This kind of adhesion makes Professor Li afraid.
He carefully observed Yang Ping's surgery just now. The surface of the heart was almost touching the inner surface of the sternum.
When sawing through the sternum, the saw blade just cut through the sternum without damaging the heart attached to it. This is definitely not luck. Simply relying on luck, it is impossible to control the saw blade without making mistakes during the entire process.
Professor Li's teacher once said: "Remember, a good surgeon must be good at using his brain to compose pictures."
So now there is only one explanation. Dr. Yang has already sketched a three-dimensional anatomical diagram of the surgical area in his mind based on the images and pictures. With this picture in his brain, he can command the electric saw in his hand to act accurately.
Professor Li performed his 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 and the inner surface of the sternum were adhered together. Professor Li took a thoracotomy saw and sawed from top to bottom.
The sternum was broken, and then dark red blood gushes out.
At that time, he saw blood and was scared, not knowing what happened.
Fortunately, the teacher calmly gave instructions in the audience: "The saw blade cuts the atrium below, suppress it, stop the bleeding, and then repair it."
The patient's blood pressure dropped, and the anesthesiologist ordered the circulating nurse to transfuse blood. In a panic, Professor Li accepted the teacher's instructions mechanically, but could not find the bleeding point.
"Saw the sternum completely. The crack is right below." The teacher yelled, then put on gloves and prepared to go on stage.
Professor Li bit the bullet, picked up the electric saw again in a pool of blood, and completely cut open the sternum.
Sure enough, with the help of the suction device, Professor Li saw the bleeding point and a 3-centimeter wound on the right atrium. He stretched out his hand to hold the wound.
"Sew it up!"
The teacher ordered. The teacher took over Professor Li's trembling hand and pressed the wound to stop the bleeding. Professor Li began to repair the tear in the atrium. The teacher let go and used the suction device to create a field of vision that was barely clear. Fortunately, Professor Li is usually well-trained.
The tear was quickly repaired, the bleeding was stopped, and the patient's blood pressure rose again.
Since then, Professor Li has been like a soldier who has been baptized by the flames of war. Faced with blood and his heart, he has never trembled again.
But at this time, Professor Li couldn't help but be shocked. The heart and the large blood vessels connected to it were all blurred, especially where the large blood vessels were, as there were adhesions everywhere.
Compared with round knives, sharp knives have higher separation accuracy, but the risk is also higher.
First open the pericardium. The pericardium is a layer of capsule outside the heart. It has a fibrous layer and a serosa layer. A potential cavity is formed between the two layers. There is a slurry 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, can not only protect the wrapped heart, but also fix the heart in the correct position and limit excessive heart expansion.
Without the restriction of the pericardium, when the heart contracts, the intracardiac pressure rises rapidly and the heart expands without restriction, which can cause heart rupture.
Of course, this situation occurs when the heart contracts violently.
It's like putting a balloon in a bag. No matter how you blow it, it will not exceed the size of the bag. If there is no limit to the bag, if you blow hard, the balloon will expand to a certain extent and it will burst.
The pericardium, which originally had a positive effect, has now formed adhesions and narrowing, 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 this contracted capsule will strangle the heart.
The sharp knife was replaced with a round knife. The tip of the knife scratched the pericardium with an appropriate depth. It just cut through the pericardium without damaging the real heart surface. This kind of knife skill made Professor Li unbelievable.
The fibrous layer and serous layer of the pericardium have adhered together to form a hard connective tissue.
"Be careful!"
Professor Li couldn't restrain his worry and spoke out.
But Yang Ping didn't seem to hear his reminder, and the knife had already made a long gash in his heart, forming it all at once.
Professor Li's worries are unnecessary, because this incision cuts through the capsule just enough without hurting the heart underneath the capsule.
The capsule is opened, and the living heart is ready to come out.
The toothless forceps lifted the capsule, with the tip almost touching the surface of the heart, and began to separate it from all sides. Slowly, half of the capsule that restrained the heart was separated, and the heart could no longer be restrained.
"Leave the rest to fix the position of the heart." Yang Ping stopped the knife in his hand.
If the entire capsule is peeled off like an egg, the bare heart will roll and hit everywhere in the chest because there is no restriction, and the blood vessels connecting it will be torn and ruptured or spasm.
All internal organs in the human body must be properly fixed, otherwise they will wander around.
The remaining pathological pericardium can no longer restrain the heart, so that the heart can contract freely. At the same time, compared with a normal heart, there is a risk that when a sudden violent contraction occurs, the heart is at risk of rupture.
Replace the blade!
The blade needs to be replaced every time a section is separated.
Because the quality of these blades is worrisome, they start to become dull after only a few minutes of use and cannot meet the requirements of fine anatomy.
The thing that surgeons hate most---the scalpel blade is too dull!
Changing back to the sharp knife again, Yang Ping began to separate the aorta along the heart and left ventricle. The aorta and vena cava had been pulled toward the front of the spine by adhesions and stuck together with the front.
The deformed spine and thorax cause the chest cavity to be extremely narrow, blood vessels and organs are almost squeezed together, and the large blood vessels are tortuous like the intestines, but due to adhesions, nothing can be seen clearly.
The adherent connective tissue overwhelmed everything, and it was impossible to tell which ones were blood vessels. There was only one tissue under the knife, and that was the adherent connective tissue.
The sharp knife worked unswervingly, and the tortuous ascending aorta was slowly exposed.
Immediately afterwards, the first major branch of the aorta, the brachiocephalic trunk, began to show its outline under the sharp knife.
The tip of the knife seemed to have some special detection ability, and 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 reset of the entire aorta.<
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"The operating space is too small, they are squeezed together, they are stuck to themselves, and they are stuck to everything around them."
Professor Li was highly focused and followed Yang Ping's rhythm. Because every time he was struck with a knife, there was something unknown, so every strike was scary.
It's like running blindly in a minefield!
Although this surgery is not an open-heart surgery and everything is done outside the heart, any negligence can cause blood vessels to rupture.
Yang Ping seems to know these anatomical structures in advance, and he never makes mistakes in the position of the knife every time, whether it is the coordinates of up, down, left, or right, or depth.
This is completely different from what Professor Li imagined.
What he imagined was that the blood vessels would be broken from time to time, with blood gushing out or spurting out, and then the blood vessels would be repaired quickly before he could continue.
But Dr. Yang is not like this at all. So far, there has been no accidental bleeding from the root of the aorta to the brachiocephalic trunk.
Several times I thought blood was going to spurt, but it didn’t.
Does Dr. Yang have any other sophisticated examination equipment to complete imaging examinations?
Impossible.
Professor Li looked up and then around, everything was normal.
---
Family waiting area.
Zheng Baosheng's parents were worried again and again, and they couldn't suppress the worry that they were connected by blood.
Now their son is lying on the operating table and will probably never wake up.
Lao Zheng looked at his mobile phone from time to time and counted the time. He was afraid that the operating door would suddenly open and the doctor would say frustratedly: "We have tried our best."
Zheng Baosheng's mother was muttering something silently, probably asking for blessings from Bodhisattva.
This kind of suffering is very painful.
"Old Zheng, do you think our son can 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 could walk through it. He said that there were countless people who were brought back from hell by Dr. Yang, and he would be one of them."
When my mother heard this, she felt a little comforted.
This kind of thing, really, depends on your fate!
---
Nurse Qin is now standing in the operating room. Because the video was shot in the operating area, she cannot see the performance of the instrument nurse.
Therefore, she could only come to the operating room and observe on the spot.
The silent cooperation between the surgeon and the instrument nurse, the seamless tacit understanding, was an eye-opener for Nurse Qin.
She considers herself to be the best equipment nurse. She receives the most advanced training in the best hospital in China and undergoes a large number of surgeries every day, but she has never seen such perfect cooperation.
Everything is clear and orderly. This clarity and order are natural, not mechanical, rigid, or deliberate.
She once invited Xiao Su to study in 301, but now she realizes that it should be the other way around. This is the most worthwhile place to study.
The little girl who was the traveling nurse handled the off-stage tour of this operation by herself, without anyone's help, but she was not flustered and calm. What she did seemed to have used mathematical planning to arrive at the best sequence. The anesthesiologist, sitting calmly and calmly on the side of the patient's head, actually started playing 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 mobile phone.
Perhaps, all this is under his control and he doesn't have to worry at all.
The preparatory perfusionist who came from the thoracic surgery department had nothing to do. He sat aside and looked here and there in boredom.
---
"This is a cardiac surgery operation. How can Xiao Yang do it so skillfully?" Professor Liang couldn't help but ask.
We were obviously here for spinal orthopedics, but at the beginning, we were asked to perform surgery on the heart and great blood vessels.
"I don't know either. He said he would perform the entire operation himself. I thought he was joking." How did Professor Qin know the answer?
Talent can only be explained by talent.
Professor Su remained silent and stared at the screen. Although he is a master of spine surgery, when performing scoliosis surgery, thoracic surgery sometimes requires thoracic surgery to deal with heart and lung problems, so he is very clear about the difficulty of this surgery. p>
No wonder, the name of the Institute of Surgery is displayed.
It seems that the ones who really understand him are Xia Changjiang and Han Jiangong.
Professor Su glanced at Professor Qin out of the corner of his eye. Now Professor Qin is the most persistent and must dig Yang Ping to 301.
If I really go to 301, I'm afraid I won't be as good as Sanbo. Professor Su has this feeling at this time.
But there are some things that ordinary people cannot decide.
On the left of Professor Liang is Professor Su, and on the right is Professor Qin. He turns his head and talks to the left and right from time to time.
"Young people are scary, does Xiao Yang have a partner?"
Professor Qin nodded: "Yes."
"Where is the object? What's the situation?" Professor Liang asked carefully.
"The nurse in the operating room is preparing the table on the stage."
Compared to Professor Liang, Professor Qin knows Yang Ping’s personal situation better.
Professor Su looked sideways and thought to himself: What does it mean to ask someone? Are you poaching someone to get this job?