MTL - Live Surgical Broadcast-v3 Chapter 2971 Old captain
"Not for now, just a moment." Zheng Ren had cut off his right lung and placed it in the pathology basin. At this time, Lao He held a report in her hand and reported that, "The blood sample 10 minutes ago, the total bilirubin was 876 μmol / L, the blood gas ..."
He only said that the problematic item did not involve other items, which was simple and clear.
Is liver damage so serious? !! Dr Charles froze.
Severe liver damage and kidney function are good. If Dr. Charles is standing on the operating table by himself, intraoperative liver dialysis must be performed at this moment. As for the machine, the Mayo Clinic has nothing, so how to piece together a mottled dialysis machine.
Looking at that machine, parts from at least 4 manufacturers are pieced together, like a beggar.
Dr. Charles did not ridicule and ridicule, he was more surprised.
Dr. Zheng Zheng is like a captain who has been drifting on the sea for decades and has a long history, judging by clues, a storm is coming.
Before that, he had taken his assistants and fled the wrecked ship to escape the place where the wind and waves were the biggest.
I couldn't imagine it. Dr. Charles thought about it again, but sighed. If he were on the operating table, he would not have expected the symptoms of acute failure of the liver in advance.
The various unreasonable treatments became clear before, although Dr. Charles still did not understand how Zheng "predicted" that the patient would have acute liver failure.
Is it because of the impact of interventional surgery? Dr. Charles silently looked for possibilities.
"Heparin 40mg plus 5,000ml of normal saline pre-flushing tubing and plasma perfusion device, blood flow speed 75ml / min, replacement fluid speed 25ml / min." Zheng Ren Shensheng commanded.
Icu's doctor started operating the machine for bilirubin adsorption.
At the same time, Zheng Ren removed the entire heart and lung tissue in a half-expanded state and placed it in the pathological basin. After receiving the 3D printed lung tissue from the Percydex solution delivered by the Shay, they started the ice bath.
Then put the 3D printed right lower lobe into the chest cavity and perform anastomosis in the order of trachea-artery-atrial sleeve.
"Rehydration, 500ml of normal saline." Zheng Rendao, "Dopamine can be given now."
Laohe immediately turned on the micropump that had been prepared, and the drug immediately entered the body along the blood vessels.
"Adjust ECMO flow, mean pulmonary arterial pressure is below 40mmHg."
"Rapid blood flow rate of liver dialysis, 100mL / min."
"500mg of methylprednisolone impact."
After a series of doctors' orders were issued, the assisting doctors continuously adjusted the values of ECMO, liver dialysis equipment, micropump, and ventilator.
At the same time, Zheng Ren placed the lower lobe of the right donor lung in the right chest, sutured the bronchial membrane continuously with 4-0 absorbable monofilament thread, and used 4-0 Vicryl suture for intermittent suture in cartilage.
The suture is done under the microscope, simply and simply. It seems that the two things, on-the-spot command and surgery, run in the brain simultaneously and do not interfere with each other.
Even if Dr. Charles once stood at the pinnacle of surgical operation, it was only the pinnacle of technique, and he would never pay attention to every detail of the entire operation and everyone.
It's not that the details are useless, but that he ... can't do it.
Zheng Ren performed anastomosis under the microscope, no matter how subtle the technique, Dr. Charles would not be surprised. He would just be lamented by the passing of time, while taking away the vitality of youth, he also took away the stability and meticulousness. What he used to do is absolutely impossible now.
一边 But while controlling the operation, all the details on the operating table, including the ventilator, including the micropump, including ECMO, including liver dialysis, are controlled by non-humans.
In Dr. Charles's mistake, Zheng Ren clamped the proximal side of the right pulmonary artery, trimmed the blood vessels as appropriate to match the diameter of the donor pulmonary artery, and then sutured the pulmonary artery with 5-0 Prolene sutures.
His hands are stable, not ill.
Subsequently, a vascular clamp was clamped on the left atrium near the pulmonary vein, and the stump of the stump of the pulmonary vein was removed to connect the upper and lower pulmonary vein openings to form an appropriately sized left atrial sleeve and the right pulmonary vein on the 3D printed lung donor. The atrial sleeve was sutured continuously with 4-0 Prolene.
After the anastomosis was done, Zheng Ren covered all the anastomoses in turn with a 3D printed omentum, and patiently and carefully performed the anastomosis.
This ... one lung transplant is done!
Dr. Charles looked at the time in surprise, the right lung cold ischemia time was 58 minutes!
When I saw the operation, I didn't feel anything, but the moment the cold numbers appeared in my mind, Dr. Charles knew the gap.
的 The fastest lung transplant he's ever seen. It doesn't matter how fast the operation is performed. The key is that the surgeon has not devoted himself to the operation. He is still the soul of the entire field and controls all medical activities including the operation.
Is this the peak level after the peak? It has surpassed the feel that it can understand, and controls the audience without any omissions.
This is the real king in the operating room!
"Shhhhhhhh!" Su Yun exhaled, and glanced at the values of the monitor and ECMO.
"Boss, there seems to be no problem." Su Yundao, "The operation was successful?"
"It's only half, stay focused." Zheng Ren glanced at the values and started to order again.
"Adjust ECMO flow ~ www.novelbuddy.com ~ Mean pulmonary artery pressure increased by 5mmHg."
"Hepatic dialysis blood flow speeds up, 110mL / min."
"500mg of methylprednisolone impact."
"Dropamine and m-hydroxylamine decrease in speed ..."
In the song of good luck, Zheng Ren's doctor's voice became cheerful.
"The right lung is ventilated and the lungs are manually raised." Zheng Ren said softly.
Lao He responded, and began to adjust the position of the tracheal tube, changed to single lung mode, right lung ventilation. As he began to pinch the ball, the gas entered the fresh lungs, which swelled like balloons, and he could faintly hear beeps.
It's not noise, it's the sound of life!
"It's done, next." Su Yun said slightly excitedly.
"Don't worry, warm salt water." Zheng Ren said.
The chest cavity was filled with warm saline, and Lao He pinched the ball to control the expansion of the lung tissue. Finally, Zheng Ren strengthened the omentum at the anastomotic position of the tracheal trunk, which completed the unilateral operation.
仁 Then Zheng Ren retracted the Swan-Ganz catheter to the common pulmonary artery and placed it in the right pulmonary artery to begin the left lung transplantation.
博士 For Dr. Charles, the operation is actually done.
There is a difference between the left lung and right lung surgery, but for the right-sided cold ischemia time of 58 minutes, the surgeon cannot doubt whether he can complete the surgery.
In the operating room, the sound of various machines running slightly under the BGM of good luck, as if accompaniment of good luck.
Bright and clean.
