Disinfection was done, sterile surgical dr.a.p.es were laid, and the surgery began again.
Chief Mao was not in a hurry. He could wait a few minutes at night. He could wait for the general surgery to drift away and cut off the left lobe of the liver before he went onstage.
He could go in the morning. There was no need to wait at all.
Professor Yang stood in the position of the surgeon. He felt a little fl.u.s.tered.
He glanced at Zheng Ren and asked in a low voice, "Boss Zheng, are you coming to my place?"
"No." Zheng Ren smiled and said, "I'm here. I still need to give Chief Mao a hand."
Professor Yang was speechless. He remained silent, lowered his head, and began the surgery.
It was not that Zheng Ren could not perform the surgery, nor did he care about his own reputation. He just felt that his assistant's standard was a little inferior. In order for the surgery to go smoothly, he had to set up a table for the two surgical departments.
This standard...
Professor Yang had long had a basic judgment of Zheng Ren's standard. However, as the surgery progressed, his judgment had been refreshed countless times.
Though the two departments had started the surgery at the same time, the patient was still a small and thin young woman. There was not enough room for so many people.
However, everyone was waiting eagerly. They wanted to see Zheng Ren become the assistant of the two surgeons. Zheng Ren said a few words to Su Yun and Su Yun went to scrub his hands.
Everyone let out a long breath. Chief Zheng knew the severity of the surgery. He was not doing it to show off his skills.
For a moment, everyone's impression of Zheng Ren became better.
Zheng Ren and Su Yun went onstage at the same time. The chief resident of the department of general surgery and vascular surgery could only stand below the stage and watch the surgery anxiously.
The abdominal cavity was open. During the thoracic surgery, cotton pads and sterile gauze were used to cover the abdominal cavity. At this moment, there was no need to open the abdominal cavity. It was rather convenient.
During the previous surgery, the liver was almost free. Professor Yang reached out his hand and slapped a pair of blunt scissors on his palm.
After feeling the force of the blunt scissors, Professor Yang's voice came out from his throat, "Blunt scissors."
F*ck... This speed?
Professor Yang was stunned. His words were not as fast as the scrub nurse's hand. How could he be reasonable about this?
In the time it took for him to be stunned, Zheng Ren's side had already separated and clamped onto the round ligament of the liver. Professor Yang cut it off and reached out his hand again.
He patted the ligaments on his palm and handed the two ligaments to Zheng Ren and Professor Yang in less than three seconds.
He ligated, cut the ligaments, continued to look for the falciform ligament and the left triangular ligament.
The more he performed the surgery, the more absent-minded he became. Professor Yang felt that he had to be dreaming.
After experiencing the initial incident, he resisted the urge to speak. No matter what he needed, he only extended his hand.
It was enough to make a fool of himself once.
Perhaps there was also a hint of anger in it, but this emotion instantly dissipated and turned into surprise. In the end, it turned into a smooth and focused surgery.
No matter what equipment was needed, he just needed to reach out his hand.
This feeling made Professor Yang have endless doubts about the life of a surgeon.
What he had done before was all fake surgeries. It had to be!
Not only did the scrub nurse give him the equipment, she was also Chief Zheng's exclusive scrub nurse. She had to first satisfy Chief Zheng's surgical needs.
But even so, Professor Yang still felt as if he was drinking nectar.
When it came to surgeries, there were all kinds of amazing assistants who exposed all kinds of views. Whether he had thought of it or not, Chief Zheng was always able to expose himself half a step ahead of time.
As for the equipment, as long as he stretched out his hand, it would appear in his hand like magic.
If he could do this in the future, that would be great.
The left edge of the liver, the middle hepatic vein, and the left inferior vena cava were exposed. After wrapping the ligaments of the liver and duodenum with a latex tube, the ligaments were gently tightened and fixed with a vascular clamp to block the blood flow into the liver.
The surgery was carried out step by step, neither too fast nor too slow.
About 1.0 cm away from the left side of the median fissure, the liver capsule and the superficial liver parenchyma were cut open with an endoscopic electric knife.
Professor Yang glanced at Zheng Ren, then placed the thumb of his left hand on the surface of the liver. The other four fingers reached behind the liver and gently lifted it up. Blunt dissection of the liver parenchyma was used along the cutting line with the hilt of the knife.
It seemed that what Professor Yang was doing was very important, but he knew that Zheng Ren quickly clipped and ligated all kinds of pipelines--arteries, veins, and ligaments--that he encountered by his hand.
Professor Yang could even vaguely feel the wind whistling by his hand with the scissors.
It was not just the small arteries and veins. He encountered the left hepatic vein, the left branch of the portal vein, and the left branch of the hepatic artery near the first hepatic portal. Zheng Ren still did not hesitate. After clipping, he cut off and ligated. Then, he cut off the capsule on the back wall of the liver, removed the left half of the liver, and loosened the hepatic blood flow blockage. The bleeding points on the hepatic section were sewn up to stop the bleeding, and the two ends were closed.
The whole process took less than 15 minutes.
Chapter 776 - Intraoperative Cholangiography and Capillary Bile Duct Anastomosis
"Boss, slow down. You'll faint if you look at it," Su Yun said as he stood on Zheng Ren's right side and subconsciously breathed out air.
"It's alright. It wasn't too fast." Zheng Ren removed the left liver, and a pathological specimen basin appeared on the left side.
If the left liver filled with hydatid worms was placed in the basin, the patients with phobias would get sick just by looking at it.
Xie Yiren called the circulating nurse and carefully threw the basin and left liver into a yellow garbage bag to avoid contaminating the sterile area.
It was not until the left liver that was full of hydatid worms disappeared that Xie Yiren let out a sigh of relief.
Taking this much liver...was really scary.
At the same time, after Zheng Ren removed the diseased liver, he quickly poured UW solution into the portal vein.
UW solution was used to preserve the donor organs during organ transplantation. It mainly contained lactose acid, which was the main non-permeable anion and had a relatively large molecular weight.
It could reduce the swelling of cells during cold storage. It also contained glutathione, hydroxyethyl starch, and adenosine.
On the other side, portal vein resection and artificial pipeline repair had also begun.
Zheng Ren divided half of his attention to the vascular surgery surgery. When he saw that the blockage, resection, and suture were very smooth, he was relieved.
After all, Su Yun was a doctor who had done heart transplants. This was not a joke.
Heart transplants in mice were definitely more difficult than heart transplants in humans. Because the diameter of the blood vessels was small, a microscope was needed to suture them.
However, to remove the segment of the portal vein that contained hydatid emboli and replace the portal vein with an artificial blood vessel, the difficulty of suturing it could not be compared to heart transplants. The hardness of the portal vein was higher, so the difficulty of suturing it was lower.
Zhe
ng Ren knew that Su Yun would definitely be able to do it. In the operating theater of the System, the relevant steps were not trained in detail.
Initially, he wanted to be a substitute, just in case. However, Su Yun did not give him this opportunity. He and Chief Bao cooperated very smoothly.
After cutting off the liver that had been invaded by the hydatid worms, the remaining liver of the patient was pitifully small.
"Will the liver fail a long time after the operation?" someone in the grandstand could not hold it in anymore and asked.
"The volume of the liver is one-third of the original size. There is a high probability that the liver will fail."
"Then what's the significance of this surgery?"
What was the significance of this surgery? After the surgery, the patient would definitely suffer from liver failure, and the chances of the patient surviving were less than 5%.
Was there still a need for surgery?
Even a normal person would not be able to withstand the loss of such a large volume of liver tissue. Furthermore, this patient had his right kidney segmented, his lungs segmented, his pericardium partially resected, and his superior vena cava resected and rerouted...
The trauma of this series of surgeries was huge.
In addition, the patient had gone into septic shock before the surgery..
Even in the face of such a situation, the hearts of many professors of the surgical department had turned cold.
Professor Yang had the same thoughts as his colleagues who were whispering behind him, but he could not stop at all.
The assistant opposite him was as calm as an AI. He could not keep up with him, even if he was fully focused, let alone discuss the post-surgery problems with others.
Most importantly, although the surgery had already undergone a few hours, it had yet to reach the most crucial step.
The autologous liver transplantation could solve the questions of his colleagues. However, the autologous liver transplantation was the most difficult!
If the rejection was not considered, the difficulty of the autologous liver transplantation was far greater than that of the ordinary liver transplantation.
The ordinary liver transplantation could be done as long as the large blood vessels and liver tubes were anastomosed. The difficulty of the surgery...was actually very high. However, Professor Yang had performed a liver transplant before, so he could totally get it done.
When the patient was sent over, the first thing he considered was a liver transplant. However, who would have thought that the patient would have a rupture of the hydatid cyst wall in the emergency room, resulting in septic shock.
There was no time to wait for a liver source, so he could only do an autogenous liver transplant.
When he thought of an autogenous liver transplant, Professor Yang's heart was filled with despair.
Large and small liver tubes, blood vessels...
Professor Yang had tried this kind of difficult surgery before. Although he had succeeded, he was not satisfied with his performance. He had originally planned to hone his skills and then once again tackle the final barrier of the Department of Hepatobiliary and Pancreatic Surgery. He did not expect that an extremely difficult surgery for an autologous liver transplant would fall from the sky and force him to the operating table.
"Professor Yang, how do you feel about cutting the liver into eight pieces?" Zheng Ren gave Su Yun a hand as he said politely during the interval.
Professor Yang's hand was numb.
Cutting the liver into eight pieces was indeed the best choice at the moment. Based on the condition of the liver, eight pieces of the liver was considered intact, but it was not the most important part of the liver. If he could successfully perform an autologous transplant and form the left lobe of the liver, the surgery could be said to be a great success.
However...
Because there was not much left of the liver, the liver function was severely damaged, and the operation time had to be controlled within two hours.
This was still different from a normal autotransplantation. It was more difficult than that, and it was unbelievably large.
Professor Yang moved his hand, sighed, and asked, "Chief Zheng, are you confident? To be honest, I'm not confident at all."
Upon hearing Professor Yang's words, the operating theater fell silent again.
Everyone saw the difficulty of the surgery. No one would say that Professor Yang was not good enough because of this. The patient's condition was too serious. There would always be a time when human resources were exhausted.
Could he only sigh?
If such an amazing surgery did not succeed in the end, it would be too disappointing.
"Eighty percent sure," Zheng Ren said lightly when he saw that Su Yun's side had already started to block the superior vena cava and was about to be resect and suture.
Eighty percent... Was that high?
Professor Yang was a little puzzled.
He raised his head. Because his cervical vertebra had been in a posture for a long time, it made a squeaking sound that made one's teeth ache.
Professor Yang did not have the time to move his cervical vertebra. He looked into Zheng Ren's eyes, trying to see if it was a joke.
"After the intraoperative cholangiography, there will be no problem in anastomosing the bile duct. The thin branch of the bile duct can also be anastomosed." Zheng Ren's words completely knocked Professor Yang out.
Generally speaking, autogenous liver transplantation was anastomosing the bile duct. It was only a thick bile duct, and the remaining bile duct would close by itself. After the surgery, drainage was needed to avoid complications like an infection.
But what did he hear?
Intraoperative cholangiography? And then anastomosing to the capillaries?!
This... Professor Yang had heard of this kind of surgery, but only a master would do it once when he proved that he could do it.
In theory, it could work. But, under such circ.u.mstances, would anyone be able to do it?
"Chief... Chief Zheng, you're not joking, right?" Professor Yang began to stutter.
In his opinion, this was just a joke.
"Cut the liver into eight pieces and prepare for the transplant. The patient's vital signs are not very stable. We don't have much time," Zheng Ren said, glancing at the ECG monitor.
"You're coming to my side?" Professor Yang said again.
"You go first. After the contrast, I'll help you with the autogenous liver transplant." Zheng Ren narrowed his eyes, as if he was smiling.
It was a great shame to lose the position of surgeon at the operating table!
However, when Professor Yang heard Zheng Ren's words, his heart suddenly relaxed.
Since he dared to say that, the possibility of him succeeding was very high. If it was an ordinary young doctor, Professor Yang would have coaxed him out long ago.
However, the person standing opposite him was a doctor nominated for the Nobel Prize. Under the halo of the Nobel Prize, and in the face of such a situation, Professor Yang could only choose to believe it.
"Okay!" Professor Yang said, gritting his teeth.
Chapter 777 - Microsurgery from the General Surgery Department
At the same time that the Vascular Department's surgery was completed, Professor Yang and Zheng Ren also cut off the eighth segment of the liver.
They used a titanium clip and a PRL line to stop the bleeding. The wound looked a little terrible.
Professor Yang looked at Zheng Ren as the Vascular Surgery Department stepped down from the stage.
"You can leave first. I'll do the angiogram," Zheng Ren said. "You can go on stage after the angiogram is done."
"Boss? Is the blood vessel going to be used for the radiographic films?" Su Yun rarely showed his eagerness to try.
"No need, for cholangiography, you can do the radiographic films outside. It has to be detailed and from different angles. If there's a problem, call Lil Fugui up. Oh
right, let Lil Fugui or Xi Bao'er send up the bile duct retrograde radiographic films... Have they all gone back?
"Ask who's here and send one up," Zheng Ren instructed calmly, as if he had ordered an appendectomy during ward rounds.
"There are plenty of catheters. I'll make a call right away, but Lil Fugui doesn't need to help." Su Yun tore off the sterile clothes on his body. "Not only have you improved, I don't think Lil Fugui's current level can catch up to mine."
Zheng Ren smiled. Was that so? If that was true, that would be great.
Su Yun had indeed improved, but Zheng Ren estimated that his level and Professor Rudolf Wagner's level should be about the same.
It was indeed enough to have him around, if he had the confidence.
"Yiren, you go down first in a while. Come up again after I take an angiogram," Zheng Ren said.
Xie Yiren nodded without hesitation. At the operating table, Zheng Ren was the king. No matter what he said, no matter how strange and bizarre it was, they had to obey.
The professors who were gathered behind were a little absent-minded. In 912, what surgery had they not seen? However, they had not seen the choledochography and autologous liver transplantation during the liver hydatidosis surgery.
If Chief Zheng wanted to anastomose the capillaries, was it because he was skilled and bold, or was it because he was ignorant and fearless?
No one was stupid enough to stand up and question Zheng Ren at this time, but everyone, except for Su Yun and Xie Yiren, had countless questions.
Zheng Ren tore off the sterile clothes and went to wash his hands again.
Everyone knew that he was going to wear lead clothes.
The people in the stands behind silently made way for Zheng Ren. Before it was time to step on the line, no one wanted to leave so early.
What if...what if the surgery was successful? This was a particularly awesome surgery. It was enough to brag about for a lifetime.
Zheng Ren came to the place where he washed his hands; he took out the lead jacket and a black box from the System space.
In the box was the microscope used by the Department of Neurosurgery that he had exchanged for when he was researching the surgery.
The Surgeon's Studio c1-799 Page 368
