Chapter 960: Patch Repair
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
After all, he did not perform the surgery himself. He absolutely could not make guesses based on the surgical records of the patient’s chest and abdominal cavity.
When Zheng Ren was in the Department of General Surgery of Sea City General Hospital, he had encountered such a patient.
After the C-section, the patient suddenly suffered a massive hemorrhage. The doctors of the local hospital performed an emergency laparotomy. When they discovered that they were performing a C-section, they did not know what had happened, but the spleen was punctured.
This was definitely a medical accident, but the strange thing did not stop there.
After the emergency splenectomy, the patient found that he had difficulty breathing. Therefore, they checked the CT scan of the lungs and found that the left diaphragm hernia, pneumothorax, and compression of the lung tissue.
The chief of the hospital panicked and hurriedly sent the patient to Sea City General Hospital.
To them, Sea City General Hospital one was their superior hospital. It was their sky.
Liu Tianxing had a good relationship with the chief of the town hospital, so he accepted this patient and helped him clean up his mess.
After an investigation, he found that the patient had a large number of pneumothorax in his left chest.
He asked the Chest Department to go on stage together and found that when the patient had his spleen resected, a hole had appeared in his diaphragm for some reason and his lungs had ruptured.
Therefore, after a series of repairs and sutures, the patient was finally discharged from the hospital successfully half a month later.
The standard of the doctors in the township hospital was truly unpraiseworthy. It was just like how the doctors in the prestigious hospital in the Imperial Capital and the Sorcery Capital scrutinized the first hospital of Sea City General Hospital.
This was the difference in skill level. There was nothing they could do about it.
Up until now, Zheng Ren still could not understand why a C-section could rupture the spleen — why a splenectomy could cause the lungs to rupture and the diaphragm to rupture.
This was simply too terrifying.
It was really a joke to have a doctor who was not skilled. However, one could not expect all doctors to be skilled. That was unrealistic.
This was also Zheng Ren’s main purpose of opening the live surgery broadcast room. In any case, if he was in trouble, he could just do his best.
The situation of the patient in front of him was similar to the female patient that Zheng Ren had done a C-section on. However, the actual situation was different.
The moment Zheng Ren saw the radiographic films, he was certain that it was definitely a liver hernia.
This was definitely something that could be caused by a side injury. However, it was not because the doctor had made a low-level mistake that would make one feel regretful. It was because the congenital retrosternal diaphragmatic hernia was relatively rare. In addition, the patient was older, so the diaphragm was not strained.
Zheng Ren made his judgment at the first moment.
Cui Lao put on his reading glasses and began to read the scans frame by frame.
Soon, Chief Ren of the emergency department, Chief Zhang of the Department of Hepatobiliary and Pancreatic Surgery, and Chief Li of the Department of Thoracic Surgery rushed to Cui Lao’s office.
When they saw Zheng Ren, they were stunned.
Chief Zhang chuckled and said, “Boss Zheng, that surgery just now was really beautiful!”
“You flatter me.” Zheng Ren smiled and said humbly.
“It’s good that you did well. It’s not good for young people to be too humble.” Chief Zhang laughed and finished speaking. Then, he began to listen to Zhou Litao report his medical history again.
The chief resident hated this kind of work the most. The same medical history had to be reported once or twice, or even three or five times continuously.
Fortunately, the few chief directors were here. It seemed that they did not need to report more times.
Soon, after listening to the patient’s medical history, everyone began to study the radiographic films.
The patient’s condition was not good. After a week of recovery from the two general anesthesia operations, his body had just recovered slightly. However, he had a liver hernia and had to go through a long journey before he came to the 912.
After going through so much trouble, even if his body was made of iron, there would still be some problems.
Whether the emergency surgery would be performed by the Thoracic Surgery Department or the Hepatobiliary Surgery Department was a problem.
No one was willing to accept a patient who was badly cut. Therefore, Cui Lao, who was very experienced, ‘invited’ the two chief physicians of the relevant departments to his office to avoid arguing with each other.
Of course, the Emergency Department had the right to directly push the patient to a certain department, so they could not refuse to accept the patient. However, it was a better choice for everyone to sit together and explain things to each other in a friendly manner before going on stage together.
This was done with great experience, but only an old man who was at the level of an academician had the confidence to do it. He brought over the chief directors of the two departments concerned and the chief directors of the Emergency Department for a consultation in one go.
Zheng Ren had originally planned to be a salted fish.
The patient’s condition was relatively clear. He could perform an operation, conduct a detailed investigation, and repair the diaphragm. There was no way for him to tell which chief to accept this kind of thing.
Anyway, with Cui Lao around, he could only enjoy himself for a moment.
However, his wishful thinking was quickly shattered. The few chief physicians did not say anything and looked at Zheng Ren.
“Little Zheng, tell me your thoughts,” Cui Lao said slowly.
“…” Zheng Ren did not understand. He looked left and right. Seeing that the two chief physicians did not speak, he knew that he had to say something.
Cui Lao’s attention was on one hand. On the other hand, he had just finished the surgery for Gaucher disease, so Chief Zhang took it seriously.
If it were someone else, it would be an honor. However, Zheng Ren knew how deep the waters were. He felt that it was difficult to handle.
Zheng Ren muttered to himself. Cui Lao’s gaze was like a whip that lashed at Zheng Ren.
“Then, I’ll first attract the jade. I’ll briefly tell you my opinion.” Zheng Ren thought for a moment and said politely, “If there’s something unexpected, I hope that the chief physicians can give me some pointers.”
“Due to the congenital retrosternal diaphragmatic hernia and the age of the patient, the right diaphragmatic muscle has atrophied.
“Moreover, due to the large size of the primary hernia and the longer course of the disease, the diaphragmatic muscle function was disturbed after the operation. In addition, the entire hernia sac was removed during the operation, which further weakened the diaphragmatic muscle function and possibly damaged the surrounding tissues.
“In conclusion, I think the reason for the patient’s liver hernia is due to the resection of the congenital retrosternal hernia sac, which resulted in the high tension of the diaphragmatic muscle, the combination of the large alveoli, and the high tension of the mechanical ventilation, which caused a large area of the right diaphragmatic muscle to be striated.
“For surgical repair, it is best to use a patch to relieve the local tension. Do we have the relevant patch in our hospital?” Zheng Ren asked.
“Yes.” Chief Zhang nodded. “I estimate that the length of the tear is about 15 cm, and I agree with Boss Zheng’s analysis. If this surgery is performed from the abdominal cavity, there will be liver obstruction, and it will be very difficult to have a surgical field. I recommend that the Thoracic Department open the chest for treatment, and we can assist on stage.”
Thoracotomy had always been the most common invasive method for hernias, especially because the removal of hernias was more suitable for this method. The morbidity and mortality rate after laparotomy were considered to be the highest. Chief Zhang’s statement was not wrong.
However, Zheng Ren hesitated for a moment, but in the end, he remained silent.
“Little Zheng, what do you want to say?” Although Cui Lao was wearing reading glasses, he was very observant.
“I think Chief Zhang is right. I think the crux of the patient’s surgery lies in the patch,” Zheng Ren said. “There is a high probability that the patient’s diaphragm will atrophy, which is why the tension will be too high due to the removal of the hernia sac, causing it to be striated. The patch itself is more resilient than the diaphragm, and it can also fully relieve the tension of the diaphragm.”
“With such a large patch, the surgery will be somewhat difficult,” said Chief Li of the Thoracic Department