When people in the observation area saw this scene, they all got off their chairs. A sudden cardiac arrest occurred during the operation, which is a severe test of clinical experience and psychological quality for any surgeon.
"Heartbeat stopped?"
"Defibrillating!"
---
"Yes!"
"Yes."
Amid the noise and exclamations, everyone saw the normal electrocardiogram on the screen and let out a long breath. Some people reached out to touch the chair and sat back down.
People who have lingering fears crawl out of the danger and adjust their emotions.
"Dr. Yang is a generation ahead of us in the research on this kind of tumor. He had already anticipated the cardiac arrest."
"We are still in the primitive exploration stage. In our view, problems that are temporarily insurmountable seem to have become routine here."
The huge waves that had just been stirred up in Johannesson's heart slowly calmed down, but there were lingering waves.
Griffin wasn't much better, he was also frightened.
The medulla oblongata is part of the brainstem. Many nerve nuclei of the brainstem are distributed in this area. In the past, surgery in this area was restricted.
In recent years, advances in brainstem anatomy, advances in operating techniques under microscopes, and the application of various advanced examination and surgical equipment, as well as navigation equipment, have allowed surgeons to enter the restricted area.
However, the operation is also limited to the safe zone, and is performed in the gap between the nerve nuclei and the conductive bundles. Feng's kind of tumor is tightly adherent to the vital nuclei, so it is still a restricted area for surgery.
Yang Ping's hand is very stable, like a precision machine. What is even better than the machine is that the good tactile feedback allows the operating force to be accurately controlled, which is something that no current machine can achieve.
Wen Rentao, who is good at operating under microscopes, saw Yang Ping's operations and had to admit that the gap with Yang Ping could not be narrowed.
Under the magnifying microscope, the operation is very smooth, with maximum precision always maintained, and the movements are not out of shape at all.
After crossing the first danger zone, the tumor is continued to be separated, and the bleeding is stopped while separating.
In Yang Ping's eyes, unencapsulated tumors seem to have some kind of invisible capsule, and Yang Ping can separate them on the surface of this capsule.
It's really like rock climbing with bare hands. There will be five falls during the entire rock climbing process. After falling, you have to grab the rock again and continue climbing.
If you miss once, you will never recover.
"This is the limit of human beings. His hands have always been stable, without any signs of relaxation and fatigue."
"Whether it succeeds or fails, this operation should become a classic."
"Oops, the adhesions are too tight, and we are in danger again. The accuracy of 0.1 mm cannot meet the needs of this operation. Another fall is going to happen. Oh my god."
"——"
The more I can see clearly, the more nervous I feel.
Johannesson covered his mouth and almost made a sound. Griffin and Woodhead were already huddled together, as if they could gain a sense of security.
The laser scalpel head emitted a faint light and entered the death zone again. Yang Ping paused briefly here to communicate with his assistant in advance to remind him of what was going to happen next.
"Attention everyone, the second cardiac arrest is coming soon, cheer up." Yang Ping's clear and calm voice.
Everyone regroups all their energy and waits for the second coming of death.
There was an uncontrollable scream in the conference room.
The second cardiac arrest occurred, this time it happened faster and without any warning.
Without any delay, with quick movements, the sterile drape covered and protected the surgical area, the sterile drape on the back was lifted, and the ECG monitoring electrodes and leads were removed.
The first defibrillation failed——
The right side of the screen in the observation room displays the panoramic view of the operating room and various monitoring parameters.
The second defibrillation failed---
Johanathan stood up after the people in front, everyone stood up, and failed for the second time.
Time passes by second by second. With this kind of cardiac electrical disorder, if defibrillation fails in the early stage, the chance of defibrillation in the later stage is slim. Johannessen understands the risk.
As if the patient was right in front of him and Johannesson was unable to help, he clenched his fists with both hands.
"Come on, come on!"
He clenched his fists, fingers clasped deeply into his palms, and felt a heartbreaking pain.
Continue---
Dr. Wu from the ICU has experienced many rescue operations and many fights with death. When he failed for the second time, his hands began to tremble slightly.
At this time, the doctor's good professionalism was fully demonstrated. Even so, he still pressed the electrode plate to the accurate position with the fastest movement and without any deformation, and completed the third defibrillation.
"Yes!"
The anesthesiologist kept staring at the ECG waves on the defibrillator screen. Behind the dense ventricular fibrillation waves, the familiar sinus heart rate waveform jumped out.
"Yes--" Everyone almost cheered.
The anesthesiologist didn't even notice it. When he shouted "Yes", there were two tears on his face.
It’s not just because of Mr. Feng. Doctors don’t want any patient to die in his hands. Life slipping away from his hands is a spiritual shock to any doctor.
Life and death are at this moment, life and death are between three defibrillation actions.
Heartbeat recovery---
The circulating nurse wiped the sweat from everyone's forehead one by one.
Outside the door of the operating room, Han Jiangong and Hong Zhigang have been waiting at the door. Doctors from other departments look here from time to time, but they dare not come over.
They know that as long as the operating room door is not opened in advance, things will continue inside.
Han Jiangong and Hong Zhigang, their hearts were on fire. They could see what was going on inside through the small window, and they had already passed the second gate of hell.
Professor Zhang sometimes stood still and sometimes walked around with his hands behind his back. A doctor from the neurosurgery department brought a stool and asked Professor Zhang to sit against the wall.
Professor Zhang waved his hand to indicate that he would not sit down. His whole body shivered when he sat down, but he felt better after walking around.
Dean Chen was sitting in the dressing room, leaning on the back of the chair. He never went in. He held his cell phone in his hand, checking from time to time to see if there were any missed calls.
"Caught, God, he's caught it again."
Everyone sat down again. Johannesson gasped for air and loosened his white fingers. Woodhead and Griffin clasped their hands together.
Senior surgeons were terrified every step of the way while observing this kind of surgery, especially when the heart stopped, for fear that they would not be able to be revived.
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This kind of heartbeat and respiratory arrest is caused by general anesthesia, which inhibits spontaneous breathing and relies entirely on the ventilator to take over breathing, so it cannot be expressed.
The heartbeat will be reflected immediately. If rescue cannot be carried out, even if ECMO is used to temporarily replace the heart to promote blood circulation, it will have no effect.
Because the vital functional areas of the patient's brain have been disrupted, brain death is inevitable.
"Everyone adjusts their mood. Does anyone want to be replaced?"
Yang Ping asked everyone that countless devil trainings made him hard-hearted and extremely rational during surgery, like a robot, and so rational that he was inhumane.
In the face of this kind of surgery, any mood swings and any impassionedness will be of no use.
Everything must be done in accordance with scientific laws, and all choices and judgments must be rational to be closest to success.
After two cardiac arrests and two battles with death, everyone spent a lot of energy.
Under Yang Ping's questioning, no one said anything. The quality of the doctors at the No. 6 Hospital in Modu is indeed among the best in the country.
"There will be a few more times in the future. Everyone, cheer up. The God of Death is beside us and can reach out at any time. We must not miss it every time and check the power of the defibrillator." Yang Ping warned everyone.
Reorganize the operating table, change clothes and gloves, and continue the operation.
The surgeon's firm will is focused on the tip of the scalpel, which is fearless and continues to move forward.
The operation has entered the most dangerous area of the medulla oblongata, and the heartbeat has stopped for the third time, which will be even more sudden in the future.
Yang Ping must judge in advance and give other doctors enough time, five seconds. If there is a slight hesitation or delay, the opportunity will be lost.
Five seconds, the God of life only gives five seconds every time.
"How can Dr. Yang accurately determine at which step cardiac arrest occurs?"
"It shows that his research on the anatomy and physiology of the brain stem has been very thorough."
"In China, brainstem surgery is the job of neurosurgeons."
"I heard that when he was studying tumors in the upper cervical spine, they extended up to the medulla oblongata, and that's where the research started."
"Our trip to China will advance the surgical level of cervical spinal cord tumors and brain stem tumors by at least ten years."
"The Chinese are so crazy. There seems to be no problem they can't overcome."
"Sir, don't forget, the world's first case of replantation of a severed limb occurred in this hospital."
Johanathan, Griffin and Woodhead sat there all the time without even going to the bathroom.
The same goes for everyone else in the observation room. No one went out and they were all concentrating.
The surgical object, which is one-third the size of a thumb, is all fragile soft tofu, with countless blood vessels and many nerve nuclei inside, forming a world full of dangers.
The deeper you go, the more difficult it becomes to separate. Mistakes in judgment and operation can be fatal.
The laser knife follows a precise trajectory without any jitter or deviation. The surgeon seems to know the boundary between the tumor and the normal tissue. Even if there is no boundary, he can separate it.
As the separation deepens, the third cardiac arrest is getting closer and closer.
In fact, this is the third and fourth gathering. The interference of two consecutive dangerous areas is responded to by a stop.
"The third cardiac arrest is coming soon. This time it will be very stubborn. It may take more than ten rounds of heart compressions and electric defibrillation to succeed. Everyone must hold on."
Wen Rentao listened. He could predict more than a dozen rounds of cardiopulmonary resuscitation and be so calm. He was a half-god and half-man.
"This time, we want to peel out the tumor from the superficial layer of the nerve nucleus?"
The hairs all over Johannesson's body stood up, this was the real death zone.
If we were operating on the verge of death before, this time we are operating directly on the verge of death.
This is something that no neurosurgeon in the world dares to do. Operating in the gap has reached its current limit. Now you want to enter the superficial layer of the nerve nucleus? Even fiddling with tweezers may cause death.
Yang Ping adjusted his sitting posture. This time, there were two dangerous operating points connected together. Yang Ping planned to cross them at once, but he could only cross them once. If he crossed them twice, the success rate would decrease.
If the nerve nuclei are densely packed reefs in the vast ocean, they were swimming between the reefs before, but now they have to collide with the reefs.
At this time, the 0.1 mm laser knife also seemed to lack confidence.
This time, crossing the danger zone and the two operational risk zones, one needs to draw a curve continuously. Any pause will increase the time the tool tip stays, causing the heat accumulation effect to increase, causing irreparable consequences.
"Everyone, please pay attention. When you hear my order, you don't need to look at anything. Direct defibrillation. Electric defibrillation and cardiac compressions are performed alternately without stopping until success."
There is only one chance, and you must succeed once.
In "The Thief", riding a motorcycle across a canyon and landing on an isolated peak, there is only one chance. Failure means death. Now Yang Ping has to cross two canyons in a row.
Wen Rentao dared not move the suction device on his hand at all. There was no bleeding now. Even if there was bleeding, he would not dare to put it in to suck blood.
"Take a rest, are you scared?" Yang Ping asked Wen Rentao.
Wen Rentao tried his best to calm himself: "The target of your operation should be the heartbeat center?
"That's right, I want to enter the superficial layer of the inner core and peel out the part where the tumor has entered." Yang Ping told him.
"If this is feasible, there is only one chance. There is no time to wait. The beginning must end. There is only one chance to succeed or not." Wen Rentao understands the danger of the next operation.
"Everyone, please take a break and adjust your emotions. The next recovery will be more challenging. Believe me, we will definitely be able to get through it." Yang Ping encouraged everyone.
Yang Ping took a short rest and got a buffer before continuing the operation.
He adjusted his breathing several times and kept adjusting the laser knife in his hand, looking for the best feeling, just like a sniper looking for the best time to shoot.
The laser head began to move, changing from its previous calmness. Small bright spots quickly traced along the predetermined curve at the junction between the brain tissue and the tumor.
Once, twice, three times, four times, each overlap is precise, deepening the separated parts.
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Finally, the two death zones were crossed. When the last operation was completed, Yang Ping put down the equipment and directly ordered: "Heart compression, electric defibrillation!"
As soon as the words fell, the wavy lines disappeared and the heartbeat stopped. This time it was a flat straight line, not a ventricular fibrillation wave. Although Yang Ping told everyone in advance, everyone was still shocked by the sudden change.
Straight lines are more dangerous than ventricular fibrillation waves.
Cover the surgical area, lift the sterile drape, and start reverse cardiopulmonary resuscitation.
Dr. Wu's actions in the ICU were very standard. The amount of compression on the back was pushed back by the sandbag on the lower sternum on the ventral side. The sandbag compressed the lower sternum, causing the thorax to sink, forming an artificial pump, squeezing the heart, and driving blood to circulate around the body with oxygen. Johannesson was extremely nervous for such a bold operation, but if he didn't do it like this, there would be no hope of success.
The pores all over his body were shrunk and his muscles were in a state of spasm. He leaned on the back of the chair and remained motionless.
"Anesthesiologist, continue the intravenous epinephrine injection."
"Yes!"
Ventricular fibrillation waves appear, which are fine fibrillation waves.
"Anesthesiologist, turn it into a thick tremor wave, quickly!"
Another quick intravenous push of epinephrine.
Thin fibrillation waves are very dangerous and difficult to successfully defibrillate.
With the efforts of the anesthesiologist, the thin tremor waves immediately turned into thick tremor waves, like a rapidly shaking rope.
"Wen Rentao, prepare for defibrillation, quickly!"
Wen Rentao didn't hesitate at all. The electrode plate in his hand had already been coated with conductive paste and pressed against Mr. Feng's back.
Yang Ping looked at the screen calmly, his heart as solid as a rock.
"Go on, don't be discouraged. You can definitely be saved. You can definitely do it." Yang Ping said firmly.
"Defibrillation again!"
Failed again.
Outside the door, Han Jiangong and Hong Zhigang saw the rescue operations going on inside through the small glass window. Their hearts pounded, and a tight contraction came from their chests.
Professor Zhang sat on the stool, squinting his eyes. He could no longer stand up. Whether he could survive it or not depended on the old man's life.
Cardiac compressions and electric defibrillation are performed alternately.
The third time, the fourth time, the fifth time, the sixth time, the seventh time ---
There was no sign of success yet. Johannesson looked at the screen, not daring to blink. He was in extreme pain, hoping that sinus rhythm electrocardiograms and QRS complexes would appear.
The QRS complex, which everyone has, is now out of reach for Professor Feng.
"God---" Griffin kept making the sign of the cross.
Woodhead's whole body was cold. He held Griffin's hand tightly, and his body had slipped from the chair and was lying down.
"Hurry up, hurry up!"
Someone in the observation room burst into tears.
The fifteenth time, electric defibrillation.
Professor Ma, the anesthesiologist, looked at Yang Ping, and everyone did not stop.
"CPR substitution, Zeng Ran immediately replaced Wen Rentao."
Zeng Ran comes on stage.
"Not strong enough!"
Yang Ping immediately replaced Zeng Ran. Originally, he was supposed to take overall command, but he usually had less training in reverse cardiopulmonary resuscitation. Even the assessment was done in the supine position, so Zeng Ran was a little unskilled.
Yang Ping pressed his back hard and rhythmically. The pressure on the back and the squeezing of the sternum sandbag deformed the chest, and the heart pumped out the blood. When he released his hand, the chest rebounded, and the blood in the whole body returned to the heart.
"Keep defibrillating!"
Wen Rentao underwent defibrillation for the eighteenth time. He was almost desperate. It had already been defibrillated for the eighteenth time.
"Go on, don't panic, everyone, it will definitely be possible, it will definitely be possible---"
Yang Ping's tone was firm and confident, giving everyone strong courage and confidence.
Finally, after the twenty-first round, sinus rhythm was restored.
After the death ECG storm, there was silence, watching the sinus rhythm wave diagram on the defibrillator screen.
Connect the ECG monitoring again, and the long-lost QRS wave reappears on the screen, and the curve is like the most beautiful music in the world.
With the relief of surviving the disaster, everyone panted and turned to look at Yang Ping. In their eyes now, he is a god, not a human being.
"Wipe off the sweat, brush your hands on the stage again, and continue the operation. Do you need to replace someone?"
Everyone shook their heads and encouraged each other.
There were three cardiac arrests on the operating table, and this time it took 21 rounds to save him. Every doctor felt exhausted just now, but now he is full of energy.
"Don't be afraid, everyone. Remember, follow my command in all actions, and you will definitely be rescued. If I guess correctly, there will be another cardiac arrest, and I will tell everyone in advance."
"The rescue was successful again?"
Griffin woke up Johannesson, who had his eyes closed, and a surprising sinus rhythm appeared on the screen.
"I love you---"
The world's top neurosurgeon blew a kiss to the QRS wave complex on the screen.
The wailing gentleman was a student of Professor Feng who rushed back from Germany.
He sobbed like a child, and others handed him tissues.
