Back in 2002 as a doctor

Page 478

Zhou Congwen is a bit interesting, this is the rhythm of preparing to make a performance to show the boss.

Director Miao's eyes on Zhou Congwen's back became more and more complicated.

"The preparations are relatively adequate." Zhou Congwen and Liu Wei beside him said.

"I checked it early in the morning." Liu Wei smiled.

"Come on." Zhou Congwen said, "I'll go brush my hands."

"Congwen, I did some calculations. It is more appropriate to set the positive end-expiratory pressure to 6 mm of water column. What do you think?" Liu Wei asked.

"Yes." Zhou Congwen said, "According to kilograms of body weight, the tidal volume for double-lung ventilation is 8ml/kg, and for one-lung ventilation is 6ml/kg. The oxygen concentration is 60%, and blood gas is measured twice during the operation. Say it again."

"Oh." Liu Wei made an OK gesture.

Director Miao was completely speechless.

Is Zhou Congwen so careful? !

Even PEEP; the tidal volume of one lung and two lungs must be controlled.

This……

Chapter 0821 I saw it, but I couldn't see anything

The patient was placed in a supine position, and Zhou Congwen adjusted the angle of the operating table after anesthesia, and the left side was elevated by 20°.

Director Miao smiled, the equipment in the Second Hospital of Medical University is not bad, at least the operating table is electrically adjustable.

This kind of machine has only been in the hospital for less than a year, and I didn't expect that it has already started to use it.

In the past one or two years, the hardware conditions of various hospitals have changed greatly. It is not like when I first started working, there has been no change for more than ten years.

All kinds of hardware upgrades are very fast, which makes people dizzy.

"Boss, the fifth intercostal space on the left?" Zhou Congwen asked.

"Ah."

Elder Huang's voice came from Director Miao's side.

"Then I'll go wash my hands."

"go together."

Seeing Mr. Huang's figure with his back bent, Director Miao's heart was pounding.

One-stop, this is a one-stop operation!

I heard that Mr. Huang opened the emergency department for coronary artery surgery. Sometimes the anastomosis was uncertain or there were other conditions, and the stent was directly inserted during the operation.

I didn't expect to see it with my own eyes today.

Although they both work in the imperial capital, Director Miao has not had much contact with Huang Lao, especially the high-end surgery such as one-stop surgery, which he has never seen before.

Soon, several people brushed their hands back.

Zhou Congwen did not accompany his boss, but walked in quickly to start disinfection and lay down sterile towels.

What surprised Director Miao was that Zhou Congwen disinfected the patient's chest surgery area, while Deng Ming disinfected the patient's left thigh.

He understands what Deng Ming means, taking the great saphenous vein as a vein graft, it's nothing difficult to understand.But it's too early!

Generally, if Director Miao is the chief surgeon, if a vein graft is needed, it will be at least 2 hours after the operation.

If it is taken too early, the vein graft will have various problems, such as thrombosis and necrosis.

Before the operation started, Director Miao was already very curious when he saw something different from the normal operation.

"Professor Chen, Dean Xiao, which one of you will follow me." Deng Ming asked with a smile while disinfecting.

The two looked at each other, Xiao Kai said, "Let me help you."

After speaking, he turned to brush his hands.

It's not a good job. Although he was on stage, he didn't have the opportunity to see the operation.

What's more, what Deng Ming needs to do is to take the great saphenous vein, which is not technically difficult at all, and belongs to the job of a trainee doctor.

Zhou Congwen ignored the division of labor below, he laid out the sterile chest sheet, sanitized his hands again, and stood in the first assistant's position, "Shen Lang, move the footstool for the boss."

The footstool has already been prepared, Shen Lang carefully moved away from Huang Lao's body, put the footstool in the operator's position, adjusted the light of the shadowless lamp, focused, and shot it towards the operation area.

Huang Lao stood on the operator's seat, Director Miao regained his spirits, and tiptoed behind Huang Lao.

The shadowless lamp is very bright, and the sterile drapes in the operation area are tightly laid, leaving a very small incision for surgery, which is indeed not the conventional way of laying drapes for heart bypass.

Director Miao just glanced at it and was sure that it was a new technique.

"Prepare the suspender." Zhou Congwen disinfected the operation area for the last time, wiped it dry with dry gauze, quickly prepared the suction device and electric cautery, and instructed the equipment nurse.

"Professor Zhou, which one is it?" The equipment nurse asked in a low voice, dazed by a pile of equipment she had never seen before.

Zhou Congwen glanced at it, "You have the second device on your left."

Director Miao looked, and a strange device appeared in front of him.

What's this?Director Miao was startled.

Although puzzled, he didn't ask.At this time, it seems a bit redundant to ask, and it will be used soon, and you can understand how to use it at a glance.

Huang Lao stretched out his hand and slapped the scalpel in his hand.

The hand was raised, the knife was dropped, and the moment the incision appeared, before the blood flowed out, the dry gauze in Zhou Congwen's hand was pressed on it.

Huang Lao slapped the knife on the side of the patient's leg, and the large tweezers were slapped in the hands of the equipment nurse.

In such a short period of time, Zhou Congwen burned all the bleeding spots on the edge of the skin with the electric burner.

The cooperation is really tacit, Director Miao praised in his heart.

I didn't even see the blood. First, Huang Lao's knife was fast, without trembling at all, and the depth of the cut was just right, only breaking the capillaries and not the slightly larger blood vessels under the skin.

Coupled with Zhou Congwen's quick eyesight and quick hands, and his cooperation in place, although it was only scratched, Director Miao was a little envious of the swiftness of the operation.

But as Zhou Congwen removed the dry gauze in his hand, Director Miao was stunned.

Incision - 6cm, visual inspection.

I go!

Although I knew in advance that it was a small incision and minimally invasive coronary artery bypass surgery, but 6cm... what can such a small incision do?

Director Miao always believed that the so-called small incision should be about 12-15cm, but there is no need to split the sternum.

After all, an incision of more than ten centimeters is considered a small incision and minimally invasive compared to a sternum-splitting incision of at least 25 cm.

However, when he saw that the incision was only 6cm, he was dumbfounded and stunned.

This kind of "big fart" opening, before the advent of thoracoscopic surgery, even bullae could not be done, let alone the iconic coronary artery bypass surgery.

6cm, enough for what?

For the next closed thoracic drainage, about 3cm has to be cut. Is Mr. Huang doing it wrong, or is it necessary to extend the mouth later?

Director Miao was thinking about various things in a mess. In a trance, Zhou Congwen had cooperated with Huang Lao to complete the hemostasis, blunt separation, and enter the chest cavity.

He took the unfamiliar instrument to the operating table, and the two "claws" hooked the inner side of the chest wall, separated and suspended.

The small incision suddenly became bigger, but no matter how big it is, the foundation is there, it's not that big.

This is a hanger, and Director Miao understood the function of the device at a glance.But the incision is still very small...the operation area cannot be seen at all.

He never thought that there would be no surgical field for coronary artery bypass surgery.

As the hanger "hangs" the chest wall, Shen Lang stepped on his feet and reached out to hold the handle under the shadowless lamp to focus again.

The light slanted and shone in along the incision.

"Old Huang, do you look at the lights like this?" Shen Lang asked.

"Yes." Huang Lao just hummed and focused on the operation area.

At this time, one lung was ventilated, and the left lung was deflated.

"Zhou Congwen, you can make the triangle sail." Mr. Huang said bluntly, "Let me take a look."

"Okay, boss." Zhou Congwen was not polite, and started to move his heart bag with blunt scissors in one hand and large tweezers in the other.

Spinnaker? !

Director Miao heard another unfamiliar term.

what is this?

He stared intently at the operation area, but!

Zhou Congwen and Huang Lao's hands fell on the small incision of 6 cm, and Director Miao couldn't see anything.

He almost cried.

Just after the new year, I rushed over from the imperial capital just to see Huang Lao and Zhou Congwen's surgical procedures in the World Surgery Competition.

But I saw it, or stood at the best position behind the operator, but I couldn't see anything!

This is so special!

Chapter 0822 exquisite spinnaker

Zhou Congwen's blunt free pericardial fat and part of the left thymus.

Although the incision is narrow, he is able to do a job with ease within a square inch.

Coupled with the cooperation of my boss, the operation went smoothly.

Free up to the pericardial reflection, the left edge of the fat is still attached to the pericardium.

"Round needle, No. [-] thread." Zhou Congwen stretched out his hand.

The equipment nurse was busy preparing the round needles. Zhou Congwen's fingers moved slightly, and just as he was about to turn his head, the large tweezers suddenly fell and hit his fingers.

A soft sound.

Zhang You watched with joy in his heart.

Zhou Congwen also has today!

Beat it!

It must be something wrong with the operation, but I can't see it.Zhang You stood on the sidelines and watched the excitement with a smile on his face. He is relatively neutral now. It doesn't matter to Zhang You whether Zhou Congwen's operation is successful or not.

"Don't worry." Elder Huang said leisurely, "You can't expect the little nurse to be perfect for the first time with a new technique."

"The boss taught me that." Zhou Congwen smiled wryly, "I didn't concentrate on the operation, I didn't pay attention for a while."

"Zhou Congwen, the flow state must be switched back and forth freely." Huang Lao said lightly.

"Huh?" Zhou Congwen was taken aback.

"I was the same as you when I was young. Later, when I got old, my body couldn't bear to enter the state of flow frequently, and my mental power was consumed very quickly. It was like flowing water. So, I started to think about switching things.

Enter if you need it, and switch it out if you don’t need it, do you understand? "

Zhou Congwen was speechless.

This kind of... Even I, who has acquired the flow ability in the system, can't do it, and the boss in the last life didn't tell me about it.

The needle holder slapped Zhou Congwen's palm.

Zhou Congwen thought about it for a few seconds, narrowed his eyes and said, "I'll go back and think about it, and do the surgery first."

Huang Lao nodded.

Zhou Congwen suspended the right edge of the pericardial fat in the 3rd to 5th intercostal space, making the pericardial fat perpendicular to the left edge of the pericardium, and isolating the thoracic cavity from the pericardial cavity.

"Old Liu, you can ventilate your lungs now." Zhou Congwen said softly.

Hearing what Zhou Congwen said, Director Miao, Zhang You, and Chen Houkun were all stunned.

With a small incision of 6 cm, the surgical field itself is extremely small.In the case of one-lung ventilation, the left lung is deflated, and it must be done so as not to affect the view inside as much as possible.

But once the lungs are ventilated...

The swelling of the lungs will definitely affect the surgical field!