Zheng Ren made a preliminary judgment on how difficult this patient's surgery would be.
Hepatic echinococcosis, patients with autologous liver transplantation, and pig hooves are not assigned task classifications. And this patient actually gave an S-level judgment.
Is the surgery S-level
Zheng Ren was stunned for a moment, what is the difficulty? Want to keep a kidney? !
He recalled the images of kidneys shown in the film and began to reconstruct them in his mind. Both kidneys were severely damaged and difficult to preserve. At the very least, judging from Zheng Ren's own level, it is indeed difficult to retain.
I have a master-level skill book in my hand, and I can try to use it if needed. Then there is still some surgical training time, which should be able to support the completion of this operation.
However, S-class surgery shrouded Zheng Ren's mind like a lingering shadow.
Judging from Big Pig Hoof's judgment, he knew that what Director Miao said, that is, try it, the probability of success is less than 20%. But it is better than watching the movie and thinking that there is no way to operate and that you have to wait until death.
"Come together, squeeze in, hurry up, don't delay." Director Miao said.
Wash your hands and go on stage.
Fang Lin didn't even have a seat. The director of the chest department must have heard from the emergency department that the chest trauma was not serious, so he had to come up later. Let Fang Lin come and get a breast bottle.
Hepatobiliary, urology, and interventional departments were opened at the same time.
The warmed plasma was poured in bag after bag, and my blood pressure was still extremely low. Time is life. No one spoke in the operating room, only the sound of hurried footsteps echoed.
Making orders is a difficult task, but you can just deal with it.
Zheng Ren pushed Director Kong on the chair and signaled that it was enough for him to get in alone. Then I went to put on my lead clothes and brush my hands.
Professor Yang and Director Miao also wore lead clothes to brush their hands. They were not used to it. It was too awkward to wear more than ten kilograms of stuff on their bodies.
However, interventional embolization surgery for severe pelvic fractures takes about two hours. How many threads are needed? !
It is possible that the surgery in the abdomen has been completed and the interventional surgery cannot be completed yet.
So it should be awkward, but it should still be awkward.
The hospital managers knew that time was tight and moved very quickly. Mr. Yu and Mr. Dong quickly laid out the orders. After Professor Yang and Director Miao came up, they stood on the right side of the patient, and the two general residents stood at the first assistant position.
Zheng Ren stood by his leg and asked Su Yun to lift a corner of the sterile drape, and he immediately started to puncture the femoral artery.
The posture was extremely awkward, but Zheng Ren couldn't be bothered by anything. Director Miao and Professor Yang had a brief exchange and when they chose an incision acceptable to both of them, Zheng Ren had already completed the femoral artery puncture and inserted the guide wire.
"Get ready to step on the thread." Zheng Ren said in a deep voice when he felt that the guide wire was in position.
The airtight lead door closed. Director Miao was a little surprised. How could it happen so quickly? But he didn't have time to think about things. He cut open the patient's abdomen from bottom to top and connected it with Professor Yang's incision.
Quickly separate the skin and subcutaneous tissue and enter the abdominal cavity.
After one glance, Director Miao wanted to turn around and step down.
There was a huge hematoma near the kidney. Although it was wrapped in yellow fat, it was visible to the naked eye that the kidneys on both sides were crushed.
Probably because he came to the hospital early, he had a chance of rescue. If it were three to five minutes late, there would really be no chance at all.
Even so, Director Miao felt that it was no longer possible.
The injuries to the liver and spleen were relatively minor, and Professor Yang had already begun suturing them.
Director Miao carefully separated and continued ligation. What he wanted was to save at least one kidney.
But five minutes later, it was discovered that the left kidney was gone.
Almost all of it was shattered, and there was no way to sew it open.
A prompt decision was made to block the renal artery and start a left nephrectomy. All that's left is to pray that the patient's right kidney still has a chance to survive...
"How much urine is produced?"
"No urine." The anesthesiologist replied immediately.
No more urine! This is a manifestation of complete loss of kidney function.
If you want to remove the entire kidney, Director Miao doesn't need to be too skilled. For him, it only takes a few minutes.
But making this choice is extremely difficult.
The left kidney was removed. The operation was simple and the bleeding could be stopped immediately. But what if the right kidney fails
However, the suction device was sucking arterial blood, and the hissing sound reminded Director Miao that he could no longer hesitate.
Use the renal pedicle forceps to clamp directly, cut off the ligament, and prepare for total left kidney resection.
Because there were many people on the operating table, there were two nurses delivering the instruments, but Director Miao stood in the middle, which was very inconvenient.
He clamped the renal pedicle, and when he was about to ask for something, a pair of blunt scissors came into his hand. A sterile-gloved hand took the renal pedicle forceps from his hand.
Well…
Director Miao was startled.
This is... Boss Zheng
"Is the operation completed?" Director Miao asked in surprise.
"Well, the embolization is over." Zheng Ren took the forceps and did not step down. Instead, he stood on the operating table and acted as an assistant to Director Miao.
Su Yun hid under the operating table, squeezed in between the people, hid under the sterile drape, and used an extremely awkward posture to apply pressure to the puncture point.
Although the patient is now in a state of hemorrhagic shock, if the bleeding can be stopped, the blood pressure will definitely rise. Don't forget that after the surgery, when you look at the blood on the other side, your pants will be wet.
The amount of bleeding should be at least around 1000ml. The patient is already in hemorrhagic shock. It would be helpful to save some blood.
Director Miao looked up at the time. It had only been ten minutes since the show started. Zheng Ren's surgery had already been completed
"Is the retroperitoneal injury serious?" Director Miao asked seemingly casually while cutting the kidney.
"Five blood vessels are bleeding and all are clogged. It's no problem." Zheng Ren knew his doubts and answered the question incorrectly.
Director Miao raised his head and glanced at the screen opposite. The screen stopped at the embolization interface, with no post-operative imaging.
"Why didn't you take an image to confirm?"
"The patient has stopped urinating. Taking less contrast agent will be beneficial to the postoperative recovery." Zheng Ren said matter-of-factly: "Can the right kidney be saved?"
"It depends on the situation." Director Miao neatly cut off the left kidney. Then he explored the right kidney and gave Zheng Ren to pick up the left kidney residue bit by bit and put it in the pathology basin next to it.
The left kidney was broken like a rag doll that couldn't be sewn back together. The right kidney... was a little better, but not much better.
Zheng Ren watched Director Miao suturing as much as possible and trying his best to save the right kidney. He knew in his heart that this was just a desperate struggle.
No wonder the system determined that it was an S-level mission, which was impossible to complete.
"Su Yun, how much is the urine output?" Zheng Ren helped Director Miao repair it and became concerned about the urine output.
If there are a few milliliters of urine, it can also prove that the injured person's right kidney still has residual function.
However, Su Yun's words made Zheng Ren fall into an ice cave.
"There is no urine, and there is no urine in the urine tube." Su Yun said calmly.
After Director Miao heard Su Yun's words, his hand paused.