godfather of surgery

Chapter 385

The people in the observation area saw the scene just now, and they all left their chairs with their buttocks. The sudden cardiac arrest occurred during the operation, which is a severe test of clinical experience and psychological quality for any surgeon.

"Heart stopped?"

"Defibrillating!"
-
"Have it!"

"There is."

Amidst the noise and exclamations, everyone saw the normal heart waves on the screen, let out a long breath, someone reached out to touch the chair, and sat back again.

People with lingering fears climbed out of the thrill and adjusted their emotions.

"Dr. Yang is a generation ahead of us in the study of this tumor. He has long anticipated cardiac arrest."

"We are still at the stage of primitive exploration. From our point of view, difficult problems that cannot be overcome for the time being seem to become a routine for him."

The huge waves that had just been stirred up in Johannesson's heart gradually calmed down, but there were still waves.

Griffin was not much better, and was also taken aback.

The medulla oblongata is a part of the brainstem, and the numerous nerve nuclei of the brainstem are distributed in this area. In the past, surgery in this area was a forbidden area.

In recent years, due to the advancement of brainstem anatomy, the advancement of operating techniques under the microscope, and the application of various advanced inspection and surgical equipment, and navigation equipment, surgeons have entered the restricted area.

But the operation is also limited to the safe area, and it is carried out in the gap between the nerve nucleus and the conduction bundle. Feng Lao's tumor has been closely adhered to the life nucleus, and it is still a restricted area for surgery.

Yang Ping's hand is very stable, like a precision machine. What is even better than a machine is that it has good tactile feedback, which makes the operation force very appropriate, which is currently impossible for any machine.

Wen Rentao, who is good at operating under a microscope, saw Yang Ping's operation and had to admit that the gap with Yang Ping could not be narrowed.

Under the magnified microscope, the operation is very comfortable, the maximum precision is always maintained, and the movement does not have the slightest distortion.

After crossing the first danger zone, the tumor was further divided, and the bleeding was stopped while separating.

In Yang Ping's eyes, the tumor without capsule seems to have some kind of invisible capsule, and Yang Ping can separate it on the surface of this capsule.

He is really like rock climbing with bare hands. There will be five falls during the whole rock climbing process. After the fall, he has to grab the rock again and continue to climb.

Once you miss, you will be lost forever.

"It's the limit of a human being, and his hand has been steady, showing no signs of sagging or fatigue."

"Success or failure, this operation should become a classic."

"Oops, the adhesion is too tight, and it's in danger again. The accuracy of 0.1 mm can't meet the needs of this operation. There will be another fall, my God."

"—"

The more I can see clearly, the more nervous I feel.

Johannesson covered his mouth and almost made a sound. Griffin and Woodhead were already huddled together, as if they could gain a sense of security.

The laser scalpel head emitted a faint light and entered the death zone again. Yang Ping made a short pause here to communicate with his assistant in advance to remind him what was going to happen next.

"Attention, everyone, the second cardiac arrest is coming soon, cheer up." Yang Ping said in a clear and calm voice.

Everyone regrouped all their spirits and waited for the second coming of death.

There was an uncontrollable scream in the conference room.

A second cardiac arrest occurred, this time more quickly and without warning.

Without delay, quickly move, cover the surgical area with sterile drapes, lift the sterile drapes on the back, and remove the electrode pads and wires for ECG monitoring.

First defibrillation, failed—

The right side of the screen in the observation room displays the panorama of the operating room and various monitoring parameters.

Second defibrillation, failed—
Johannesson followed those in front to their feet, and all stood up, failing a second time.

Time passed by second by second. If the defibrillation failed in the early stage, the chances in the later stage would be slim. Johannesson understood the risks involved.

As if the patient was right in front of him, and Johannesson couldn't help him, he clenched his hands into fists.

"Come on, come on!"

He clenched his fists tightly, and his fingers clasped his palm deeply, feeling a sharp pain in his heart.

continue--
How many rescues Dr. Wu in the ICU has experienced, how many fights with the god of death, when he failed for the second time, his hands began to tremble slightly.

At this time, the doctor's good professionalism was fully demonstrated. Even so, he still pressed the electrode plate to the exact position with the fastest movement without any deformation, and completed the third defibrillation.

"Have it!"

The anesthesiologist kept staring at the ECG waves on the screen of the defibrillator. Behind the dense ventricular fibrillation waves, a familiar sinus heart rate waveform jumped out.

"There—" everyone almost cheered.

The anesthesiologist didn't realize it himself, and when he shouted "Yes", there were two teardrops hanging on his face.

Not only because of Mr. Feng, the doctor does not want any patient to leave in his hands, and life slips away from his hands, which is a spiritual shock to any doctor.

Life and death, at this moment, life and death, between three defibrillation actions.

Heartbeat resumes—
The itinerant nurse wiped the sweat from everyone's forehead one by one.

Outside the operating room, Han Jiangong and Hong Zhigang had been waiting at the door. Doctors from other departments looked over from time to time, but none of them dared to come over.

They know that as long as the operating room door is not opened in advance, the inside is still going on.

Han Jiangong and Hong Zhigang were heartbroken, and they could see through the small window what was going on inside that they had already passed the second gate of hell.

Professor Zhang sometimes stood still, and sometimes walked around with his hands behind his back. A neurosurgery doctor brought a stool and asked Professor Zhang to sit against the wall.

Professor Zhang waved his hand, indicating that he would not sit down. He was shaking when he sat down, but he felt comfortable after walking.

Dean Chen sat in the locker room, leaning on the back of the chair, never going in, holding the phone in his hand, checking from time to time if there were any missed calls.

"Caught it, God, he got it again."

Everyone sat down again, Johannesson gasped and let go of his whitened fingers, and Woodhead and Griffin clasped their hands tightly.

Senior surgeons, observing this kind of operation, are terrified every step of the way, especially when the heart stops, and they are afraid that they will not be able to resuscitate.

This kind of heartbeat and breathing stops, and the breathing is suppressed by the general anesthesia, and the breathing is completely taken over by the ventilator, so it cannot be expressed.

The heartbeat will be reflected immediately. If the rescue cannot be rescued, even if ECMO is used to temporarily replace the heart to promote blood circulation, it will have no effect.

Because the life function area of ​​the patient's brain has been disordered, brain death is inevitable.

"Everyone, adjust your emotions. Is there anyone who wants to change?"

Yang Ping asked everyone that countless devil trainings made him feel as hard as a rock during surgery, extremely rational, like a robot, rational to the point of inhumanity.

In the face of this kind of surgery, any mood swings, any impassioned, will not help.

All act in accordance with the laws of science, and all choices and judgments must be rational in order to be the closest to success.

After two cardiac arrests and two contests with death, everyone consumed a lot of energy.

Under Yang Ping's questioning, no one spoke. The quality of the doctors in the Sixth Hospital of Shanghai is indeed the best in the country.

"There will be a few more times in the future, everyone cheer up, the god of death is by our side, reach out at any time, we can't miss it every time, check the power of the defibrillator." Yang Ping urged everyone.

Reorganize the operating table, change clothes and gloves, and the operation continues.

The chief surgeon's firm will is focused on the tip of the scalpel, and it continues to move forward without fear.

The operation has entered the most dangerous area of ​​the medulla oblongata, and the third heartbeat stopped, which will be more sudden in the future.

Yang Ping must judge in advance and give other doctors enough time, five seconds, if he hesitates a little, or if there is a delay, the opportunity will be lost.

Five seconds, the God of Life only gives five seconds each time.

"How can Dr. Yang accurately determine which step the cardiac arrest occurred at?"

"It shows that his research on the anatomy and physiology of the brainstem has been very thorough."

"In China, brainstem surgery is the job of neurosurgeons."

"I heard that when he studied the tumor of the upper cervical spine, it extended up to the medulla oblongata, and the research came from there."

"Our trip to China this time has pushed the level of surgery for upper cervical spinal cord tumors and brainstem tumors forward by at least ten years."

"The Chinese are so crazy, there seems to be no problem they can't overcome."

"Sir, don't forget that the world's first case of replantation of a severed limb occurred in this hospital."

Johannesson, Griffin, and Woodhead sat without using the bathroom.

The same goes for the others in the observation room, no one went out, and they all concentrated on it.

One-third of the thumb-sized surgical object is all fragile tender tofu, with countless blood vessels and many nerve nuclei inside, forming a dangerous world by itself.

The deeper you go, the more difficult it is to separate, and mistakes in judgment and operations will be fatal.

The laser knife follows a precise trajectory without any trembling or deviation. The chief surgeon seems to know the boundary between tumor and normal tissue. Even if there is no boundary, he can separate the boundary.

As the separation deepened, the third cardiac arrest was getting closer and closer.

In fact, this is the third and fourth collection. The interference of two consecutive danger zones is reflected by a stop.

"The third cardiac arrest is coming soon. This time it will be very stubborn. It may take more than a dozen rounds of cardiac compression and defibrillation to succeed. Everyone must hold on."

Wen Rentao listened, he was able to predict more than a dozen rounds of cardiopulmonary resuscitation, and he was still so calm. This is a demigod.

"This time, we want to peel off the tumor from the superficial layer of the nerve nucleus?"

The hairs all over Johannesson's body stand on end, this is the real dead zone.

If we said that we were operating on the verge of death before, this time we are directly stepping on the death operation.

This is something that any neurosurgeon in the world dare not do. The operation in the gap has reached the current limit, and now it is necessary to enter the superficial layer of the nerve nucleus? Even the fiddle with tweezers may cause death.

Yang Ping adjusted his sitting posture. This time, there were two dangerous operation points connected together. Yang Ping was going to cross it once, but he could only cross it once.Cross over twice, the success rate will drop.

If the neural nuclei are densely covered reefs in the vast ocean, before swimming among the reefs, now they have to collide with the reefs.

At this time, the 0.1mm laser knife also appeared to be less confident.

Crossing the dangerous zone this time, the two operational risk zones need to draw the curve once in a row. Any pause will increase the time the tool tip stays, resulting in an increase in the heat accumulation effect and causing irreversible consequences.

"Attention everyone, when you hear my order, you don't need to look at anything, just do the electrical defibrillation directly, and the electrical defibrillation and cardiac compressions are performed alternately, and you can't stop until it succeeds."

There is only one chance, and one must succeed.

In "Extreme Thief", riding a motorcycle across the canyon and landing on an isolated peak, there is only one chance, and failure means death. Now Yang Ping has to cross two canyons in a row.

Wen Rentao didn't dare to move the suction device in his hand. There was no bleeding now, and even if it did, he didn't dare to stick it in to suck blood.

"Take a break, are you afraid?" Yang Ping asked Wen Rentao.

Wen Rentao tried his best to calm himself: "The object of your operation should be the heartbeat center?

"That's right, I want to go into the superficial layer of the inner core and peel off the part where the tumor enters." Yang Ping told him.

"If this is feasible, there is only one chance. There is no time to wait, the beginning must end, and there is only one chance to succeed." Wen Rentao understands the danger of the next operation.

"Everyone take a break and adjust your emotions. The next recovery will be more challenging. Believe me, we will be able to overcome it." Yang Ping encouraged everyone.

Yang Ping took a short rest and continued the operation after gaining a buffer.

He adjusted his breathing several times, and kept adjusting the laser knife in his hand, looking for the best feeling, just like a sniper, looking for the best time to shoot.

The laser head started to move, changing from the calmness before. The small bright spots quickly moved along the predetermined curve at the junction between the brain tissue and the tumor.

One time, two times, three times, four times, each precise overlap deepens the separated part.

Finally, the two death zones were crossed, and when the last operation was completed, Yang Ping put down the equipment and directly ordered: "Heart compression, defibrillation!"

As soon as the words were finished, the wavy line disappeared and the heartbeat stopped. This time it was a flat straight line, not a ventricular fibrillation wave. Although Yang Ping told everyone in advance, everyone was still shocked by the sudden change.

Straight lines are more dangerous than ventricular fibrillation.

Cover the operation area, lift the sterile drape, and start reverse cardiopulmonary resuscitation.

The movements of Dr. Wu in the ICU are very standard. The pressure on the back is pushed back by the sandbag on the lower sternum on the ventral side. The sandbag compresses the lower sternum, causing the thorax to sink, forming an artificial pump, squeezing the heart, and driving the blood to circulate around the body with oxygen.

Johannesson was terribly nervous, such a bold operation, but if he didn't do this, the operation would have no hope of success.

The pores of his whole body shrank, his muscles were in a state of spasm, and he leaned against the back of the chair, motionless.

"Anesthesiologist, continue to push the epinephrine."

"Have it!"

Ventricular fibrillation appears, which is fine fibrillation.

"Anesthesiologist, turn it into rough tremors, quick!"

Another quick push of adrenaline.

Fine tremors are very dangerous and difficult to successfully defibrillate.

With the efforts of the anesthetist, the fine tremors immediately turned into coarse tremors, like a rapidly vibrating rope.

"Wen Rentao, prepare to defibrillate, hurry up!"

Wen Rentao didn't hesitate at all. The electrode plate in his hand had already been coated with conductive paste and was pressed against Feng Lao's back.

Yang Ping looked at the screen calmly, his heart was like a rock.

Defibrillation failed!Continue cardiac compressions.

"Go on, don't be discouraged, you can definitely be saved, you can." Yang Ping said firmly.

"Defibrillation again!"

Failed again.

Outside the door, through the small glass window, Han Jiangong and Hong Zhigang saw that the rescue was being carried out inside, their hearts thumped, and a tight contraction came from their chests one after another.

Professor Zhang sat on the stool, squinting his eyes. He couldn't stand up anymore, and whether he could get through it depended on the old man's life.

Alternate compressions and defibrillation.

The third time, the fourth time, the fifth time, the sixth time, the seventh time——
There was no sign of success yet. Johannesson looked at the screen without daring to blink, in extreme pain, hoping for a sinus rhythm heart wave, hoping for a QRS complex.

QRS complexes, the QRS complexes that everyone has, are now out of reach for Professor Feng.

"God——" Griffin kept making the sign of the cross.

Woodhead's whole body was cold, he held Griffin's hand tightly, his body had slipped from the chair, and he was reclining.

"Hurry up, hurry up!"

I don't know who in the observation room burst into tears.

No.15 times, electric defibrillation.

Anesthesiologist Professor Ma looked at Yang Ping, and everyone kept on going.

"CPR is replaced, and Zeng Ran immediately replaces Wen Rentao."

Zeng Ran played.

"Not strong enough!"

Yang Ping immediately replaced Zeng Ran. Originally, he had to take overall command, but usually there was relatively little reverse cardiopulmonary resuscitation training. Even the assessment was performed in the supine position, and Zeng Ran was a little unskilled.

Yang Ping pressed his back forcefully rhythmically. The back pressing and the squeezing of the sternal sandbag deformed the chest, and the heart pumped out the blood. When he let go, the chest rebounded, and the blood in the whole body returned to the heart.

"Continue defibrillation!"

Wen Rentao performed No. 18 defibrillation times, he was almost desperate, already [-] times.

"Go on, everyone, don't panic, it will definitely work, it will work——"

Yang Ping's tone was firm and confident, giving everyone great courage and confidence.

Finally, after a round on No.20, sinus rhythm was restored.

After the electrocardiographic storm of death, there was silence, watching the sinus rhythm wave diagram on the defibrillator screen.

Connect the ECG monitoring again, the long-lost QRS wave reappears on the screen, and the curve is like the most beautiful music in the world.

After the catastrophe, the rest of the life was so easy, everyone panted and turned to look at Yang Ping. Now in their eyes, he is a god, not a human being.

"Wipe off your sweat, reapply your hands and go on stage, continue with the surgery, do you want to change someone?"

Everyone shook their heads and encouraged each other.

There were three cardiac arrests on the operating table, and this time it took 21 rounds to rescue them. Every doctor felt exhausted just now, but now he is full of energy.

"Everyone, don't be afraid, remember, follow my command in all actions, and you can definitely be rescued. If I guess correctly, there will be another cardiac arrest, and I will tell everyone in advance."

"The rescue was successful again?"

Griffin woke up Johannesson, who had his eyes closed, and a surprising sinus wave appeared on the screen.

"I love you--"

The world's top neurosurgeon blew a kiss to the QRS complex on the screen.

The wailing gentleman was a student of Professor Feng who had rushed back from Germany.

He was sobbing like a child, and someone handed him tissues.

(End of this chapter)