David Hawley went out of the cabin and checked the MDM. It could not be repaired and could only be replaced.
Fortunately, Russia's Soyuz rocket is extremely powerful and unambiguous. It completed the docking in three hours and forty minutes and completed a space express mission.
Finally, David Hawley and the Russian astronauts relied on safety ropes to complete the spacewalk, replaced the electrical components, and the power system was protected.
The whole process took a full five hours.
Stable voltage allows the control of the robotic arm without the worry of downtime.
The operation can continue, but there is not much time left for Yang Ping.
On the angiogram of the whole cerebral blood vessels, microaneurysms have expanded to close to the limit and may burst at any time. The second one has begun to expand rapidly, and the third one is also looming.
IBM's Wall was right, there was indeed a second aneurysm, and Yang Ping was even more right, the third one was already looming.
"According to the speed at which he entered the vascular network in the brain the first time, it would take at least half an hour to solve one aneurysm. Now there are three, which is not enough time." Johannesson also became worried. After all, there are now three, and they need to be solved at once. The left femoral artery, right femoral artery, and left radial artery were punctured at the same time! Yang Ping ordered Susan to change the instrument.
Simultaneous puncture? Do you need to insert three guide wires at the same time? How is this possible?
Massimo looked at the screen, then looked around the hall. He was not the only one surprised.
But Yang Ping's voice came out on the radio and said this: puncture from three locations and put in three micro guide wires at the same time.
At the same time, three guide wires shuttle through human blood vessels, enter the intracranial vascular network, and finally reach the target arteriole.
This requires the surgeon to be extremely familiar with the patient's intracranial vascular pathways, including tens of thousands, hundreds of thousands, and millions of blood vessels, how they intertwine, bifurcate, and form circuits. No human's knowledge of anatomy can accomplish this. p>
The surgical robot has four robotic arms, and only two robotic arms are needed to complete the intervention. Wouldn't it be a waste of time if the surgery was performed in stages?
If three robotic arms operate at the same time, the operation time will be short, which in a sense minimizes the risk of surgery.
But three guide wires enter at the same time, which is a mythical operation.
In interventional surgeries, two guidewires are also inserted, such as the dual guidewire technology of cardiac intervention, but this is completely different from the current three-pronged approach.
In cardiac intervention, there is a dual guidewire technology. For example, during percutaneous coronary intervention, a 0.36 mm coronary guidewire is placed along the first coronary guidewire, which can stably guide the catheter.
, to help the balloon and stent pass through the lesion, this is the partner guidewire technology.
During percutaneous coronary artery treatment of bifurcated lesions, in order to protect the coronary branch vessels, a coronary guidewire is placed. After the stent is released, the guidewire between the vessel wall and the stent is withdrawn. This is called protective guidewire technology. In percutaneous coronary treatment of chronic total occlusive lesions, when the first guidewire enters the subintimal space, remains in place as a false lumen marker, and then introduces a second harder guidewire into the true lumen, this is parallel
Guide wire technology.
Regardless of the dual guidewire technology, the other guidewire is an auxiliary, not three guidewires that treat different targets independently.
But Yang Ping seems to be doing this now!
It is already difficult to safely deliver a guide wire to the arterioles in the brainstem. Now three guide wires are required to be sent simultaneously, and they cannot repeat, cross, or contact on the path they pass. This route planning ability is already a part of artificial intelligence.
level, it is not the work of human beings.
Professor Eugene changed seats with others and sat with Johannesson and Massimo.
"Are you sure that his three puncture points will be started at the same time and the surgery will be performed at the same time?" Massimo asked.
"It shouldn't be possible. Two of the guide wires should be the same as our dual guide wire technology and play a supporting role, right?" Eugene judged.
"No, Dr. Yang just said that three guidewires need to be operated independently at the same time. Each has its own goal. He wants to solve three aneurysms at once." Although Johannessen did not believe it, he did hear Yang Ping say this just now.
Said.
He is planning to perform embolization on three aneurysms at the same time, yes, at the same time. This will be the first of its kind in the world.
The three manipulators operate independently, and the remaining manipulator operates as an assist. What an international joke.
When everyone is confused, all speculation is no longer necessary.
The three guide wires, controlled by the robotic arm, have begun to enter along the blood vessels at the same time, traveling long distances over mountains and ridges, and approaching the intracranial blood vessel network step by step. They start from different paths and have nothing to do with each other.
All roads lead to Rome!
The same is true for the blood vessels of the human body. The true meaning of intervention has been grasped by Yang Ping.
In the ink-like image of whole-brain angiography, three guide wires are competing to advance along the blood vessels like a race.
This extremely slippery loach guidewire is very easy to use in Yang Ping's hands. Every time he encounters a fork, no matter whether the angle of the fork is an obtuse angle, an acute angle or a right angle, the magical guidewire can easily cross it.
The three guide wires are like flexible greedy snakes, and every super selection is so magical and wonderful.
However, those three filament-like greedy snakes entered the depths of the human brain and continued to penetrate deep along the complex blood vessel network.
The surgery demonstrated on the entire screen was like a game, with the snake moving dexterously, which made the audience extremely uncomfortable. Some people felt like the three tiny things were swimming inside their bodies, causing spasms of pores and numbness in the scalp. The largest aneurysm may have reached its limit. GG's artificial intelligence keeps flashing red lights to remind that the blood vessel may explode at any time.
The second one has also expanded, and the third one is beginning to take shape, expanding faster than the first two.
There is a limit to how a guide wire can enter a blood vessel. This limit is not only related to the thickness of the diameter, but also related to the accuracy of the doctor's control of the guide wire. The guide wire cannot enter a blood vessel that is thinner than itself. Similarly, it cannot cross the bifurcation at will and reach the target blood vessel. In general,
There is a fork that cannot be overcome.
Not all target blood vessels can be reached, and not all aneurysms are suitable for intervention.
"Three guide wires entered the skull at the same time? Pointing to three different aneurysms." Massimo finally believed that this was a high-dimensional creature that he could not match.
Three guide wires are inserted at the same time. No doctor in the world dares to do this, and no doctor can do it, but Steven needs to do it now. This is the only hope.
If it had not been an accident, Dr. Yang would have had enough time to resolve the aneurysms one by one, but an accident took more than five hours, leaving him with only one hour, maybe not even one hour.
He has no other choice but to adopt a three-pronged approach.
The natural advantages of the robotic arm are brought into full play in Yang Ping's hands, just like any other instrument in his hands will inevitably reach its limit.
The deeper blood vessels go deeper, the smaller the inner diameter of the blood vessels, the more complicated the mutual communication, and the more difficult the path is to identify.
For some well-known blood vessels, the progression of sinking is very simple, but now the blood vessel that Yang Ping wants to enter is an unknown artery, and the progression of sinking is already unknown.
This kind of intervention can clearly find the target blood vessel without getting lost. Massimo is one of only a handful in the world, but he only touched the door handle.
The operation at this time requires the surgeon to study the cranial brain, especially the blood vessels in the brainstem, higher than any existing anatomical study.
No doctor can do this level of anatomy, not surgical, interventional, or internal medicine doctors, nor professors who study human anatomy in medical schools. This requires researchers to have a large number of "gross teachers" to study, and no one has it.
This condition.
The total length of the brain's blood vessels, arteries, veins and capillaries, and the entire blood vessel network stretched in a straight line, is 1.6 million kilometers, and the circumference of the earth is only 40,000 kilometers. What a complex network this is.
People's research on this vascular network is far from enough, and it still remains on some main roads.
From the centimeter level, to the millimeter level, and then to the sub-millimeter level, the three guide wires continue to sink. It must reach the target and complete the task within the last half hour.
This is its only chance and the last chance.
Massimo curled up. In the warm hall, he was like a patient with a high fever. Waves of coldness hit him and spread quickly throughout his body. If possible, he would like to wrap himself in a thick quilt.
High stress not only consumes adrenaline, but also consumes a lot of calories due to the evaporation of sweat and excessive and continuous muscle contraction.
"He really solved three aneurysms at once, and he really manipulated three guide wires at the same time!" Massimo murmured to himself.
The look in Johannesson's eyes when he saw Massimo was the same look in his own eyes, empty and empty, as if all the glory and glory in the past had vanished into ashes.
"I said, he is one dimension higher than us." Johannessen was relatively calm. He had already gone through a test.
Dr. Eugene is not much better than Massimo: "He controls four robotic arms with two hands, three main robotic arms and one assistant robotic arm."
Dr. Eugene's words reminded everyone that these four robotic arms are controlled by Yang Ping's two hands.
But there is no rhythm out of sync. Every time, one guide wire slows down and pauses when it is about to cross the bifurcation, and the other two guide wires rush forward at high speed. When the other guide wires encounter the bifurcation and pause, the guide wire that has just stopped has completed its turn and crossed over.
Fork.
Just like an acrobat throwing several balls at the same time, Yang Ping controls four robotic arms with two hands. There are always two robotic arms moving and two robotic arms resting. Rest is not rest, but the key to every high-risk super selection.
Pause and turn.
The mechanical arm that rotates at any angle makes the guidewire more flexible than human manipulation.
The speed of the guide wire is getting slower and slower, but it never loses its flexibility and precision.
Because the blood vessels are getting thinner and thinner, any rough operation will be fatal. Any rapid or large operation will make the guidewire difficult to control due to inertia, so it must be slow now.
At the same time, the longer the guidewire is released, the more difficult it is to control the tip direction.
The blood vessels are getting thinner and thinner, and the guide wire is sinking continuously, just like a submarine sinking deeper and deeper until it reaches the deepest seabed.
The deeper and thinner it is, the more dangerous it is and the more difficult it is to control.
This kind of depth, this kind of sinking, there is no turning back, either success or death.
This is the reason why Yang Ping is unwilling to operate when the voltage is unstable. He must kill with one strike without any chance of turning back or any possibility of remediation.
Success or failure, just this one time, life or death, just this one chance, the blood vessels that have sunk deep into the brainstem level, there is no chance to quickly withdraw the guide wire.
"He is still not lost. In the labyrinth-like network of blood vessels, they each follow the nearest route."
Massimo didn't even dare to breathe too loudly or too fast. This was the most critical moment. He once used the thinnest guide wire and with the help of various auxiliary equipment to intervene in the monkey's intracranial brain stem and central blood vessels.
, so far, I don’t know how many monkeys have been tortured to death.
On the huge and clear screen, three filamentous greedy snakes meander.
Everyone was concentrating and holding their breath, unexpectedly they had penetrated so far.
