Zheng Ren quickly inserted the aortic stent.
The airtight lead door opened, Chu Yanran held the tracheal intubation tube, and Su Yun and Mr. Wang positioned the patient.
The patient was placed in a supine position, and Su Yun took a pillow to elevate the left side of the body.
"Boss, is one enough?" Su Yun took a look and thought it was about the same, so he asked again.
Whether the assistant thinks it is good or not, the final decision on the posture is still made by the practitioner. But under normal circumstances, it is a fixed formula, so there is no need to ask.
This patient's situation is special. Su Yun asked a few more questions. There is no harm in being cautious.
"Well, no problem." Zheng Ren nodded, turned around and went to wash his hands again.
"Don't take off your gloves next time to avoid brushing your hands." Su Yun said while positioning the patient.
"Not rigorous." Zheng Ren said, "I brushed my hands anyway, feeling relieved."
"Boss, you have a mental illness and you need to have a look at it when you have time. How about I introduce you to a better psychiatrist?" Su Yundao said.
"I'm mentally healthy, but your narcissism and nagging need to be looked at." Zheng Ren went directly to wash his hands regardless of Su Yun's nagging.
"When I came back for surgery, there was no background music. It was really quiet." Su Yun finished his position, took a look, and felt very satisfied.
"What kind of music is played in the imperial capital?" Mr. Wang asked.
Speaking of this, he began to miss 912.
"Lao He, as long as that guy catches up with the boss, he'll be lucky. The first time I heard it, I thought it was okay. After hearing it too much, it's really frustrating." Su Yun picked a point, turned around and asked, "Boss, left Enter the fifth rib?"
"Okay." Zheng Ren's voice came from the washing area.
Mr. Wang was a little surprised. The two of them seemed to have changed little, but also seemed to have changed a lot.
For chest surgery, Su Yun naturally asked Boss Zheng about the position and surgical incision.
What happened in the imperial capital during this time? Brother Yun even asked Boss Zheng about thoracic surgery.
Mr. Wang glanced at Su Yun in surprise, feeling very strange.
He had seen Su Yun perform surgery before, and his style could be said to be domineering. Zhao Yunlong scolded him so much that he started nagging him and never asked him for surgery again.
It can be said that a good surgeon is absolutely dictatorial on the operating table.
But seeing the situation in front of him, Mr. Wang had a guess in his mind. Although it seems ridiculous, after thinking about it, what is left is the truth.
Brother Yun was so scared.
Sterile drape is laid and the surgery begins.
Mr. Wang didn't come on stage. As Su Yun said, there was really no need for him.
Seeing Zheng Ren and Su Yun standing on the operating table, Mr. Wang felt a little emotional. Boss Zheng's demeanor is becoming more and more calm.
The last time he came back, he called him Mr. Zheng, but this time he couldn't help but call him Boss Zheng.
As soon as Zheng Ren stretched out his hand, the knife was slapped in his hand.
Make an arc-shaped incision along the fifth intercostal space to stop bleeding, incise layer by layer, bluntly separate, and enter the chest.
Zheng Ren first found the internal thoracic artery, cut it off and ligated it.
The thoracotomy device opened the chest, and Su Yun said: "This pericardium! It's really amazing."
There is about 800ml visible to the naked eye in the pericardial cavity.
The most eye-catching thing is that the distal free position of the K-wire is not far from the pericardium.
"This is the most sensible person I have ever seen." Su Yundao said.
"If it weren't for the protection of the pericardium, I'm afraid the heart would be broken." Mr. Wang stood behind Zheng Ren and nodded.
It's a pity that the stimulation time is a bit long. The inside of the pericardium seems to be wrapped with a layer of fiberboard, and the heart beat is somewhat restricted.
The pericardium is no longer soft and slightly square, and there are signs of chronic constrictive pericarditis.
Chronic constrictive pericarditis is a chronic inflammatory process involving the pericardial wall and visceral layers. Causes pericardial fibrosis and thickening, restricts the diastolic activity of the heart, and thereby reduces cardiac function.
But in the patient in front of me, the constricted pericardium protected the heart like armor from fatal damage caused by the Kirschner needle.
But not to mention that Kirschner needles are like the sword of Damocles and can kill you at any time. A narrowed pericardium alone is a fatal disease.
Once the symptoms and signs of chronic constrictive pericarditis appear, the patient's life expectancy is approximately 5 to 15 years without the ability to perform normal activities. When ascites, etc. appear, the condition progresses rapidly, especially in children.
Zheng Ren made a small incision on the pericardium with a sharp knife. The moment he left, the suction device was inserted by Su Yun before the pericardial effusion came out.
Watching as the light red bloody pericardial effusion was drawn out, the pericardium did not collapse and had a weird shape.
"Separate the pliers." Zheng Ren reached out and clapped a pair of pliers in his hand while speaking.
"Boss Zheng, what kind of pliers are these?" asked Mr. Wang.
He is a gastrointestinal surgeon and cannot understand thoracic surgery. Asking casually will save you from having to guess, and it will also liven up the air in the operating room.
"Look for the left phrenic nerve." Zheng Ren finished speaking,
Together with as much fat, pericardial tissue and left phrenic nerve as possible, Zheng Ren incised the pericardium from the position of the left ventricle, leaning toward the posterolateral side.
"Mr. Zheng, when did you come back?"
Mr. Zhou from the Department of Orthopedics entered the operating room and greeted him warmly.
"Mr. Zhou, I haven't seen you for a long time." Zheng Ren only greeted me for a while, and then said: "Look at the Kirschner needle."
"What's wrong?" Mr. Zhou looked at the incision and knew it was a chest surgery. He came over and took a look, and his face turned pale with fright.
"Let me go... there is really a situation where the distal end of the Kirschner needle comes loose!" Mr. Zhou exclaimed.
"What? Never seen it?" Zheng Ren is not an orthopedic surgeon, and he has not upgraded his orthopedic skill tree to any level.
He didn't know the chance of the distal end of the K-wire becoming free.
"There is this in the pre-operative instructions. I also learned how my master taught me back then. Every time I explained to the patient's family, I would make gestures." Mr. Zhou's face changed again and again, and he happily stretched out his head to watch the operation. District, I immediately remembered something.
"Mr. Zheng, where did the patient undergo clavicle fracture fixation surgery?" Mr. Zhou asked anxiously.
If he had done it himself, this would have been a disaster.
Although there was an explanation before the operation, this kind of postoperative complication is real, but the chance is so small that even I have never encountered it.
But once it appears in a certain patient, the chance is 100%. It's fine when you meet someone who is reasonable, but when you meet someone who is unreasonable...
Mr. Zhou had a lot on his mind, and the excitement he had just seen when he saw the special case was suddenly extinguished. I felt uneasy and my eyes were a little wandering.
"I didn't ask." Zheng Ren said, "Looking at the incision, I guess it's at least three years old."
"Why don't you ask?" Mr. Zhou sighed and complained slightly.
"What's the matter? You knocked out the Kirschner needle and the aorta was almost scratched. How can you still make sense? We are in a hurry for rescue. Who has time to ask those who have it or not?" Su Yun listened to the complaining tone in Mr. Zhou's words and said, He immediately shouted back.