MTL - Doctor’s Life Simulator-Chapter 367 The department of Zijingang No. 1 Hospital remotely observed Qinlang's operation

"Director Huang, Director Qian, I seem to have some ideas, but I'm not very mature. You can help me think about it together."

Hearing what Director Zhu said, everyone except Qin Lang looked at Director Zhu.

"Director Zhu, do you have any ideas for improvement?"

"Yes, in fact, the most difficult part of the Cox Maze III operation is the "cut and suture" line design. The most likely accident during the operation is the treatment of the tricuspid annulus, mitral isthmus and coronary sinus, so I was wondering if I could use Medtronic's bipolar radiofrequency forceps to replace the traditional cutting and suturing. In theory, radiofrequency ablation is easier to control than traditional methods, and can greatly reduce complications and operation time. "

After Director Zhu finished speaking, he was also very excited. Damn it, am I creating an original and improving technique?

On the opposite side of the screen, Director Huang and Deputy Director Qian were stunned after listening. After thinking for a while, they looked at Director Zhu with shock:

"Director Zhu, what you said is very reasonable, and the feasibility is very high. In this way, let's design a bipolar radiofrequency ablation line together."

Director Huang was very familiar with the Cox Labyrinth III technique, so he took a red marker and started to draw on the whiteboard. Just as he was drawing, his brows furrowed:

"There seems to be some problem. Bipolar RF forceps cannot reach the tricuspid annulus of the right atrium, and bipolar ablation in the left atrium cannot reach the mitral valve annulus."

"It seems so."

Several people stopped again, very regretful and uncomfortable, and fell into silence again.

"I know, it can be supplemented with a monopolar radio frequency pen. The monopolar radio frequency is more compact and can handle the places that these bipolar radio frequency cannot reach."

Director Zhu thought of the set of bipolar radio frequency and monopolar radio frequency pens in the laboratory and blurted out.

"Yes, yes, Director Zhu is amazing."

Of course, Director Huang knew everything at one point, and directly asked the lower-level doctor on the side to ask for a blue pen, and began to draw the supplementary ablation line on it.

The ablation line plan is getting better and better. Director Zhu watched it with relish, and his heart was very excited. This was a rare flash of inspiration that he thought of an improved technique for so many years.

And it was an expert from the First Affiliated Hospital of Zijingang University a few years ago, who was too long-faced.

It's just that Director Zhu always felt that this aura came by coincidence. Did he really come up with this?

After thinking for a while, Director Zhu affirmed his talent and luck. This should be the so-called medical saint possessed himself at this moment.

On the side, Dr. Sun saw the more and more perfect ablation line, and his eyes were protruding.

"I've seen this picture before!"

Physician Sun muttered to himself, and then the whole person was startled, isn't this the ghost painting that Qin Lang used on the heart model before!

No, the picture in Qin Gallery is smoother and more streamlined than what Director Huang is drawing!

Of course, Dr. Sun didn't dare to say such amazing information on this occasion, but his heart was pounding, and he looked aside at Qin Lang, who was looking at Director Huang Fang An on the screen. He was completely an old master. Silently recognized, Ru Zi can teach approving eyes.

Dr. Sun suddenly realized that Qin Lang didn't even want to jump out and point out that this plan was actually what he thought ahead of Director Zhu. Obviously, his plan was more complete and mature.

Physician Sun suddenly became a little moved. It wasn't because he didn't want to, it was because Qin Lang didn't care about it.

Also, with a genius like him, how could he count such a little reputation.

This kind of plan that Director Zhu and experts from the First Affiliated Hospital of Zijingang University came up with is nothing more than a "ghost drawing" that Qin Lang casually sketched with the mentality of having a play while watching the video.

Soon, with Director Huang's profound skills, the design of the ablation line was gradually improved.

In Dr. Sun's eyes, it is also getting closer and closer to Qin Lang's "ghost painting talisman".

"Director Zhu, your improved plan this time is really a big leap on the basis of the Cox maze III operation. After our operation is completed, we can complete a paper by sorting out the data, the world's first Cox maze. IV surgery."

Director Huang and Deputy Director Qian are both generous in their praise. Director Zhu's improvement this time is groundbreaking in the field of atrial fibrillation treatment. It is very practical and popular. It is very likely that this improved Cox maze IV Surgery is popularized in most hospitals in China, making the treatment of atrial fibrillation popular, and even become the "gold standard" of treatment in the near future.

"This is also thanks to Director Huang and Director Qian working together to improve the plan. Now that the plan is available, I will start arranging the operation immediately. After that, the two directors will need to guide the operation remotely together."

Director Zhu was also in a good mood and immediately began arranging surgery.

"Of course, Director Zhu, like this, I want to organize all the key doctors in our department to observe this pioneering Cox Labyrinth IV operation."

Director Huang thought about it, this is a very meaningful operation.

"Welcome, it's an honor."

Director Zhu wanted to be able to show his face in front of the doctors in the entire First Affiliated Hospital of Zijingang University.

"Okay, then Director Zhu, I'll go get ready, and we'll go online after the operation starts."

"Okay, see you later."

Soon both sides were offline and began to prepare for the first Cox Labyrinth IV operation.

...

...

Department of Cardiovascular Medicine, The First Affiliated Hospital of Zijingang University.

Director Huang and Deputy Director Qian began to summon the backbone physicians under them to participate in this operation.

On the way, I met Dean Wen Yunqi. Dean Wen is a top expert in the cardiovascular field.

Of course Director Huang didn't want Director Wen to miss such a moment:

"President Wen, we just had a joint consultation with Director Zhu of Hecheng First Hospital. This time, Director Zhu had a flash of inspiration and proposed a world-first Cox Labyrinth IV operation. After he arranges it, it will begin. For the operation, I have arranged for the key doctors of the department to participate in the observation. Are you interested and time?"

"The first Cox maze IV surgery?"

Hearing this improved technique, Wen Yunqi was naturally very interested. He quickly exchanged views with Director Huang, and he said with admiration:

"Director Huang, this is a once-in-a-lifetime opportunity. I will participate in the observation with you. This operation has provided new ideas and concepts for the entire medical community to carry out maze surgery, and it can be extended to other surgical procedures. The impact may be more profound than we thought!"

Wen Yunqi's sense of scientific research is still very keen, but it is a pity that the founder is the director of the first hospital of Hecheng City, otherwise Zijingang University can do something about it.

When the First Affiliated Hospital of Zijingang University was ready to observe the general department, the Cardiovascular Department of Hecheng First Hospital was also busy.

At this moment, Director Zhu is proudly returning to the big office to arrange the operation.

Soon before arriving at the desks of Qin Lang and Dr. Sun, he inadvertently saw the heart model on Qin Lang's desktop and the familiar ghost symbols on it.

Director Zhu's smile froze all of a sudden, the whole person woke up in an instant, and pictures flashed in his mind, no wonder he always felt a little strange about this inspiration:

"Director Qin, you..."

When Qin Lang came back, he made some subtle optimizations to the surgical plan. Director Huang and Director Qian were the top leaders in the field after all. Through their consultation, Qin Lang had a new idea.

During the RF clamp operation, there is myocardial ischemia, so in order to have higher requirements, Qin Lang prepared to add Const Protection Solution (HTK solution) to make the whole operation more perfect.

After Qin Lang thought about it, when he turned around, Director Zhu looked at himself with a blushing old face, and asked a little embarrassedly:

"Director Qin, you thought of this optimization plan from the beginning?"

Director Zhu pointed at the heart model on Qin Lang's desktop. No wonder he was able to come up with a creative plan. It turned out to be because of Qin Lang Fang's psychological suggestion.

Director Zhu can't wait to find a ground seam drill.

"Director Zhu, I can't say that. After all, I just watched the Cox Labyrinth III procedure and had some ideas, so I tried the ablation line, but it was not that systematic, and a complete operation had not yet been formed. Fang An. I didn't fully understand until I listened to the detailed analysis of you and Director Huang and Director Qian."

"So speaking, we can only say that our heroes see the same thing. Director Zhu, in fact, the improvement of the Cox Labyrinth III technique this time is mainly driven by you."

What Qin Lang said was the truth. Director Zhu really only left a little impression before, and his performance depended on his accumulation.

"Huh? That seems to be true."

How can it be called plagiarism?

After being rounded by Qin Lang, Director Zhu suddenly felt at ease, and he appreciated and liked Qin Lang more and more.

Seeing that Qin Lang licked Director Zhu without a trace, Dr. Sun's eyes were straight.

Otherwise, someone is a director at a young age!

Alas, the current workplace is too difficult. Some people not only look better than you, but also have better skills. The key is that the ability to lick dogs is first-class.

Director Zhu pursed his lips, and immediately thought again, since he was inspired by Qin Lang, then as the real founder, Qin Lang's understanding of this technique should be deeper than his own. Moreover, Qin Lang's surgery Ability, that is the highest in Hecheng.

"Director Qin, I have an idea. After a while, the world's first Cox Labyrinth IV operation will be performed by you, and I will do it for you. How?"

Director Zhu directly suggested.

Hearing this sentence, Dr. Sun was immediately stunned, and immediately persuaded:

"Director Zhu, although Director Qin first thought of this surgical plan, it's only theoretical knowledge. This operation is really very difficult. I'm afraid it would be inappropriate for Director Qin to be the main surgeon?"

No wonder Dr. Sun is worried. After all, even if Director Zhu, who is very experienced in maze surgery, is the chief surgeon, he still needs the guidance of experts from the First Affiliated Hospital of Zijingang University.

And Qin Lang has just seen a few of them. Being able to design an operation does not mean that he can do it.

Director Zhu ignored Dr. Sun's opinion and just looked at Qin Lang, waiting for his answer.

"it is good."

Qin Lang directly agreed to Director Zhu's suggestion without any hesitation, and completed the system's tasks along the way.

"Director Zhu, Director Qin, you..."

Physician Sun saw that one dared to entrust blindly, and the other dared to take care of it, and it was unbelievable.

"Okay, that's it."

Director Zhu certainly has his own considerations.

Such a complicated and first-time operation, and under the observation of experts from the entire department of the First Affiliated Hospital of Zijingang University, Qin Lang still performed calmly and confidently.

Director Zhu really admired this courage and determination: "Director Qin, we will start preparing for the operation immediately. Dr. Sun, go to adjust the equipment and contact the experts from the First Affiliated Hospital of Zijingang University to go online on time."

"All right."

Dr. Sun sighed, maybe this is the difference between a mortal and a genius?

To be able to participate in such an important operation, even if it was an assistant, his hands were shaking with excitement. Seeing Qin Lang who was about to be the main surgeon, he was even more envious and admired.

Ten minutes later, Qin Lang, Director Zhu and Dr. Sun entered the operating room.

The remote observation guidance system was also opened simultaneously, and soon, the situation in the operating room was displayed in the observation room of the Cardiovascular Medicine Department of Zijingang Hospital.

In the observation room, in addition to President Wen, Director Huang, Deputy Director Qian, the other seven or eight attending and deputy chief physicians of cardiovascular medicine expect the start of the operation.

Director Huang introduced to his colleagues:

"Today I invite you to observe an improved Cox Labyrinth IV operation with great promotion significance. This operation was proposed by Director Zhu of the First Hospital of Hecheng City, and was designed and completed with the participation of Director Qian and I. The "new energy" of the polar radio frequency forceps and the single-stage pen replaces the "cut and sew" of the traditional maze operation, which is very ingenious and practical, and also provides us with an idea for the treatment of cardiovascular diseases in the future. "

"I hope you will observe and study well in the future."

Before Director Huang could finish speaking, he heard a commotion in the observation room.

Director Huang frowned and turned his head to look at the screen where everyone was discussing, and then saw the familiar Director Zhu standing in the position of the assistant, and the chief knife was someone else!

Looking closely, isn't this Qin Gallery?

Everyone was stunned, and Director Qian blinked. When will Qin Lang perform the Cox Labyrinth IV operation again? This is not a new operation that Director Zhu proposed not long ago, and he and Director Huang jointly perfected it.

This kid, could it be that he just listened to the surgery plan once?

Wen Yunqi was also a little surprised, but also a little curious, how could Qin Lang be so powerful.

In the observation room, everyone naturally knew Qin Lang, but I didn't expect that this guy had returned to the first hospital in the city and was able to demonstrate the operation to everyone.

After all, Qin Lang was famous, and everyone calmed down to watch.

On the operating table, Qin Lang has already begun to issue the first order, Chen Wenhao began to use intravenous inhalation combined general anesthesia, radial artery and right subclavian vein puncture and catheterization to monitor arterial pressure and central venous pressure.

In time, Qin Lang gave instructions to the equipment nurse:

"Medtroniity-541 type membrane oxygenator in the United States. The pre-filling solution consists of 1500ml of Ringer's acetate solution, 500mg of methylprednisolone, and 10~20g of albumin."

"The Italian Soria-type blood recovery machine is used for blood washing and recovery. The intraoperative perfusion flow is 2.2~2.4L/(m2·min), and the hematocrit (HCT) during transfer is not less than 0.21."

Qin Lang further optimized the operation plan of Director Huang and Deputy Director Qian, so when he issued these two strange orders.

In the observation room, Director Huang and Deputy Director Qian were stunned. This is a little different from what they designed.

Huh?

It's just that in the operating room, Qin Lang's quick operation did not mean to explain to the experts on the other side of the screen.

Directly took the scalpel and began to open the chest in the middle.

"Heparin...a help, ready to establish cardiopulmonary bypass..."

Seeing Qin Lang's incision, he was amazed.

"Block the superior and inferior vena cava..."

"Scalpel..."

Qin Lang performed continuous operations to make a right atrium oblique incision perpendicular to the right atrioventricular groove.

Seeing this step of Qin Lang's operation, Director Huang raised his brows in the observation room, almost applauding Qin Lang's precise operation.

"As expected of Director Qin, everyone should pay attention to his operation, especially the position of the hand incision. Afterwards, everyone should also pay attention to cutting off the ridge at the lower end, and avoid the sinoatrial node area to avoid damage to the conduction system."

After listening to Director Huang's speech, the doctors also learned with humility.

The doctor himself eats technical food. If he can do it or not, he will be clear as soon as he makes a move. Qin Lang's cutting skills, in the observation room, these attending physicians and deputy chief physicians believe that none of them can surpass him.

"When did the first hospital in this city become so powerful. Director Zhu came to our department for further study before. I didn't expect that it would take such a long time to create such a powerful Cox Labyrinth IV operation. Director Qin is also excellent as always. A brand new operation, It's so perfect that they can do it."

When the entire observation room was engrossed by Qin Lang's few hard-core operations, Qin Lang started the core improvement and optimization of the operation.

"Medtronic Bipolar RF Forceps...Single Stage Pen..."

Qin Lang picked up the bipolar radio frequency forceps very stably with both hands. Radio frequency is a high-frequency vibration with a frequency of 150,000 times per second.

The principle is that the human body is a complex structure composed of many organic and inorganic substances. Body fluids contain a large number of dielectrics, such as ions, water, and colloidal particles. The human body mainly relies on the movement of ions to conduct current.

Under the action of high-frequency alternating current, the change direction of ion concentration changes back and forth with the current direction as positive and negative half-cycles. Under the high-frequency oscillation, the ions between the two electrodes move rapidly along the direction of the electric force line, and gradually change from a moving state to a vibrating state.

Due to the different sizes, masses, charges and moving speeds of various ions, the ions rub against each other and collide with other particles to produce biothermal effects.

Therefore, the friction between them and other molecules and ions in the cell heats up the lesion site, causing the water inside and outside the cell to evaporate, dry, shrink and fall off, resulting in sterile necrosis, so as to achieve the purpose of ablation.

"So everyone must not underestimate this step. It is a test of the chief surgeon's grasp of the ablation time and to ensure that complete transmural damage to the atrial wall is avoided. Moreover, since a large amount of heat is generated during ablation, temperature control is more important."

Director Huang, as the main designer of this operation, of course has a very deep understanding of these operations, and the more this is the case, the more he admires Qin Lang. This kid knows how to listen to it once.

"It's really amazing."

Director Huang couldn't help but sigh.

The attending physicians in the observation room~www.novelbuddy.com~ also nodded their heads, unawares!

"The next step is to cool down, block the aorta, and start perfusion of cold blood cardioplegia..."

When Director Huang was very confident and forward-looking in introducing the next operation, Qin Lang's voice also sounded in the operating room:

"Cool down...occlude ascending aorta and perfuse HTK fluid..."

Hearing Qin Lang's instructions, there was an uproar during the observation, especially Director Huang who thought his ears had misheard.

Wen Yunqi in the middle also opened his eyes slightly and looked at the young doctor on the screen. Regarding this improvement plan, Director Huang naturally reported to him, and he also recognized it very much.

But now there is a major deviation from the plan set in advance by Director Huang and others in the operating room.

What exactly is going on?

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