first essence of surgery is safety. Pursuing visual and psychological perfection without surgical safety is tantamount to ignoring the importance and giving up the basics. Of course, we can't sacrifice the quality of surgery, ignore the requirements of the specification, scribble, and regard surgical safety as a shield for our incompetence and incompetence.
Surgeons must be soberly aware of what they can do, what they can't do, what they should do and what they shouldn't do. They can do better and do their best only so far.
For the operation of difficult and dangerous parts, it is necessary to evaluate whether you can do it, whether you are good at doing it, and what is the difference between doing it and not doing it. If there is little difference between doing it and not doing it, it will not affect the effect and it will be harmless. Due to the limitation of my own level and ability, from the perspective of surgical safety, sometimes it is perfect to leave a little regret.
Surgeons want to make every operation a perfect work of art.
However, gold is not pure, no one is perfect, and surgery is always full of regrets, or sometimes surgery with regrets is the real art.
If you have something, you will lose it, and the gains and losses will always be conserved.