Chapter 2833 Fast Surgery
Dean Yan chatted with Mr. Peng, and Mr. Gu from the chest department caught up after a few minutes.
While Lao He was busy performing without real objects, he listened to what they had to say. At times like this, it's all boss-level chats, and it would be too boring for an anesthesiologist to come up and talk about things.
But he was curious, why Boss Zheng took such a big job. Usually, other doctors are more cautious about the operation of the more important people. I just heard from Yi Ren that it seems that Boss Zheng persuaded me to come here.
From the conversation, Lao He could tell that Gu Lao didn't really agree with the operation, he always hesitated to speak, he should have gone to the Shuai Mansion for consultation the day before yesterday, and participated in the diagnosis.
But Gu Lao's opinion is not important, Lao He has nothing to worry about, he now has an almost blind worship of Boss Zheng's level.
It is certain that Boss Zheng has a high level, but the key is stability! No matter what kind of rare operation Boss Zheng will take it down steadily, Lao He has an "illusion", as if Boss Zheng has done this kind of operation countless times.
It might be an "illusion", Lao He thought to himself. He was just a little curious. After expert consultation, Mr. and Mrs. Peng also gave up the surgery and planned to return to their hometown, Ye Luo. How much confidence did Boss Zheng have in order to keep them here.
Soon, the flat car sounded, and the patient was brought in.
Lao He helped lift the patient to the operating table, and asked softly, "Boss Zheng, do you have any special needs?"
"Line on the left side, lean forward 30 degrees, and put the right side into the chest." Zheng Ren said in a deep voice. While talking, he inserted the patient's film into the film reader, and habitually watched the film with his arms folded, without the slightest thought of talking to Mr. Peng.
"Okay." Lao He lowered his voice and replied.
"Anesthetize, I'll go brush my hands right away," Zheng Ren said.
In such a hurry? Lao He was in a daze.
"The operation should be completed within 45 minutes from the time of anesthesia, and the surgical blow should be as light as possible. The elderly are old, so it should be as fast as possible." Zheng Ren explained with a smile.
This time, Lao He knew why Gu Lao felt that this operation was unnecessary. This was determined by the patient's own physical condition.
Including 45 minutes of anesthesia, even laparoscopic surgery is too fast, Boss Zheng really dared to think about it.
Seeing Boss Zheng brushing his hands, Lao He glanced at Su Yun. Seeing that Su Yun had already installed the hand frame and other auxiliary equipment, he asked in a low voice, "Brother Yun, shall I start?"
"Let's start. I'll start to position you after you have inserted the cannula." Su Yun's voice reached Lao He's ears through the three-layer mask, a little muffled. Lao He knew that Brother Yun might also be a little nervous today. After all, even if Dean Yan drove away a group of people, there were still many boss-level tasks left to watch the stage.
After intubation, anesthesia, and positioning, 4′22 seconds later, Zheng Ren had finished brushing his hands, laid down the sterile drapes, and stood in front of the operating table.
Lao He closely watched Boss Zheng's movements, and started left one-lung ventilation at the most appropriate time.
Zheng Ren placed a thoracoscope at the 7th intercostal hole on the right posterior axillary line, and the 3rd intercostal space on the midaxillary line and the 8th intercostal space on the scapular line were used as operating holes. After poking the card and looking down at the camera, Lao He breathed a sigh of relief, and the one-lung ventilation was perfect, which did not affect Boss Zheng's operation time.
But Boss Zheng did not directly attack the mediastinum, but began to deftly dissociate it with long-headed forceps, and soon the azygos vein bow appeared in the operative field.
A linear cutting stapler was slapped in Zheng Ren's hand, and after cutting off the arch of the azygos vein, the mediastinum was freed, and soon a huge diverticulum appeared on the screen.
The esophagus was mobilized at the level of the carina and lifted around the belt, and Zheng Ren was mobilized upward along the esophagus, exposing the lower end of the diverticulum.
In the operating room, only the singing of good luck wafted, and the others stood behind Zheng Ren, watching the operations that were proficient to the bone. No one spoke, and only occasionally raised their heads to look at the electronic clock hanging on the lintel.
12'22", the diverticulum has been fully exposed.
For the laparoscopic surgery of the esophagus, this is a time that makes all operators dumbfounded.
Normally, the only thing that can be done in such a short period of time is the completion of anesthesia and the positioning of the body. The medical team that is a little slower may not even have the surgical drape laid out. But Boss Zheng has already seen the esophagus.
Soon, but not enough.
Gu Lao glanced at the time, and his black and white eyebrows under the sterile cap frowned.
The actual surgery has only started now, can Boss Zheng finish it?
He didn't disapprove of Boss Zheng's operation plan, but he doubted whether the operation could be completed within an hour. Although it is said that the oldest patient he has done as the chief surgeon is 104 years old, but that is the case where the physical conditions are suitable.
Dr. Zheng's operation this time seemed a bit mendicant.
Time was not a problem for Zheng Ren. After exposing the diverticulum, he used an electric knife to make a small hole in the lower end of the diverticulum to enter the diverticulum, sutured 2 stitches and then retracted it. The limitations of the endoscope did not seem to affect Zheng Ren's technique, the sutures were neat and neat, and the cooperation with the assistants and equipment nurses was perfect.
After sewing, Su Yun clamped the suture with a pair of pliers and reserved it for lifting.
A small hole was made on the right side wall of the esophagus at the level of the bottom of the flat diverticulum, and 2 stitches were also sutured before being retracted.
Then Zheng Ren used an endoscopic cutting and suturing device to enter the esophageal cavity and diverticulum cavity respectively through the esophageal opening and the diverticulum opening, and cut and sutured the diverticulum and the side wall of the esophagus side by side.
The creaking and creaking sound of the cutter and stapler, although clean and neat, still made everyone's hearts tremble.
Boss Zheng didn't even do a comparison, and started directly after getting off the cutter and stapler, which is too confident.
The operation time was 23'54", and the diverticulum was fully opened.
The diverticulum and interesophageal ridge are dissected so that the diverticulum forms a common cavity with the compressed upper thoracic esophagus.
This way of relieving the compression of the esophagus is rare, but looking at the anatomy, it can be clearly found that the squeezed esophagus has begun to restore the shape of the lumen. In short, if the operation is successful, the patient should be able to eat.
The biggest problem with doing this is the fistula.
Afterwards, the diverticulum and esophageal incision formed after cutting and suturing were sutured intermittently.
Gu Lao's brows became tighter and tighter, now is the most critical part of the operation.
No matter how fast and delicate the operation was before, once an esophageal fistula occurs after the operation, it will be an unbearable blow to an 84-year-old man in poor condition.
The anatomical structure of the esophagus itself and the countless times of blood supply suggest that the operator and doctor have a high probability of esophageal fistula.
Is it just intermittent sutures?
It seems that it is not enough. If this is the case, it will be difficult to ensure the healing of the esophagus even if jejunal nutrition is given after the operation.
Boss Zheng sewed very meticulously, and this section took a lot of time. When Mr. Gu looked at the electronic clock again, the operation time had already taken 33 minutes.