Since 1981 Health School

Chapter 554 Accidental Esophageal Perforation

Chen Qi's endoscopic surgery takes about 50 minutes on average.

After one morning, 5 surgeries were done with ease, and Chen Qi showed the group of colleagues from the United States what "Hua Guo Speed" is.

When the foreigners were eating lunch, their mentality was actually broken. Many people sat in twos and threes and talked softly:

"John, are you surprised? That's what endoscopic surgery can do?"

"It's not surprise, it's just shock. I feel like I've learned a lot of shit after studying endoscopy for so many years."

"It seems that the sky will change in the future. We are no longer the most developed country in endoscopic surgery in the United States. This is so frustrating."

"It seems that this amazing Chen's mentor is too powerful. It would be great if I could also be his student."

"Who says it's not, this level is better than Professor Bradrick's."

"Keep your voice down, idiot!"

Compared with the surprise, unwillingness, and shock of other doctors, Professor Grace, who is the president of the World Society of Gastroenterology Organizations, has a much more complicated mood.

On the one hand, as the leader of an international medical organization, he should be happy to see the new technologies and procedures for gastrointestinal system diseases invented around the world, and actively promote them.

But on the other hand, as a white man and a top doctor in the United States, Professor Grace originally had a very strong sense of superiority in his heart, but now this sense of superiority has disappeared.

What was the former Huaguo medical field? Those were all low-end existences that he looked up and would not catch his eyes at all.

Every time the WGO held a meeting, those Hua Guo doctors would nod and bow their heads when they saw him, showing as much humility as they needed.

But Professor Grace took it for granted, and even meeting doctors from third world countries and giving them a few words was a gift.

As a result, a young doctor from Huaguo slapped him hard today.

Medicine is the same as competitive sports, the first place is the first place, the second place is the second place, there is no blur in the middle.

Chen Qi can perform operations that others cannot, he is the No. 1.

Even if Grace is the president of the WGO organization, a member of the American Academy of Sciences, the dean of the Duke University Medical Center, the director of the gastroenterology department, a senior professor, and a series of positions or titles.

But he can't do such complicated endoscopic surgery, so he can never say that he is the best doctor in the field of gastroenterology.

Professor Grace never dreamed that he would be defeated by a young doctor.

Of course, he is not a small-hearted person. As the president of WGO, he has a bigger structure. After all, he is not the president of the National Society of Gastroenterology.

Therefore, Professor Grace did not intend to attack Chen Qi, and would affirm Chen Qi's achievements with tears in his eyes. Who said that his bounden duty is to promote the development of gastrointestinal medicine, and this professional ethics still exists.

Compared with Professor Grace's inner sadness, Professor Bradrick from Sid-Sinai Medical Center is thinking about his little one.

He had studied Chen Qi's surgery video repeatedly in the United States before, and this morning he also saw the whole process of Chen Qi's surgery with his own eyes.

For Professor Bradrick, a senior doctor who has been engaged in gastrointestinal specialties for more than 20 years, POEM surgery does not seem to be so difficult.

if……

If he, Bradrick himself, has also learned the POEM technique and the tunneling technique, will the huge bounty offered by the Hollywood tycoon be able to keep the fat and water away from outsiders?

The possible bounty of several million dollars, even if Bradrick himself is a top doctor, is also full of temptations.

Who doesn't like money?

Thinking of this, Professor Bradrick coughed a few times, pretending to be decent and suggested:

"Chen, the POEM technique you invented is really amazing. You also know that I have traveled all the way to China to learn this new technology. Can you let me try a POEM surgery this afternoon? "

As soon as Professor Bradrick finished speaking, Professor Grace next to him gave him a meaningful look.

But obviously Chen Qi still lacks experience in the world, and he has never seen the insidiousness of Americans. He thinks that he can help this foreign colleague purely from the perspective of medical technology promotion.

Another important reason why Chen Qi was not vigilant was that the POEM technique was plagiarized for him, so he didn't cherish it that much.

"Professor, what do you mean, you want to do an endoscopic surgery for achalasia yourself?"

"Yes, Chen, I want to get your permission, and I can do it under your guidance."

Seeing that the professor from the University of the United States spoke so modestly, Chen Qi shrugged and said indifferently:

"OK, it's not a problem, I'll leave the chief surgeon in the afternoon to you."

Seeing that Chen Qi took the bait so easily, Professor Bradrick was excited and nervous for a moment, eager to try, and at the same time a little secretly happy.

In the afternoon, in the operating room, the patient was already under general anesthesia.

Holding the handle of the endoscope, Professor Braderick slowly put the gastroscope catheter into the patient's mouth and extended it to the esophagus.

Then, following Chen Qi's technique, submucosal injection of normal saline was performed at 10 cm above the cardia, and the mucosal layer was cut longitudinally. Until this step, Professor Bradrick performed very steadily.

He can become one of the most famous gastroenterologists in the United States, which also has two brushes.

Then it is time to "open the tunnel". In this step, the doctor needs to separate the submucosa and muscular layer of the esophagus.

And this separation is completely relying on the surgeon to manipulate the gastroscope operating rod, cut off or melt off the submucosal tissue with a Hook knife, so that there is no link between the mucosal layer and the intrinsic muscle, and a tunnel is formed.

It is equivalent to making a long hole in the wall of the esophagus.

This process seems simple, but for doctors who have not practiced it, the brain understands it, but the hands may not understand it.

Surgical operations require millions of times of training, which is an important reason why medicine is called "empirical medicine".

After successfully completing the first few steps, Professor Bradrick felt that the operation was nothing more than that. After explaining the principle, it was actually quite simple, so he was a little confused for a while.

He was even in the mood to joke with the doctor next to him. At this time, if nothing else happened, an accident happened.

When Professor Braderick was manipulating the Hook knife to dig the tunnel, he didn't grasp the strength well. When he stabbed down with a little force, the muscular layer and adventitia of the esophageal wall were all opened up at once. .

It was too late for Chen Qi to stop it.

The esophagus is perforated.

"Hiss~~~"

"God~~~"

All the onlookers were gastroenterology doctors. Everyone gasped. This esophageal perforation is no joke. If it is not good, it will kill people.

Professor Braderick froze there on the spot, even forgot to take back the gastroscope, and kept perforating.

Professor Grace's face darkened all of a sudden, and he cursed: "Idiot, you have caused great harm to an innocent patient."

The white old man was really angry, because he knew Braderick's little thoughts, and now his operation failed, which made Professor Grace furious.

An important principle of medical ethics is the principle of "do no harm".

If the US media knows that this well-known doctor at Sid-Sinai Medical Center is using patients as experiments, not treating patients as human beings, and even piercing his esophagus, he will be sprayed until he can't take care of himself.

Professor Bradrick came here on behalf of the WGO organization this time, and was known by outsiders and the media, causing the WGO organization to be criticized.

The older the doctor, the less courageous he is.

Chen Qi didn't have time to blame the American doctor for his three-legged cat kung fu.

Now this patient is nominally operated by him, Chen Qi, and he is trusted by Chen Qi, who has waited so many days and waited for all the foreign doctors to come to perform this teaching operation.

As a result, the person's achalasia was not cured, but a perforation of the esophagus occurred instead. How can this be justified?

After being pushed away by Chen Qi, Professor Bradrick knew that he had caused trouble. As a gastroenterologist, he also knew the danger of esophageal perforation.

In particular, POEM is to make a hole in the esophagus. Now, once the hole is pierced, the outside and the inside are connected. This becomes a "fistula", that is, an esophageal fistula in Chinese.

That's more of a danger than a danger.

"Chen, I'm sorry I'm sorry, I didn't know there would be a piercing."

Professor Bradrick even apologized, completely panicking. If this kind of medical accident happened in the United States, he would not be able to get it without millions of dollars in a lawsuit.

There could also be massive reputational damage to his career.

Chen Qi didn't mean to blame the doctor from Miguo either. An accident occurred during the operation, which is a normal clinical thing. What's more, this professor from Miguo was doing POEM surgery for the first time.

But how to solve this esophageal perforation has become the top priority.

Fortunately, in order to meet the leaders of the departments and offices and foreign friends, all the staff of the People's Hospital have to go to work these days and are on standby.

So Chen Qi roared:

"Head nurse, quickly call Guo Shuji and surgical director Zhu, and tell them to come to the operating room as soon as possible. There is a patient with esophageal perforation who needs immediate thoracotomy."

"Good Dean Chen!"

The head nurse in the operating room is more experienced. Seeing that the dean rarely yelled at others, she knew that these foreign doctors probably screwed up the endoscopic surgery, which might cause serious harm to the patient, so she ran to the office in two steps.

In less than 5 minutes, Lao Guo's loud voice came in from outside:

"What's the matter, what's the matter? What's the matter? Chen Qi, you bastard, I've ordered you to take this reception task seriously, what are you doing, why did you perforate other people's food for no reason? ?”

Before he finished speaking, Lao Guo entered the operating room, and Director Zhu also came running, panting.

"Chen Qi, what happened, the esophagus was perforated no matter what."

Chen Qi didn't have time to explain:

"During the endoscopic surgery just now, the endoscopic electric knife accidentally opened up the wall of the esophagus. Fortunately, the patient is now under general anesthesia. I have asked the anesthetist to adjust the dose, and urgent esophageal perforation is needed immediately. Repair surgery, I can't do it alone."

Lao Guo was taken aback when he heard this, and asked in Chinese:

"This endoscopic surgery is still dangerous. Will it affect the visit of these foreigners and cause bad influence?"

If a doctor fails in an operation, it is called a rollover, but if the operation fails in front of colleagues, it is called a rollover, but if your operation fails in front of a foreign expert group, it is definitely a super rollover.

As the leader, Lao Guo immediately thought about how to deal with the aftermath and whether it would have a negative impact on Chen Qi himself.

Chen Qi replied softly: "It wasn't me, it was the foreigner next to me who performed the operation, the perforation was caused by him, it has nothing to do with us."

Lao Guo and Director Zhu breathed a sigh of relief when they heard that, as long as Chen Qi is fine.

"Okay, push this patient to the next operating room. We will do this repair. You can explain it to the family. We can't be sorry for the patient."

Chen Qi nodded heavily: "Sure, please trouble Guo Shuji and Mr. Zhu."

Professor Braderick couldn't understand Chinese, so he asked anxiously: "Chen, what should we do now? Can your hospital perform esophageal repair?"

The white doctor was in a hurry and accidentally asked this kind of discriminatory question.

Chen Qi was also a little upset when he heard that, what do you mean "Will your hospital do it?"

"Professor Bradrick, don't worry, the two surgeons just now are the best surgeons in our hospital. They have 30 years of clinical experience in surgery. One esophageal repair is not a problem. The point is that now I have to ask the patient's family for forgiveness." , after all, this is considered a medical malpractice."

Professor Bradrick shuddered when he heard the word "malpractice".

Americans pay attention to rights protection in everything, and American lawyers are all-pervasive, so medical lawsuits in the United States are hard to guard against, and there are countless cases.

It's just that the insurance in the United States is relatively sound, even if the hospital loses the lawsuit, there will be insurance compensation.

Although the doctor himself does not have to bear the loss of money, if the doctor has too many medical accidents, the insurance company will downgrade the doctor's credit and even refuse to insure the doctor.

The doctor who was abandoned by the insurance company also ended up a tragedy.

So sometimes, as long as the amount of compensation is not too huge, those top doctors who are not short of money would rather choose to go private and pay a sum of money to buy a peace, so as not to cause adverse effects.

"Chen, I'm really sorry, please tell the patient's family for me, I am willing to compensate them 50,000 US dollars, oh no, 100,000 US dollars, as long as they give up pursuing my responsibility."

Professor Bradrick does not have the qualifications to practice medicine in China. He is an "illegal practice of medicine". According to the laws of the United States, he may be jailed.

A combination of various factors frightened the white doctor into a panic.

But he seems to have forgotten that this is Huaguo, and the relevant laws of Huaguo in the 1980s did not seem to be so sound.

Chen Qi was quite surprised to hear that this American doctor was willing to pay so much money.

Even if the official exchange rate is 1:4, this patient can still get 400,000 yuan in compensation, which is 400,000 yuan in 1989.

It doesn't take so much to squeeze a waist.

If you know that you can get 400,000 compensation, let alone a hole in the esophagus, it is estimated that many people would rather have stomach perforation, intestinal perforation, and heart perforation, and wait in line for foreigners to have the perforation.