Zheng Ren did not say anything. He just changed his clothes in silence.
"Let's go and see the situation." Department Chief Kong also took the time to change his clothes, put on a sterile cap, and quickly walked in.
First, Department Chief Kong came to the operating table and began to review the images of the surgery process.
During the removal of the stent, the angle was slightly off and it touched the liver parenchyma, causing a small artery to rupture and bleed.
This was also the reason why the previous TIPS surgery only used one stent and never recovered it.
The second recyclable stent was placed, and the patient could only be removed after adapting to the blood ammonia level. Expanding the outflow tract was indeed a perfect idea. However, there were many difficulties in taking out the second recyclable stent.
Zheng Ren only dared to do this because his interventional surgery skill tree had already reached the Legend level. However, before he could teach Zhu Liangchen many details, he tried to do it himself.
This matter …
Actually, it could not be said that Zhu Liangchen was completely wrong.
However, this kind of mistake was completely unnecessary.
He stood behind Chief Kong and watched the image of Zhu Liangchen performing the surgery. However, he went to the System Space and clicked on the surgery training.
The System's operating theater rose from the ground and Zheng Ren entered without hesitation.
His heart was bleeding.
Although there was still plenty of time left for surgical training, it was an unnecessary "consumption". Zhu Liangchen!
Zheng Ren thought bitterly.
His heart was already bleeding. He did not waste his surgical training time and immediately began the surgery.
In fact, with his level of interventional surgery, he could have gone on stage directly. But after all, this was an unexpected situation. Taking over Zhu Liangchen's surgery and doing it himself were two different concepts.
Zheng Ren still chose to buy surgery training time safely. If there were any problems, it was better to let the simulation mannequin endure it in the System's operating theater.
Zheng Ren had studied this complication a long time ago. Embolization was undoubtedly the best choice.
He first let the stent deflate a little. After the angiography, he immediately saw blood flow.
Zhu Liangchen had already finished the puncture work. Zheng Ren began to superselect the arteries.
The liver of patients with advanced cirrhosis had atrophy, and the arteries had anatomical abnormalities due to various reasons. In addition, the spleen was large, and the blood coagulation mechanism was not good. Therefore, one or two hours of hemostasis with a covered stent did not have much effect.
The results of the angiography showed that the bleeding artery was an artery at the junction of grade four and grade five. It was very thin, and the difficulty of the super selection was not just a little high.
However, for Zheng Ren, this kind of superselection was not more difficult than prostate interventional embolization.
Zheng Ren crossed his left and right hands. He was very skilled and meticulous in his choice.
Because the liver function of patients with advanced cirrhosis was very poor, coupled with liver atrophy, embolization was avoided to avoid liver failure.
The guide wire entered, layer by layer, and finally arrived at the bleeding artery.
He was practically embolizing the bleeding point. Zheng Ren was sure that even if his interventional surgery skills were at its peak, this was the best he could do.
There was nothing special about the surgery. It was just a test of the technique of superselection.
Embolization, re-imaging.
He was confident, but the System only gave him an 85% success rate.
Strange, why was it like this?
After a few minutes of observation, he noticed that other than one small artery, the passage through which the stent was inserted was continuously oozing blood.
This was the result of repeated friction, resulting in a large area of liver parenchyma contusion.
Zheng Ren was also helpless.
Zhu Liangchen's technique was wrong, causing even more side injuries during the surgery.
What should he do? For a moment, Zheng Ren felt a little helpless. Embolization of small arteries could solve a big problem. It was fine for the patient to leave the stage just like that. The problem of blood oozing might get better quickly, but it could also continue to ooze blood, causing the condition to worsen, and finally leading to hemorrhagic shock.
He could not wait for the patient to recover on his own. He had to solve this problem! Zheng Ren immediately made his own choice.
It was better not to try things that depended on luck. Although Zheng Ren had the bonus of luck, deep in his heart, he was very disgusted by this.
After superselection, he found a few blood supply arteries at the location of the bleeding contusion, superselection, and embolization.
Zheng Ren was faced with a difficult problem. The more detailed the superselection, the smaller the range of bleeding control. If that was the case, he would have to do more superselection and embolization.
It was very difficult to obtain the greatest benefit and the least damage.
Fortunately, he had a lot of surgical training time. Zheng Ren simply tested it bit by bit and did it bit by bit.
Fortunately, this was the operating theater of the System. He could make mistakes.
As time passed, Zheng Ren gradually found a balance point. Embolizing the third or fourth grade small arteries could avoid causing more damage to the patient, but it could also successfully stop the bleeding.
However, the waste of surgical training time made Zheng Ren feel a little distressed.
Fifteen hours later, Zheng Ren finally saw that the completion rate of the surgery had reached 97%.
That was it. Any more would probably be difficult to achieve.
After all, the patient's platelets were less than half of a normal person's. Under such circumstances, achieving a 97% completion rate of the surgery was almost the limit.
He glanced at the simulation mannequin and felt a little regretful.
He turned around and left the operating theater of the System and returned to reality.
After Department Chief Kong finished flipping through the surgical process, he said in a deep voice, "Old Fifth, Boss Zheng and I will go up. You rest."
Zheng Ren quickly went to scrub his hands.
Unlike Professor Rudolf Wagner, he couldn't wait for the professor to finish his preparations before he went on stage with Department Chief Kong.
He still had to show respect to the old chief.
Seeing Zheng Ren run to scrub his hands and make preparations, Department Chief Kong looked deeply at Zhu Liangchen and shook his head slightly.
Zhu Liangchen felt his mouth go dry. He was a little embarrassed, but he was also a little dissatisfied with Zheng Ren's arrival.
All kinds of complicated emotions intertwined. He lowered his head and did not look at Department Chief Kong.
Department Chief Kong did not say anything. He scrubbed his hands and went on stage.
"Boss Zheng, you do it." After Department Chief Kong went up, he directly stood under Zheng Ren and squeezed him to the surgeon's position.
Zheng Ren did not continue to stand on ceremony. He directly stuffed the micro-guide wire in and began to perform superselective arteriography and arterial embolization.
In the operating room, Zhu Liangchen looked at the old and young man on the operating table through the lead-lined glass.
Did he do something wrong? He did not think so.
It must be a problem with the surgical design. There should not have been two membraned stents!
The second-stage surgery was very difficult. It completely violated the standards of performing TIPS surgery for so many years.
Zhu Liangchen tried for a long time and did not operate too violently. They were all old doctors and people who had performed hundreds of TIPS surgeries. They knew in their hearts that violence would definitely not solve the problem.
Perhaps they could violently remove the membraned stent, but it would definitely be accompanied by massive bleeding. In the end, Zhu Liangchen had no choice but to call Department Chief Kong and ask for help.
He should be able to successfully stop the bleeding. Zhu Liangchen began to look forward to it.
As for the future, it was better not to touch TIPS surgery. Even if it was improved, the risk was too great.
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