This doctor is very stable

Chapter 106 Interventional Embolization of Hepatic Vascular Tumors
Hepatic hemangiomas are generally benign tumors, and even hepatic hemangiomas with a diameter of less than 5cm do not need to be treated. As long as you maintain a positive and optimistic attitude, they will not cause harm to the human body.

When the hepatic vascular tumor is larger than 5 cm, the preferred treatment is subabdominal minimally invasive resection or direct laparotomy.

It is convenient, simple, thorough, and the operation risk factor is small.

However, Wang Lijun has high blood pressure and high body fat, so laparotomy can easily lead to massive bleeding.

That's why Lin Ran chose interventional therapy. Of course, interventional therapy also has its own limitations.

That is, interventional embolization agents are likely to cause complications, affecting liver function metabolism, abdominal pain, abdominal distension, nausea and vomiting, etc.

Of course, this is also related to the quality of the operation and the amount of embolization agent.

Of course, all surgeries are chosen based on the principle that the benefits outweigh the risks.

For an operation, if it is not beneficial to the patient, the doctor will not choose to perform such an operation.

After Li Canghai gave the anesthetic, Wang Lijun, who was lying on the operating table, soon fell into a deep sleep.

Lin Ran reached out, "Tweezers, alcohol cotton, iodophor."

Femoral artery puncture in the first step of interventional surgery for hepatic hemangioma.

Lin Ran disinfected the base of the patient's thigh.

Interventional surgery is not as open and closed as other surgeries.

They couldn't help Lin Ran until the puncture was completed.

Xu Hong will also do femoral artery puncture, but he will not take Lin Ran's job.

After the puncture is done, there is still operation to follow!
It can be said that there is no point in doing femoral artery puncture for Lin Ran.

Lin Ran was disinfecting, and the nurse set up the angiography equipment at the door, waiting for Lin Ran to complete the puncture.

After finishing the disinfection work, the nurse spreads the surgical towel.

Lin Ran's expression also turned solemn, "The puncture needle."

After receiving the puncture needle, Lin Ran took a deep breath.

The reason why few people do tumor interventional surgery is that the risk of interventional surgery is higher than that of ordinary laparotomy, and the operation is more complicated.

Moreover, Wang Lijun is still a hypertensive patient, and the arteries must be more fragile than ordinary patients, which increases the difficulty of interventional surgery in a tangible way.

You must know that all interventional operations are carried out in blood vessels!

Lin Ran used the thumb and middle finger of his left hand to touch the position below the inguinal ligament to determine the femoral artery point.

Lin Ran began to puncture the needle, starting from the inner thigh from bottom to top at a 45-degree angle.

Following Lin Ran's action, everyone in the operating room couldn't help but hold their breath.

The atmosphere suddenly became tense.

Lin Ran lowered his head, feeling the reaction from the puncture needle in his hand and the middle finger of his left hand.

Skin, fat, tendons, ligaments, fascia, femoral arteries.

The feel of the puncture needle is different for each type of tissue passed through the hand.

Or tough, or soft, or waxy...

Until the puncture needle penetrates the mutual artery point, the feeling of puncture is returned, and the pulsating blood flow is ejected from the puncture needle.

"The puncture was successful."

"A little level!"

…………

Bleeding is essential.

"Establish the intravenous access, the anesthesiologist pays attention to the patient's blood pressure, and prepares the blood transfusion pack."

Lin Ran's voice was neither slow nor slow, with a faint sense of majesty, just like the roar of a lion cub with its own majesty.

After Lin Ran finished speaking, the nurse began to establish the intravenous access and connect the blood bag.

At this moment, Li Canghai did not sit leisurely on the small bench, but stared at the monitor closely.

It is very dangerous for hypertensive patients to experience a significant drop in blood pressure.

Because the heart of hypertensive patients is more adapted to higher blood pressure levels.

Once blood pressure is too low, it is more likely to cause rapid heartbeat and arrhythmia.

"Arterial sheath, ultra-smooth guidewire, catheter."

As Lin Ran took over the arterial sheath, he slowly fed it from the puncture into the femoral artery, and then withdrew the puncture needle.

After Lin Ran completed this step, Chen Qiufeng and Xu Hong's foreheads were already dripping with sweat.

They watched Lin Ran perform the operation, and they were more nervous than when they performed the operation themselves.

On the other hand, Fu Changwen was talking with Yang Xu in a low voice, nodding from time to time.

The difficulty of the operation came. Lin Ran needed to use a super-smooth guide wire to slowly push the catheter along the arterial sheath, femoral artery, and aorta to the hepatic artery.

This process is similar to holding an iron wire through a water pipe, but blood vessels are not water pipes!

The slightest inadvertence in the blood vessel may puncture, causing the artery to rupture and cause massive bleeding.

Moreover, the blood vessels of the human body extend in all directions, even if the barrel is in the wrong position.

While Lin Ran was pushing the arterial sheath at the front end, Xu Hong was holding the syringe connected to the end of the catheter to give the contrast medium with iodine ions.

Their eyes were fixed on the contrast device monitor.

The arterial sheath moves forward bit by bit, and the arterial blood vessels will be displayed on the monitor under the action of the contrast medium. Lin Ran dare not blink to stare at the monitor.

If you want to perform interventional surgery, you must have sufficient understanding of human vascular medicine, otherwise you don't even know which hepatic artery is.

The monitor will not show you which blood vessel is the hepatic artery and which blood vessel is the splenic artery.

This process is also like playing the game King of Glory to explore the map. Wherever you go, the blood vessel vision in the monitor will light up.

If the chief surgeon of an interventional operation gets lost in the densely packed blood vessels, it would be fun, and it would be embarrassing for adults.

Doctors play blood vessels, players play games, it is really possible to get lost when playing for the first time!

At this time, the accumulation of medical knowledge usually comes in handy, just like players do game strategy in advance,
Lin Ran's "Vascular Medicine" is not blind!
It can be said that the body's blood vessels are also distributed regularly in the eyes of doctors. Will the old wet machine get lost in the urban traffic extending in all directions?
Fu Changwen nodded again and again, "There is something!"

Even Yang Xu, who was at odds with Chen Qiufeng, looked at Lin Ran's operation and praised: "Lin Ran's hands are very steady."

Lin Ran steadily manipulated the arterial sheath to approach the hepatic artery bit by bit.

Everyone's eyes moved back and forth between the monitor and the arterial sheath on Lin Ran's hand.

They were all praying silently in their hearts.

'But don't puncture the veins! "

Once the blood vessel ruptures, it is equivalent to the failure of the operation.

Moreover, emergency rescue must be carried out, otherwise the patient will die.

Lin Ran's hand movements were gentle, and the coordination of his hands was very tacit, without any disorder.

Looking at his forehead, there are already a lot of beads of sweat, and some of them flow down the straight bridge of the nose, dripping on the green surgical gown, and finally passing through the air and falling heavily on the floor of the operating room .

Fine operations are the most exhausting, and Lin Ran's nerves are tense now, and he dare not be careless.

Finally the hepatic artery arrived, Lin Ran stopped his hands slowly and said, "Wipe your sweat, slow down."

"Ok."

As early as just now, the little nurse with Taiwan had been staring at the sweat on Lin Ran's face.

Just after Lin Ran finished speaking and dried herself, she immediately squeezed a white towel to wipe Lin Ran's sweat.

After a while, the distribution of the entire hepatic artery will be displayed on the monitor of the angiography machine.

The location of the hepatic hemangioma and the branch arteries supplying blood to the tumor can be clearly seen on the display screen.

Lin Ran continued to slowly push the guide wire and catheter to the most prominent hemangioma.

After accomplishing this step, Lin Ran just paused for a while, and Chen Qiufeng said proudly: "Lin Ran, I did not misread you, haha."

Xu Hong also smiled, and Fu Changwen nodded in satisfaction.

If the interventional surgery for liver tumors can be advanced to this stage, the surgery is considered half of the success.

If after Lin Ran finished this operation, the patient could really recover and leave the hospital, that would be really amazing.

Interventional surgery requires a high level of talent and experience from the surgeon.

In China, only those top tertiary hospitals can perform tumor interventional surgery!Almost none of the top three municipalities can perform tumor interventional therapy.

For five vascular tumors, Lin Ran put on a guide wire and catheter, and Xu Hong gave embolism drugs with a syringe.

Under the attention of everyone, five vascular tumors with diameters greater than 5cm were all embolized sequentially.

The principle of interventional embolization of tumor blood vessels is to directly inject radiotherapy drugs into the tumor through the hepatic branch arteries, and then block the branch arteries that supply blood to the tumor.

Let the tumor gradually necrosis, and then slowly shrink smaller, so as to achieve the purpose of treatment.

After the embolization, Lin Ran began to slowly withdraw the guide wire and catheter. Compared with pushing in, withdrawing would not reduce the difficulty, and withdrawing too quickly would easily cause rupture of the aortic vessel.

until the guidewire and catheter are completely withdrawn.

Fu Changwen applauded.

"Clap clap..."

There was applause in the operating room.

Although an interventional operation is completed, it does not mean that the operation is successful and the patient can be cured fundamentally.

But if you can completely perform one interventional operation, you can completely complete the second interventional operation!

And the application of interventional surgery is also very wide.

It can be said that after Lin Ran underwent the liver tumor interventional surgery, he seemed to have completed a transformation.

This tumor interventional surgery also means that Hengshan City Hospital can also perform tumor interventional surgery!

The application of a cutting-edge surgical method can treat more than one disease.

Liver tumors are just one of them, and interventional surgery can be used for most cancer patients.

Especially for those elderly patients whose tumors are not well located and not suitable for subcavitary and laparotomy surgery, there is an additional option, that is, interventional embolization surgery!
Lin Ran smiled slightly, "I still need the trust and support of Teachers Chen and Teacher Xu to perform this operation. As for the success or failure of the operation, it is still too early to tell. I will continue to proceed cautiously."

"it is good."

Chen Qiufeng shouted softly, and after finishing speaking, he looked at Yang Xu proudly and said with a smile: "Vice President Yang, don't you insist on dismantling our emergency operating room?"

"Hmph." Yang Xu looked at Chen Qiufeng's complacent look, and chuckled, "Old Chen, you are lucky. If I had discovered Lin Ran's talent earlier, why would he be in the emergency room?"

Lin Ran came directly from the cardiothoracic surgery department to the emergency department, and it was Wang Bingsheng, who was under his command, who contributed to the flames. Now Yang Xu can't wait to run to the chest and hang Wang Bingsheng up for a pump. Talent like Lin Ran is under Wang Bingsheng's hands. Working, Wang Bingsheng didn't notice it at all, he was so blind!

(End of this chapter)