Start with an emergency physician

See all

TảDownload time: 0.394s Scan time: 0.053s

"Zhou Yuan, can you still hold on?……"

He Jian saw that Zhou Yuan looked unhappy and asked with some distress.

He knew Zhou Yuan's inner struggle and pain.

But... this is what you have to go through on your way to becoming a doctor.

Only by dealing with these things well can you become a good doctor!

""Start removing the right lung."

A few seconds later, Zhou Yuan opened his eyes and said.

Because Zhou Yuan chose a sequential bilateral single lung transplant, the order of the operation was to remove one lung first, transplant one lung, then remove the other lung and transplant the other half of the lung.

""Why the right lung?"

He Jianyi asked as he handed over tissue scissors, vascular clamps, etc.

He was not an expert in this area, so he naturally didn't know.

Zhou Yuan smiled and said,"The right lung is in better condition than the left lung, so the right lung will definitely be transplanted first."

"How did you figure that out? He Jianyi was stunned.

Zhou Yuan:"Intuition."

He believed in his master-level double lung transplant intuition.

Zhou Yuan looked up and saw that another thoracic surgeon had already moved to operating room No. 1 to continue processing Chu Chu's father's body.

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

"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, exposing the pulmonary artery and vein in the surgical field.

He Jianyi and others have seen this kind of skilled operation many times, but when they saw it again, they couldn't help but wonder: Even if they have been practicing surgery since their mother's womb, they are not so skilled.……

""Scalpel."

Zhou Yuan put down the tissue scissors and said again.

In between taking the cut, Zhou Yuan looked up at the time.

In Operating Room No. 1, it took half an hour to remove the donor lung, and now it has been seventeen minutes here.

""Vascular clamp."

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

"Left atrial clamp."

He Jianyi had been waiting on the side and placed the left atrial clamp at the anatomical site of the interatrial groove.

"Swan-Ganz catheter."

Swan-Ganz catheter, also known as pulmonary artery floating catheter, is an expensive and difficult-to-source material, suitable for patients who need complex breathing methods to support their life 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 perform single-lung ventilation and maintain the patient's normal breathing activities.

""Should the left pleural cavity be opened?" Lu Chenxi asked.

Zhou Yuan shook his head:"No, maintain the pressure difference to facilitate lung qi."

As he spoke, Zhou Yuan began to test the patient's pulmonary contraction and breathing activity after the n-Ganz catheter was placed.

The results were not ideal. Even with the Swan-Ganz catheter added to the left lung, it was difficult to ensure the patient's normal breathing.

""Establish an extracorporeal circulation system." Zhou Yuan said immediately.

The extracorporeal membrane oxygenation system that he had applied to the dean for came in handy.

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

The bright red blood flowed in the transparent hose, then passed through the power pump equivalent to an artificial heart, through the oxygenator equivalent to an artificial lung, with sufficient oxygen, through the patient's blood vessels throughout the body, and then returned to the hose.

Everyone in the operating room had long been accustomed to this scene and was not surprised.

"Maintain the pulmonary artery systolic pressure below 4kPa.

Director Lin nodded:"I understand."

Zhou Yuan:"Scalpel."

He Jianyi stepped forward and freed the pulmonary artery with tissue forceps.

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

"There is still a bronchus left."

Zhou Yuan picked up the forceps and scalpel again and cut off the main bronchus near the opening of the right upper lobe.

At this point, the removal of the right lung has been basically completed.

"Start taking out the right lung."

Zhou Yuan said as he slowly lifted the right lung out and handed it to the nurse who had already prepared the instrument.

"Now, we will start to separate the right lung from the donor."

Because the donor lung has been separated from the human body, there is no need to process the surrounding blood vessels, which makes the operation much easier.

""Start the right lung transplant." Zhou Yuan gritted his teeth and said weakly.

The right lung was placed in the patient's right chest.

"Bronchial anastomosis."Zhou Yuan said

"4-0 absorbable monofilament thread."

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

Continuous suture was used here. Zhou Yuan sewed all the way to the end. At the bronchial cartilage part, Zhou Yuan changed to 4-0 needle suture thread. Because it was not continuous here, Zhou Yuan used interrupted suture.

"Anastomosis of the pulmonary artery."

He Jianyi and others came back to their senses from the suturing, 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 anastomose it with the recipient's pulmonary artery.

Generally speaking, the donor lung and the recipient's pulmonary artery need to be trimmed before anastomosis to make the caliber, shape of the vascular gap, etc. correspond.

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

Therefore, after simply repairing the caliber, Zhou Yuan started to sew directly.

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

Cutting a knife on the pulmonary artery of two people can actually achieve a basic anastomosis...

This grasp is too precise!

"5-0 Prolene suture."

Zhou Yuan quickly sutured the donor lung and the recipient's pulmonary artery continuously.

"Next step is to anastomose the atrial cuff."Zhou Yuan said.

Director Lin was stunned:"So fast?!"

He glanced at the time. It's only been four hours...

After Zhou Yuan asked the instrument nurse to help wipe the sweat off his face, he clamped a vascular clamp on the left atrium near the pulmonary vein of the recipient to block the blood flow. Then, he removed the stump of the pulmonary vein that was ligated during the previous operation.

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

Zhou Yuan also connected the corresponding blood vessels of the right lung to the blood vessels of the recipient lung.���After anastomosis and appropriate trimming, suturing began.

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

"The right lung transplant is complete.

Zhou Yuan glanced at the time. It was 4:51.

It was faster than he expected.

""Are you okay?" He Jianyi asked when he saw Zhou Yuan's face getting paler.

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

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

"Let's continue. There is another left lung transplant."

Zhou Yuan said, and placed the Swan-Ganz catheter in the transplanted right pulmonary artery, saying:"Remove the extracorporeal circulation system."

Director Lin, who was in charge of the extracorporeal circulation, was stunned.

"Zhou Yuan, do you want to... use the newly transplanted lung to ventilate and support life activities?"

The right lung has just been successfully transplanted, and the blood vessels have just been unblocked. Is it really possible to do this..._

Feilu reminds you: Three things to do when reading - collection, recommendation, and sharing