Is the perfectly-grade large blood vessel anastomosis really perfect enough?

Chen Cang looked at his stitching and began to ask himself such a question!

What is perfection?

Perfection is a threshold reached using current means.

But the current methods are inherently limited.

Whether it is surgical skills or surgical plans, there is room for improvement and improvement.

This is a process that requires continuous research and improvement.

That's even perfect, let alone master level.

Chen Cang's aortic dissection surgery and total aortic arch replacement at this time were both masters.

It takes a long distance to break through to perfection.

“Line 4.”

"Rinse saline!"

"Pliers!"

...

The operation continues.

Faced with the repair of the intercostal artery, Chen Cang began to calm down and observe carefully, the third rib... the fourth rib...

Chen Cang suddenly asked Xu Ziming: "Is the time limit for the intercostal artery to the spinal cord blood supply is large?"

Xu Ziming nodded: "Well, according to the 2009 version of the guide, it can be completed within 60 minutes. However, later research found that in fact, the ischemia and hypoxia reaction of the spinal cord nerve tissue began to appear in about 45 minutes. Although there is no intuitive manifestation, there are some problems with later repair!"

Chen Cang looked at such a complex intercostal artery: "What is the best time?"

He Chao, who was standing aside, blurted out: "Professor Wu of Ruijin Hospital can complete the repair of all intercostal arteries in 35 minutes! That's...my teacher."

Xu Ziming nodded: "Well, that's true. Professor Wu Nan has rich experience in Marfan syndrome and has been committed to it for a long time. He has been practicing the repair of intercostal arteries."

After hearing this, Chen Cang nodded!

More than 20 arteries, 30 minutes!

All time is counted, and a blood vessel only has one and a half minutes, which also requires handling thread heads, thread knots, needle insertion, etc.!

The most important thing in the treatment of intercostal blood vessels involves the issue of avoiding damage to the intercostal nerve.

It's much more troublesome than the large blood vessels in the chest.

The limit time for Chen Cang to hold the grinder is thirty or forty seconds, but how long will it take if it is put in this situation?

Chen Cang decided to find some time to practice.

...

After the operation began, the anesthesiologist Zhou He has been monitoring the vital signs of the patient. Because the operation time is long, it is necessary to choose appropriate brain protection.

In fact, if the patient does not have Marfan syndrome and is just an acute type 1 aortic dissection, he can only undergo ascending aortic replacement or semi-arch replacement.

However, under Marfan syndrome, the originally damaged ascending aorta and aortic arch have already undergone changes in the fiber layer. If it is not controlled, it will definitely be a problem!

It is definitely good to use a total arch replacement, or the effect of using common "elephant rhinoplasty" is also very significant!

But this actually has high requirements for both the patient and the surgeon.

Not only does the surgeon require skilled skills, but also requires the patient's overall condition to be in good condition so that the operation can be carried out smoothly.

Tian Zhengkai, who is an athlete, has a good foundation and Chen Cang is skilled enough, so at this time, full bow replacement surgery is actually the best choice!

The ascending aorta has been processed!

The patient's vital signs are completely normal and he is ready for a complete arch replacement surgery!

Chen Cang breathed a sigh of relief and said, "Check down!"

Low temperature, circulatory cessation, plus retrograde perfusion of superior vena cava are effective brain protection strategies!

Everyone started to get busy!

"How much degree Celsius is adjusted?" Zhou He looked at Chen Cang and asked directly.

"Current to 20 degrees Celsius!" Chen Cang said decisively!

Zhou He was stunned!

Low temperature and stop cycle are directly related.

The lower the temperature, the longer the allowable time for the stop cycle. At 15 to 18 degrees Celsius, it can last for 60-80 minutes!

In this way, the operation time becomes more abundant.

If the temperature is high, the time will be limited, but... the patient's injury may be slightly smaller.

But again, if you have plenty of time, the patient may need some price!

Why is medicine difficult?

Because the time we fight for is actually given by the patient, and the time of the patient is devouring the god of death!

Every extra minute we consume and one minute of disease damage, the god of death swallows a little!

This is a tug-of-war game, and the chips are time.

Whoever grabs the patient first will win!

Perhaps at this moment, this feeling of fighting for time with the God of Death will become more and more obvious!

Chen Cang chose 20 degrees Celsius, and his requirements for the doctor were suddenly increased because the operation time became shorter, but the patient's damage was also reduced.

Zhou He glanced at Chen Cang's firm eyes and nodded!

Xu Ziming and He Chao also sighed: Chen Cang, this is Chen Cang!

He Chao even felt a little more anticipated and excited.

When the temperature drops to anal temperature of 20c, circulation stops or retrograde vena cava perfusion is completed at the same time!

Chen Cang began to isolate the aortic arch!

Tension atmosphere!

The low temperature sensation from your hands!

An anxious time!

The sound from the monitor!

The breathing of several doctors became clearer.

All the signs are that this is a difficult operation.

The distal end of the free aortic arch is a precise operation.

The vagus and recurrent laryngeal nerves should be carefully confirmed, and the nerves should be freed first and then placed in a harness to pull them. Pay special attention to prevent damage to the recurrent laryngeal nerve when the distal end of the lower edge of the arch.

Chen Cang, who is blessed with agility and stability, is careful to avoid danger.

It took less than 8 minutes to separate successfully!

Xu Ziming and He Chao looked at each other, full of surprises.

Such a fast and accurate free aortic arch saves too much time for a replacement surgery in a while.

The seemingly ordinary operation is full of details and invisible technology.

However, this is also an opportunity for the experienced Xu Ziming to learn and exercise.

He Chao became a little excited.

Chen Cang's free time just now was no less than his teacher.

Immediately afterwards, Chen Cang put down the separation forceps and began to trim the aortic arch!

Then select the appropriate artificial blood vessel and first suture the descending aorta orifice with 4-0 polypropylene thread.

Chen Cang spent even less time in this process. As the champion of the large blood vessel suture competition in the Heart Surface Technology Energy Competition, Chen Cang had almost no pressure to deal with these things.

Then, the suture arch begins to contain the posterior wall of the opening of three branches of blood vessels. These are the branches and directions of the blood vessels. The suture needs to be tightly prevented from leaking blood.

This is the aorta, and the blood pressure is very high. If there is a crack or something, it will be a potential disaster for the patient!

Therefore, the anastomosis between artificial blood vessels and blood vessels is the key to surgery!

Not only should it be fast!

And it must be secret!
Chapter completed!