Chapter 2973 Being overly cautious
Faced with Zheng Ren’s relaxed smile, everyone’s nervousness was somewhat alleviated.
The surgery began. After opening up the chest, Zheng Ren cut open the medicinated pleura around the base of the lung and blunt separated it to the side of the lung, revealing the blood vessels of the pulmonary portal.
Then, Lin Yuan and Gu Xiaoran pulled the upper and lower lobe of the lung backward, exposing the front of the lung. First, he separated the shallow superior pulmonary vein, ligated and cut off the upper and middle hepatic veins.
Dr. Charles silently stood to the side and watched the operation. His pupils gradually shrank.
It was a standard total lung resection surgery, and it was a textbook surgery. Fifteen minutes after the surgery, the armors of the right lung were exposed, and ligation began.
The doctor could see that Zheng Ren did not deliberately pursue speed, but performed the surgery step by step. However, the surgery was performed very smoothly. Not only the surgeon and the first assistant, but even the second assistant and the third assistant had a good understanding of the surgery process, and their tacit cooperation was to an outrageous extent.
What did a sorcerer hope for the most?
He hoped that the surgical field would be clean. Not only would the bleeding block his vision, but it was also very important to use a retractor to open up the other tissues and expose the surgical field.
When Zheng Ren performed blunt separation on the right lung to reveal the blood vessels of the pulmonary portal, the second assistant, Lin Yuan, and the third assistant, Gu Xiaoran, pulled apart the tissues that needed to be pulled apart in advance, so the surgical field was fully exposed.
Dr. Charles didn’t pay attention to the role of the assistant during the surgery practice. He was focused on the 3d printed lung tissue donor. He put it on Zheng Ren’s microsurgery skills.
But today, when he faced a real patient and watched the operation from the beginning, Dr. Charles thought that the performance of the two young people was perfect.
The surgery was not done by one person. Today, the second assistant and third assistant had perfectly illustrated this point.
“Liver function, Valley-three merry-go-round …”
“Blood Qi analysis …”
15 minutes later, old he began to report the test results. Liver and kidney function, blood Qi analysis, and several other major indicators were reported clearly.
“Next time,” Zheng Ren’s simple reply might sound like a brainless one to others, but old he nodded his head to show that he understood.
Dr. Charles ‘assistant translated for him, and the doctor began to think about these values.
Now, he saw that the total bile in liver function was 89 μ mol/L, which was four times higher than the upper limit of the normal value. However, according to the medical records, this young patient’s total curiously high levels of blood red before the surgery might be related to the multiple times of interventional hepatic embolism surgery.
His kidney function was good, the blood analysis was ideal, and the ECMO was running quite smoothly. Dr. Charles laughed. Doctor Zheng was really very cautious. He had even limited the amount of low-molecular heparin used before the operation and had been constantly observing it during the operation.
Although doctors were supposed to be cautious, doctor Zheng was a little too cautious today.
After receiving the first test report, Zheng Ren ligated and severed the first branch of the pulmonary artery, which was the artifice.
Immediately after, the right pulmonary artery was completely exposed, and a thick silk thread was used to block it.
“Zheng, you’re too cautious.” Dr. Charles finally couldn’t stand it anymore and began to communicate with Zheng Ren.
There was a waiting time here, which was usually 10 minutes. However, the patient had already been administered ECMO. Even if the removal of the tumor caused his blood pressure to drop, it would not be a big problem as long as he paid attention to fluid replacement for a long time.
“Doctor, because the patient’s liver is not working well, I have to be careful.” Zheng Ren explained to Dr. Charles why he was still carefully observing the blood pressure with the help of ECMO.
Zheng Ren’s voice in the operating theater was mixed with the song of good luck. The other people on the stage, including Su Yun, did not move. They seemed to be waiting for something.
“Beep, beep, beep~~~” the monitor’s alarm sounded, and the arterial pressure displayed on it was constantly decreasing.
Dr. Charles didn’t think it was necessary. As long as fluid replacement was done for a long time, the operation couldn’t be stopped just because the blood pressure dropped after blocking the right pulmonary artery.
It was impossible, so Zheng’s waiting was meaningless.
But then, Su Yun made a gesture without hesitation, and Gu Xiaoran, who was standing beside him, pulled up the sterile one-way bar, leaving the sterile area and exposing the left groin.
What was he doing? Dr. Charles was stunned.
The icu doctors, who were already prepared, immediately came in from the operation room and pushed over a set of strange-looking machines. Xie Yiren handed him a puncture kit. After disinfecting his hands, he started the procedure.
The machine … It was jumbled up and looked like it had been patched up countless times. It was somewhat shabby and old. The ringing of the monitoring equipment’s alarm caused one to feel a sense of irritation. It was as if the song of ‘good luck’ was no longer as pleasing to the ear, and it had become irritable.
Dr. Charles did not comment on the machine. He squinted his eyes and carefully observed the icu doctor’s operation.
The doctors from the icu started to turn on the machine and connect the tubes to the femoral vein.
He had activated blood transfusion for the absorption of bile! Professor Charles quickly discovered the use of the machine. His blood pressure had dropped, and he needed to do liver dialysis? Wasn’t this a little too much?
Indeed, low blood pressure could lead to kidney function and liver damage, but it was generally considered that the kidney damage would be more serious. Intraoperative dialysis … Did not seem to be necessary.
Could it be that Dr. Zheng had practiced surgery for too long and lost himself in the end? Professor Charles guessed. However, out of respect for the Sorcerer, he did not voice out his doubts about Zheng Ren’s thoughts.
After establishing the liver dialysis channel, Zheng Ren immediately opened the blockage and continued the surgery. He began the surgery in an orderly manner again despite the alarm of the wounded artery and blood pressure.
Lin Yuan pulled the lower lobe forward while Zheng Ren and Su Yun started to ligate and cut off the lower lung ligament.
Then, he pushed open the medicinated pleura and dissociated the inferior pulmonary vein. After that, he bound and sutured it before cutting it off.
Gu Xiaoran pulled down the upper lobe of the lung, separated the right main trachea under the Arcana vein bow, cut it off 0.5 – 0.8 cm away from the trachea Ridge, and sutured it.
No one spoke. The silent surgery process was accompanied by the piercing sound of the alarm. Even the tacit cooperation in the surgery did not seem so clear and eye-catching, and they became impatient.
Would this work? Dr. Charles looked at the monitor and observed the changes in blood pressure. He was a little worried. He was worried that the drop in the patient’s blood pressure would directly lead to cardiac arrest, which would then lead to the failure of the operation.
Although the blood pressure was still within an acceptable range, it would not make sense if the fluid was not replenished.
“Administer 82 u/kg of heparin and 860 u/kg of epinephrine E1. Perferdex liquid should be poured in smoothly. The pressure should be 52 cm H2o, and the temperature should be 4°C.” Zheng Ren said in a deep voice.
“Zheng, do you need fluid replacement?”
After holding it in for a few minutes, Dr. Charles finally couldn’t hold it in anymore when Zheng Ren was preparing to give him the infusion before the lung transplant. He began to suggest in a low voice.