Doctor: Picking Up Attributes in the Hospital

Chapter 210: Surgery—Encounter with an Arterial Thrombus!


The next day.

9 a.m.

Inside Operating Room No. 3.

At this moment, Sun Xinxin was already lying on the hospital bed, Zhao Heng was administering preoperative anesthesia, and the chief surgeon, of course, was Liu Ziang, who was accompanied by two resident doctors. The instrument nurse was Sun Li, and Tian Zhen acted as the circulating nurse assisting Zhao Heng.

This surgery was of great importance to the hospital, and an expert discussion meeting was even held before the operation.

During this discussion, different opinions were presented regarding the surgical approach for Sun Xinxin.

Generally speaking, there are two main methods for brain aneurysm surgery.

One is aneurysm neck clipping, the most common and thorough method for brain aneurysm surgery. The doctor separates the neck of the aneurysm from the surrounding tissues and then uses an aneurysm clip to close off the neck of the aneurysm.

The second method is the interventional approach, which involves treating the aneurysm by vascular intervention, using coils to effectively fill the intracranial aneurysm, thus achieving the treatment goal.

For typical patients, the aneurysm clipping method is usually preferred, as it is more thorough. However, this method comes with a high risk of causing permanent damage to the brain tissue.

For Sun Xinxin, if this method is used, it would mean she could never continue her career as an athlete.

Therefore, Zhao Heng and Liu Ziang discussed and decided to use the interventional method, specifically the endovascular embolization technique. This involves employing high-resolution three-dimensional reconstructed DSA, modified coils, assistive balloons, stents dedicated to intracranial aneurysm treatment, and flow-diversion devices to directly embolize the aneurysm and cut off the blood flow to the aneurysm.

Once the aneurysm loses its blood supply, it will naturally shrink over time. Then at a certain stage, a complete excision can be performed, repairing the part of the arterial wall occupied by the aneurysm.

Only in this way can Sun Xinxin have hope of continuing as an athlete.

However, although this approach is best for Sun Xinxin, it significantly increases the complexity of the surgery for the chief surgeon, essentially splitting one operation into two.

The most critical aspect is that the location selection for the first surgery, the embolization, must be incredibly precise. Otherwise, the second repair surgery will not achieve the expected result.

Thus, this surgery is actually quite challenging.

Just as Zhao Heng finished with the anesthesia and waited for it to take effect beside the table, Liu Ziang stood by Zhao Heng and said, "Junior, we might need your cooperation for this embolization procedure."

No matter how skilled a doctor is, they can't complete a surgery alone, especially a complex brainstem aneurysm surgery like this.

To achieve the best outcome, the embolization placement must be precise, allowing no room for error. Even someone like Liu Ziang requires the cooperation of an expert like Zhao Heng.

"Okay."

Zhao Heng nodded. Performing surgery with Liu Ziang while also handling anesthesia and stepping onto the surgical platform during crucial moments might seem unusual, but it was something he had grown accustomed to.

"I'm doing both anesthesia and surgery; shouldn't I get paid for two jobs?"

Zhao Heng joked to Liu Ziang.

"I'll treat you to a big dinner tonight,"

Liu Ziang chuckled and said.

Hearing this, Zhao Heng became a bit interested. Even with someone like Liu Ziang, who could afford to buy a coffee machine worth over ten thousand for his office, promising a big dinner was something he quite looked forward to.

Shortly afterward, the anesthesia took effect, and the surgery officially began.

As the surgery commenced, Zhao Heng stepped onto the operating table. For this intracranial embolization procedure, he had to follow through from beginning to end.

First, it required two people to cooperate, performing a Seldinger method routine femoral artery puncture, inserting a 6F sheath, and a 6F guiding catheter one after the other, guiding it to the patient's carotid artery under real-time fluoroscopic guidance.

This step sounds simple, essentially just advancing a guiding catheter from the femoral artery to the carotid artery.

However, this route passes through the body's major arteries, and any slight twitch or damage to an artery would make the surgery impossible, with unimaginable consequences.

Most importantly, this procedure requires two people to perform simultaneously: one person to hold steady and the other to advance the catheter.

And naturally, Zhao Heng was the one holding steady, because, in many ways, the stabilization point must not waver at all.

This also showed that Zhao Heng's hands were even steadier than Liu Ziang's, which is why Liu Ziang sought Zhao Heng's assistance.

Watching Zhao Heng and Liu Ziang cooperate with such seamless synergy, the scene was akin to an artistic performance.

It was at this moment that Liu Ziang's brow furrowed slightly, and his actions stopped.

"Senior, what's wrong?"

Seeing Liu Ziang pause, Zhao Heng asked with some confusion.

"Look at the center of the screen."

Liu Ziang said.

Upon hearing this, Zhao Heng looked up, and his expression shifted to one of seriousness.

Because he saw on the electronic screen, in the area near the carotid artery, a small embolus attached to the carotid wall, swaying as the blood flowed past.

Although it's a small embolus, if it gets carried away by the blood flow, it could enter the circulatory system. If it blocks the lungs, it's a pulmonary embolism; if it blocks the heart or brain vessels, it's cardiac or cerebral embolism.

If any of these situations occur, the surgery cannot proceed.

Moreover, the catheter was barely inserted into the carotid. Withdrawing and re-inserting it would mean starting over.

"Senior, let's use the Rotarex to suction the thrombus. I'll handle it."

Pressed for time, Zhao Heng considered briefly and spoke to Liu Ziang.

The Rotarex thrombus aspiration system Zhao Heng referred to is a new type of guidewire-guided thrombectomy device that is safe, fast, and effective in thrombectomy.

It primarily relies on a spiral cutterhead located within the side hole of the catheter tip, which rotates at high speed to create negative pressure, suctioning the thrombus and plaque into the side hole, where it's fragmented by the rotary cutter and aspirated out.

"If you use Rotarex, you'll need to operate one-handed. Is it doable?"

Zhao Heng's words prompted Liu Ziang to ask with some concern.

With Zhao Heng still stabilizing, taking on the task of thrombus removal would demand operating one-handed.

This not only required multitasking but also an unbelievably high level of stability.

"I'm confident, Senior. We won't make it in time otherwise."

Zhao Heng nodded assuredly.

The time for interventional treatment is limited, and leaving the catheter in the artery impacts arterial blood flow significantly. Extending the duration could trigger unforeseen chain reactions.

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