godfather of surgery

Chapter 1205 The Secret
Yang Ping turned his head to observe the angiographic images on the screen for a while, analyzed the state of the guidewire in the blood vessel and its relationship with the stent, and constructed a three-dimensional image in his mind.

There are actually only three possibilities now. It would be better if the guidewire and stent could be untangled.

If the entanglement between them cannot be resolved, they can only be taken out together.

If they cannot be removed, they must be left inside. Leaving them inside constitutes medical malpractice and will have serious consequences for the patient.

Director Ji was pondering which method Yang Ping would choose.

In any case, the first two methods are very difficult. Interventional surgery is not the same as open surgery. There are only a few instruments available for interventional surgery, and the operations that those instruments can perform are also limited. If the entanglement between the guidewire and the stent is really complicated, it may not be possible to untangle them even by hand, let alone with interventional instruments that are beyond our reach.

Why do I say this? To remove the broken guidewire, we can only use the guidewire and loops inside the blood vessel. It's like having a knotted rope that you can't untie by hand. If I give you a thin, elastic wire, you can only use that wire to untie the knot. If I give you two wires, they have to be tightly joined together along their entire length, so the possibility of untying the knot is extremely slim.

"I first removed the blood clot to improve the field of vision, then untangled them, and then removed the three guide wires. The stent is in a good position, so I left it inside to continue to function."

Yang Ping had his own plan: he would first remove the blood clot in the area, then slowly unlock the broken guidewire, and finally remove the guidewire.

"Untangle the entanglement?" Director Ji thought he had misheard. How could that be?

Whether you use a loop or use the inserted guidewire to entangle it, you pull the tail of the guidewire and then pull it back with a little force. Use the force of the pull back to pull the guidewire out. There is one condition for doing this: the entanglement between the guidewire and the stent must be very simple, and they should separate from each other with a pull.

However, Director Ji had already tried and couldn't pull it at all, which meant that the entanglement must be very troublesome, and pulling too hard might cause problems.

While Director Ji was still considering the feasibility, Yang Ping began the thrombectomy procedure. Whether it was the thrombectomy stent or the aspiration catheter, they seemed to have a soul in his hands. His movements were light, fast, and precise, like a dragon swimming in water, which was extremely comfortable.

This wasn't the first time Director Ji had seen Yang Ping perform interventional surgery. Every time he watched Yang Ping perform surgery, what he found most unforgettable was that the ends of the instruments seemed to have their own consciousness and could operate on their own. Sometimes he wondered if he was watching magic rather than surgery.

After each surgery, Director Ji would privately try out discarded catheters and guidewires. He tried to learn how to operate the guidewire from Yang Ping, but he could never quite get it right.

Yang Ping quickly removed all the blood clots. Throughout the entire process, not a single tool touched the blood vessel wall, and there were no missed attempts. This level of skill was beyond what could be described as proficient; Director Ji couldn't find a suitable adjective to describe it.

Director Guan, standing nearby, was also dumbfounded. It was a gift from heaven; there was nothing that could be done about it. He knew Yang Ping well. At the Municipal People's Hospital, Yang Ping specialized in orthopedics. He continued in orthopedics at Sanbo Hospital until the establishment of the General Surgery Department, which was later transformed into a research institute. The entire process had nothing to do with interventional surgery, yet this guy performed interventional surgeries so exceptionally well; only talent could explain it.

After the thrombus was removed, the angiography images on the fluoroscopy screen showed that the other end of a guidewire was in contact with the stent. Undoubtedly, this guidewire was entangled with the stent, and the other two guidewires were also entangled with it. In addition, this location is where the blood vessel bends, so it makes sense that the three guidewires could not be removed.

If the surgeon had reported the breakage of the first guidewire to his superiors in time, the current predicament might not have been possible. Such complications usually arise from repeated failed attempts, becoming increasingly complicated and eventually leading to a dead end.

Although the guidewire and stent could be seen to be in contact, the details of their contact area could not be clearly seen. The angiography image is not like a photograph; it only shows black and white outlines. Yang Ping thought about the details of the stent and then deduced how the guidewire and stent were entangled together.

Then, he could use the guide wire in his hand to touch the tangled area with its tip, using this subtle touch to understand the details. This requires extremely strong sensory abilities, which neither Director Ji nor Director Guan could do.

After several touches, Yang Ping roughly understood the details and had a clear idea of ​​what was going on.

After standing in the operating room for a while, Director Zhao knew that the chances of the surgery being successful were very high. He then went out and stood at the door of the operating room to communicate with the patient's family and tell them about the progress of the surgery.

"Our two directors have just tried their best, but it's very difficult to remove. It's extremely challenging because the guide wire is easily broken at the bend of the blood vessel, and once broken, it's very difficult to remove. However, you don't need to worry too much. We have invited Professor Yang from our hospital to come to the operating table. Professor Yang was originally going to Beijing for an academic conference and was about to board the plane, but when he heard that we needed his help to solve the problem, he rushed back without hesitation and is now working hard on the operating table."

"We will work together to solve the problem. Don't worry, we will do our best."

The family members were very grateful to Director Zhao for coming out every few minutes to inform them of the progress. Gradually, they also felt that Director Zhao was very responsible.

"Can it be removed?" The family member asked anxiously.

Director Zhao said, "We are very confident, but we dare not say 100%. Medicine is a very complex thing with too many variables. No one dares to make a sure thing. We can only say that we will do our best."

Hearing Director Zhao say this, the family felt a little relieved.

"I'll keep you informed of any progress in the surgery. I'm going in now." Director Zhao put on his mask and returned to the operating room.

The surgery is continuing here.

The ring toss that Director Ji made himself became an extremely flexible tool in Yang Ping's hands. It could shrink, expand, lengthen, and shorten at any time, changing very quickly. The tool and the man had become one, and the end of the tool was like his hand, able to hit wherever he pointed and operate however he wanted.

That tiny ring is like a hand; it can grab the tail of any target it wants to manipulate, or simply use the smaller ring to nudge the target.

Logically, with such a long and flexible guide wire, this operation should be impossible, yet Yang Ping has managed to do it. Director Ji and Director Guan watched in disbelief; Yang Ping had turned this simple toss game into a dazzling display.

He used this small loop to untangle the guidewire tail from the stent, and then miraculously untangled the guidewires one by one. The first guidewire was removed, and then the second, the third...

While Director Ji was still pondering what Yang Ping should do, the three guidewires were already placed in the curved tray on the sterile table. The images of the guidewires could no longer be seen on the fluoroscopy screen; only the images of the normal blood vessels and stents were visible, and the previous thrombus had also disappeared.

"It's best to send him to the ICU for a few days of monitoring, and be aware of the possibility of cerebral hemorrhage caused by ruptured blood vessels," Yang Ping instructed Director Ji. He explained that his procedure had not damaged the blood vessel wall, but the procedure performed by the doctors at the Municipal People's Hospital would definitely have damaged the blood vessel wall, so it was necessary to guard against cerebral hemorrhage.

"Hmm!" Director Ji remembered Yang Ping's words. His gaze lingered on the catheter and guidewire that Yang Ping had pulled out. It was the same set of instruments, nothing special.

Have you finished collecting them?
Director Guan came over to take a look and confirmed that the procedure was complete, even removing all the blood clots. The stent could still be left inside for continued use.

After finishing the finishing touches, Director Ji picked up the guidewire with the loop that Yang Ping had just withdrawn. He tried pulling it out and pushing it in, and the loop contracted and expanded. This thing was so powerful! Professor Yang had just used this thing to untangle the guidewire from the stent. He made this thing himself. How come he didn't know it could be used so flexibly? How come he couldn't do it like this?

The young doctor busied himself contacting the ICU to accept the patient. Director Ji and Director Zhao went out together to explain to the patient's family that the broken guidewire had been completely removed, including the blood clot inside. Director Ji showed them the three guidewires on a curved tray, and Director Zhao took a picture of the angiography image with his phone and showed it to the family.

As long as the tube can be removed, the family will feel at ease. Most families are reasonable. The actions of the doctors at the Municipal People's Hospital were truly outrageous. When problems arose during the surgery, they neither informed the family nor sought help from their superiors. They just silently messed around with the tube, and after two or three hours, they still hadn't managed to remove it. Didn't they have any sense of responsibility? If the anesthesiologist and circulating nurse hadn't discussed and privately notified the department head, the patient might have died on the operating table. What would have happened if there had been a life-threatening situation?

Director Zhao was also angry, and the family members also complained to him. Director Zhao comforted and reassured the family, telling them, "The doctor's actions were indeed wrong. He may have been overconfident at the time, thinking that he could remove it, but he did not expect things to go beyond his judgment."

"The department head there also contacted us actively and transferred the patient over in a timely manner. We took it very seriously and found the problem to be quite difficult, so we immediately asked Professor Yang for help. You may not know Professor Yang, but he is a world-class doctor. Now he is leading his team to remove the guidewire, and not only remove the guidewire, but also remove the blood clot inside completely."

"So, the Municipal People's Hospital will punish those who should be punished. Right now, the good outcome is more important than anything else."

Hearing what Director Zhao said, the family felt much more at ease, mainly because the guidewire had been removed and they heard that even the blood clot had been completely removed. So they were quite satisfied. He didn't want to make things too complicated, after all, they came to see a doctor, not to cause trouble. Most patients and their families come to the hospital with the intention of seeking medical treatment, not to cause trouble.

Director Zhao has served as the director of the medical affairs department for many years. He is experienced and knows how to resolve conflicts, which is his job.

"Dean Chen personally communicated with us for a long time before finally getting Professor Yang to come and perform the surgery. Professor Yang is usually very busy and can't perform these kinds of surgeries. Dean Chen put in a lot of effort. Look now, Professor Yang not only removed the guide wire, but he also removed the blood clot. It's very difficult to remove this kind of blood clot completely in any hospital, but Professor Yang removed it completely. This is an unexpected bonus, but it doesn't excuse their mistake. Dean Chen has made it clear that this doctor must be severely punished." Director Zhao spoke with great persuasiveness.

The patient's family didn't really have any particular demands. The patient is fine now, and we heard that the blood clot has been removed because the stent was placed after the initial attempt to remove the clot failed. The family is very satisfied now.

"He needs to be transferred to the ICU for a few days. I will be keeping a close eye on him these days, so please don't worry." Director Zhao spoke gently, politely, and with great affability.

Since nothing serious had happened and the blood clot had been removed, the family felt there was no need to make things too tense, so they didn't plan to pursue the matter further.

Yang Ping returned to the research institute to rest for a while. It was almost lunchtime when Xiao Su brought him lunch. After eating, Yang Ping chatted with Xiao Su for a while, and then rested in his office chair. He was used to resting in his chair. It was a good time to enter the system space to perform surgery and do research. His efficiency was very high at this time.

The calmer Yang Ping's mind was, the more empty his mind was, and the more stable the system space was, the higher his work efficiency was. The system space also had a very big hidden function, which was that after staying in the system space for a period of time, returning to the real space was just like taking a good nap, making people feel refreshed.

At 2 o'clock, Li Guodong came to report that Sisi's re-examination results were out again. Yang Ping looked at the results of various tests. Although most of the tumor cells had been eliminated, some remained. These remaining tumor cells were now making a comeback. Yang Ping was thinking about how to eliminate all of these tumor cells.

There are two issues here: the accuracy of K virus identification and its effectiveness in killing tumors.

While the stability of the K virus has been addressed, its precision has not been fully resolved, and the success rate of initiating tumor cell apoptosis has not been maximized. If these two parameters can be further improved, it will be entirely possible to eliminate all tumor cells in one or more treatment courses.

How to solve this problem?
Yang Ping decided that the focus of his next research would be on these two issues: improving these two parameters, making it possible to cure some tumors that are sensitive to K-virus therapy.

"How should the follow-up treatment be arranged?" Li Guodong asked.

"Continue with the original plan."

Yang Ping decided to improve the treatment while continuing the therapy. The K-virus therapy is currently very safe with few side effects, and the main direction is correct. The remaining work is actually much simpler; it's just a matter of refining the details. That's how a mature product is crafted.

After visiting the patients in the ICU, Director Ji and Director Guan returned to the operating room. They tried for a long time using discarded catheters and guidewires, but felt it was impossible to achieve the same effect as Yang Ping.

"How come this thing is so obedient in Professor Yang's hands?"

"How about we ask them sometime and see if they have any secrets?"

The two discussed it, because that amazing skill they had just witnessed was truly spectacular.