The intellectualization and humanization of the big pig's trotters Zheng Ren is experienced, and this is the operation of the mandate. Therefore, after entering the system space, Zheng Ren had no doubts and clicked to purchase surgical training time.

The operating room of the system rises from the ground, and the subject lies on the operating table.

Jeong-in began surgery.

For Zheng Ren, who is at the peak of interventional surgery, renal artery stent is just a very simple operation.

Punctures, overselections, renal arteries and fourth- and fifth-grade arterioles are like driving on an eight-lane road with bumps on a non-existent road in the tropical jungle.

The superselection goes smoothly, goes down into the bracket and opens.

It's that simple.

However, the completion of the operation was not even 50%, and the words appeared on the system panel, and the subject died 58 hours after the operation.

For this result, Zheng Ren was not surprised.

Because the process of this operation is the same as the process of the Mayo Clinic doctor in the video, and the surgery is the most basic one.

At the end of the operation, the subject died, and Jung in began the dissection.

That's what Jung Ren really wants to do.

The structure of the renal artery has changed significantly, and about 5 cm from the initial segment has become narrowed. Narrowing of the renal arteries causes an increase in blood pressure, known as renovascular hypertension.

Because the decrease in intrarenal perfusion pressure and renal parenchymal disease, as well as renin-secreting cell tumors, can cause paraglomerular cells to release a large amount of renin, causing increased angiotensin II activity, and the constriction of the arteriole wall throughout the body to produce hypertension.

Renin and angiotensin II can also promote the increase of aldosterone secretion, leading to sodium and water retention, increasing blood volume and producing hypertension.

But when the renal arteries are dilated, why is the blood pressure higher?

Zheng Ren knew that this involved areas that existing science could not understand. As a person who is particularly compelled in his heart, Zheng Ren is not prepared to completely solve the problem of nephrogenic hypertension.

As long as he can complete a task and get time for surgical training, Zheng Ren is very satisfied.

Dissecting the renal artery, Zheng Ren found that the renal sympathetic preganglionic neuron cell body emitted from the middle lateral column of the spinal cord from the 12th thoracic segment to the second lumbar segment was normal before entering the celiac ganglion and located in the aorta, and there was no abnormality.

However, when the aorta branches and forms the renal artery, the renal sympathetic nerve, which is supposed to accompany the renal artery, fuses with the renal artery in the stenosis.

Here's why!

Due to the thermal stimulation of radiofrequency ablation, local anatomical structure variation is generated, resulting in renal artery stenosis and renal sympathetic nerves are also fused with renal arteries due to the exuded substance.

When the stent is inserted, the renal artery in the narrowed section is opened, and the renal sympathetic nerve is stimulated, resulting in irreversible hypertension.

The transmitter released by the renal sympathetic postganglionic fiber terminals is norepinephrine, which regulates renal blood flow, glomerular filtration rate, tubular reabsorption, and renin release.

When the renal artery and renal sympathetic nerve are stretched open by the stent and the nerve is compressed, this series of physiological processes is changed.

Zheng Ren looked at the experimental subjects on the operating table in the operating room of the system and began to ponder.

The problem is found, what should be done?

He was in no hurry to end the operation, and although it had now become the scene of a forensic autopsy, Zheng Ren still did not end the process.

First, the part of the fusion of the renal artery and the renal sympathetic nerve was measured with a stent, and it was found that no matter how the angle was changed, it was absolutely impossible to avoid compressing the renal sympathetic nerve while the stent was open to the renal artery.

Zheng Ren hesitated for a moment, changed his thinking, and began to prepare to use surgical means to solve such a problem.

Surgery to remove the renal artery from the sympathetic nerve...... Just thinking about it, one of Zheng Ren's heads becomes two big.

The difficulty of this kind of surgery has soared directly to the sky!

Although his general surgery skills have reached the level of a master, Zheng Ren is still not sure.

But now that you've found an idea, let's give it a try. The system does not give an S-level surgical grade, which proves the difficulty...... It's still very difficult, Zheng Ren sighed.

Such a difficult task, but there are not many rewards, is the big pig's trotters down? Zheng Ren scolded in his heart.

At the beginning of the second operation, the subject was placed in a lateral decubitus position, and the abdominal aorta, renal artery, and renal vein were exposed along the retroperitoneal path through a lumbar longitudinal incision. Under a dissecting microscope, the renal sympathetic nerves accompanying and fused to the renal arteries and veins are carefully dissociated.

But Jung Ren did find a benefit.

During normal dissection, it is also necessary to avoid fascia and other nerve tissues being mistaken for renal sympathetic nerves.

And in the face of this patient, it is enough to have a retrograde dissection.

This can reduce a lot of surgical procedures and shorten the time spent on surgical training.

Zheng Ren has already made a plan, and if there are 1,800 surgeries of this difficulty, it is estimated that he will not be able to take them.

The process of dissociation was relatively smooth at first.

However, a little bit of freedom under the microscope, less than 1cm away, the subject's blood pressure suddenly increased, and then the system reminded Zheng Ren that the subject had died due to the rupture of cerebral blood vessels due to high blood pressure.

Zheng Renleng paused.

I'm already very careful, using a 20x microscope, and under the microscope, it seems that I didn't touch the sympathetic nerves of the kidneys.

But the subject's death is a fact, and something must have gone wrong.

Jung in started surgery again.

The results are still the same.

Again...... Death again.

Again and again, the test subjects died, and the time for surgical training was rapidly consumed.

After the failure of his 78th operation, Jung in finally hesitated. Although he was still sure that he had chosen the right way, the operation had failed repeatedly, and he always had to find the reason.

It's certainly not a matter of technique.

He didn't continue his surgical training, and he didn't bother to look at the little white fox's sneering expression, and went directly out of the system space.

"Su Yun, are you sleeping?" asked Zheng Ren.

"If you don't speak, I'll already be dreaming. ”

"Dreaminess is a manifestation of poor rest, unable to enter deep sleep, and has a great impact on the body. Zheng Rendao.

"What's the matter?" Su Yun didn't argue with Zheng Ren, but got up and asked.

"I have seen the patient's case and the surgical process, and I highly suspect that the renal sympathetic nerve is fused with the renal artery. After the built-in stent, the renal sympathetic nerve is stimulated, which leads to malignant and refractory hypertension. Zheng Rendao.

Su Yun frowned.

It's just that during the operation, you can see the sympathetic nerves in the kidneys?

But he didn't ask Zheng Ren how he found out, because there was only one answer - the technical level was not enough.

Su Yun rarely bored himself.

"When you had a heart transplant, how did you get your nervous system?" Zheng Ren asked.

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