Chapter 593: with translation of chapter title

584 Personal experience, strongly recommend.

By around 11:30, all TIPS surgeries for the cirrhotic patients were completed.

Li Jianguo escorted patients downstairs; that day, his job was to take patients down, then verify the information of the next patient, and bring patients back up.

By the time they came back up, the TIPS surgery was almost finished.

He could sense a different atmosphere, unlike the last time Zheng Ren came to the Provincial City Medical University Affiliated Hospital for surgery.

This time, however, Teacher Gao himself was personally performing the TIPS surgery!

As it turns out, as long as you find a way, the TIPS surgery can become this simple.

In the operating room, Zheng Ren and Gao Shaojie discussed the key points to note for the second-stage surgery.

Because Director Kong arrived unexpectedly, Zheng Ren was caught off guard, so he wanted Gao Shaojie to quickly master everything about the TIPS surgery.

Many details had already been discussed in the office; at this moment, Zheng Ren saw Gao Shaojie's slightly bewildered gaze and sighed inwardly.

"Old Gao, let's go up and talk again." Zheng Ren realized he had been too hasty; perhaps the professor could manage it, but Gao Shaojie… probably could not.

Gao Shaojie also realized that the first-stage and second-stage surgeries are two completely different concepts; Zheng Ren's tone and expression dampened the joy of having successfully completed the first-stage surgery.

"Boss, I think you should hit him with the hemostatic forceps—it's quick to learn, from personal experience, I strongly recommend it." Professor Rudolf Wagner, upon hearing their conversation, spoke seriously.

However, this is the Medical University Affiliated Hospital; Gao Shaojie and I had agreed it's best not to hit him. Zheng Ren just got carried away and tapped him lightly, and he still feels a bit embarrassed.

Forget it, Zheng Ren thought; taking it slow is actually faster.

Gao Shaojie furrowed his brows in thought, remaining silent.

"Doctor Zheng, let's have lunch first and then do the surgery." President Qi was in high spirits; although he hadn't managed to recruit Zheng Ren to the Medical University Affiliated Hospital, that wasn't exactly normal, he sensed something odd from Old Wu's tone.

This young man before us should be going to the capital, the magic city, or even to large medical centers in Europe and America.

And stay in the provincial city?

That is absolutely impossible.

"President Qi, we won't eat lunch." Zheng Ren said solemnly, "The difficulty of the later surgeries will be greater; I'm afraid we won't finish today."

Are the later surgeries more difficult?

President Qi didn't mind Zheng Ren's refusal; he was just surprised that the TIPS surgeries were already done, yet why are the later surgeries more difficult?

From a surgical perspective, generally the second-stage surgery has a clearer objective and is much simpler than the first-stage.

President Qi glanced at Gao Shaojie, saw he was deep in thought, didn't stand on ceremony, and invited Zheng Ren to eat.

If we can't keep Doctor Zheng, then we must definitely retain Gao Shaojie.

President Qi had already guessed the value of the new TIPS approach from his overseas classmates, and his little mental calculator was clicking away.

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

The surgery began.

"Little Liu, did Doctor Zheng just say the second-stage surgery is harder than the first?" President Qi stood in the control room, looking through the leaded glass at Zheng Ren and Gao Shaojie inside, and asked softly.

Also mentions Doctor Zheng, Gao Shaojie, possibly the operating room, lead glass, and President Qi.

Professor Liu had long been envious, every time thinking how great it would be if he himself were the one inside learning the TIPS procedure.

Too bad, life doesn't come with suppositions.

President Qi posed a question; Professor Liu paused for a moment, collected his thoughts, and then said, "President Qi, according to the standard surgical approach, there is no second stage for TIPS."

"Huh?" President Qi exclaimed in surprise.

"Being able to complete the first stage already puts one at a national-level interventional standard." Professor Liu gave a wry smile; he himself could do it, and just a month ago his surgical skill was still slightly ahead of Gao Shaojie's.

Yet in such a short time, Gao Shaojie has already made his own shadow disappear.

A few days ago, Gao Shaojie called from Haicheng, asking me to help collect patients for TIPS surgery. Back then he didn't realize the problem; now thinking about it… if only he had said something.

Professor Liu was hopelessly distracted.

Listening to him speak, he trailed off into silence; President Qi tilted his head, let out a nasal hum, slightly dissatisfied.

Professor Liu realized he had again sunk into that inexplicable feeling of loss and regret; he gave a bitter smile and said, "In the past technique, the TIPS procedure only needed to connect the hepatic vein and the portal vein. The postoperative complication rate is high, for example, hepatic encephalopathy."

"Because of the stent's thickness, if it's too thick, more blood returns from the vein without being metabolized by the liver, leading to high ammonia levels and thus hepatic encephalopathy."

But if the stent is too thin, there are also problems: the patient's hepatic encephalopathy occurs less often, yet the venous return is insufficient, so issues like gastric venous varices and portal hypertension are only alleviated, not fully resolved.

In other words, there remains a risk of vomiting blood in the future.

President Qi fell into contemplation.

What Professor Liu said was already simple and easy to understand; being clinically trained, President Qi instantly grasped the problem.

"Doctor Zheng placed two stents; the first is a covered stent, which is what a standard TIPS procedure entails." Professor Liu's eyes were full of envy, that feeling almost melting the leaded glass.

"But he also placed a retrievable stent. Its advantage is that it can solve both of the aforementioned problems; once the patient adapts to the ammonia concentration in the venous blood, the retrievable stent is removed, thereby more perfectly resolving postoperative complications."

"But… retrieving the stent from within the liver is extremely difficult."

"Is that so?" President Qi asked.

"The liver parenchyma would be damaged and bleed; I can't figure out how to successfully retrieve the retrievable stent." Professor Liu felt somewhat wistful.

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

While answering President Qi's questions, he stared intently at the screen in the control room.

The surgery has begun; the retrievable stent's balloon is deflating, and it is being withdrawn.

In the operating room, Gao Shaojie's movements are very gentle and slow.

Although he is walking the line, every minute and second of his body is exposed to X-ray radiation, causing bodily harm.

But he dares not go fast.

Watching Zheng Ren perform the second-stage surgery, it is absurdly simple.

But only when he tries it himself does he realize how difficult it is.

As soon as he moves, he feels resistance coming back.

「Old Gao, seven o'clock position, 15° down, use light force. 」 Zheng Ren stared at the screen without blinking, and said calmly.

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

But the seven o'clock position…… is still off by 15°, is this even human speech?

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

The retrievable bracket moved a few millimeters, almost invisible on the image.

He felt no joy at all; why he succeeded, even Gao Shaojie himself didn't know.

"Below, at the five o'clock position, bend the wrist slightly, 25° angle, tap lightly, tap even lighter."

This time, Gao Shaojie tried four or five times, but still didn't succeed.

Within ten Minute, Zheng Ren completed the Shou Bing.