Professor Lang Jinghe's lecture -- how to learn surgery

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A, CASE1, how we treat an operation, with what method of governance, this concept should be correct. ConceptWhen does palace neck cancer com



1, how we treat an operation, with what method of governance, this concept should be correct. Concept

When does palace neck cancer come to do an operation, when do not have an operation, when should do cure?. When ovarian cancer to do surgery, is the first to fight chemotherapy and then surgery, or direct surgery, these are a concept, these concepts are the most important. So first is a concept, also known as Concept.

2, the second is to have a very good anatomy. (important)

I speak on the first day, is the anatomical route, the route with you while you can't do anything, not good, but you don't know where to go.

Surgery is the same, the anatomy of the operation, that is, our surgical route, is our way.

So no matter how many years you have been a doctor, how many surgery. Anatomy is still the most important.

3 the third is your skill. (hand)

Of course is important, is that you have a good surgical technique, we can observe several operations of their skills, their skill is very good.

4/ fourth is emergency treatment. Emergency

Various problems encountered in the operation (bleeding, injury problems).

Emergency should do,

You can not repair, probably know what is wrong with the car.

But to do surgery, they should be able to deal with these emergencies. Otherwise, you will have no way.

So it's very important to have ideas, anatomy, techniques, and emergencies. These 4 words add up to CASE. We passed a case of a case, CASE BY CASE, one to accumulate our experience, to form our style, to be a very skilled surgeon, a gynecologist.

Second, how to do surgery, another concept is decision-making.

Decision making is the most important and skill is second.

Choice accounted for 75%, an operation success, skills accounted for only 25%.

What is decision making? Decision making is a very divisive,

Diagnostic treatment specification,

Treatment principle,

To choose a good indication,

Have a good preoperative preparation,

Surgical design,

Surgical considerations and strain,

Selection of surgical range,

Sometimes the operation also do well, too, it's not a blind road.

Finally, after the treatment, all of which are decision-making.

These should be considered before surgery, and then the operation.

So, this is how to do a good idea of surgery.

Three, how do we practice this operation?

Of course, to practice knotting, practice incision, suture practice, etc. This is the basic skills.

We emphasize the practice, one is to learn more to see.

Study what? I think a very important thing is to learn to develop a habit of looking at anatomical maps.

We have a variety of anatomy, systematic anatomy, local anatomy, I also said that day, there are applied anatomy, there are static anatomy, dynamic anatomy, and so the anatomy. A surgeon at his desk in his bed, put on a very good anatomical atlas of anatomy books, I think it is very necessary. I've been doing this for years, and I have to read a few times a week. Not to say that you do not understand this map, it is necessary to ponder this map, it is very important.

I also stressed that some of the classic map, including the classic books. We have a lot of things on the Internet right now. It's very good. Our Dr. Gong Xiaoming is very good.

But you still have time to see a classic things, see the classic rules of Obstetrics and Gynecology, gynecological pathology Novak, are these. These are very good, because you can learn the knowledge and skills in addition to these, you can also experience the minds of these pioneers and masters, which is very important.

In addition to the regular operation demonstration, to watch the video. In addition, often to listen to some lectures, and practice.

I also emphasize the importance of our logical thinking and image thinking.

What is logical thinking? Is that you have to interpret the whole process, you have to analyze.

Image thinking is that you have to be good at drawing maps, you have to think about their own image, these combined, the operation probably how to do, you want to come out of this process.

In addition, you can well describe the operation process, and you use the map to express it, this is a way to exercise our brains.

One hand, one is mental. We do not completely or just to be a craftsman, should also be a scholar.

How to practice surgery, practice first. Practice alone is not enough, or should be thinking. To bring our experience to the practice of things to sublimate, this is a really useful thing.

You just do it, and you can't think about it.

Therefore, I gave a book to a student in a book, wrote such a passage, perhaps we have seen. Is a three year resident I, a doctor, she is the teacher for several years round things recorded, and finishing, and refer to some articles, some reference books, a book called, a good one simple thing, I call her "Department of Obstetrics and Gynecology clinical memorandum", is also very interesting. In this page, I gave her a question like this: we are not learning, learning is not much, but we think is not enough; we think is not enough, but we're going to get us to think our sublimation is not enough; we remember not less, but to forget the. So we should practice more thinking, and forget to fight, so you can do. So that you can form their own strengths, to form their own style, you will become a more mature surgeon.

Finally, we'll talk about how to get a perfect operation.

First of all, we must comply with the principles of surgery, as we have just begun to say, there are norms and principles which is the most important.

Next we will know how to deal with a benign lesion and how to deal with a malignant lesion. In different tissues of malignant tumor is a malignant disease that is not the same, even in the same organ of the malignant tumor, so their classification, different stages, different grade, is not the same. For example, an ovarian cancer, different ovarian cancer, epithelial, or gonadal interstitial, or germ cells are not the same. Stage, an early and late, a 1 and phase 4 is not the same. Classification and cell differentiation 123 are not the same. These principles are very important. This is called standardization, is your general behavior is good.

In addition, we emphasize the individualization. We emphasize the individualization of the two: one is the condition, one is human.

This sentiment is not the general situation of the people we talk about, you have to pay attention to your patients, this is called human. Condition, not only do not see a doctor. In addition, it is important to know the patient, including her family. There was a note that we did today, a radical hysterectomy for cervical cancer, and she had a baby. Is it because she is still a strong demand for a child, she is not a target of second? She should have, or she would have been raised. So we respect her wishes.

The third is that we must grasp the indications and contraindications.

Here we emphasize that the concept, ability, experience, and technique of the operator are also important conditions.

Today, I saw a variety of surgery, there are more general surgery but do different styles, there are more difficult surgery and difficult surgery, also known as endoscopic surgery. So it is not necessary for us to study here, I think that is not necessarily. We can't ask a doctor to do all kinds of surgery, and we can't ask a doctor to do all the work in one way or another. Therefore, we have to master a variety of operations, to be able to master a variety of operations, but also their best at what surgery, this is a good doctor a good surgeon.

Third, we should pay attention to humanization. Especially modern, how effective and minimally invasive, how to retain or maintain her physiological function, and to take care of the patient's fertility, if she asked. These requirements, these are also reflected in human. Or by laparoscopy, a small incision, a small transverse incision, or a vaginal incision, have a beautiful incision. Beautiful, of course, is a skill. So a perfect operation should be like this.

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