Yang Ping walked very fast, and Gao Qiao trotted along with him.
Soon, everyone entered the elevator.
"Mr. Takahashi, what do you think of this patient?"
Takahashi is an internationally renowned trauma surgeon. He is by no means an ordinary person. He definitely has his own unique insights in many areas.
"I just saw that the professor wanted to use the resuscitative endovascular aortic occlusion balloon (REBOA) technology, but the femoral artery of the injured person has been damaged and the balloon cannot be successfully inserted. The current common REBOA technology has lagged behind. We
Intelligent REBOA technology uses portable equipment and ultrasound guidance to enter the aorta from any relatively thick artery in the human body, such as the subclavian artery, radial artery, brachial artery, femoral artery, popliteal artery, and even the dorsalis pedis artery.
It can explore its own path. Even if it enters from the upper limb artery, it can cross some dangerous bifurcations, enter the aorta, and deliver the balloon to the predetermined location."
Everyone was in a hurry and spoke very fast. Although Takahashi's Chinese was a bit rusty, he could express himself clearly and there was no problem at all.
"If Dr. Yang is interested, I will send the complete set of information to Dr. Yang. However, the precise vascular occlusion technology that Dr. Yang just used is already one level ahead of our simple aortic occlusion!"
Takahashi was surprised that Yang Ping actually asked for his opinion, and his attitude towards him was not condescending, but treating him as an equal.
And the last time I came to China, my arrogant attitude seemed so narrow-minded. I was like a clown. Dr. Yang is the real master.
Soon everyone rushed to the operating room dressing room, and the discussions on the road stopped. There was no time for academic discussions.
Everyone took the time to change clothes, and the injured had already entered the operating room through another special channel.
When I usually change clothes, I would fold the clothes and put them in their respective cabinets. Now I take off the clothes and throw them into a pile. No one cares if I accidentally throw them on the ground.
"Brother, please save her, can you?" Song Zimo lowered his head and put on his pants.
Who can guarantee to save this kind of injury? We can only fight with all our strength. Whether we can survive or not really depends on the sky.
Yang Ping didn't understand how Song Zimo, who was usually rational, could suddenly say such emotional and wishful thinking.
Song Zimo put on his pants and looked up, and Yang Ping saw that his eyes contained tears.
Yang Ping understood immediately and put his hand on his shoulder: "I will definitely make her come back to life!"
Yang Ping doesn't know whether he can survive or not, and he doesn't know whether he can survive the operation. This is a good wish.
The wounded person was pushed into the operating room and transferred to the operating bed. Fatty Liang was already waiting.
"My blood pressure is 65/30mmHg!"
The blood pressure was finally measured, and the nurse who first discovered it was so surprised that she shed tears.
For this kind of trauma, the main cause of death in the early stage is massive bleeding. If the bleeding can be successfully stopped and blood transfusion and fluid replenishment can be followed, there is a glimmer of hope.
Yang Ping inserted more than a dozen blood vessel clips, large and small, into the abdominal cavity to accurately block almost all possible bleeding.
In this way, continued blood loss will be controlled to a minimum, and blood transfusion and fluid replenishment will follow, and there is still a glimmer of hope for success.
Because feces contaminates the abdominal cavity, the autologous blood transfusion machine cannot be used, and conventional allogeneic blood transfusion can only be used.
Two blood transfusion machines with heating function continuously pressurize blood transfusions. Blood products are continuously injected into the wounded body from the subclavian veins on both sides. However, blood transfusion is not unlimited. To a certain extent, it will cause some complications.
Symptoms.
The time of occlusion of those blood vessels cannot be too long. The safe time is 60 minutes. Calculated from the time of occlusion, the operation must be completed within 60 minutes.
Fatty Liang's hands never stopped, dopamine, epinephrine, etc., were pushed through the veins, and blood pressure slowly rose. The anesthesia machine was connected to the tracheal tube that had been inserted, and various parameter adjustments were at his fingertips.
Hearing the sound of the cart wheels rubbing against the ground outside, someone opened the sensing door of the operating room in advance and blocked the sensing area with their hands, allowing the blood cart to enter the operating room smoothly and without delay.
Another cart of blood bags came in, containing suspended red blood cells and plasma. The nurse was very skilled in changing the blood bags, pulling them out, inserting them into the suspension, and doing it all in one go.
Several instrument tables have been laid out, Xiao Su has put on surgical clothes, the instruments have been classified and partitioned, the first used ones have been picked out, the needles and threads have been threaded, and the alcohol and saline classification notes have also been posted.
Their respective tasks are carried out at the same time, and there is no need for anyone to direct, let alone shout at the top of their lungs.
Those who are allowed to observe should suppress their pounding heartbeats and consciously stand in a corner so as not to interfere with the operation.
After the anesthesia was successful, the blood pressure continued to rise, which was as strenuous as rock climbing with bare hands.
Takahashi judged based on his rich professional knowledge that if he performed the entire operation, it would take at least four hours. If a multidisciplinary model is used, and each injured part of the operation is performed by doctors of different specialties, the operation may take eight hours.
hours.
Experts from general surgery, urology, and obstetrics and gynecology rushed to the operating room one after another. The trauma emergency center was originally a multidisciplinary model, but it was dominated by trauma and orthopedics.
Seeing that Yang Ping was there and preparing to go on stage, everyone had no plans to go on stage. Yang Ping's surgical authority can perform whole-body trauma. This is authorized by the hospital, and he can do it better than everyone else.
This operating room is very spacious. Since everyone is here, they stay to observe and learn. This kind of trauma is too rare.
Rinse, rinse repeatedly with large amounts of normal saline, hydrogen peroxide, normal saline, type III amriodine, normal saline, regardless of quantity, alternate with large amounts of flushing.
A large amount of feces contaminates the abdominal cavity, and the possibility of infection is very high. Many pelvic open fractures are caused by feces contamination, and the patient eventually dies of severe infection.
Rinse, keep flushing, and keep diluting the bacteria. This is the best way.
Yang Ping flushed almost obsessively, and the mixture of blood clots and feces was constantly being diluted and flushed.
He moved his sterile-gloved hands around his abdominal cavity, letting the pulse nozzle in Song Zimo's hand flush the area without any blind spots.
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The three-liter bag of physiological saline is hung up, passed through the pulse flushing machine, connected to the flushing pipe, and the water spurts out from the flushing head.
The physiological saline is consumed very quickly, and the circulating nurse keeps replacing it. There are already more than twenty bags in the bucket containing the empty bags.
The water level in the bucket that collects liquid continues to rise, and it contains a lot of dirt.
Yang Ping and Song Zimo didn't wash their hands until the rinse liquid was clear.
Zhang Lin Xiaowu, who had already brushed his hands, began to disinfect and spread the sheets, seamlessly.
In order to save time, Yang Ping brushes his hands much faster than usual, and his movements have been simplified.
The electrosurgery, double-click electrocoagulation, suction tube, and irrigation tube have been connected.
Yang Ping put on the surgical gown and gloves and started the operation. The usual pre-operative verification procedures were naturally dispensed with.
The knife is used to extend the abdominal wound and expose the entire abdominal cavity as much as possible.
The two large S hooks are gently inserted, and Xiao Wu and Zhang Lin are in place.
A complete set of new pipes, continue to be responsible for flushing. After flushing, everyone changes gloves.
Yang Ping reached in with both hands and carefully explored the organs in the abdominal cavity one by one to determine which ones were worthy of repair and which ones needed to be resected decisively.
The spleen was in pieces, and Yang Ping was sometimes ligating the blood vessels, sometimes separating his fingers, sometimes separating the tissue with scissors, and switching between different instruments was dizzying.
The movements were so fast that I couldn't clearly see the steps. Soon, it was like a mashed spleen that had been successfully removed and thrown into a metal basin.
Without stopping for a moment, he began to resect the broken right lobe of the liver. The resection of the right lobe of the liver was originally a difficult operation, but in his hands, some steps did not even need to be exposed and could be completed by touch.<
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The steps of ligating blood vessels, removing the gallbladder, and separating the right lobe of the liver were not clear at all. The vascular forceps went in with silk threads, knotted, and then the tissue was cut in and separated. After a few rounds, the gallbladder was taken out, and the broken right lobe of the liver followed.
Also took it out.
The pancreas was gently touched, turned, and quickly explored from the head to the tail of the pancreas. The pancreas was slightly bruised, and we need to pay attention to traumatic pancreatitis after surgery.
The hand immediately changed the target, starting from the stomach and exploring the entire digestive tract of the abdominal cavity from top to bottom. The stomach was bruised and did not need to be treated. The small intestine was turned over while touching in the hand, allowing the eyes to see the circumference of the intestine and the mesangial blood vessels.
, the information collected by touch and vision is integrated in the brain and converted into accurate judgment.
Yang Ping's proficiency in anatomy has reached a state of freedom where he can accurately identify anatomical structures without even looking, with just the feel of his hands.
As soon as he stretched out his hand, the handle of the knife was slapped in his hand. Before everyone could catch their breath, the small intestine was cut open and decompressed. The hand continued to move down. The smooth and slippery intestinal tube could be adjusted arbitrarily in the hand, even the cecum and appendix were not spared.
, then, the ascending colon, transverse colon and descending colon were retained, and the entire sigmoid colon and rectum were completely resected and taken out.
The large metal basins containing the resected tissues are placed in a neat row on a special sterile instrument cart, and some of them are already full.
Bilateral kidneys and adrenal glands are explored with both hands at the same time. After exploring the kidneys, go down along the ureters, to the bladder, and then to the urethra.
Following the exploration, Yang Ping reported the location and extent of the injury, as well as the immediate surgical plan.
"There is no obvious damage to the kidneys and adrenal glands, bilateral ureters are broken, the bladder is ruptured, and the urethra is damaged——"
The voice was loud and clear, but seemed extremely calm, without roaring or urging.
But everyone tried their best to keep up with his speed, especially Song Zimo, who was highly focused and did not dare to relax at all.
Everyone understands that at this time, Dr. Yang is competing with the God of Death. If he is slightly negligent, the God of Death will take away his life from his hands.
There is no problem with the ovaries, but the fallopian tubes are stretched and even the uterus is bruised.
While exploring and repairing these organs, suturing, ligation or electrocoagulation of blood vessels are interspersed.
The bilateral internal and external iliac arteries and veins, the left lumbar artery and vein, and both inferior epigastric arteries and veins were ligated; the presacral venous plexus was sometimes sutured and sometimes electrocoagulated.
The various operations are uninterrupted and seem chaotic, but they are in the most optimized order.
When all exploration was completed, the entire greater omentum was lifted out of the abdominal cavity and thrown into the metal basin.
It turned out that while the surgeon was exploring and repairing the organs, he was actually removing the greater omentum. As the exploration was completed, the greater omentum was naturally and completely removed.
"Microscope!"
Zhou Can had already prepared and advanced the surgical area, while Yang Ping and Song Zimo adjusted the focus and interpupillary distance.
Bilateral ureteral anastomosis, bilateral ureteral catheter stent renal pelvic drainage, and bladder rupture repair were completed under the microscope.
Continue to use the stump of the cystic duct to insert a T-shaped tube to perform choledochostomy; the original location of the spleen is also put into a drainage tube.
Cystostomy; descending colostomy, a series of fistulas.
If there is no urethra, a temporary cystostomy is performed. If there is no rectum and anus, a temporary descending colostomy is performed to preserve the temporary urination and defecation function after surgery.
Finally, a beautiful skin flap was used to repair the stump wound.
Three more drainage tubes were inserted into the wound for drainage. In addition to the various tubes inserted into the abdominal cavity, a total of more than ten drainage tubes extended from the body.
During the operation, 20,000 milliliters of blood and fluid were transfused to barely maintain blood pressure.
Finally, the entire lower body was separated from the body, and a pile of mud-like lower body left the wounded person's body.
A person who is more than 1.6 meters has become half a person about 70 centimeters, like a half-length ceramic doll.
The operating room was surprisingly quiet. Takahashi stared at the screen and watched the entire operation. He accurately calculated the time, starting from the time he washed his hands and went on stage. It only took thirty-five minutes.
And every step, there is no pause, no hesitation, as if every step has been clear, what needs to be done, the consciousness arrives before the hand, the consciousness leads the hand, and completes every action accurately.
Countless surgeries are not simply carried out step by step, but are intertwined and flexibly spliced together without any sense of disharmony.
This kind of splicing is not done one by one. In order to save time, the surgeon coordinates all the independent surgical steps, disrupts them, mixes them together, intersperses surgeries, and combines surgeries.
Just like a DJ, speed up here, insert there, suddenly stop this section, and connect to another section, with both hands in the abdominal cavity, cooperate when you want to cooperate, operate independently if you want to operate independently, and the cooperation is seamless.
The entire operation process was completed under the oppressive atmosphere of death, which was urgent, thrilling and exciting.
A powerful force rushed towards his face like a tsunami, making Takahashi feel a huge pressure. He was helpless to fight back, and his knees almost gave out and he knelt down.
The needle holder was gently placed on the steering wheel of the sharp instrument. Yang Ping raised his head: "Vital signs?"
"After passing the first gate of hell, there are still many gates of hell waiting for her." Yang Ping breathed a sigh of relief.
"I'll take care of this patient." Song Zimo stared at the monitor screen.
"You are responsible for setting up the medical team, including Takahashi. I will tell the head nurse that a nursing team needs to be formed. If this patient wants to survive, a dedicated team must be responsible. Any small mistakes may lead to wasted efforts.
, the god of death will take advantage of the situation at any time."
"In addition to this, there are currently only two cases of such high-ranking people in China. One case was reported in Shanghai, and he died six days after the operation——"
