Chapter 1202: 【1202】Multidisciplinary Trials
Surgical teachers have a fondness for joking around. Xie Wanying listened and understood that Teacher Nie would never casually call doctors from other departnts to join; there must be a solid rationale behind it. After all, colleagues from other departnts have their own busy workloads.
For instance, everyone knows that doctors from cardiothoracic surgery and respiratory dicine are often summoned because they use bronchoscopes. But why call in doctors from the cardiology departnt? Senior Jin is a renowned expert in cardiovascular intervention. Teacher Nie must have called Senior Jin with the intention of leveraging cardiovascular intervention to solve the child’s issue.
This brings up an obscure piece of knowledge: bronchial foreign body retrieval, aside from the commonly known fiber optic bronchoscopy or, when unavoidable, cardiothoracic surgery, can also be perford using intervention techniques from cardiology—a thod less commonly seen or heard about.
As for how cardiovascular interventions achieve this, it involves the sa principle: foreign body retrieval.
The bronchoscope uses a fiber optic probe equipped with micro instrunts to remove the foreign body, guided by light and a cara.
Similarly, cardiovascular intervention employs catheters and guidewires to access the bronchus, which can also carry micro tools such as retrieval snares or forceps for foreign body extraction. Instead of a cara, the procedure is guided by X-ray imaging.
If it seems similar to fiber optic bronchoscopy, why consider using the intervention approach instead?
The reason lies in cases where the foreign object is lodged too deep in the bronchus, beyond the reach of the bronchoscope, which cannot adequately examine or treat third-and-fourth-level airways. In contrast, guidewires used in intervention procedures can be extended farther.
The pediatric bronchoscope has a diater ranging between 2.2 mm and 4.9 mm. Based on the bronchoscope’s diater as a reference, clinical practitioners can easily select appropriately sized catheters for intervention.
From the child’s current X-ray imaging, the foreign object seems to be located in the child’s lower left lung lobe. There are signs of bronchiectasis and inflammation, and the object is lodged deep.
Following standard procedure, respiratory dicine would first attempt bronchoscopic removal; if that fails, the cardiology departnt would apply intervention techniques. If both thods are unsuccessful, cardiothoracic surgery would proceed with a lung lobe resection. Essentially, if neither bronchoscopy nor intervention can retrieve the object, there’s only one possibility: the object is adhered to the tracheal wall and requires surgical excision.
Nie Jiamin’s decision to call upon several departnts simultaneously was undoubtedly correct. Given the child’s condition, it would be impractical to consult one departnt at a ti. Everyone needed to convene and pool their technical expertise right away.
Saving the child’s life was paramount.
Doctors from multiple departnts gathered, brainstorming and conducting specific analyses of the case.
“Why not let the cardiothoracic team initiate with the bronchoscope? They have the right tactile experience. If they find the object tightly adhered during their attempts, there’s no need for our intervention team to try. They can proceed directly to surgery,” Jin Tianyu said after contemplating the X-ray images on the lightbox for a while.
His words were factual and practical.
Everyone in the hospital knew that cardiothoracic surgeons are far more skilled in this operation than respiratory specialists. It was puzzling why Nie Jiamin called the respiratory team over. Perhaps it was because Nie Jiamin was new and hadn’t yet thoroughly grasped the strengths of the various departnts in this hospital. If that were the case, his team mbers should have reminded him.
Under the gaze of the cardiology team, Luo Jingming, who accompanied Nie Jiamin, remained conspicuously silent. Their guesses were accurate; as Nie Jiamin’s team mbers, they undoubtedly shared input on departntal strengths with him. However, the ultimate decision was entirely in the professor’s hands. Therefore, it wasn’t that Luo Jingming hadn’t already inford Nie Jiamin that respiratory dicine was not as proficient as cardiothoracic surgery.
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