godfather of surgery

Chapter 416 The Three Snakes

David Hawley went out, checked the MDM, it couldn't be repaired, it could only be replaced.

Fortunately, the Russian Soyuz rocket was extremely powerful and unambiguous, and completed the docking in three hours and forty minutes, completing a space express mission.

Finally, David Hawley and the Russian astronauts, relying on the safety rope, completed the space walk, replaced the electrical components, and the power system was guaranteed.

The whole process took a full five hours.

Stable voltage, so that the control of the robot arm will not worry about downtime.

The operation can continue, but there is not much time left for Yang Ping.

On the angiogram of the whole cerebral blood vessels, the microaneurysm has expanded to the limit and will burst at any time. The second one has begun to expand rapidly, and the third one is also looming.

IBM's Wall was right, he did have a second aneurysm, and Yang Ping was even more right, the third one was already looming.

"According to the speed at which he entered the vascular network in the brain for the first time, it would take at least half an hour to solve one aneurysm. Now there are three, which is not enough time." Johannesson also became worried. After all, there are three now, and it needs to be solved at one time.

Left femoral artery, right femoral artery, left radial artery, three arteries were punctured at the same time!Yang Ping ordered Susan to change the equipment.

Puncture at the same time?This is to put three guide wires in at the same time?how can that be possible.

Massimo looked at the screen, then looked around the hall, surprised that he wasn't alone.

But Yang Ping's voice came out on the radio: puncture from three parts, and put in three micro-guide wires at the same time.

At the same time, the three guide wires shuttle through the blood vessels of the human body, enter the intracranial vascular network, and finally reach the target arteriole.

This requires the surgeon to be very familiar with the patient's intracranial vascular access, how tens of thousands, hundreds of thousands, and millions of blood vessels intertwine, how they bifurcate, and how they form circuits. No human anatomical knowledge can do this.

The surgical robot has four robotic arms, and only two robotic arms are needed to complete the intervention. Wouldn't it be a waste of time to perform operations in batches?

If the three robotic arms operate at the same time, the operation time is short, which in a sense minimizes the risk of surgery.

But three guide wires enter at the same time, which is a fabulous operation.

In interventional surgery, there are also two guide wires, such as the double guide wire technology for cardiac intervention, but it is completely different from the current three-pronged approach.

In cardiac intervention, there is a double guide wire technique, such as during percutaneous coronary intervention, a 0.36 mm coronary guide wire is placed along the first coronary artery guide wire, which can guide the catheter stably , to help the balloon and stent pass through the lesion, which is the partner guide wire technology.

During the percutaneous coronary treatment of bifurcation lesions, in order to protect the coronary artery branch vessels, a coronary guide wire is placed. After the stent is released, the guide wire between the vessel wall and the stent is withdrawn. This is called the protection guide wire technique.

In the percutaneous coronary artery treatment of chronic total occlusive lesions, when the first guide wire enters the subintimal space, it remains in place as a false lumen marker, and then the second harder guide wire is sent to the true lumen, which is parallel Guidewire technology.

No matter what kind of double guide wire technology, the other is an auxiliary, not three guide wires independently treat different targets.

But Yang Ping seems to want to do this now!
It is extremely difficult for one guide wire to be safely sent to the arterioles of the brainstem. Now it is necessary to send three guide wires at the same time, and the paths they pass cannot be repeated, crossed, or touched. This kind of route planning ability is already artificial intelligence. level, not human effort.

Professor Eugene changed places and sat with Johannesson and Massimo.

"Are you sure that his three puncture points started at the same time and operated at the same time?" Massimo asked.

"It shouldn't be possible. The two guide wires should be the same as our dual guide wire technology, playing an auxiliary role, right?" Eugene judged.

"No, just now Dr. Yang said that the three guide wires need to be operated independently at the same time, and each has its own goals. He wants to solve three aneurysms at once." Although Johannesson didn't believe it, he did hear that Yang Ping just said so. Said.

He is going to embolize three aneurysms at the same time, at the same time, yes, at the same time, which will be the first in the world.

The three manipulators operate independently, and the remaining one is an assistant. What an international joke.

When everyone is puzzled, all speculation is unnecessary.

Under the control of the robotic arm, the three guide wires have started to enter along the blood vessels at the same time, trekking over mountains and mountains, and approaching the intracranial blood vessel network step by step. They start from different paths and have nothing to do with each other.

All roads lead to Rome!
The same is true for the blood vessels of the human body. The essence of intervention has been grasped by Yang Ping.

Ink-like whole brain angiography image, the three guide wires are scrambling to advance along the blood vessels like a race.

This extremely slippery loach guide wire is very smooth in Yang Ping's hands. Every time he encounters a fork, no matter whether the angle of the fork is obtuse, acute or right, the miraculous guide wire can easily cross it.

The three guide wires are like nimble and greedy snakes, and every super-selection is so magical and wonderful.

However, those three thread-like greedy snakes entered the depths of the human brain, going deeper along the complex blood vessel network.

The surgery demonstrated on the entire screen was like a game. The snake dexterously moved around, which made the audience extremely uncomfortable. Some people felt that the three tiny things were moving around in their bodies, causing spasms of pores and numbness of the scalp.

The largest aneurysm may be approaching its limit, and GG's artificial intelligence keeps flashing red lights to remind the blood vessel that it may explode at any time.

And the second one has also swelled up, and the third one has just taken shape, and the speed of expansion is faster than the first two.

There is a limit for the guide wire to enter the blood vessel. This limit is not only related to the thickness of the diameter, but also related to the accuracy of the doctor's control of the guide wire. There are impassable forks.

Not all target vessels can be reached, and not all aneurysms are suitable for intervention.

"Three guide wires entered the brain at the same time? Pointing to three different aneurysms." Massimo finally believed that this was a high-dimensional creature, and he was incomparable.

Three guide wires go in at the same time, no doctor in the world dares to do this, and no doctor can do it, but Steven needs to do it now, this is the only hope.

If it wasn't for an accident, Dr. Yang would have enough time to solve the aneurysms one by one, but an accident took more than five hours, leaving him with only one hour, maybe not even one hour.

He has no other way but to use three prongs.

The natural advantages of the mechanical arm are brought to the extreme in Yang Ping's hands, just like any other equipment in his hands will inevitably be brought to the limit.

Level-by-level blood vessels go deep, and the smaller the inner diameter of the blood vessels, the more complicated the communication with each other, and the more difficult it is to identify the path.

For some well-known blood vessels, the descending series is very simple, but now the blood vessel that Yang Ping wants to enter is already an unknown artery, and the descending series is already unknown how many layers.

This kind of intervention can clearly find the target blood vessel without getting lost, which is one of the few in the world, and Massimo is one of them, but he just touched the handle of the door.

The operation at this time requires the surgeon to study the brain, especially the blood vessels in the brainstem, higher than all existing anatomical studies.

No doctor can achieve this level of anatomy, including surgeons, interventionalists, and physicians, and professors who study human anatomy in medical schools. This requires researchers to have a large number of "general teachers" to study, and no one has the ability. this condition.

The total length of blood vessels in the brain, arteries, veins and capillaries, and the entire vascular network are 160 million kilometers in a straight line, and a week of the earth is only [-] kilometers. What a complicated network this is.

People's research on this vascular network is far from enough, and they still stay on some main roads.

From the centimeter level, to the millimeter level, and then to the submillimeter level, the three guide wires are constantly sinking, and it must reach the target within the last half an hour to complete the task.

This is its only chance and its last chance.

Massimo curled up. In the warm hall, he was like a patient with a high fever. The cold hit him one after another and quickly spread throughout his body. If he could, he wanted to wrap himself in a thick quilt.

High tension not only consumes adrenaline, but also consumes a lot of calories due to the evaporation of sweat and excessive continuous contraction of muscles.

"He really tackled three aneurysms at once, he really manipulated three guide wires at the same time!" Massimo murmured.

Johannesson saw Massimo's eyes, which were his own eyes, empty and empty, as if all the glory and glory of the past were now wiped out.

"As I said, he is one dimension higher than us." Johannesson was relatively calm, he had already experienced a temper.

Dr. Eugene is not much better than Massimo: "He controls four robotic arms with two hands, three robotic arms for the main surgeon, and one robotic arm for the assistant."

Dr. Eugene's words remind everyone that the four robotic arms are controlled by Yang Ping's two hands.

But there is no slight rhythm out of touch. Every time, one guide wire slows down and stops when it crosses the fork, and the other two rush forward at high speed. fork.

Just like an acrobat throwing several balls at the same time, Yang Ping manipulates four robotic arms with two hands. There are always two robotic arms moving and two robotic arms resting. Pause and turn.

The mechanical arm that rotates at any angle makes the guide wire more flexible than manual manipulation.

The wire speed is getting slower and slower, but it never loses the flexibility and precision it should have.

Because the blood vessels are getting thinner and thinner, any rough operation will be fatal, and any fast and large range will make the guide wire difficult to control due to inertia, so it must be slow now.

At the same time, the more length the guidewire is released, the more difficult it is to control the direction of the tip.

The blood vessels became thinner and thinner, and the guide wire kept sinking, like a submarine sinking deeper and deeper, until it reached the deepest seabed.

The deeper, the thinner, the more dangerous, the more difficult to control.

This depth, this sinking, with no turning back, is either successful or fatal.

This is why Yang Ping is unwilling to operate when the voltage is unstable. He must kill with one blow, without any chance of turning back, and without any possibility of remedy.

Success or failure, just this one time, life or death, just this one chance, blood vessels that have sunk deeply to the level of the brain stem, there is no chance to quickly withdraw the guide wire.

"He is still not lost. In the maze-like network of blood vessels, they each follow the nearest route."

Massimo didn't even dare to breathe too much or too fast. This is the most critical moment. He used the thinnest guide wire and with the help of various auxiliary equipment to intervene in the central blood vessels of the monkey's brainstem life. , Up to here, I don’t know how many monkeys have been killed.

On the huge and clear screen, three filaments are greedy for snakes, winding and twisting.

Everyone held their breaths intently, unexpectedly they have penetrated so far.

At this time, don't make any problems!

　Originally, last Sunday was a break, and I wanted to make a big update, but the work task was postponed, and the break was gone, and I haven’t had a break since I came back. The promised 1-word supplementary update has not been fulfilled, so I am powerless, brothers!I will definitely make up for it when I pick up a rest day.Regarding the case of the International Space Station, it was inspired by a real event. During a routine self-examination on the space station, an astronaut found a thrombosis in the left internal jugular vein. On Earth, this disease is also very troublesome, and 10.3% of patients will develop lung cancer. Embolism, the 44% mortality rate is chilling, and the doctors on the ground are terrified. Dr. Stephan Moll from the School of Medicine at the University of North Carolina at Chapel Hill was invited to help diagnose and treat this doctor. Medicine, after a thrilling treatment, the astronaut returned to Earth safely.The ISS medical emergency was written up as a case report and published in the New England Journal of Medicine (NEJM).

　　
　
(End of this chapter)