I, Tomoya Aki, am not a bootlicker

The project is led by Tomoya Aki and assisted by Maki Nishikino.

As for why Yoshida Aoba was not the one to assist, it was because he was a veteran, and the other three people in the surgical team, including the chief surgeon, needed more practical experience.

Everyone stared at the laparoscope screen. Compared with open chest surgery, the laparoscopic surgical field is limited, and the surgeon needs to be more focused and perform more careful operations.

Use a retractor to expose the mitral valve. After confirming the indication for valve replacement, use thick silk thread to suture the large flap as a traction line. Use right-angle forceps to clamp the traction line and unfold the large flap.

Make a small incision on the large flap about 3 mm away from the valve ring, cut the large flap forward and backward along the valve ring 3 mm away from the valve ring, and at the same time cut the papillary muscle at the tip of the papillary muscle.

"Pay attention to the left ventricular wall..."

Aki Tomoya muttered to himself, narrowed his eyes slightly, and paid attention to his movements to prevent any damage during the removal.

After completing this step, he continued to remove the small flap in the same way.

Finally, the size of the valve ring is measured with a valve gauge to determine the number of artificial heart valves required.

"Sent for pathological examination."

The removed diseased tissue was handed over to the nurse for pathological examination, and the operating hole was replaced with a new instrument under the subsequent instructions of Tomoya Aki.

"Mechanical valve... Doctor Majima, I'll need your cooperation in suturing it..."

"As ordered."

That's a really nice word, yes!

Amano Tomoya raised his eyebrows. Mashima's "obey your command" gave him a strange feeling.

It’s true that being the chief surgeon is different. The feeling of being in control of the overall situation is still as fulfilling as always.

"2-0 line."

As for the suturing method, Aki Tomoya uses interrupted mattress suture.

The needle is inserted from the atrial side of the valve ring and removed from the ventricular side, and the suture ring of the artificial heart valve is immediately sewed from the ventricular side to the atrial side.

The position where the suture comes out of the suture circle should be as close to the edge as possible under the operation of Aki Tomoya.

"Put in an artificial valve."

After all sutures are arranged and straightened, the artificial valve is inserted into the valve ring.

Confirm that implantation is in place and tie the tubes one by one.

"Cut the cord."

A mitral valve replacement was completed, followed by treatment of atrial fibrillation with the Medtronic Cardioblate irrigated surgical radiofrequency ablation system.

When there is left atrial thrombus, it should be completely cleared and the left atrial appendage should be ligated.

There is basically no problem with this, just operate normally and pay attention to the patient's condition.

Proceed according to the surgical plan and suture at the end.

Finally, it is the tricuspid valve.

"Prepare for a DeVegaplasty."

The operation took a long time, not only because it was not a traditional open-heart surgery, but also because the patient needed more than just a mitral valve replacement.

On the basis of mitral valve disease, the patient also has tricuspid regurgitation.

These can all be done in one go.

Because DeVega plasty often causes wrinkling of the anterior leaflet and reduction in leaflet area, Akitomo decided to use a staged DeVega plasty.

That is, the valve ring is folded only on the anterior septal valve side and the posterior septal valve side, which can not only shrink the valve ring to eliminate tricuspid valve regurgitation, but also retain the leaflet area of ​​the anterior tricuspid valve ring as much as possible.

The operation took nearly three hours.

The operation officially started at around 9:30 in the morning and it is already noon now.

After the DeVegaplasty was completed, Tomoya Aki immediately breathed a sigh of relief.

The full thoracoscopic surgery was not only a mitral valve replacement, but also a blood clot removal, atrial fibrillation, and a DeVega angioplasty.

Not only did the operation save a critically ill patient, but the success of the operation also gave the surgeon Tomoya Aki a huge sense of accomplishment.

In short, it's just one word when it's done -

Cool!

"Open the ascending aorta."

With the ascending aorta open, the patient's heart will automatically restart.

The operation has also reached the final stage.

"Ventricular fibrillation!"