The Godfather of Surgery

Under the guidance of the fighter plane, the plane entered the sky over Alaska, made contact with the tower of Fairbanks Airport, and landed smoothly.

The manager of the airport boarded the plane with several staff members, expressed his intentions to Yang Ping, and led Yang Ping to transfer to the special plane that had been prepared. This special plane will fly directly to Houston.

They were very warm and thoughtful. I heard that there were three people who had prepared three coats to let Yang Ping and the three of them take shelter from the cold temporarily. There was still a little distance from one plane to another, and they had coats to keep them warm on the way, so that they would not suddenly feel too cold.

Fairbanks is close to the North Pole, and the average air throughout the year is relatively low. It is really cold when you get off the plane.

Emergencies in international space are now the hottest news in the United States, even in the far-flung Fairbanks, everyone knows it.

Knowing that Yang Ping was going to Houston to participate in Steven's rescue on the International Space Station, the black manager told Yang Ping that after completing the mission, he would definitely come to Fairbanks to play. Venison and king crab, and also enthusiastically left Yang Ping's phone number.

The sky was already a little dim, and everyone raced against time, so they did not dare to waste time, and immediately boarded the special plane and rushed to Houston.

By the time we got to Houston, it was late at night, and Jim Barça was waiting at the airport with Johannesson and several other officials.

This is the world's top expert recommended by Mayo Johanneson. He is even more top-notch than Johanneson. He is regarded as a teacher by Johanneson. He is not as famous as meeting him.

With Johanneson's status in neurosurgery in the United States, he strongly recommended Yang Ping, and Jim Basa dared to rely on Yang Ping to fight hard.

The commercial vehicle rushed them to Space City, the ground control center of the Johnson Space Center, where the lights were on all night.

The emergency rescue team has already set up the ground bunk for the march here. Those who want to rest can lie down for a while, and everyone takes turns to work 24 hours a day.

Yang Ping stepped into the hall of the ground control center. The large and small screens, the busy staff, and the sound of keyboard tapping all indicated that this was the contact center between the United States and the International Space Station.

I heard that Dr. Yang is here. There are nearly 100 doctors, engineers, and ground control center staff.

Finally got to see the expert Johanneson highly admired, just much younger than I thought.

In extraordinary times, there is no time to waste time to introduce each other, and the condition has been communicated many times. Johanneson went straight to the topic and brought Yang Ping to a screen, and the doctors also gathered around.

Blood pressure is 85/40mmHg, heart rate is 38 beats per minute, nifedipine is currently used for controlled blood pressure reduction, and the head is cooled by an ice cap. Johannesson said the most important thing.

Yang Ping entered the state as soon as he took his seat. He had already consulted Steven's medical records on the plane, and now he was just reviewing it.

On the special plane that came to Houston, Yang Ping had already replicated Steven's experimental body in the system space to perform simulated surgery. The powerful replication capability of the system space could not only replicate the case, but also the surgical equipment and environment.

Yang Ping has simulated two scenarios, using telemedicine surgical equipment and operating directly on the space station.

Yang Ping is also the first time he has encountered such a strange case. In human history, Steven is probably the first astronaut in space to need surgery, and there are many things to explore.

This is the whole-brain DSA that our astronaut Dr. Susan did to Steven on the space station. The imaging quality is not very good. Johanneson opened the DSA image.

The image quality is too poor, but it is enough to diagnose a small aneurysm. This artery is too dangerous. It crosses the heartbeat center of the medulla oblongata. Once it explodes, it will be fatal immediately. Immediately, an interventional operation will be performed to embolize the aneurysm. Everyone is a doctor, or A first-class doctor, Yang Ping goes straight, and there is nothing to detour.

The MRI and CT cerebral angiography on the ground showed no abnormality. It should be an occult cerebral aneurysm. The initial symptom was a slow heart rate, and the headache, dizziness, and hypoxia suffocation only occurred a few days ago. Johanne Sen continued to introduce his condition.

Yes, occult cerebral aneurysms, in a microgravity environment, the loss of normal gravity on the earth, the venous return of the head becomes difficult, relative venous stasis and arterial congestion occur, occult aneurysms appear under higher blood pressure , it interferes with the heartbeat center and causes myocardial depression, which is central myocardial depression, and surgery should be arranged as soon as possible, what drugs, equipment and medical conditions do you have on your space station, give me a detailed list, be quick! Yang Ping was too late! Lecture, Steven can't wait.

Interventional surgery must be performed. It is better if there are drug-loaded microspheres in this area, especially the flexible stent-loaded microspheres, which adsorb the coagulation drugs and deliver them to the location of the hemangioma. The coagulation drugs carried by the microspheres gradually trigger the coagulation mechanism locally. When a thrombus is formed, without blood flow, the aneurysm will naturally not have the impact of blood flow, and there will be no rupture. After two weeks, the thrombus becomes an old thrombus, with increased stability and can withstand high-speed falling belts when returning to the earth. shock to come.

Companies with relatively mature drug-loaded microsphere technology include Biocompatibles in the United Kingdom, BioSphere in the United States, and Hengrui in China. Their embolizing microspheres DC Bead, HepaSphere, and CalliSpheres are all used for the treatment of liver cancer, through ionic bonds (mainly) and hydrogen The bond interaction with anthracyclines can be precisely quantified, and the drug is slowly released through an ion exchange mechanism after reaching the lesion.

If the microspheres can carry coagulation drugs such as thrombin, there is no need to release them, allowing them to act locally at the target site.

Some companies' laboratories are currently researching such microspheres, and Yang Ping does not know whether it can be developed for clinical use.

Without such microsphere products, only conventional spring coils can be used for embolization.

There is a risk of subsequent embolization of the metal coil. After the aneurysm crisis is resolved, Steven will always return to Earth, and it is impossible to stay in the space station all his life. Falling at a high speed when returning to Earth, once the coil moves in the brain, it is also life-threatening.

Therefore, the second method, coil embolization, after controlling the condition, in order to successfully pass through the high-speed fall, a craniotomy is required to ligate the artery.

Craniotomy on the space station, or brainstem surgery, is simply impossible.

After Yang Ping introduced his ideas, he hoped that the first method could be used once, which is simple, safe and minimally invasive.

Either way, I want to know the success rate?

Professor Massimo has not spoken, he is very disgusted with Yang Ping's confidence.

This is Professor Massimo, director of the Johns Hopkins Interventional Division. Johanneson acted on a whim, and introduced him when he encountered something that needed to be introduced.

Hello, Professor Massimo!

Many of the classic interventions Yang Ping has seen in the system space are his works, and he also designed the latest miniature spring coils that are currently leading the industry.

But now Yang Ping has no mood or time to praise him.

Success rate? If you have to have a certain number, it's more than 80%. Yang Ping can only give a rough idea.

Eighty percent? Massimo almost couldn't help laughing on the spot, and the magic stick didn't dare to brag like that. Whoever Johannesson invited was a magic stick, even if it said 30 to 40 percent, Massimo was also willing to listen.

What's wrong? Professor, what did I say wrong? Yang Ping felt that his expression was too exaggerated.

You're not wrong, maybe I heard it wrong. How many cases has Dr. Yang performed interventions for such patients? Massimo asked in a questioning tone.

At this time, every second counts, the aneurysm in the sky might burst at some point, and you are still arguing with me.

Professor Massimo! This is to doubt my surgical ability? I don't have time to accept your questioning. You asked me to come to Houston, do you want to accept your questioning? Neither do you, now either listen to me, or you can solve the problem yourself, help me buy a plane ticket, and I will go back to China immediately. Yang Ping was a little impatient, life and death were at stake, so he had time to bullshit you.

Jim Bassa felt that although Massimo's entanglement was reasonable, it was meaningless. It was not suitable for the emergency scene at this time. With the endorsement of Johanneson and Mayo, there was no need for any doubts, otherwise he would not be invited.

The technical implementation of medical rescue, follow the command of Dr. Yang Ping, and do not accept refutation and debate. Jim Bassa stabilized the situation.

We immediately contacted BioSphere and asked if there were microspheres loaded with blood clotting drugs. NASA Chief Medical Officer Alpha acted immediately.

The emergency rescue team, directly appointed by the president, with Jim Bassa as the team leader, can dispatch all resources during extraordinary times.

This kind of direct dispatch of resources by the rescue team, flat crisis management, is very efficient.

After a few phone calls, it was soon confirmed that the coagulation drug-loaded microspheres researched by BioSphere Company have not yet succeeded and failed to meet the clinical requirements. Currently, there are only microspheres for the treatment of liver cancer.

Then, we can only use spring coil embolism, solve the most urgent problems first, and then study the later problems.

Professor Massimo has more sophisticated intracranial interventional instruments. Dr. Eugene reminded everyone.

If necessary, we will launch another rocket and send the equipment up, but it will take eight hours. Richard feels that the rocket can be launched at a high density.

Eight hours is too long, and Steven can't last that long. Yang Ping denied this plan. His simulated surgery and pathological anatomy were very accurate in judging Steven's condition.

The Russians can deliver it in three hours.

The stuff is in America, their rockets are in Kazakhstan.

Let's start! Direct surgery, just use your existing equipment and prepare to open the remote surgery system. Yang Ping was preparing for overnight surgery.

Once it waits until tomorrow morning, Steven will not need rescue and the aneurysm will burst.

The 80 percent success rate, Yang Ping refers to using the telesurgery system.

All doctors were stunned. The remote surgery system had uncertain communication delays and interruptions, and the space station was also unstable for various reasons.

In this case, the intervention of the arterioles in the brainstem, let alone the interruption of communication, any delay, the blood vessel will be punctured, and the death will be immediate.

But now only he has confidence, there is no other way.