Practicing embroidery on the wings of the cicada

Occupational hazards faced by physicians in different departments vary

Writing |Yao Yuan

Source | “Medical Community Think Tank” Public Account

Voice is also known as the second face of a person, and it may take 10 years to cultivate an excellent voice doctor. Because throat surgery under a microscope is like dancing on an embroidery needle. But the recent emergence of an innovative medical training system has broken this dilemma:

It not only allows young doctors to complete the operation volume of experts for ten years in one day, but also has been recognized by experts from well-known domestic hospitals such as Zhongnan Xiangya and the First Affiliated Hospital of China Medical University. , many deans even led their teams to come, and the 2-day special training class was so popular that it was hard to find one.

Not long ago, Lei Wenbin, director of the Otolaryngology Hospital of Zhongshan No. 1 Hospital, took this innovative system, the simulation training system for laryngeal microsurgery, and signed up to participate in the capacity of the National Health Commission. Construction and Continuing Education Center hosted the first National Continuing Medical Education Innovation and Development Case Collection Activity for the New Road “Routine” program.

“Medical Think Tank” had the honor to have a conversation with Lei Wenbin and Professor Deng Jie, Dean of the Otolaryngology Hospital of Sun Yat-sen First Hospital, and have a further in-depth understanding of the development and improvement of this innovative system.

The training dilemma of pharyngolaryngology clinicians:

Ten Years of Success

There may be no more than 10 experts who can perform minimally invasive throat and voice surgery in China.

On the Fudan Ranking 2020 comprehensive list of ENT specialists, the First Affiliated Hospital of Sun Yat-Sen University ranked 4th. Even in such a top department, Director Lei Wenbin still admitted that the training Such talents are difficult, he explained to the “medical think tank”:

First of all, the surgical site is located deep in the mouth, and after the entrance, it needs to be probed into about 20 cm. The space is narrow, and it needs to be exposed with special instruments before the operation;

Secondly, the needle type of 8 0s is used for surgical suture, any hand shaking will be magnified several times or even more than ten times, which requires extremely high stability of the operator’s hand;

Finally, a lot of minimally invasive voice surgery requires suturing, and the suturing of minimally invasive surgery is very difficult and requires a lot of practice to be skilled and standardized. However, in reality, young doctors have very few opportunities to get started. .

Although with the advancement of medical education and technology, simulation training has become popular in the surgical system, and even animal experiments and simulation training are already in the regular training courses of surgeons, but the current domestic throat voice Surgery does not yet have mature equipment that can be used for simulation training, and young doctors can only perform actual operations on patients under the supervision of superior doctors. Considering patient safety, most young doctors only perform non-core operations. As long as the patient is in danger, the superior doctor will immediately stop it and take over to continue the operation.

“Even for this kind of practice, there are very few opportunities, and most of them rely on video and video to learn. Because of this, the growth of young doctors is relatively slow.” Professor Deng Jie said Summarize the dilemma of pharyngologist training.

Shotgun for Cannon,

Laryngeal microsurgery becomes a master craftsman

Director Lei Wenbin found that with the birth of some new professions in society, such as Internet celebrities, more and more patients have throat lesions and need to seek medical treatment,” said (the proportion of patients) ten One part is not excessive, and the operation is very delicate and demanding.” In addition to his clinical work, he is also very interested in mechanical design.

Is it possible to design a laryngeal microsurgery simulation training system for young doctors to learn and use? After the idea came into being, even he himself felt a little fanciful, but despite this, he started to act.

The first step is to select the appropriate test material. “In the beginning, we went to the anatomy teaching and research department of the medical school to cooperate with the general specimen. Although the simulation degree is very high, the cost is very high, and only one can be used at a time.” Lei Wenbin turned his attention to animals. After trying all the dogs, sheep, and pig throats, he and the team finally decided to use pig throats. First of all, pig throats are cheap enough. You can buy three or four for ten yuan. Pig itself is also food, which is more convenient to obtain, and also avoids some ethical issues of animal protection.

After determining the test material, how to fix it becomes a new problem to be solved. Lei Wenbin’s first thought was to fill the basin with sand to fix the mineral water bottle, then put the pig’s throat in the mineral water bottle, and the mobile phone holder lifted the rubber hose needed for the operation. In this way, the first-generation training system was built little by little. Although it was still quite primitive, it also laid a solid foundation for future upgrades.

“Our professors still often talk about the stalk of ‘mineral water bottle’.” Talking about the first system that he explored, Director Lei Wenbin is very familiar, eloquent, humorous, and amusing. The people present couldn’t stop laughing.

During the epidemic this year, Director Lei Wenbin ordered aluminum plates from the Internet at home, drew drawings, drilled holes, designed and polished the third-generation laryngeal microsurgery simulation training system. Do it, all by hand.” He spoke with pride. It is reported that the latest version of the simulation training system has been upgraded. It not only customized fixed molds for professional mold companies, but also added professional equipment such as tables, throat tubes, microscopes, etc. for doctors to support the elbows, and even equipped with the latest big data tracking and analysis system. , just like “the shotgun for the cannon”.

“Some young doctors in our department feel that the operation is not perfect, and they will practice on the training system a few times. After the big data analyzes the reason, they end the practice with satisfaction.”


“I thought I did it, but it turned out to be our Professor Deng”

“Our training classes are held twice a year for 2 days each time.” Professor Deng Jie said, if this is the case, there are still a lot of deans and directors who came to inquire about registration, okay? The places that are easy to grab are only willing to go to the senior doctors in Corey. Many doctors who have studied have also said that the training has benefited a lot and has greatly helped to improve their professional skills.

Professor Deng Jie gave two examples.

During the second training class in 2020, the department asked postgraduates and graduate students to come and help. After the training, they can also carry out some learning operations. “In a recent training class, they have reached the level of senior attending physicians in some basic operations of laryngeal microscopy, or the level of otolaryngologists for more than 5 years. They are in line with our new students. You must know The trainees in the training class are very senior, and 70% of them have worked in ear, nose and throat specialists for more than 5 years. For them, this is very beneficial when looking for a job after graduation, and we did not expect such a good harvest. “< /p>

An in-patient training doctor also made a deep impression on Professor Deng Jie. After two days of training, he completed routine operations such as cutting and stitching in three to five minutes, which originally took ten, twenty minutes or even half an hour.

Speaking of this, Director Lei Wenbin added loudly without losing time: “Our professor Deng is the beneficiary of this training system! It’s a good example!” World Think Tank” shared an interesting story.

Professor Deng was playing a video of an operation. Director Lei Wenbin, who was passing by, looked at the skillful technique in the video and thought it was his own operation, but the more he watched, the more strange it became, especially the suture at the end. , not like his own method. Only then did he know that the person in the video was none other than Professor Deng Jie, and was taken aback. Speaking of which, Director Lei Wenbin was proud and half-jokingly added: “I have been a professor for decades, she has just been promoted to (professor) for two years, she has grown so fast in a short period of time, and she has learned everything. , I will depend on her for meals in the future.”

Director Lei Wenbin talks about innovation:

Top disciplines keep top secrets

As the head of the department, Director Lei Wenbin also has his own understanding of innovation.

In his view, innovation is first and foremost personal innovation, and only innovation can make the discipline stand in the top position at home and abroad. As the top hospital in China, the First Affiliated Hospital of Zhongshan encouraged all doctors in the department to innovate and provided corresponding resources and platforms. “If there is no innovation, don’t talk about moving forward, it will be difficult to maintain, and you will find that you will soon fall behind.”

Director Lei Wenbin said that he has applied for nearly 10 invention patents, and he is still striving for innovation on the road of innovation. After the achievement, it is an important reason to turn to the minimally invasive field.

From a national level, the standardization and standardization of medical technology is also conducive to improving the clinical level of medical care in my country. This is the case for regular and specialized training. This laryngeal microsurgery simulation training system is more It is so. Director Lei Wenbin revealed that in the future, he also hopes to promote this system, so that more doctors can be trained, and more excellent throat and voice surgeons can be trained!

Source: Medical Think Tank

Proofreading: Zang Hengjia

Editor in charge: Tian Dongliang

* The medical community strives for the accuracy and reliability of its published content when it is reviewed and approved, but does not regard the timeliness of the published content, and the accuracy and completeness of the cited materials (if any), etc. Make any promises and guarantees, and do not assume any responsibility for the outdated content, possible inaccuracy or incompleteness of the cited information. Relevant parties are requested to check separately when adopting or using it as a basis for decision-making.