Chapter 2274: then translation of title

"Using cryotherapy technique..." Su Yun asked a beginning, then stopped.

"I've considered it, but the patient is currently coughing up blood; if we use cryotherapy, poor control of the scale makes problems more likely." Fang Lin frowned and said.

"I think we can try it; this location would be more suitable for cryotherapy." Zheng Ren looked at the image and said softly.

Fang Lin carefully considered the difficulties of doing bronchoscopy plus cryotherapy, finding it somewhat challenging.

Zheng Ren looked at the image, entered the System Space, and prepared to perform bronchoscopy.

The principle of cryotherapy is based on the Joule-Thomson effect, treating the lesion to achieve the doctor's desired goal.

The high-pressure gas inside the cryoprobe, after being jetted out through the nozzle, rapidly expands in the low-pressure area; when the probe contacts tissue, heat exchange occurs, drawing heat from the tissue and causing it to freeze.

Tissue damage caused by freezing can occur at the cellular and tissue levels, without causing additional harm.

The difficulty in the patient's condition lies in bronchial foreign bodies or stones with severe adhesion to surrounding tissue, already causing bronchial wall rupture and bleeding.

Being able to cough up 350 ml of blood means the bleeding vessel is relatively large, at least akin to a slightly larger bronchial artery branch.

Severe adhesion means it's not a discrete foreign body with clear borders; frankly, cryotherapy makes it difficult to completely remove the bronchial foreign body.

Fang Lin's concern is whether directly removing the foreign body while preserving lung tissue would cause more severe hemoptysis, though it has never endangered the patient's life.

We can only try it.

Zheng Ren began surgical training with a "let's try" attitude; if it really doesn't work, he can only follow Fang Lin's opinion and remove a lung lobe.

Preoperatively, administer intramuscular diazepam 10 mg. Zheng Ren still felt uneasy, so he added intramuscular clonidine 50 mg and atropine 0.5 mg, and gave nebulized inhalation of 2% lidocaine 10 ml.

After the medication took effect, Zheng Ren operated the fiber bronchoscope, inserting it into the right lung and entering the problematic right lower lobe.

Soon, Zheng Ren saw the foreign body.

Mucosal edema, granulation hyperplasia; a foreign body is visible distally, wrapped in granulation tissue; when the scope touches the foreign body, bleeding is obvious, accompanied by copious purulent secretion.

What the hell is this? It looks problematic. Its appearance… seems somewhat familiar.

Zheng Ren carefully examined the wrapped foreign body with the fiber bronchoscope, then suddenly recalled several domestic case reports.

It is… chili pepper.

Inhaling chili pepper while eating it into the lungs sounds unbelievable, but there have been sporadic reports over the years.

However, knowing what the foreign body is is utterly useless.

Combining the medical history and the patient's recurrent episodes, the foreign body has likely been there for several years; granulation hyperplasia is obvious, causing the lumen to narrow, making complete removal of the foreign body difficult inside. Moreover, adhesion between the foreign body and surrounding tissue causes bleeding when the scope touches it; attempting complete removal is therefore quite difficult.

Zheng Ren did not hesitate; first he cleared secretions and necrotic material from the lesion surface so the cryoprobe could make adequate contact with the lesion.

Subsequently, the sterile cryoprobe was inserted through the biopsy channel, with its metallic tip placed at the center of the lesion, the probe tip positioned more than 5 mm distal to the bronchoscope tip; one can use the probe tip vertically or tangentially to act on tissue, or directly act inside the lesion, to achieve maximal freezing effect.

Pressing the pedal activates the probe; after about 15–20 seconds, an ice ball forms at the probe tip, visibly whitening and freezing the tissue; releasing the switch allows it to thaw naturally.

One to three freeze‑thaw cycles, each cycle lasting 3–4 minutes in the same or adjacent area; larger lesions may require multiple freeze points until the visible portion is completely frozen.

After several failures, Zheng Ren summarized the experience.

The freezing time is approximately 18 seconds, requiring four freeze‑thaw cycles, each cycle lasting 3 minutes 20 seconds.

Finally, despite minor bleeding, Zheng Ren used foreign body forceps to extract the entire foreign body.

The chili pepper had rotted, emitting an unbearable strange odor.

Moreover, because the bronchial wall was severely corroded, Zheng Ren placed a bronchial stent, thereby completing the surgery.

Seeing the prompt indicating 99% surgical completion, Zheng Ren let out a sigh of relief.

He was very curious about what changes the chili pepper had undergone inside the trachea.

Holding the hemostatic forceps, Zheng Ren began to open the organized layer wrapped around the chili pepper; but as soon as he opened it, the odor from the rotted chili pepper rushed into his nasal cavity, into the olfactory epithelium composed of supporting cells, olfactory cells, and basal cells.

Via the olfactory nervous system and the nasal trigeminal nervous system, it reaches the olfactory bulb region of the telencephalon.

He felt a bit dazed and almost fainted in the System Operating Room.

This odor… no wonder Quan Xiaocao doesn't eat anything; it's strange that anyone could ingest anything after smelling this every day.

Moreover, it's not just an odor but also toxic gas; if not for the enhanced physical condition in the System Space, Zheng Ren would likely have passed out in the operating room.

By then, even if a person could survive, countless surgical training hours would be "wasted," and Zheng Ren might even feel like dying.

Zheng Ren exited the System Operating Room, ending surgical training. If he had fainted inside the System Operating Room, all that surgical training time would have been wasted in vain, and Zheng Ren would be grief‑stricken.

"Boss, can you handle cryotherapy? I think we can try it. Although the difficulty is high, anyway we were already preparing to remove a lung lobe, so why…"

"We can try it; in the Hybrid Operating Room, first use cryotherapy with the fiber bronchoscope to remove the foreign body. If successful, we still need to place a bronchial stent to seal the bleeding point."

Su Yun, hearing her own boss say that, felt reassured.

"Fang Lin, who is today's second‑line professor?" he asked.

The Inpatient Chief handles emergencies; for dangerous surgeries that might not be manageable, one naturally seeks a second‑line.

"Teacher Zhu is second‑line, but he has many surgeries today and hasn't finished yet," Fang Lin said.

"Go communicate with the patient's family, then look for a second‑line to assess the situation," Su Yun said.

Fang Lin also didn't hesitate; since Zheng Lao Ban said it was okay, he just pulled him along to have a look. As for Teacher Zhu of the second‑line, he wanted to try it himself and wouldn't stop himself.

He performs eight laparoscopic surgeries a day, and reportedly needs to do three thoracoscopic esophageal cancer radical resections in the afternoon; where would he find time to handle a bronchial foreign body?

"Zheng Lao Ban, Yun Ge'er, wait a moment for me," Fang Lin said, wearing a huge red stethoscope, swaying, speaking in an unusually flirtatious manner.

"Mm, we'll go back to the ward and wait for you," Zheng Ren said, "Once we're ready, we'll call Su Yun and then go up."

After saying that, Zheng Ren thought for a moment and told Su Yun: "What shift is Lao He on? Let's team up. If there's massive bleeding, we'll need emergency intubation."

Just thinking about massive bleeding and emergency intubation gave Fang Lin a headache.

For this kind of surgery, once it has to be done emergently, the risk spikes sharply.

Merely seeing Zheng Lao Ban appear quite confident, Fang Lin's heart wavered for 3.2 seconds; he ultimately decided to thoroughly explain the intraoperative risks to the patient's family, making sure they understood everything so they could choose for themselves.