MTL - Doctor’s Life Simulator-Chapter 366 The world's first improved surgery

After hearing Director Zhu's words, Dr. Sun's face was solemn. Many diseases in the cardiovascular department are very difficult.

Qin Lang nodded humbly.

Director Zhu was quite satisfied with the modest attitudes of Qin Lang and Dr. Sun, and continued:

"The treatment of new atrial fibrillation complicated with structural heart is mainly surgery, and its development process has experienced left atrial isolation, atrioventricular node catheter ablation, corridor surgery, maze surgery, etc. Since Cox pioneered and carried out the maze surgery, atrial fibrillation has The surgical treatment of the patient has made great progress, and through continuous improvement, it has developed from the maze type I to the current maze III."

"Maze III surgery is also known as the "gold standard" for the treatment of atrial fibrillation. However, due to its large trauma, complicated operation and long operation time, domestic institutions and hospitals are actually not as many as imagined. The effectiveness still needs to be further confirmed, and this time our department will try to perform Maze III surgery."

Director Zhu originally wanted to say that Qin Lang and Dr. Sun could also take this opportunity to learn and accumulate experience.

But after thinking about the unfathomable Qin Lang, Director Zhu asked tentatively:

"Qin Lang, do you know anything about Maze III surgery?"

Qin Lang wanted to say, isn't this a coincidence? However, in the end, I chose to keep a low profile. I gave Director Zhu a chance to show it, and I could check it out myself and take action if there was a problem.

After all, he will definitely go out to exchange and study in the future. The First City Hospital still has to cultivate an elite team. Although Director Zhu has average qualifications, he is better than experienced and diligent, and he is a training object.

It takes a lot of experience and practice.

"Director Zhu, I know a little about Maze III surgery. I have to learn more from you."

Director Zhu heard that Qin Lang only understood a little, so he felt relieved, and then he could output boldly.

However, Director Zhu is still very cautious, and he is still ready to invite Director Huang of the First Affiliated Hospital of Zijingang University for a remote consultation.

"In this way, we will conduct a comprehensive examination of the patient for a while. Then, we will first formulate a surgical plan. After that, I will invite Director Huang of the First Affiliated Hospital of Zijingang University to conduct a remote consultation together. If surgery is required in the hospital, we will perform surgery on the patient. If it can't be done, then transfer it to Hangcheng, and then you can follow Qin Lang to study. "

Hearing Director Zhu's arrangement, Qin Lang had no feeling about Director Huang's participation in the consultation, but Dr. Sun was different. This was an opportunity to learn from experts from the First Affiliated Hospital of Zijingang University, which was very rare.

Under the leadership of Director Zhu, he quickly conducted a comprehensive examination on the patient. With the master-level technique, Qin Lang initially had an idea.

[Patient: Li Xiulan, female, 63

Symptoms: rapid and very irregular ventricular rate, heart season, chest tightness, dizziness, fatigue...

Diagnosis: Atrial fibrillation with valvular heart disease.

The best treatment plan: In the conventional COX maze type III operation, the traditional incision and suturing have great potential safety hazards. It is recommended to use the world's first Cox maze IV operation. 】

[Ding, new task, propose an improved technique. On the basis of Cox Labyrinth III operation, a new energy source is used to replace the traditional "cut and suture", and a specific ablation line is formed on the atrium, so as to achieve the purpose of eliminating atrial fibrillation and sinus rhythm reconstruction, making the operation simple and convenient. And can achieve the same effect as Cox maze III surgery. Mission reward: 1.2 life simulation points. 】

Looking at this brand new task, Qin Lang could not laugh or cry, it seemed that he was going to take action this time.

While Qin Lang was contemplating, Director Zhu had also completed the preliminary work, and the next step was to wait. The experts from the First Affiliated Hospital of Zijingang University in Hangzhou decided the time for the remote consultation.

"Director Qin, Physician Sun, I'll be here today. If you have time, you can study the Cox Labyrinth III technique by yourself, and then you can come up with new ideas in the consultation with experts from Hangcheng."

Director Zhu specially took care of a sentence, which has two meanings, one is to take care of Dr. Sun to do more homework and prepare, and when the remote consultation, at least be able to understand the terminology of the experts, not too embarrassing.

As for Qin Lang, it really means literally, after all, Qin Lang's talent is too high, I'm not sure, just go back and watch the video to understand something, and he can really put forward incredible opinions in the conference room.

"Okay, Director Zhu, we must prepare well after we go back."

Physician Sun assured that, secretly in his heart, he must not pull his legs during the joint consultation.

However, Qin Lang also began to consider designing an improved plan. Under the master-level technique, a very mature left atrial ablation circuit appeared in Qin Lang's mind soon!

Qin Lang and Dr. Sun returned to the office. Dr. Sun began to search for relevant videos and learned about the Cox Labyrinth III technique with relish.

Physician Sun studied for a while, then looked at Qin Lang, who was beside him. To his surprise, Qin Lang did not open the relevant video to study. Instead, he did not know what to draw on the paper.

Dr. Sun touched his chin, and looked at his video more and more attentively. He thought to himself that although he is not very talented, he can still work hard. In this consultation, he surpassed Qin Lang once. The so-called stupid bird flies first. .

After studying for a while, Dr. Sun began to study the details of the Cox Labyrinth III procedure, especially how to design the main means of "cut and seam".

At this time, Qin Lang looked at Dr. Sun and asked, "Doctor Sun, do you have a heart model over there? You can study it for me."

"Heart model?"

Dr. Sun was alert for a moment, and immediately reacted. Could it be that Qin Lang was going to try to design incisions and sutures on the model: "Director Qin, don't tell me, are you going to try to simulate the incision and suture design of Cox Labyrinth III?"

Qin Lang was a little surprised. It seemed that Dr. Sun's introduction to Cox Labyrinth III was ok.

Qin Lang intends to improve the ablation line, and instead of using the traditional incision and suture, Medtronic bipolar radiofrequency forceps and monopolar pen are used to complete the right atrial ablation line and the right atrial ablation line. The formula is different.

After thinking about it for a while, I couldn't explain it directly to Dr. Sun, who was just getting started, so I could only perfunctory: "That's not true, it's just a small idea, just try it out."

After Dr. Sun listened to it, it seemed that Qin Lang was similar to himself, and he was just starting out, so he was not confident, so he could only try it secretly, but he did not expose Qin Lang's careful thinking: "I have some, I do. go get one."

Dr. Sun quickly brought a model that was twice as large as a real heart. The equipment and equipment of the First City Hospital were of very high quality. Qin Lang took a look at it and found that the anatomical structure on the heart was very clear and detailed.

"Director Qin, are you trying to design the incision and suture of the left atrium and right atrium?"

Dr. Sun watched with great curiosity. After all, Qin Lang was famous, and he also wanted to know how much Qin Lang was able to do after learning the Cox Labyrinth III technique.

Qin Lang didn't care about Dr. Sun's onlookers, anyway, he couldn't understand his high-end operations.

Picked up two markers, one red and one blue, and drew on the heart model, very focused, and soon immersed in it, as if performing surgery on the operating table.

Qin Lang held two pens in his hands, and the simulated bipolar RF forceps and the single-stage pen drew on the heart model.

It soon appeared on the right atrium, two circles with double red lines, a small hole with a single blue line, which looked like a sword from a distance, and finally at the very edge, a little bit like a flower was drawn. line type.

Looking at these ghostly talismans drawn by Qin Lang, Dr. Sun was suddenly confused. Although he was not proficient in this operation, he still had some basic judgments, and he read it very carefully several times, these lines drawn by Qin Lang. , It has nothing to do with cutting and sewing.

Could it be that he overestimated Qin Lang's understanding of the Cox Labyrinth III technique.

"This is too unprofessional, how can there be incisions and sutures designed like this."

Dr. Sun groaned in his heart, and the more he looked at it, the more he felt that Qin Gallery's design was outrageous.

"What is this for?"

I saw that Qin Lang began to draw again in the left atrium, and the movement of holding the pen was very strange, like holding an unknown instrument. Looking at the symbols on the model, Dr. Sun became more and more puzzled. A face all huddled together:

"It looks like a pig's nose shape, hey, two blue lines are added, what's the matter!"

Dr. Sun looked at it for a while, and completely lost interest in Qin Lang's outrageous plan.

"I just said, how can self-study be able to master such a difficult technique. It seems that this time, Qin Lang and I are also half a catty. The new technique involving this profession is also blind, and the technique is like a mountain."

Dr. Sun still sat back in front of his computer and started watching his video, nodding his head:

"This is the orthodox Cox Labyrinth III technique, what kind of thing is Qin Lang! It seems that this joint consultation is my chance to perform well."

After Dr. Sun watched the surgery video again, Qin Lang had also completed the design of the ablation lines for the left atrium and right atrium. However, because Qin Lang used red and blue pens instead of radiofrequency ablation, it seemed very strange, and again. It is the first improved technique, so it is very difficult to understand. In the eyes of ordinary people, it is just a series of strange red and blue symbols.

If you let the top experts in the field of Cox Labyrinth III techniques look at it, you can see Qin Lang's ingenious thoughts:

Since the right atrial incision and the ablation line on the left side of the right atrial appendage cannot reach the tricuspid annulus due to bipolar ablation forceps, the ablation here is performed with a monopolar radio frequency pen to perform "supplementary ablation", so that the radio frequency line here reaches the tricuspid valve annulus. place.

The ablation of the left atrial isthmus could not reach the mitral valve annulus, so a monopolar radio frequency pen was also used here to perform "supplemental ablation" to make the ablation line reach the mitral valve annulus. At the same time, turn the heart up, apply a monopolar pen to the epicardium to extend the mitral isthmus ablation line and fully ablate the coronary sinus…

Qin Lang looked at the ablation line again, put the heart model on the table with satisfaction, and looked at Dr. Sun again: "Doctor Sun, I want to go to the next laboratory, if Director Zhu starts a consultation later, you can call I'll go."

Dr. Sun nodded, looked at the heart model on Qin Lang's table again, and shook his head:

"The brain circuit of a genius is really different from that of ordinary people. Why don't you go to the laboratory to grind the research technique here?"

After a while, Director Zhu came to the office and walked over:

"Doctor Sun, Director Qin, you can go to the consultation room with me. I have already contacted the two chief physicians of the Department of Cardiovascular Medicine of the First Affiliated Hospital of Zijingang University, and the remote consultation will start in a while. Director Huang and Director Qian are also Qin. I'm an old acquaintance in the gallery. Hey, what about Director Qin?"

Director Zhu walked in and saw that Qin Lang's seat was empty.

Physician Sun immediately stood up: "Oh, Director Qin, he said he has something to go to the laboratory for verification, or I'll call him."

Director Zhu thought for a while: "You go to the consultation room to set up the venue and check the signal source. I will go to the laboratory to find him."

Director Zhu also wanted to know what Qin Lang was doing. Before leaving, he inadvertently glanced at the heart model on Qin Lang's table, saw some strange red and blue lines, and stopped to take a look.

It's just that after looking around, I don't quite understand it.

However, this image left a little impression in his mind.

But he didn't care too much.

Soon, Director Zhu came to the supporting laboratory of the Cardiovascular Department of the First Hospital of the City, and saw Qin Lang tinkering with a set of Medtronic bipolar radiofrequency forceps and a monopolar pen, which was not long after the department was introduced. The equipment is not promoted and practical.

Seeing that Qin Lang was so curious about the new equipment, Director Zhu also smiled. After all, he was still a young man in his thirties, and he really didn't change his mind.

Director Zhu coughed lightly: "Director Qin, stop playing and go to the consultation room with me. The experts in Hangzhou have agreed to guide us and design the surgical plan for the patient together."

Hearing Director Zhu's call, Qin Lang immediately got up. Anyway, he had already tested it. The radio frequency forceps and single-stage pen used in the laboratory are suitable for the Cox Labyrinth IV surgery he proposed.

Soon Qin Lang followed Director Zhu to the consultation room, and Dr. Sun had already debugged the signal source. Soon, through the screen, a cross-hospital consultation officially kicked off!

Seeing the two directors on the opposite screen, Qin Lang was of course familiar.

On the screen, it was Director Huang and Deputy Director Qian of the Department of Cardiovascular Medicine of the First Affiliated Hospital of Zijingang University.

Director Huang is very accomplished in the field of new atrial fibrillation, especially the research on Cox maze III surgery.

After several previous academic exchanges, Director Huang is still very kind to the First Hospital of the City, and the patient itself is very clinically valuable.

Director Zhu Ren directly communicated with Director Huang. After listening to the patient's situation, he analyzed the medical records in detail. Director Huang soon had a plan.

"The most important part of the Cox Maze III procedure is the "cut and suture" line design, especially for the treatment of the tricuspid annulus, mitral isthmus and coronary sinus..."

Director Huang was very experienced and began to explain to Director Zhu, and at the same time talked about the difficulties and skills.

At the same time, he pulled over a small whiteboard, and started to draw the expanded plane of the heart with a marker on it. The blood vessels, tissues, and anatomical levels on it were very clear, so he had to obey. The basic skills of the director of the First Affiliated Hospital of Zijingang University of solidity.

Director Huang described his surgical experience while talking. Director Zhu listened carefully. Although he had performed the Cox Labyrinth III before, he did not understand it as profoundly as Director Huang.

The reason why Cox Labyrinth III is not carried out in domestic hospitals is because if the "cut and suturing" is not done well, it is very easy to cause great trauma, and the whole operation is complicated due to the complex structure of the heart, and the points that need to be operated There are many and discontinuous, so the operation time is also very long.

Only an experienced person like Director Huang can work out the most appropriate and suitable route.

After listening to Director Huang's explanation, Director Zhu, Physician Sun, and Qin Lang were very impressed. In terms of the handling of Cox Labyrinth III, Director Huang was indeed a top expert in the province.

However, what makes Director Zhu a little embarrassed is that he can understand many details of the operation, but it is still very difficult to operate.

"Director Huang, your plan is indeed the limit of what Cox Maze III can do, but the operation time, cardiopulmonary bypass time, aortic blocking time, tracheal intubation time, etc. are controlled at the time points and the main surgeon's surgery. The speed is closely related, and if something goes wrong, it may lead to complications of the operation.”

Of course, Director Zhu knows that Director Huang's plan is done by himself, and the success rate is very high, but it is not necessarily suitable for the main surgeon of the city's first hospital. For example, with his operating skills, he cannot complete such a beautifully designed and complicated operation. .

A complex operation like this sometimes really needs a specific person to do it to be successful. To a certain extent, it is an imperfect operation that requires experience and talent.

The one that is simpler and more popular, and the one that ordinary doctors can master through practice is the better one.

Of course, Director Huang also understood what Jules meant, and felt that his design plan was too complicated.

Deputy Director Qian on the side also frowned, and he wanted to scold people a little bit. With the plan, your city's first hospital is not good, who can blame?

The scene fell into silence for a while.

"Is it possible to improve the optimization technique?"

Qin Lang, who was on the side, saw the needle ~www.novelbuddy.com~ How could I miss such an opportunity and said softly.

"optimization?"

Director Zhu looked at Qin Lang, who was on the side. Since Qin Lang was not in the screen, on the other side of the screen, Director Huang and Deputy Director Qian only heard voices. Although they were familiar, they didn't recognize them. The two were also in deep thought. Come on, just, how easy is it to improve and optimize the program?

"It would be nice if 'cut and sew' could be simplified."

Qin Lang calmly muttered to himself.

The speaker has the intention, the listener has the intention.

"How can it be so easy to improve the technique."

Director Zhu gave a wry smile, but just after he finished speaking, a picture he had seen somewhere flashed in his mind, eh?

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