Chapter 144 Family members, who knows, he really dotes on Luo Hao
The fishing car was abandoned, and several people got on the helicopter.
Luo Hao took off his coat and wanted to put it on Boss Chai. When the clothes were handed over, I saw Director Qian also holding a coat and handing it to his boss.
"I'm young, Director Qian, please take care of yourself." Luo Hao smiled and put his clothes on Mr. Chai.
Director Qian didn't insist, he just looked at Luo Hao, with a strange look on his fierce face.
Time flies and we arrive at the location where the hospital helicopter lands.
It was also the first time for Luo Hao to ride in a helicopter, and he was a little dizzy.
This thing doesn’t look very safe.
After getting off the plane, several people hurried to the ercp room.
In the hybrid surgery room, preparations for surgery have been made.
The surgery can be major or minor. Generally speaking, indwelling drainage is the safest option.
On the helicopter before, several people had already learned about the patient’s medical history and surgery-related conditions.
Qin Chen was wearing a sterile cap, and his big back was a little messy under the cap.
Zheng Siyuan's face was not good-looking either, he was serious and deep.
"It's okay." Mr. Chai came in and patted Qin Chen on the shoulder first, "We need to do the research that needs to be done, admit it when something goes wrong, and get the understanding and approval of the patient's family. As for the future, what should we do? What else are you doing? Don’t be restrained.”
"Boss Chai, we...I..." Qin Chen stammered.
Boss Chai had a smile on his face. He was not nervous at all, nor did he blame Qin Chen.
As for Zheng Siyuan, he belongs to the role of guest minister, and Boss Chai has no reason to let Zheng Siyuan take the blame.
"What did the interventional department say?"
"The tumor is too big, even the interventional department can't handle it." Qin Chen replied.
"I'm looking for a consultation. Director Pan is in the emergency department and hasn't come down yet." Zheng Siyuan added.
"Let me try." Luo Hao said.
“You?” Qin Chen rolled his eyes, “Director Qian is here, go ahead.”
“Director Qian, the guide wire just leaked the bile duct, please help. Just look at it and leave a drainage, or..."
"I thought you had torn the duodenum open, you were so anxious," Boss Chai said lightly.
Qin Chen had a dark look on his face.
He glanced at Luo Hao, Qin Chen swore, just one look!
When Mr. Chai first came in, he comforted himself gently that it was all a trivial matter, don’t worry about it, do a good job in the aftermath, and get the family’s understanding, so that this type of research surgery will have to continue in the future.
But after just one look, Chai Lao changed his face, changing his face faster than in Sichuan opera, and started taunting him directly.
In Boss Chai’s eyes, he, a director, is not as good as Luo Hao’s hair.
"Boss Chai, look at what you said. You can at most make a small eye, and how much force you have to use to tear it open." Although Qin Chen felt a little awkward, he explained quickly.
Qin Chen gave Boss Chai the greatest respect.
Can we not talk about Luo Hao?
Can you stop crossing Luo Hao with your eyelids?
"Don't you know ptcd? The sectarian view is so important. Just because you can't do it, doesn't mean that ptcd can't do it either. One is retrograde and the other is antegrade. How can that be the same?" Mr. Chai started to watch the video. , while scolding.
Ptcd is percutaneous transhepatic biliary drainage.
Before the advent of endoscopic ercp, it was a treatment method for the "minions" of obstructive jaundice, and it was a "job" of the interventional department.
“It doesn’t matter that we in the Department of Hepatobiliary Surgery have objections to intervention, but your endoscopists also have objections to intervention.”
Listening to Boss Chai’s nagging talk, Qin Chen and Zheng Siyuan They all have black lines on their faces.
Chai Lao’s next sentence is - you deserve it too.
Hepatobiliary surgery has a lot of prejudices at all, and it is blatant.
With the subdivision of the medical industry, even doctors know little about the sub-disciplines.
The biggest concern for interventional subjects is hepatobiliary surgery. Boss Chai is...
Qin Chen, Zheng Siyuan, and even Director Qian did not dare to speak.
They couldn't guess what Boss Chai meant.
Just doting on Luo Hao?
"Liver Cancer Treatment Guidelines", Mr. Chai is one of the chief editors and has been for more than 20 years.
The existence of interventional surgery was almost ignored in the guide. It was only in recent years that interventional surgery was mentioned in the corner, and it was almost negligible.
In terms of personal opinions, Boss Chai has profound opinions on interventional subjects.
“Why don’t you speak anymore.” Boss Chai stretched out his right hand, spread his thumb and middle finger, pressed them on both sides of his reading glasses, and straightened his glasses.
"Boss Chai, the location of the tumor is not good, and ptcd may not be feasible. In addition, Director Pan has an emergency mission from the health care team, so we...were thinking that we should take a look at the surgery." Qin Chen explained.
“You guys.” Boss Chai smiled slightly, “It’s just a joke.”
“…”
“…”
Whether it is Qin Chen was still Zheng Siyuan, but Boss Chai said nothing.
Boss Chai's seniority and status in the world were there, so they had to endure it no matter how unhappy they were.
"Xiaoluohao, come and see if ptcd can do it." Mr. Chai waved.
"Boss, I can do it." Luo Hao had been following Boss Chai for a long time, looking at the video, but he never spoke. When Boss Chai asked, Luo Hao immediately answered.
"Go and give it a try. If you need anything, go to the interventional catheterization laboratory and get it."
Boss Chai looked at all the images again, turned around and sat on the sofa.
Luo Hao saw that Qin Chen was unhappy wearing a mask, so he waved and asked Qin Chen to go get the supplies with him.
"Director Qin, a few years ago I asked my boss how to choose a direction in the future." Luo Hao took Qin Chen to the interventional cath lab to get things, and "chatted" with Qin Chen while walking.
"What's the matter? Boss Chai suggested that you learn intervention?" Qin Chen said scornfully, "He is the one who has the biggest objection to the interventional department."
Out of the door, behind Mr. Chai, Qin Chen still had the guts to complain.
“Yes, my boss at the time suggested that if I wanted to learn surgery, I’d better get in touch with the interventional discipline first.”
"???"
"???"
Qin Chen and Zheng Siyuan were both stunned.
"Minimally invasive is the future direction. The boss has made a clear judgment a long time ago. No matter how small the surgical trauma is, it is limited. You two know that."
"Then Boss Chai wants you to Why do you want to learn interventional surgery?" Zheng Siyuan asked.
"Teacher Zheng, the boss at that time took me to the door of the circulatory interventional operating room to watch several times. There was a group of people squatting there waiting. If there was a problem with the operation, they would come immediately."
Zheng Siyuan was dumbfounded.
Boss Chai cares so much about this kind of nonsense.
When cardiac interventional surgery first began, the cardiac surgeons did not take it seriously and just went about their business.
However, operations are performed less and less. Simple congenital heart diseases are first taken away by circulatory intervention. There are no patients with atrial or ventricular septum, leaving only complex tetralogy of Fallot and so on. wait.
Later, there were fewer and fewer coronary artery bypass grafts. The patients sent to the surgery were in extremely poor physical condition, and the difficulty of the surgery suddenly increased.
On the one hand, there is a lack of practice in simple surgeries, and on the other hand, the difficulty of complex surgeries has suddenly increased, putting cardiac surgery in a dilemma.
Subsequently, cardiac surgeries across the country collapsed one after another. So far, there are almost no cardiac surgeries in prefectural and municipal hospitals.
Even if there are, they are merged with general chest surgeries, and cardiac surgery mainly relies on the flying knives of cardiac experts in Imperial City and Magic City.
The cardiac surgery department can be said to have been beaten to the point of being left with only one breath left.
Where is Boss Chai? Could it be said that he has been aware of this for a long time?
“The boss told me at that time that if one day the Department of Hepatobiliary and Gastrointestinal Surgery was reduced to this situation, he would never rest in peace.” Luo Hao scratched his head and smiled slightly.
"It won't be harmful." Qin Chen said sarcastically.
Qin Chen Director Qin seems to have forgotten that he once made a bold statement at the annual meeting-endoscopy can replace all common surgical operations.
“Boss Chai is afraid, so he suggested that I do intervention first, and then go back and do the surgery. Minimally invasive surgery can be done well, and surgery is not difficult.”
"..."
Qin Chen and Zheng Siyuan were speechless.
“Actually, if the interventional surgery is done well, not only the surgical operation is not difficult, but the endoscopic surgery is also really not difficult.”
! ! !
If he wasn't familiar with Luo Hao, Qin Chen would definitely have kicked Luo Hao in the butt.
What are these words?
Are you provoking in front of the two great masters from the north and the south?
“It’s true.” Luo Hao said seriously, “During interventional super-selection, the microguidewire travels in the 3rd and 4th level blood vessels. It can almost be thought of as a reduced version of the endoscope in the digestive tract. March."
"The interventional surgery was done well, and the endoscope was fine."
"Qin Chen raised his hand habitually and placed it on the sterile cap. Can you have double drainage for malignant hilar bile duct? Stop talking nonsense. Boss Chai loves you so much.”
"I heard from Director Qian that Director Qin and Teacher Zheng are going to study double drainage surgery for malignant tumors in the porta hepatis, and they need surgical escort." Luo Hao smiled, "I am also good at surgery."
Qin Chen and Zheng Siyuan were stranded.
The full of complaints were stuffed back by Luo Hao's words that sounded a little off topic.
Interventional and surgical procedures, Luo Hao has both hands on them, both hands are strong.
If something goes wrong during the operation, Luo Hao will perform the surgery himself in the hybrid operating room.
This is also a regret left behind by the Department of Cardiac Surgery. It seems that Boss Chai has fully learned the experience and lessons, and has always been thinking about letting Luo Hao start with minimally invasive surgery.
As for surgery, Mr. Chai probably saw Luo Hao's talent and thought that as long as Luo Hao came under his command, he would be able to perform 1,800 surgeries a year and it would not be important.
"Luo Hao, why did you return to your hometown back then?" Qin Chen asked.
“The competition is too fierce, I don’t want to get involved.”
“…”
"..."
"Just kidding." Luo Hao chuckled, "I came home mainly because I want to accumulate some experience, starting from the medical department."
"???"
“A lot of grassroots work has special significance. For example, the 912 medical office will not face the problems that my hometown mine manager faced.” Luo Hao said, “If I missed many things when I was young, I would have really missed them. "
"Exercise at the grassroots level?" Zheng Siyuan asked intently.
Doctors never take this approach, they always choose a certain category to specialize in.
“2-3 years, that’s about it.” Luo Hao replied, “I’ve probably figured out all the complicated contradictions and tricks that clinicians often use. In medical treatment, clinical practice is the most important thing. , but it’s not just clinical.”
“The boss often says this.” Qin Chen said, “Did the boss suggest you go back?”
Luo Hao smiled and said nothing.
Arrived at the interventional catheterization room, Luo Hao selected what he needed, and several people carried it back to the endoscopy room.
After some exchange, both Qin Chen and Zheng Siyuan were a little confused.
They didn’t expect that Boss Chai, one of the top leaders in general surgery at that time, would think so much.
On his side, he is also thinking about replacing all surgical operations with endoscopic surgery. Although this long-term goal sounds unreliable, both Qin Chen and Zheng Siyuan regard it as an ideal.
But the general surgery department is not idle either. Boss Chai has already taken action.
A sense of urgency arose spontaneously, and Qin Chen looked at Zheng Siyuan.
Qin Chen saw Zheng Siyuan looking at him, his eyes full of worry.
This is not the time for internal fighting within the discipline. Faced with the pressure brought by the extremely powerful general surgery boss, the discipline must first unite. Indeed, for disciplinary reasons, endoscopy...
Bah!
Qin Chen immediately realized why he and Zheng Siyuan were so sympathetic to each other!
Unite with him?
Unite the big-headed ghosts!
He raised his hands and clasped his big back head. Although he was separated by a sterile cap, he still made the move.
What kind of onion are you, Zheng Siyuan!
Luo Hao is from our Xiehe! !
Qin Chen immediately stood together with Luo Hao.
"Little Luo." Zheng Siyuan also realized Qin Chen's psychological fluctuations, smiled and said to Luo Hao, "Are you sure about ptcd? The tumor has almost completely blocked the hilar bile duct, and the guide wire is difficult to Go over."
"It should be fine." Luo Hao said, "The next stent will remove all the wounds and tumors."
"Besides, ptcd is an intrahepatic puncture. If it is punctured, there will be liver tissue around it and the pressure will be great. It will not be a big deal."
Zheng Siyuan fell into silence when Luo Hao said firmly.
There is no point in saying anything at this time, just watch the surgery.
Luo Hao prepared various equipment and concentrated on his work, not communicating with anyone, including Chen Yong.
It sounded simple to Qin Chen and Zheng Siyuan, but Luo Hao knew very well how difficult the operation was.
In terms of endoscopic surgery, neither the two master-level experts from the north or the south had performed the surgery. If I wanted to complete it, I had to open it up.
[Flow] Although the negative state has been weakened, it still exists after all, and Luo Hao does not dare to be careless.
That weak state is really uncomfortable, and every second the surgery time can be shortened is just one second.
"Luo Hao."
Luo Hao did not speak to Chen Yong, but Chen Yong came over.
"Huh? What's wrong?"
"I have also studied ptcd surgery."
"Oh?" Luo Hao frowned.
"Put me in one?" Chen Yong volunteered, "I'm not talking about the most critical step. Pass the guide wire through it, remove the stent, and you can rest."
"No..."
Luo Hao was about to say no, but then he thought of a possibility - open up the business by himself, only do the most critical steps, and leave the rest to Chen Yong.
But I have never seen Chen Yong do it. This is a headache.
"Can you please give me some trust?" Seeing that Luo Hao didn't speak, Chen Yong continued to beg.
"This is Xiehe..." Luo Hao was helpless, "You can do it at home."
That's what he said, but Luo Hao was already ready to let Chen Yong go.
If it doesn’t work, just open it up yourself and complete the ptcd surgery.
"Then let me give you one, don't be careless!"
"Huh? You actually agreed?" Chen Yong was startled.
Luo Hao was also stunned for a moment, what does Chen Yong mean?
"I thought you wouldn't agree. You would be embarrassed to say 'no' when I want to do the surgery when I go home."
"Fuck!"
Luo Hao cursed.
"I'm really good at it, let's try it this time!" Chen Yong quickly rounded off his words.
Whether this guy is reliable or not, Luo Hao is a little sad.
Anyway, he has a backup plan, so he is not afraid. Luo Hao said in a deep voice, "The superior doctor performs the operation, but you know the consequences if it cannot be performed."
Chen Yong hesitated.
Luo Hao also felt that what he said was too serious would add a certain amount of psychological pressure to Chen Yong.
"If I do too well, will you lose face?" Chen Yong asked.
"..."
Luo Hao looked at Chen Yong, how come this guy has no skills at all? !
It turns out that he hesitated because he was afraid of losing face.
What are you thinking about!
Luo Hao glanced at the system panel and really didn't believe that a magic Taoist priest could perform surgery better than himself.
"Don't worry, if you do well, I will be very happy. Remember, don't do it if you can't do it!" Luo Hao warned.
"I know, I know, just let me do the surgery."
Disinfection, laying out sterile towels, closing the airtight lead door, and the surgery begins.
B-ultrasound positioning.
Luo Hao selected the location under the xiphoid process and used 1% lidocaine for local infiltration anesthesia.
A 1mm incision was made with a sharp knife, and subcutaneous expansion was performed with mosquito forceps.
The main purpose is to stably control the advancement of the fine puncture needle without interference from skin resistance; to avoid damage to the subcostal artery; and to reduce resistance when the subsequent catheter passes through the skin and subcutaneous tissue and enters the liver.
Although Luo Hao was 99% sure, he still chose the safest method without being pretentious or careless.
21G fine needle puncture into the liver.
The fine needle entered the liver very quickly. After sensing the resistance, Luo Hao suddenly asked, "Chen Yong, do you know why the needle must be inserted quickly?"
"To prevent the needle tip from scratching the liver surface Capsule. For patients with congestive heart failure or early Budd-Chiari's syndrome. "?" Luo Hao was surprised.
Chen Yong actually knows.
“There is an animated video of the up owner on site B.” Chen Yong was not proud. He seemed to be fully focused on the operation. Although Chen Yong thought he could do anything before going on stage, once the operation was performed, he still It's inevitable to be a little nervous.
"In the animation video of the up owner, there is a description of the slow insertion of the needle, and the liver was scratched and the skin was ripped open."
Luo Hao breathed a sigh of relief. Indeed, Chen Yong was right.
After I step down, I will also go to Station B to take a look.
After inserting the needle, Luo Hao immediately started to step on the thread.
Under the guidance of fluoroscopy, the puncture needle tip reaches 2cm above the liver portal. Stop fluoroscopy and slowly withdraw the needle while using a syringe to aspirate.
Bile appeared in the syringe. Luo Hao stepped on the line again and injected a small amount of dilute contrast agent under fluoroscopy to see if the puncture needle tip was in the bile duct.
After confirming that the puncture needle tip has entered the bile duct, continue to inject the contrast agent until the target punctured bile duct is visualized.
Introducing the guide wire, with the assistance of Chen Yong, Luo Hao did not cross his left and right hands, and twisted the guide wire with both hands to try to pass through the compressed part of the tumor.
The tumor was very large and compressed tightly, almost tightly suppressing the bile duct.
No wonder Qin Chen and Zheng Siyuan failed to pass the guide wire after repeated attempts. Luo Hao confirmed his previous guess.
Turn it up!
Luo Hao started [Flow] without hesitation after trying it once.
......
Qin Chen stared at the screen, nagging when he saw that Luo Hao's first attempt to pass the guide wire through the tumor compression site failed.
"Boss Chai, are you just going to let Ronaldinho go to Donglian City? You don't know what he has learned."
"Ronaldinho is too young. If you don't let him study with my boss, you have to keep him by your side."
"Look at him, he knows how to pretend now, and he said that the bile ducts are like the sea in his eyes. Just as wide."
"Huh? That's what Xiaoluohao said?" Boss Chai asked, looking at the screen.
“That’s not the original statement, but that’s basically what it means.”
“I just said, Xiaoluohao doesn’t watch basketball, how could he say such a thing.” Boss Chai said lightly, “ It looks difficult, but I guess the small snail number should be fine.”
"Boss Chai, you really have confidence in Luo Hao, I..."
Before Qin Chen finished his sentence, he saw the guide wire slowly but firmly passing through the bile duct under the pressure of the tumor.
How did you get there?
Qin Chen was stunned, he didn't see clearly.
Soon, Qin Chen turned his head and looked at Zheng Siyuan.
Zheng Siyuan's eyes were also confused, and he didn't understand.
The self-expanding stent was then inserted along the guide wire, and the entire operation was uneventful.
If he hadn’t tried it countless times before, Qin Chen would have thought that the operation was not that difficult.
But both myself and Zheng Siyuan tried it. In the end, the guide wire pierced the bile duct after repeated attempts, but they failed.
Luo Hao actually tried for the second time...
When Qin Chen turned his head, he was shocked to see Luo Hao coming down from the stage wearing a lead suit and sitting on a stool in the corner of the operating room.
Qin Chen's pupils narrowed, as if he had seen something incredible.
"Look, I said the operation is not difficult." Boss Chai said calmly, "Luo Hao has finished the key steps, and his assistant can do the rest."
" ..."
Qin Chen suddenly thought of what he said when he was showing off in the First Hospital of the Medical University.
He was just taking advantage of Luo Hao's momentum.
Now Luo Hao calmly sat down on the stool!
He is really looking more and more like a top magician. Qin Chen looked at Luo Hao through the leaded glass, and then his eyes fell on Luo Hao's assistant Chen Yong.
Chen Yong is not very fast, he is cautious, and he is obviously a novice.
But his operation was very accurate, a little slow, but no mistakes.
Luo Hao was also watching Chen Yong's operations.
The negative state of [Flow] has been partially weakened, and Luo Hao also has the blessing of [Energy Conversion], making Luo Hao's body much more comfortable.
The opening time was not long this time, and Chen Yong's finishing movements were still slow. By the time Chen Yong finished the operation, Luo Hao had already stood up.
“Not bad.” Luo Hao praised sincerely.
"Really." Chen Yong was a little weak. It seemed that the end result of a ptcd surgery was more expensive than his single prayer.
"Are you... nervous?" Luo Hao asked.
“It’s okay.” Chen Yong connected the external drainage bag to the drainage bag.
Luo Hao noticed that Chen Yong's hands were shaking a little.
But Luo Hao did not make fun of this matter, even if it was well-intentioned.
It was difficult to perform an unfamiliar surgery for the first time. You can imagine the pressure on Chen Yong.
However, the operation process started today is quite good. From now on, I will open it up and control the time, and let Chen Yong complete the remaining finishing work.
Otherwise, Luo Hao would always feel a little unworthy of doing the innocuous finishing work of the operation while opening it up, including suturing skin and the like.
"Okay." Chen Yong breathed a sigh of relief.
“Not bad, you are awesome.” Luo Hao praised.
Chen Yong was startled.
He imagined Luo Hao saying "you are awesome" countless times, but he never thought that it would appear in such a scene.
(End of this chapter)