Oncology Physician Life

Chapter 60 Chapter 59
In the evening, Jiang Li stood alone in front of the green sterile table in the simulated operating room, with a silicone human cranial prosthesis model in front of him.

She propped her hands on the sterile table, not knowing how many times she had failed, feeling very depressed.

The air conditioner in the simulation room was turned on very high, and the cicadas could be faintly heard from the canopy of the hospital park outside the half-closed windows.

Just when she was about to pull off the brain CT film on the map reader and want to study the location of the tumor again, the light above her head suddenly went out, and the simulation room was dark. Then, there was a muffled thunder outside the window, which scared her. Jiang Li jumped.

She took two steps back and slammed into a man's hot chest.

Even through the clothes, I can still feel a warm strange feeling from the other party.

The empty room was very quiet, Jiang Li took out the mobile phone in the pocket of his white coat, turned on the flashlight and looked backwards, with the help of the precariously weak light, he saw the sharp-edged face behind him, and he was relieved.

"Don't make a sound in the middle of the night, don't you know that people can scare people to death?!"

Jiang Li patted his chest, fumbled in front of the wall and turned the switch of the light tube, but there was still no brightness in the room.

Ji Han's gold-rimmed glasses on the bridge of his nose reflected a faint light in the dark night. He looked up at the extinguished chandelier, and said slowly, "The circuit in this simulated operating room is aging, and the circuit often trips. Just call and ask someone to fix it."

Hearing Ji Han's words, Jiang Li glanced at him from the corner of his eye, then looked at the pitch-black room, and couldn't help but move his footsteps to his side.

Ji Han's tall and straight body was as motionless as a mountain, and he called the hospital's office, even if he was asking for help, his tone was very indifferent, and he sounded like he didn't want to call: "Yes, it's still the simulated operating room, it should be the same as last time. Same, come and have a look.”

Ji Han hung up the phone, glanced at Jiang Li who was very close to him, and asked back: "Have you found a way to control blood volume through surgery?"

"Not yet!" Jiang Li shook his head.

With the weak brightness of the backlight of the mobile phone, the faces of the two were close to each other, concentrating on the brain CT film in their hands.

"Shall we change places?"

Turning his head, Jiang Li almost bumped into Ji Han's profile, only to realize that the two were so close without knowing it, and he could even feel his breath.

Ji Han didn't notice Jiang Li's abnormality, and with his thin lips pursed into a straight line, he pointed to the area occupied by the tumor on the film, and said: "The tumor is too big, with a diameter of almost 6 centimeters, occupying the back of the baby's head, surrounded by The two main blood vessels of the brain provide a rich blood volume to the tumor. If the tumor is to be resected, it is necessary to find a way to pinch these two blood vessels first. More importantly, the amount of bleeding must be maintained at the size of three Coca-Cola bottles. Traditional surgery, which removes the tumor while stopping the bleeding, is definitely not going to work.”

Seeing Ji Han looking over from the corner of his eye, Jiang Li hurriedly turned his head sideways, but his elbow inadvertently hit his ribs, causing the other party's dissatisfaction, and a pair of thick brows instantly frowned.

Jiang Li raised his head in a panic, freed from this awkward atmosphere, just about to get up, only to find that his legs were numb and stiff after standing for a long time, almost instinctively falling backwards in the dark night.

Ji Han stretched out his hand to grab her shoulder, but Jiang Li grabbed her white coat in desperation.

In the darkness, with a stabbing sound, the corner of the white coat was torn instantly, and both of them fell to the tiled floor of the simulation room in horror.

Jiang Li only heard a dull sound of hitting the ground, followed by a stone on his body.

In the darkness, the two pairs of eyes looked at each other so close that one could even feel the other's hot chest pressed against her.

Forgot to speak for a moment.

After a few seconds, Jiang Li woke up from the stupefaction. He wanted to pull out his body and stand up, but his legs were firmly held down by Ji Han. He couldn't help frowning, and said angrily, "You still don't get up!"

Hearing Jiang Li's voice, Ji Han came to his senses, straightened his hands on the ground, and hurriedly looked for a support point, but touched a very solid object.

Jiang Li's roar suddenly came from the darkness: "Ji Han, where are you going to touch your hands! Take your hands away!"

Ji Han had never been so flustered before, he withdrew his hand almost like lightning, knowing that he touched something that shouldn't be touched.

Just as the two of them were about to get up in a panic, the lights in the simulated operating room suddenly returned to normal. They both heaved a sigh of relief, but heard an exclamation from the door of the simulated room.

"Professor Ji, you, what are you doing!"

"Both of you..."

Lu Jiajia and Xu Youshu couldn't believe the scene they saw in front of them, they bent down desperately, trying to see who the woman Ji Han was pressing under them was.

As a result, when he saw Jiang Li's face, his mood was even more shocking.

"Jiang, Teacher Jiang! How could it be you!"

Jiang Li got up from the ground in a panic, straightened his wrinkled white coat, and coughed: "It's not what you think, I fell just now, and Lao Ji came to pull me, and I accidentally fell down."

Lu Jiajia nodded like a chicken pecking at rice: "I understand, I understand, Mr. Jiang, don't worry, I won't think too much about it."

Jiang Li's heart was in a mess, he sighed and didn't bother to explain.

Tao Dayong, the vice president of the hospital office, came from behind with a toolbox, not knowing what happened.

"I checked it just now. The circuit is aging and the fuse is blown. I'll find an electrician tomorrow and replace the aged and blown fuse and wire."

Hearing Tao Dayong's words, it was as if a lightning flashed across Jiang Li's mind.

The whole person froze in place, chanting silently: "Fuse, fuse, fuse!"

She clapped her hands suddenly, and laughed loudly: "Yes, why am I so stupid, I didn't think of fusing!"

She picked up the film, looked at the brain CT, and saw the two cerebral blood vessels connected to the goose egg-sized tumor. She paced back and forth excitedly, imitating the new surgical plan just thought of in her mind!
As long as these two cerebral blood vessels are blown like a fuse, the amount of bleeding can be minimized and the tumor can be completely removed!

This set of plans went back and forth in her mind, lingering.

What method can be used to fuse these two cerebral blood vessels?
Suddenly, Jiang Li suddenly raised her head, she thought of something!
Bipolar coagulation!

Bipolar coagulation is generally a common tool for intraspinal hemostasis in spinal cord surgery.

However, bipolar coagulation can also play the role of coagulation and hemostasis in the presence of liquid, such as effusion.

The principle of bipolar coagulation is to use electric current to generate heat to quickly stop bleeding.

And what she has to do is not just to stop the bleeding!
She wants to use the current heat energy generated by bipolar coagulation to quickly cut off the two blood vessels in the baby's brain!Keep the vessel completely closed.

Like a blown fuse!Instantly interrupted by a strong current.

As long as she can block and fuse the two blood vessels connected to the tumor, she is sure to control the bleeding volume of this operation to 30 milliliters, which is the size of three Coca-Cola bottle caps!
The more he thought about it, the more Jiang Li felt that this method was very feasible.

She looked at Tao Dayong with a dazed face, and smiled happily: "Thank you Tao Yuan, if it weren't for you, I might not have thought of such a way!"

"No...you're welcome?!"

Tao Dayong felt baffled, he didn't do anything, he just changed a fuse, why was the other party so moved?

Jiang Li didn't have time to explain to them, and immediately walked towards the nurse's desk.

She wanted to redo the operation plan and discuss it with Professor Jiang Yuyi. If the other party agreed, she wanted to perform this medulloblastoma operation on Bei Bei!

On the other hand, Lu Jiajia wanted to secretly send what happened in the simulated operating room and the "intimate" photos of Jiang Li and Ji Han to Zhang Linlin for gossip, but accidentally posted it in the doctor group .

By the time I found out, it was too late to withdraw.

Lu Jiajia looked at the group of doctors in horror. In the middle of the night, it was as if a frying pan had been turned on, her heart suddenly turned upside down, and her face was ashamed!
Doctor A: Who is this, posting such crazy photos in the middle of the night?

Doctor B: Professor Ji still knows how to play, tsk tsk, so intimate.

Doctor C: Unexpectedly, we had a knife on the outside of the swollen body, and "big news" broke out among the doctors in the middle of the night.

Doctor D: Even the white coat was torn, my God, it was so fierce!

Sitting on the wheelchair in the lounge, Ji Han looked at the 100+ news from the doctor group on the screen of his mobile phone, and couldn't help but raise his eyebrows.

These guys don't sleep most of the night, and they still gossip here leisurely!
The next day, at one o'clock in the afternoon, the operating room of tumor surgery.

The first assistant, second assistant, anesthetist, and instrument nurse involved in the operation are all ready.

The bright shadowless lamp shone on the operating table, and the eight-month-old Beibei lay quietly on the operating table.

The nurse began laying down the sterile drape, exposing the baby's brain.

The instrument nurse reconfirmed that all surgical instruments on the instrument table, from electric knife, scalpel to tweezers, and hemostatic forceps, were correct.

It was 10:[-] p.m., and the door of the preparatory room opened.

Jiang Li walked in after washing his hands before the operation.

She straightened her hands and let the nurse put on a sterile surgical gown, rubber gloves, and surgical cap for herself.

Turn your hands flexibly to confirm that there are no gaps or twists between the rubber gloves and your hands.

She looked at the clock, and at 25:[-], she gave the order to start the operation.

At the same time, in the observation room just a wall away from the operating room, residents, interns, and regular trainees from the Department of Oncology, Neurosurgery, and Neurosurgery all ran over.

More than 40 people crowded into the small observation room, and everyone looked up at the LED screen hanging above their heads.

They couldn't believe that this female surgery professor who came back from MD Anderson Cancer Center really dared to perform this operation!

They don't know what method Jiang Li will use?
The amount of bleeding in this craniotomy can be strictly controlled and kept within 30ml of the size of three Coca-Colas.

Because in their view, this seems to be a bit of fantasy.

The brain surgery team had studied the film beforehand. The goose egg-sized tumor was closely connected to the blood supply vessels of the baby's brain. With a rich blood supply, the tumor grew very large, with a diameter of more than 6 centimeters.

Even if the blood supply to the brain can be cut off quickly, there is no way to stop the bleeding in an instant.

As long as there is bleeding, the amount of bleeding will be very large, and it is almost an instant thing if it exceeds 30 milliliters.

Not to mention a series of problems such as shriveled blood vessels, inability to quickly transfuse blood, and heart failure, it is not an easy task to completely remove this tumor with a diameter of more than 6 centimeters in the brain of an eight-month-old baby.

They were both curious and skeptical, and at the same time there was a hint of expectation in their hearts.

Looking forward, I can witness the emergence of miracles.

When doctors in other hospitals refused to perform craniotomy, what if the female professor from MD Anderson in their hospital successfully completed the operation and saved the eight-month-old baby?
in the operating room.

Jiang Li had already finished his preparations, and he glanced at the baby on the operating table, like a baby the size of a watermelon, and signaled the second assistant to start the preoperative preparations.

Jiang Li put on a binocular loupe (Kepler's binocular magnifying glass), and looked at the electron microscope set up in front of the operating table.

Under this unique electron microscope, the baby's head is completely magnified thousands of times, and even blood vessels of a few microns can be seen clearly.

The equipment nurse took out medical cotton from the alcohol bottle, plugged the baby's ears, and covered the baby's eyes with a protective film. The whole body, except for the one covered with a sterile bag, was naked and awkward. head.

Because of the tumor, Beibei's head is also much larger than normal babies.

There was no sound in the operating room, only the ups and downs of the heart monitoring equipment.

The roving nurse completed the establishment of the venous channel on the only remaining 4 mm venous vessel in the baby's whole body.

This 4mm vein was the only one that Jiang Li found after searching for an hour and a half with an ultrasound guide. It was a intact vein on the baby.

Jiang Li came to Beibei's head, and the roving nurse pushed the screen in front of Jiang Li so that she could read the film and determine the location of the craniotomy.

She took the red marker from the nurse and drew a red arc on the back of the baby's head, and a smaller arc on the other side.

In the observation room, all the residents and interns held their breath, not daring to breathe.

Jiang Li put down the marker pen, took a deep breath, and said, "Scalpel with a pointed tip."

The second assistant handed over a shiny pointed scalpel from the equipment nurse, and handed it to Jiang Li.

Jiang Li raised the knife in his hand, and a line of blood ran across the baby's scalp. The scalp was quickly turned up, and the excess blood was removed with a negative pressure suction device, exposing the skull.

Following the "buzzing" sound of the skull in the operating room, Jiang Li carefully removed the skull from the back of the baby's head.

Immediately, under the electron microscope, a clear picture of the tumor and brain tissue in the back of the baby's brain was revealed.

The tumor the size of a goose egg is closely connected to two cerebral blood vessels, and several tiny blood vessels of 2.4 mm around the tumor are clearly visible.

Jiang Li looked at the anesthesiologist: "Baby's vital signs?"

The anesthesiologist Zhang Qihua kept staring at the instrument, not daring to slack off: "The heartbeat is normal, the intracranial pressure is normal, and the blood oxygen is normal."

Apart from all distracting thoughts, Jiang Liping glanced at the second assistant.

The second assistant took the bipolar electrocoagulation that had been prepared in advance and handed it over to Jiang Li.

Jiang Li looked at the bipolar electric coagulation with a diameter of only 1 mm in his hand, like a "chopstick", indicating that the second assistant can discharge.

In the observation room, everyone showed a shocked look.

"Professor Jiang intends to use bipolar coagulation to cut off the blood vessels connected to the tumor?"

"Can this be done?"

"The resection of brain tumors is different from general surgery. Hemostatic forceps cannot be used to clamp the blood vessels to stop bleeding. Normally, the tumor can only be removed while the bleeding is stopped, and the blood is transfused slowly."

At some point, the white-haired Jiang Yuyi appeared in the observation room, answering everyone's questions.

"And this baby is even more special. The tumor caused intracranial hypertension. Because mannitol was used to lower the blood pressure in advance, the veins and blood vessels of the baby's limbs were almost shriveled. In addition, it was only eight months old, so it was impossible to quickly transfuse blood, because it would cause blood pressure. Baby heart failure!"

"The baby's tumor is connected to the blood vessels of the brain, which has a rich blood supply, which leads to the abnormality. Hemostasis while resecting the tumor. In order to prevent heart failure, the bleeding volume of the baby must be controlled at 30 milliliters during the operation. It was the size of three Coca-Cola bottle caps, and such harsh conditions caused almost all doctors in other hospitals who had seen the film to refuse the operation, basically announcing the death of the baby.”

Jiang Yuyi looked at Jiang Li on the screen, and his eyes lit up: "But our Professor Jiang, she didn't give up, not only didn't give up, but also found a solution, using bipolar coagulation, completely cut off the two Blood supply blood vessels, and, using the hemostatic feature of bipolar coagulation, these two blood supply vessels can be completely closed in an instant, reducing the bleeding volume of the baby during the operation, I have to say, it is really ingenious and ingenious design!"

Listening to Jiang Yuyi's answer, everyone couldn't help feeling emotional.

This operation is really a different approach, even touching.

In the operating room, Jiang Li looked at the 1mm-thick bipolar coagulation in his hand. This special "chopstick" quickly cut off the two cerebral blood vessels connected to the tumor.

Almost at the moment of severing the blood vessel, the heat energy generated by the bipolar coagulation quickly makes the blood vessel close automatically.

Under the electron microscope, there are no blood vessels to provide blood supply to the tumor. The tumor, which was originally the size of a goose egg, slowly began to shrink visible to the naked eye.

In the operating room, all the medical staff who noticed this scene all heaved a sigh of relief, with smiles on their faces.

There was also a burst of exclamation in the observation room.

"Success!"

"It really did!"

"The tumor has shrunk!"

Jiang Li still kept a solemn expression on his face, and cut the goose egg-sized tumor tissue into countless small pieces with a scalpel, and began to carefully suck it out with the suction device.

On the electronic clock on the wall of the operating room, the numbers slowly passed.

Four and a half hours later, Jiang Li moved his numb arm and put down the aspirator in his hand.

The tumor in the back of Beibei's brain was completely removed.

She glanced at the others, nodded, and began to sew up the dura mater, restore the bone flap, and sew up the scalp.

Until, five and a half hours later, the lights in the operating room were completely turned off.

Warm cheers erupted in the observation room!
Anesthesiologist Zhang Qihua looked at the blood pump, which was bleeding less than 30 milliliters, and gave Jiang Li a thumbs up!

Jiang Li walked to the window, pulled off his mask, and breathed in the fresh air outside. Although he was tired, he couldn't help being happy.

She glanced at the three Coca-Cola bottle caps in her hand, smiled, and handsomely threw the three bottle caps into the trash can one by one, and rejected Qi Song's invitation to celebrate, and turned towards Go to the lounge.

In Ji Han's lounge, Pei Xiaonan ordered fried chicken, lotus root noodles, eggplant box, and fried rice. Wei Ran took out four bottles of Coca-Cola from the bag and placed them on the table.

Jiang Li walked in relieved, and Pei Xiaonan gave her a thumbs up: "What did I say, our Jiang Jiang is not normal, isn't it that the amount of blood loss in the operation should be controlled within 30 milliliters! Isn't it just three Bleeding the size of a Coca-Cola bottle cap! Drizzle!"

Jiang Li couldn't help laughing happily: "Compared with Director-General Pei, my ability is nothing. Director-General Pei is considered powerful. I heard that the laboratory's CAR-T cell therapy has made another breakthrough? "

Wei Ran heard the two women brag about each other, and got goosebumps all over his body: "I really can't stand the business bragging between the two of them."

Ji Han gnawed on the fried chicken and asked, "Has the PS5 you bought yesterday arrived?"

Wei Ran was facing an enemy: "What are you doing?"

Ji Han mumbled his bones, threw them into the trash can, and said, "Lend me to play for a few days!"

"No!" Wei Ran shook his head, "For a man, PS5 is his second wife. Have you ever seen someone lend his wife out?"

Ji Han's murderous intent appeared in his peripheral vision, but Wei Ran was determined not to persuade him.

Pei Xiaonan suddenly said: "Tomorrow is the weekend, let's go hiking. We haven't gone camping for a long time. I heard that there may be a meteor shower tomorrow night. Let's go hiking and camp to watch the meteor shower!"

Wei Ran hurriedly shook his head: "No, I'm going to play PS5 at home tomorrow, if I don't have time..."

Before Wei Ran could finish speaking, Ji Han nodded in agreement: "Okay, that's it, I just don't have surgery tomorrow."

Wei Ran looked at Jiang Li, his eyes were full of pleading.

Jiang Li smiled: "Okay, I'll rest tomorrow too, then we'll go hiking and camping!"

Wei Ran wailed again: "Why, you always can't care about my feelings!"

Pei Xiaonan ignored him directly: "Should we rent a car or drive?"

Ji Han: "Let's drive. I drive an off-road vehicle. It's big enough for the four of us."

Jiang Li: "I want to bring binoculars and hot pot. Eating hot pot when camping is a perfect match!"

Pei Xiaonan snapped his fingers: "Bring something spicy, the spicier the better!"

Wei Ran gave up his resistance, with a look of lovelessness: "I have no objection, as long as you are happy."

In the evening, Jiang Li went to the ward to visit Beibei before leaving get off work.

A few hours after the operation, Beibei passed the anesthesia and was able to drink milk smoothly. For the first time, the baby showed dimples on her face, and she was naughty enough to stretch out her little feet to kick her mother.

Beibei's father Qin Zhang saw Jiang Li, his eyes were red, and he bowed to Jiang Li: "Thank you, Professor Jiang, if it wasn't for you, our child might..."

Jiang Li smiled: "Don't say that, I am relieved to see that the child is fine, the results of the biopsy have not yet come out, and we don't know if the tumor will recur in the future, but as long as the child is still alive, there is always hope, isn't it ?"

Qin Zhang nodded: "Regardless of whether the tumor will recur in the future, whether it is surgery or other treatments, our husband and wife will not give up this child!"

Jiang Li glanced at Beibei's smiling dimples, and felt a great sense of satisfaction in his heart, feeling that everything he did was worth it.

Maybe this is what it means to be an oncologist yourself!

　Six thousand words, three chapters in one
　　
　
(End of this chapter)