Chapter 584 Personal Experience, Serious Recommendation

Near 11:30, TIPS operations for all patients with liver cirrhosis were completed.

Li Jianguo sent the patient down. On this day, his job was to send the patient down, then check the information of the next patient, and then send the patient up.

When I came up, the TIPS surgery was almost done.

He could feel a different atmosphere, different from the last time Zheng Ren came to the Affiliated Hospital of Medical University in the provincial capital for surgery.

This time, Teacher Gao is doing the TIPS surgery himself!

It turns out that as long as a way is found, TIPS surgery can become so simple.

In the operating room, Zheng Ren and Gao Shaojie were chatting about the points that need to be paid attention to in the second-stage operation.

Because Director Kong came so suddenly, Zheng Ren was a little caught off guard, so he wanted Gao Shaojie to grasp everything about the TIPS operation as soon as possible.

Many details were discussed in the office. At this time, Zheng Ren sighed inwardly when he saw Gao Shaojie's slightly confused eyes.

"Old Gao, let's talk on stage." Zheng Ren knew that he was too hasty. The professor might be able to do it, but Gao Shaojie... probably couldn't.

Gao Shaojie also realized that the first-stage operation and the second-stage operation are two completely different concepts. Zheng Ren's tone and expression diluted the joy of successfully completing the first-stage operation.

"Boss, I think you hit him with a hemostat. If you learn it quickly, you have experienced it yourself. I highly recommend it." Professor Rudolf Wagner said seriously after hearing the conversation between the two.

But this is the Affiliated Hospital of Medical University, Gao Shaojie told himself that it is best not to beat him. Zheng Ren was too preoccupied just now, so he knocked on it casually, and he is still a little embarrassed now.

Forget it, Zheng Ren thought, taking it slow is faster.

Gao Shaojie frowned in thought, but didn't speak.

"Doctor Zheng, let's have lunch before surgery." Dean Qi was in a good mood, although he failed to lure Zheng Ren to the Affiliated Hospital of Medical University, isn't that normal? He heard something unusual in Old Wu's tone.

The young man in front of him should go to the imperial capital, the magic capital, or even a large medical center in Europe and America.

And stay in the provincial capital?

That is absolutely impossible.

"Principal Qi, I won't have lunch at noon." Zheng Ren said with a serious expression, "The next surgery will be more difficult, and I'm afraid I won't be able to finish it today."

Is the subsequent operation more difficult?

Dean Qi didn't mind Zheng Ren's refusal, but he was just surprised that the TIPS operation was done, so why is the subsequent operation more difficult?

From a surgical point of view, generally the second-stage surgery is more purposeful and simpler than the first-stage operation.

Dean Qi glanced at Gao Shaojie, seeing that he had been thinking about something, he didn't continue to be polite, and invited Zheng Ren to dinner.

If you can't keep this Dr. Zheng, then you must keep Gao Shaojie.

Dean Qi has already guessed the value of the new approach of TIPS surgery from his classmates on the other side of the ocean, and the small calculations in his heart are crackling.

Soon, Li Jianguo sent up the patients who underwent the second-stage TIPS operation.

The operation begins.

"Xiao Liu, just now Doctor Zheng said that the second-stage operation is more difficult than the first-stage operation. Is that true?" Dean Qi stood in the operating room, looking at Zheng Ren and Gao Shaojie through the leaded glass, and asked in a low voice.

Professor Liu has long been envious of seeing it, and every time he thinks that the person standing inside to learn TIPS surgery is himself.

Unfortunately, life has no assumptions.

When Dean Qi asked a question, Professor Liu was taken aback for a moment, sorted out his emotions, thought for a while and said: "Dean, according to the conventional surgical method, there is no second stage of TIPS surgery."

"Huh?" Dean Qi was surprised.

"If the first phase can be done, it is already at the national level of intervention." Professor Liu smiled wryly. If he could do it himself, his surgery level was slightly better than that of Gao Shaojie just a month ago.

But in a short period of time, Gao Shaojie could no longer see his own shadow.

A few days ago, Gao Shaojie made a phone call in Haicheng, asking himself to help accept patients for TIPS surgery. At that time, I didn't realize the problem, but now that I think about it... it would be nice if I just said it.

Professor Liu was hopelessly distracted.

Hearing that he fell silent halfway through his speech, Dean Qi turned his head and snorted, slightly dissatisfied.

Professor Liu realized that he was immersed in the feeling of inexplicable loss and regret again, smiled wryly, and said: "In the previous operation, TIPS operation only needs to connect the hepatic vein and portal vein. The probability of postoperative complications is very high. , such as hepatic encephalopathy."

"Because of the thickness of the stent, if it is too thick, more blood will flow back from the vein without liver metabolism, and the blood ammonia content will be high, which will lead to hepatic encephalopathy.

But the bracket is thin, and there are problems. The incidence of hepatic encephalopathy in the patient is less, but the return of venous blood is not enough, and the problems of gastric varicose veins and portal hypertension are only alleviated, but not completely resolved. "

"That is to say, there will be a risk of vomiting blood in the future."

Dean Qi pondered.

What Professor Liu said was very simple and easy to understand. They were all from a clinical background. Dean Qi knew the problem in an instant.

"Ms. Zheng placed two stents. The first one is a membrane-covered stent, which is required for ordinary TIPS surgery." Professor Liu's eyes were full of envy, as if he wanted to melt the leaded glass.

"But he installed another retractable stent. The advantage of this stent is that it can solve the above two problems. After the patient adapts to the blood ammonia concentration in the venous blood, the retractable stent is taken out, which is a perfect solution to postoperative complications. disease problem."

"But...it's too difficult to remove the stent from the liver."

"Really?" Dean Qi asked.

"The liver parenchyma will be damaged and bleed. I can't figure out how to take out the recoverable stent smoothly." Professor Liu was a little emotional.

Because I don't understand, I am more curious.

While answering Dean Qi's question, he stared at the screen in the operating room.

Surgery has begun, and the balloon of the retractable stent is deflated and is being removed.

In the operating room, Gao Shaojie's movements were light and slow.

Although stepping on the line, the body is exposed to X-ray radiation every minute and every second, causing damage to the body.

But he dare not hurry.

Seeing Zheng Ren undergoing the second-stage surgery, it was simply a mess.

But when you do it yourself, you will know the difficulties.

As soon as he moved, he felt resistance coming.

"Old Gao, at the seven o'clock position, 15 degrees downward, lightly apply force." Zheng Ren stared at the screen intently, and said lightly.

Gao Shaojie responded for a moment, then nodded, and followed Zheng Ren's instructions carefully.

But the seven o'clock position... is still 15° down. Is this really human?

Gao Shaojie tried several times, and finally succeeded in following Zheng Ren's instructions to do this.

The retractable bracket moved a few millimeters, barely visible on the image.

He didn't have the slightest joy. Gao Shaojie himself didn't know why he succeeded.

"Below, at the five o'clock position, bend your wrist at a 25° angle, tap lightly, tap lightly again."

This time, Gao Shaojie tried four or five times, but all failed.

Afraid of hepatic parenchymal injury and bleeding, Zheng Ren finally switched positions with Gao Shaojie helplessly, and Zheng Ren performed the operation, and the operation was completed within ten minutes.