"Su Yun, Lao Zhao, are you wearing lead clothes?" Zheng Ren asked.
"wore."
Zheng Ren nodded and went directly to wash his hands.
In fact, after the filter is lowered in, generally speaking, it will not step on the line. But Zheng Ren is also afraid of unexpected situations. There have been many accidents in the system operating room.
Wearing dozens of kilograms of lead clothing to perform surgery is a physically demanding job. But for Su Yun and Zhao Yunlong, it is not a big deal.
After coming back and getting dressed, Hu Yanhui put on the live broadcast glasses and the surgery officially began.
Zheng Ren made a midline incision on the sternum, which started slightly below the sternal notch and reached about 5cm below the xiphoid process.
Use an electric knife to incise the periosteum of the sternum along the median, separate the sternal notch to the retrosternal level; then dissect the xiphoid process and separate the retrosternal space. After removing the xiphoid process, Zheng Ren said in a deep voice: "Chainsaw."
The separately sterilized electric saw was ready, and Xie Yiren handed it to Zheng Ren.
After debugging, the buzzing sound echoed in the operating room.
"It's been a long time since I heard this sound during cardiothoracic surgery." Lao He sighed with emotion.
"There will be fewer and fewer in the future." Zheng Ren inserted the head of the electric saw into the stripped position under the xiphoid process, and pressed it tightly against the sternum. "Interventional surgery will complete all cardiothoracic surgeries." , this is the big trend in the future.”
Zhao Yunlong was a little unconvinced.
“There’s also heart transplants, aortic arch replacements.”
"Old Zhao, you are trying to make an argument." Zheng Ren rolled his eyes and raised the electric saw upwards to avoid causing too much damage to the tissue in the patient's mediastinum. He said, "Heart transplantation is not What kind of major surgery? Aortic arch... Within 10 years, type 1 can be solved by interventional surgery and related stents."
Is this human talk? Isn't a heart transplant a major surgery
If it weren’t for Zheng Ren standing in front of me,
If he hadn't been holding a chainsaw...
Zhao Yunlong wanted to curse directly.
Buzz…
The chainsaw began cutting through the sternum.
The bone of the sternum was sawed open, and drops of blood and white bone fragments kept splattering out.
Zhao Yunlong and Su Yun weakly held white sterile gauze on their sternum to block the splash.
"Boss, you are looking down on our broadmindedness." Su Yun was dissatisfied, "How come I don't believe you can perform lung transplantation through interventional surgery?"
"Don't keep mentioning the transplant, it's pointless." Zheng Ren held the electric saw and sawed through the sternum not very fast, but with a steady hand. The vibration caused by the high-frequency collision of the chainsaw head with his sternum did not affect the stability of his hands holding the chainsaw.
"Just like coronary artery bypass surgery is on the verge of being eliminated, surgeries other than transplantation will be minimally invasive in the future. If you cannot learn minimally invasive surgery, you will be eliminated."
The sound of the electric saw suddenly stopped. Zheng Ren took the sterile gauze handed over by Su Yun, briefly wiped the non-coagulable blood and bone fragments on the head of the electric saw, and handed the electric saw to Xie Yiren.
He stretched out his hand, and electrocoagulation appeared on his hand.
Electrocoagulation was used to stop the bleeding at the severed periosteum. At more than 20 points, it was completed with a bang. A burning smell spread. Without stopping, Su Yun and Zhao Yunlong asked for bone wax and began to apply it evenly on the sternum bone.
The sternum was sawed, and periosteal bleeding was stopped with electric cautery. For bone, you can only use bone wax to stop bleeding.
"Boss Zheng, have you seen Saw?"
"I've seen it, and I didn't really like it except for the first episode." Zheng Rendao.
"Boss, I cosplayed Saw. Well, it was the inspiration for the surgery. But sometimes I was afraid that it would be too sexy and I wouldn't be able to control it during the surgery, so I started cosplaying Freddy from A Nightmare on Elm Street." Su Yun said while He said as he smeared the bone wax on his hand.
"I haven't played it before, so I don't find it interesting. You wouldn't put that kind of machine on your head." Zheng Ren used a spreader to open the sternum and bluntly separated it, exposing the heart.
"How could it be possible? I'm not stupid." Su Yun said.
In the surgical field, the heart was beating loudly. Su Yun reached in, probed it with his fingers, and said, "The heart is suffering from ischemia and lack of oxygen, and its beating force is very weak."
"Hurry up and stop talking." Zheng Ren said. He stretched out his hand and the lancet was slapped on his hand.
The pericardium is incised longitudinally in the midline, up to the reflected part of the ascending aorta, down to the diaphragm. The lower part of the incision is made on one side on each side to facilitate the exposure of the surgical field.
Zheng Ren then sutured the pericardial resection edge to the soft tissue outside the sternum on both sides, which would save the assistant some trouble.
The operation is huge. Not only the surgeon, but also the assistants are very busy, and six hands are not too many.
After opening the pericardium, Zheng Ren began the first step of exploration.
The main objects of exploration are the aorta, pulmonary artery, left and right atria, left and right ventricles, superior and inferior vena cava, and pulmonary veins.
The purpose is to explore the size, tension, and presence of tremor at these locations, as well as to check for the presence of the left superior vena cava and other extracardiac anomalies that can be detected.
Although Zheng Ren had been checked countless times in the system operating room, in the real world, Zheng Ren still confirmed and checked again.
There must be no carelessness at all!
The surgery was standard, the process was smooth, and no detail was missed.
Su Yun and Zhao Yunlong, two guys who can handle major cardiothoracic surgery independently, serve as assistants, making the surgery a lot faster.
Zheng Ren reached out and touched the tissue near the pulmonary valve and said, "You guys touch it."
The tone of his speech was like that of an old professor asking students to experience the palpation of a certain disease when leading a ward round.
"What did you touch?" Su Yun was curious and tapped the hemostatic forceps on Zhao Yunlong's radial process. When he retracted his hand, he placed his right index finger on the tissue near the pulmonary valve.
Su Yun understood without using any force, just with a touch.
"Stable!" Su Yun said.
"What's stable?" Lao He looked anxiously.
These two people were playing charades on the operating table, which was a very unethical thing to do.
"The patient's diagnosis is clear. It's a pulmonary valve tumor, definitely not a large emboli." Su Yun said with a smile.
He retracted his hand, and Zhao Yunlong put his finger on it.
"Well, it's pulsating and soft, and it's body tissue. It's considered a pulmonary valve tumor." Zhao Yunlong said more and more detailedly. It seemed that he was used to saying a few more words to let his doctors remember it, and he would get better. Then write a surgical record.
But after finishing speaking, Zhao Yunlong realized that among the people on the operating table, the most junior doctor was actually himself!
If you want to write a surgical record, you can only write it yourself.
Pointing at Su Yun and writing, he would definitely fall out with himself.
MD, Zhao Yunlong cursed secretly in his heart.
…
…
Note: A friend of mine has a patent ductus arteriosus. Twenty years ago, I told him that I described in detail the process of cutting open the sternum with a chainsaw, which frightened him terribly.
More than ten years ago, he was told that there was a minimally invasive surgery that could be completed with just three eyes.
Ten years ago, I told him to use interventional surgery, from the neck or wrist, or... jokingly speaking, any artery, go under the guide wire catheter, and the operation is over as soon as the umbrella is opened.
But that coward still didn’t dare to do it.