Chapter 989: Chapter 989: Huang Bo Wants to Show Off

(Thanks to Yang for the monthly ticket encouragement)

It’s not about hoping patients get sick, but when encountering a suitable NOSES surgery patient, Liu Banxia felt a little excited.

Although he only gauged by sight, the patient’s BMI index should be acceptable.

As for the cost, although it would be a bit higher than laparoscopy, if they really choose to do NOSES, the discount he applied for might be even lower.

He took out his phone and reported the situation of Chu Wanting’s father to Qiaoqiao.

It wasn’t to ask Qiaoqiao to persuade Chu Wanting to choose the new surgical method; it was merely because it was Qiaoqiao’s friend, and it was discussed last night.

"Teacher Liu, do you have time now?"

At this time, Huang Bo also rushed back with the patient.

"Sure, nothing much going on, let’s go to the side examination bed." Liu Banxia nodded.

"Teacher Liu, the MRI and CT scans are not yet available. But the teachers from the radiology department said there’s nothing seen on the head MRI, and the chest cavity doesn’t look great," Huang Bo said.

"There are diffuse granular shadows in both lungs, spreading outward from the hilum, but this situation doesn’t quite explain his leg’s nerve response."

"So next comes your diagnostic process, as if I’m not here. Diagnose as you wish." Liu Banxia said.

Huang Bo nodded, actually feeling a bit anxious now.

Liu Banxia waved and called Liu Yiqing over.

"Teacher Liu, what’s up?" asked Liu Yiqing as she ran over.

"I’ll consult with Huang Bo later, and I need you to understand both laparoscopic rectal cancer radical surgery and NOSES radical surgery. A patient will come by later." Liu Banxia said.

"Just give an objective description without excessive guidance. The patient’s father is a friend of Qiaoqiao’s. The NOSES related materials are in my computer; handing them over to you for explanation should be no problem, right?"

"Yes, leave it to me," Liu Yiqing replied enthusiastically.

She hadn’t expected to have the opportunity to witness a NOSES surgery. It’s not that there hadn’t been any patients recently, but the BMI indices weren’t suitable, plus many people resisted the new surgery.

"Can you tell me about any symptoms you experienced before fainting?" Huang Bo asked after reaching the examination bed.

"Nothing special, maybe it’s because I’ve been working overtime for too long, and I haven’t been having breakfast in the mornings; maybe I’m just too tired," the patient said.

"The blood test results haven’t come in yet, but from the recent chest CT, your lungs have some inflammation," Huang Bo said.

"Have you recently felt any loss of leg strength in your daily life, like suddenly feeling weak walking, or sometimes not sensing your legs?"

The patient shook his head, "None of that, everything was fine before. I just suddenly fainted this time. I’ve been working overtime, going to bed at one or two in the morning every day, for more than a week now."

"Alright, then lie down here for a while, and once the blood test results come in, we’ll take another look," Huang Bo said.

He couldn’t make any diagnosis considering the current situation, especially with the patient having weakness in the legs and no knee-jerk reflex. Even though it’s returned to normal now, he still felt something was off about the initial situation.

"Teacher Liu, what do you think is wrong with the patient?" Huang Bo asked after stepping out. 𝘧𝓇ℯ𝑒𝓌𝑒𝑏𝓃𝘰𝘷𝘦𝘭.𝒸ℴ𝓂

"Why ask me? I’m waiting for your diagnosis result." Liu Banxia chuckled.

Huang Bo was taken aback, having been preoccupied with contemplating the patient’s condition that he forgot about this.

"I was too hasty; we haven’t even seen the patient’s blood test results yet." Huang Bo said somewhat embarrassed.

"However, considering the situation seen in the chest CT, there is certainly some pneumonia. Additionally, his body is quite fatigued, possibly due to overworking resulting in physical exhaustion and impaired immune response, causing pneumonia."

"Regarding the condition in his legs earlier, with the head MRI being negative and now that it’s back to normal, further observation is necessary."

"Teacher Liu, could you tell me what you think might be the case with this patient? I think there’s definitely something wrong with his legs, likely due to nerves," Huang Bo insisted.

"You’re overthinking, I can’t just wildly guess." Liu Banxia said.

"But you were right before; the lung inflammation is the direct symptom. Whether it’s a viral or bacterial infection, we should wait for the blood test results to determine."

"As for whether the patient has any other illnesses, it can’t be ascertained with the current situation. Also, the information provided by the patient is insufficient."

"For example, you only asked about the recent days but didn’t inquire about a longer duration. Often, immune deficiency caused by fatigue isn’t due to short-term results."

"It’s usually from a prolonged state of fatigue brought about by recent excessive overtime. However, there would have been certain manifestations earlier."

"Such manifestations could include mental and physical exhaustion, changes in eating habits, sleep quality, etc., which you can inquire about from the patient later."

"In my judgment, the presentation isn’t typical of acute pneumonia. Your reception of the patient was passable, albeit a bit hurried; it’s crucial to wait for the blood test results."

"I’d rather people say I’m a mediocre doctor, solely relying on instrument checks for diagnosis, than mistakenly judge an illness due to an oversight of mine."

"Thank you, Teacher Liu." Huang Bo sincerely expressed.

He was indeed a bit eager, his subconscious wanting to make a good impression in front of Liu Banxia. Diagnosing the patient in such circumstances would also indicate an improvement in his level.

However, the gap between reality and ideal always exists, and this time the gap was quite large.

Teacher Liu spared him embarrassment, discerning but not pointing out the flaws, only providing a certain degree of reminder. Medicine offers no shortcuts, requiring a step-by-step solid approach.

"Teacher Liu, Teacher Liu, if we’re performing a NOSES surgery, how are you planning to do it?" Seeing him come out, Liu Yiqing ran over again.

"End-to-end anastomosis after circular resection can cut down some equipment costs. But this also tests operational skills. This can serve as an alternative option for the patient to choose from." Liu Banxia said.

"I just talked with Qiaoqiao; her family is also in business. Although they have some savings, the current market environment might not be great, requiring economic consideration."

"Actually, you should be mindful in the future. If the technology achieves its goal, try to minimize the use of equipment. The consumables cost in this area is too high, unless the technology doesn’t meet the standard or there’s no operating space."

Liu Yiqing nodded, "Teacher Liu, does this count as traditional NOSES surgery or a variant?"

"Haha, I don’t think it matters much. The purpose of surgery is to alleviate patients’ suffering, finding the most suitable and cost-effective way is what matters." Liu Banxia said with a smile.

"Unless some patients’ families are wealthy and want to lessen human errors, then we can freely use the instruments."

"For this patient, the entire operation would cost more than a hundred thousand yuan. Insurance can cover part of it, but the family must still spend quite a sum. When admitting, patients should first be defined as economically disadvantaged, which opens many choices for us."

"Some people wouldn’t blink an eye buying a car worth tens to hundreds of thousands, but when it comes to spending tens of thousands solely on treatment, they’d have to think hard."

"There is this impression that we’re earning money too easily, wielding the scalpel not only to remove a lesion but also to cut a ’sucker.’ This is an area our emergency center needs vigilant attention in the future, an overarching direction that Director Chen insists on managing."

"Gee, Teacher Liu, is this really feasible? All the literature says that using a stapler results in better outcomes, with a lower incidence of complications," Liu Yiqing said.

"Therefore, one must have confidence in their suturing skills and make judgments based on the circumstances surrounding the lesion." Liu Banxia replied.

"This patient’s tumor surroundings are relatively clean, hence my confidence. Some patients have extensive infiltration, where parts of the intestine within a certain range show inflammation. I wouldn’t dare to suture like that; the stapler would be the first choice."

"There aren’t so many ’musts’ in surgery. Often, we need to find some adaptable methods. To reduce patients’ costs, some solutions need to be thought of elsewhere."

"If this operation succeeds, it will be of great reference value for the future. But we shouldn’t blindly persuade patients to undergo such a surgery just because of this."

"With no deviation from the major goal of curing, the choice should always lie with the patient; that’s what’s most important. Don’t assume you can self-authoritatively decide what’s ’good’ for the patient just because you’re a doctor. True or false goodness should be determined by the patient."

"Alright, go and review, they should be here by around noon. If I’m out for lunch, help admit them and conduct the explanation directly."

"Rest assured I’ll complete the task," Liu Yiqing said earnestly.

Watching Liu Yiqing eagerly get back to the computer, Liu Banxia felt quite gratified.

To be honest, choosing Xu Yino might have been better since she’s articulate. However, due to precisely this reason, Liu Banxia didn’t choose her.

If it were Xu Yino, she would definitely sway Chu Wanting towards the NOSES surgery. There’s no need to worry about Liu Yiqing; she’s sincere and simply follows instructions, without mixing in many personal biases.

That’s Qiaoqiao’s friend, even a minor issue in the future can affect Qiaoqiao’s friendship, so it’s best not to do it.

Ultimately, it’s just about doing the surgery sooner or later, with no major impact on the overall direction.