Back in 2002 as a doctor

"No..." Academician Chu replied.

After all, endoscopic duodenal papillary myotomy has secondary damage. Academician Chu originally had to wait until he became proficient in this step.

"Is everything all from Olympus?"

"Yes."

"Then I say, you do it. Don't worry, endoscopic duodenal papillary myotomy is very simple."

"and then?"

"Cut it open, clamp the broken guide wire and take it out. If you don't take it out, it will go down the digestive tract by itself in 3-5 days."

"!!!"

Although Academician Chu knew that it was possible for the broken guide wire to go down by itself with the peristalsis of the intestinal tract, how could he feel relieved.

What if the pestle breaks?

"Do you have headphones?" Zhou Congwen asked.

"No, what do you want headphones for?"

"Academician Chu..." Zhou Congwen was obviously very helpless. He sighed, but he still remained calm, gentle and even said respectfully, "The patient should not be under general anesthesia. Besides, it's not bad for your students and nurses to hear you. OK."

Academician Chu was not angry when he heard what Zhou Congwen said, but had boundless hope in his heart.

Zhou Congwen was indeed thinking of himself, and he was full of confidence, maybe it might be a trivial matter for him to cut it open.

But when he thought of the broken wire, academician Chu lost all confidence.

"Xiao Zhou, then... I have a background in internal medicine."

"Academician Chu, look at what you said." Zhou Congwen said with a smile, "Circulatory medicine is also internal medicine, and now more and more coronary operations are being done. The first people who died of surgery were old, and they have practiced it. It's okay, Do not worry."

Is this persuading yourself?Academician Chu was taken aback.

Regardless of others, you can't kill people under your hands!Academician Chu thought to himself.

Chapter 1140 The Soothing Confidante

"Tell me the specific situation first." Zhou Congwen didn't waste time, and asked directly about the operation.

Although thousands of miles apart, neither Zhou Congwen nor academician Chu seemed to find anything strange.

They seem to be pulled into an inexplicable space by a strange force, and they are communicating face to face.

Academician Chu wanted to briefly talk about what he saw, but Zhou Congwen kept interrupting him, inquiring deeply about the local anatomical structure, and even the color, shape, and angle of muscle deformation of some anatomical structures.

For a moment, Academician Chu even had a feeling that Zhou Congwen was making things difficult for himself on purpose.

The anatomical structure is easy to see with the eyes, but it is difficult to describe it in detail.Especially Zhou Congwen's question was tricky, academician Chu was born in internal medicine.

What Zhou Congwen asked was that these things were difficult for Academician Chu.

Fortunately, Zhou Congwen didn't seem to have any embarrassing thoughts. When Academician Chu stuttered and couldn't answer, he would throw out a few alternatives.

It's a lot better when quizzes become multiple choice questions.

After describing everything, Zhou Congwen's hearty voice came, "Then go on stage. By the way, Academician Chu, you can hold the phone on your shoulder and talk every step. It doesn't matter if you keep your voice down, I can hear you.

The operation may be a little inconvenient, but the operation is still simple, so you don't need to think too much. "

"..." Academician Chu was silent.

"During the operation, I try to keep my voice as low as possible. If you can't hear clearly, just cough."

Academician Chu couldn't laugh or cry when he heard Zhou Congwen say that, but he was a little moved after thinking about it.

When I first stepped into the clinic, the teacher led the rounds. Even if there was any mistake, the teacher would not say it face to face. Even if I returned to the doctor's office and the teacher scolded me, I would not embarrass myself in front of the patient. .

At the very beginning, Academician Chu didn't think anything, only thought that the teacher had a good temper.

But after decades of clinical work, he gradually understood and further understood the truth behind this behavior.

Doctors must ensure authority in front of patients.

If the superior doctors keep denying, denying, and denying the operations of the subordinate doctors and even the nurses, the clinical work will become more and more difficult in the future.

As for the patient's doubts and the increasing difficulty of work, coupled with the impact of the superior doctor's negation on the little doctor, you can think of it with your toes.

Zhou Congwen is really an old clinician, he can't tell at all that he is just a freshman in the third grade, and he hasn't received the attending doctor yet... No, the attending doctor seems to have made a special application for him by Mr. Huang, and Academician Chu suddenly lost his mind.

"Academician Chu, are you ready? If you are ready, go ahead. I want a push electric knife." Zhou Congwen's voice came.

"I'll go right away." Hearing Zhou Congwen's voice, Academician Chu felt inexplicably ashamed when he thought of the fact that he had directly slapped the assistant and the nurse when the operation went wrong a few days ago.

Although the theory is well understood, it is very difficult to implement it.

Especially when the operation is not going well, the whole person is in a state of stress, the mitochondria are running at high speed, and the ATP high-energy phosphate bonds are crackling to release energy. Normal people are stimulated by that energy and hormones, and their emotions will be high.

After thinking about it, Academician Chu walked back to the operating room.

The atmosphere in the operating room was relatively deserted, and everyone was very nervous.

Especially the assistant who made a mistake was even more silent.Not to mention talking, he didn't even have a single unnecessary movement or expression, he just hoped that Academician Chu would completely forget himself.

Seeing Academician Chu walking in with his mobile phone, who seemed to be still chatting with someone, Mo Yang with a relaxed face, the head nurse and the others were stunned for a moment.

This is not in line with surgical norms!

But Academician Chu's status is so transcendent that no one dares to question it.

The most important thing is that Academician Chu did not have a straight face, but a gentle chat, and everyone felt confident in an instant.

"Prepare the push electric knife." Academician Chu smiled at the head nurse and said warmly.

The head nurse shuddered.

Academician Chu is very serious when doing ERCP, so serious that his face seems to be covered with frost, the frost that will not melt for thousands of years.

That was when the operation was relatively smooth and there were no major setbacks.

But today, the guide wire broke and fell into the bile duct. It's hard to say whether academician Chu will run away on the spot for such a big event.

The head nurse had already made countless guesses when Academician Chu went to call, but she just didn't expect him to smile at her.

"Don't stand still, go and prepare things." Academician Chu seemed to have returned to that gentle and intelligent top expert in gastroenterology.

The head nurse hurriedly turned around to look for the push electric knife.

Because the operation did not expect the guide wire to break, even Academician Chu was not familiar with ERCP surgery, and the head nurse did not know what to prepare. There was no push-type electrosurgical knife in the storage cart.

"Don't worry, slow down." Academician Chu was very gentle after making a phone call. He said with a smile, "Go to the warehouse and remember to ask for Olympus."

After finishing speaking, Academician Chu held the mobile phone in one hand and said to the patient, "Your situation is quite special, you know."

"I know, I went to several hospitals and said that I need many needles for this disease."

Academician Chu knew that the patient's needling meant percutaneous puncture.

"And I still don't know how many needles to get. A doctor told me that the last patient had more than 20 needles but couldn't find the place. And even if they found a way, they didn't know much. It counts as much as it can be drawn out, because there are stones in it. "

The patient said honestly.

"Well, the operation is more troublesome than I imagined, but don't worry." Academician Chu said with a smile, "Just keep this posture, are you tired?"

"Not tired."

Others in the operating room looked at each other.

At first, everyone guessed that Academician Chu should be looking for foreign aid. After all, his son works at the Mayo Clinic, the best in the world. Looking for a world-class ERCP surgeon to give advice can be regarded as a group of relatives and friends.

Unexpectedly, academician Chu walked in with his mobile phone, as if he was a different person, and forced him gently.

Could it be an old lover?

Being able to soothe the irritability caused by surgical mistakes, and make Academician Chu who was already on the verge of eruption calm again, probably not a young lover, but an old lover who knows Academician Chu well.

The reason why he never put down his phone is because he wants to feel the breath of the other side through the phone.

Even just the sound of gentle breathing can relax Academician Chu's tense and anxious nerves to a certain extent.

Everyone was guessing wildly, and some even envied Academician Chu for having such a confidante.

The head nurse fetched the Olympus push electric knife, Academician Chu held the mobile phone between his head and shoulders, and put on sterile gloves.

"Start now."

Chapter 1141 Success!

"2/3 of the steel wire of the push-type electric knife is outside the RT of the duodenum. Let me add a word. If you use a pull-type electric knife, make 1/3 of it outside the RT, and ensure that the direction of the steel wire is in line with the direction you want to cut. In the same direction."

Zhou Congwen's voice came over the phone.

The voice was warm and warm, and it seemed that there was a magical power to drive away the anxiety in Academician Chu's heart.

Academician Chu felt at peace and tranquility, and he sent the push electric knife in the way Zhou Congwen said.

"Mixed current is often used for cutting current, and the current intensity is about 3 or between 20-30W."

"Don't worry, I don't know the situation on your side, come a little bit."

"If there is no accident, just do as I said, and ask anytime if you don't understand."

Zhou Congwen's explanations are simple and easy to understand, and ordinary people can complete the operation step by step according to his words.Although Academician Chu is still in the groping stage of ERCP surgery, he is an academician of the Chinese Academy of Engineering after all, with a very high basic quality.

He didn't speak, just coughed to signal that he understood, and then asked the head nurse to adjust the energy of the electric knife.

"Sparks appear after 1-2 seconds of electrification, and the tissue turns white. Gradually push or pull out the electric knife, so that the steel wire is in light contact with the RT mucosa, and maintain a certain force, and gradually cut the RT sphincter."

According to Zhou Congwen's description, Academician Chu pressed the button outside his body.

In the duodenoscope, sparks appeared in the head of the push electric knife.

As Zhou Congwen said, the tissue at the large RT of the duodenum gradually turned white.

The energy used by the push electric knife is not strong. Academician Chu knew that Zhou Congwen left a lot of room for trial and error.

Once the situation is different from what he described, he can ask questions at any time.

The steel wire made light contact with the RT mucosa, and academician Chu pushed and pulled out the electric knife little by little.

The small blood vessels were "coagulated" by the energy conducted by the electric knife before they even had time to bleed, and there was no such a bloodstain as Academician Chu thought.

It turns out that there is no difficulty in using the electric knife like this. Academician Chu gradually gained confidence as he worked on it.

Confidence comes from the fact that the situation on the RT sphincter is completely consistent with what Zhou Congwen described.

There were no accidents, everything went according to plan; and with strong support behind, what did Academician Chu have to worry about?

Chu Yuntian is right, Zhou Congwen can even do DK-crush surgery, this little surgery is nothing to him.

"The length of the incision is based on the length of the bulge on the side of the RT mouth, which is generally about 1-1.5cm. If you want to remove the broken guide wire by yourself, I recommend that the incision be at 1.5cm."

"If it goes well, you cough." Zhou Congwen's voice came out.

"Cough cough."

"That's good, don't worry about it. According to your description, the stone in the common bile duct is less than 1.0cm, and you can use the basket to remove the stone directly."

"Don't worry about the broken wire, just get the stone."

Academician Chu held his mobile phone in his hands, his posture was a bit awkward, but he operated step by step very steadily.

Zhou Congwen has made it so clear, and the operation is indeed not difficult. If he still can't do it, Academician Chu feels that he can really retire.

"You are doing it, I will say a few words casually."

"If the stones are larger, about 2.0cm, insert a lithotripter to crush the large stones, and then take them out with a stone extraction basket.

If there are many stones in the common bile duct, especially small stones, a balloon can be used to remove the stones. "

"Getting stones is very simple, just take it easy and take it step by step."

Academician Chu's restless heart was soothed by Zhou Congwen's confident words, and he calmed down, and began to use the net to fetch stones.

People in the operating room looked at the screen in astonishment. Academician Chu's operation seemed to be more stable than usual.

Although it is not a delicate operation, but...is it really okay to cut the RT sphincter directly with a push electric knife?

The doubts have long been shattered by academician Chu's confident operation.

Even the strange behavior of Academician Chu holding his mobile phone "reluctantly" while listening to the breathing of the "old lover" on the other side of the phone while performing surgery is a sign of self-confidence in everyone's eyes.