Near 11:30, all patients with cirrhosis had completed the TIPS surgery.

Li Jianguo sent the patient down, and on this day, his job was to send the patient down, then check the information of the next patient, and then send the patient up.

By the time I arrived, the TIPS surgery was almost done.

He could feel a different atmosphere, which was different from the last time Zheng Ren came to the Affiliated Hospital of the Provincial Medical University for surgery.

This time, Mr. Gao is doing the TIPS surgery himself!

It turns out that as long as a way is found, TIPS surgery can be so simple.

In the operating room, Zheng Ren and Gao Shaojie chatted about the key points that need to be paid attention to in the second phase of surgery.

Because Director Kong came suddenly, Zheng Ren was a little caught off guard, so he wanted Gao Shaojie to grasp everything about the TIPS operation as soon as possible.

A lot of details have been said in the office, and at this time, Zheng Ren saw Gao Shaojie's slightly confused eyes, and sighed in his heart.

"Lao Gao, let's talk about it on stage. Zheng Ren knew that he was in a hurry, and the professor might be able to do it, but Gao Shaojie ...... It shouldn't be possible.

Gao Shaojie also realized that the first stage of surgery and the second stage of surgery are two completely different concepts. Zheng Ren's tone and expression diluted the joy of successfully completing the first phase of surgery.

"Boss, I think you hit him with hemostats, the thief who learned to pull fast, I have experienced it personally, and I seriously recommend it. Professor Rudolf Wagner heard the conversation between the two and said it seriously.

However, this is the Affiliated Hospital of the Medical University, and Gao Shaojie told himself that it was best not to beat him. Zheng Ren was too engrossed just now, and he knocked on it with his hand, and he was still a little embarrassed.

Then forget it, Zheng Ren thought, it is faster to take your time.

Gao Shaojie frowned and pondered, but did not speak.

"Dr. Zheng, let's have a bite to eat at noon and then have surgery. Dean Qi was in a good mood, although he couldn't dig Zheng Ren to come to the Affiliated Hospital of the Medical University, but wasn't that normal? He heard something abnormal from Lao Wu's tone.

The young man in front of him should go to the imperial capital and the magic capital, and even go to a large medical center in Europe and the United States.

And stay in the provincial capital?

That's absolutely impossible.

"Dean Qi, I won't eat at noon. Zheng Ren's expression was serious, and he said: "The surgery will be more difficult in the future, and I'm afraid I won't be able to finish it today." ”

Is the surgery more difficult later?

Dean Qi didn't mind Zheng Ren's refusal, but he was surprised that the TIPS surgery was completed, why was the subsequent surgery more difficult?

From a surgical point of view, the purpose of the second-stage surgery is generally clearer and simpler than the first-stage surgery.

Dean Qi glanced at Gao Shaojie and saw that he had been pondering something, so he didn't continue to be polite and invited Zheng Ren to dinner.

If you can't keep this Dr. Zheng, then you must keep Gao Shaojie.

Dean Qi had already guessed the value of the new approach to TIPS surgery from his classmates on the other side of the ocean, and the little abacus in his heart crackled.

Soon, Li Jianguo sent the patient for the second-stage TIPS surgery.

Surgery begins.

"Xiaoyanagi, just now Dr. Zheng said that the second-stage operation is more difficult than the first-stage operation, is that true?" Dean Qi stood in the operation room, looked at Zheng Ren and Gao Shaojie inside through the leaded glass, and asked in a low voice.

Professor Yoo was already blushing at the sight, and he thought that the person standing inside to learn TIPS surgery would be good if he were himself.

Unfortunately, there are no assumptions in life.

Dean Qi asked, Professor Liu was stunned for a moment, sorted out his emotions, thought about it and said, "Dean, according to the conventional surgical method, there is no second stage of TIPS surgery. ”

"Huh?" Dean Qi was surprised.

"The first phase can be done, which is already a national level of intervention. Professor Liu smiled bitterly, he could do it himself, and just a month ago, the level of surgery was slightly better than Gao Shaojie's.

But in a short period of time, Gao Shaojie couldn't see his shadow.

A few days ago, Gao Shaojie called in Haicheng and asked him to help collect patients for TIPS surgery. I didn't realize the problem at the time, but now I think about it...... It would be nice to say it.

Professor Liu was hopelessly distracted.

Listening to what he said, he fell silent halfway, Dean Qi turned his head sideways and snorted with his nose, slightly dissatisfied.

Professor Liu realized that he was immersed in that inexplicable feeling of loss and regret again, smiled bitterly, and said, "In the past, TIPS surgery only needed to connect the liver vein and the portal vein. Patients have a high chance of complications such as hepatic encephalopathy. ”

"Because of the thickness of the stent, too thick is too much blood to flow back from the veins, which is not metabolized by the liver, and the blood ammonia content is high, which leads to hepatic encephalopathy.

But the bracket is thinner, and there is also a problem. The patient's hepatic encephalopathy was less, but the reflux venous blood was not enough, and the problems of gastric varices and portal hypertension were only relieved and not completely solved. ”

"In other words, there is a risk of hematemesis in the future. ”

Dean Qi pondered.

What Professor Liu said was very simple and easy to understand, they were all from clinical backgrounds, and Dean Qi knew the problem in an instant.

"Mr. Zheng ordered two stents, the first one is a stent with membrane, which is what ordinary TIPS surgery does. Professor Liu's eyes were full of envy, and that emotion seemed to melt the leaded glass.

But he placed another recyclable stand. The advantage of this stent is that it can solve the above two problems, and after the patient adapts to the blood ammonia concentration of venous blood, the retrievable stent can be taken out, which is a perfect solution to the problem of postoperative complications. ”

"But...... Removing the stent from the liver, this one is too difficult. ”

"Really?" asked Dean Qi.

"The liver parenchyma would break and bleed, and I couldn't figure out what to do to get the retrievable stent out smoothly. Professor Liu was a little emotional.

Because I don't understand, I'm more curious.

While answering Dean Qi's question, he stared at the screen in the operation room.

The operation has begun, and the retrievable stent balloon has deflated and is being removed.

In the operating room, Gao Shaojie's movements were very light and slow.

Although he was stepping on the line, his body was exposed to X-ray rays every minute and every second, causing damage to his body.

But he didn't dare to hurry.

Watching Zheng Ren do the second phase of surgery, it was a simple mess.

But when I got started, I knew the difficulties.

As soon as I moved, I felt resistance coming.

"Lao Gao, seven o'clock position, 15 degrees down, light and force. Zheng Ren looked at the screen intently and said lightly.

Gao Shaojie reacted for a moment, then nodded, and cautiously followed Zheng Ren's instructions.

But at seven o'clock...... It's also 15 degrees down, is this a human talk?

Gao Shaojie tried several times, and finally succeeded in following Zheng Ren's instructions and did this.

The retrievable stand has been moved a few millimeters away and is barely visible on the image.

He didn't have the slightest joy, why he succeeded, Gao Shaojie himself didn't know.

"Below, at five o'clock, bend your wrist, at a 25° angle, tap, tap. ”

This time, Gao Shaojie tried four or five times, but it didn't work.

Afraid of liver parenchymal injury and bleeding, Zheng Ren finally reluctantly switched places with Gao Shaojie, and Zheng Ren took action, and the operation was completed within ten minutes.

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