Chapter four hundred and eighty fourth closed abdomen
At any time, the right to speak is in the hands of the strong, and this is the same in any industry or field.
Facts speak louder than words. As long as there are hard facts, any argument will be powerless in the face of the facts.
Rong Degao was like this, and so were Chu Jianlin and others.
In the operating room, the liver transplant operation has reached a critical moment. After several hours of surgery, the patient's diseased liver has been removed by Fang Le, and the donor has been removed by Xiao Conglin, and the aftermath has been dealt with at the same time.
I had already had a semi-isolated liver resection operation before, and the doctors from Xijing Hospital who participated in the operation this time had richer experience and better cooperation.
The difficulty and risk of semi-isolated liver transplantation actually lies in the cooling process when the liver is isolated from the body and the long-term operation outside the body. Liver transplant surgery is actually closer to full isolation. The liver is completely removed. If there is a tacit cooperation, the liver can be maintained outside the body. The time is shorter.
The biggest difference between living donor liver transplantation and solid liver transplantation is that more living donor liver sources come from relatives, and often the two surgeries are performed together. Just like this time, the two surgeries were performed next to each other.
After calculation, the donor surgery should be performed earlier, so that after the diseased liver is removed, the new liver can be transplanted into the patient in a relatively timely manner, reducing the cold storage time and reducing the probability of thrombosis and necrosis.
As Xiao Conglin and others joined in, the side of the operating table also seemed nervous.
"How's the situation over there?"
Fang Le asked Xiao Conglin.
"About 40% was retained, and everything was fine. I did it until the very end, which was to leave some finishing touches to the doctors below."
Xiao Conglin answered honestly.
"Um."
Fang Le nodded and commanded at the same time: "Pay attention to the bleeding point, pay attention to the surgical field, and reconstruct the connection."
"Continuous end-to-end anastomosis, suprahepatic and inferior vena cava, pay attention to the anastomosis of the middle and left hepatic meridians..."
This step is the biggest difference between piggyback and classic orthotopic liver transplantation.
"When anastomosing the inferior vena cava, infuse 4°C albumin emulsion solution through the portal vein..."
Because this was the first liver transplant, all the doctors only listened to the pre-operative explanation, and it was the first time for the specific operation, so Fang Le had a lot to worry about. He was constantly giving instructions, and every detail had to be taken into consideration.
"Dr. Fang's basic skills are so great that he is worthy of being the inventor of the new flexor tendon suturing method."
Chu Jianlin stood on tiptoes and looked in the direction of the operating table, sighing with emotion as he looked.
For many surgeries, suturing is very critical, especially liver transplant surgeries, end-to-end anastomosis, wound treatment, and reconnection all rely on suture methods.
These delicate treatments test the doctor's skill very much.
You must know that in a specific operation, suturing is different from suturing the patient's wound in the treatment room. Sometimes the position of the suturing is not good, the suturing needs to be less tricky, and the blood vessels and some things are smaller. The operation is many times more difficult than suturing outside the skin.
For Fang Le, who invented the flexor tendon suturing method, his suturing skills are very good, and even small tendons can be manipulated by Fang Le.
In particular, in the eyes of others, this was the first operation performed by Fang Le, but in fact Fang Le had performed similar operations many times before.
In the time and space before rebirth, about four or five years after Fang Le was born, Jiangzhong Hospital established its own liver transplant center.
Jiang Zhongyuan takes the path of combining traditional Chinese and Western medicine methods. Just as Fang Le said to Rong Degao and Sun Qingping, it is not a combination in principle, but a combination in form.
It's like two people working together to do the same thing, rather than two people merging into one.
The original model of integrating Chinese and Western medicine was fusion. Many people wanted to integrate the concepts of Chinese and Western medicine. In the end, they just learned from Chinese medicine and focused on Western medicine. Chinese medicine became a vassal and gradually lost its identity.
The model of Jiangzhong Hospital is who is good at what and who is responsible for which part. Even if some doctors are proficient in Chinese and Western medicine, they can still distinguish the severity.
Under this model, the emergency department of Jiangzhong Hospital has developed rapidly in the surgical field.
Fang Le has obviously done it, but others think he has not done it, which shocks people even more.
"Is this piggyback orthotopic liver transplantation?"
Chu Jianlin said with emotion: "It is indeed a new technique, and Dr. Fang seems to be very experienced."
"If I hadn't known that this was the first case in China, and if I hadn't inquired specifically and found out that Dr. Fang had never been abroad, I would have suspected that this was not the first liver transplant he had performed."
Meng Qingfei was completely convinced, there really are such awesome people in this world.
"Doctor Fang!"
Fang Le was undergoing surgery when the anesthesiologist suddenly shouted: "The patient's electrocardiogram is abnormal."
Chu Jianlin and others were trembling in their hearts.
"Director Xiao!"
Fang Le called out to Xiao Conglin, asking Xiao Conglin to replace him, and then looked at the electrocardiogram.
"Liver transplant surgery has a certain impact on the heart, and intraoperative cardiac arrests often occur."
While watching, Fang Le said: "Continue the operation, pay attention to controlling the blood flow, and appropriately reduce the burden on the heart..."
As he spoke, Fang Le walked to the patient, leaned into his ear, and said loudly: "Your mother gave you the liver. She is next door now. If you can't hold on, you will have wasted what your mother gave you."
With this liver, she is bearing the same risks as you."
Fang Le said it several times in a row.
Strangely enough, just after Fang Le said it three times, the patient's electrocardiogram changed again, and the monitor data also changed again.
"Continue with surgery, hepatic artery, and biliary tract reconstruction."
"Pay attention to the indwelling T-tube and abdominal drainage tube..."
As the operation continued, the patient's vital condition remained stable. With the indwelling drainage tube in place, the new liver was successfully transplanted and anastomosed in all aspects, and the abdominal closure stage was reached.
"call......"
Chu Jianlin let out a long breath: "At this stage, the operation is considered a success."
"So far, the surgery is actually a success."
Niu Baohua nodded.
As for the liver transplant in Jingnan, although the patient only lived for 12 days after the operation, the operation was actually considered a success. Later rejection and complications, etc., are generally not included in the surgery by the surgeon.
middle.
It's just that that surgery was performed under the guidance of experts from country r, so it wasn't considered the first in the country.
"The first living donor liver transplant."
Meng Qingfei's voice was a little excited: "This has filled the gap in living donor liver transplantation in our country."
"Everything is normal, close the abdomen."
Fang Le did a final check and then began to close his abdomen.
At the same time, in the demonstration classroom, the doctors who were watching the surgery video also got the news.
"Currently, the operating room has begun to close the abdomen. So far, the operation has gone smoothly and the patient's vital signs are normal..."