godfather of surgery

Chapter 443 Deadly Adhesion
This kind of adhesion makes Professor Li fearful.

He carefully observed Yang Ping's operation just now, the surface of the heart was almost attached to the inner surface of the sternum.

When sawing the sternum, the saw blade just cut through the sternum without damaging the heart attached to it. This is definitely not luck. It is impossible to control the saw blade not to make mistakes during the whole process by relying solely on luck.

Professor Li's teacher once said: "Remember, an excellent surgeon must be good at using the brain to compose pictures."

So now there is only one explanation. Dr. Yang has already sketched a three-dimensional anatomical map of the operation area in his mind with the help of video pictures, and with this picture in his brain, he directs the chainsaw in his hand to act precisely.

Professor Li performed the first heart surgery that year. The patient had a history of heart surgery, but he didn't know that because of the previous surgery, the heart was adhered to the inner surface of the sternum.Professor Li took a chest saw and sawed the sternum from top to bottom, and then dark red blood gushed out.

At that time, he saw the blood and was scared, not knowing what happened.

Fortunately, the teacher commanded calmly in the audience: "The saw blade cut through the lower atrium, press it down, stop the bleeding, and then repair it."

The patient's blood pressure dropped, and the anesthesiologist ordered the itinerant nurse to transfuse blood. In a panic, Professor Li mechanically accepted the teacher's instructions, but he couldn't find where the bleeding point was.

"Saw the sternum completely, the crack is just below." The teacher roared, and then put on the gloves and got ready to go on stage.

Professor Li bit the bullet, picked up the chainsaw again in a pool of blood, and sawed the sternum completely.

Sure enough, with the help of the suction device, Professor Li saw the bleeding point, a 3 cm wound on the right atrium, and he stretched out his hand to hold the wound.

"Sew it up!"

The teacher ordered, the teacher replaced Professor Li's trembling hand, pressed the wound to stop the bleeding, Professor Li began to repair the gap in the atrium, the teacher let go, and used the suction device to create a barely visible field of vision, fortunately, he is well trained, Professor Li The breach was quickly repaired, the bleeding was stopped, and the patient's blood pressure rose.

Since then, Professor Li has been like a soldier who has been baptized by the flames of war. He never trembled in the face of blood and heart.

But at this moment, Professor Li couldn't help being shocked. The heart and the large blood vessels connected to it were blurred, especially where the large blood vessels were, and there were adhesions everywhere.

Pointed knives have higher separation accuracy than round knives, but the risk is also higher.

Let’s open the pericardium first. The pericardium is a layer of envelope outside the heart. It has a fibrous layer and a serosal layer. A potential cavity is formed between the two layers. There is a serous fluid similar to lubricating oil in this cavity.

This slurry can reduce friction when the heart beats, similar to engine oil.

The entire pericardium, especially the fibrous layer, not only protects the wrapped heart, but also fixes the heart in the correct position and limits excessive expansion of the heart.

If there is no restriction of the pericardium, when the heart contracts, the intracardiac pressure rises rapidly, and the heart expands unrestrictedly, which will cause the heart to rupture.

Of course, this situation is when the heart is contracting violently.

Just like putting a balloon in a cloth bag, no matter how you blow it, it will not exceed the size of the cloth bag. If there is no restriction of the cloth bag, if you blow it hard, the balloon will burst when it expands to a certain extent.

The pericardium, which was originally all positive, now forms adhesions and narrows, restricting the normal beating of the heart and endangering life. Yang Ping now wants to peel off this layer of capsule that restricts the heart.

The pericardium must be opened to fully release the vitality of the heart, otherwise the contracted capsule will strangle the heart.

The sharp knife was replaced with a round knife. The tip of the knife cut across the pericardium with a proper depth. It just cut through the capsule without hurting the real surface of the heart. This kind of knife skill made Professor Li unbelievable.

The fibrous and serosa layers of the pericardium have adhered together to form a firm connective tissue.

"Be careful!"

Professor Li couldn't restrain his worry and spoke up.

But Yang Ping didn't seem to hear his reminder, the knife had already made a long cut in the heart, forming it in one go.

Professor Li's worry was unnecessary, because the capsule was just cut through in every part of this incision without hurting the heart under the capsule.

The envelope was opened, and a fresh heart was ready to come out.

The toothless tweezers lifted the envelope, and the tip of the knife was almost attached to the surface of the heart, and began to separate in all directions. Slowly, half of the envelope that restrained the heart was separated, and it could no longer restrain the heart.

"Leave the rest to fix the position of the heart." Yang Ping stopped the knife in his hand.

If the entire envelope is peeled off like an egg, the naked heart will roll and bump around in the chest cavity because there is no restriction, and the blood vessels connecting it will be torn and burst or spasm.

All internal organs on the human body must be properly fixed, otherwise they will run around.

The remaining pathological pericardium can no longer restrain the heart, so that the heart can contract freely. At the same time, compared with the normal heart, there is a risk that the heart may rupture when it contracts suddenly and violently.

Change the blade!
The blade should be replaced every time a segment is separated.

Because the quality of these blades is worrying, after only a few minutes of use, they begin to become dull and cannot meet the requirements of fine dissection.

The thing that surgeons hate the most --- the scalpel blade is too blunt!
Changing back to the sharp knife again, Yang Ping began to separate the aorta along the heart and the left ventricle. The aorta and vena cava had been pulled to the front of the spine by adhesions and stuck together with the front.

The malformed spine and thorax lead to a very narrow chest cavity. The blood vessels and organs are almost squeezed together. The large blood vessels are tortuous like intestines, but because of the adhesion, nothing can be seen clearly.

Adhesive connective tissue overwhelmed everything, and it was impossible to tell which were blood vessels. There was only one tissue under the knife, and that was the adhesive connective tissue.

The sharp knife worked unswervingly, and the winding ascending aorta was slowly exposed.

Immediately afterwards, the brachiocephalic trunk, the first main branch of the aorta, began to be outlined under the sharp knife.

The tip of the knife seemed to have some kind of special detection ability. An unnamed branch artery was separated. Yang Ping did not intend to ligate it, but continued to separate it until it reached a satisfactory length. It would not involve the restoration of the entire aorta because of it.

"The operating space is too small, they squeeze together, they stick to themselves, and they stick to everything around them."

Professor Li was highly focused and followed Yang Ping's rhythm, because every time the knife was cut was something unknown, so every knife made people feel nervous.

It's like running blind in a minefield!
Although this operation is not an open-heart operation, all operations are performed outside the heart, but any negligence will cause the rupture of blood vessels.

However, Yang Ping seemed to know these anatomical structures in advance, and he never made mistakes in the position of the knife every time, whether it was the coordinates of up, down, left, right, or depth.

This is completely different from what Professor Li imagined.

What he imagined was that the blood vessel should burst from time to time, the blood gushing or spurting out, and then the blood vessel should be repaired quickly, and then it could continue.

But Dr. Yang didn't do that at all. So far, there hasn't been a single accidental bleeding from the root of the aorta to the brachiocephalic trunk.

A few times I thought it was going to squirt blood, but it didn't.

Does Dr. Yang have any other high-tech inspection equipment to complete the imaging examination?
impossible.

Professor Li looked up and looked around, everything was normal.
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Family waiting area.

Zheng Baosheng's parents were worried one after another, the worry of being connected by blood could not be suppressed.

Now their son is lying on the operating table, likely never to wake up.

Lao Zheng looked at his mobile phone from time to time to calculate the time. He was afraid that the operation door would suddenly open. The doctor said dejectedly, "We have tried our best."

Zheng Baosheng's mother was muttering something silently, probably asking for blessings from the Bodhisattva.

This torment is very painful.

"Old Zheng, tell me, can our son survive this test?" Zheng Baosheng's mother opened her eyes.

Old Zheng looked towards the door of the operating room: "My son said that he can step over. He said that there are countless people who were pulled back from the gate of hell by Dr. Yang, and he will be one of them."

When mother heard this, she felt a little comforted in her heart.

This kind of thing, really, depends on fate! ——
Nurse Qin is now standing in the operating room, because the video was shot in the operating area, she cannot see the equipment nurse's performance.

Therefore, she could only come to the operating room and observe on the spot.

The silent cooperation between the chief surgeon and the equipment nurse, the seamless tacit understanding opened Nurse Qin's horizons.

She considers herself to be the best instrument nurse. She received the most advanced training in the best hospital in China and undergoes a lot of operations every day, but she has never seen such coordinated cooperation.

Everything is clear and orderly, this clarity, this order, is natural, not mechanical, rigid, or deliberate.

She once invited Xiaosu to study in 301, but now she finds that it should be the other way around, this is the most worthwhile place to study.

The little itinerant nurse handled the rounds of the operation by herself without anyone's help, but she didn't panic and remained calm. What she did seemed to use mathematical planning to arrive at the best sequence.

The anesthetist, sitting calmly next to the patient's head, actually played with his mobile phone.

Every once in a while, he would glance at the monitoring screen, and then lower his head to play with his phone.

Perhaps, all of this is under his control, so he doesn't have to worry about it at all.

The preparatory perfusionist who came from the Thoracic Surgery Department had nothing to do, sitting aside, looking here and there boredly.
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"This is a cardiac surgery, how did Xiao Yang do it so proficiently?" Professor Liang couldn't help asking.

Obviously they came to see the spinal correction, but at the beginning, they were shown the heart and great vessel surgery.

"I don't know either. He said he performed the whole operation himself. I thought he was joking." Professor Qin didn't know the answer.

Talent can only be explained by talent.

Professor Su kept silent and kept staring at the screen. Although he was a master in spinal surgery, he was very aware of the difficulty of this surgery because sometimes he needed a thoracic surgeon to deal with cardiopulmonary problems during scoliosis surgery.

No wonder, it has to hang the sign of the Institute of Surgery.

It seems that the ones who really understand him are Xia Changjiang and Han Jiangong.

Professor Su glanced at Professor Qin from the corner of his eye. Now, Professor Qin is the most persistent and must dig Yang Ping to 301.

If I really went to 301, I am afraid that I am not as good as Sanbo. Professor Su has this feeling at this time.

But there are some things that ordinary people can't decide.

On the left of Professor Liang is Professor Su, and on the right is Professor Qin. He sometimes turns his head to talk to the left and right.

"Young people are scary, does Xiao Yang have a partner?"

Professor Qin nodded: "Yes."

"Where is the subject? What's the situation?" Professor Liang asked very carefully.

"The nurse in the operating room is working on the stage."

Compared with Professor Liang, Professor Qin has a better understanding of Yang Ping's personal situation.

Professor Su looked sideways and thought to himself: What do you mean by asking your partner?Digging the wall, did you get to this point?

(End of this chapter)