godfather of surgery

This is a dextrocardia, and any surgery on a dextrocardia is more difficult than a normal left heart.

This is like a surgeon's habitual decision on anatomy. It's like an old driver who drives on the left with a left-hand steering wheel. Suddenly he finds it difficult to adapt to a country where the traffic rules are opposite, with a right-hand steering wheel and driving on the left. If it is an area with very complicated traffic, it will be even more unsuitable.

When the Fontan surgery was performed, if it had not been for Academician Wang's superb skills, he would not have performed the Fontan surgery on dextrocardia so well.

In fact, dismantling surgery is not that simple. The operation must be precise. While dismantling, the quality and integrity of the "parts" must be preserved. Reorganization and reconstruction still rely on these dismantled "parts" rather than relying on substitutes.

The pulmonary artery is connected to the superior and inferior vena cava, which is the core of the Fontan operation. Now Yang Ping needs to cut off this connection from the original anastomosis to allow the pulmonary artery to return to its connection with the right ventricle.

The separation between the left and right atria had been eliminated during the original operation, and now the wall had to be rebuilt.

The original plan to use the heart only for systemic circulation was completely dismantled and scrapped. Now the heart must return to its normal position to undertake the dual tasks of systemic circulation and pulmonary circulation. It has changed from a similar two-chamber structure formed after the last surgical transformation back to a four-chamber structure.

But this is far from enough. This is just to remove the original surgery and lay the foundation for the heart and great blood vessels to restore their original appearance.

Demolishing the house is only the first step, and building the house later is the most complicated project.

After Yang Ping removed the original surgery, all the "parts" inside were scattered, and the entire heart and great blood vessels were in pieces.

Academician Wang stood up from the stool so that his line of sight was more at the same level as the screen, making it easier to observe. It was only the first step of the operation, and everyone began to worry that the current work was just to knock down the building, and then restore and rebuild it. That is the most difficult thing. The difficulty of restoration and reconstruction is not to start from scratch, but to rely on these ruins to rebuild a complete building.

As several of the world's top cardiac surgeons, they had never performed such an operation. They had even planned it in their minds for a long time, but they had no idea. They couldn't believe that this kind of operation could be achieved.

With one cut and one stitch, Yang Ping began to reconstruct the heart. This was an arduous task that not only tested his skills, but also his confidence and patience.

The malformation of the heart is corrected first, and then the malformation of the great blood vessels is corrected. Yang Ping's surgical procedures are very clear, and the big steps are followed by small steps, and they are advanced step by step.

The atrial septum must be rebuilt. The original large room must now be divided into two isolated small rooms. In this step, the separation wall must be sealed to prevent blood leakage. That is to say, after the atrial septum is rebuilt, the blood in the left and right atria will no longer flow. Able to mix.

If the ruins do not have materials that are not available in the entire reconstruction, a combination of autologous materials and artificial materials will be used. In short, the goal must be achieved.

Not only is the atrial septum defective, but now the ventricular septum is also defective. After rebuilding the atrial partition wall, the partition wall between the ventricles must also be reconstructed.

There is severe stenosis under the pulmonic valve. Academician Wang had already solved this problem during Fontan surgery, otherwise Fontan would not have lasted for more than 10 years.

Atrioventricular valve insufficiency. Now reconstruction must solve this problem. Normal blood should flow from the atrium to the ventricle without reverse flow. The atrioventricular valve is a one-way valve. This one-way valve ensures the one-way blood flow. Sex, but incomplete closure will cause the function of the one-way valve to be destroyed, and blood will flow backward.

At this time, only the atrioventricular valve can be repaired or replaced. If it can be repaired, it can be repaired. If it cannot be repaired, it can only be replaced.

Fortunately, Yang Ping felt that his atrioventricular valve could still be repaired, but it would be more difficult.

After repairing the atrioventricular valve, Yang Ping began to deal with the hepatic vein. The operation progressed unhurriedly, methodically, quickly and not chaotically.

Song Hanhui originally opened the hepatic vein directly into the right atrium. Now Yang Ping wants to remove it and connect it to the inferior vena cava. There are two ways to handle this step. Directly perform an end-to-side anastomosis between the hepatic vein and the inferior vena cava, that is, A small opening is trimmed in the wall of the inferior vena cava, and then the hepatic vein is connected to this small opening.

Another method is to find a branch of the inferior vena cava that joins the vein. This vein also has a brother vein, and then cut this vein and anastomose it with the hepatic vein.

Relatively speaking, the latter is much better. Yang Ping adopted the latter method. It turns out that the hepatic vein outlet of the right atrium still needs to be blocked.

Later, there are correction of the double outlet of the right ventricle, adjustment of the opening positions of the aorta and pulmonary artery, etc. The surgery is very complicated.

Academician Wang kept staring at the screen. Yang Ping's surgery looked very comfortable. It was originally a complex and messy matter, but through Yang Ping's hands, it turned into simplicity and order. The entire surgery reflected a transcendent sense of art.

Every step seems to have been refined thousands of times, and there seems to be some kind of precipitation in it.

Several graduate students also gathered in the demonstration classroom to watch the surgeries, but they all took time out to watch the surgeries. Some had to go back halfway through, and some came in during the middle of the surgery.
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The operation lasted for more than three hours, and Yao Xiurong couldn't wait any longer. She ran to the door of the operating room again, but the door was closed, and she couldn't see anything. She wanted to raise her fists and punch her a few times, but she was afraid that her husband would scold him. So I held back and didn't move.

"Concentration! Have concentration!"

Lao Song reminded his wife.

Yao Xiurong stepped in front of the door of the operating room. At this time, the graduate student who was rushing back to the ward hurriedly came out, and another graduate student hurriedly entered.

"How was the operation inside? Did the heart arrest?"

"It's been stopped for a long time. Come in and take a look."

"I just finished my work."

"Hurry up. If you don't hurry up, it will be gone."

Yao Xiurong wanted to catch a graduate student to ask what happened, but the one who came out had already entered the elevator, and the one who entered had already entered, and the door was closed.

"Cardiac arrest?"

Yao Xiurong was stunned. Cardiac arrest means that the heart has stopped beating. Then wouldn't the person be dead?

Yao Xiurong seemed to understand everything and could no longer bear it. She knocked hard on the door of the operating room, bang bang bang!
Lao Song pulled her away: "What are you doing? You are crazy. This is the operating room, and your son is undergoing surgery inside."

"My heartbeat has stopped, and no one has come out to tell me what's going on. Just you, doing nothing, just not caring about things. Are you so hard-hearted? It's our son inside." Yao Xiurong scolded.

"Did you listen to the doctor's pre-operative talk? This operation requires the heart to be stopped. It's not the first time. It has been like this for the previous three operations." Lao Song tried his best to explain.

Yao Xiurong was so anxious that she couldn't tell the difference between east, west and north. Because of her anxiety, she didn't listen at all to every pre-operative conversation: "Only you understand. You understand everything. I understand nothing. Don't I understand cardiac arrest?"

Regardless of Sanqi 21, Yao Xiurong knocked on the door hard. Soon, the door opened and a nurse came out wearing a mask and a sterile cap.

"What's going on? Don't knock on the door like this. There's an operation going on inside. This will interfere with the doctor's operation," the nurse said.

Lao Song immediately apologized and pulled Yao Xiurong aside: 'I'm sorry, I'm sorry! '

Yao Xiurong shook off Lao Song's hand: "How is Song Hanhui inside? It's been more than three hours, why is there no movement at all? We are his parents, and we are very worried."

"I'm still undergoing surgery inside now, everything is going well." The nurse explained.

"My heart has stopped, but everything is going well? I ask you, has your heart stopped?"

Yao Xiurong's questioning tone.

The young nurse was also confused by the sudden questioning: "Yes, the heart has stopped now -" Yao Xiurong's head was dizzy, and the nurse quickly helped her: "What's wrong with you? Are you okay?"

"Why did the heart stop?" Yao Xiurong turned pale, fell into the nurse's arms, and fainted.

The nurse realized that it was a misunderstanding. Every parent with congenital heart disease knew what was going on, why didn't she know?

Because she was worried about her child's surgery, Yao Xiurong had no appetite in the morning and skipped breakfast. Now she is hypoglycemic. When she is anxious, she will have a hypoglycemic reaction.

The nurse was relatively experienced. She knew it was hypoglycemia when she saw this, and immediately called: "Come quickly, rescue me!"

This is an operating room, not a ward. Everyone is busy with operations. When the nurse shouted, a doctor ran out. The nurse said, "Quick, open the bottle of glucose."

Lao Song was really speechless. He didn't eat breakfast even though he knew he had hypoglycemia. He said he was worried about the child. Isn't this adding to the chaos? The surgery was done well. Now if you cry or make a fuss, the doctors and nurses will have to sort it out. Manpower came to rescue the family members.

If it weren't for his wife, Lao Song would really want to kick her. His intention was good and he was worried about the child, but the result was just more chaos.

This is not the first time this has happened. In the past, my child had just entered elementary school and had poor academic performance. My wife and my parents-in-law discussed how to find a solution. As a result, my parents-in-law listened to the recommendation of a health care product seller and bought a course of "smart medicine" that cost a total of Twenty-eight thousand.

You said it would be okay if this "smart medicine" was flour. It contained something similar to stimulants, something completely harmful. After Lao Song found out, he was determined not to eat it.

As a result, my wife, father-in-law and mother-in-law were very aggrieved. They said that they spent all their savings to buy medicine for the sake of their children. You still don’t appreciate it. Others who bought health care products said that these are the latest foreign products and cannot be bought by ordinary people.

Oh my gosh, they believe what people selling health care products say.

As a result, the father-in-law and mother-in-law had a dispute over this matter, and tried to feed the child secretly several times, but Lao Song discovered it. They also said that Lao Song was impersonal, did not understand the old man's thoughts, and mistook the old man's good intentions as a donkey's liver and lungs.

Isn't it like this again this time? I am really anxious, but isn't it a disservice to me to be anxious? There are not many such things.

Doctors and nurses immediately rescued Yao Xiurong on the spot, letting her drink a few sips of glucose and then inhaling oxygen through a nasal cannula. About ten minutes later, Yao Xiurong woke up: "Where is my child -"

"It's still being operated on, don't worry."

"You lied to me, my heart stopped beating, why shouldn't I be anxious?"

The nurse couldn't laugh or cry: "The doctor should have told you before the operation that this kind of operation requires artificially stopping the heart and restarting it after the operation. This is a normal step in the operation."

"My heart has stopped. Can a person still live? You think of me as a three-year-old child. If a person has no heartbeat, how can he still be alive? Let me go in and have a look." Yao Xiurong refused to give up. He believed that the doctors and nurses had lied to her.

Lao Song shouted: "What are you making a fuss about? The operation went well. Do you have to make trouble to be happy?"

"How are you talking? You don't care about me. Your heart has stopped and you are still here humming. Is there a father like you?"

Yao Xiurong was so angry at Lao Song that she vomited blood and the child's heart stopped. He was unresponsive here and was being fooled around by doctors and nurses.

Old Song was so angry that Yao Xiurong was so angry that he vomited blood. He was so stupid that he shed tears when the doctor talked and didn't listen carefully. At this time, he still doesn't know what cardiac arrest means. Old Song can even understand the general steps of surgery. Memorize it.

The anger over the "smart drug" incident resurfaced, and Lao Song almost spat out a mouthful of blood.

Don't be afraid of godly opponents, but pig teammates!

And he is also a pig teammate who has been practicing for thousands of years!
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"What's going on outside?"

Academician Wang asked. Although there was no knocking on the door outside in the operating room, we just learned from the traveling nurse that the family member had fainted at the door of the operating room and was being rescued.

"Are the family members okay?"

Yang Ping also knew about this and asked.

Because Xiao Su was on vacation, the equipment nurse on the stage was Zhou Can, and the circulating nurse was the new nurse Wang Xiaowen. Wang Xiaowen said: "I have low blood sugar. I just drank a few sips of glucose. I woke up and should be fine."

"I heard that she was banging on the door of the operating room, clamoring to come in." Wang Xiaowen said.

Song Zimo didn't understand why the family members suddenly acted abnormally: "Why did she come in?"

"She said her child's heart had stopped and we didn't tell him in time—"

"How could this happen? Didn't the surgery conversation make it clear to them? Cardiac arrest is a normal step."

It was Song Zimo who came forward to talk about the operation. He said: "I said it, and I said it in very detail. I emphasized it again and again. I also said that there is a possibility that the heartbeat cannot be restarted after stopping, but the possibility is very small. They all said they understood and then signed. "

"Then why is there still a misunderstanding?"

"I also do not understand."

"The nurses made it clear before the operation that they should not eat or drink before the operation, but they still violated the doctor's orders and ate secretly. I heard that the egg yolk pie was secretly left for Song Hanhui by his mother. His father didn't even know about it. His mother was afraid of the child. I’m hungry, so it shouldn’t be a problem to eat something.”

"how do you know"

"Today, the baby in the next bed will be transferred back to the general ward. The baby's parents told the nurse that his dad packed all the snacks for his mother to take away. Before leaving, his mother secretly stuffed two egg yolk pies under the pillow."

Isn't this harmful?
I don’t know what to say about this parent, who seems to be good to his children, but is actually harming them. This has been discovered in advance. If he hadn’t discovered it, he would have vomited and suffocated due to anesthesia on the operating table, and he would have died of suffocation. How could this have happened?

"The baby's parents asked the nurse not to tell anyone, otherwise the baby's father would definitely scold his mother," the graduate student said.

After saying this, Fatty Liang immediately put down his legs and checked the child's endotracheal intubation and monitoring data on the screen, as well as the normal blood oxygen saturation. Fatty Liang couldn't help but break into a cold sweat.

"Fat, are you alright?"

Yang Ping asked when he saw the fat man moving.

The fat man, who had always been confident about anesthesia, didn't have the confidence to speak: "It's okay for now!"

Because I don’t know if this kid has food in his stomach now. If there is food, it will be a time bomb at any time.

Academician Wang wanted to go out for a visit and criticize Song Hanhui's parents. However, the operation was now a critical moment and Academician Wang did not want to miss it. Moreover, Song Hanhui's mother was fine, and Academician Wang did not want to go out again.