godfather of surgery

Chapter 411 Let's start work
Under the guidance of the fighter plane, the plane entered the airspace of Alaska, got in touch with the control tower of Fairbanks Airport, and landed smoothly.

The manager of the airport boarded the plane with several staff members, expressed his intention to Yang Ping, and led Yang Ping to transfer to a special plane that had been prepared, and this special plane would fly directly to Houston.

They were very warm and thoughtful. I heard that there were three people, and they prepared three coats for Yang Ping and the three to take shelter from the cold temporarily. There was still a little distance between one plane and another plane, and there were coats to keep them warm on the way so that they would not suddenly feel too cold.

Fairbanks is close to the North Pole, and the average air temperature throughout the year is relatively low. It is really cold when you get off the plane.

The emergency in the international space is now the most popular news in the United States, even in Fairbanks, which is far away on the border, everyone knows about it.

Knowing that Yang Ping will go to Houston to participate in the rescue of Steven on the International Space Station, the black manager told Yang Ping that after completing the mission, he must come to Fairbanks to play. He will show everyone the northern lights and invite everyone to eat red Venison and king crab, and enthusiastically left Yang Ping's phone number.

The sky was getting a bit dark, and everyone was racing against time, not daring to waste time, and immediately boarded the special plane and rushed to Houston.

When we arrived in Houston, it was already late at night, and Jim Basa took Johannesson and several officials waiting at the airport.

This is the world's top expert recommended by Mayo Johannesson. He is even more top-notch than Johannesson. He is regarded as a teacher by Johannesson. Famous is not as good as meeting him.

With Johannesson's status in the American neurosurgery department, Jim Basa dared to rely on Yang Ping to fight hard because he strongly recommended Yang Ping.

The commercial vehicle drove them to Space City, the ground control center of the Johnson Space Center, where the lights were on all night.

The emergency rescue team has set up the marching floor here, and those who want to rest can lie down for a while at any time, and everyone takes turns to work 24 hours a day.

Yang Ping stepped into the lobby of the ground control center. Large and small screens, busy staff, and the sound of keyboard typing all reminded that this is the contact center between the United States and the International Space Station.

I heard that Dr. Yang has arrived, and there are nearly 100 doctors, engineers, and ground control center staff.

Finally, I saw this expert whom Johannesson highly respected, but he was much younger than expected.

During the extraordinary period, no time was wasted to introduce each other, and the illnesses also came and went and communicated many times. Johannesson went straight to the point and brought Yang Ping to a screen, and the doctors also surrounded him.

"Blood pressure is 85/40mmHg, heart rate is 38 beats per minute. Currently, nifedipine is used for controlled blood pressure reduction, and an ice cap is used to cool the head." Johannesson said the most important thing.

As soon as Yang Ping took his seat, he got into the mood. He had already checked Steven's medical records on the plane, and now he was just reviewing.

On the special plane to Houston, Yang Ping has already copied Steven's experimental body in the system space to perform simulated surgery. The powerful copying ability of the system space can not only copy the case, but also copy the surgical equipment and environment.

Yang Ping has simulated two scenarios, using telemedicine surgery equipment and operating directly on the space station.

This is also the first time that Yang Ping has encountered such a strange case. In the history of mankind, Steven may be the first astronaut in space who needs surgery. There are many things to explore.

"This is the whole brain DSA done by our astronaut Dr. Susan on the space station. The imaging quality is not very good." Johannesson opened the DSA picture.

"The image quality is too poor, but enough for diagnosis. Small aneurysm. This artery is too dangerous. It passes through the heartbeat center of the medulla oblongata. Once it explodes, it will be fatal immediately. Interventional surgery will be performed immediately to embolize the aneurysm." Everyone is a doctor, or A first-class doctor, Yang Ping went straight to the doctor without any detours.

"The physical examination MRI and CT cerebral angiography on the ground showed no abnormality. It should be an occult cerebral aneurysm. The initial symptom was a slowed heart rate. Only a few days ago, I had headaches, dizziness, and a sense of hypoxia and suffocation." Johnny Sen continued to introduce his condition.

"Yes, occult cerebral aneurysm, in microgravity, without normal gravity on Earth, venous return to the head becomes difficult, relative venous stasis and arterial congestion occurs, occult aneurysm occurs at higher blood pressure , it interferes with the heartbeat center and causes myocardial depression, which is central myocardial depression, and the operation should be arranged as soon as possible, and give me a detailed list of the drugs, equipment and medical conditions on your space station, hurry up!" Yang Ping didn't have time Steven couldn't afford to wait for the lecture.

Interventional surgery is necessary. If there are drug-loaded microspheres in this area, it is better, especially drug-loaded microspheres with flexible stents, which can absorb coagulation drugs and be delivered to the hemangioma. The coagulation drugs carried by the microspheres will gradually trigger the coagulation mechanism locally. When a thrombus is formed, there will be no blood flow through the aneurysm, so naturally there will be no impact of blood flow, and there will be no rupture. After two weeks, the thrombus will become an old thrombus with increased stability and can withstand high-speed falling belts when returning to the earth coming shock.

Companies with relatively mature drug-loaded microsphere technology, such as British Biocompatibles, American BioSphere, and China Hengrui, their embolic microspheres DC Bead, HepaSphere, and CalliSpheres are all used to treat liver cancer through ionic bonds (mainly) and hydrogen. The bond can be combined with anthracyclines, which can be accurately quantified, and the drug can be released slowly through the ion exchange mechanism after reaching the lesion.

If the microspheres can be loaded with coagulation drugs such as thrombin, it does not need to be released, allowing it to act locally at the target site.

The laboratories of some companies are currently researching such microspheres, and Yang Ping does not know whether they can be developed into clinical use.

If such microsphere products are not available, only traditional coils can be used for embolization.

There are risks in the subsequent embolization of metal coils. After the aneurysm crisis is resolved, Steven will always return to Earth, and it is impossible to stay on the space station for the rest of his life.Falling at high speed when returning to the earth, once the coil moves in the brain, life is also in danger.

Therefore, in the second method, coil embolization, after controlling the condition, in order to smoothly go through the high-speed fall, a craniotomy is required to ligate the artery.

It is simply a fantasy to have a craniotomy on the space station or perform brainstem surgery.

After Yang Ping introduced his idea, he hoped that he could use the first method, which can be done in one go, simple, safe and minimally invasive.

"Either way, I want to know the success rate?"

Professor Massimo has not spoken, he is very disgusted with Yang Ping's self-confidence.

"This is Professor Massimo, the director of the Johns Hopkins interventional department." Johannesson played by ear, and when he encountered something that needed introduction, he would introduce it.

"Hello, Professor Massimo!"

Many of the classic interventions that Yang Ping has seen in the system space are his works, and the latest miniature spring coils that are currently leading the industry are also designed by him.

But now Yang Ping is not in the mood and has no time to praise him.

"Success rate? If you must have a definite number, it should be more than [-]%." Yang Ping can only give a rough idea.

"80.00%?" Massimo almost couldn't help laughing on the spot, and the magic stick didn't dare to brag like that. Whoever Johannesson invited was a magic stick, even if it was [-] to [-]%, Massimo Also willing to listen.

"What's wrong? Professor, what did I say wrong?" Yang Ping felt that his expression was too exaggerated.

"You're not wrong, maybe I got it wrong, how many cases has Dr. Yang done for this type of patient intervention?" Massimo asked in a questioning tone.

At this time, every second counts, the aneurysm in the sky might burst at any time, and you are still arguing with me.

"Professor Massimo! Is this doubting my surgical ability? I don't have time to accept your question. You invited me to Houston to accept your question? Or to help deal with the crisis. If it's the former, I don't have the leisure, believe me. Neither do you, now you have to listen to me, or you can solve the problem by yourself, help me buy a plane ticket, and I will go back to China immediately." Yang Ping is a little impatient, life and death are at stake, so he has the time to talk to you.

Jim Basa felt that although Massimo's entanglement was reasonable, it was meaningless. It was not suitable for the first aid scene at this time. With the endorsement of Johannesson and Mayo, there was no need for any doubts, otherwise he would not be invited.

"The technical implementation of medical rescue follows Dr. Yang Ping's command and does not accept rebuttals and debates." Jim Basa stabilized the situation.

"We immediately contacted BioSphere to ask if there were drug-loaded microspheres for blood clotting drugs." Alpha, NASA's chief medical officer, acted immediately.

The emergency rescue team is directly appointed by the president, and Jim Basa is the team leader. During the emergency, all resources can be dispatched.

This kind of flat crisis management, which directly dispatches resources by the rescue team, is very efficient.

After a few phone calls, it was quickly implemented. The coagulation drug-loaded microspheres researched by BioSphere have not been successful and cannot meet the clinical requirements. At present, there are only microspheres for the treatment of liver cancer.

Then, only coil embolization can be used, and the most urgent problem should be solved first, and the latter problem can be studied later.

"Professor Massimo has more sophisticated intracranial interventional devices." Dr. Eugene reminded everyone.

"If necessary, we will launch another rocket to send the equipment up, but it will take eight hours." Richard felt that rockets could be launched at high density.

"Eight hours is too long, and Steven can't last that long." Yang Ping denied this plan. His simulated surgery and pathological anatomy were very accurate in judging Steven's condition.

"The Russians can deliver it in three hours."

"The stuff is in the US, their rockets are in Kazakhstan."

"Let's start the operation! Just use your existing equipment and prepare to activate the remote surgery system." Yang Ping prepared to operate overnight.

Once by tomorrow morning, Steven will not need rescue and the aneurysm will rupture.

80.00% success rate, Yang Ping refers to the use of remote surgery system.

All the doctors were stunned. The remote surgery system had uncertain communication delays and interruptions. The space station also made the surgical object unstable due to various reasons.

Intervention in this situation, the intervention of small arteries in the brainstem, not to mention the interruption of communication, any delay, blood vessel puncture, and death directly.

But now only he has confidence, there is no other way.

(End of this chapter)