Doctor’s Life Simulator

When Deputy Director Qian was shocked by Qin Lang's creative thinking, Qin Lang directly used a pen to make the last connection, then picked up the whole picture and attracted it to the whiteboard with a small magnet.

He moved the whole small whiteboard over, and said calmly, "This is my improved plan for this operation, which I call "one and a half" ventricular correction."

Deputy Director Qian and Chief Zhong both looked at this diagram of the surgical plan hand-painted by Qin Lang in shock, and began to think.

The resident doctor, licking his lips, didn't see anything, but it didn't prevent him from being excited for no reason. He first blew a wave: "Awesome, Doctor Qin! But, what does this technique mean?"

Deputy Director Qian and Chief Zhong also seemed to understand, after all, Qin Lang's operation was a hybrid of Rastelli + Half-Mustard + Two-way Glenn operation, three conventional methods.

For the doubts of several doctors, it is normal. After all, this is a brand-new technique that he has spent most of his life in the simulation world, studying and improving.

He explained in a clear tone: "This "one and a half" ventricular correction surgery has three significant advantages compared to the traditional single ventricle correction surgery. First, the half-Mustard surgery can reduce intra-atrial sutures and help Reduce the late complications of the atrial barrier in Mustard surgery, such as sinus node dysfunction, pulmonary vein obstruction, etc."

Hearing Qin Langyi's explanation, Deputy Director Qian kept nodding his head:

"Yes, pulmonary venous obstruction is a common high-incidence complication of traditional corrections, and it is also a pain point that has been insurmountable."

Qin Lang continued: "Second, for patients with pulmonary artery-right external tube connection, semi-Mustard/bidirectional Glenn surgery reduces the blood flow through the right ventricle-pulmonary artery external tube, which can prolong the service life of the external tube."

Hearing Qin Lang's detailed explanation, Deputy Director Qian and Zhong Zhuzhi glanced at each other. Both of them were shocked. This Qin Lang was really open-minded and had unbridled ideas. By combining two unrelated operations The combination produced unexpected results.

It directly and fundamentally solves the biggest defect of conventional techniques.

At this time, Qin Lang added the last point:

"Semi-Mustard surgery is simpler than traditional Mustards, especially for diseases with complex cardiac anatomy, which greatly improves the success rate of surgery and reduces postoperative complications."

Deputy Director Qian got up and walked to the small whiteboard. He carefully looked at Qin Lang's diagram. After Qin Lang's explanation, he looked at it again. Director, of course, his understanding is very high, and he quickly understood the mystery. The more he understood, the more he admired the ingenuity of this technique.

Deputy Director Qian clapped his palms: "It's done!"

"Qin Lang, how did you come up with this technique, learned from Dean Wen?"

Deputy Director Qian asked very excitedly.

"Oh, I happened to be researching correctional surgery recently, so I came up with such a "one-and-a-half-ventricular" correctional surgery."

Anyway, now, the entire First Affiliated Hospital of Zijingang University knows that he is that kind of talented doctor, and Qin Lang is no longer humble.

"I created it myself."

Deputy Director Qian and Zhong Zhuzhi were at the side, looking at Qin Lang and didn't know what to say.

Sure enough, people are different.

"Qin Lang, how's your head growing? It's too powerful, okay, just follow this plan to do the surgery."

Deputy Director Qian put both hands on Qin Lang's shoulders and was excited. This was the first surgery in the country, and it was another huge leap in the treatment of corrective transposition of the great arteries. Deputy Director Qian had already thought about the operation video after the release , caused a sensation, long face!

"Director Huang is really unlucky. It seems that this is the first "one and a half ventricle" correction surgery launched in the country. It's Qin Lang and I's turn to operate."

"Dr. Zhong, you go to arrange the patient's signature before the operation. Dr. Qin and I will perform this brand-new operation. Remember to record the whole process and upload it directly to the medical forum after completion."

Three hours later, several people walked out of the operating room with ease.

The whole operation was very successful, and the video data of the operation was also uploaded to the medical forum by Mr. Zhong for the first time.

After this operation, Qin Lang completely convinced Deputy Director Qian and Chief Zhong, and he was indeed a young talent appointed by the Dean!

[Ding, congratulations to the host for completing the task and proposing a genius-like improvement plan! Obtained task rewards: 1.1 life simulation points, 2, bupropion smoking cessation drug: drug research and development laboratory simulation permission. 】

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On the second day, while Qin Lang was still in front of the salted fish, Director Huang brought Professor Yang Guoshu and his party to the First Affiliated Hospital of Zijingang University.

Director Huang took Professor Yang and his doctoral student Wang Xiaoying to his office.

After an introduction to the other party, he directly talked about the content of the academic exchange and the discussion on ventricular correction.

Professor Yang is very accomplished in this, which basically represents the ceiling level of China.

"Professor Yang, this time happens to have a very special case in our department. The patient was transferred from the First Hospital of Ningbo City. It was a double outlet right ventricle (DORV) combined with complete atrioventricular septal defect, a very rare congenital heart disease. It just so happens that our department is still studying the surgical plan, and I would like to ask Professor Yang to give us some guidance."

Wang Xiaoying on the side, her eyes glowing, this is the first time she has encountered this kind of disease.

Seeing the curiosity on his doctoral student's face, Yang Guoshu was also interested and explained to Wang Xiaoying:

"DORV-AVSD is a complex, rare cardiac malformation that includes an anteriorly extending unrestricted VSD, primary ASD, common atrioventricular valve, aortic straddle or right aorta due to anterior-superior displacement of the infundibulum septum. Ventricular outflow tract stenosis, etc."

"Internationally, in 1975, the idea that the combined deformity could be corrected by expanding the ventricular septal commissure was first proposed. The first corrective operation was successfully performed in 1980, but the operative mortality rate was high, especially when combined with pulmonary artery stenosis or pulmonary vein heterotopic connection. of patients with higher operative mortality. In the 1990s, it was reported in the literature that the operative mortality was about 50%.”

Hearing the data from Professor Yang, Wang Xiaoying was obviously a little surprised, it was really a terrible disease.

"Director Huang, let's not waste any time, let's check the patient's condition first?"

Professor Yang is a very dedicated and dedicated old expert in medicine, and he doesn't care about being overwhelmed.

"Okay, then it's hard work for Professor Yang. I'll ask Director Qian and Dr. Zhong to participate in this joint consultation, and let them study hard with you."

Director Huang's remarks are of course sincere. After all, Professor Yang's level is recognized in China, especially in ventricular correction surgery.

Soon, after receiving a call from Director Huang, Deputy Director Qian and Chief Zhong rushed over quickly.

Seeing that, the well-known Professor Yang, Deputy Director Qian and Chief Zhong are naturally humble and respectful, and their postures are particularly low.

"Professor Yang, I have long admired the name. This time, I want to learn from you the experience and skills of ventricular correction."

Deputy Director Qian said excitedly that Zhong Zhuzhi, who was beside him, was also boasting about business.

"Director Qian, Physician Zhong is very polite, we just communicate and share with each other. Then let's take a look at the patient's condition first?"

"Okay, okay."

Deputy Director Qian had already prepared the patient's situation in advance.

"Professor Yang, this is the patient's echocardiogram and cardiovascular angiography data."

After Professor Yang took it, he looked at it carefully, and saw that the patient's two major arteries completely originated from the right ventricle, and there was pulmonary hypertension, which was a typical DORV-AVSD disease.

Professor Yang continued to look at the rest of the patient's examination information:

The patient had moderate growth retardation, mild symptoms of heart failure, and grade 3/6 systolic murmurs could be heard in the 3rd and 4th intercostals of the left sternal border, and P2 hyperactivity; chest X-ray showed: whole heart enlargement, double The pulmonary blood was significantly increased, the pulmonary artery segment was bulging, and the cardiothoracic ratio was 0.62-0.85.

After reading it, even Professor Yang felt a little heavy: "Director Huang, this patient's situation is a bit complicated, it's really tricky."

Director Huang was not too surprised by Professor Yang's reaction, but he was still slightly disappointed. Could it be that even the senior experts from the 301 PLA Hospital couldn't come up with a perfect plan?

In the office, everyone was silent for a while, only the sound of flipping pages was heard.

Deputy Director Qian looked at the prestigious Professor Yang and sighed.

Although Professor Yang lowered his head, looked at the documents, and thought about Fang An, in the quiet office, Director Huang's sigh was very obvious, hitting Professor Yang's heart heavily.

The First Affiliated Hospital of Zijingang University was the first to propose a consultation, but it was a bit embarrassing that he could not come up with a solution.

After all, Professor Yang is also an expert with cards, and he pondered for a while. Although he could not come up with a one-time solution, he also thought of a transitional method:

"Director Huang, Director Qian, although I can't think of a one-time solution, I have an idea that we can take two-stage operations to solve this problem."

"In the first-stage operation, we can use body-lung shunt, which can increase pulmonary blood perfusion, increase oxygenated blood volume, and promote the further development of the pulmonary artery and left ventricle, providing conditions for the second-stage radical surgery. "

"In two installments?"

Hearing Professor Yang's thoughts, Director Huang also pondered for a while:

"Professor Yang's suggestion is also a solution. However, the body-lung shunt, the function maintenance of the operation center, the patency of the shunt blood vessels and the size of the shunt flow are the key factors that affect the surgical effect. If the shunt is too large, it will lead to pulmonary edema and pulmonary Perfusion, it will not wait for the second-stage radical operation."

"Yeah, so the selection of the main surgeon for this phase of the body-lung shunt is very critical. It requires superb skills and a keen ability to judge artificial blood vessels. Moreover, the response and speed requirements during the operation are very high. At the same time, it is best to have superb suture technology and incision technology."

Professor Yang also sighed, although he was able to formulate a two-stage overall surgery plan, but he was not too sure about the implementation of this surgery.

If it is in the imperial capital, his team will naturally have no shortage of candidates for the main sword.

"Moreover, this patient has a patent ductus arteriosus, and during the operation, it is necessary to avoid the opening of the ductus arteriosus as much as possible to prevent hypoxia."

Director Huang has the deepest understanding of this patient's situation, so he added a little detail that Professor Yang ignored, but it is also a key point.

Hearing this, Professor Yang directly took the patient's physical examination data of this small detail from Director Huang, and took a closer look:

"Really, in the first stage of this operation, the difficulty and risk have increased exponentially. The surgeon must be required to complete these complicated operations within an hour and a half. Based on my current experience, the operation of the entire operation must be completed. The control is stronger than when I was young, I don’t know how much, but after all, I am older now, and I can’t keep up with my physical strength. If I come to the main knife, I may not be able to do it so fast, it’s difficult to do.”

Professor Yang evaluated again. As a cautious expert, the success rate is less than 30%, and of course he will not take risks. He said with great regret:

"Director Huang, I have carefully evaluated the patient's physical condition and tolerance. The success rate of this surgical plan is too low. I do not approve of trying it."

Hearing what Professor Yang said, the glimmer of hope that Director Huang, Deputy Director Qian and others had just raised was dashed again.

Professor Yang shrugged, and he proposed the surgical plan, but the doctors at the First Affiliated Hospital of Zijingang University couldn't do it, so they could only call for help.

Of course, it's not that the doctors at the First Affiliated Hospital of Zijingang University are not good enough, but the patient's physique is too poor and the operation is too complicated:

"If I were ten years younger, I would be 90% sure."

Deputy Director Qian and Chief Zhong murmured: "Superior technology, keen judgment on artificial blood vessels, operation speed, and suture technology, incision technology..."

Suddenly, his eyes lit up, and Zhong Zhuzhi, who was beside him, was obviously in a good mood. The two of them said in unison:

"Doctor Qin!"

Physician Zhong whispered beside Deputy Director Qian: "Let me ask, to hear what Physician Qin thinks?"

Deputy Director Qian nodded. After all, it was not clear whether Qin Lang could perform the difficult technique proposed by Professor Yang, so they decided to seek Qin Lang's opinion first. After all, their cubs had to be well protected.

After a while, if Qin Lang couldn't figure it out in front of Professor Yang and Wang Xiaoying, then it would be a shame.

Zhong Zhuzhi got up directly and went to Qin Lang.

However, Professor Yang did not notice the small movements of Deputy Director Qian and Chief Zhong, and said to Director Huang:

"Director Huang, I think we should go to the patient's family and communicate. The best way now is conservative treatment. The risk of surgery is too great."

Director Huang also thought about it carefully. Professor Yang's plan is theoretically possible, but because the patient's tolerance is too poor, he does not have much confidence.

After all, for a senior director like them, there is a set of judging criteria, and the success rate of the operation is too low, it is not worth the risk.

Especially in the current medical environment and doctor-patient relationship, conservative treatment is the best way, although it seems a bit ruthless, but this is the most mature and professional way to deal with it.

Soon, Director Huang and Professor Yang came to the patient's ward together.

The patient's son and daughter greeted him anxiously and looking forward to it.

"Director Huang, is there any surgical plan for my father's illness?"

Seeing the eager eyes of the patient's family, Director Huang was also a little uncomfortable, and said in a regretful tone:

"This is Professor Yang from the 301 People's Liberation Army Hospital. Just now, we conducted a comprehensive and systematic consultation on your father's situation. Is there no surgical plan, but your father also has a patent ductus arteriosus, the situation is too complicated. The success rate of surgery is too low, so my opinion with Professor Yang is to give up surgery and carry out conservative treatment."

Hearing what Director Huang said, the light in the patient's daughter's eyes suddenly disappeared, and she murmured, "Can't surgery? How can this happen, how can this happen."

The patient's son was relatively calm, and understood the meaning of Director Huang's words:

"Director Huang, as long as there is a possibility of success, we are willing to accept surgical treatment, conservative treatment, it is not a day's delay. We do not accept it."

The patient's daughter also reacted and grabbed Director Huang's hand:

"Director Huang, I beg you, give my father an operation. We are willing to bear the accident of the operation. We do not treat it conservatively."

Seeing the patient's excited plea, Director Huang hesitated for a while, but he still looked at Professor Yang, who proposed the operation.

After all, Professor Yang has seen strong winds and waves. His heart is like a rock, his will is firm, and he has his own judgment:

"Director Huang, I still have this opinion. The success rate of the operation is too low. Taking such a big risk to perform the operation will only make the patient suffer more and the family will waste more money."

"Conservative treatment is the best way."

Professor Yang made the final decision.

Hearing what Professor Yang said, the sons and daughters of the family members were disappointed, bowed their heads, and remained speechless.

Director Huang's heart twitched slightly, and he could only sigh. Although Professor Yang looked ruthless, his judgment was rational.

Deputy Director Qian stood aside, staring at the door anxiously, saying, "Why haven't you come yet!"

"Then it's settled."

Just as Professor Liu was about to draw a conclusion, he saw two figures approaching from outside the door.

As soon as Zhuzhi Zhong came in, he excitedly gave Deputy Director Qian an OK gesture.

Deputy Director Qian's eyes lit up, and he stepped out directly, his voice trembling slightly between the patient and Professor Yang, and said:

"Professor Yang, in fact, it is not impossible to perform surgery. Physician Qin in our department has a very high technical level, and is notorious for his high frequency of operations and long-lasting movements. He is especially good at incision and suture. A good candidate for surgery.”

Hearing what Deputy Director Qian said, Professor Yang and Wang Xiaoying also looked at Qin Lang, but Qin Lang was really young and outrageous, and confirmed with suspicion:

"Director Huang, what do you mean, this little doctor can complete this difficult first-stage operation?"

"Doctor Qin, come here."

Director Huang immediately called Qin Lang over: "Qin Lang, can you complete the body-lung shunt in more than an hour~www.readwn.com~ Qin Lang did not directly agree, of course, he did not agree to Professor Yang's plan. It can be done, just not the best option.

I looked at the patient's condition before. Under the master-level ventricular correction surgery series, there is a new idea, but it is still necessary to diagnose the patient.

"Director Huang, I am very skilled in body-lung shunt surgery, but I still need to look at the patient's condition first."

Hearing what Qin Lang said, Director Huang quickly made room for Qin Lang, and even squeezed Professor Yang to the side, Director Huang turned his head and smiled apologetically.

Professor Yang frowned. The name Qin Lang, he had heard from some old friends before, was a young man with great potential and talent, and he was Wu Jizong's nephew.

In addition to Professor Yang's scrutiny attitude, the two family members were the most excited at the scene. When they heard that there was a possibility of surgery, the patient's daughter went directly to Qin Lang: "Doctor Qin, take a good look, I must operate on my father. , the surgical risk we are willing to take."

Qin Lang did not speak.

"Don't disturb Doctor Qin's diagnosis."

The patient's son pulled his sister, who was a little gaffe.

PS: Thanks to the 100 coins for the little fairy who loves to learn~