Chapter 144 Why is the ring not obedient? Completed in six seconds, stunning the audience
At this moment, even a fool would understand that Director Wen, whom they regarded as the most powerful person, had encountered difficulties.
The patient's aneurysm neck was too narrow, and the flexibility of the catheter limited the ability to precisely place the coil at the target location.
Director Wen was in a difficult situation in front of students and doctors from other groups.
People need face and trees need bark.
Sometimes, people are burdened by false reputation and can do many incredible things in order to save face and dignity.
Director Wen gritted his teeth and decided to be brave and give it a try.
The spring coil was directly released from the catheter.
After this special spring coil is placed in the target blood vessel, direct current is passed through it. The spring coil attracts negatively charged blood components: red blood cells, white blood cells, platelets, etc., causing electrocoagulation.
Eventually a blood clot forms within the aneurysm.
At the same time, the part connecting the spring coil and the stainless steel guide wire is dissolved due to electrolysis, and the spring coil is released and remains in the aneurysm.
It was not delivered to the ideal target position, the circle position was not correct, and it was released forcibly.
The consequence is that the spring coil does not play its intended role.
You know, the patient's aneurysm has ruptured and is bleeding.
It needs to be completely blocked.
This necessitates the insertion of multiple coils.
But the first one was not placed properly, what about the rest?
Director Wen’s idea was very simple. If the circle was not placed properly, he could just try to adjust the position.
The GDC coil is extremely soft and has good compliance when moving forward and backward within the aneurysm. If the placement is not satisfactory, it can be adjusted.
Generally speaking, occlusion of the parent artery is less likely to occur.
Then just adjust it slowly.
Unfortunately, the results are getting worse and worse, and Director Wen is getting very worried.
"Today is really weird. Why is this spring coil not obeying me at all?"
Director Wen’s speech is quite fluent.
If it were a surgeon with a bad temper, he would have started cursing a long time ago.
"Director Wen, please take a break first and let me fight for a while."
The attending physician, whose surname was Zou, volunteered.
To share Director Wen’s worries.
"Maybe I'm a little tired after having performed two operations today. You hold on for a while, I'll go to the side and take a breath."
Director Wen also took advantage of the situation and gave up his position at the right time.
The situation wasn't much better after Dr. Zou took over.
After all, this requires real skills.
And now that the spring coil has been released from the catheter, the operation is more difficult.
After a few minutes, Dr. Zou was already sweating profusely.
Half of it is because of tiredness, and half of it is because of urgency.
The operation is always not done properly and the patient's intracranial hemorrhage is continuing. How can he not be anxious?
At this moment, the patient's body suddenly began to tremble.
Immediately afterwards, the life monitoring equipment issued a shrill alarm.
"Not good, the patient's blood pressure is dropping rapidly, his heart rate is speeding up, and his brain waves are abnormal!"
The anesthesiologist was sitting against the wall to rest, glancing at the display screen of the monitoring equipment from time to time.
Under normal circumstances, it is just an interventional surgery for a cerebral aneurysm and there is almost no risk.
Who would have thought that Director Wen and several of his students would leave the patient like this.
"What happened?"
Director Wen also ran over nervously to check.
"It's probably because the spring coil was not placed properly. Repeatedly adjusting the position of the spring coil actually aggravated the bleeding."
The anesthesiologist was very experienced and gave the reason after checking the condition.
"I, I didn't do anything!"
Dr. Zou felt that he was quite wronged.
Isn’t interventional surgery said to have extremely low risks?
The most dangerous catheter puncture has been completed.
There is almost no danger in inserting a spring coil. It only took a few minutes, so how could it cause such a big problem for the patient?
It's so unlucky.
"If the coil cannot be successfully inserted in time to stop the bleeding, the patient may not be able to get off the operating table."
Anesthesiologists are more depressed than anyone else.
In this situation, he didn't even have a way to rescue him.
The patient has intracranial hemorrhage, and the only way is to stop the bleeding.
"You are capable of causing trouble but not of achieving anything. Get out!"
Director Wen's eyes were extremely cold.
The face hidden under the mask must have become extremely ugly.
He even cursed Dr. Zou with extremely ugly words.
I was really anxious.
There is a huge difference between failing a procedure and killing a patient.
The consequences were simply beyond his ability to bear.
"The patient had been bleeding for more than an hour before entering the operating room. Now, due to Dr. Zou's operating error, the bleeding has worsened. There is no point in opening the skull to save the patient. The only way is to insert all the coils in the shortest possible time to cut off the blood supply to the aneurysm."
Zhou Can really couldn't bear to see the patient die or become a vegetable.
In order to save this patient, he has paid a lot with his meager strength.
Wu Baihe can't come, Director Wen's level is just that.
At the moment, perhaps only a humble small-time trainee like him can turn the tide and bring the situation back to life.
"You have no right to speak here. Everyone knows the truth."
Doctor Zou scolded coldly.
Zhou Can just pointed out directly that it was because of his operating error that the patient's bleeding worsened.
It's the truth.
But he found it very harsh and felt very uncomfortable.
"I've had the implantation done before. Director Wen, can you let me try it? It doesn't take too long. Thirty seconds will be enough."
Zhou Can never stops until he makes a shocking statement.
Director Wen operated the elastic ring for nearly half an hour without any progress. Doctor Zou operated it for seven or eight minutes, but not only was there no progress, the patient's bleeding worsened.
This young intern with a nervous face actually said that thirty seconds would be enough.
"Do you know what you are talking about?"
Director Wen looked at Zhou Can with cold eyes.
It was also the first time that I looked at this intern seriously.
With his status, let alone a resident trainee, even a medical intern, if he is not particularly outstanding, he would not even be worthy of remembering his name.
"I said give me thirty seconds and I can solve the problem of coil placement."
Zhou Can's eyes were clear and his voice was sonorous and powerful.
This is a sign of extreme self-confidence.
"Xiao Zhou , don't be so stubborn."
Dr. Ou gave him a hand.
This kid doesn't know his limits. The patient could die at any time. If he starts to operate now, he will definitely be a scapegoat.
Hospitals are never the beautiful holy places we imagine.
On the contrary, beneath the sacred appearance, there is too much filth and ugliness hidden.
"If this patient is not saved, he will probably die. I can't think too much about my personal interests."
Zhou Canchong said gratefully to Dr. Ou.
After saying this, he looked at Director Wen again.
If the surgeon doesn't agree, he won't have the chance to perform the operation.
"Seeing how confident you are, I have no choice but to give you a chance. Come on, the result is already like this, it can't get any worse." Director Wen actually agreed.
Zhou Can didn't care about anything else, as long as he agreed.
He walked quickly onto the operating table and stood in the best operating position, only to be seen fiddling with the thin guide wire.
Before everyone could see clearly, he had already stopped the operation.
"alright!"
He said lightly.
Just now, after watching Director Wen and Doctor Zou perform the operation, he felt that he could do it.
Now that I have gotten started, I have successfully placed the spring coil into the target position.
Total time taken was six seconds.
It could have been faster, mainly because it was the first official operation.
"Is this all right?"
Director Wen's eyes almost popped out.
"Oh, it seems this intern has actually put it right!"
The female attending physician exclaimed in surprise.
"It was done in just five or six seconds?" Dr. Zou had done it himself, so he knew the difficulty.
Not to mention five or six seconds, even fifty or sixty minutes would be very good if you could get the spring coil to the target position.
Those three graduate students and two residents had a great eye-opening today.
The surgical task that neither their teacher nor Dr. Zou could handle was easily accomplished by a resident trainee.
Is this the legendary Sweeping Monk who defeated the martial arts master?
Or is it the legendary pig that won't eat chaff but only swallows dragons and tigers?
Director Wen stared at the screen again and again, and after watching it for no less than ten times, he finally confirmed that this inconspicuous boy in front of him had created a miracle. He really completed an almost impossible operation in just a few seconds.
This aneurysm cannot be treated with just one coil.
You have to put in more to completely block it.
Zhou Can has already given up his seat.
And he looked indifferent.
It seemed like just a trivial thing.
Such behavior made Director Wen feel ashamed and embarrassed.
Family members know their own business.
Even though Zhou Can easily fixed the elastic ring, if he were to do it, the subsequent elastic rings would most likely still get stuck.
By then, Director Wen’s face would really be slapped.
"May I have your name?"
Director Wen calmed himself down and took the initiative to ask Zhou Can's name.
Almost all senior doctors use this routine.
When you meet a particularly outstanding junior doctor, the first thing he or she will ask is his or her name.
Just like when acquaintances greet each other, the opening remarks are always the same few sentences.
"Have you got a meal yet?"
“What a nice weather today!”
…
"My name is Zhou Can , and I'm a resident doctor in our hospital who has just been assigned to the Department of Neurosurgery."
We should have added a general practitioner in our hospital.
After thinking about it, I decided to forget it.
The status and weight of general practitioner trainee doctors are actually higher than that of all other trainee doctors.
"Xiao Zhou, you performed very well just now. It shows that you are particularly talented in the field of implantation. I have decided to let you do the rest of the elastic coil implantation. Young people should be trained more and given more opportunities to practice."
Director Wen is very good at speaking in clichés.
He clearly didn't have the ability to operate it and wanted Zhou Can to complete the rest of the elastic ring placement. But he had to say it so high-soundingly.
"That's not good! I have little experience and low rank. Why don't we let Dr. Zou or Dr. Tang Li do it?"
Zhou Can hates this kind of hypocrite the most.
Deliberately retreat in order to advance, to stimulate Director Wen.
"No, no, they will have plenty of opportunities to practice in the future. You must be the one to do it this time."
Director Wen was eager to give this training opportunity to Zhou Can.
Because only Zhou Can can operate it well.
Ask Dr. Zou to do the operation, he would never agree to it. He almost killed the patient just now.
As for Dr. Tang Li, her skill is not even as good as Dr. Zou.
It would be even more impossible for him to agree.
Zhou Can was just teasing Director Wen, but when he saw Director Wen's anxious denial, he almost burst out laughing.
"Okay, I won't be polite then! Thank you Director Wen for your cultivation and trust."
Zhou Can also decided to quit while he was ahead.
There is absolutely no benefit in offending a chief physician.
It's just to satisfy my temporary craving.
He stood at the operating table and started the next surgical operation.
He played with the spring coils one by one, inserting them into the target position easily and arranging them tightly.
Soon, the entire brain aneurysm space was filled with spring coils, and after thrombus formation, intracranial hemorrhage was finally successfully stopped.
"Very good! The patient's blood pressure, heart rate and other indicators are gradually stabilizing!"
The anesthesiologist's heart finally settled down.
He looked at Zhou Can with a complicated look, one that contained admiration, shock, and a hint of gratitude.
If Zhou Can hadn’t intervened at the critical moment, the patient might not have been able to get off the operating table.
"Well, the operation is not bad. But there are still areas for improvement. For example, the opening directions of these elastic rings are not consistent." Director Wen made a few comments in a pretentious manner.
I have never heard that the opening direction of the spring ring should be consistent.
It's almost like picking out a thorn in the flesh to maintain his authority as director.
Through this operation, Zhou Can also fully understand Director Wen's strength and character.
The ability of other surgeries is unclear, but the ability of puncture and insertion can only be considered average.
It's definitely not amazing.
Also, this person is particularly concerned about his reputation.
Whether it was forcibly releasing the coil from the catheter, or asking Zhou Can to save the situation later, but making his words sound high-sounding, as well as his so-called comments at this moment, all of them fully show that this person is particularly hypocritical.
It seems that not every chief physician has a decent style and strong character.
Fortunately, the patient's cerebral aneurysm interventional surgery was finally successfully completed.
The patient's life was saved.
"Director Wen, there is a certain amount of blood accumulated in the patient's brain. Do you think it needs to be drained?"
Zhou Can looked at the location of the brain tumor.
As long as he is given the opportunity to puncture, he is confident that he can successfully complete the puncture without damaging the cerebral blood vessels, nerves, and important brain tissues, and draw out the accumulated blood.
Although the aneurysm bleeding has stopped now, the intracranial pressure is definitely still very high due to the continued bleeding.
"From the patient's X-rays, the amount of bleeding was not particularly large. Even if the bleeding increased during the operation, it was still within the tolerable range. The risk of brain puncture and drainage is too high, and there is no need to take this risk. After a few days, his body will naturally absorb the accumulated blood."
Director Wen has experienced dangerous situations before.
Being very cautious at this moment, I am not willing to take any more risks.
Successfully completing a brain aneurysm interventional surgery can generate considerable revenue for the department and commission for the surgeon.
It is also the accumulation of the achievements of a surgery.
Therefore, Director Wen's mood at this moment has gone from hell to heaven.
Surprisingly good.
After the examination is correct, the catheter is removed and the patient is given coagulation medication.
Then wake up from anesthesia.
Unlike the awake anesthesia in ordinary surgery, the anesthesiologist did not dare to remove the vital signs monitor, but simply stopped the medication through the breathing mask.
Generally speaking, the patient will wake up on his own about ten to twenty minutes after stopping the anesthetic.
There are also abnormal situations, in which case the anesthesiologist can use some corresponding methods to wake up the patient.
For example, antagonistic drugs can be given to counteract the sedative effect and achieve the purpose of waking up the patient.
Director Wen did not dare to evacuate when the patient was regaining consciousness.
The main concern is that something unexpected might happen.
Those who can become chief doctors generally take safety issues very seriously.
Because they have experienced too many dangerous situations, they know that some small negligence may lead to big mistakes.
"Dr. Zhou, nice to meet you. My name is Tang Li, and I'm a neurosurgeon. I specialize in functional neurological diseases and am good at surgical treatment of Parkinson's disease and intractable epilepsy."
Tang Li smiled and took the initiative to greet Zhou Can.
Perhaps it was because they saw that this young intern showed amazing surgical potential, and they tried to establish a good relationship with him in advance.
There are many doctors in the hospital who are good at networking like her.
If we wait until Zhou Can becomes famous, it will be very difficult to get to know him.
Apart from anything else, the fact that the two people are in different departments creates a natural gap between them.
"Hello! Nice to meet you!"
Zhou Can was quite polite to her.
I don't feel cold towards this woman.
She looks pretty, but she has no real skills. At least her surgical skills are not good enough.
In comparison, Dr. Shan from the Orthopedics Department is also a young female doctor, but she is much more pragmatic than her.
"Dude, are you really just a trainee? I saw you were so good at inserting the spring ring!"
A graduate student couldn't help but strike up a conversation.
Regular and master's degree are integrated. During the postgraduate study, you can follow the teacher to perform surgery in the hospital, which is also equivalent to regular training.
However, Tuya has been developing rapidly with its continuous rise in recent years.
In order to improve the quality of diagnosis and treatment and the level of the medical team, regular training for postgraduate students has also been implemented, which has been criticized as a painful secondary regular training.
For example, a graduate student with a master's degree may only need to undergo a dozen or twenty days of regular training in a small hospital to symbolically familiarize themselves with the situation, and then they can officially become a resident and start receiving a salary.
But it doesn’t work in Tuya.
It doesn't recognize it.
