Start with the emergency physician

“Zhou Yuan, can you still hold on…”

He Jianyi 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 doctors must go through on their way to growth.

Only by dealing with these 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 sequential bilateral single lung transplantation, the order of surgery is to first remove one side of the lung, perform one lung transplantation, and then resect the other side and transplant the other half of the lung.

“Why the right lung?”

He Jianyi asked while passing over tissue scissors, vascular forceps and so on.

He is not an expert in this area, naturally it is not clear.

Zhou Yuan smiled and said, “The donor lung situation is better than the left lung, and the right lung transplant must be performed first.” ”

“How do you see that?” He Jianyi was stunned.

Zhou Yuan: “Intuition. ”

He trusted his instincts for a masterful double lung transplant.

Zhou Yuan glanced up, and another thoracic surgeon had already transferred to Operating Room No. 1 to continue to dispose of the body of his first father.

The operating room is still the same group of people as before.

“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 to expose the pulmonary arteriovenous in the surgical field.

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

“Knife.”

Zhou Yuan put down the tissue scissors and said again.

Between receiving the knife, Zhou Yuan glanced up at the time.

The removal of the donor lung took half an hour in Operating Room 1, and now it is seventeen minutes.

“Vascular forceps.”

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

“Left atrial clip.”

He Jianyi was already waiting on the side, and placed the left atrial clip in the anatomical part of the room sulcus.

“Swan-Ganz catheter.”

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

For example, double lung transplantation, myocardial infarction, cardiovascular surgery and so on.

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 respiratory activity.

“Is the left pleural space going to open?” Lu Chenxi asked.

Zhou Yuan shook his head: “No need, keep the pressure difference, stool lung qi.” ”

Saying that, Zhou Yuan began to test the patient’s lung contraction and respiratory activity after placing the n-ganz catheter.

The results were not satisfactory, and the Swan-Ganz catheter was added to the left lung, and it was difficult to ensure that the patient could breathe normally.

“Building an extracorporeal circulation system.” Zhou Yuan said immediately.

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

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

The bright red blood flows in a transparent tube, then passes through a power pump equivalent to an artificial heart, passes through an oxygenator equivalent to an artificial lung, carries sufficient oxygen, passes through the blood vessels of the patient’s body, and then returns to the hose.

The crowd 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.

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

“There are bronchi left.”

Zhou Yuan picked up the tissue forceps and scalpel again and cut off the main bronchi proximal to the opening of the upper lobe of the right lung.

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

“Start removing the right lung.”

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

“Now, start isolating the donor lung right lung.”

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

“Start a right lung transplant.” Zhou Yuan gritted his teeth and said a little weakly.

The right lung is placed in 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.

The continuous suture is used here, Zhou Yuan sutured to the end, and in the bronchial cartilage part, Zhou Yuan changed 4-0 sutures with needles, because it is not continuous here, so Zhou Yuan used intermittent sutures.

“Anostomosis pulmonary artery.”

He Jianyi and others came back from the suture, and Lu Chenxi immediately clamped the proximal side of the patient’s right pulmonary artery with vascular forceps.

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

In general, the donor lung needs to be modified before the pulmonary artery anastomosis of the recipient lung so that the caliber, the shape of the vascular notch, and so on match.

However, since both the donor lung and the recipient’s pulmonary artery are treated by Zhou Yuan, Zhou Yuan has considered this before cutting the pulmonary artery.

Therefore, after simply repairing the caliber, Zhou Yuan directly began to stitch.

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

A cut in the pulmonary arteries of two people can actually achieve basic anastomosis …

That’s too accurate!

“5-0 Priling suture.”

Zhou Yuan quickly performed continuous sutures of the donor lung and the pulmonary artery of the recipient.

“Next, fit the atrial sleeve.” 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, he clamped a vascular forceps on the left atrium proximal to the lung vein of the recipient to block blood flow, and then removed the pulmonary vein stump that was ligated during the previous operation.

“Connect the upper and lower pulmonary vein openings.” This step is to form the left atrial sleeve to 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 suturing.

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

“Right lung transplant completed.”

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

Faster than expected.

“Are you okay?” He Jianyi saw that Zhou Yuan’s face was getting paler and paler, and asked.

Zhou Yuan took a moment: “It’s okay, teacher, I can hold on.” ”

Although the vitality potion did not have the function of replenishing physical strength, the incomparable mental fullness would be fed back to the body, which made Zhou Yuan’s body feel much better.

“Let’s go ahead, there’s also a left lung transplant.”

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

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

“Zhou Yuan, are you trying to… Ventilate with newly transplanted lungs to support vital activities? ”

The right lung has just been successfully transplanted, and the blood vessels have only been unclogged for a long time, is it really possible to do it……_

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