What Is the Preoperational Stage?

Although medical reform has witnessed unprecedented developments in China's medical technology and medical equipment, the reform has made it difficult for the people to see a doctor, see a doctor expensively, and over-medicine. Even though there are various forms of medical treatment, medical institutions in various places Race to introduce talents and build high-end diagnosis and treatment sites, but primary medical institutions are facing the embarrassing situation of shrinking and unattended, which seriously departs from the harsh reality of China s large population and the initial stage of socialism. It can be said that medical reform has a long way to go.

Surgical grading system

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Medical reform, although China's medical technology, medical treatment

At the same time, experts pay a lot of fees for various types of fee-charging items, including name-calling and name-calling surgery. People everywhere irrespective of the size of the hospital and regardless of the qualification of doctors, race to launch some difficult surgery items. Here, frequent medical disputes occur. This triggered the emergence of a hierarchical surgery management system. First, pilot projects in Henan, Hainan, and Tianjin ("Hainan Provincial Hospital Surgery Management Standards (Interim)") were gradually rolled out across the country. At present, it has become a key system for regulating medical institutions and practitioners.

Surgery and invasive surgery graded surgery refers to a variety of open surgery, laparoscopic surgery and anesthesia methods (hereinafter collectively referred to as surgery). According to its technical difficulty, complexity and risk, surgery is divided into four levels:

Primary surgery: Various operations with low technical difficulty, simple surgical procedure, and low risk.

Secondary surgery: all kinds of surgery with moderate technical difficulty, uncomplicated surgical procedure, and medium risk.

Tertiary surgery: Various operations with greater technical difficulty, more complicated surgical procedures, and greater risks.

Four-level surgery: Various operations that are technically difficult, complicated, and risky.

According to his health technical qualifications, employed technical positions and years of work in corresponding technical positions, the level of surgeons is specified. All surgeons should obtain the qualifications of practicing physicians according to law.

1. Resident

(1) Residents with low seniority: those who have worked in the resident position for less than 3 years, or have obtained a master's degree and have worked in the resident position for less than 2 years.

(2) Residents with senior qualifications: those who have worked in the residency position for more than 3 years, or obtained a master's degree, obtained the qualification of a licensed physician, and have worked in the residency position for more than 2 years.

2. Attending physician

(1) Low-level attending physicians: those who have engaged in the post of an attending physician for less than 3 years, or who have obtained a clinical doctorate and engaged in the post of an attending physician within 2 years.

(2) Senior physicians: Those who have worked in the position of attending physician for more than 3 years, or have obtained a doctorate degree in clinical work, and have worked in the position of attending physician for more than 2 years.

3. Deputy Chief Physician:

(1) Associate Chief Physician with low seniority: who has worked in the post of Deputy Chief Physician for less than 3 years, or has a post-doctoral degree and has worked in the post of Deputy Chief Physician for more than 2 years.

(2) Senior Senior Physician: Those who have worked in the post of Deputy Chief Physician for more than 3 years.

4. Chief Physician: employed as a post physician.

(1) Residents with low seniority: under the guidance of a senior doctor, they can preside over first-level surgery.

(II) Senior residents: On the basis of mastering the first-level operation, the second-level operation can be carried out gradually under the guidance of the doctor on the spot.

(3) Low-level senior physicians: They can preside over secondary surgery, and gradually carry out tertiary surgery under the guidance of a senior physician.

(4) Senior senior physician: Can preside over tertiary surgery.

(5) Associate Chief Physician with low seniority: can preside over the third-level surgery, and gradually perform the fourth-level surgery under the guidance of the doctor on the spot.

(6) Senior Senior Physician Deputy Chief Physician: Can preside over four-level surgery, under the guidance of a higher-level physician on the spot or according to the actual situation, he can preside over new technology, new item surgery and scientific research item surgery.

(7) Chief Physician: Can preside over Level 4 surgery, general new technology, new project surgery, or high-risk scientific research project surgery approved by the competent authority.

(8) In addition to qualifying for surgery, in addition to meeting the above requirements, the chair of the surgery must also be a qualified person for the corresponding special surgery.

1. The professor in the operating department must be the chief physician or deputy chief physician. The professor in the operating department determines the list of surgeons and assistants for each operation in the group according to the doctor's level. If a general consultation is needed, it should be submitted to the department director at least 1 day in advance to organize a general consultation and approval.

2. The director of the department approves the list of surgeons and assistants for each operation in each medical group of the whole department, ensuring that the physician level corresponds to the surgery classification, and the signature takes effect. In principle, skip surgery is not approved. Approval is allowed under special circumstances, but there must be guidance from a superior physician.

3 When selecting a doctor, patients should take the medical group as the unit and implement the doctor's graded surgery system as a prerequisite.

Surgery approval authority refers to the approval authority for different levels of surgery and different situations and types of surgery to be performed. The hospital has implemented a computer-managed surgery notice, and the written signatures of the department heads and professors should be implemented in the review and approval column of the preoperative summary.

Routine surgery:

First-level surgery: With the approval of the group professor, the doctor in charge who is the chief physician or above reports the operation notice.

Second-level surgery: With the approval of the professor in the group, a doctor with a senior doctor or higher should report the operation notice.

Tertiary surgery: Approved by the director of the department, the physician who is the deputy chief physician or above will report the operation notice.

Four-level surgery: The department chief approves, and the senior physician with a deputy chief physician or above reports the operation notice.

1. Eligibility for surgery

Qualified admission surgery refers to the surgery that requires special surgical qualification certification or authorization according to the regulations of the municipal or higher health administrative department. The competent administrative department of health at or above the municipal level or a professional academic institution recognized by it shall issue hospitals and surgeons with special surgery qualification admission certificates or authorization certificates. Only the surgeons who have obtained the corresponding types of surgical qualifications have the authority to conduct qualified admissions operations.

2. High-risk surgery

High-risk surgery refers to any level of surgery deemed high-risk by the director of the operating department. Subject to discussion within the department, the director of the department reports to the medical department after signing and agreeing, and the person in charge of the medical department decides to approve or submit it to the vice president of the department for approval. After approval, the director of the surgical department is responsible for approval.

3. Emergency surgery

Surgery can be performed when the level of the operation is expected to be within the level of operation authority of the doctor on duty. If it is a high-risk operation or the operation is expected to exceed the level of its surgical authority, an emergency report should be taken with the group professor for approval, and if necessary, it should be reported to the department director. However, in the case of emergency rescue of life, during the period when the superior doctor is temporarily unable to attend the operation to preside over the operation, the doctor on duty has the right and must, according to the specific circumstances, preside over the rescue operation that he deems reasonable, and must not Delayed rescue time.

4. New technologies, new projects, scientific research surgery

(1) General new technology, new item surgery, major surgery, and disability surgery must be discussed in the department. After the director of the department signs the consent opinion on the completed "Important Surgery Approval Form", it is reported to the medical department and filed by the medical department. And approved.

(2) High-risk new technologies, new projects, scientific research and surgery shall be reported by the hospital to the provincial health department for approval. When necessary, the academic group commissioned by the Provincial Department of Health will demonstrate it, and it can be implemented in the hospital only after it has been reviewed and approved by the expert committee.

5. Surgery that needs to be reported or approved to the medical department.

(1) Major or new surgery in this discipline.

(2) Surgery involving famous experts at home and abroad.

(3) Surgery with poor prognosis or high risk.

(4) Surgery that may cause medical disputes or reoperations that have medical disputes.

(5) Surgery by foreign guests, celebrities from Hong Kong, Macao and Taiwan invited by the state.

(6) Surgery for cadre patients (provincial, municipal, school leaders, well-known figures inside and outside the province).

(7) Surgery that may cause disfigurement or disability.

(8) Large organ transplantation.

The above operations must be discussed within the department, and the department director should sign and agree to report to the medical department for the record, and the department chief of the operation department is responsible for approval.

6, out of consultation surgery

Practitioners of the hospital who are invited to surgery outside the unit or field must go through relevant examination and approval procedures in accordance with the requirements of the "Practising Physician Law" and the "Regulations for the Administration of Physicians' Out-patient Consultation". The operation conducted by the out-going surgeon must not exceed the corresponding operation level specified in these rules.

1. In order to ensure medical safety, according to the responsibilities of the doctor's professional title, a hierarchical surgery system for doctors at all levels is implemented. Each operating department shall implement the regulations on the scope of operations of physicians at all levels, and bring the group professor or the director of the department to approve the list of surgeons and assistants participating in the surgery according to the regulations. When the surgeon upgrades the level of surgery, the head of department and the professor in the group will carry out a specific assessment, and it will take effect with the signature and seal of the "pre-operative summary" approval process.

2. The operation is performed according to the determined division of labor of the surgical personnel, and no leapfrogging operation is allowed. During the operation, the scope of the surgery may be enlarged or the planned operation may be changed according to the medical condition. The superior doctor shall be consulted to perform the operation according to the doctor's graded operation scope. If you perform extra-level surgery, you need to be approved by the director of the department and there must be the guidance of a superior physician.

3. Except for those who are undergoing surgery, they must ask their superiors for instructions. The superiors must not directly participate in the surgery without consulting the patient, not participating in the preoperative discussion, and not going through the surgical procedures.

4. New technologies, new projects, scientific research operations must obtain the informed consent of the patient or immediate family members, and sign the informed consent notice.

Departments and persons responsible for surgery that violates the authority of this Code will be investigated for responsibilities if they are verified. For those who cause medical accidents, the corresponding personnel will be held responsible.

Defining the surgical authority of doctors at all levels is a powerful measure to regulate medical behavior, ensure medical safety, and protect the interests of patients. All operating departments and doctors at all levels must strictly follow the implementation.

Gynecology

Primary surgery

1. Dilatation and curettage 2. Fallopian tube ventilation and fluid flow 3. Posterior fornix puncture 4. Vulvar and cervical biopsy 5. Surgical removal of benign vulva and vestibular large cyst 6. Transvaginal pedicled uterine muscle Tumor excision 7. Cervical polyp removal, Cervical neoplasm resection 8. Cervical electrocautery, cryosurgery, and laser treatment

Secondary surgery

1. Hysterectomy, hysterectomy and appendectomy 2. Laparoscopic accessory surgery 3. Transabdominal myomectomy 4. Endometriosis surgery 5. Simple urinary fistula repair 6. Posterior vault incision 7. Annex resection 8. Ectopic pregnancy surgery

Tertiary surgery

1. Uterine fistula and fecal fistula repair 2. General hysteroscopic surgery 3. Broad ligament myoma and cystectomy 4. Simple vulvectomy 5. Uterine prolapse or transvaginal repair 6. Pelvic abscess removal and drainage Operation 7. Enlarged, extensive and sub-extensive uterine resection 8. Extensive vulvar resection and inguinal lymph node dissection 9. Complex endometriosis 10. Cervical fibroidectomy

Fourth-level surgery

1. Pelvic dissection 2. Combined pelvic organ resection 3. New technology and new item surgery 4. Radical surgery for complex ovarian and choriocarcinoma 5. Vulvovaginoplasty 6. Vulvar reconstruction 7. Laparoscopic hysterectomy

Obstetrics

Primary surgery

1. Perineal incision and perineal suture 2. Perineal and degree laceration repair 3. Classical cesarean section 4. Induction of labor 5. Fetal head suction 6. Conventional midwifery

Secondary surgery

1. Uterine laceration repair 2. Gluteal traction 3. Artificial placental dissection 4. Gluteal midwifery 5. Low neck cesarean section 6. Classical cesarean section

Tertiary surgery

1. Extraperitoneal cesarean section 2. Hysterectomy for cesarean section 3. Surgery for uterine rupture in late pregnancy 4. Fetal destruction 5. Forceps 6. Hysteromyomyoma of cesarean section 7. Pregnancy with ovarian pedicle torsion 8 .Accessory resection, tumor resection

Fourth-level surgery

1. Critical surgery 2. New technology and new item surgery 3. Repair of perineal degree laceration 4. Reduction of uterine withdrawal 5. Pregnancy complications (heart disease, hyperthyroidism, blood system diseases, etc.) 6. Cesarean section

Department of Reproductive Medicine

Primary surgery

1. IUD placement 2. IUD removal 3. Fallopian tube ventilation and fluid flow 4. Induced abortion and suction 5. Abdominal tubal ligation 6. Amniotic fluid puncture 7. Villus removal

Secondary surgery

1. tubal anastomosis 2. tubal ostomy 3. tubal angioplasty 4. artificial insemination

Tertiary surgery

1. Vaginal tubal ligation 2. Laparoscopic intrauterine transplantation 3. Laparoscopic egg retrieval 4. Laparotomy and oviduct gamete 5. Laparoscopic egg oviduct gamete

Fourth-level surgery

1. Anastomotic fallopian tube transplantation 2. Allogeneic fallopian tube transplantation 3. Ovarian transplantation 4. New technology and new item surgery

ENT

Primary surgery

1 Tonsillectomy, squeezing 2 Pharyngectomy 3 Nasal cavity, posterior nostril tamponade 4 Conventional tracheotomy 5 Turbinectomy 6 Vocal cord polyp removal 7 Tympanostomy 8 Simple mastoidectomy 9 Behind the ear Subperiosteal abscession 10 Maxillary sinus puncture 11 Preauricular fistula removal 12 Simple esophageal foreign body removal 13 Adenoid curettage 14 Middle ear cannulation 15 Nasal bone fracture reduction

Secondary surgery

1 Mastoidectomy 2 Tympanoplasty (Type I) 3 Nasal Septum Submucosal Orthopedics 4 Complex Esophageal Foreign Body Removal 5 Maxillary Sinus Surgery 6 Benign Mass Resection of the External Auditory Canal 7 Nasal Incision 8 Paranasal Sinus Surgery

Tertiary surgery

1 Full auricle external ear canal plastic surgery 1 External ear cancer surgery 3 Tympanoplasty (types ~ ) 4 Middle ear malignant tumor surgery 5 Nasopharyngeal atresia and hysteria surgery 6 Laryngotracheoplasty 7 Nasal plasty 8 Nasal cavity and Maxillary sinus tumor resection 9 Cerebrospinal fluid rhinorrhea repair 10 Tracheal foreign body removal 11 Laryngeal and total laryngectomy 12 Nasopharyngeal fibrohemangioma removal 13 Auricle deformity correction surgery 14 Endoscopic paranasal sinus surgery

15 Vocal Cord Surgery 16 Cervical Surgery

Fourth-level surgery

1 Eustachian tube angioplasty 2 Labyrinthectomy 3 Ear sclerosis surgery 4 Acoustic neuroma resection 5 Larynx, laryngo, esophageal resection and primary reconstruction 6 Laryngeal reconstruction after total laryngectomy 7 Acoustic angioplasty after total laryngectomy 8 Sphenoidal tumor resection 9 Nasal meningoencephalocele repair 10 Transnasal pituitary tumor resection 11 New technology item surgery

Ophthalmology

Primary surgery

1. Minor eyelid surgery 2. Correction of ectropion 3. Correction of ectropion 4. Correction of blepharoplasty (if it is cosmetic surgery, it should be secondary) 5. Double eyelid surgery (if it is cosmetic surgery, it should be secondary) 6. Trachoma follicle crushing and trachoma rubbing. 7. Pterygium excision and conjunctival transplantation. 8. Corneal and conjunctival foreign body removal (superficial corneal foreign body) 9. Eyeball removal and eyeball enucleation 10. Tears Probing and dacryocystectomy 11. Ciliary body condensation

Secondary surgery

1. Corneal laceration suture 2. Correction of drooping eyelid 3. Correction of eyelid retraction 4. Correction of blepharoplasty 5. Lacrimal plasty, correction of lower lacrimal ectropion 6. Lacrimal canaliculi and anastomosis, Lacrimal nasal anastomosis 7. Conjunctival masking 8. Resection of benign conjunctival lesions 9. General strabismus surgery 10. Intraspherical foreign body aspiration 11. Glaucoma surgery 12. Irisectomy, trabeculectomy, and angular incision Technique

Tertiary surgery

1. Optical corneal transplantation 2. Refractive keratoplasty 3. Refractive keratotomy 4. Excimer laser surgery 5. Lamellar keratotomy 6. Intracapsular cataract extraction, extracapsular cataract extraction, crystal emulsification Lens extraction 7. Simple retinal detachment surgery 8. Pedicled skin flap, arterial island flap transplantation and repair, full-thickness eyelid defect reconstruction 9. Eyelid and conjunctival malignant tumor resection and formation 10. IOL implantation 11. Vitreous body Lens resection 12. Complex ophthalmic surgery (paralytic strabismus, nystagmus, extraocular muscle strabismus, etc.) 13. Decompression of the optic canal 14. Removal of magnetic and non-magnetic foreign bodies in the posterior pole 15. Orbital Internal tumor removal

Fourth-level surgery

1. Large orbital tumor removal 2. Skull base surgery involved 3. New technology and new item surgery 4. Retinopathy of prematurity 5. Subretinal foreign body removal and retinectomy 6. Macular translocation 7. Special types of retina Detachment surgery (macular hole retinal detachment, large retinal retinal detachment, cataract and aphakic retinal detachment, retinal detachment with choroid detachment, choroidal defect with retinal detachment, retinal detachment with retinolysis, diabetic retinal detachment, retina Necrotizing retinal detachment, Coats disease retinal detachment, retinal choroid tumor retinal detachment, etc.)

neurosurgery

Primary surgery

1. Scalp mass resection 2. Skull fracture reconstruction, skull tumor resection and skull defect repair 3. Epidural and subdural hematoma, abscess clearing 4. Subtemporal decompression

Secondary surgery

1. Cerebral debridement 2. Intracerebral hematoma, removal of brain abscess 3, Superficial tumor resection of the cerebral hemisphere 4, Intraspinal tumor resection 5, Cerebrospinal fluid nasal fistula and ear fistula repair 6, Meningocele, Spinal column Fissure, spinal meningocele surgery 7, ventricular-abdominal shunt surgery 8, whole brain angiography 9, retrograde decompression surgery 10, severe craniocerebral injury surgery

Tertiary surgery

1. Pituitary tumor resection 2. Facial muscle spasm and microvascular decompression 3. Superficial tumor resection: meningiomas, gliomas 4. Cerebellar tumor resection 5. Removal of occupying lesions in the saddle area 6, extracranial, cranial Internal artery vascular anastomosis surgery 7, neuroendoscopic surgery 8, lateral ventricle, fourth ventricle tumor resection

Fourth-level surgery

1. Intracranial aneurysm clipping and embolization 2. Cerebral arteriovenous malformation (AVM) resection and embolization 3. Cavernous sinus arteriovenous fistula surgery 4. Cerebellar cerebellar horn tumor surgery 5. Rock slope tumor surgery 6. Brain stem Tumor resection 7, high cervical spinal tumor resection 8, saddle nodular meningiomas, 1/3 meningiomas in the sphenoid condyle and cavernous sinus tumor resection 9, third ventricle tumor, craniopharyngioma, and pine cone Total body tumor resection 10, Internal carotid artery and vertebral artery stent placement 11, Internal cranial artery stent placement 12, New operation

Hepatobiliary and Pancreatic Surgery

Primary surgery

1. Simple open cholecystectomy, gallbladder ostomy 2. Simple common bile duct incision and stoma 3. Hepatic cyst opening and liver abscess incision and drainage 4. Acute pancreatitis drainage surgery and external drainage of pancreatic cysts

Secondary surgery

1. More complicated open cholecystectomy 2. More complicated common bile duct incision and stoma 3. General gallbladder, common bile duct-duodenum, jejunostomy 4. Repair of liver rupture, liver biopsy and liver Marginal lesion resection 5. Marginal liver resection, left lateral lobe resection 6. Intrahepatic drainage, intrapancreatic pseudocyst drainage 7. Pancreatic tail resection, pancreatic tail cleft surgery, pancreatic necrotic tissue removal and drainage 8. Laparoscopic cholecystectomy and opening of hepatic cyst 9. Splenectomy 10. Hepatic artery ligation, embolization and hepatic artery, portal vein intubation, chemotherapy box implantation 11. Oddi sphincteroplasty 12. Percutaneous transhepatic cholangiopancreatography And drainage (PTC, PTCD) 13. Simple portal drainage

Tertiary surgery

1. Hepatectomy 2. Hilar hepatobiliary angioplasty and high hepatobiliary jejunostomy 3. Complex or improved common bile duct jejunostomy 4. Common bile duct cyst surgery 5. Re-biliary duct surgery 6. Laparoscopic bile duct surgery 7 Endoscopic, X-ray or ultrasound-guided gallstones, biliary stricture stent surgery 8. Pancreatoduodenectomy, pancreas, pancreatic head resection 9. Complex laceration of pancreatic head and combined pancreaticoduodenal injury 10 . Portal vein shunt and complicated portosystemic surgery 11. Laparoscopic liver margin resection and splenectomy

Fourth-level surgery

1. Liver transplant recipient surgery 2. Hepatectomy over hepatic liver, mid-hepatectomy, hepatic lobectomy 3. Live donor liver resection 4. Pancreas transplantation 5. Budd-Chiari syndrome surgery 6. New technology and new item surgery

Gastrointestinal Surgery

Primary surgery

1. General abdominal hernia repair 2. Appendectomy 3. Simple repair of gastroduodenal ulcer 4. Simple repair of gastrointestinal rupture and stoma 5. General hemorrhoid and anal fistula surgery 6. Small bowel anastomosis and other abdominal cavity Simple surgery of the gastrointestinal tract

Secondary surgery

1. Stomach and colon resection and reconstruction of benign lesions 2. 2. Vagus nerve amputation surgery 3. Simple portal vein cutoff 4. Duodenal surgery and extensive small bowel resection 5. 5. Complex hernia repair and artificial patch hernia repair 6. 6. Complex hemorrhoid and anal fistula surgery 8. Laparotomy of diffuse peritonitis 8. Gastrointestinal fistula repair and ostomy closure General digestive tract foreign body removal

Tertiary surgery

1. Total stomach, total (subtotal) colectomy 2. Radical surgery for gastric, colon, and rectal cancer 3. Cardiac surgery 4. Anal and anal canopy surgery 5. Exploratory surgery in the state of abdominal trauma and shock 6. Digestion Exploratory surgery for hemorrhagic shock 7. Laparoscopic gastrointestinal perforation repair and appendectomy 8. Complex gastrointestinal endoscopy 9. General laparoscopic gastrointestinal surgery for benign lesions 10. Complex and high-risk foreign bodies in the digestive tract Removal 11. Huge polyp removal

Fourth-level surgery

1. Laparoscopic gastric, colorectal resection, and digestive tract reconstruction surgery for malignant tumors 2. Allogeneic small bowel transplantation 3. Laparoscopic radical resection of colorectal cancer 4. New technology and new project surgery

Thyroid surgery

Primary surgery

1. Thyroid adenoma or cyst resection 2. Thyroglossal cyst resection 3. Partial thyroid resection 4. Neck lymphatic cyst resection 5. Neck resection biopsy

Secondary surgery

1. Thyroid lobectomy 2. Major or subtotal thyroidectomy

Tertiary surgery

1. Radical thyroidectomy 2. Cervical lymph node dissection 3. Total thyroidectomy 4. Retrosternal thyroidectomy 5. Parathyroid surgery

Fourth-level surgery

1. Laparoscopic thyroid surgery 2. New technology and new item surgery

Anorectal surgery

Primary surgery

1. Perianal subcutaneous abscess incision and drainage and primary radical resection 2. Simple anal fistula incision, resection or suture line therapy 3. Anal fissure resection 4. Anal papillary hypertrophy 5. Simple internal hemorrhoids and thrombectomy external hemorrhoidectomy 6 Colostomy

Secondary surgery

1. Partial colonectomy 2. Transanorectal benign polypectomy 3. Mixed hemorrhoid external peeling and ligation 4. Reduction of sigmoid colon 5. Anastomotic hemorrhoids with superior mucosal circumcision (PPH) 6. Hidden hair sinus Cyst and Sinectomy 7. Perianal Paget Disease Surgery 8. Parastoma Hernia Repair 9. Stoma Resuscitation

Tertiary surgery

1. Radical surgery for right, left, transverse and sigmoid colon cancer 2. Transabdominal or perineal rectal cancer radical surgery 3. Rectal prolapse fixation 4. Rectal sacral suspension 5. Rectal vertebral vertical bowel sclerotherapy 6 Anal Circle Reduction 7. Ripstein, Goldberg, Aitemeir, Nigro Surgery 8. Complex anal fistula incision or suture 9. Incision and drainage of abscess on the levator ani muscle 10. Transanal or vaginal rectal prosthesis 11. Colon Subtotal resection of cecumectomy 12. Hartmann operation 13. Total colorectal ablation, permanent ileostomy

Fourth-level surgery

1. Expanded radical mastectomy for rectal cancer 2. Modified Bacon surgery 3. Posterior pelvic resection 4. Total pelvic dissection 5. Combined colectomy, ileal pouch anal anastomosis 6. Laparoscopic radical mastectomy for colorectal cancer 7. Each 8. Surgery for complications after colorectal or anal surgery. 8. Surgery with new technology and new items

Urology (Transplant Center)

Primary surgery

Foreskin circumcision, testicular and epididymal resection, testicular sheath or reversal, semen cystectomy, vasectomy, high spermatic cord ligation, prostate biopsy, external urethral incision, urethra Sarcoma resection or electrocautery, urethral dilatation, cystoscopy and ureteral intubation, minor bladder incisions within the bladder (stone removal, foreign body removal, small tumor removal), cystostomy, renal biopsy and renal Puncture ostomy, peri-renal abscess incision and drainage, kidney transplantation, liver and other organ biopsy.

Secondary surgery

Repair of penis, scrotum (injury), partial or total penectomy, surgical treatment of abnormal penile erection, vasectomy, testicular release fixation, testicular torsion reduction, transurethral prostatectomy, urethral stricture incision , Urethral anastomosis and angioplasty, urethral incision and lithography, urethral reunion surgery, hypospadias first stage penile straightening, transurethral resection of bladder tumor, partial cystectomy, bladder neck (open or transurethral) incision Resection, transurethral calculi, lithotripsy, bladder trauma repair, ureterotomy, ureteroscopy, ureterostomy, ureteral anastomosis, ureterocystostomy, ureteral anastomosis, ureteral cyst Resection, pyelotomy, cystectomy, renal or pyelostomy, repair of renal laceration, arteriovenous fistula.

Tertiary surgery

Scrotal angioplasty, simple primary hypospadias repair or secondary urethroplasty, urethral stricture repair, simple bladder (or urethral) vaginal (or bowel) fistula repair, transurethral resection of the prostate, bladder Cervical plasty, total bladder resection, ureteroplasty, pyeloplasty, renal tumor enucleation, laparoscopic nephrectomy, ureteroscopic lithotripsy, nephrolithotomy, nephrectomy , Adrenal adenoma resection, high arteriovenous fistula, transplant nephrectomy, brain death donor kidney, organ removal, donor kidney resection.

Fourth-level surgery

Penile cancer bilateral iliac inguinal lymphectomy, testicular tumor retroperitoneal lymphectomy, complex primary hypospadias repair, superior urethral repair, stress urinary incontinence surgery, radical prostatectomy, bladder eversion repair Surgery, complex bladder (or urethral) vaginal (or intestinal) fistula repair, total bladder resection of the colon, ileum or rectal bladder surgery, nephrectomy, horseshoe kidney isthmus resection, various renal blood vessel surgery, pheochromocytosis Tumor resection, adrenal cancer resection, radical resection of renal pelvis and ureteral cancer, radical resection of renal cancer, laparoscopic nephrectomy, laparoscopic radical prostatectomy, laparoscopic ureteroplasty, laparoscopy Adrenal adrenalectomy, percutaneous nephroscopic surgery, new technology, new surgery, penile prosthesis implantation, living donor nephrectomy, allograft kidney transplantation.

Vascular surgery

Primary surgery

1. Arterial and venous catheterization 2. Vascular suture 3. Superficial venous surgery

Secondary surgery

1. Peripheral arterial and venous thrombectomy 2. Vascular anastomosis 3. Small peripheral arterial and venous tumor resection 4. Simple venous segment grafting 5. Large saphenous vein and superficial femoral vein annulus 6. Large saphenous vein Laser Endovascular Therapy and Rotary Resection 7. Deep Femoral Vessel Valvuloplasty

Tertiary surgery

1. Arterial saphenous vein bypass surgery 2. Arterial vascular grafting surgery 3. Limb aneurysm removal 4. Carotid endarterectomy 5. General inferior vena cava surgery

Fourth-level surgery

1. Thoracic aortic aneurysm and abdominal aortic aneurysm surgery 2. Complex inferior vena cava surgery 3, cervical aneurysm surgery 4, carotid body tumor surgery 5, angioscopy surgery 6, new technology and new item surgery

Orthopedic surgery

Primary surgery

1. General debridement, muscle and tendon repair 2. Manipulative reduction of limb fractures, plaster external fixation 3. Bone traction 4. Reduction of shoulder and elbow joints 5. Removal of tendon sheath cysts 6. Arthrotomy of incision and drainage 7. Incision decompression of fascial space syndrome

Secondary surgery

1. Open reduction and internal fixation of long tube fractures in one limb 2. Management of open fractures (single limb, single site) 3. Complex debridement and tendon repair 4. Tendon displacement and tendon extension 5. Dislocation of upper extremity joint dissection, joint capsule repair 6. Acute and chronic osteomyelitis lesion removal 7. Internal dislocation of joint dislocation 8. Management of multiple open fractures 9. Resection of multiple long limb bone fractures Open reduction and internal fixation 10. Intraoperative reduction and internal fixation of long limb fractures with special technical requirements 11. Debridement of six major joints 12. Arthroscopic meniscectomy and synovectomy 13. Bone transplantation , Joint transplantation, free bone and muscle transplantation with blood vessels

Tertiary surgery

1. Hallux (foot) valgus orthopedics 2. Femoral neck fracture fixation 3. Orthopedic surgery of bones, bone extension 4, joint fusion 5, arthroscopic structural reconstruction surgery 6, arthroplasty, hemiarthroplasty Total hip replacement 7, limb amputation 8, cerebral palsy SPR surgery 9, comminuted fractures of the proximal joint that affect joint function

Fourth-level surgery

1. Pelvic fracture open reduction and internal fixation 2. Sacral tumor resection 3. Artificial total joint replacement, revision surgery, artificial main hip replacement for special types of diseases 4. Artificial total knee replacement 5. Limb tumor bone Segmental resection and reconstruction 6. Congenital hip dislocation surgery 7. New technology and new project surgery

Spine Surgery

Primary surgery

1. Skull traction 2. Sternocleidomastoid muscle cut 3. Extralaminar foreign body removal 4. Soft tissue debridement and exploration 5. Soft tissue abscess incision and drainage

Secondary surgery

1. Endophyte removal 2. Bone graft fusion of posterior lamina, articular processes, and transverse processes 3. Excision of benign tumors of the spinal canal 4. Posterior cervical and lumbar laminectomy decompression of the spinal canal 5. Neck Focus removal of tuberculosis of chest, chest and lumbar spine

Tertiary surgery

1. Posterior lumbar disc nucleus pulpectomy 2. Posterior lumbar disc nucleus pulpectomy 3. Thoracic and lumbar spine fracture posterior incision reduction and indirect decompression and bone graft fusion internal fixation 4. Posterior cervical lamina enlargement Angioplasty 5. Anterior cervical discectomy or subtotal vertebral body bone graft fusion and internal fixation 6. Posterior thoracic spinal decompression 7. Thoracic pedicle screw internal fixation 8. Posterior thoracic and lumbar intervertebral disc pulp Nuclear excision and intervertebral bone fusion and internal fixation 9. Lumbar spondylolisthesis and reduction and internal fixation of intervertebral bone fusion and internal fixation 10. Thoracic and lumbar spine anterior decompression and bone fusion and internal fixation 11. Thoracolumbar spinal injury posterior approach Open reduction 360 ° decompression and bone graft fusion internal fixation 12. Upper cervical spine injury open reduction and reduction and bone graft fusion internal fixation 13. Spinal canal tumor resection

Fourth-level surgery

1. Cervical pedicle screw internal fixation 2. Incision and reduction of direct cervical decompression and bone graft fusion and internal fixation after lower cervical and thoracolumbar spine injury 3. Spinal tuberculosis, benign tumor anterior or posterior lesion resection and bone fusion Fixation 4. Reconstruction of anterior and posterior vertebral resection of malignant spinal tumors 5. Subtotal sacral resection 6. Total sacral resection 7. Scoliosis deformity correction and bone grafting and internal fixation 8. Spinal deformity osteotomy orthopedic implantation Bone fusion internal fixation 9. Spinal deformity revision 10. Percutaneous disc decompression 11. Percutaneous vertebral or kyphoplasty 12. Percutaneous spinal fixation 13. Endoscopic discectomy or release 14. Endoscopic spinal fixation 15. Artificial disc replacement

Thoracic Surgery

Primary surgery

1. Open and closed thoracic drainage 2. Empyema drainage, mediastinal drainage 3. Removal of chest wall lesions 4. Resection of pleural lesions 5. Traction and internal fixation of rib and sternal fractures 6. Tracheotomy

Secondary surgery

1. Thoracic remodeling 2. Lung wedge and local resection 3. Resection of lower esophageal cancer 4. Repair of septal hernia and hiatal hernia 5. Thymus surgery 6. Pleural pleura resection

Tertiary surgery

1. Total pneumonectomy, lobectomy and segmentectomy 2. Total pleural pneumonectomy 3. Tracheal carotid resection and reconstruction 4. Radical resection of middle and high esophageal cancer 5. Mediastinal tumor resection 6. Complex thoracoscopy

Fourth-level surgery

1. Lung transplantation 2. Combined heart and lung transplantation 3. New technology and new item surgery

Breast surgery

Primary surgery

1 Breast abscess drainage 2 Breast biopsy 3 Resection of benign breast tumors 4 Breast trauma surgery

Secondary surgery

1 Simple breast resection 2 Breast segmental resection 3 Intraductal papilloma resection

Tertiary surgery

1 radical mastectomy and modified radical mastectomy 2 mammoplasty 3 breast reconstruction 4 breast-conserving surgery

Fourth-level surgery

1 Expanded radical mastectomy for breast cancer 2 New technologies and new items for surgery

Cardiac surgery

Primary surgery

1. Pericardial puncture 2. Pericardial incision and drainage, partial pericardial resection 3. Tracheotomy 4. Open arterial catheter ligation

Secondary surgery

1. Extracorporeal circulation establishment 2. Closed heart valve expansion 3. Pericardial exfoliation 4. Atrial septal defect and ventricular septal defect repair 5. Endocardial cushion defect repair

Tertiary surgery

1. Arterial valve angioplasty under direct vision 2. Valve replacement 3. Congenital heart surgery such as triad and quadruple 4. Repair operation of main-pulmonary artery septal defect 5. Simple heart surgery for infants and young children

Fourth-level surgery

1. Repair of intrathoracic large vessel injury 2. Aortic aneurysm surgery 3. Complete aortic transposition correction surgery 4. Cardiac multiple valve replacement and plastic surgery 5. Coronary artery bypass graft surgery 6. Complex neonatal and infant surgery 7. Heart surgery with severe comorbidities 8. Heart transplant, heart-lung transplant, artificial heart implant 9. New technology item surgery

Oral Surgery

Primary surgery

1. General tooth extraction; 2. Tongue and lip correction; 3. Biopsy and pathology; 4. Oral and maxillofacial abscess incision and drainage; 5. Dental trauma ligation and fixation 6. Mandible simple fractured teeth Interstitial fixation 7, alveolar plasty 8, maxillofacial trauma debridement and suture

Secondary surgery

1. Jaw osteomyelitis curettage; 2. Cleft lip and palate repair 3. Replantation of teeth 4. Gum and gingival tumor resection 4 Parotid gland and submandibular gland duct stone removal 5. Removal or scraping of benign lesions of the jaw bone; 6. Intermaxillary splint ligation and fixation; 7. Replantation of teeth 8. Superficial foreign body removal from the maxillofacial region

Tertiary surgery

1. Repair of deformity after cleft lip 2. Orthodontic correction, lip valgus correction 3. Tooth replantation 4. Jaw, sacrum, zygomatic arch fracture reduction 5. Low abutment tooth extraction 6, submandibular gland, Sublingual gland and tumor removal 7, Trigeminal nerve terminal avulsion 8, Partial tongue resection

Fourth-level surgery

1. Temporomandibular joint arthroplasty 2. Removal of oral and maxillofacial hemangiomas 3. Resection of facial nerve and parotid glands and tumors 4. Complex interosseous fixation of oral and maxillofacial jaw fractures 5. Surgical lymph node removal 6 , Partial maxillary and mandibular excision 7, giant jaw cyst removal 8 new technologies and new items surgery

Pediatric Surgery

Primary surgery

Venous incision, tracheotomy, superficial lymphadenectomy, superficial abscess incision and drainage, superficial benign tumor resection, appendectomy, high hernia sac ligation, high sheath ligation, simple rectum Polypectomy, bladder puncture.

Secondary surgery

Thyroid cyst or fistula resection, intussusception reduction, intestinal resection and anastomosis, small bowel diverticulectomy, colostomy, pyloric ring myotomy, low anal interlocking-perineal anal plasty, circumcision, Removal of various simple or mixed hemangiomas on the body surface, abdominal wall incision hernia repair, abdominal abscess incision and drainage, testicular traction fixation, empyema, closed chest drainage, thoracentesis, drainage , Chest wall tumor resection.

Tertiary surgery

Lymphatic cystectomy, thyroid adenoma resection, neck tumor resection, complex intestinal obstruction, intestinal atresia laparotomy, intestinal malrotation-intestinal reduction, umbilical fistula or cystectomy, umbilical bulge Excision repair, abdominal fissure repair, diaphragmatic hernia repair, ilioplasty-diaphragmatic muscle folding, retroperitoneal tumor resection, pancreatic cyst drainage, splenectomy, nephrectomy, ureteroplasty, ureteral bladder replantation , Hypospadias, one-stage urethroplasty, urethral surgery, rectal perineal fistula repair.

Fourth-level surgery

Congenital radical colon resection, common bile duct cyst reconstruction, congenital mid-high anorectal anal plasty, supraurethral repair, esophageal atresia-esophageal angioplasty, esophageal hiatal hernia-esophageal hiatus repair, anti-reflux Lobectomy, lower esophageal resection, esophagogastric anastomosis, mediastinal tumor resection, funnel-thorax Nuss surgery.

Plastic surgery

Primary surgery

Skin surgery, subcutaneous fat range surgery, simple trauma cosmetic suture, suture double eyelid surgery, simple rhinoplasty

Secondary surgery

Simple scar contracture orthopedics, free skin grafting, dilator implantation, double eyelid surgery, internal epiphyseal skin surgery, eyebrow orthopedics, pouch surgery, simple ear deformity correction, rhinoplasty, rhinoplasty, Liposuction, torticollis correction, general flap flap repair, plastic surgery after trauma

Tertiary surgery

Breast augmentation, wrinkle removal, breast reduction surgery, iliac ligament repair, blepharoptosis, ectroplasty, blepharoplasty, blepharoplasty, blepharoplasty, full eyebrow Defect reconstruction, wind ear deformity correction, concealed ear deformity correction, pedicled composite tissue flap angioplasty, crooked nose correction, complex saddle nose correction, nasal partial defect repair, lip deformity correction, dilator removal Flap transplantation, vaginal tightening, vulvar surgery, nipple and areola surgery, mandibular angle amputation, etc.

Fourth-level surgery

Compound tissue free transplantation, craniomaxillofacial deformity correction, orbital reconstruction, broken ear reconstruction, total auricle reconstruction, total nasal reconstruction, lip defect repair, penile reconstruction, vaginal reconstruction, breast reconstruction, Nipple and Areola Reconstruction

Hand and Foot Surgery

Primary surgery

1. General debridement 2. Simple skin grafting 3. Tendon incision and release 4. Tendon suture 5. Scar release and Z-shape modification of the hand 6. Removal of collateral ligament of the metacarpophalangeal joint Technique 7. Excision of superficial fingers and soft tissue lesions

Secondary surgery

1. Internal fixation of metacarpal and phalanx fractures 2. Removal of finger and metacarpal lesions 3. Carpal, metacarpal, and phalangeal joint fusion 4. Carpal dislocation incision and reduction 5. Joint dissection and amputation 6. Peripheral nerve anastomosis, loosening Solution 7. Late repair of finger tendons

Tertiary surgery

1. Severed finger replantation 2. Myocutaneous flap transfer 3. Tendon, nerve displacement and transplantation 4. Thumb and finger reconstruction 5. Bone and joint flap transplantation

Fourth-level surgery

1. Replantation of amputated limb, broken palm and complex broken finger 2. Hand and foot finger transfer operation 3. Knuckle transplantation, knuckle artificial joint replacement 4. New technology and new item surgery

Endoscopy

Primary surgery

1. General gastroscopy, colonoscopy, microscopy and brushing 2. General bronchoscopy, microscopy and brushing

Secondary surgery

1. General polyp removal / electrocautery / resection (polyp diameter less than about 1.0cm) 2. General digestive tract foreign body removal 3. Endoscopic electrocoagulation, laser, argon and microwave treatment, thermal biopsy 4. None Pain gastroscopy 5. Staining and magnifying endoscopy 6. Capsule endoscopy 7. NBI endoscopy 8. Endoscopic jejunal nutrition tube placement 9. Expansion of esophageal stricture and balloon dilation Operation 10. Endoscopic chemoradiation particle placement 11. Pediatric stomach and colonoscopy 12. Endoscopic treatment of non-variceal bleeding under endoscope (including injection hemostasis, drug hemostasis, hemostatic clip application, etc.) 13. Heart Of patients with poor lung function and general condition 14. Bedside operation of high-risk patients in the ward 15. Nasal gastroscopy 16. Pediatric bronchoscopy 17. Bronchoscopic alveolar lavage 18. Fine bronchoscopy with bronchoscopy Operation 19. Foreign body removal through bronchoscope 20. TBLB

Tertiary surgery

1. Tissue glue or sclerotherapy 2. Varicose vein ligation 3. EMR (endoscopic mucosal resection) 4. ERCP 5. ENBD 6. Endoscopic papillary balloon dilation 7. Bile duct stent placement technique 8 EST and Needle Knife Papillary Surgery 9. Oddi's Diastolic Manometry 10. Endoscopic Bile Duct Lithotripsy 11. Gastrointestinal Stent Implantation 12. Percutaneous Endoscopic Stomach and Jejunostomy Fistula (PEG) 13. Confocal endoscopy 14. Complex and high-risk foreign body removal of digestive tract 15. Large polypectomy and malignant tumor resection 16. Double balloon electronic enteroscopy and small colonoscopy 17. Choledochoscopy and treatment under choledochoscopy 18. Transbronchoscopic lymph node biopsy 19. Transtracheal benign tumor resection

Fourth-level surgery

1. Newly developed diagnosis and treatment items and surgery 2. Endoscopic ultrasonography and guided ultrasound guided puncture (EUS-guideFNA) 3. Endoscopic treatment of pancreatic duct obstruction 4. Endoscopic treatment of pancreatic pseudocysts 5. ESD6. Orthodontic choledochoscopy laser lithotripsy 7. Ultrasound bronchoscopy 8. Tracheoscopy tracheal stenosis and dilation 9. Tracheoscopy tracheal stent placement

Department of Anesthesiology

Primary anesthesia

Low plane subarachnoid spinal nerve block, lumbar epidural spinal nerve block, hypothoracic epidural spinal nerve block, pediatric ketamine muscle or intravenous anesthesia, pediatric basic anesthesia, milder limb extremity manual reduction of intravenous anesthesia , Anesthesia for ophthalmic surgery, common anesthesia for otolaryngology pediatric surgery, static suction combined anesthesia.

Secondary anesthesia

Commonly used nerve block, upper thoracic epidural spinal nerve block, anesthesia for general craniocerebral surgery patients, anesthesia for chest patients, bronchial anesthesia. Anesthesia for major maxillofacial surgery in children, anesthesia through nasal tracheal intubation, anesthesia for cardiac catheterization patients, anesthesia for emergency patients with critical and complicated conditions (hemorrhagic shock, severe intestinal obstruction), epidural anesthesia for children, trachea Internal anesthesia, anesthesia for cleft lip surgery. Anesthesia for tonsil and adenoid surgery in children.

Tertiary anesthesia

Anesthesia for open heart surgery, anesthesia for patients with pericardial resection, anesthesia for patients with endocrine disorders, anesthesia for severely ill patients (cardiac insufficiency, coronary heart disease, hypertension and liver, renal dysfunction, etc.), controlled hypotension anesthesia, Anesthesia for patients with severe airway obstruction, anesthesia for kidney transplantation, anesthesia for complex craniocerebral surgery, anesthesia for wet lung patients, difficulty in tracheal intubation due to oral and maxillofacial diseases, and anesthesia requiring myocutaneous flap transplantation. Pediatric tracheal foreign body removal anesthesia, controlled hypothermia surgical anesthesia.

Fourth grade anesthesia

Anesthesia for complex open heart surgery, anesthesia for patients with severe endocrine disorders, anesthesia for patients with previous myocardial infarction, severe shock, and anesthesia for patients with severe organ dysfunction. Various complex operations and anesthesia for critically ill patients with unidentified diagnosis. Anesthesia for patients undergoing new surgical projects.