Start with an emergency physician

"The patient has cerebral ischemia!"

Zhou Yuan immediately said:"Switch tube!"

"Which one?" Haiyang asked hurriedly.

Shunt tubes are mainly divided into balloon type and non-balloon type. Shunt tubes with balloons can be better fixed, easy to enter farther parts, and reduce the anatomical length. The straight non-balloon shunt tube can provide a clearer field of view, with a smooth tip and easy insertion.

Both types of shunt tubes are suitable for the current situation, each with its own advantages. Haiyang can't judge which one should be used.

Zhou Yuan took a few glances and said,"Balloon type!"

Haiyang nodded, and while installing the balloon shunt tube, he asked,"Why not choose the straight non-balloon type? Don't you need a field of view?"

Zhou Yuan shook his head and said,"The patient's condition is very bad, and the elderly have a slower metabolism. It takes longer for the wound to heal. We should try to avoid making a large incision. The balloon type can reduce the anatomical length and reduce postoperative complications."

"However, I can do this because I am confident that I can complete the operation under poor surgical field conditions, but that does not mean that others can do it. If you are not skilled, it is better to choose a straight non-balloon shunt tube that is easy to operate."

He Jianyi touched his head:"Why do I feel that this sentence is so familiar?"

Zhou Yuan smiled, carefully cut a small incision at the bifurcation of the carotid artery, took the balloon shunt tube handed over by Haiyang, and quickly and gently inserted the outflow section of the shunt tube into the normal internal carotid artery lumen. Then

, Zhou Yuan quickly inflated the balloon and opened the valve to allow the returning arterial blood to drive out the air in the shunt tube, and then inserted the injection end of the shunt tube into the common carotid artery.

Inflate the balloon for the second time, adjust the valve after fixing it, and let the blood flow drive out the air at the injection end. Finally, adjust the valve to restore blood flow in the carotid artery

"The carotid artery was blocked for four minutes and twenty seconds. The bypass tube has been connected to the cerebral blood vessels, and the cerebral ischemia has been relieved!"He Jianyi also breathed a sigh of relief

"Teacher, please place a brain drainage tube to drain the fluid in the patient's ventricles." Zhou Yuan looked up, his tone a little weak.

Before the carotid endarterectomy, Zhou Yuan had already completed a high-intensity operation, and the continuous operation made Zhou Yuan pale.

He Jianyi felt a little distressed and nodded,"I will deal with the fluid in the ventricles, you continue to clean the carotid intima!"

Zhou Yuan smiled:"It's okay. Anesthesiologist, the patient's blood pressure and heart rate are"

"Surgery is possible."The anesthesiologist reported the result directly.

""Okay."

After that, Zhou Yuan continued to use the stripper to carefully separate the thickened inner membrane from the outer membrane, and carefully remove the tiny fragments and floating tissues on the peeling surface.

Some floating distal inner membranes were directly sutured and fixed by Zhou Yuan.

"It's so sore." Zhou Yuan smiled bitterly.

After kneeling for dozens of minutes, the whole body's gravity was pressed on the knees. How could it not be sore?

The nurse who was in charge of keeping everyone's mobile phones not far away saw this scene and unconsciously took out her mobile phone to take a picture of this scene. She uploaded this picture to her circle of friends as soon as she prepared the operating table!

Zhou Yuan did not notice this scene.

On the other side, He Jianyi's voice also rang.

"Zhou Yuan, the brain drainage tube has been placed, and I am ready to drain the accumulated fluid."

""Okay." Zhou Yuan stopped what he was doing,"Negative pressure, drain the effusion."

A few minutes later, the ventricle was emptied.

Zhou Yuan asked the nurse next to him to wipe the sweat off his face,"Teacher, you can do the suture. The lining on my hand has not been completely peeled off."

He Jian nodded.

Finally, after more than ten minutes, the operation was about to end.

""Withdraw the shunt tube." Zhou Yuan said.

He slowly emptied the distal balloon, withdrew the outflow end of the shunt tube, and then blocked the internal carotid artery.

After the blood flow was blocked, Zhou Yuan continued to withdraw the injection end of the shunt tube to block the common carotid artery.

Finally, the internal carotid artery was opened to exhaust the air in the blood vessel and suture was performed here. After the suture was completed, the internal carotid artery was blocked again, and the external carotid artery and the common carotid artery were opened in turn, and finally the internal carotid artery was reopened.

"Blood circulation."

Zhou Yuan put the needle holder on the operating tray and asked

"Blood circulation is smooth." Haiyang reported with some joy.

He Jianyi:"The blood circulation in the brain is also fine, the cerebrovascular blockage has disappeared, the symptoms of cerebral infarction have eased, and the patient should wake up soon."

Zhou Yuan nodded, and a long-lost smile appeared on his face again

"Finally, he was saved!"

The next step is to suture the skin on his neck.

"You guys watch me carefully!"

After the patient's critical period passed, He Jianyi's mood also improved. He reminded Haiyang and Liu Kai to pay attention to Zhou Yuan's suturing skills.

Zhou Yuan did not sew quickly this time. On the one hand, it was to ensure the effect of the suturing, and on the other hand, it was also to give Haiyang and Liu Kai a learning opportunity.

Otherwise, with Zhou Yuan's master-level docking suturing technique, if he really wanted to pursue speed, Zhou Yuan would have finished the next stitch before Haiyang figured out why he had to insert the needle here.

Just as Zhou Yuan was concentrating on suturing, He Jianyi's voice rang again.

"Haiyang, Liu Kai, have you two noticed any special features of Zhou Yuan's suture?"

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The fourth update is here! The fifth update begins!