White armor

Chapter 386: Details can be guessed, but cannot be imitated at all

During the puncture, color ultrasound showed bleeding in the retroperitoneum and abdominal cavity, and there was also fluid accumulation around the liver and spleen, so bleeding was suspected.

Luo Hao knew very well that he couldn't wait.

As for Feng Zixuan's problem, it is not actually a problem. It's just that Luo Hao thinks that liquid metal robots are too expensive now and cannot be deployed on a large scale for the time being.

As Luo Hao was thinking about it, he suddenly remembered that in the past, neurosurgeons would go through a computer program to find the best approach before performing an operation.

Of course, this neurosurgery refers to the world's top neurosurgery research centers abroad.

Only they have the time to go through it again.

There are two or three operations a week, and each operation costs hundreds of thousands of dollars, so there is definitely time for repeated consideration.

As for other people, everyone has to be responsible for themselves. There is no point in seeing a doctor if you don’t have money.

And in China? Every surgeon is overwhelmed with surgeries, and the ridiculous metric of bed turnover rate has to be included in the assessment indicators.

If we could adopt the treatment methods of neurological centers in the United States and Canada, we could reduce the number of surgeries by at least half on average each year.

I am so exhausted now that I can’t even finish it. If I do less than half of it, that would be a joke.

Watching patients with minor illnesses either recover directly or go straight to the crematorium?

It doesn't conform to the Chinese concept.

"Old Meng, there is a patient in the Nephrology Department who had a renal puncture and suffered severe bleeding. You go and give the preoperative instructions for interventional hemostasis." Luo Hao returned to the interventional catheterization room and began to make arrangements.

Meng Liangren nodded, a solemn look appearing on Fang Zheng's face.

"The patient's family members are emotionally unstable, and there is a risk of medical disputes."

Meng Liangren nodded again, a trace of solemnity appearing on Fang Zheng's face.

"Xiao Zhuang, send the next patient up here, hurry up!" Luo Hao said, "Once I finish the operation here, the patient over there can be sent in."

"Okay." Zhuang Yan ran out immediately.

The entire medical team began to move rapidly and seamlessly, without even the rustling sound of the Erhei robotic arm.

21 minutes later, Luo Hao finished the operation. Three minutes later, a patient suffering from hemorrhagic shock due to renal biopsy was sent in.

Meng Liangren walked up to Luo Hao seriously.

"Professor Luo, the patient's family may file a complaint."

"Ah."

"It has nothing to do with us, but I have done the preoperative instructions very carefully." Meng Liangren's voice was a little low, and it was obvious that this communication was extremely difficult.

Luo Hao also understood the feelings of the patients' families. A simple kidney biopsy could cause a person to go into hemorrhagic shock. He himself could not accept it.

It is highly likely that the patient's family will be unhappy, but improper response by the Nephrology Department may lead to their unhappiness turning into complaints, which is a low-probability event.

But what to do next?
One of the characteristics of modern medicine is that it is unstable and has an extremely low accident rate.

This is why preoperative instructions are important before every operation.

Although the preoperative instructions won't be of much use if something really goes wrong, it's better than nothing.

"Prepare for surgery." Luo Hao nodded, and Meng Liangren began to get busy.

"Xiao Luo." Feng Zixuan saw Meng Liangren preparing for surgery and walked to Luo Hao. "Is the patient okay?"

"Director Feng, you know, all surgeries..."

Luo Hao only said half a sentence, paused under Feng Zixuan's sharp gaze, and then smiled.

"Director Feng, no problem."

Feng Zixuan's expression softened a little.

"I think there might be a small pseudoaneurysm in the kidney. B-ultrasound... is hard to find. The puncture needle pierced the pseudoaneurysm, causing bleeding."

"Just occlude it. I will select a thinner one during the operation to minimize the impact on the patient's future kidney function." Luo Hao gave Feng Zixuan a positive answer.

"That's right, you talk to me like you're talking to a patient's family member! You need to change this habit." Feng Zixuan scolded familiarly.

"Got it, Director Feng. I won't do that anymore."

Luo Hao smiled gently.

Feng Zixuan was very satisfied with Luo Hao's attitude. As for the complaint, Feng Zixuan didn't really take it to heart.

The First Hospital of Medical University performs nearly 100,000 surgeries a year and receives countless complaints. If he cared about all of them, I'm afraid he wouldn't be able to hold the position of Director of Medical Affairs for long.

A few minutes later, Luo Hao was dressed in his uniform, and Shen Zizai also came on stage to serve as Luo Hao's assistant.

Luo Hao was not polite to Shen Zizai.

After all, the patient has entered a state of hemorrhagic shock, and it would be good to stop the bleeding one minute earlier.

The patient is placed in supine position.

The bilateral inguinal areas were disinfected and draped.

After asking about the patient's allergy history, Luo Hao performed local infiltration anesthesia with 2 ml of 5% lidocaine subcutaneously in the right inguinal area and within the femoral artery sheath, then performed a modified Seldinger technique to puncture the right femoral artery and successfully introduced a guide wire.

Luo Hao did not rush to use the centralized procurement catheter. Instead, he chose the 5F-C2 catheter without hesitation and inserted it.

The main trunk of the right renal artery was first explored, and DSA angiography showed that the right renal artery and right adrenal artery had normal courses, the right kidney parenchyma was well displayed, and no contrast agent overflow was observed.

Seeing this scene, Feng Zixuan's face was so gloomy that it seemed like water was about to drip out.

"Director Feng, don't be nervous." Technician 66 tried to persuade him.

He knew that no bleeding was seen in the right renal artery angiography, which meant that the operation was not simple and was beginning to become complicated.

"What do you think?" Feng Zixuan asked.

"I don't have any considerations. I just simply trust Professor Luo." Technician 66 grinned.

He didn't wear a mask in the operating room, and his teeth were not very white, but his smile was extremely sincere.

Technician No. 66 is telling the truth.

"When you were in India, you left early..."

When Feng Zixuan heard this, his face turned dark.

"Professor Luo encountered many unexpected situations, but none of them could stump him. Basically, the problem can be solved by simply changing the catheter. I have never seen anyone who can perform interventional surgery better than Professor Luo."

Technician No. 66 was chatting with Feng Zixuan, and Luo Hao had already replaced the catheter in the operating room.

A 5F pigtail catheter was introduced and positioned above the opening of the celiac trunk. Abdominal aortography was performed, and a pseudoaneurysm was seen at the distal end of the right colon supplying artery, a branch of the superior mesenteric artery.

The pseudoaneurysm was located adjacent to the lower pole of the right kidney. A microcatheter was introduced into the target vessel, and repeat angiography showed extravasation of contrast agent into the abdominal cavity.

"Look, I told you so." Technician No. 66 was a little proud, "But it's really impressive that this position can bleed."

He was just feeling proud because Professor Luo performed the operation according to his instructions, but the next second he realized that he had said the wrong thing.

Technician No. 66 raised his hand and slapped himself lightly.

"Director Feng, I..."

Feng Zixuan didn't even look at technician No. 66. His eyes stared through the leaded glass at Luo Hao who was performing the operation.

I thought there might be something wrong with the renal artery, but the reality was that there was nothing serious with my right kidney.

Who would have thought that the bleeding pseudoaneurysm was actually supplied by a branch of the right colon supplying artery.

But Luo Hao did not hesitate at all and found out the problem in the second step.

Feng Zixuan had even imagined in his mind that if Luo Hao was not there, Shen Zizai would have to perform at least 3-5 angiography sessions before he could find the bleeding artery.

The more angiography was performed, the harder it was to find the bleeding artery. The patient's blood pressure dropped rapidly, and Shen Zizai's movements became distorted due to nervousness.

The more deformed the movements are, the slower the surgery will be.

Directly close the loop and form negative feedback.

But Xiao Luo was really steady! The branch blood supply of the right colon supply artery was seen during the second angiography, and the operation went smoothly.

Feng Zixuan nodded slightly.

After discovering the bleeding point, Luo Hao introduced the tip of the microcatheter into the opening of the pseudoaneurysm and slowly injected about 0.2 ml of tissue glue through the microcatheter under fluoroscopy.

Subsequently, DSA angiography was performed again, which showed that the pseudoaneurysm was filled and closed, and there was no sign of contrast agent overflow.

Luo Hao immediately withdrew the microcatheter.

The operation is over!
Feng Zixuan glanced at the time, 11′12″.

Cattle!
I should have consulted Xiao Luo earlier. Why am I being so reserved? Feng Zixuan cursed himself in his heart.

But even though the microcatheter was pulled out, Luo Hao and Shen Zizai did not leave the stage.

Luo Hao placed his hands on the operating area and seemed to be talking to Shen Zizai.

Feng Zixuan's mind moved, and he pressed the intercom, and Luo Hao's voice came from the speaker.

"Bamboo is a bully in the Qinling Mountains. It's a real headache. Now we have to pay more than 2 yuan to the villagers every month. Director, tell me how difficult it is to raise a pet. If the country is not more supportive of scientific research now, if it were not the time when you were young and professors were selling tea eggs, I would probably have to take bamboo to the streets to perform."

"..." Feng Zixuan was stunned.

"That's bamboo! It's earned a lot of money from the surrounding areas! No matter how much money is spent, it's all earned by the bamboo itself!" Shen Zizai definitely stood on the side of the bamboo, his butt was crooked.

"I made tens of millions from my business, but I'm going to make a set of clothes for Zhuzi using liquid metal. You don't know how expensive liquid metal is. This amount of money is not enough for a set of clothes, even if it's just a bellyband.

Fortunately, I can still apply for Qingchang funding, but I am responsible for both projects, so there is a problem. So I plan to talk to Brother Geng and see if we can make more bamboo surroundings. "

"Liquid metal can be used like this? A set of armor must weigh dozens of kilograms...converted to tens of thousands of grams?" Shen Zizai was surprised.

Feng Zixuan just listened silently to Luo Hao and Shen Zizai chatting.

Although the patient's operation was over, Luo Hao did not leave the stage. It seemed strange that he stood on the operating table and chatted with Shen Zizai.

But Feng Zixuan guessed that Xiao Luo was being cautious and planned to do another angiography in ten minutes to see if there were any bleeding spots.

The patient's family was anxious and restless. If the bleeding was stopped successfully at one time, the patient's family could accept it. If the doctor had to go to the hospital for a second or third time, the patient's family would probably have to settle the dispute.

It’s better to be cautious, it’s better to be cautious, Feng Zixuan advised himself in his heart.

"By the way, remember to save me a copy of Zhuzi's new peripherals."

"Don't worry, Director. I need 800 copies first. It will take two hours to mail them." Luo Hao said this, but he didn't seem depressed. Then he looked at the patient and asked, "Do you like bamboo?"

"That giant panda? The one whose son celebrated his one-month-old birthday a few days ago?" The patient's mental state was okay and he started chatting with Luo Hao.

"Yes, if you like, I'll leave you a new peripheral."

"Okay, okay, okay, okay." The patient responded excitedly, "Do you know who it is? I heard it's called the King of Qinling Mountains. It will be back from Qinling Mountains soon. The tickets for the panda house are booked for a few months later. I can't see it, I really can't see it."

"I'm the one who raised the bamboo." Luo Hao narrowed his eyes.

"???" Luo Hao smiled and began to tell the patient about Zhuzi's past. It was a story with many ups and downs, but not complicated.

Ten minutes later, Luo Hao ended the story "just right".

Feng Zixuan glanced at the time. 10 minutes, no more, no less.

This story... Feng Zixuan even felt that Luo Hao must have told it on purpose. While telling the story, he observed the patient's exchanges and communication and made his own judgment on the condition.

Even Feng Zixuan couldn't help but sigh in admiration at how meticulous he was.

Luo Hao then performed angiography on the superior mesenteric artery again and found no signs of contrast agent overflow, indicating that the blood supply to the right colon was good.

The patient was conscious and clear-headed, and even asked Luo Hao about the bamboo gossip. He had lost some blood, but it had not reached the level of hemorrhagic shock.

"Okay, the operation is over. It went smoothly." Luo Hao smiled. "When you go back, tell Director Geng of the Nephrology Department and ask her to give me your address. I will mail five or ten copies to you."

"thanks, thanks."

"Oh, you're welcome. We met in the operating room. This is fate." Luo Hao narrowed his eyes and said, "Bamboo and I are also destined to meet. Our main point is a coincidence. These peripherals are not worth much. You can get them before they go on the market. Give them to the children around you. It's quite interesting."

Feng Zixuan sighed.

He knew exactly what Luo Hao was doing.

But Feng Zixuan knew that this kindness was something that no one could refuse.

Although it is impossible to completely eliminate medical disputes, it can at least reduce the hostility of patients and their families by 20%.

What are the details, this is it!

But Feng Zixuan changed his mind and realized that he also had to give something as a gift. If it were a hospital, would he give the patient a three-month ICU trial card?

Or maybe give me ten used syringes?

"Stab it~~~"

Luo Hao kicked open the airtight lead door, tore off the lead cap and threw it aside.

Zhuang Yan followed Luo Hao like a little follower, picking up the lead cap.

This was not the first time I had met Feng Zixuan, but my mood changed a little every time I saw him.

Gradually, he has accepted this scene.

"Director Feng, it's done. It's your turn next." Luo Hao walked to Feng Zixuan and said with a smile.

"so fast."

"The operation was simple, so it was right to be quick. The bleeding stopped smoothly, and I'm quite satisfied."

"Xiao Luo, not bad, really very good." Feng Zixuan said, "To be honest, before, even when I invited you to Johns Hopkins to perform a demonstration surgery, I still felt that you were not qualified."

Feng Zixuan didn't realize that his words had touched Luo Hao's wound.

Luo Hao raised his right eye and his eyebrows slanted into his temples.

Feng Zixuan felt that Luo Hao's aura had changed, like a sword being unsheathed, and he was stunned for a moment.

But the feeling soon disappeared.

"Director Feng, it has nothing to do with the surgery. The food they cook over there is really unpalatable. What a bullshit French dinner, what aristocratic ceremony, it's all self-made."

Luo Hao said lightly.

"Actually, I'm also wondering why so many chefs go abroad and fail to cook Chinese food well." Feng Zixuan followed Luo Hao's direction and changed the subject.

Feng Zixuan thought that the moment just now must have been his illusion.

But even if it was an illusion, even if there was no reason, Feng Zixuan didn't want to get close to that area again.

"Hey, I actually know about this!" Luo Hao laughed, "Chen Yong told me that he almost starved to death after going to England, and then he called home to ask how to make braised pork."

"Oh?"

As Luo Hao was speaking, he saw Chen Yong walking out of the operating room and waved.

"Chen Yong! Come and tell Director Feng about this."

"What are you talking about?" Chen Yong was a little puzzled.

"Tell me about the braised pork you made in London." Luo Hao had already forgotten what Feng Zixuan mentioned.

When mentioning the word London, Chen Yong paused slightly, and then his eyes turned a little red.

"Director Feng, let me tell you, I almost starved to death in London."

Chen Yong began to complain. He usually didn't like talking to men, but as long as his experiences abroad were mentioned, Chen Yong would immediately become excited and complain non-stop.

"I was so hungry and wanted to eat braised pork. I drooled every day. When I saw that this was not going to work, I called home and wrote down the recipes for braised pork and several home-cooked dishes."

"But when I tried it, it wasn't the case at all. I was thinking the wrong way."

"Crooked? What happened?" Feng Zixuan had calmed down at this time, and asked with a smile to show his support.

"I blanched the meat first, then added boiling water and stewed it for half an hour. Let me tell you, Director Feng, at this time I felt like I was eating meat and couldn't even speak. Have you ever seen a dog drooling when it's greedy? It's stringy."

Feng Zixuan didn't understand why Chen Yong compared him to a dog.

"But after stewing it for half an hour, I still felt it was not good enough, so I asked Liuzi next door to borrow a pressure cooker, put garlic, peppercorns and cooking wine in it and stewed it for another hour."

"After it was stewed, it was inedible. Even though I was craving for meat so much that I wanted to bite my tongue, the pot of meat still went into the trash can."

"Why?" Feng Zixuan was a little surprised.

Even if Chen Yong can't cook, he can at least cook half as well as he wants by following the process.

As long as it is enough, it's fine.

"It smells like urine! I feel like I'm not eating meat, I'm drinking pig urine! Do you understand? Do you understand?"

Chen Yong thought of the past that he couldn't bear to recall, his eyes were filled with tears, he even sniffled, and he was about to cry.

"..."

Feng Zixuan's description of Chen Yong was regrettable.

Although the protagonist is Chen Yong, Feng Zixuan still feels the smell of urine in his mouth.

"I was definitely not convinced and thought I must have done something wrong, so I bought more meat and tried again."

"Shredded pork with green peppers, I felt like I was cooking urine after putting them in the pot."

"!!!"

"I later found out that pigs from abroad don't taste good because they are not castrated."

"Huh? There is such a thing? Don't eunuchs smell like urine after being castrated?" Feng Zixuan was puzzled.

"Director Feng, this is the case. Some of the unmetabolized androstenone in adult boars is deposited in fat and muscle, causing boar meat to have a urine smell."

"???"

"And the smell of urine doesn't count. Skatole, or 3-methylindole, is produced in the large intestine of boars by microbial fermentation of tryptophan.

It is absorbed through the intestines and enters the blood circulation. Skatole is metabolized in the liver of the boar, and the unmetabolized skatole in the boar is deposited in the fat and muscle of the boar, causing the boar meat to have a fecal odor.

"The smell of urine and feces combined, like entering a pigsty, whoever can get in will have a bite, right?"

"..."

Feng Zixuan thought about it blankly, and it seemed like something was wrong.

"There is no castrated boar meat in the UK? And don't we still have sows?"

"The Brazilian pork imported from there is mostly from boars, with very few from sows. Chen Yong was also unlucky, as he only bought boar meat several times."

"And it's hard to tell whether they're boars or sows just by looking at their appearance, so they look like this."

"Director Feng, don't go abroad. It's like hell." Chen Yong raised his fist exaggeratedly and complained.

"It's not that exaggerated, but it's true that the food doesn't taste good. Snails are now all domestically produced. Steaks and the like are from Argentina, but the way they cook them... By the way, Director Feng, the beef imported from Argentina has driven up the price of meat this year. Shall we go out for a Western meal tonight?"

"Are you sick?" Chen Yong was angry. "Is the hot pot not delicious? Is the barbecue not delicious? Or is it that Wuchang rice is not enough to feed you, an ungrateful wolf."

Faced with the radical Chen Yong, Luo Hao just shrugged.

"Okay, I'll come see you after get off work." Feng Zixuan happily took up the topic.

The time for pressing to stop the bleeding has come, and Feng Zixuan takes the patient away.

The patient's family members gathered around and asked about the situation. The patient's face had begun to show signs of blushing. She kept telling her family members that there would be bamboo-related dolls in the future.

Bamboo, bamboo, is it still useful in resolving medical disputes?
Feng Zixuan thought in his heart.

Although it cannot be said to be completely useful, a little bit is always good. It can resolve a small amount of hostility, make communication smoother, and everyone understands each other.

Some things are unavoidable.

With Xiao Luo around, things were much easier. Not only did he seal the bleeding point during the surgery, but he also "conveniently" resolved some of the patient's hostility.

This guy does things flawlessly, and Feng Zixuan's favorability towards Luo Hao has reached 100%.

Let's treat the medical team to dinner in the evening. After Feng Zixuan watched Director Tang deal with the problem, he called Director Geng from the Nephrology Department to go find Luo Hao together.

Although there is an outsider, I think Luo Hao will not be dissatisfied.

The patient's condition is stable, and the patient's family members are gradually becoming more relaxed and can communicate.

But Feng Zixuan was not in a hurry. He thought it would be better to wait until the patient recovered before talking.

He believed in Director Tang.

Most of the problems were solved. Feng Zixuan made himself a cup of tea and sat in the office, leisurely watching short videos for an hour.

It was not until the end of get off work that Director Geng came to find Feng Zixuan and asked Luo Hao to have dinner together.

"Director Feng, thank you." Director Geng was still in a state of panic, but he still said thank you awkwardly.

"It was Professor Luo who performed the surgery. Don't thank the wrong person."

"Professor Luo... well, we do have to thank him, but medical disputes are not limited to surgery."

Feng Zixuan was stunned thinking about the ten minutes that Luo Hao waited after the operation. The more he thought about it, the more interesting it became. The more he thought about it, the more he felt that every move Luo Hao made was full of meaning.

"Dinner tonight, you should thank Professor Luo more. You know his new topic, right?"

Director Geng shook his head in confusion.

"Boss Chai from Union Hospital came to preside over the work these days, and the scientific research operation was successfully completed. Similar cases can be transferred to your Nephrology Department, and then you don't have to worry about kidney puncture problems."

"what?!"

(End of this chapter)