Chapter 584： Personal experience, seriously recommended

Near 11:30, all TIPS surgeries in patients with cirrhosis were completed.

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

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

He can feel a different atmosphere, and it is different from the surgery of the Zheng Renlai Provincial Medical University Affiliated Hospital last time.

This time, Gao teacher himself is doing TIPS surgery by himself!

It turns out that TIPS surgery can be as simple as finding a solution.

In the operating room, Zheng Ren and Gao Shaojie talked about the points that need attention in the second phase of surgery.

Because of the sudden arrival of Director Kong, Zheng Ren was caught off guard, so he wanted Gao Shaojie to master everything about TIPS surgery as soon as possible.

A lot of details were said in the office. At this time, Zheng Ren saw Gao Shaojie's slightly confused eyes and sighed in his heart.

"Old high, let's talk about it." Zheng Ren knows that he is too hasty, the professor may be able to do it, but Gao Shaojie... should not be able to do it.

Gao Shaojie also realized that the first phase of surgery and the second phase of surgery are two very different concepts. Zheng Ren’s tone and look dilute the joy of successfully completing the first phase of surgery.

"Boss, I think you knocked him with a hemostatic forceps. The thief who learned it was quick, personal experience, and was highly recommended." Professor Rudolf Wagner heard the contents of the conversation and said it seriously.

However, here is the Affiliated Hospital of Medical University, Gao Shaojie and himself said that it is best not to hit him. Just now Zheng Ren was too ecstasy and knocked it. He is still a little embarrassed.

Then forget it, Zheng Ren thought, slowly coming soon.

Gao Shaojie frowned and didn't speak.

"Dr. Zheng, take a meal at noon and then have surgery." Qi Dean is in a good mood. Although he could not dig Zheng Ren to the Affiliated Hospital of the Medical University, isn't that normal? He heard anomalies from Lao Wu's tone.

In front of this young man, it is only necessary to go to the emperor and the devil, and even go to a large medical center in Europe and America.

And stay in the provincial capital?

That is absolutely impossible.

"Qi Dean, I will not eat at noon." Zheng Ren said with a serious expression, "The surgery behind will be more difficult, I am afraid that I can't finish it today."

Is the surgery behind it more difficult?

President Qi did not mind Zheng Ren’s refusal. He was surprised that the TIPS operation was done. Why is the surgery behind it more difficult?

From a surgical point of view, the general second-stage surgery is more clear and simpler than the one-stage purpose.

Dean Qi looked at Gao Shaojie and saw what he had been pondering. He did not continue to be polite and invited Zheng Ren to eat.

If you can't keep this doctor, you must leave Gao Shaojie.

Dean Qi has already guessed the value of the new approach to TIPS surgery from the students on the other side of the ocean, and the small abacus in his heart screamed.

Soon, Li Jianguo sent the patients with the second phase of TIPS surgery.

The surgery started.

"Xiao Liu, just Dr. Zheng said that the second phase of surgery is more difficult than the first phase. Is that true?" Qi Dean stood in the operation room and looked at Zheng Ren and Gao Shaojie inside the lead glass and whispered.

Professor Liu has already seen the red eyes, and everyone who wants to study TIPS surgery is always good.

Unfortunately, there is no assumption in life.

Dean Qi asked, Professor Liu gave a sigh of relief and combed his emotions. He thought about it: "The dean, according to the conventional surgical approach, there is no second phase of TIPS surgery."

"Hmm?" Qi was surprised.

"The first phase can be done, it is already a national level of intervention." Professor Liu smiled, and he could do it. Just a month ago, the level of surgery was slightly better than Gao Shaojie.

However, in a short period of time, Gao Shaojie has not seen the shadow of his own fall.

A few days ago, Gao Shaojie called in Haicheng, please help the patients who received TIPS surgery. At that time, I didn't realize the problem. Now think about it... just say it.

Professor Liu is hopelessly distracted.

Listening to him talking about half of it will be silent, Qi Dean sideways, with a nose, a little dissatisfied.

Professor Liu realized that he was immersed in the inexplicable and regretful emotions. He smiled and said: "In the past, TIPS surgery was only possible to connect the hepatic vein and portal vein. The incidence of postoperative complications is high. For example, hepatic encephalopathy."

"Because of the thickness of the stent, it is too thick to return more blood from the venous, without liver metabolism, high blood ammonia content, resulting in hepatic encephalopathy.

But the bracket is thin and there are problems. There were fewer patients with hepatic encephalopathy, but there was not enough blood in the venous return. The problems of gastric varices and portal hypertension were only alleviated and not completely solved. ”

“That is, there will be a risk of hematemesis in the future.”

Dean Qi meditation.

Professor Liu said that it is very simple and easy to understand, all of them are clinically born, and Qi Dean knows the problem in an instant.

"Mr. Zheng has two stents. The first one is a stent with a membrane. This is what ordinary TIPS surgery does." Professor Liu’s eyes are full of envy, and the emotion seems to melt the lead glass.

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

"But... take the stent from the liver, this is too difficult Is it?" Qi said.

"The liver parenchyma will break the bleeding, I can't think of what to do to get the recyclable stent smoothly." Professor Liu felt a little emotional.

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

As he answered the question from the dean, he stared at the screen in the operation room.

The surgery has begun and the retractable stent balloon has been removed and is being removed.

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

Although the line is being stepped on, the body is exposed to X-rays every minute and every second, causing damage to the body.

But he didn't dare to be fast.

Seeing Zheng Ren doing the second operation, it is a simple mess.

But when I started, I knew the difficulty.

Just after a move, I felt the resistance came.

"Old high, seven points position, down 15 °, lightly force." Zheng Ren looked at the screen intently, faintly said.

Gao Shaojie reacted a bit, then nodded and carefully proceeded according to Zheng Ren’s statement.

However, the seven-point position... is also 15° below. Is this a special person?

Gao Shaojie tried several times and finally succeeded in following the instructions of Zheng Ren.

The recyclable holder moved a few millimeters away and was barely visible on the image.

He didn't have the slightest joy. Why did he succeed? Gao Shaojie didn't know it.

"Below, at five o'clock, bend your wrist, 25°, tap, and tap."

This time, Gao Shaojie tried four or five times and did not make it.

Fear of hemorrhage of liver parenchymal injury, Zheng Ren finally had no choice but to exchange the position with Gao Shaojie. Zheng Ren shot and completed the operation within ten minutes.