"No need for the moment, just a moment." Zheng Ren had already cut out the right lung and placed it in the pathology basin. At this time, Lao He held the report sheet in his hand and reported, "The blood sample from 10 minutes ago, the total bilirubin was 876 μmol/L, and the blood gas..."
He only talked about the project in question and did not touch on other items. It was simple and clear.
Is liver damage so serious? ! Dr. Charles was stunned.
The liver function was severely damaged but the kidney function was not bad. If Dr. Charles stood on the operating table by himself, he would definitely need intraoperative liver dialysis at this moment. As for machines, the Mayo Clinic has nothing, so it can only cobble together a patchy dialysis machine.
Look at that machine. Parts from at least four manufacturers are pieced together, like a beggar.
But Dr. Charles didn't sneer or ridicule, he was more surprised.
Dr. Zheng is like an experienced captain who has been drifting at sea for decades. He can judge that a storm is coming based on clues.
Before that, he had already led his assistants to escape from the place where the wind and waves were the biggest in this broken ship.
It was unimaginable, Dr. Charles thought about it again, but could only sigh. If he were on the operating table, he would not have predicted in advance that the liver would suffer from acute failure.
All the previous unreasonable treatments also became clear, although Dr. Charles still couldn't figure out how Zheng "predicted" that the patient would develop acute liver failure.
Is it because of the impact of interventional surgery? Dr. Charles silently searched for possibilities.
"Heparin 40mg plus normal saline 5000mL pre-flushed pipeline and plasma perfusion device, blood flow rate 75mL/min, replacement fluid speed 25mL/min." Zheng Ren commanded in a deep voice.
The Icu doctor began to operate the machine to adsorb bilirubin.
At the same time, Zheng Ren removed the heart and lung tissue en bloc in a semi-inflated state and placed it in the pathology basin. After receiving the 3D printed lung tissue preserved in Perferdex solution from Xie Yi, he began to take an ice bath.
Then the 3D printed lower lobe of the right lung was placed into the chest cavity, and anastomosis was performed in the order of trachea-artery-atrial sleeve.
"Fluid rehydration, 500ml normal saline." Zheng Ren said, "Dopamine can be given now."
Lao He immediately opened the micropump that had been prepared, and the drug immediately entered the body along the blood vessels.
"Adjust ECMO flow so that mean pulmonary artery pressure is less than 40 mmHg."
"The blood flow rate of liver dialysis is accelerated, 100mL/min."
"Methylprednisolone 500mg Shock."
Medical orders were issued one after another, and the assisting doctors constantly adjusted the values of ECMO, liver dialysis equipment, micropumps, and ventilators.
At the same time, Zheng Ren placed the lower lobe of the right donor lung in the right chest, and used 4-0 absorbable monofilament suture mo to continuously suture the membranous part of the bronchus, and used 4-0 Vicryl suture to make interrupted sutures in the cartilage part.
The suturing is done under a microscope and is simple and straightforward. It seems that on-the-spot command and surgery are running simultaneously in the brain and do not interfere with each other.
Even if Dr. Charles once stood at the pinnacle of surgery, it was only at the pinnacle of technique, and he would never pay attention to every detail of the entire operation process and everyone.
It's not that the details are useless, it's that he... can't do it.
Zheng Ren performed the anastomosis under a microscope. No matter how exquisite his technique was, Dr. Charles would not be surprised. He just laments that the passage of time has taken away youthful vitality and also stability and meticulousness. He can never do what he once was able to do now.
However, while operating, he was also meticulously controlling all the details on the operating table, including the ventilator, micropump, ECMO, and liver dialysis. This was simply beyond the reach of humans.
While Dr. Charles was astonished, Zheng Ren clamped the proximal side of the right pulmonary artery, trimmed the blood vessel as appropriate to match the caliber of the supplying pulmonary artery, and then used 5-0 Prolene suture to continuously suture the pulmonary artery.
His hand was steady, neither fast nor slow.
Then a vascular clamp was clamped on the left atrium proximal to the pulmonary vein, the pulmonary vein stump ligation was removed, and the upper and lower pulmonary vein openings were connected to form a left atrial sleeve of appropriate size, which was connected to the right pulmonary vein of the 3D printed lung donor. The atrial sleeve is continuously sutured with 4-0 Prolene suture.
After the anastomosis was completed, Zheng Ren used 3D printed omentum to cover all the anastomoses in sequence, and performed the anastomosis patiently and carefully.
This... the lung transplant on one side is complete!
Dr. Charles looked at the time in surprise. The cold ischemia time of the right lung was 58 minutes!
He didn't feel anything when watching the surgery, but the moment the cold numbers appeared in his mind, Dr. Charles knew where the gap was.
This was the fastest lung transplant surgery he had ever seen. Regardless of how fast the operation is performed, the key point is that the surgeon does not devote himself wholeheartedly to the operation. He is still the soul of the entire operation and controls all medical activities including the operation.
Is this the peak level after the peak? It has gone beyond what I can understand, controlling the entire scene without missing a beat.
This is the real king in the operating room!
"Shhh" Su Yun let out a long breath and glanced at the various values of the monitor and ECMO.
"Boss, there seems to be no problem." Su Yun said, "Did the operation succeed?"
"It's only half of it, please concentrate." Zheng Ren glanced at the various values and began to give medical instructions.
"Adjusting ECMO flow increases mean pulmonary artery pressure by 5mmHg."
"The blood flow rate of liver dialysis is accelerated, 110mL/min."
"Methylprednisolone 500mg Shock."
“Dopamine and metahydroxylamine rates decrease… ”
In the song of good luck, Zheng Ren's voice became cheerful as he gave the doctor's orders.
"Ventilate the right lung and expand the lung manually." Zheng Ren said softly.
Lao He responded and began to adjust the position of the tracheal tube, changing it to single-lung mode and ventilating the right lung. As he began to squeeze the ball, the air entered the fresh lungs. The lungs inflated like balloons, and a faint beeping sound could be heard.
That's not noise, that's the sound of life!
"Okay, next one." Su Yun said slightly excitedly.
"Don't worry, warm salt water." Zheng Ren said.
The chest was filled with warm saline, and Lao He held the rubber ball to control the expansion of the lung tissue. Finally, Zheng Ren reinforced the omentum at the anastomosis of the main trachea, and then completed the unilateral surgery.
Zheng Ren then retreated the Swan-Ganz catheter to the common pulmonary artery, placed it in the right pulmonary artery, and started the left lung transplant.
For Dr. Charles, the surgery has actually been completed.
There are differences in the surgical procedures for the left lung and the right lung, but for the surgeon with a cold ischemia time of 58 minutes on the right side, there is no doubt whether he can complete the operation.
In the operating room, under the BGM of good luck, the sound of various machines operating was slightly loud, as if to accompany the good luck.
Bright and clean.