Chapter 290 Percutaneous nephroscopic surgery

Director Dou thought about it again and again, and finally agreed with Su Jie's idea.

This is indeed a cost-effective business, and the Department of Urology of Southeast Hospital does have a need to develop percutaneous nephroscopic holmium laser surgery.

The only person who was harmed might be Yamashita Oda who was kept in the dark.

But, as Su Jie said, it depends on whom. For Yamashita Oda, who cares whether he is hurt or not?

Yamashita Oda himself was very satisfied with this proposal and agreed that he would fully assist the Department of Urology of Southeast Hospital in developing percutaneous nephroscopic surgery. Although three weeks was not long, it was enough for him to leave a lot behind.

Su Jie took this opportunity to tell the boss of the Department of Urology that he wanted to learn percutaneous nephroscopic surgery.

The CEO of the Department of Urology hesitated for a moment and said, "Are you going too far? You have just been exposed to rigid ureteroscopy and soft ureteroscopy, and now you have to start learning percutaneous nephroscopy surgery again?"

"This is a rare opportunity. After all, Yamashita Oda is a world-renowned expert in percutaneous nephroscopy. If you have the opportunity to follow him on the stage of percutaneous nephroscopy, you will definitely benefit a lot," Su Jie said.

"That's true."

The CEO of the Department of Urology nodded: "You don't have to go on stage to perform surgeries after learning skills. If you understand the surgical procedures and key techniques a little bit, you won't be confused when you watch Yamashita Oda's surgery."

"Well, that's what I mean." Su Jie smiled.

So in the next few days, the CEO of the Department of Urology took some time every day to teach Su Jie the percutaneous nephroscopic surgery technique in the simulated operating room of the Department of Urology.

Compared with flexible ureteroscopy, percutaneous nephroscopy is slightly less invasive.

Percutaneous nephrolithotomy is clinically also commonly known as ‘punch stone removal’.

As the name suggests, a channel is established in the patient's waist from the skin to the kidney, and a nephroscope is inserted into the kidney through this channel, and the kidney stone is crushed and removed using lithotripsy tools such as laser and ultrasound.

Ureteroscopic lithotomy is somewhat similar to the NOTES technique. It uses the natural orifice of the human body, the urethra, as the approach. No scalpel is used during the entire operation, and no incisions are left on the body after the operation.

But percutaneous nephrolithotomy is different. A hole is drilled directly from the waist to the inside of the kidney. The trauma may seem small, and it is incomparable with the frequent incisions of several centimeters long in abdominal surgery. However, in fact, the risk factor is almost the same.

"The blood flow in the kidneys is very large and the blood vessels are very rich. The blood flow in the kidneys accounts for a quarter of the entire cardiac output. This number is quite impressive."

"Percutaneous puncture directly enters the kidney. Once the puncture is made incorrectly, it is very easy to cause bleeding or subcutaneous hematoma of the kidney. Moreover, once bleeding occurs, it is generally difficult to stop, and the bleeding may even last for more than a week."

"This is a very troublesome complication. For a surgeon performing percutaneous nephroscopic surgery, controlling bleeding is always the most important part of the operation."

The CEO of the Urology Department passed on all his experience: "However, compared with the previous surgical method of incision and stone removal, percutaneous nephroscopic surgery is still much better."

“A few decades ago, if kidney stones were discovered in patients, most patients still used the ‘incision and stone removal’ method. This required a large incision of about 20cm in the patient’s waist, and then cut through the muscles layer by layer to peel out the kidneys.

, then make a small incision in the renal pelvis or renal parenchyma, and then take out the stone."

"I once saw an old patient who had an incision to remove stones when he was young. The scar on his waist almost spread to his back. It looked very huge and hideous."

"It has to be said that patients living in today's world are still happy. Minimally invasive surgery has gradually become mainstream, and patients often only need to pay a small price to regain their health."

Su Jie then said: "It will get better and better in the future. Maybe in a few decades, it will be like what is shown in science fiction movies. When you get sick, you take a robot pill bag and it will directly enter the body to perform the surgery."

It’s done.”

"It's too exaggerated." The boss of the Department of Urology blinked his eyes, somewhat unable to accept it.

"Doctors from decades ago, would they be able to accept today's 'punching holes to remove stones'? To them, we are probably a science fiction film," Su Jie said with a smile.

"That's true..."

After briefly introducing the relevant knowledge of percutaneous nephroscopy, the manager of the Department of Urology directly took out a set of simulation equipment and personally demonstrated the surgical procedure to Su Jie.

In fact, whether it is percutaneous nephroscopic surgery or ureteroscopic surgery, the most important part is the lithotripsy part in the middle. For the previous mixed stones, Su Jie has mastered various holmium laser lithotripsy techniques.

Therefore, the CEO of the Department of Urology directly focused on 'channel establishment'.

“One of the difficulties in percutaneous nephroscopic surgery is ‘channel establishment’.”

"The surgeon must ensure that bleeding is avoided and the stone must be removed cleanly. The two are actually opposites, but the surgeon needs to unify the two."

"Determining the location and diameter of the channel based on the location, size, number, and composition of the stones all test the surgeon's experience and operation."

As the CEO of the Department of Urology was talking, he started to demonstrate the key points of renal puncture to Su Jie. Su Jie watched carefully from the side, not daring to be distracted in the slightest.

Time for learning always flies by. Su Jie himself has ample experience in various types of surface punctures. Although he has never been exposed to renal punctures before, he is often familiar with this type of operation. The boss of the Department of Urology only demonstrated it.

After a few times, Su Jie gradually started to feel comfortable with it.

Regarding Su Jie's learning speed, the boss of the Department of Urology just smiled bitterly and said: "Dr. Su, being your teacher is really a very unfulfilling thing..."

"No." Su Jie smiled shyly.

After teaching Su Jie the most basic operating procedures of percutaneous nephroscopy, the manager of the Department of Urology went back to the department to continue his work, while Su Jie stayed and continued to familiarize himself with percutaneous nephroscopy.

After practicing several times in the simulated operating room, Su Jie entered the virtual operating room again and tried a 100% realistic renal puncture and catheterization on a real simulated person.

Su Jie was pleasantly surprised by the effect of [Bloodless Renal Puncture (Master Level)].

The CEO of the Urology Department said that one of the biggest problems with renal puncture and catheterization is puncture bleeding, but with the help of the system, Su Jie was able to vaguely see the red blood flowing in the kidneys on the B-ultrasound display.

By avoiding the direction of blood flow and puncturing through the gap, the bleeding rate is indeed greatly reduced.

However, Su Jie made slow progress in a short period of time on how to balance the contradiction between reducing bleeding and removing stones. This requires a lot of experience accumulation and a long period of operation time.

But for Su Jie, this is just a matter of thousands or tens of thousands of points.
Chapter completed!