godfather of surgery

Chapter 944 The stalled engine

Davenport heard Yang Ping's voice and immediately ran into the locker room and stood next to Yang Ping.

At this time, everyone was chatting. Although Davenport couldn't understand what everyone was talking about, his focused eyes showed that he was also actively participating.

The Swede followed Yang Ping like a follower, asking him to follow, not to let him follow, but to let him keep up with the pace of work. Language and cultural differences seemed to be a big problem.

Yang Ping waved to Song Zimo, and Song Zimo came over. Yang Ping said, "Can you explain to him what it means to follow us?"

Song Zimo understood, and immediately stood up and patted Dr. Davenport to tell him to follow him. Davenport looked at Yang Ping, obviously unwilling to follow Song Zimo. Yang Ping nodded, and Davenport was willing to follow Song Zimo. locker room.

Fatty Liang was chatting with his brothers. Xiaowu and Zhang Lin were teaching the philosophy of marriage and love as people who had experienced it. The brothers were talking to each other, and Fatty Liang was stunned for a while.

"Let women revolve around you. You can't revolve around women. Do you understand this?"

"The dog licker ranks second to the dog. With your conditions, are you afraid of not having a girlfriend? Let's talk if you want to, and if you don't talk, you'll knock her down."

"There are so many festivals a year, and you have to buy gifts and spend time with me. Do you still want to be a doctor? I'm not married yet, but I will get married in the future."

''How to put it, you are both right, but they are not suitable. "

"Sometimes women are born to coax and accompany her. There is no way around it. This is the characteristic of such creatures. My wife, when she works the night shift, sometimes she doesn't need me to accompany her."

These people were still chatting, and Tang Shun came in carrying a set of hand-washing clothes. He was not a doctor, but he was in the hospital. Sometimes he wanted to come to the operating room to see operations and gain more knowledge.

At this time, the chatting buddy's voice suddenly stopped, and then remained silent. Who can express his opinion on love when the master is here? It's obvious that he is playing with an ax in front of the gate, and playing with scissors in front of Guan Gong's gate.

Originally, the fat man wanted to ask the instructor for advice on how to deal with this problem, but the nurse over there had already urged: "The patient who has been taken over has been delivered, and the anesthesia can be started."

However, after the fat man and his brother chatted like this for a while, he felt much more comfortable. He was no longer as depressed as before. Although Soft China did not smoke, but he put it under his nose and smelled it, which was considered a pleasure. Fatty, Zhang Lin and Xiao Wu put their arms around each other. Out of the locker room.

Yang Ping continued to rest on the bench and seize the time to do experiments. This is really a surgical experiment. In reality, surgery is performed to save people, and in the system space, scientific research is carried out quickly. It is cool to carry a laboratory with you, and you can do experiments anytime, anywhere, and The progress of the experiment is many times faster than in reality.

In the operating room at this time, the extracorporeal circulation team of Sanbo Hospital is also in place. The perfusionists are busy debugging their own machines, installing and connecting various pipelines and systems, pre-charging exhaust, etc., to provide support for operations at any time.

At that time, Sanbo Hospital did not have many cardiac surgeries, and could only perform general chest surgeries. Many people said that maintaining an extracorporeal circulation team was a waste. President Xia said: If a hospital wants to be upscale, it must perform cardiac surgeries, so Even if there are only a few cardiac surgeries, Director Xia still has to deploy a cardiopulmonary bypass team, and everything is built from scratch, from weak to strong.

Now, the extracorporeal circulation team is finally put to great use. Since Yang Ping founded the Institute of Surgery, top cardiac surgeries have been performed one after another.

Some things are like a rising tide. The extracorporeal circulation team of Sanbo Hospital was originally a few young doctors with little experience. However, since Yang Ping promoted cardiac surgery, the extracorporeal circulation team has also accumulated a lot of experience. These people are not lacking in theory. , what they lack is experience. Once they gain more experience, they will be able to take off.

Director He Xiangjun of the Thoracic Surgery Department also came early to help. Director He has not yet performed Commando surgery, and now that he can experience the MAX version of Commando surgery with Yang Ping, he is naturally looking forward to it.

It's just that Professor Yang's pace is too fast, and He Xiangjun feels that he can't keep up. These heart surgeries are always done in one step, and Director He is a little unable to do it.
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After almost resting, Yang Ping walked into the operating room. Fatty Liang had already anesthetized Karen, and the doctors and nurses were working together to position the patient.

Surgical posture is very important. A good surgical posture can provide better exposure during surgery. A poor posture will not only affect the exposure of the surgical field, but also cause harm to the patient.

With the head nurse helping to take care of his father, Xia Shu was able to find time to follow the surgery. He was a doctor specializing in cardiac surgery, so he was naturally more interested in this kind of surgery than others.

Qiu Nuo slightly recovered from her "broken love". She had already participated in the work in the operating room of the Institute of Surgery. When she saw Yang Ping walking in, Qiu Nuo glanced at Yang Ping. Yang Ping didn't react at all, but just looked like her. Say hello as usual. Qiu Nuo realized that he was being sentimental. In fact, Professor Yang had a lovely wife at home, and he had always regarded her as an ordinary colleague at Union Medical College. Since it was just her unrequited love, there was no embarrassment in her heart. There was nothing in the first place. It was just a daydream in her mind, not to mention embarrassment. Who would be embarrassed about a dream? She just couldn't hold her head up in front of Xiao Su in the future. Being held tightly by that guy, I couldn't lift my head for the rest of my life.

Zhou Can was the instrument nurse for this operation, and Qiu Nuo began to carefully observe how Zhou Can worked.

Fatty Liang couldn't help but sigh in his heart, girls are really difficult to take care of. Since he was in school, Fatty has chased several girls but failed. Anyway, the reasons for not being together are different. Some people think he is not handsome, others think he is not handsome. He has no money, but now he has money, and his girlfriend thinks he has no time. Doesn’t he need time to make money?

If I am rich, handsome and have a lot of free time, do I still need a regular girlfriend?

Man! Disaster!

"Don't be in a daze, be more attentive."

Zhou Can took time out of his busy schedule to remind Fatty Liang, who had wandering eyes.

Fatty Liang nodded, and immediately Zhou Can was a very considerate girl. Knowing that Fatty Liang was troubled these days, Zhou Can not only comforted him, but also took him to a movie to relax, and told him how to tolerate girls and make girls happy. After all, every girl wants her lover to spend more time with her.

You must work seriously and not be distracted. Fatty Liang still understands such a simple truth. He was just calculating the dose of anesthetic for the patient in his mind.

Zhou Can brushed her hands on the stage and began to set up the instruments. She learned the job of an instrument nurse from Xiao Su. She followed Xiao Su every day and had a lot of surgical practice. Zhou Can naturally mastered the equipment of many cutting-edge surgeries and took the role of an instrument nurse to the next level. It can be said that the work has been done to the extreme.

According to Xiao Su's requirements, Zhou Can not only learned how to use the instruments, but also mastered the design principles of the instruments, the invention history of the instruments, etc., and also mastered the history of the entire operation, the entire process of the operation, every detail, and the involvement of these instruments in every step of the operation. When it comes to a step, why use it and how to use it.

Qiu Nuo followed Zhou Can on stage. She watched Zhou Can arrange the equipment and silently remembered the order of placing the equipment.

The instrument partition on the operating table here is obviously different from the traditional instrument partition. The order of each instrument is carefully arranged based on practical experience. Even Qiu Nuo, who works at Xiehe, has never seen the arrangement of surgical instruments. There is so much science.

Zhou Can quickly arranged the equipment while explaining to Qiu Nuo why it was arranged like this. At the end, she added: Sister Xiao Su taught me this. It's Xiao Su again. Well, let's call her sister from now on. Originally, Qiu Nuo was a few months older than Xiao Su.

The Swedish patient's position had been arranged, and Xia Shu took a graduate student to start disinfecting and laying out the sheets. Yang Ping decided to let Xia Shu be the first assistant.

The cardiac surgery team is often composed of surgeons, anesthesiologists, extracorporeal circulation perfusionists, and nurses. All of them are indispensable. Everyone cooperates with each other to complete this cutting-edge surgery.

When some hospitals want to poach top cardiac surgeons, they often need to poach his entire auxiliary team. It is difficult to poach only one chief surgeon to create combat effectiveness.

Dr. Yu, an extracorporeal circulation perfusion specialist at Sanbo Hospital, is busy. He has never gone anywhere for further study. He grew up following Yang Ping's heart surgery. He used to be unknown, but now he is slowly starting to emerge.

The extracorporeal circulation team is an indispensable auxiliary team for cardiac surgery. This is because the human heart is beating all the time. The presence of blood and the pulsating heart affect the surgeon's vision and operation during surgery. The purpose of extracorporeal circulation During open-heart surgery, when the heart stops pumping blood, the peripheral organs of the human body are perfused with machine-oxygenated blood to maintain the blood supply to tissues and organs throughout the body.

Just like if a car's engine needs repair, it must first be shut down and stopped. The principle is the same.

With the development of surgical technology, surgical techniques for non-stop heart beating have also been developed, such as coronary artery bypass surgery for non-stop heart beating.

All heart-beating surgeries have a premise - this kind of surgery does not require opening the heart. For example, coronary artery bypass grafting does not require completely opening the heart. It only operates on the surface of the heart or in the myocardial layer, just like building indoor pipelines. There is no need to open the heart. The entire wall was penetrated.

Some surgeries require the heart to be completely opened. At this time, the heart-beating technology cannot be used and the heart must be stopped.

It's very simple. If the heart is not stopped and the heart is opened, the blood in the heart will flow out. Not only will the operation be inoperable, but this is the largest amount of bleeding for the human body. Soon the human body will die due to blood loss. .

The specific operation of extracorporeal circulation is to draw blood out of the human body. After being processed by a specialized machine, the blood is oxygenated, gas exchanged, filtered, and then returned to the human body. The purpose of this is to block the blood flow of the heart and facilitate the surgeon. Open-heart surgery is performed to ensure a clear surgical field of view during the operation, and at the same time, the blood perfusion of the human body is still carried out to ensure the survival of the entire life body.

In fact, the extracorporeal circulation machine is equivalent to a temporary replacement of the human heart and lungs, which is the same principle as ECMO.

ECMO, the full name is extracorporeal membrane oxygenation. It is actually an extracorporeal circulation technology that can be used for a long time. Because the extracorporeal circulation technology has a short maintenance time, it can only be used as a temporary replacement in just a few hours during surgery, while ECMO can For long-term use, it is generally used for 7 to 30 days. Currently, the longest ECMO use record in the world is 605 days.

The principle of ECMO is to replace the heart with a blood pump, and replace the lungs with membrane lungs to continuously transport blood to the human body, maintain the blood supply to various organs, and maintain life, so that it can replace the heart and lung functions for a long time.

The extracorporeal circulation system used for cardiac surgery is also called an artificial heart-lung machine. It is a set of devices that can replace the human heart and lungs for a short period of time. Its structure includes an artificial heart, artificial lungs, a thermostat, a blood storage chamber, an ultrafilter, etc. wait.

The artificial heart is composed of multiple pumps that pump blood instead of the heart. The function of the artificial lung is to add oxygen to the blood. After the oxygenated blood flows through the human body, it returns to the artificial lung, and the nitrogen dioxide in it is discharged again.

The thermostat adjusts the temperature of the blood to suit the needs of the body and surgery.

The blood storage chamber contains a filter and a defoaming device, which are used to store prefill fluid, return blood to the heart, etc.

The filter filters out air bubbles, platelet clots, cellulose, fat particles, silicone oil plugs and shed tiny tissue pieces, etc., and prevents them from entering the blood circulation.

Monitoring instruments mainly observe changes in various vital indicators, such as arterial blood pressure, heart rate, oxygen saturation, coronary perfusion pressure, and blood gas electrolytes.

These structures are precisely coordinated to form an artificial heart-lung machine, which temporarily replaces the human heart and lungs during surgery, allowing all the blood in the human body to bypass the heart, freeing up the heart for the surgeon to perform a good operation.

After sterilizing the drapes and checking before surgery, Yang Ping started the surgery.

Skin incision, thoracotomy, and pericardial opening were performed to expose the heart, aorta, and superior and inferior vena cava.

Yang Ping placed catheters in the active and superior and inferior vena cava, and asked the perfusionist to connect the pipes to the extracorporeal circulation machine. In this way, the entire human body's blood circulation bypasses the heart and lungs, and the machine replaces the functions of the heart and lungs. Extracorporeal circulation officially begins. , Dr. Yu stared attentively at every data on the monitoring instrument, and then kept communicating with the anesthesiologist Fatty Liang. The two cooperated with each other to adjust the patient's vital signs to the safest and most suitable state for surgery.

Dr. Zhao adjusts the machine's thermostat to lower the temperature of the blood to achieve the purpose of lowering the patient's whole body temperature.

Artificial circulation has been established, and the heart can now be shut down. Yang Ping injects cardioplegia antegrade from the aortic root and the left and right coronary ostium, allowing the heart to slowly stop beating under the action of this special liquid. After the beating completely stopped, Yang Ping cut open the heart again.

The hood is open and the engine has been turned off. Now you can open the engine to see what's going on inside.

It was indeed a mess inside. There were a large number of vegetations attached to the previously replaced aortic valve and mitral valve. Bacteria had seriously eroded these valves and their attachments, destroying the previous operation to a horrific extent. This not only made the original operation The effect is zero, and the basis of the remedy is destroyed, and the infection remains the source of the whole body.

Although the patient's heart has stopped and the lungs have stopped working, life is still alive. Life at this time is completely maintained by the perfusionist sitting and the machine beside him.

When the machine stops, the patient's life stops; when the machine runs, the patient's life remains.

At this time, Fatty Liang no longer had any distracting thoughts in his mind, and all his thoughts were focused on the surgical patients. He would wait for the data from the monitoring instruments from time to time, and then communicate with the perfusionist to analyze any data fluctuations at any time and eliminate some hidden dangers.

(End of this chapter)