Doctor of Healing

Jixiang talked a lot today, he must die without a place to bury him.

After three times of failure in the super selection, he will taunt this ignorant kid and trample him in the dust.

But in Ling Tian's vision, Ji Xiang didn't show a disappointed expression, but started the second super-selection in a calm manner.

"It's the second time." Ling Tian said coldly.

Talking less is talking less, putting some pressure on Jixiang is a must.

"I know, Teacher Ling." Ji Xiang began to super-select the intercostal arteries.

The intercostal arteries include a larger posterior intercostal artery and two smaller anterior intercostal arteries.

The former originates from the thoracic aorta, and the latter originates from the internal thoracic artery and the myophrenic artery. The two anastomose with each other. The spinal branch of the posterior intercostal artery enters the spinal canal through the intervertebral foramen to supply the spinal cord and its capsule.

The anterior intercostal artery divides into upper and lower branches after originating from the internal thoracic artery and the diaphragmatic artery.

The upper branch runs on the lower edge of the upper rib, the lower branch runs on the upper edge of the lower rib, and the two branches run laterally; there are 9 pairs of posterior intercostal arteries, which run along the costal groove in the intercostal space below the third rib.

It is possible, but not very likely, Ling Tian instantly gave Ji Xiang a conclusion—the probability is less than 5%.

The most probable phrenic artery has been super-selected and proved not to be a branch of the phrenic artery.

It is estimated that Jixiang killed a mouse by killing a blind cat.

Moreover, there are many intercostal arteries, and it is even more difficult to find the problem among them.

It's a good idea, Ling Tian despises it, let's daydream.

If it's easy to find, why doesn't my boss...

Just thinking of this, Ling Tian's eyelids jumped suddenly.

Ji Xiang's method of super-selection exceeded his expectations, and it was no surprise that he super-selected the intercostal artery of the ninth rib on the right.

Are you sure?

Ling Tian suddenly had a very bad feeling.

If Ji Xiang succeeds, it will be a large-scale face-slapping scene!

dong dong dong~

Ling Tian, ​​who was always calm and indifferent, had his heart beating faster, but he didn't stop Ji Xiang from undergoing surgery, he just prayed secretly.

Contrast.

A high-pressure syringe injects contrast material into blood vessels.

As the black contrast agent spread on the screen, Ling Tian's heart beat faster and faster.

The uncontrollable heartbeat that could not be controlled by 95mg of Betaloc made Ling Tian feel quite uncomfortable.

Fortunately, this process is very short.

Within 3 seconds, the conclusion was out—it was not the branch of the intercostal artery that passed through the diaphragm to feed the liver tumor.

Ling Tian heaved a sigh of relief.

"The second super-selection failed." Ling Tian held back the joy in his heart. He felt that the big iron plate in front was getting closer, and Ji Xiang was rushing towards him at an indescribable speed, hitting his scalp. blood flow.

Young man, arrogant and domineering, he dared to respond to the boss's obvious digging.

This time I must teach him how to behave!

Ling Tian sneered in his heart, it was the second time, and when he failed next time, he could terminate the operation due to the excessive dose of contrast medium.

This is a decision that no one can fault.

Want to defecate while standing on the prostate of morality?Young man, you are still very young.

If you don't go on the Tongtian Avenue, you have to take the narrow path instead, looking for death!

Ji Xiang returned to the operating room of the system and had already failed twice, and he could not fail again.

Using the simulator to find out the feeding vessels of the tumor, although there is no guidance from the system NPC, Ji Xiang feels that he will succeed with a little effort.

however,

The difficulty of the operation was beyond Jixiang's imagination.

After 28 super-elections, Ji Xiang still did not find out the problem.

However, Ji Xiang is extremely stubborn, and his empathetic experience has also given him endless courage and patience.

The system NPC did a good job as an assistant, without a word of nonsense, just quietly helping Jixiang find the "damn" blood vessel for support.

52 times

64 times

78 times

Jixiang failed countless times and tried countless times.

……

……

Ling Tian raised his head slightly, wanting to see Ji Xiang's embarrassment.

But the next second he was stunned.

Although Ji Xiang was wearing a mask, Ling Tian seemed to see Ji Xiang smiling and looking determined.

This is completely different from what he imagined!

What did Ji Xiang discover?

Ling Tian shuddered and concentrated on watching the imaging.

There is no problem!

He turned his head to look at his boss through the leaded glass. Qin Chu stared at the screen with an indifferent expression.Based on Ling Tian's understanding of his boss, the boss should not have noticed any problems.

that……

Chapter 187 Accompanying small blood vessels

Ji Xiang began to over-select again.

Ling Tian watched the micro guide wire go up the artery, higher and higher, farther and farther.

"Which artery do you want to overselect?" Ling Tian asked without doubt.

Although his first feeling was that Ji Xiang had gone off track, Ling Tian still had a bad feeling.

"Under the collarbone."

"!!!" Ling Tian felt that Ji Xiang had gone crazy, the subclavian artery!He actually wanted to overselect the subclavian artery!

The subclavian artery is a large arterial trunk at the root of the neck. It supplies blood extensively, from the top to the intracranial blood supply, and the bottom to the thoracic vertebral body. The subclavian artery has branches.

However, the subclavian artery is separated from the liver by a chest cavity, and it has to branch out into a blood vessel, which travels a long distance through the chest cavity, through the diaphragm to the liver, and then climbs into the liver to supply blood vessels to the tumor.

how can that be!

No, it's still possible.

One branch of the subclavian artery is the internal mammary artery, which runs in the thorax close to the diaphragm.If the liver tumor is close to the diaphragm, it will be supplied by a branch of the internal mammary artery.

Ling Tian knew about this, but the tumor was not close to the edge of the liver, it was far away from the diaphragm.

So he subconsciously ruled out the possibility of internal mammary artery.

Jixiang must have been unable to find any ideas. He felt that the three super-elections would inevitably fail, and he was going to do an operation that other people could not complete, so as to save some face.

The turn from the thoracic aorta to the subclavian artery is extremely difficult and requires great skill.

ridiculous,

Ridiculous!

Ling Tian sneered angrily, "Under the collarbone? You..."

He forcibly endured the countless ridicules in his heart. After all, he was on the operating table and the patient was under local anesthesia.

Ling Tian still has the most basic morals.

In addition, Ji Xiang is just a Gui Peisheng, a surgeon who only performs the surgery because of a coincidence. In the end, no matter what troubles arise, they are all his own.

So he endured it.

Let's see what he has to say when the super selection fails!

Ling Tian thought viciously in his heart.

The guide wire was winding, Ji Xiang gently twisted the guide wire with his right hand, walking not fast, but extremely firm.

All the technical difficulties along the way were overcome by unknown means, as if the road was smooth.

Especially at the turn from the thoracic aorta to the subclavian artery, even if Ling Tian made this extremely difficult turn, it would take at least a few attempts under the premise of concentrating on it.

However, Ji Xiang twisted his wrist, and the guide wire went into the right subclavian artery obediently and docilely, without any difficulty.

Ling Tian was a little jealous when he saw Ji Xiang's surgery.

Such a good technique, at such a young age, it would be great if he didn't have much to do.

It is extremely difficult to cultivate talents in the interventional department, and the difficulty of superselecting level 4 blood vessels is beyond the imagination of most people.

After so many years, the boss has not formed an echelon.

There are other reasons, such as word-of-mouth among doctors.

But the more important reason is that surgical operations can rely on proficiency, while interventional operations need talent to reach the highest level.

Insufficient talent, even if the variation of eating the thread is not up to the first-line level.

But Ji Xiang... It's a pity, Ling Tian hates it as much as he regrets it.

The domineering and domineering Jixiang not only delayed his own future, but also delayed the boss's vision and blueprint, and even delayed his own design for the future of interventional disciplines in the hospital.

Damn!

"Spray medicine." Ji Xiang said softly after the super-selection was completed and the catheter was inserted into the right subclavian artery.

This should be the last time Jixiang stood on the operating table in Shanghai and spoke. Ling Tian didn't question it, but touched the panel with the sterile film and operated the high-pressure syringe to spray medicine.

"Brush~"

A dark image of the contrast material appears in the subclavian artery.

This time Ling Tian was not particularly nervous, he thought it was absolutely impossible for the tumor to be supported by the subclavian artery.

The tumor factor is also very disciplined. With so many blood vessels left unused, how could it summon the subclavian artery from thousands of miles away to branch off one.

He was just beginning to imagine how it would end if he were Ji Xiang, when suddenly a black line appeared in his vision.

It goes from top to bottom, like the water of the Yellow River coming up from the sky, rushing down, passing through the pleura, chest cavity, and diaphragm, and entering the liver.

This is impossible!

Absolutely impossible! !

Ling Tian's pupils shrunk on both sides, their light reflexes disappeared, and they were not equal in size or round.

Is it really a branch of the right subclavian artery?

Although the facts appeared before his eyes, Ling Tian still couldn't believe it.The internal mammary artery, he thought.

But Ling Tian was dumbfounded immediately.

The branches of the internal mammary artery are visualized, and there is a thin shadow accompanying the artery, penetrating the diaphragm.

He tried his best to keep his eyes wide open, and his pupils contracted like needlepoints to watch carefully.

The blood vessel and the internal mammary artery almost overlapped, and there was a double image, which could not be seen clearly without careful observation.But even if you look closely, it's still... hard to tell.

Fortunately, the concept of sterility has already been engraved in the DNA, Ling Tian did not do such a shameful thing as raising his hand to wipe his eyes, but lowered his head and rubbed on Ji Xiang's shoulder.

The stiff orbicularis oculi muscle was relieved with a rub, and Ling Tian's vision returned to normal.

He stared intently.

Sure enough, what I saw just now was not an illusion. There was indeed a branch of the subclavian artery descending, supplying blood to the tumor in the liver.