Surgical artist

Chapter 376 Think Again!

Lin Jinsong, the chief director of the joint organizing committee, snorted: "They must care. This pancreas project was originally in their pocket in the past."

"Lack of competition for many years has led to an overall decline in Suzhou's innovation capabilities."

"But now, the emergence of an extremely good Zhao Peiru immediately made them nervous."

He picked up a report and said to Director Nie: "Look, this is the report of the first project of Suzhou Province."

"Although Suzhou Province lost to Jiangnan Province, this report is still remarkable. Compared with previous years, it is much better."

Director Nie picked it up to look at it, and nodded slightly.

This is true.

Su Sheng also knew that Mou had worked hard this year, even though he was defeated.

Lin Jinsong said with a smile: "So, I still have that opinion. Appropriate competition is a good thing."

"Let Dean Zhao Peiru scold Su Sheng well."

"And at the same time, I am also looking forward to the performance of Jiangnan Province."

"Being able to come up with such an amazing technique of 'Short Gastric Tube Preservation and Spleen Preservation Method' in Project [-] has made countless people above all amazed..."

"This shows that President Zhao Peiru's research on the pancreas may have exceeded everyone's expectations. I am also full of expectations for his next few projects, and see if he can bring us new surprises."

……

In Jiangnan Province, the president of the conference, Ge Jianming, and the vice president, Lu Guangxuan, also paid close attention to Zhao Peiru's special group.

Vice President Lu even often came to the West Campus of Jiangxin Hospital every three days.

"President Zhao."

Lu Guangxuan: "If you need any help, just ask."

"President Ge specifically asked me to tell you that whether it is coordinating work or coordinating patients, the province will fully support the work of your special team."

Zhao Peiru smiled and said, "This time, it's really unnecessary. It's not just that you don't need to coordinate your work."

"Patient, there is no need to coordinate."

"There happened to be a suitable patient in the inpatient department of our fourth hospital."

Hearing this, Lu Guangxuan subconsciously nodded and said, "Really? That's good... what?"

He suddenly reacted.

"No need to coordinate patients?"

"Don't you mean that you are about to enter the stage of instance surgery again?"

Only after completing the first theoretical part will the scope of the patient's indications be narrowed down and the indications for the patient's condition will be clarified.

Only then will the patients be selected!
That is to say, since Zhao Peiru has found a "suitable patient", it means that the special group's requirements and indications for patients have been clarified, and the theoretical part of the first stage has almost been completed!
Zhao Peiru nodded with a smile: "Yes, the first part is almost finished."

At this moment, Lu Guangxuan's jaw almost dropped from shock.

This speed can be called divine speed!

The theoretical part of the first stage is actually the most time-consuming!

Generally, the project team is at this stage, the shortest is one to three months, and the longest is about half a year.

No matter how long the theoretical research is, it generally means that the medical technology at the current stage cannot reach the level of completing the project.

Therefore, two to four months is more appropriate.

But for Zhao Peiru, it usually only takes about a week to do the theoretical part of the project.

This time it took a little longer, about ten days.

But this has already included the period of time during which the Fourth Hospital and Harbor Hospital were merged.

"Dean Zhao, why are you so fast?"

"I thought that our pancreatic cancer project would be slower."

Lu Guangxuan also knew that the level of pancreatic cancer in Jiangnan Province was relatively poor, so he didn't have much hope.

It is not easy to spend a lot of time slowly grinding out a decent plan. I never thought it would be so fast!

"What did the other members of the special group say, what did Academician Gao and Professor Zhou say?"

Lu Guangxuan wanted to know what other experts thought.

After all, whether this plan is good or not is the last worry in Lu Guangxuan's heart.

The two walked while chatting. At this time, they happened to reach the door of the conference room.

Inside, many experts are discussing Zhao Peiru's new plan.

The voice of Academician Gao Xianmin came from inside: "This vascular reflux technique is wonderful! In order to analyze it, I specially made a set of analysis diagrams of blood supply and circulation, everyone look at it!"

"Look, everyone, this is the original blood supply and circulation of the human body, and everyone should be able to understand it at once."

"And this one is the flow of blood supply in Director Zhao's new plan."

"Although he changed the local blood supply and made the partial blood flow reverse, but it was ingeniously combined with the overall blood supply of the human body. You can see my arrow mark, his partial reverse blood flow is completely consistent with the human body. The overall blood flow is fused together!"

"The nutritional function of the blood supply has not been affected at all."

"Especially the blood supply to the liver, it can be said that it is not compromised at all! From this point alone, this plan is better than any other plan!"

Next to it, Professor Zhou Dandan's female voice came out: "Academician Gao is right, any other treatment plan, after the surgery, the blood vessels must be re-established."

"Artificially re-established blood vessels are not as exquisite as the natural blood flow formed by the human body. This is the most exquisite blood flow formed by human evolution over tens of millions of years."

"Therefore, any other technique that changes the trend of blood flow cannot compare to Dean Zhao Peiru's new technique."

Many experts, you have a word, I have a word.

It is not only to analyze the advantages of this scheme, but more importantly, to try to find out its shortcomings, try to find out where it is not medically reasonable, try to find out where it is prone to intraoperative accidents, and make a countermeasure.

But they analyze and analyze...

All the analysis is the advantages of this program.I couldn't find anything that didn't fit the medical principles.

The disadvantage is that I found a few innocuous little points...

For example, gastric mucosal ischemia and ulcers may occur after surgery due to invasion of the gastric mucosa, but this problem can be alleviated only by acid suppression therapy. Compared with the advancement and superiority of the entire operation, These are acceptable specific complications.

Outside.

Hearing that the members of the special group highly praised the treatment plan, the last worry in Lu Guangxuan's heart was completely let go.

What followed was intense anticipation.

"The experts are so optimistic about this plan?"

"Could it be that our Jiangnan Province is about to usher in another miracle?"

Lu Guangxuan and other provincial leaders originally did not have much hope for the second and third projects.

As soon as Zhao Peiru can win a project for them, they are already very happy, and they are already very satisfied.After all, the strength of Suzhou Province is an objective fact, and they all have self-knowledge.

But the more he listened to it, and listened to the expert group's high-profile praise for this project plan, a certain part of Lu Guangxuan's heart became active, excited, and began to generate expectations.

……

Lu Guangxuan returned to the Provincial Medical Association.

The chairman of the conference, Ge Jianming, said: "How is it? Dean Zhao and the others are going well? Did you make any requests?"

Lu Guangxuan looked outside the door first, then closed the door.

"President Ge, you have to be mentally prepared for what I'm going to say next."

Ge Jianming raised his eyes and looked at Lu Guangxuan through the top rim of his glasses.

Did something happen to the expert group?
Ge Jianming: "Good news or bad news?"

Lu Guangxuan lowered his voice, but the excitement in his tone was unstoppable: "It's good news!"

"I just went to Dean Zhao, and he said that the first theoretical stage is over."

"It will soon enter the stage of instance surgery."

Ge Jianming frowned.

"So fast?"

As far as he knows, because of the accumulated progress of the previous research and development projects in Jiangsu Province, the theoretical part of the first stage is still often reworked and the theoretical plan is constantly revised.

In other words, the first stage has not been completely finished.

Compared with Suzhou Province, the speed of their special team is like riding a rocket!

Lu Guangxuan lowered his voice and said, "More importantly..."

"I heard the evaluation of the new plan from experts, it is very high!"

"I'll paraphrase you a few words from them."

Lu Guangxuan repeated what he had just heard, especially the comments made by Academician Gao Xianmin and Professor Zhou Dandan.

Ge Jianming's heart skipped a beat when he heard it.

Rating so high?
This is simply to boast to the sky!

Especially Academician Gao Xianmin, who is relatively conservative, and has always been cautious about new plans and ideas every time.Once you encounter a new technology, you will definitely study it in depth, and you will only say this when you are fully sure.

Being able to get such a high evaluation from him shows that this project plan is really eye-catching!

Ge Jianming suddenly thought of something, and his heart moved.

"Is this new proposal proposed by Dean Zhao Peiru?"

If it was Zhao Peiru, he could indeed have enough hope!
This is what Zhao Peiru has proved through time and time again.

Lu Guangxuan nodded with a smile on his face: "Yes, this time it was Dean Zhao who came up with the plan again. The plan he proposed can always make people feel at ease."

There was also a smile in Ge Jianming's eyes.

"Yeah, the things he brought out can always give people confidence and peace of mind. Even Director Lin of the Joint Organizing Committee and the others often ask questions."

There was also a bit of hope in his eyes.

"If we can beat Suzhou Province again this time..."

The heartbeats of both of them couldn't help speeding up.

Then their Jiangnan Province will usher in unprecedented glory!

……

Zhao Peiru asked Mu Sisi to bring the patient's information.

Xiaomeng and Xiaomu turned on the projector, opened the electric curtain, adjusted the equipment, and opened the patient information...

Zhao Peiru came to power.

Explain the patient information to everyone.

"Our patient this time is a 54-year-old male patient with long-term low back pain and rapid weight loss for five months before being admitted to the hospital."

"After being admitted to the hospital, the serum CA19-9 was greater than 1000. After CT, it was found that there was a mass in the tail of the pancreas, which surrounded the celiac trunk for more than 180 degrees."

Everyone nodded slightly, this already met their project requirements.

Unexpectedly, Zhao Peiru continued: "In this patient, not only the celiac trunk was surrounded, but also the splenic artery and common hepatic artery were surrounded."

When everyone heard this, they couldn't help frowning.

The anatomical mobilization of the splenic artery and the common hepatic artery is more difficult. Once the envelopment is severe, the cutting and separation during the operation will undoubtedly involve a greater workload and more risks during the operation.

"Dean Zhao, isn't the difficulty of this case a bit high?"

"Yeah, let's just find one patient with the celiac trunk wrapped around, it will help improve our success rate."

Zhao Peiru smiled slightly, but didn't answer this question.

Instead, he continued: "This morning, I asked Marin to perform an arterial angiography on the patient."

"The patient's celiac trunk, common hepatic artery, and splenic artery were narrowed and occluded by tumor invasion and extrusion."

As soon as he said this, everyone's expressions changed.

This has reached... the point where it's complicated and critical!
"Dean Zhao, think twice!"

"Yes, according to our project, as long as the wrap exceeds 180 degrees of the abdominal cavity, it is enough. The constriction and occlusion of this patient are very difficult to deal with!"

Everyone's faces were full of embarrassment.

Even if they just got a new plan, they couldn't give everyone more confidence.

The new plan is good. After several days of repeated discussions and deduction, it was found that it can indeed solve the enveloping problem.

But in a blink of an eye, the difficulty of the case is much higher than expected. Will the new plan be too difficult to deal with?neither knows.

Zhao Peiru said: "Before I came, I specifically asked the project review team of the Joint Organizing Committee."

"Their scoring standards change according to the difficulty of our project."

"That is to say, the higher the difficulty of the patient, the higher the score."

Everyone didn't say anything on the surface, but in their hearts, they added a sentence: "This is only on the premise of the success of the project, in order to get a high score!"

Zhao Peiru continued: "Besides, our Jiangxin Hospital's inpatient department happens to have such a suitable patient, and it saves us from coordinating other patients."

"The detailed information about the patient is here."

"Director Hao, Academician Zhou, take everyone to review the films together."

"Study this patient carefully, and make some adjustments to the plan according to the patient's condition."

Everyone saw that Zhao Peiru had already made a decision, so it was not good to refute at this time.

After all, Zhao Peiru is the leader of the special team, and he has a lot of prestige.

After Zhao Peiru left, everyone gathered around Academician Zhou Xianmin and Director Hao Xihua.

"Academician Zhou, Director Hao, we were at the meeting just now, so it's not good to refute Director Zhao explicitly."

"But this patient is too difficult!"

"A surrounding artery, the common hepatic artery and the splenic artery, are distracted to deal with. This is likely to prolong the operation time by another two hours, which means that there is a risk of two more hours."

The longer the operation time is, the more intolerable the patient will be, and all kinds of unexpected accidents will emerge one after another.

Even in the later stage, there will be repeated rescue operations on the operating table. At that time, it is hard to say whether the patient's life can be saved!

……

……

……

Professor Zhou Dandan: "Moreover, it's not just about enveloping."

"And the problem of stenosis!"

Everyone's faces were extremely ugly: "Narrowing and blocking is also a big problem that is as difficult as enclosing!"

A project originally had only one big problem.

However, the patient Zhao Peiru selected had two serious problems.

Zhou Xianmin and Hao Xihua also had serious expressions on their faces.

"Okay, we got it."

"When we turn around, let's go find Dean Zhao in private, and then persuade him."

Professor Zhou Dandan also persuaded: "The difficult patients mentioned by Dean Zhao can get higher scores. This is indeed true. But..."

"But now we are too far behind Suzhou Province. It is time for us to seek stability. First complete the direct goal of the project, and then talk about other things."

"Besides, the new plan proposed by Director Zhao is so excellent, it is true to implement the plan first. At this time, there should be no more side effects."

All the members of the task force nodded. This is what they said in their hearts. It is true that such an excellent new plan should be implemented as soon as possible, otherwise the night will be long and dreamy.

It happened before that a certain expert created a new technique, but the patients selected were too difficult, and the results of the project were delayed.And one of his "friend doctors" has completed similar projects in other hospitals and reported them to the state.

That amazing new technique became the technique under the name of that "friend doctor".

Whether the "friend doctor" copied the technology, or just happened to create the same solution, is anyone's guess.

Therefore, while keeping it as secret as possible, completing the project as soon as possible is what everyone is thinking at the moment.

Zhou Xianmin and Hao Xihua also nodded deeply.

I was thinking about what to say to persuade Zhao Peiru when I went to see Zhao Peiru later.

After a while.

The two came to Zhao Peiru's office.

knock on the door.

"Come in."

When the two entered Zhao Peiru's office, they saw Mu Sisi sitting in front of Zhao Peiru's computer, typing on the keyboard continuously.

And Zhao Peiru was beside him, pacing slowly, drinking tea and dictating something.

Zhao Peiru dictated, Mu Sisi typed and organized.

"President Zhao."

Zhou Xianmin and Hao Xihua just opened their mouths and wanted to persuade them.

Zhao Peiru stretched out his hand and raised his palm, signaling for the two to be quiet first.

"Xiaomu, I would like to say a few more things about the assistant's cooperation in this part, about the free exposure of the gastroduodenal artery and the treatment of the common hepatic artery and the proper hepatic vein near and far from its origin..."

"Dean Zhao is..." Zhou Xianmin and Hao Xihua looked at each other in surprise.

This is dictating a personalized treatment plan!

The target is this patient!

Moreover, not only the work that the chief surgeon is responsible for, but also the parts that the first and second assistants are responsible for, and the matters that need to be paid attention to in each part, and even how to deal with various accidents in the emergency plan...

List them all!

In detail!Eloquent!
The more the two listened, the more shocked they felt!

Gradually, the thoughts of the two also followed Zhao Peiru, immersed in it!

Even the original intention to persuade Zhao Peiru to give up when he came in by himself in the first place was forgotten.

"Dean Zhao, has the plan been perfected to such an extent?"

"Even the personalized improvement for patients has been done!"

"Even the details of every step of the operation have been refined to the point of maturity, detail, and specificity."

The two were astonished.

The members of the special team on their side have just begun to understand the patient's situation, and try to deliberate on the details of the operation through the patient's various indications.

As a result, Zhao Peiru's work was all ready-made.

The members of the special group are not needed at all.

And more importantly...

The more the two listened, the more they realized that the two problems they were worried about...

In this detailed plan, there are corresponding processing methods for all of them!

When the two heard that Zhao Peiru was dealing with the "closed and narrow" treatment, the shock on his face was undeniable!

"solved!"

"The problem of occlusion stenosis and local reflux has all been solved!"

"Moreover, it's done by a branch operation of the 'local counterflow' operation."

This also means that the solution part of "occlusion and narrowness" can be completed by the way without adding many additional operations and workload.

"Many patients with pancreatic cancer with severe encirclement will actually be complicated by occlusive stenosis."

Tumor compression squeezes important surrounding blood vessels, which is very common in clinical patients with cancer surrounding the body of the pancreas.

On the contrary, it is the "single enveloping patients" that the members of their special group are looking for, which is relatively rare.

It's just to complete the project quickly, so I want to find that rare patient.

"Dean Zhao's operation will have more important reference significance for the pancreatic medical community."

"Compared to completing the project purely for the sake of the project... the structure is obviously higher."

In comparison, they only wanted to complete the project. Fortunately, they beat Suzhou Province in the competition.

On the other hand, Zhao Peiru is all about the patients, thinking about the surgery that is truly patient-friendly.

Comparing the two patterns, it is better to judge.

After the two of them finished feeling in their hearts, the words of "persuasion" in their hearts could not be uttered.

Dean Zhao has already detailed the operation plan to such an extent, and has not added much workload to the operation, so there is no need to insist on persuasion.

At this time, Zhao Peiru's dictation finally came to an end.

Mu Sisi finally stopped typing on the keyboard.

At this time, Zhao Peiru said to Gao Xianmin and Hao Xihua: "Excuse me, what did you want to say just now?"

The two hesitated.

Zhao Peiru said: "I happened to be looking for you."

"This operation requires two assistants."

"Xiao Meng is the first assistant."

"Then the second assistant, choose one of you, which one of you wants to come?"

The two looked at each other, sparks almost collided with each other's eyes!
They all want to be second assistants on the operating table!
If you don't participate in such a wonderful operation and such a delicate technique, it will be a lifelong regret!

In fact, the second aid position should have been contested by three people.

There is also Mo Chang, a foreign aid expert, who should also have a place.

But Mo Chang went back to Guangren Hospital, but he didn't call back after calling twice, which made their chances even bigger.

At this moment, they still have to thank the foreign aid expert Mo Chang in their hearts.

"Dean Zhao, we both want to go, who do you think is suitable for us?"

From each other's eyes, both of them saw eagerness to move and great desire.

In the end, the decision-making power can only be handed over to Zhao Peiru.

Zhao Peiru thought for a while: "Then... Academician Gao."

"I have seen several videos of academician Gao's public surgery. You have a full understanding of pancreatic cancer surgery and should be more beneficial to this surgery."

It is headed by Academician Gao.Director Hao Xihua also needs to thoroughly understand the treatment plan. If there is any situation during the operation, you must be able to step up at any time. "

This is just a statement on the surface, and it won't make Hao Xihua next to him feel uncomfortable.

In fact, he still took a fancy to Gao Xianmin's relatively good operation skills in the field of pancreatic cancer.

Zhao Peiru: "Academician Gao is in charge. Director Hao Xihua also needs to understand this treatment plan thoroughly. If there is any situation during the operation, you must be able to step up at any time."

Gao Xianmin was overjoyed!
Hao Xihua squeezed out a smile and nodded.He knew that most of this operation would not give him a chance to perform.

After hearing the details of this operation just now, he also roughly estimated the time it will take.

About 5 to 8 hours, depending on the situation during the operation.This time, whether it is Zhao Peiru, who has always been superb in operation, or Xiao Meng, a young man, and Academician Gao Xianmin, who has been fighting on the front line of pancreatic cancer all year round, can obviously be easily won.

……

Finally, it was time for surgery.

In the observation room, a group of members of the special team took their positions early.

Before, they encouraged Gao Xianmin and Hao Xihua to persuade Zhao Peiru to give up this patient who "combines two major difficulties".On the same day, after the two returned to the conference room of the special group, they explained the matter to everyone.

Moreover, Academician Gao Xianmin also assured everyone, "Although I cannot disclose the specific treatment plan, I can assure you that the second problem of occlusion and narrowness will not affect the smooth progress of the project."

At this moment, everyone looked at the operating table inside.

"I don't know how Dean Zhao, Academician Gao and the others will solve the problem of occlusion."

"Yeah, I'm really worried."

Professor Zhou Dandan was also a little reticent: "This operation is a bit too hasty. We should discuss more about the solution to the problem of occlusion and stenosis, and then proceed."

She was also afraid that the problem of occlusion and stenosis would make this surgery, which should be full of bright spots, go to waste.

Among the crowd, Professor Shan Hongqi, who had been following Zhao Peiru, was relatively calm.

He followed Zhao Peiru and Hao Xihua, went to Los Angeles, and completed a series of pancreas projects. He knew Zhao Peiru's behavior and style, and knew that Zhao Peiru was also a very stable person.

"The patient is under anesthesia and pushed in."

"The operation is about to begin."

Everyone held their breath and looked inside with apprehension.

Zhao Peiru chose to make an incision in the middle of the abdomen, and then explored the ascites in the abdominal cavity, as well as whether the nodules and liver were squeezed and transferred.

Subsequently, with the work of dissociation and separation, the body of the pancreas is gradually exposed.

The common hepatic artery, the proper hepatic artery, is clamped with arterial clips.

After that, cut off the celiac trunk from the root, and cut off the proximal end of the common hepatic artery near the gastroduodenal artery...

After a whole set of procedures, everyone was dazzled.

They only know the macroscopic treatment plan, and the details at this moment, some doctors are higher level and can understand more, while some low level doctors are completely at a loss.

Professor Gao Dandan watched with relish, and there was even light in his eyes.

She suddenly said: "The local vascular reverse flow work is almost finished."

"The problem of occlusive stenosis..."

She has also been worried about the problem of occlusion and stenosis.

The next moment, her eyes widened suddenly, and she stopped talking!

"Can it be handled like this?"

"While performing partial vascular reflux, as well as resecting the neck of the pancreas, the body and tail of the pancreas including the tumor, and the spleen, should the whole stomach be preserved to relieve the problem of occlusion and stenosis?"

Their previous solution was to re-expand the squeezed and narrowed common hepatic artery and other important blood vessels.

However, Zhao Peiru's method is to incorporate these important blood vessels into the local reflux circulation at the same time as "local reflux", changing the attributes of their "important blood vessels", so that the non-stenotic blood vessels can be used instead. its important role.

This method of "civet cat for prince" not only ensures the smooth local blood supply, but also saves the workload of re-expanding blood vessels, or cutting and suturing blood vessels.

This is a very suitable and patient-friendly way to avoid unreasonably increasing workload for a case of traumatic surgery that requires tumor removal.

"This step of operation is ingenious and ingenious!"

At this moment, Professor Zhou Dandan's scalp is numb!

This is the deduction of the treatment plan into a logically well-conceived and well-conceived medical logic.

"The anatomy of the pancreas, let him dissect it thoroughly, and it's all brilliant."

Zhou Dandan subconsciously said: "Professor Shan Hongqi, you, Dean Zhao of the special team, can establish a school in the field of pancreas!"

With such a high evaluation, none of the other experts objected, and all of them deeply sympathized.

They thought that they were shocked to be able to conceive a "vascular reflux".

Unexpectedly, on the basis of "vascular reflux", Director Zhao Peiru could conceive another method of "civet cat for prince" to replace important blood vessels!
Amazing!

No wonder, when Zhao Peiru faced such a difficult patient before, he didn't have the worry and anxiety of others at all. Instead, he always seemed confident and calm all the time.

on the operating table.

Academician Gao Xianmin, as the second assistant, happened to be free at this time, and there was no work for him at this stage.

He also felt the scorching eyes and shocking eyes from the observation room.

He glanced at Zhao Peiru, who was working hard, and felt admiration in his heart.

"One operation shocked me twice, and I came up with two unparalleled and exquisite ideas."

"I've had pancreatic cancer surgery for so long, why didn't I come to visit Director Zhao Peiru sooner?"

If he could have learned about these two treatment methods earlier, many of his previous pancreatic cancer operations would have saved the patient a lot of suffering.And some patients who are inoperable due to various reasons can also rely on these two ingenious ideas to give them a chance to be treated.

In everyone's thoughts...

This operation is finally over.

It took five and a half hours.

When the operation was over and the patient was pushed into the observation room, everyone in the observation room applauded in unison!

Professor Zhou Dandan clapped his hands and subconsciously shook his head in admiration: "Dean Zhao, your local vascular reverse flow replacement operation really opened my eyes!"

"Compared to you, I am like a frog in a well. I feel that the surgery for pancreatic cancer in the past seven or eight years was all for nothing!"

She has done so many operations for pancreatic cancer, but she never thought of this "reverse flow" method and "replacement method".

(End of this chapter)