"Ruan Bin, you can go with me to find someone. Later, when you have a consultation, you will come with me for a long time. Director Qian said to Ruan Bin. This kind of tricky case is extremely rare, and he asked Ruan Bin to participate with him because he intended to cultivate Ruan Bin.

Let the other party have a long insight, and learn from the elite of each subject.

"Good. Ruan Bin nodded.

Under the call of Director Qian and the organization of the Medical Department, experts from eight departments, including Peritoneal Oncology Surgery, Vascular Surgery, Urology, Gastrointestinal Oncology Surgery, Anesthesiology, ICU, Imaging, Blood Transfusion, and Pathology, formed a multidisciplinary team to conduct eight-department consultation!

The eight-department consultation is really rare in the hospital.

Even Ruan Bin encountered it for the first time.

The main reason is that this patient's condition is more complicated, so so many departments will be consulted together.

Consultation room.

Except for Ruan Bin, the others are basically bigwigs above the deputy director level.

"Look, the results of the patient's abdominal MRI showed that there was an egg-sized tumor in the right upper abdomen, and the main body of the tumor was located in the inferior vena cava, which not only blocked 4/5 of the "main road" of blood return in the lower body of the human body, but also closely related to the surrounding duodenum, kidney blood vessels, liver, pancreas, etc. Director Qian said.

"The tumor is just here in the inferior vena cava, the problem is very tricky!" said the director of the peritoneal tumor surgery with a solemn face.

"I looked at the patient's renal vein just now, and I found that his right renal vein has been invaded, and if surgery is performed, the affected kidney may be removed during the operation! In this way, we need to evaluate the kidney function in the first step and improve the PET-CT examination to rule out the possibility of distant metastases!" said the director of the Department of Urology.

"The tumor is not only located in the inferior vena cava, not only almost completely blocking the inferior vena cava, but also invading outward, and the head of the pancreas, duodenum and liver are not clearly demarcated!

"The patient's tumor invaded the inferior vena cava, and if the tumor is to be completely removed, part of the inferior vena cava needs to be removed!" said the director of vascular surgery.

"How can I remove part of the inferior vena cava?"

"At present, I don't know how the patient's kidney function is, and if it is completely resected at that time, I am worried that it will be difficult to ......."

Many chief experts have told me all about the various 'forbidden areas' and surgical problems of this operation. Everyone's faces became more and more solemn!

This operation is not easy to do.

"Assuming that the patient's kidney function can accept the removal of a part of the kidney, how to deal with the invaded inferior vena cava?" the director of the Department of Urology asked the puzzle.

"I have a way, since the patient's tumor invades the inferior vena cava, if you want to completely remove the tumor, you need to remove part of the inferior vena cava, and then the resected part of the inferior vena cava can be replaced with artificial blood vessels!" Director Qian is worthy of being a general practitioner in the hospital. Artificial blood vessels can be used directly by name.

"However, the scope of vasoresection of the inferior vena cava will be very large, and I am afraid that our hospital does not have a model of artificial blood vessel suitable for the needs of patients!" said the director of vascular surgery. If it is one or two veins, it is estimated that the hospital will have them. But this patient had so many inferior vena cava vessels that they couldn't have all of them!

"Why don't you ask other brother hospitals, and if you have one, borrow it first?" said the director of general surgery, squinting.

"Well, this can be there!"

"Although we don't know how the kidney function is yet, it doesn't prevent us from making a preliminary surgical plan first, and everyone can express their opinions. Director Qian said.

Soon, the crowd began to discuss it again.

Ruan Bin was completely a little transparent, listening carefully.

An hour later, the preliminary opinion of the eight departments of consultation: further improve the relevant examinations, if there is no contraindication to surgery, multidisciplinary combined surgical treatment.

After completing renal function tests, PET-CT tests, On the basis of additional examinations such as CT 3D reconstruction, the directors still formulated a preliminary surgical plan: preoperatively placed a venous balloon on the upper and lower tumors to block venous blood flow in case of emergency, completely free all organs of the right abdomen after laparotomy, completely exposed the inferior vena cava, moved the right kidney to expose the tumor, protected the pancreaticoduodenum, removed part of the liver, resected the inferior vena cava tumor, and replaced artificial blood vessels, and performed advanced life support treatment in the anesthesiology department and intensive care unit......

Seeing this, Ruan Bin had to marvel, he deserved to be a group of big guys. Although the patient's condition is extremely rare, the surgery is completely performed in the forbidden area.

But they also worked out a feasible surgical plan!

Seeing that the preliminary plan for the operation had come out, everyone was relieved. Just wait for the relevant examinations to be further improved, and then the surgical plan will be repaired, and the operation can be performed.

"Let's estimate how long this operation will take?" Director Qian suddenly asked.

The crowd counted again.

"The situation is complicated, there are many surgical procedures, and there are many places that need to be operated, so we estimated that this operation will take more than 10 hours!" said the director of general surgery.

"More than ten hours?" Director Qian frowned after hearing this.

"Can you shorten the time? Control it to about 6 to 7 hours?" Director Qian said solemnly.

He knows that an operation of more than 10 hours is a great test for both the patient and the doctor!

The longer the surgeon's surgery, the greater the physical and mental considerations. The longer the time, the greater the ability of the surgeons to operate.

It is important to know that surgery is a highly focused operation, and the slightest mistake may occur.

Up to 10 hours of high-intensity surgical operation is a big test for any doctor!

Of course, as the chief boss, various expert bosses, they often do seven or eight hours of surgery. Even more than ten hours of surgery have been done.

But if the surgery time can be shortened, of course, everyone will be happy!

It can reduce the risk of patients and make doctors more delicate!

"Shorten the time? I don't think it's likely, we are now evaluating the surgery according to what we can predict, and if there is something we don't know about during the operation, it will take longer!"

"The main reason is that the anatomical structure of the right upper abdomen is complex, and the hepatic artery, portal vein, bile duct, gallbladder, pancreas, duodenum, right adrenal gland, right kidney and blood vessels, inferior vena cava, abdominal aorta and other important organs and blood vessels are closely adjacent, which is very easy to be injured during the operation, and the consequences of the injury are extremely serious, and it is estimated that it will take a lot of time to deal with this piece alone!"

"There is also a close relationship between the right renal vein and the tumor, and the branch blood vessels are directly connected to the tumor! At that time, it is estimated that it will take a long time for us to separate this right renal vein!" said the director of the Department of Urology.

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