Feel? Dr. Lehner has been vaguely aware of Dr. Charles's erratic words in recent years.
But exactly how to do it, he didn't know yet.
"Wearing sterile gloves will affect the surgeon's judgment. Each pair of sterile gloves has a different feel. So I said that sterile gloves are the most important aspect of surgical operations."
Dr. Reiner remembered that Dr. Charles had indeed said this.
At that time, I thought the teacher was joking, but I didn't expect it to be true.
"But a sterile environment must be ensured, so the initial stage of the operation is the key for the surgeon to become familiar with the patient's anatomy and understand the feel." Dr. Charles continued to speak slowly.
In his opinion, the operation before him was bound to be a great success.
It was a real pleasure to watch this kind of surgery, the flawless process, and Dr. Charles was somewhat obsessed with it.
It's just that no one except myself and the surgeon on the operating table can understand the realm of hand feeling. Sometimes life is as lonely as snow.
"Every person's body tissue has unique elasticity and toughness. The initial blunt dissociation is the best time for the surgeon to establish communication with the unique body tissue." Dr. Charles said: "And this kind of communication, It will allow the surgeon to clearly understand the feel of the organs. As long as the communication method is established and the feel is clear, many complications and mistakes will never occur. "
"Look, the strength and angle of the needle tip when Dr. Zheng anastomosed the blood vessels were all choices made based on the information left by the feel of the blood vessels." Dr. Charles said happily: "Perfect, without a single flaw. Watch this The unparalleled surgery brings people an inexplicable enjoyment.”
Reiner was speechless.
Everything Dr. Charles said, he was only dimly aware of seemed to be so. But if it is to be applied in clinical operations, it is completely impossible without 3-5 years of running-in.
And after 3-5 years, I am already old. Although the experience will be richer, it is past the peak period of surgery.
There are some actions that the body no longer allows itself to complete flawlessly.
Dr. Reiner felt a little regretful.
But if it is said to be 3-5 years, it is possible that we still won’t be able to understand it after 5 years, and a new 5 years will be needed.
It has nothing to do with hard work. To reach this level, what is needed is talent.
"After establishing this connection, as soon as you place your hand on the brachiocephalic artery, you will know how much force you should use to perform the anastomosis. Of course, this anastomosis method must be based on almost flawless microsurgery."
"It's a perfect fit, Reiner. This surgery has reached the level of my peak period, and there is even overflow. After the surgery, remember to copy the whole process back and try to figure it out."
"Although you are no longer able to reach this level at your age, it is still good for improving your surgical skills."
Reiner looked at the surgical images speechlessly. While his teacher, Dr. Charles, was explaining the "feel", within a few words, the surgeon had completed the brachiocephalic artery anastomosis.
After all three brachiocephalic blood vessels are anastomotic, full-flow perfusion begins.
The proximal end of the main trunk of the four-branch artificial blood vessel was anastomosed end-to-end with the distal end of the original ascending aorta artificial blood vessel. After exhaustion, Zheng Ren opened the ascending aorta.
After the mixed venous blood oxygen saturation reaches above 90%, slow rewarming begins and the heart automatically restarts.
At this time, a row of numbers appeared on the screen—perfusion time 110 minutes, occlusion time 95 minutes, deep hypothermic circulatory arrest selective cerebral perfusion time 84 minutes.
Perfect!
Flawless!
Dr. Reiner looked at these similar figures and he couldn't help but be stunned.
If you perform the surgery yourself, these numbers will basically be doubled. The multiple is not critical, the perfusion time and the blocking time will never differ that little.
The small time difference means one thing - the surgeon performed the operation steadily and quickly.
Is this all a change brought about by “feel”? Dr. Reiner watched the operation in silence.
The surgeon should have finished the operation, but when he saw that the hypothermic extracorporeal circulation was completed and the heart restarted, another image appeared on the screen.
The interventional guidewire enters the blood vessel, passes through the anastomotic segment, and starts angiography.
At the same time, the surgical field was still clean, with only a small amount of blood seeping out, but no trace of contrast agent.
This is the final confirmation.
Generally, interventional surgery is not used to confirm bleeding after elephant trunk surgery. Dr. Reiner does not approve of this behavior of the surgeon.
If the guidewire touches the anastomosis segment, it may cause unpredictable changes in the anastomosis.
"Reiner, this is a field that I have never reached." Dr. Charles said suddenly.
"Teacher, I don't think it's necessary here." Dr. Reiner said stubbornly.
"No, you will know as you continue reading." Dr. Charles had already guessed Zheng Ren's thoughts. He said with a smile, "The surgeon made bold changes to the surgical technique, which was all based on his understanding of the anatomical structure. and a thorough understanding of the patient’s status.”
"What is he going to do?"
"You must have forgotten what technique this young man used to get recommended for the Nobel Prize."
"..." Reiner was speechless.
Is it possible that if you are recommended for the Nobel Prize for interventional surgery, do you need to demonstrate interventional surgery techniques in such a large-scale operation
This should be a very irresponsible behavior, but why does the teacher still expect this
Suddenly, an idea appeared in Reiner's mind.
Two years ago, the patient underwent coronary artery bypass grafting and ascending aorta valve conduit replacement. Now the replaced blood vessels have also undergone certain changes under the influence of Marfan syndrome.
This is the terrible thing about congenital diseases. The transplanted blood vessels will also be affected, especially the location of the coronary artery bypass graft established from the internal mammary artery.
After watching the film and analyzing the images before the operation, Lena believed that the patient's coronary arteries had some minor problems, but they were not noteworthy.
With the torn aorta as a backdrop, nothing was noteworthy.
And the magician's ambition is so big? What is he going to do? Could it be...
Reiner's suspicion soon became reality.
Interventional stent surgery.
Coronary arteries… Ascending aorta… Descending aorta…
Every blood vessel that is likely to tear is covered with a covered stent. There is no gap between the stent and the stent, which is perfect and calm.
"Did he go for interventional surgery?" Dr. Reiner asked in a daze.
"Yes." Dr. Charles finally changed his position. It took too long and his body was not used to it. "Marfan syndrome will cause pathological changes in the media of the aorta. It is better to use a stent to solve the problem."
Dr. Reiner felt so tight that he couldn't breathe out.
If surgery itself still has hope to reach the level of surgeons, then the current interventional surgery...
You simply can't do it yourself.
This is a crushing of the field!