Chapter 2628 All-Round Transcendence

"Boss, do you feel that something happened when Lao He is not here?" Su Yun asked with a smile while standing in the operating room while preparing the instruments.

"Well, I'm used to it." Zheng Ren nodded and said.

But you can't bring all the members of the medical team with you every time you travel, that's unreasonable.

"You played Lao He once in Yangcheng. I heard him say that there will be an anesthesia academic meeting this weekend. Director Qiu from Yangcheng will definitely come to meet Lao He." Su Yun said.

"It's not blowing, Lao He's level must be very high." Zheng Ren said, "Otherwise, the separation operation of the conjoined twins with a heart would not be able to be done."

"It's not you who scolded me."

"When did I scold Lao He?"

"Artistic exaggeration, don't be so serious, okay?" Su Yun adjusted the operating table and asked, "The angle of the semi-recumbent position can only be the current level. See if it works."

Zheng Ren nodded, "As long as the patient can accept it."

Generally speaking, the supine position is required for surgery, but the patient in front of him cannot inhale oxygen due to airway blockage, so he has cardiopulmonary function problems and cannot lie supine at all.

This is also a common feature of many patients with advanced lung cancer, also known as orthopnea.

It is impossible to lie down for surgery, so the surgeon can only barely cope with it, change the surgical position, and choose a semi-recumbent position.

Soon the patient arrived and was carried to the operating table, placed in a semi-recumbent position and inhaled oxygen with a mask at 10 liters/min.

Seeing that the patient's blood oxygen saturation was good, Zheng Ren performed an operation, and brushed his hands with Su Yun to prepare for the operation.

The right femoral vein was percutaneously inserted into a 28F venous catheter for drainage, and the left femoral artery was percutaneously inserted into a 20F femoral artery catheter for perfusion.

Then I waited quietly for 30 minutes to start VA-ECMO.

After ECMO started, Zheng Ren made a gesture.

But he immediately realized that this was not in China, and Lao He was not with him.

Su Yun noticed it, laughed, and said, "Boss, you just forgot after I finished talking."

"Well, I'm really used to it." After Zheng Ren finished speaking, he began to communicate with Bota's anesthetist.

Intravenous propofol was given for basic anesthesia and sedation, and then the patient's position was changed to the supine position. Patients who were unable to lie supine did not have any abnormal reactions when they entered the supine state under the action of ECMO.

Oxygen saturation is good, vital signs are stable, everything is going well.

It was only at this time that Su Yun let out a sigh of relief, and the doctor Nicole who was standing in the operating room felt lost.

The idea is so simple, why didn't I think of it? In the minds of the two of them, an idea emerged at the same time.

"Su Yun, you are staring at ECMO, Fu Guier and I are doing surgery." Zheng Ren said.

"Well, boss." Professor Rudolf Wagner replied cheerfully.

Su Yun didn't say much, but kept staring at the machine. Circulatory system priming - fresh plasma 100ml, Ringer's solution 400ml, heparin 2mg/kg, monitor MAP and SaO2 during the bypass. The blood flow rate is 2.5L/min, keeping SaO2 above 90%.

Everything was perfect, he made a gesture to indicate that Zheng Ren could start operating.

The data displayed on the ECG monitor also satisfied Zheng Ren, and the patient inserted a fiberoptic bronchoscope through the nose.

Zheng Ren saw through the screen that the middle segment of the trachea was narrowed by external pressure and accompanied by new growths in the lumen, and the lumen was basically blocked. He began to select the guide wire and slowly sent it in along the patient's airway.

As predicted before, the airway is different from the esophagus, and as long as the patient is alive, it is impossible for the main airway to be completely occluded.

Although the airway passage was twisted, Zheng Ren easily inserted the guide wire.

"Boss, step on the line or use a bronchoscope?" Su Yun asked.

"Step on the line." Zheng Ren still chose the safest way.

It is also possible to simply observe the stent with a bronchoscope to see the patient's condition, but it is not as intuitive as the DSA robot man.

A 18mm×40mm nickel-iron alloy tracheal stent was delivered to the position, and then the stent was released, and the stent implanter was pulled out. Zheng Ren began to suck the bloody secretions and adjusted the position of the stent with biopsy forceps. The tracheal stent was opened under the DSA machine, and the airway became unobstructed.

"We can stop ECMO," Zheng Ren said.

Su Yun then began to communicate with the anesthetist here, neutralized it with protamine, and stopped the operation of ECMO.

The actual running time of ECMO is only 12'26 seconds, and the operation is simply completed.

An operation that was judged inoperable by Bota was done so calmly.

Zheng Ren was not in a hurry to send the patient back, and observed for a full 30 minutes in the operating room, which was even longer than the actual operation.

Being cautious to such a degree, Su Yun is also very convinced.

"Doctor Zheng, your thinking is really powerful." Dr. Nico walked into the operating room and communicated with Zheng Ren. Dr. Zheng's surgical skills could not be seen in this operation. It was mainly an alternative method of using ECMO, which opened up Nicole's thinking.

"Well, the operation process is still a bit slow, and there is a problem with the coordination." Zheng Ren kept observing the ECG monitor and the patient back and forth.

"The cooperation is already very good!" Dr. Nico said in surprise. Is this Dr. Zheng telling the truth? The longest delay in the entire operation was during his postoperative observation of the patient.

"The turnaround of ECMO, if my anesthesiologist comes, it can be controlled in about 6 minutes." Zheng Ren didn't even look at Dr. Nico, just chatting casually.

6 minutes...

This number surprised Dr. Nicole very much.

Only a well-trained medical team can control the start-up time of ECMO within 15 minutes, and the start-up time before Dr. Zheng's surgery was 30 minutes.

This time is not long, it is just normal.

But 6 minutes, is this really good?

"My God..." Dr. Nico was surprised by Dr. Zheng's operation and thinking, but he didn't expect him to talk about the start time of ECMO with himself.

Is this Dr. Zheng telling himself that his medical team surpasses himself and Bota Private Hospital in all aspects?

Su Yun glanced at his boss, smiled and said: "Boss, if you brag about Lao He so much, won't he be proud?"

"Tell me the truth." Zheng Ren said, "He's recovering well, so prepare to send him back to the ward."

In the operating room of the system, the assistant who cooperates with the operation should be based on Lao He as a template. Indeed, it only took 6 minutes during the ECMO warm-up phase. Zheng Ren was just telling the truth without any exaggeration.

"Doctor Zheng, is there anything I should pay attention to after the operation?" Dr. Nico asked.

"Re-examine the CT after 1 day to see if the tracheal lumen is unobstructed and how the stent position is. After 2 days, re-examine the bronchoscope to see if the tracheal stent in the middle of the trachea has fully re-expanded." Zheng Ren said, "There is nothing else, the patient breathes The difficult situation has been resolved, and the rest is to rest for a few days, and the next step of treatment can be done after the body recovers."

After finishing speaking, Zheng Ren left the operating table, turned around, took off the sterile gloves, and threw them into the bucket of medical waste.