Chapter 83 The Nanny's Niece's Counterattack
Director Zheng added, "Theoretically it is feasible, but so far no one has succeeded."
Some patients have narrow and tortuous blood vessels, unlike the unobstructed blood vessels of ordinary people. In such cases, it is very difficult to deliver the catheter using the conventional route.
However, such patients are rare, perhaps only one in tens of thousands. Even when a single case appears, it is considered an important case for medical researchers to discuss. However, most people consider it a contraindication and therefore cannot undergo surgery.
However, some people have suggested the same idea as her: to find a smoother route. But when blood vessels are fragile, thin, and tortuous, it is difficult to find a suitable route.
So far, even though a group of people found a relatively suitable path, they still failed because the blood vessels were too thin, and although the catheters were also thin, they were ultimately not as easy to access as the original femoral veins and subclavian veins.
Elderly people's bodies are fragile and cannot withstand repeated trauma.
As for her question about whether patients with poor blood clotting function can't undergo radiofrequency ablation, the answer is yes, they can, but the risks are too high. Who can guarantee that blood vessels won't be damaged during catheter delivery? What if bleeding occurs and can't be stopped?
Nobody wants to take this risk.
Lin Wei understood, but still wanted to try it because compared to other open surgeries, radiofrequency ablation was already a minimally invasive procedure with good postoperative recovery.
Because of this, she specifically looked up some information and also asked Director Zheng if there were any related videos, which she wanted to watch.
Director Zheng was somewhat surprised to hear this, but after thinking about it, she agreed, "Okay." It would be impossible for an ordinary person to watch, but she was a participant in the Talent Strengthening Program, and she wanted to watch and learn, so naturally her request was granted.
So within a few hours, the materials were delivered to her. It was a USB drive containing not only the published papers, but also videos, medical records, and examination data from the failed surgeries.
Thanks to her recent experience reviewing patient case files, Lin Wei was able to look at a little bit of echocardiograms and imaging films, so she quickly got to the point.
"Patient Cai, male, 74 years old..."
"Patient Wu, female, 96 years old..."
"Patient Yang Moumou..."
In total, only five similar surgeries were performed, and all of them were performed on elderly patients. All five surgeries ended in failure, so no one was willing to have this kind of surgery afterward.
Some people believe that this method is simply not feasible.
However, after Lin Wei finished reading them, she still felt that what those medical papers said made sense and was theoretically feasible.
However, this requires a high level of skill and is a very difficult procedure. If there is even the slightest mistake, the surgery will fail. Unfortunately, the patient Lin Wei encountered in the simulation room was atrial fibrillation, had very poor vascular conditions, and also had coagulation dysfunction.
In reality, he wouldn't even consider radiofrequency ablation; he'd dare to do it to a doctor, but the doctor wouldn't dare to do it to him. However, this is a simulation room, and the case she's drawn up is a radiofrequency ablation case, which means that radiofrequency ablation will still be used to treat this patient.
Let alone surgery, even if she could, a patient this old wouldn't be able to withstand such a long surgery, and the prognosis would definitely not be as fast or good as radiofrequency ablation.
So Lin Wei glanced at the case file and ultimately took action.
Once she makes a decision, her eyes become extremely calm.
Selecting a suitable blood vessel, electrode catheter, marking the location, disinfecting, and puncturing—each step is the same as before, the only difference being the puncture site.
Compared to her previous ease, this time she walked with extreme caution, not daring to tremble for even a moment, for fear of damaging a blood vessel. Twenty minutes passed, and she had only walked a few centimeters. However, by this time, Lin Wei's forehead was already covered in cold sweat. At this moment, she had to thank the strength she had practiced when pressing to stop the bleeding and the steadyness of her needle holding, otherwise she would not have been able to hold on at all.
It requires absolute focus; you can't be distracted for a moment. Most importantly, you can't damage the blood vessels. If another blood vessel is damaged, you can find another one to puncture. But if this patient is injured, not to mention bleeding, just finding another suitable blood vessel is impossible. This was already the best blood vessel she could find.
However, if only the surgery were that simple, two hours later, Lin Wei's hand was the first to give out. Although it was only two hours, it was actually equivalent to more than ten hours of a normal surgery. Under such intense pressure, whose hand could withstand it?
After finishing the surgery, Lin Wei looked at her trembling hands and glanced at the score, which kept fluctuating between F+ and F, and knew that it was due to bleeding from the blood vessels.
So that's how it is. No wonder no one wants to do it. It requires a lot of skill and absolute concentration. She calculated that to complete the surgery, two people would need to coordinate and cooperate, otherwise one person's hand wouldn't be able to support it.
Taking over during this process is also a problem, because there will be some big movements involved, and it is impossible to keep your hands still. That is a more dangerous situation than when the catheter was being delivered.
After learning this, Lin Wei no longer had the idea of continuing the surgery. Knowing that the conditions were limited and it was impossible to do it, why would she continue to insist?
Although the surgery was unsuccessful, it was still good for practicing concentration and precision. It's easy to imagine that if a catheter could be inserted into such a small blood vessel without damaging it, it would be much easier for her to perform femoral vein and subclavian vein punctures in the future.
In this way, she performed hundreds of surgeries at once. If it weren't for the simulation room having a function to eliminate fatigue after surgery, her hands wouldn't have been able to hold up even for one surgery, let alone hundreds.
Even so, Lin Wei was still exhausted when she came out, as if she had stayed up for several nights in a row. Fortunately, she was resting today; otherwise, she really wouldn't have dared to push herself like that.
By this time, she had given up on the surgery she had initially considered. It's always better to be honest and steady, and she was still self-aware.
No matter how skilled her hands are, they can only last for ten or twenty hours at most. How could she use them tirelessly for days and nights? She'd be practically ruined by then.
The next day at Hanshao City Hospital, she had barely arrived at the department and hadn't even sat down for a drink of water when she was pulled onto the operating table.
"So soon?" She hadn't expected that.
However, she was clearly more confident than before. The day before yesterday, she was given the patient's information for the exam, and she had also looked at the patient's condition. Although it was difficult, it was definitely not as difficult as the patient in the simulation room.
So, very soon, a test of her abilities was launched.
"Do you think she can complete this surgery? It's much more difficult than before, and it's quite normal for her to make a mistake along the way." In the observation room, a group of people discussed among themselves.
"Even if she made a mistake, are you planning to eliminate her?" Just the fact that she completed so many surgeries in such a short time is enough to keep her on the talent development program.
They don't just do it on everyone, especially since comparisons are inevitable. Compared to the other contestants, isn't she just amazing? Whether she's a genius or not, and whether she can meet their requirements, is another matter.
However, one thing is certain: even if she can't stay in the talent program, she will eventually become an excellent doctor.
On the operating table, Lin Wei was oblivious to what those people were saying. She was completely focused on the surgery, and this time, she was clearly more skilled and her operation was smoother than before. It was as if she were walking in her own backyard, which once again shocked the onlookers.
"Her technique seems to have improved even more than before." This is somewhat unbelievable; how could her surgical skills have improved in such a short time?
Director Zheng was also surprised, but the more skilled Lin Wei was, the happier he became. The surgery, which was originally a bit difficult, was handled by her with ease, as if it were nothing.
Unsurprisingly, Lin Wei received a unanimous vote for the radiofrequency ablation certificate, which was recognized by both the state and the hospital.
When she received the certificate, her joy was indescribable; it meant she could now operate independently. Director Zheng, a man of action, readily scheduled surgeries for her whenever possible.
It's just that she should quickly call for help when she encounters a problem she can't handle.
Believe it or not, she even got the phone numbers of all the chief physicians. The thought of being able to call in someone if she encountered a patient she couldn't handle made her happy.
However, it's best to avoid having to use them.
Meanwhile, a group of people were also discussing her, saying, "Her greatest strength isn't her surgery, but her steady hands and good mindset." While surgical experience can be improved through practice, these two qualities are much harder to enhance.
People in Kyoto said, "Why don't you say that it's because of her excellent surgical skills that she has such a stable mindset?" But one thing is true: her hands are indeed very steady and strong, even surpassing the level of many doctors.
It seems she does put in some effort.
At that moment, a new patient arrived at the cardiac surgery department. Dean Lin personally received the patient and looked at his old classmate with a troubled expression.
"We're all doctors, you should know how difficult this surgery is. To be honest, if it fails, we can't afford the responsibility."
He did want Dr. Zheng to perform the surgery, but given Dr. Zheng's current condition, could he possibly complete half of the surgery?
"But my dad is already 89 and can't afford the surgery. We're old classmates, so I'm begging you."
"Moreover, I have already contacted another doctor, Director Chen Yongyuan from Sichuan Province. No matter the outcome, I will not blame you." Because he also knew the difficulty of this surgery. It was unlikely that he would lose his life, but the surgery might fail.
“We’ve even found suitable blood vessels; all Director Zheng needs to do is get on the operating table.” Of course, if this attempt fails, he’ll basically be cut off from further surgery and will have to undergo open surgery. However, it’s clear that he prefers conservative treatment to open surgery.
In the end, Dean Lin had no choice but to agree.
"Don't get your hopes up too high. To date, I haven't seen anyone succeed in doing it." Even with two people working together, it's still quite difficult.
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