Doctor's Life Simulator

Chapter 332 Appears!The first "one and a half ventricle" correction in the country
When Deputy Director Qian was shocked by Qin Lang's creative thinking, Qin Lang directly connected the last stroke with a pen, then picked up the whole picture and sucked it to the whiteboard with a small magnet.

He moved the whole small whiteboard over, and said calmly: "This is my improved plan for this operation, which I call "one and a half" ventricular correction."

Deputy Director Qian and Zhong Zhizhi looked at the illustration of the operation plan hand-painted by Qin Lang in shock, and began to think.

As for the resident doctor, he licked his lips and didn't see anything, but it didn't prevent him from getting excited for no reason, and he blew a wave first: "Amazing, Doctor Qin! But, what does this technique mean?"

Deputy Director Qian and Zhong Zhizhi also seemed to understand. After all, Qin Lang's operation is a hybrid of Rastelli + semi-Mustard + two-way Glenn operation, three conventional operations.

It's normal for the doctors to have doubts. After all, this is a brand-new surgical technique that he spent most of his life in the simulated world to study and improve. Qin Lang clicked on the blueprint with a straight and beautiful index finger.

He explained in a clear tone: "This "one and a half" ventricle correction operation has three significant advantages compared to the traditional single ventricle correction operation. First, the half-Mustard operation can reduce intra-atrial sutures and help reduce Late complications of atrial plate defect in Mustard operation, such as sinus node dysfunction, pulmonary vein obstruction, etc.

Hearing Qin Lang's explanation, Deputy Director Qian couldn't help nodding:
"Yes, pulmonary vein obstruction is a common high-incidence complication of traditional orthodontic treatment, and it is also a pain point that has been insurmountable."

Qin Lang continued: "Secondly, for patients with pulmonary artery-right external duct connection, the semi-Mustard/two-way Glenn operation can reduce the blood flow through the right ventricle-pulmonary external duct and prolong the service life of the external duct."

Hearing Qin Lang's detailed explanation, Deputy Director Qian and Zhong Zhizhi glanced at each other. Both of them were shocked. This Qin Lang really has a broad mind and unconstrained ideas. By combining two unrelated operations The combination produced unexpected effects.

It directly and fundamentally solves the biggest defect of conventional surgery.

At this time, Qin Lang added the last point:
"Semi-Mustard surgery is simpler than traditional Mustard surgery, especially for diseases with complex cardiac anatomy, which greatly improves the success rate of surgery and reduces postoperative complications."

Deputy Director Qian got up and walked to the small whiteboard, and carefully looked at Qin Lang's diagram. After Qin Lang's explanation, he looked at it again. The director, of course, has a very high level of comprehension, and quickly figured out the mystery of it. The more he understood, the more he admired the ingenuity of this technique.

Deputy Director Qian clapped his hands: "It's done!"

"Qin Lang, how did you come up with this technique, did you learn it from Dean Wen?"

Deputy Director Qian asked very excitedly.

"Oh, I happened to be studying orthodontic surgery recently, so I thought of such a "one and a half ventricle" orthodontic surgery as soon as I had a flash of inspiration."

Anyway, now, the entire First Affiliated Hospital of Zijingang University knows that he is that kind of talented doctor, and Qin Lang is no longer modest.

"It's my own creation again."

Deputy Director Qian and Chief Zhong Zhizhi looked at Qin Lang and didn't know what to say.

Sure enough, people are different.

"Qin Lang, how did your brain grow? It's too powerful, okay, just follow this plan for surgery."

Deputy Director Qian put his hands on Qin Lang's shoulders, excited. This is the first surgical procedure in the country, and it is another huge leap forward for the treatment of corrective transposition of the great arteries. , caused a sensation, long face!

"Director Huang is really unlucky. It seems that the first "one and a half ventricle" correction surgery in the country is the turn of me and Qin Lang to perform the operation."

"Doctor Zhong, you go to arrange the signing of the patient before the operation. Dr. Qin and I will perform this brand new operation. Remember to record the whole process and upload it directly to the medical forum after completion."

Three hours later, several people walked out of the operating room with ease.

The whole operation was very successful, and the video material of the operation was also uploaded to the medical forum by Chief Zhong in the first place.

After this operation, Qin Lang completely subdued Deputy Director Qian and Chief Chief Zhong, and he deserved to be the young talent hand-picked by the director!

[Ding, congratulations to the host for completing the task and proposing a genius improvement plan!Obtained task rewards: 1.1 life simulation points, 2, bupropion smoking cessation drug: drug research and development laboratory simulation authority. 】

On the second day, when Qin Lang was still in front of the salted fish, Director Huang brought Professor Yang Guoshu and his party to the First Affiliated Hospital of Zijingang University.

Director Huang took Professor Yang and his doctoral student Wang Xiaoying to his office.

After an introduction to the other party, he directly talked about this time, the content of the academic exchange, and the discussion on ventricular corrective surgery.

Professor Yang is very accomplished in this area, which basically represents the ceiling level of Huaguo.

"Professor Yang, this time there is a very special case in our department. It is a very rare congenital heart disease with double outlet right ventricle (DORV) combined with complete atrioventricular septal defect. , it happens that our department is still studying the surgical plan, and I would like to ask Professor Yang to give us guidance."

Wang Xiaoying's eyes were shining brightly. It was the first time she encountered this kind of disease.

Seeing the curiosity on his doctoral student's face, Yang Guoshu also became interested, and explained to Wang Xiaoying:

"DORV-AVSD is a complex, rare cardiac malformation that includes anteriorly extending non-restrictive VSD, primary ASD, common atrioventricular valve, aortic overriding or right-sided Stenosis of the ventricular outflow tract, etc.

"Internationally, in 1975, it was proposed for the first time that the combined deformity could be corrected by enlarging the ventricular septal junction. In 1980, the first corrective operation was successfully performed, but the surgical mortality rate was very high, especially when combined with pulmonary artery stenosis or pulmonary vein ectopic connection The surgical mortality rate of patients is higher. In the 1s, it was reported that the surgical mortality rate was about 90%.”

Hearing the data from Professor Yang, Wang Xiaoying was obviously a little surprised, it is really a terrible disease.

"Director Huang, let's not waste time, let's go and see the patient's condition first?"

Professor Yang is a very dedicated veteran expert who is also very dedicated to medicine, and he doesn't care about the fatigue of traveling.

"Okay, then I'll work hard for Professor Yang. I'll call Director Qian and Dr. Zhong to participate in this joint consultation, and let them study hard with you."

Director Huang's words are of course sincere. After all, Professor Yang's level is recognized in the country, especially in ventricular corrective surgery.

Soon, after receiving a call from Director Huang, Deputy Director Qian and Chief Zhong Zhi hurried over.

I saw that the famous Professor Yang, Deputy Director Qian and Zhong Zhizhi were naturally humble and respectful, with a particularly low posture.

"Professor Yang, I have admired your name for a long time. This time, I will learn from you the experience and skills in ventricular correction."

Deputy Director Qian said excitedly, and Zhong Zhizhi beside him was also bragging about business.

"Director Qian, Dr. Zhong is being polite, we are just communicating and sharing with each other. Let's see the patient's condition first?"

"Okay, okay."

Deputy Director Qian had already prepared the patient's situation in advance.

"Professor Yang, here are the patient's echocardiogram and angiography data."

After Professor Yang took it, he looked carefully, and saw that the patient's two major arteries completely originated from the right ventricle, and there was pulmonary hypertension, which is a typical DORV-AVSD disease.

Professor Yang continued to look at the rest of the patient's examination information:
The patient was moderately stunted and had mild heart failure. Grade 3/4 systolic murmurs could be heard in the 3rd and 6th intercostal spaces on the left side of the sternum, and P2 hyperactivity; chest X-ray showed: whole heart enlarged, bilateral Pulmonary blood increased significantly, the pulmonary artery segment protruded, and the cardiothoracic ratio was 0.62-0.85.

After reading it, even Professor Yang felt a little heavy: "Director Huang, this patient's situation is a bit complicated, it's really tricky."

Director Huang wasn't too surprised by Professor Yang's reaction, but he was still slightly disappointed. Could it be that even the senior experts from the 301 PLA Hospital couldn't come up with a perfect solution?

In the office, everyone was silent for a while, only the sound of turning pages was heard.

Deputy Director Qian looked at the prestigious Professor Yang and couldn't help sighing.

Although Professor Yang lowered his head, looked at the information, and thought about the plan, but in the quiet office, Director Huang's sigh was very obvious, and it hit Professor Yang's heart heavily.

The First Affiliated Hospital of Zijingang University, the first to propose a consultation, could not come up with a solution, which was a bit embarrassing.

After all, Professor Yang is also an expert with cards. He pondered for a while. Although he couldn't come up with a one-time solution, it made him think of a transitional method:

"Director Huang, Director Qian, although I can't think of a one-time solution, I have an idea. We can use two-stage surgery to solve this problem."

"In the first stage of surgery, we can use systemic pulmonary shunt, which can increase blood perfusion in the lungs, increase the amount of oxygenated blood, promote the further development of the pulmonary artery and left ventricle, and provide conditions for the second stage of radical surgery. "

"In two installments?"

Hearing Professor Yang's thoughts, Director Huang also pondered for a while:
"Professor Yang's suggestion is actually a solution. However, systemic pulmonary shunt surgery, maintenance of the function of the operation center, whether the shunt vessels are unobstructed and the size of the shunt flow are the key factors affecting the effect of the operation. If the shunt is too large, it will lead to pulmonary edema and pulmonary edema. Perfusion, that can’t wait for the second-stage radical operation.”

"Yeah, so, the selection of the surgeon for this phase of the body-to-lung shunt is very critical. They need to have superb skills and a keen ability to judge artificial blood vessels. Moreover, the response and speed requirements during the operation are very high. At the same time, it is best to have superb suturing and cutting skills.”

Professor Yang also sighed, although he was able to formulate the overall operation plan divided into two phases, but he is not too sure about the implementation of this operation.

If it was in the Imperial Capital 301 Hospital, his team would naturally have no shortage of surgeons.

"Moreover, this patient has a patent ductus arteriosus, and it is necessary to avoid the opening of the ductus arteriosus as much as possible during the operation to prevent hypoxia."

Director Huang has the deepest understanding of this patient's situation, so he added a little detail that Professor Yang ignored, but it is also a key point.

Hearing this, Professor Yang directly took the patient's detailed medical examination information from Director Huang, and took a closer look:
"Really, the difficulty and risk of the first stage of this operation have increased exponentially. The operator must be required to complete these complicated operations within an hour and a half. Based on my current experience, the control of the entire operation I don’t know how much better the control is than when I was young, but after all, I’m getting older now, and my physical strength can’t keep up. If I were to be the chief surgeon, I might not be able to do it so fast, it’s difficult.”

Professor Yang evaluated it again. As a prudent expert, the success rate is less than [-]%, so of course he would not take any risks. He said regretfully:
"Director Huang, I carefully evaluated the patient's physical condition and endurance. The success rate of this surgical plan is too low. I don't agree with trying it."

Hearing what Professor Yang said, the glimmer of hope that Director Huang, Deputy Director Qian and others had just brought up was shattered again.

Professor Yang shrugged. He proposed the operation plan, but the doctors at the First Affiliated Hospital of Zijingang University couldn't do it, so they could only do nothing.

Of course, it’s not that the doctors at the First Affiliated Hospital of Zijingang University are not good enough. In fact, this patient’s physical condition is too poor, and the operation is too complicated:

"If I were ten years younger, I would be [-]% sure."

Deputy Director Qian and Chief Chief Zhong murmured: "Excellent technology, keen judgment on artificial blood vessels, operation speed, suturing skills, and incision skills at the same time."

Suddenly, his eyes lit up, and Zhong Zhizhi next to him obviously had a tacit understanding, and the two spoke in unison:

"Doctor Qin!"

Dr. Zhong whispered next to Deputy Director Qian: "Let me ask and hear what Dr. Qin thinks?"

Deputy Director Qian nodded. After all, it was not clear whether Qin Lang could perform the difficult technique proposed by Professor Yang, so they decided to seek Qin Lang's opinion first. After all, their own cubs had to be well protected.

For a while, if he boasted in front of Professor Yang and Wang Xiaoying, and Qin Lang couldn't handle it, it would be too embarrassing.

Zhong Zhizhi got up directly to find Qin Lang.

But Professor Yang didn't notice the tricks of Deputy Director Qian and Zhongzhi, and said to Director Huang:
"Director Huang, I think we should go to the patient's family and discuss it. The best way now is conservative treatment. The risk of surgery is too great."

Director Huang also thought about it carefully. Professor Yang's plan is theoretically possible, but because the patient's tolerance is too poor, he doesn't have much confidence.

After all, for senior directors like them, there is a set of criteria for judging. The success rate of the operation is too low, so it is not worth the risk.

Especially in the current medical environment and the relationship between doctors and patients, conservative treatment is the best way. Although it seems a bit ruthless, this is the most mature and professional way to deal with it.

Soon, Director Huang and Professor Yang came to the patient's ward together.

The patient's son and daughter greeted him anxiously and expectantly.

"Director Huang, is there any surgical plan for my father's illness?"

Director Huang felt a little uncomfortable seeing the earnest eyes of the patient's family members, and said in a regretful tone:
"This is Professor Yang from the 301 People's Liberation Army Hospital. Just now we conducted a comprehensive and systematic consultation on your father's situation. There is no surgical plan, but your father still has a patent ductus arteriosus. The situation is too complicated. , the success rate of surgery is too low, so my opinion with Professor Yang is to give up surgery and carry out conservative treatment.”

Hearing Director Huang's words, the light in the patient's daughter's eyes suddenly disappeared, and she muttered in her mouth: "Can't the operation be done? How could it be like this, how could it be like this."

The patient's son was relatively calm and understood the meaning of Director Huang's words:
"Director Huang, as long as there is a possibility of success, we are willing to accept surgical treatment. Conservative treatment, isn't that a delay for a day. We don't accept it."

The patient's daughter also reacted and grabbed Director Huang's hand:

"Director Huang, please, please operate on my father. We are willing to bear the accident of the operation. We don't treat conservatively."

Seeing the patient's excited plea, Director Huang hesitated for a moment, but he still looked at Professor Yang who proposed the operation.

After all, Professor Yang has seen strong winds and waves, his heart is like a rock, his will is firm, and he has his own judgment:
"Director Huang, I still have the same opinion. The success rate of the operation is too low. Taking such a big risk to perform the operation will only make the patient suffer more and the family will waste more money."

"Conservative treatment is the best way."

Professor Yang gave the final word.

Hearing Professor Yang's words, the family's son and daughter were all disappointed, they lowered their heads, silent and speechless.

Director Huang twitched slightly in his heart, and he could only sigh. Although Professor Yang seemed ruthless, his judgment was rational.

Deputy Director Qian stood aside, staring anxiously at the door, muttering, "Why aren't you here yet!"

"That's it."

Just as Professor Liu was about to come to a conclusion, two figures walked towards the door.

As soon as Zhong Zhizhi came in, he excitedly gestured OK to Deputy Director Qian.

Deputy Director Qian's eyes lit up, and he stepped forward directly, with a slightly trembling voice lying between the patient and Professor Yang, and said:

"Professor Yang, in fact, it is not impossible to perform surgery. Doctor Qin in our department has a very high technical level, and is famous for his high-frequency operations and long-lasting movements in operations. He is especially good at incision and suture. Excellent candidate for surgery."

Hearing what Deputy Director Qian said, Professor Yang and Wang Xiaoying also looked at Qin Lang, but Qin Lang was really young, so he confirmed suspiciously:
"Director Huang, what do you mean, this little doctor can complete this difficult first-stage operation?"

"Doctor Qin, come here."

Director Huang immediately called Qin Lang over: "Qin Lang, can you complete the body-to-lung shunt in more than an hour?"

Qin Lang did not directly agree. Of course, he can complete Professor Yang's plan, but it is not the best choice.

I looked at the patient's condition before, and under the series of master-level ventricular corrective surgery, I have some new ideas, but I still need to diagnose the patient.

"Director Huang, I am indeed very proficient in body-to-pulmonary bypass surgery, but I still need to check the patient's condition first."

Hearing what Qin Lang said, Director Huang hurriedly made room for Qin Lang, and even pushed Professor Yang aside. Director Huang turned his head and smiled apologetically.

Professor Yang frowned. The name Qin Lang, he had heard from some old friends before he arrived, was a young man with great potential and talent, and he was also Wu Jizong's nephew.

In addition to Professor Yang's scrutiny attitude, the two family members were obviously the most excited at the scene. When they heard that there was a possibility of surgery, the patient's daughter went directly to the side of Qin Lang: "Doctor Qin, take a good look, you must operate on my dad." , We are willing to bear the risk of surgery.”

Qin Lang didn't speak.

"Don't disturb Doctor Qin's diagnosis."

The patient's son pulled the sister who was a little out of control.

PS: Thanks for the 100 coin reward from Little Fairy who loves to learn~
(End of this chapter)