Medicine and science are two different things. Some discover the truth directly through practice, while others require scientists (medical scientists) to come up with a concept and then verify the truth of the concept.
So we find that in clinical medicine, many technical surgeries are ideas that clinicians figure out in practice and then put into action: Hey, that works too.
The human body is something so complex that it is impossible to explain. Even if scientists have dissected its organs and tissues repeatedly in an attempt to analyze them thoroughly, they can only reveal a corner of the mystery.
Dr. Li said to Dr. Cui: I don't know if it works, but someone has done it and published it in a research paper. To be honest, you and I both know the mystery of the human body mentioned above, but no one can figure out the ultimate goal.
Logically speaking, the "branches" of the lungs are interconnected, just like human blood vessels have numerous side branches. Blocking only one bronchial branch will not work.
Medicine is a field that tests courage the most, as I have said many times before. Clinicians will never give up easily in order to save patients.
Is it true that the lungs' branches are completely connected, and that all the air in the lungs will flow to a single pleural fistula? Clinicians believe that since senior medical scientists proposed that the lungs can be segmented, this means that the lungs are not necessarily completely connected, and not all the lungs' branches can flow to that leaking point.
How to prove the clinician's conception? Just try to block it. Block the bronchus and see if it can stop the air leakage, and then you can know whether the conception is true.
Which bronchus should we try to block?
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Following the theoretical foundation of the predecessors of the above conception and standing on the shoulders of giants, if there are preoperative imaging data for auxiliary diagnosis, clues can be found in the imaging data to find the lung segment corresponding to the pleural fistula and block the bronchus corresponding to that lung segment.
If there is no clue, you can only classify the lungs according to their anatomy again, and try the upper lobe, lower lobe, and middle lobe first. If that doesn't work, you can then divide the lungs into segments to try.
The blockage must be to block the superior bronchus (i.e. the "big branches") and there is no need to explore the "small branches" of the subsegmental bronchus. Because there are too many side branches in the subsegment that are connected everywhere and gas may escape everywhere, blocking one of the subsegments becomes meaningless.
The above words can be expressed in descriptive sentences. For example, when a flood occurs, it is necessary to block the large river upstream to achieve the desired effect, rather than blocking the small rivers and streams downstream.
What tool should be used to block it?
The equipment mentioned above should be removable, and it is best if it is easily accessible rather than special equipment so that it has no threshold for application and is more widely used.
After hearing the description, the experts on site quickly thought of a tool commonly used in many internal medicine and surgical operations that is too familiar to almost all doctors: the balloon catheter.
To put it simply, this tool is familiar to both nurses and anesthesiologists.
For urinary catheters, tracheal intubations, etc., don’t they all use similar balloon catheters to fill with water or air to block and fix them?
The above-mentioned ways of using balloon catheters are not the only ones. It should be said that doctors are very good at using a tool in a kaleidoscope of ways, which is all based on mathematical physics.
To date, balloon tube medical devices have been used in many clinical medical departments, and various shapes have been developed to suit respective clinical specialized uses. These are all ideas conceived by clinical doctors themselves based on surgical needs.
For example, in the interventional surgery case we just talked about, it was mentioned that the balloon catheter was used for vasodilation, and its shape and structure must be much more complicated than that of the urinary catheter.
Dr. Cui, who was familiar with all of this, asked the key question: Dr. Li, do you mean that this tool is only seen in papers and is not available off the shelf?
Doctor Li: I think there isn’t any for now. I don’t know if Xie Juanwang has it himself, or if Xie Juanwang has thought of where to find a substitute.
Everyone: ...
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