Start as an Emergency Physician

"Zhou Yuan, can you still hold on..."

He Jian saw that Zhou Yuan's face was not very good, and asked with some distress.

He knew Zhou Yuan's inner struggle and pain.

But......

This is something that must be experienced on the path of a doctor's growth.

Only by taking care of these can you become a good doctor!

"Began to remove the right lung. "

After a few seconds, Zhou Yuan opened his eyes and said.

Because Zhou Yuan chose a sequential bilateral single lung transplant, the surgical sequence was to remove one lung first, perform lung transplantation on one side, and then remove the other side to transplant the other half of the lung.

"Why the right lung?"

He Jianyi asked, while handing over tissue scissors, vascular clamps, and so on.

He is not an expert in this area, so naturally he does not know.

Zhou Yuan smiled and said, "The donor lung condition is better for the right lung than the left lung, and the right lung must be transplanted first." "

"How do you see that?" He Jian was stunned.

Zhou Yuan: "Intuition. "

He trusts his instincts for a masterful double lung transplant.

Zhou Yuan glanced up and saw that another thoracic surgeon had already been transferred to the No. 1 operating room to continue to process Chu Chu's father's body.

The same group of people in the operating room were still the same.

"Prepare to separate the right lung. Zhou Yuan said.

"Tissue scissors. "

Zhou Yuan carefully cut the adhesion tissue between the right lung and the chest wall, mediastinum and diaphragm, and exposed the pulmonary arteries and veins in the surgical field.

He Jianyi and others have seen a lot of this kind of skillful operation, but when they saw it again, they still couldn't help but wonder: Even if they started practicing surgery in the womb, they weren't so skilled...

"Knives. "

Zhou Yuan put down the tissue scissors and said again.

In the interval between receiving the knife, Zhou Yuan glanced up at the time.

On the side of operating room 1, it took half an hour to remove the donor lung, and now it has been seventeen minutes.

"Vascular clamps. "

Zhou Yuan took the scalpel steadily and slowly cut open the room ditch.

"Left atrial clip. "

He Jianyi was already waiting on the sidelines, and placed the left atrial clip in the anatomical part of the atrial groove.

"Swan-Ganz catheters. "

The Swan-Ganz catheter, also known as the pulmonary artery flotation catheter, is an expensive, difficult-to-source material for patients who need to perform complex breathing patterns to support their vital activities.

For example, double lung transplantation, myocardial infarction, cardiovascular surgery, etc.

Zhou Yuan took the Swan-Ganz catheter and pushed it into the left pulmonary artery to allow the left lung to be ventilated with one lung and maintain the patient's normal breathing activity.

"Is the left pleural cavity going to be opened?" Lu Chenxi asked.

Zhou Yuan shook his head: "No, keep the pressure difference, and the lungs will be qi." "

As he spoke, Zhou Yuan began to test the pulmonary systolic pressure and respiratory activity of the patient after the placement of the N-Ganz catheter.

The results were not satisfactory, and a Swan-Ganz catheter was added to the left lung, making it difficult for the patient to breathe normally.

"Establish a cardiopulmonary bypass system. Zhou Yuan said immediately.

The extracorporeal membrane oxygenation system that I had previously applied for with the dean came in handy.

Soon, the patient's extracorporeal blood circulation is completed.

The bright red blood flows through the transparent flexible tube, and then passes through a power pump equivalent to an artificial heart, through an oxygenator equivalent to an artificial lung, and carries enough oxygen through the blood vessels throughout the patient's body, and then returns to the flexible tube.

Everyone in the operating room had long been accustomed to this scene, and there was no surprise.

"Maintain pulmonary artery systolic blood pressure below 4 kPa. "

Director Lin nodded: "Understood." "

Zhou Yuan: "Scalpel." "

He Jianyi stepped forward and used tissue forceps to free the pulmonary artery.

Next, Zhou Yuan severed the patient's first branch of the pulmonary artery and descending limb, and cut the pulmonary vein at the distal end.

"There are still bronchial tubes left. "

Zhou Yuan picked up tissue forceps and scalpel again and cut the main bronchus at the proximal end of the opening in the upper lobe of the right lung.

At this point, the removal of the right lung is almost complete.

"Begin to remove the right lung. "

Zhou Yuan said, slowly lifted out his right lung, and handed it to the instrument nurse who had already prepared it next to him.

"Now, start separating the donor lung, the right lung. "

Because the donor lung is free from the human body, there is no need to treat the surrounding blood vessels, and the operation is much easier.

"A right lung transplant began. Zhou Yuan gritted his teeth and said a little weakly.

The right lung is inserted into the patient's right chest.

"Bronchial anastomosis. Zhou Yuandao.

"4-0 absorbs monofilament threads. "

Zhou Yuan took the needle forceps handed by Lu Chenxi and began to perform bronchial anastomosis.

In the bronchocartilage part, Zhou Yuan changed the 4-0 suture with a needle, because it was not continuous, so Zhou Yuan used intermittent suture.

"Anastotic pulmonary artery. "

He Jianyi and the others came back to their senses from the sutures, and Lu Chenxi immediately clamped the proximal side of the patient's right pulmonary artery with a vascular clamp.

Zhou Yuan exposed the pulmonary artery of the donor lung and prepared to anastomosis the pulmonary artery of the recipient.

In general, the donor lung needs to be trimmed before the pulmonary artery anastomosis of the recipient lung to make the caliber, vascular gap shape, etc. correspond.

However, since both the donor lung and the recipient's pulmonary artery were handled by Zhou Yuan, Zhou Yuan had already considered this before cutting the pulmonary artery.

Therefore, after briefly repairing the caliber, Zhou Yuan directly began to stitch it up.

This step made He Jianyi, Lu Chenxi and Director Lin feel incredible.

A cut on the pulmonary artery of two people can actually achieve a basic anastomosis...

That's too accurate!

"5-0 Priling sutures. "

Zhou Yuan quickly sutured the pulmonary artery of the donor lung and the recipient.

"The next step is to fit the atrial sleeves. Zhou Yuan said.

Director Lin was stunned: "So fast?!"

He glanced at the time, it was only four hours...

After Zhou Yuan asked the instrument nurse to help wipe the sweat, a vascular clamp was clamped on the left atrium proximal to the pulmonary vein of the recipient to block the blood flow, and then the stump of the pulmonary vein that had been ligated during the previous operation was removed.

"Connect the upper and lower pulmonary vein openings. "This step is to form the left atrial cuff and protect the atria and blood vessels.

Zhou Yuan anastomosed the corresponding blood vessels of the right lung with the blood vessels of the recipient, and after proper trimming, began to suture.

After a long time, Zhou Yuan put down the needle holding pliers and breathed a sigh of relief.

"The right lung transplant is done. "

Zhou Yuan glanced at the time, 4:51 minutes.

It's a little faster than you think.

"Are you okay?" He Jianyi asked when he saw Zhou Yuan's face becoming more and more pale.

Zhou Yuan paused: "It's okay, teacher, I can hold on." "

Although the vitality elixir does not have the function of replenishing physical strength, the incomparable mental fullness will be fed back to the body, which makes Zhou Yuan's body feel much better.

"Let's go on, there's a left lung transplant. "

After Zhou Yuan finished speaking, he placed the Swan-Ganz catheter in the transplanted right pulmonary artery and said, "Remove the extracorporeal circulation system." "

Director Lin, who was in charge of cardiopulmonary bypass, was stunned.

"Zhou Yuan, do you want to... Ventilation with newly transplanted lungs to support vital activity?"

The right lung has just been transplanted, and the blood vessels have only been unblocked for a short time, is it really possible..._

Feilu reminds you: there are three things to read - collection, recommendation, and points