Medicine is the same as science, and some truths are discovered directly in practice. Some require scientists (medical scientists) to come up with an idea and then verify the authenticity of the idea.
So you will find that in clinical medicine, many technical surgeries are ideas that clinicians have figured out in practice and then put them into action: Hey, that’s okay~
The human body is a lot of things that are too complicated to explain. Even if the organs and tissues of the human body are repeatedly dissected by scientists in order to thoroughly analyze them, the results can only reveal a corner of the mystery.
For this reason, Dr. Li and Dr. Cui said: I don’t know if it will work. Someone has done it and put it in a research paper. The principle, to be honest, you and I both know the mysteries of the human body mentioned above and no one can understand the ultimate goal.
It stands to reason that the "branches" of the lungs are connected, just like human blood vessels are connected to a lot of side branches. It should be impossible to manage only one bronchi by blocking it.
Medicine is the greatest test of courage, as I have said many times before. Clinicians will never give up easily in order to save patients.
Is it true that the "branches" of the lungs are completely connected, and the air running in all the lungs will pass to a single pleural fistula? Clinicians believe that since senior medical scientists have proposed segmentation of the lungs, it means that not all the "branches" of the lungs are really connected, and not all the "branches" of the lungs can go to the air leakage point.
How to prove the clinician’s conception? Try blocking it and you will know. You can know whether the above idea is true by blocking that bronchial tube and seeing if it has the effect of preventing air leakage.
Which bronchus should you try to block?
Following the previous theoretical basis of the above concept, standing on the shoulders of giants, if there are preoperative imaging data for auxiliary diagnosis, clues can be found in the imaging data to find the lung segment corresponding to the pleural fistula, and the lung segment corresponding to the blockage of bronchi.
If there is no clue, we can only classify the lungs according to their anatomy again, first try the upper lobes, lower lobes and middle lobes. If that doesn’t work, you can divide the lungs into segments.
The blockage must be to block the superior bronchus (i.e. the "big branch") without exploring the "small branch" of the sub-segmental bronchus. Because there are too many side branches in the sub-section that connect everywhere and may cause air leakage, it becomes meaningless to block one of the sub-sections.
The above words are used as adjectives. If there is a flood, it will be effective to block the big river upstream instead of blocking the small rivers downstream.
What instrument should be used to block it?
The appliances mentioned above should be removable, and it is best to be easily accessible rather than special appliances that have no threshold and are more widely used.
After listening to the description, the experts at the scene quickly thought of a tool commonly used in many medical and surgical operations that almost all doctors are familiar with: the balloon catheter.
This tool is familiar to nurses, anesthetists and doctors.
Urinary catheter, tracheal intubation, etc. are not all blocked with similar balloon catheters filled with water or air for fixation.
There are only the above ways to use balloon catheters. It should be said that doctors are too good at turning a tool into a kaleidoscope of flowers. This is all based on mathematical physics.
So far, the balloon tube -type medical equipment has a role in many clinical medical departments. It has developed a variety of adaptation to the use of the various specialty of the clinic. It is the idea of clinicians that the clinicians themselves need to think about according to the surgery.
For example, in the interventional surgery case we just finished, it was mentioned that the balloon catheter is used to dilate blood vessels, and its shape and structure must be much more complicated than that of a urinary catheter.
Dr. Cui, who is familiar with all this, asked the key point: Dr. Li, do you mean that this tool is only seen in papers and is not ready-made?
Dr. Li: It seems that it is not available at the moment. I don’t know if Xie Juan Wang has it himself, or if Xie Juan Wang has thought of where to find a substitute.
Everyone:…
