Ou Lianfeng's lungs are now almost like a stone. The long-term stimulation of the lung tissue by the deposited dust has led to diffuse fibrosis of the lung tissue. Most of the normal lung tissue has turned into fibrous connective tissue. This ineffective replacement is very common in medicine.
, ineffective cells replace normal cells. Once the number exceeds a certain number, the function of the organ will be impaired and eventually failure will occur.
This mechanism of ineffective replacement is also an important reason why tumors are fatal. Non-functional tumor cells replace a large number of normal cells in the organ. The function of the organ depends on the work of normal cells. Once the cells that can work are reduced to a certain number or disappear completely, the organ will
If the basis of function is lost and it can no longer function, the patient's life will be seriously threatened.
Ou Lianfeng's lung CT pictures were hung on the reading lamp in the doctor's office of the Institute of Surgery. Yang Ping sat in front of the reading lamp and read the pictures carefully, surrounded by crowded doctors from the entire department. Each operation plan was formulated one by one.
Opportunities to learn.
An excellent surgeon is not just an surgeon. In addition to having superb surgical skills, he must also have superb thinking skills to make the best choice for the patient.
The patient's CT films can be hung on the reading lamp of the surgical institute, which is the patient's greatest luck. No doctor who has worked in the surgical institute will disagree with this view.
“It can be done with thoracoscopy!”
Yang Ping proposed a plan.
“If thoracoscopy is used for lung transplantation, where will the donor’s lungs be delivered?”
Song Zimo asked.
Yang Ping folded his arms in front of his chest, and supported his chin with the thumb and index finger of his left hand in a figure of eight: "Open an incision of about 8 centimeters from the intercostal space, without opening the gap, and send the lungs into the chest through this incision. Under total thoracoscopy,
It is a bit difficult to anastomose the bronchus, pulmonary artery and left atrium, but it can still be completed smoothly."
"The operation will take a long time." Song Zimo analyzed.
Yang Ping doesn't care much about the operation time: "With the support of ECMO, time is not a problem. If you do it, it is estimated that the operation can be completed in about 6 hours. If I do it--"
"Is the distribution of the two entrances of mirrors and instruments like this?"
Song Zimo interrupted Yang Ping's words, immediately brought up a new topic, and pointed at the CT film to attract Yang Ping's attention. Song Zimo knew that the difference between his and Yang Ping's operation time was huge and could not be shortened, so
Try not to let him tell you the time of the operation.
Yang Ping nodded:
"Yes, it is distributed like this. During the operation, fiberoptic bronchoscopy is also needed to check whether the bronchial anastomosis is smooth and complete, and transesophageal cardiac color ultrasound is used to evaluate whether the pulmonary artery and left atrium anastomosis are satisfactory."
Song Zimo and Xu Zhiliang began to construct the surgical scene in their minds according to what Yang Ping said, trying to simulate the surgical process.
Minimally invasive surgery is not just about small surgical incisions. Small incisions are not truly minimally invasive. Minimally invasive surgery means less interference to the internal environment of the human body, such as less bleeding, less damage to normal tissues, etc.
In this way, the human body receives less surgical shock and can recover from the surgical shock as quickly as possible.
Many years ago, when laparoscopy first appeared, there were very few types of surgeries that could be performed. Many doctors ridiculed that laparoscopy had no future, that it was like taking off your pants and farting, and could never replace open surgery. With the development of medicine, laparoscopy has now become
It has become a mainstream operation in general surgery, and almost all general surgical operations can be completed laparoscopically.
If thoracoscopy is used to complete a double lung transplant, as far as Song Zimo and Xu Zhiliang know, it will be the first case in the world. A professor is a professor, and he never follows the routine and takes a path that others have not taken.
Yang Ping began to think about the CT films, and Song Zimo and Xu Zhiliang began to discuss the details of the surgery, because this brand-new surgery was still a bit difficult for them, and every detail had to be polished to perfection.
After the problem of the approach is solved, there are also surgical steps, how to deal with accidents during the operation, etc. The experience of open surgery cannot completely cover lung transplantation under thoracoscopic surgery, so the characteristics of thoracoscopic surgery must be combined with the entire lung transplantation.
A detailed construction is carried out to make the surgical plan as flawless as possible.
While Song Zimo and Xu Zhiliang were studying the details of the operation with great interest, Yang Ping suddenly said:
"Use the Da Vinci robot to perform this surgery. It is a free surgery anyway, and there is no need to worry about increasing the patient's financial burden."
Da Vinci robot for lung transplant?
Song Zimo and Xu Zhiliang were stunned. The problem of thoracoscopic lung transplantation has not been completely solved. Now it is making a leap forward and directly using the Da Vinci surgical robot to perform lung transplantation?
Minimally invasive surgery has become the direction of surgical development. Surgical technology is changing with each passing day. Following endoscopic and laparoscopic surgery, robotic surgery has emerged and become a more advanced surgical method. Robotic surgery will continue to push the concept of minimally invasive surgery to a higher level in the future.
It is no exaggeration to say that surgery in China is an era of robotic surgery. Just like when laparoscopy sprouted, robotic surgery today is also controversial. The road to development will have twists and turns, but the direction of progress remains unchanged.
"Does it need to be done without thoracoscopy?" Song Zimo felt that Yang Ping's thinking was jumping a little too fast, and he couldn't keep up with the rhythm at all. He still hadn't figured out the thoracoscopy surgery, and now he has changed the track.
Yang Ping still maintained the position of holding his chin just now: "What did I say about doing it with a thoracoscope?"
''Didn't you just say to do it with a thoracoscope?"
Song Zimo looked back at the doctor standing behind him, hoping that everyone could testify, as he had clearly said.
A graduate student said: "The professor said that it can be done with thoracoscopy, but he didn't say that this operation can be done with thoracoscopy."
Song Zimo glanced at this graduate student. Isn't this from his own medical team? Erwuzi!
"Did you hear that? I just said it could be used, but I didn't say it was useful."
Yang Ping feels that the accuracy of surgery using thoracoscopy is not as good as that of robotic surgery. The Da Vinci surgical robot is still good at performing thoracic and abdominal surgeries. Why not use the Da Vinci robot to perform this surgery and set up a brand for thoracic surgery. Since
To build a signboard, just build the biggest and tallest one.
"Robotic surgery represents the direction of surgery in the future. If thoracic surgery wants to establish a brand, use the Da Vinci robot to build a brand. It will be more difficult for others to break through this brand."
Yang Ping made the final decision on Ou Lianfeng's surgical plan.
At this time, Director He Xiangjun and his team started to go to the animal surgery laboratory to train in surgery. He was usually very familiar with thoracoscopy, but he was still not good at such a major operation as a lung transplant. He had to practice hard. When he thought of it,
Since he is the first in the world, Director He can forget about food and sleep.
Minimally invasive is the future direction of surgery, and Director He must firmly grasp the direction.
"Director, doesn't Professor Yang know how to perform this operation?" a thoracic surgeon asked.
Director He said with confidence: "If I practice the surgery to the satisfaction of Professor Yang, he will definitely let me perform the surgery, and I will just guide from the side. So everyone, come on, do your best to grab the pigs, and then the surgery will be done."
You are the first to help, you are the second to help---."
Director He has now assigned the positions of assistants.