Chapter 1139: : Chen Cang must have a deep meaning

With the order of Chen Cang.
All the medical staff have entered preparations.
"Deep vein catheterization is complete!"
"Monitor is finished!"
"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 is not because of the struggle of the department, he may have been the director of the original hospital.
Coming here, Wu Tongfu also invited him personally and was also a candidate in the anesthesiology department.
When the patient is in a lateral position, he needs to expose the whole side of the heart and make an arc-shaped incision of up to one meter!
Because there are many branches of the thoracic and abdominal arteries to be replaced, the intercostal arteries supplying the spinal cord, the bilateral renal arteries, the abdominal trunk, the superior and inferior mesenteric arteries, and the bilateral common iliac arteries must have at least six anastomoses!
After Chen Cang crossed the line, the wound almost split a person.
Start from the position of the third rib on the left midaxillary line and bypass the anterior chest area, down to the center of the serious sternum, straight down the position of the navel, and then to the anterior superior iliac spine.
The length of the entire incision looks very daunting!
Moreover, the most important thing is that patients have no time to do CT, MR, X-ray, angiography and other precise examination methods.
With echocardiography, electrocardiogram and x-ray examination alone, it is very difficult to complete the surgery accurately.
Zhou He couldn't help but ask: "Doctor Chen, do you want to do low temperature cardiopulmonary bypass?"
This problem has become the first problem currently facing everyone!
Do you use cryogenic cardiopulmonary bypass technology?
If used, it means that complications of extracorporeal circulation including bleeding, brain and lung complications greatly increase the mortality of postoperative patients.
However, the partial thoracoabdominal aortic replacement surgery performed in some heart centers is traumatized, takes a long time, and consumes a lot of blood!
If it is performed with extracorporeal circulation assistance and deep hypothermic circulatory arrest, it can effectively reduce the risk of surgery and also ensure the stable operation of the surgery.
The first contradiction stumped everyone.
Chen Cang handed the crossed marker to Ge Huai and shook his head: "Using room temperature off-pump technique, the segmentation was blocked during the operation!"
Zhou He nodded and immediately began to prepare.
He does not need to doubt Chen Cang's technology. In this war, Chen Cang is the only handsome!
Even if the emperor is in the battlefield, he can only watch the coach line up as a "mascot"!
Wu Tongfu didn't say a word from beginning to end, and it was Chen Cang who made everything clear.
Everyone knows that once the room temperature off-pump technique is performed, the patient's chance of survival will increase somewhat, but the pressure of the surgeon will increase geometrically.
Especially when dealing with thoracic aortic replacement surgery, the beating of the heart and the progress of the circulation will become an obstacle to the operation.
This requires the surgeon doctor to have sufficient ability!
Zhou He did not doubt Chen Cang, at least he will not doubt it now.
But Li Baoshan and Xu Ziming stopped talking.
Finally clenched his fists and decided to fight!
that's it……
This moment when Chen Cang took the scalpel, it also meant that the operation officially started!
The incision is very long, and it does not need to be exposed all at once. It needs to be done gradually according to the surgical 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 when the area of ​​the ascending aortic surgery is operated for a while, avoid ischemic necrosis caused by blood blockage in the kidney and abdominal organs .
In this case, the large blood vessels in the chest must be treated, so a large-scale operation may be required to fully expose all the thoracic and abdominal aorta.
Actively do all rescue measures!
If the ascending aorta is ruptured during the operation, it can be stopped in time.
The end-to-side anastomosis of bilateral iliac artery prostheses is the first step of surgery!
Unlike simple abdominal aortic replacement, the retrograde blood perfusion pathway of the descending thoracic aorta, artificial blood vessel, and left iliac artery needs to be established to ensure blood supply to other organs when the intercostal artery, abdominal artery, and lower limb artery are anastomosed.
But again, in this way, it is necessary to accurately control the operation time, and the time for the anastomosis of the blood vessel and the artificial blood vessel 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 gave Ge Huai a series of instruments such as probes, separating forceps, scalpels, spatulas ...
"Help me get it."
After talking about it, Chen Cang took the lead in wearing a scalpel.
The doctors around looked at Chen Cang holding so many things a little dazed, what is this for?
Even the device nurse feels a little blushed. Does this distrust yourself?
However, after the operation began, everyone realized that Dr. Chen might really need someone who can quickly deliver his equipment anytime, anywhere.
After Xu Ziming separated the aortic dissection area.
A dissection aneurysm with a length of seven or eight centimeters appeared in front of everyone's eyes, Chen Shen took a breath ~ EbookFREE.me ~ blocked! "
After finishing talking, quickly start to clean up the aorta and start to clean up the tumor cavity.
The whole process is fast and precise!
At this time, Chen Cang kept changing equipment in Ge Huai's hands.
After a while, the probe, the tweezers, the separating forceps, and the spatula.
Even Wu Tongfu was blinded by Chen Cang's operation!
This ... is a bit too exaggerated?
But Li Baoshan was shocked when he looked at it.
Because he found that Chen Cang's choice seemed to be the best choice.
He can always clean up things and use the most suitable equipment to complete.
It looks very simple, even troublesome!
However, in this way, it can undoubtedly effectively clean up, and even better protect the vascular intima.
Li Baoshan carefully coordinated, and Xu Ziming stared straight at each step of Chen Cang's operation.
Not dare to relax.
At this time, the instrument nurse was also stunned.
Because she found that Dr. Chen didn't look down on him, but because he needed to change instruments quickly at any time.
Even ... She felt that what Dr. Chen needed was a specialized equipment nurse.
Otherwise, it is simply not enough to maintain his operation.
Ge Huai is very engaged at this time!
I originally thought that Chen Cang called himself to let him take the equipment because he did not look at or humiliate himself.
Now it seems that this is not the case!
Compared with the people around him, Ge Huai found ... it seems that he can only do such a job.
Moreover, his angle can even see Chen Cang's operation.
If you think about it, Chen Cang is helping yourself!
For a time, Ge Huai also had mixed feelings.
However, he did not dare to think about it, since Chen Cang helped him so much, he had to do his own job well!
Pass the equipment!