I, Tomoya Aki, am not a bootlicker

The operation will be recorded in its entirety, and everything in the surgical field will be transmitted in real time to the monitor in the observation room above.

In this operation, it is not just Yoshida Aoba and Sasaki from the surgical team who have to keep watch and pay attention to Aki Tomoya's movements.

The director of cardiac surgery, Wu Bu, who is also the nominal deputy director of the Department of Surgery, is also paying attention to it.

He can also intervene at any time and give some instructions.

"Monobe-kun, Dr. Aki in your department is quite good."

Dean Fujiwara said in an appreciative tone.

Akitomo, who was the lead surgeon in the operating room, did not show any sign of timidity. Even though it was his first time performing surgery, he did not show the excessive nervousness that often occurs among new doctors.

He really hopes that the operation will be successful.

Of course, he hopes that every operation in the hospital can be completed 100% successfully.

At the same time, if the hospital has a young talented surgeon, it can also be promoted.

Private hospitals really need a reputation, and wealthy medical corporate groups are not here to throw money around.

Many poorly managed hospitals will later be acquired and turned into specialized hospitals to make money.

Regional rankings, evaluation rates, and doctor-patient relationships are all things to be concerned about.

The patient is God. No, it’s not that exaggerated, but we must be cautious when treating patients.

"Don't say that yet. The operation has only just started half an hour ago."

The director of the logistics department's expression did not change at all. He focused on the situation in the operating room while also paying attention to the images and other data on the monitor nearby.

As time passed, the surgical team established extracorporeal circulation in the operating room. The aorta, right atrium and atrial septum were cut. The heart under the fixator had stopped beating after perfusion, and the extracorporeal circulation machine began to operate.

Carefully avoiding blood vessels, the artificial mitral valve and aortic valve are gradually exposed in the surgical field.

"Begin to remove the artificial mitral valve and aortic valve..."

As he spoke, Tomoya Aki did not stop his movements. He had already pulled down the magnifying glass, and the situation in the surgical field was magnified more clearly as he slowly performed the excision.

"Wipe your sweat."

Yoshida Aoba next to him said something to the nurse.

Amano Tomoya was so focused that he didn't notice that there was a thin layer of sweat on his forehead.

Yoshida Aoba, who was closest to Aki Tomoya, naturally gave instructions to the nurse on his behalf.

Heart surgery is a complex procedure that places extremely high demands on the surgeon, and not everyone can do this delicate work.

No heart surgery is easy.

As is often said, no surgery is without risk.

And heart surgery is certainly one of the riskiest.

After the artificial mitral valve and aortic valve were successfully removed, Aki Tomoya breathed a sigh of relief.

"The mitral valve leaflets are torn off from the two commissural valve frames, resulting in leaflet prolapse with insufficiency, and the aortic valve may

See white fibrous tissue proliferate, forming a narrow ring..."

After examination, there was no deviation from the prediction before the operation and the records in Mrs. Omi's medical history.

Aki Tomoya was mumbling something in his mind, and his hands paused for a moment. Yoshida Aoba and the others were also waiting for his next instruction.

The artificial double valves that you had in your last surgery, Mrs. Omi, have been removed. If you do not need to perform curtain reconstruction, you can actually start implanting artificial valves at this time.

So, now before we do the reimplantation, there is one more very important thing.

Aortic curtain reconstruction is the prerequisite for the smooth double valve replacement.

"Measure the internal diameter of the aortic valve."

=

Chapter 489: Five-Hour Surgery (2/4)

The most difficult part of this operation is not the replacement of the double valves, but the reconstruction of the valvular valve.

Not only because it requires extremely high technical skills from the surgeon, but also because among most patients with valvular heart disease, only a very small number actually need this type of surgery.

The patient can no longer use the same type of artificial valve as in the last replacement surgery, but needs a larger artificial valve. The first thing to do is to determine the inner diameter of the aortic valve and then expand it.

"The inner diameter of the aortic valve is 19 mm."

After taking the measurements, Dr. Nakagawa began to speak and then looked at Aki Tomoya.

After quickly going over the surgical plan that was determined by the entire surgical team, Tomoya Aki made a decision immediately.

"Enlarge the aortic valve annulus to 23mm!"

The most important part of this operation begins with completely cutting open the aortic curtain structure from the position of the aortic non-coronary valve annulus to the anterior valve annulus of the mitral valve.

"here we go."

The director of the surgery department in the observation room was looking at the surgical field, and the aortic curtain structure of the aorta clamped by the forceps was clearly revealed.

And the next action of Tomoya Aki and others in the operating room was obviously the beginning of the most important part of the work.

The aortic valve and mitral valve ring have been cut open. In this operation, Akitomo decided to use bovine pericardium to expand and shape the aortic curtain.

There was no hesitation in Tomoya Aki's actions. The experienced members of the surgical team, including Aoba Yoshida, Ichiru Sasaki and Dr. Nakagawa, took action immediately without him even saying anything.

With the instructions of Tomoya Aki and many discussions before the operation, they all knew what to do next.

Time passed, and as the operation progressed, it has now been about two and a half hours.

"Bovine pericardial valve number twenty-seven."

First, a 27-gauge bovine pericardial valve is implanted at the mitral valve position, with nearly two-thirds of the sewing ring placed along the posterior leaflet of the mitral valve.

The remaining notch is toward the aorta anteriorly.

Trimmed triangular bovine pericardium piece was used to reconstruct the intervalvular fibrous body from the aorta to the mitral valve.

The base of the pericardial flap is sutured to the anterior third of the mitral valve sewing ring.

"Close the roof of the left atrium."

"Wipe your sweat."

You can almost breathe a sigh of relief at this stage, but subsequent operations still require high concentration.

Aki Tomoya opened his eyes wide and blinked very frequently. Even if he didn't blink for a long time, he didn't feel any dryness in his eyes.

In order to ensure the smooth progress of the operation, God knows how many times he simulated it in his mind.

It was his first time operating as a surgeon, and he hoped more than anyone else that the operation could be completed smoothly under his leadership.

"Bovine pericardial valve number twenty-three."

There was almost no pause during the entire operation, let alone any possibility of rest.

One of the indicators is to complete the operation safely and as far as possible within a reasonable time frame.

A No. 23 bovine pericardial valve was implanted at the aortic valve position to allow the bovine pericardial piece to expand the aortic valve ring and sinus and reconstruct the aortic root.

Curtain expansion and shaping is a prerequisite for implanting a larger biological valve, and the subsequent double valve replacement surgery is actually performed in conjunction with curtain reconstruction.

Before I knew it, the operation had been going on for nearly five hours.

The operation officially started at 10:03 in the morning, and it is now 2:52 in the afternoon.

"Monobe-kun, it looks like it worked. I'll go first."

After sitting in the operating observation room for such a long time, Director Fujiwara said goodbye to Director Mononobe next to him after confirming the situation.

The director had left the observation room long ago as there were still many things waiting for them in the hospital.

Dean Fujiwara couldn't stay here for long.

Seeing that the operation had proceeded to this point and there were no more major problems, Director Fujiwara was able to leave with peace of mind.

He still has a lot of things piled up that need him to deal with.

At the same time, he also began to think about how to publicize that their hospital had completed a very challenging heart surgery, and how to create the image of a young and talented surgeon.

The director of the physical department nodded, without moving his eyes, and still kept most of his attention on the operation.

During the entire operation, including some conversations with Director Fujiwara beside him, he hardly took his eyes off the operation. It was a surgery happening in their cardiac surgery department, and as the highest leader of the department, he was more concerned about the success of the operation.

At the same time, he also wanted to see where Aki Tomoya's limit was, and whether Yoshida Aoba or Sasaki Ichiru would take over as the chief surgeon in the operating room.

"It looks like a good knife."

The operation has reached this point, and the position of the surgeon Tomoya Aki has not changed or wavered at all.

This surprised Director Monobe.

This was also the first time that Akitomo performed surgery, and the members of the surgical team who cooperated with him were the best staff in cardiac surgery, although it is true to say so.

But at least Sasaki Ichiru and the others did not find any problems during the operation on Aki Tomoya, which proves that he does have the ability.

"That guy Yano didn't make a mistake. He's really lucky this time."

Chapter 490 Thank you for your hard work (3/4)

Director Monobe used to deal with Professor Yano frequently.

When he was in the university hospital, when he was the chief professor of the Department of Cardiac Surgery affiliated to the University of Tokyo, Professor Yano's influence in the Department of Internal Medicine was enough to influence the position of the director of the Department of Internal Medicine.

He is clearly a person hiding in the university to study, but he has such a heavy shadow in the university hospital, and his ambition is unpredictable.

But that person is very smart. He will not give up the benefits that he deserves, and he will never touch what he shouldn't take, so as not to get himself involved.

Similarly, simply sending talent to the internal medicine department seemed to be insufficient to satisfy the professor of pathology at the university's medical school, and he seemed to want to get involved in the surgical department as well.

So he started to send some talents to the surgery department.

However, in this huge white tower, everyone has their own duties and the division of labor is clear. In the strict hierarchy, it is not so easy for Professor Yano to intervene in surgery.

At the very least, he needs someone who can take the lead.

In the White Tower, either medical skills or seniority are used to speak for you.

Don't say that using seniority to speak for others may seem like taking advantage of one's seniority. In Japan, seniority is really important. Not only in Japan, doctors with high seniority give people a sense of stability at first glance.

Moreover, in Japan, even if you don't have enough ability, you can still slowly move up by relying on years of experience and qualifications. Of course, if you don't have any ability, where you can end up depends entirely on luck.

So if you don’t have enough skills and qualifications, then just play around.

Insignificant people are in short supply everywhere.

Originally, Director Monobe felt that Professor Yano's approach of casting a wide net was not a good idea, because he was from the internal medicine department after all, and was not as good as their surgical department in training their own people.

Many of the students he sent to his friends stayed there.

Either he is incompetent or he has been poached.

Others, after working in university hospitals, were eventually squeezed out and went to private hospitals because of their delicate identities.

This time, Director Monobe also thought that Professor Yano was doing the same as before, sending people to them from among his acquaintances under the banner of recommending outstanding talents. As for how they would be trained, whether they would be trained, and how well they would be trained, there were not many ways to guarantee it.

However, Tomoya Aki also met Yoshida Aoba.

One of Director Mononobe's favorite disciples, and also recognized by Sasaki Ichiru.

Otherwise, it would be impossible for him to be the main surgeon now.

"It's a pity that you don't stay in my department, but there's still a lot of time, so I can't say for sure..."

Director Monobe felt that Professor Yano should not be allowed to sit back and reap the benefits.

But after all, he didn't do much favors for Aki Tomoya, but Yoshida Aoba was his student!

Moreover, even if Akitomo goes to the university hospital in the future, it is not certain that he will be able to go on smoothly. He may not be able to come back here in the future. Then Sasaki Ichiru and Yoshida Aoba will also have successors.

"You still can't underestimate young people."

Unfortunately, he is no longer in the Tokyo University affiliated hospital, nor is he the chief professor of cardiac surgery.

However, if he was still in the Tokyo University affiliated school, Aki Tomoya would not have so many opportunities, and Director Monobe would not have turned a blind eye to Professor Yano's actions against the surgical department.

Even Professor Yano would not allow Tomoya Aki to work in the university hospital first and join the surgical department so that his label would disappear.