godfather of surgery

"Fighting each other?"

Director Shi couldn't help but ask.

However, the commentator, Director Fang, was not around. The doctor of general surgery next to him temporarily acted as the explanation for the uncle: "It means that each hand can operate independently."

"There are such irritating operations?" Director Shi couldn't help but express his feelings.

As soon as the words came out of his mouth, Director Shi felt that he had used the wrong word. Words like "sexy" should not be uttered from the mouth of a professor, doctoral supervisor, chief physician and nationally renowned expert. It was all caused by this operation. He looked at it. I just can't control it.

"Professor Yang is so coquettish and always performs miracle surgeries." The doctoral student agreed with the evaluation of coquettishness.

Director Fang is currently observing the operation at close range next to the operating table. Every time he sees the right opportunity, he will ask: "Dr. Song, do you want to take a rest? Dr. Xu, do you want to take a rest?"

But it was like taking a shot of chicken blood, and no one felt sleepy.

Song Zimo and Xu Zhiliang felt that Director Fang was very considerate today and always cared about whether they needed a rest. He was such a good colleague.

"Order lunch! Tell us your name! Everyone fill in your name and I'll come and get it later."

The nurse came in with a notebook, put it on a shelf, and then went to do other things. Now there are several nurses in the operating room of the Institute of Surgery. Xiao Su used to be the head nurse. Now Xiao Su is on vacation. Zhou Can is the acting head nurse. Now Zhou Can works as an instrument nurse on the stage.

The conditions at the Institute of Surgery are relatively good. Whether they are doctors, nurses, or visitors, whether they are on stage or off stage, when it comes to eating, everyone can order a meal if they have a share.

Several graduate students immediately turned around when they heard the meal was announced. It was said that the surgical meals at the Institute of Surgery were of very high quality and everyone wanted to try them. Some graduate students even often came here to eat.

A graduate student picked up the notebook and began to volunteer to help register names: "Those who are eating lunch, raise their hands!"

Everyone raises their hands.

"Don't you have surgery this afternoon?"

“I’ll do the surgery after eating.”

"Why do you want two copies?"

"Hey, my girlfriend is too busy in the gastroscopy room. Let me send a copy later."

"Director Fang, Director Shi, would you like one too?"

Director Fang nodded: "One for each."

When he heard the announcement of the meal, Director Fang had an idea. Wouldn't they also have to eat later? They must take turns to eat. While either Song Zimo or Xu Zhiliang was eating, he directly stepped onto the stage and stood in the position of Yishu. Isn't that right? It's just natural.

Failure to do so will lead to failure. Director Fang began to plan to eat in advance and make full preparations.

Director Fang made up his mind and immediately found his own graduate student in the general surgery department and quietly told him: "Help me go to the Water Lotus Bakery to buy something. I have a gastrointestinal problem these past two days, so I shouldn't eat."

"Go now?" The graduate student still wanted to continue watching the surgery.

"Go now, go back quickly!" Director Fang said.

Regardless of whether the graduate student is happy or not, there is no room for negotiation when it comes to running errands for the tutor, so he immediately accepts the order and goes out to buy bread temporarily. Director Fang smiles inwardly and finally seizes the opportunity. The rest is to play by ear.

Those who achieve great things do not stick to trivial matters, and Director Fang is very satisfied with his arrangements.

Now the separation has reached the left kidney, which has been very obviously invaded by the tumor and must be completely removed. Fortunately, people can survive normally with only one kidney, and a healthy solitary kidney has no impact on the body.

The entire dissection is performed by removing some areas with obvious loose connective tissue gaps, using the handle of the knife for blunt dissection. In most parts, because the tumor has obvious adhesions, a sharp knife is used for sharp separation. Therefore, the entire operation is sometimes performed by the tip of the knife, sometimes by the handle of the knife. , the tip and handle of the knife have been used interchangeably.

The separation of the inferior vena cava has been completed. Follow it downward, close to the midline of the psoas major muscle, and cut the perinephric fascia longitudinally with a sharp knife, fully exposing the kidney upward, then all the way down to the iliac blood vessels, and along the outside of the kidney. The perirenal fat is incised longitudinally to reach the renal capsule. At this time, only the blood vessels of the renal pedicle of the left kidney are connected to the human body, while other parts of the kidney have been separated from the human body.

In the video, the blade tip and handle were exchanged very quickly, with almost no time interval, so Director Shi was very curious about how the scalpel was exchanged in Yang Ping's hands, and he moved to the operating table to observe.

The scalpel in Yang Ping's hands was like performing acrobatics. The switch was very fast. This was not a surgeon using an instrument. This was obviously playing with an instrument. It only took an instant to switch from the knife to the handle.

Young people are really good at playing. It would be very dangerous if the scalpel were to fall off.

Director Shi took a closer look and found that there was no such possibility, because the equipment seemed to have grown in Yang Ping's hands and his control was very stable. It was estimated that if someone tried to grab it now, they might not be able to grab it, let alone get rid of the equipment.

The kidneys have been separated, and the eight organs now have no other tissues connected to the human body except their own blood vessels.

At this time, Director Fang's graduate student had already bought bread and placed it in the lounge. Director Fang immediately left the show and hid in the lounge to wolf down the bread, and then he breathed a sigh of relief.

His stomach has been filled, and now all that is left is to wait for them to get hungry. Then they will definitely take turns to come off the stage to eat. Once someone comes down, he will take the opportunity to replace him, firmly occupying the position of first aid, and no one can shake it by then. One's own help.

''When it's time to eat later, you take Professor Shi to the lounge for dinner, you know? "

Director Fang told his graduate students that he would no longer accompany his seniors to have meals in person, so as not to waste this great opportunity.

The graduate student knew that his supervisor was going to undergo surgery later, which was a big deal. Of course, he had to take good care of his supervisor on behalf of his supervisor.

"Open an artificial blood vessel!"

Now we can finally know the purpose of the artificial blood vessels brought by the equipment manufacturer. This is like opening a blind box. You don't know the purpose of the equipment until you use it. How can anyone do this kind of surgery?

Hearing Yang Ping's voice, Director Shi's eyes immediately shifted from the screen to the operating table.

Yang Ping is going to use a relatively new method, that is, ischemia-free autologous transplantation. He wants to learn from Professor Yao from the First Affiliated School of Nandu Medical University. Professor Yao created his own ischemia-free organ transplantation. Now Yang Ping wants to apply this technology to autologous organs. Transplanted.

Because autologous transplantation can make use of the body's own blood circulation, if the isolated organs are connected to the patient's blood circulation system with artificial blood vessels, good blood perfusion can be obtained even if they are isolated from the body, and almost no new blood is added. of instruments and equipment.

Huang Jiahui drove the sterile-packaged artificial blood vessels onto the operating table. These artificial blood vessels were very long and curled inside the sterile packaging bags.

Director Shi wondered how to use these artificial blood vessels. Even if a section of the inferior vena cava was cut off, such a long blood vessel would not be needed. Besides, these artificial blood vessels are not only used for the inferior vena cava, because there are pipes of various thicknesses. .

Eight organs including the liver, gallbladder, pancreas, spleen, stomach, small intestine, inferior vena cava, and a kidney on the left side are now ready to be separated from the human body. They and the tumor will be separated from the human body as a whole. There were at least dozens of artificial blood vessels of various diameters placed on the operating table. Everyone was dazzled by the sight, and the artificial blood vessels were sent into the abdominal cavity one by one.

Everyone finally saw clearly that this was using artificial blood vessels to bridge the blood supply of the organs. All the arteries and veins of the organs were cut off and then bridged with artificial blood vessels. This could ensure that the organs received almost normal blood supply.

However, the workload of the arteries and veins of eight organs is so huge, it is really nerve-wracking to watch.

"You are this?"

Director Shi couldn't help but asked curiously,
  "Ischemia-free autologous transplantation!"

Ischemia-free autologous transplantation? Director Shi had only heard that Professor Yao from the First Affiliated Hospital of Nandu Medical University was doing ischemia-free allogeneic transplantation, but he had not heard that anyone was doing ischemia-free autologous transplantation.

"How come I haven't heard of this technology?"

Director Shi blushed and asked, "Science is an honest thing. If you don't understand, just ask. Don't pretend to understand."

"Aren't you looking at it now? There is a first time for everything. Isn't it strange?" Director Fang replied.

There are more and more artificial blood vessels. Because the organs have not been taken out from the body, dense artificial blood vessels are curved and exposed from the abdominal cavity. The scene is particularly spectacular.

"Anesthesiologist, we're going to take the big guy out!"

Yang Ping shouted.

Fatty Liang immediately reported his vital signs, indicating that there was no problem now and that he could start the bottom.

At this time, no one was watching the video. They were all staring at the operating table to see what was coming out. Everyone's eyes were glaring, like a star waiting for the star of a concert to appear.

It's out, it's out, it's finally out!
  After being separated inside for so long, everyone is looking forward to what it will be when it is taken out.

Whoa!
  A bunch of huge things were taken out from the abdominal cavity, and ordinary sterile trays could not fit at all. The nurse specially prepared a huge metal sterile basin, and this pile of things could barely fit in.

Wow!
  There was a chorus of low-pitched screams in the operating room.

No matter whether they are young doctors or senior doctors, they have never seen such a spectacular resection, eight organs plus tumors. Even the relatively huge tumors they have seen before are only single, and there is no visual shock brought by this guy at all. .

It's just that due to the invasion of the tumor, clear organs can no longer be seen. All that is known is a pile of human organs and tumors, with connective tissue.

How to put such a huge pile back later? Everyone is full of doubts.

The pile of things taken out is connected to many artificial blood vessels, and the organs rely on the artificial blood vessels to obtain the patient's blood supply.

If there is no blood supply from these artificial blood vessels, these organs must be placed in a special ice-water protection solution to extend the survival time of the organs outside the body.

Professor Yao from Nanjing Affiliated to Nanjing University created the "ischemia-free" allogeneic organ transplantation. After the allogeneic organ is separated from the body, a machine is used to perfuse the organ with a special artificial "nutrient solution", and the "nutrient solution" is used to deliver oxygen and nutrients to the organ. Prolong the survival time of organs and reduce organ damage caused by ischemia.

Yang Ping is currently using "non-ischemia" autologous transplantation. Because it is an autologous organ, the organ can always be kept within close range of the patient after it is removed from the body. Unlike the allogeneic organ, which has a long-distance transportation process, since it is within close range of the patient Within the range, the patient's body can be used to continue blood supply and keep the patient's organs from ischemia.

However, due to the extended blood transport distance, the perfusion of organs is still lower than normal, but it is not known to be much better than ischemia, and these pipes do not affect the various turnovers of isolated organs. Next, the tumor must be completely removed from this pile of organs.

Director Shi discovered a major secret - there was no obvious bleeding from the pile of organs placed on the sterile table. Could it be that the perfusion was too low due to the bridging of the artificial blood vessels, so there was no bleeding?

But the color of the organs and tissues is obviously very good, and the perfusion should not be too low. Is the hemostasis done very well?
  It's impossible. How could the hemostasis be done so well? There would probably be a pool of blood on the operating table.

"Everyone takes turns to eat and the operation continues."

Yang Ping told everyone.

This operation takes a long time. It should be the longest operation in the history of the surgical institute. There is no replacement team, everyone can only come one by one and take turns to eat.

Upon seeing this, Director Fang hurriedly brushed his hands. How could he miss such a precious opportunity? He immediately left the operating room and took the time to brush his hands. Once Song Zimo left the operating table, he immediately grabbed the first assistant position.

Director Fang quickly brushed his hands without any hesitation. He would rather wait in the operating room to brush his hands well than miss the opportunity.

Just as Director Fang finished brushing his hands, the door of the operating room opened, and Song Zimo came out. Director Fang and Song Zimo nodded slightly in greeting, then snickered inwardly, and immediately rushed to the operating room, preparing to snatch Isuke's position at lightning speed.

But—but—
  At this time, the senior brother had already put on surgical clothes and stood in Song Zimo's original position on the operating table.

What's going on? Did he not even eat just now, but went to wash his hands quietly? Why didn't I pay attention just now?

I have never considered the senior brother. Now that the senior brother is on the stage, if I still come up, it will be equal to occupying their two positions, which is not suitable. Even if I forcefully occupy them, Zhang Lin on the stage is not a good person and will definitely get angry. ,what to do?
  ''Professor Shi, how can I trouble you if you haven't eaten yet? Go eat quickly and I'll take over for a while. Director Fang said immediately.

Director Shi replied without looking back: "I ate a bit too much in the morning, and I haven't digested it yet. It's time to do some exercise."

"Shall we continue? I'll help, patrol, and give you a pair of fluorescent glasses." Director Shi quickly got into the mood, and he didn't plan to have lunch at all.

With this kind of surgery, what else is there to eat for lunch? This is a common thing that delays meals during surgery, and the stomach has long been used to it.

How to start this? It's a mess, it doesn't look like it at all, and many of the blood vessels connected to the artificial blood vessels need to be cut off. What about the blood supply? Director Shi feels that if he is the surgeon, he will not be able to start.

"Who is this?"

Zhang Lin asked.

Director Fang immediately answered for Director Shi: "Professor Shi Guosheng from Nandu Medical University Cancer Hospital."

"Who asked you to come on stage?"

Zhang Lin is not polite, no matter who he is, he ran up to the stage without being allowed to go on stage. That's okay. If there is no discipline in the surgery, everyone is so chaotic, and everyone is not allowed to fight each other in order to compete for the surgery position.

Zhang Lin's question caused the air in the operating room to condense instantly. Here was the nationally renowned Professor Shi, and over there was the awesome Teacher Zhang.

(End of this chapter)