Chapter 1137 Chen Cang Must Have Deep Meaning

With Chen Cang's order.

All the medical staff entered the preparations for the battle.

"Deep vein catheterization completed!"

"The monitor is over!"

"The blood is ready!"

...

The anesthesiologist is not the director of the anesthesiology department, but Zhou He!

Zhou He is quite good at anesthesia for cardiovascular surgery, and he has a good grasp of patients. If it weren't for the struggle between departments, he might have been the director of the original hospital.

It was also invited by Wu Tongfu himself to come here, and he is also a candidate for the Department of Anesthesiology.

The patient remains in a lateral decubitus position, and the entire side of the heart needs to be exposed to make a one-meter-long arc incision!

Because there are many branches of the thoracoabdominal arteries to be replaced, the intercostal arteries supplying the spinal cord, the bilateral renal arteries, the celiac trunk, the superior and inferior mesenteric arteries, and the bilateral common iliac arteries, at least six anastomosis should be done!

After Chen Cang drew the line, the wound was almost like splitting a person.

Start from the third rib on the left midaxillary line and go around the anterior chest area, down the center of the sternum, straight down to the navel, and then to the anterior superior iliac spine.

The length of the entire incision looks very ferocious!

Moreover, the most important thing is that patients have no time to do accurate examinations such as CT, MR, X-ray, and angiography.

It is very difficult to complete the operation accurately with echocardiography, electrocardiogram, and x-ray examination alone.

Zhou He couldn't help but ask, "Doctor Chen, do you want to do hypothermic cardiopulmonary bypass?"

This question has become the first question that is currently in front of everyone!

Is hypothermic cardiopulmonary bypass technology used?

If used, it means that the complications of cardiopulmonary bypass including bleeding, brain and lung complications greatly increase the mortality of postoperative patients.

However, the total thoracoabdominal aortic replacement surgery performed by some heart centers is hugely traumatic, time-consuming, and consumes a lot of blood!

If it is carried out under the assistance of extracorporeal circulation and deep hypothermic circulatory arrest, it can effectively reduce the risk of surgery and ensure the stability of surgery.

The first contradiction made everyone stumped.

Chen Cang handed the marked marker to Ge Huai and shook his head: "Using normal temperature non-corporeal circulation technology, block it in sections during the operation!"

Zhou He nodded and immediately started to prepare.

He doesn't need to doubt Chen Cang's skills. In this war, Chen Cang is the only handsome man!

Even if the emperor came to the battlefield in person, he could only watch the coach line up as a "mascot"!

Wu Tongfu said nothing from the beginning to the end, and made it clear that it was up to Chen Cang.

We all know that once the normal temperature off-pump technique is performed, the patient's chance of survival will increase, but the pressure on the surgeon will increase exponentially.

Especially when dealing with thoracic aortic replacement surgery, the beating of the heart and the progress of circulation will become obstacles to the surgery.

This requires the chief surgeon to have sufficient ability!

Zhou He never doubted Chen Cang, at least not now.

But Li Baoshan and Xu Ziming were hesitant to say anything.

Finally, I clenched my fists and decided to fight!

that's it……

The moment Chen Cang took over the scalpel also meant that the operation officially began!

The incision is very long, and it does not need to be fully exposed at once, but needs to be carried out gradually according to the operation stage.

However, the patient is an exception. The operation must first perform an end-to-side anastomosis of the iliac artery, so as to ensure that the area of ​​the ascending aorta operation will be operated to avoid ischemic necrosis caused by blocking blood in areas such as kidneys and abdominal organs. .

In this case, the large blood vessels in the chest must be processed, so the operation may require a large-scale operation to fully expose all the thoracoabdominal aorta.

Actively do all the rescue measures!

In case of intraoperative rupture of the ascending aorta, it can be stopped in time.

End-to-side anastomosis of bilateral iliac artery artificial blood vessels becomes the first step of surgery!

Different from simple abdominal aortic replacement, it is necessary to first establish a retrograde blood perfusion pathway between the descending thoracic aorta-artificial blood vessel-left iliac artery, so as to ensure the blood supply to other organs during anastomosis of the intercostal artery, abdominal artery and lower extremity artery.

However, in this way, it is necessary to precisely control the operation time, and the time for anastomosis between blood vessels and artificial blood vessels is very limited.

With the help of Li Baoshan, the abdominal tissue forceps controlled the surrounding surgical field. Xu Ziming exposed the location of the aortic aneurysm and began to separate the surrounding abdominal omentum layer by layer.

At this time, Chen Cang handed over a series of instruments such as probe, separation forceps, scalpel, spatula, etc. to Ge Huai.

"Help me get it."

After speaking, Chen Cang took the lead to get the scalpel.

The surrounding doctors looked at Chen Cang with so many things at a loss, what is this for?

Even the equipment nurse felt a little blush. Is this because you don't trust yourself?

However, when the operation started, everyone realized that Dr. Chen might really need someone who can quickly hand him instruments anytime, anywhere.

After Xu Ziming separated the area of ​​aortic dissection.

A dissecting aneurysm with a length of seven or eight centimeters appeared in front of everyone, and Chen took a deep breath.

"Block!"

After speaking, quickly start to clear the aorta and start to clear the tumor cavity.

The whole process is fast and precise!

At this time, Chen Cang kept changing the instruments in Ge Huai's hands.

A probe for a moment, tweezers for a moment, separation forceps for a moment, a spatula for a moment.

Even Wu Tongfu was taken aback by Chen Cang's actions!

Is this...a bit too exaggerated?

But when Li Baoshan saw it, he was a little shocked.

Because he found that Chen Cang's choice seemed to be the best choice.

He can always get the cleanup done using the most suitable equipment.

It looks so easy, even cumbersome!

However, in this way, the cleaning can undoubtedly be effectively completed, and the intima of the blood vessel can even be better protected.

Li Baoshan cooperated carefully, while Xu Ziming stared at every step of Chen Cang's operation.

Don't dare to relax in the slightest.

At this time, the equipment nurse was also stunned.

Because she found that Dr. Chen did not look down on herself, but because he needed to change the equipment quickly and at any time.

Even... She felt that what Dr. Chen needed was a specialized instrument nurse.

Otherwise, it is simply not enough to maintain his operation.

And Ge Huai was very involved at this time!

Originally, he thought that Chen Cang called him here to get the equipment because he despised or humiliated him.

Now it seems that is not the case!

Compared with the people around him, Ge Huai found...it seems that he can only do such a job.

Moreover, from his angle, he could even just see Chen Cang's actions.

Thinking about it carefully, it was actually Chen Cang who was helping him!

For a time, Ge Huai also had mixed feelings.

However, he didn't dare to think too much. Since Chen Cang helped him so much, he had to do his own job well!

Hand over the equipment!