Chapter 255 Surgery Cost

Professor Amano Atsushi, known as the master of surgery in Maruko Country, stood firmly on the small bench behind the surgeon, not moving a step. Even if a doctor wanted to change positions with him to observe, he would refuse by saying that he was the supervisor of the princess' surgery.

He must see how Zhang Fan performed this surgery today, because he couldn't do this kind of surgery.

Once surgery involves words such as reconstruction, replacement, repair, etc., it is usually a major surgery. Of course, repairing some kind of membrane can be simple. Some even repair it after it has been punctured for a short time. I don’t know why.

The development of extracardiac surgery, to be honest, is one aspect of improving surgical technology, but the most important aspect is the leap-forward development of surgical equipment that has brought about the current rapid development of cardiac surgery. Especially for cardiac surgery, packaged medical treatment has a significant impact on the outcome.

The so-called packaged treatment actually means that all treatments are provided in one system starting from the moment you enter the hospital, without the patient having to find the corresponding department.

For example, perioperative medication (anesthesia!), critical care, cardiology, and nephrology also play extremely important responsibilities here.

In the early years, a foreign medical expert said to cardiac surgeons: If your hospital does not have these necessary supporting conditions, please change the medical environment or transfer the patient to other hospitals.

This may sound a bit equipmentist, but it is also true.

For example, for Zhang Fan's surgery today, he first needed to establish extracorporeal circulation. This thing is actually to create a heart outside the body, which can still form a blood transfusion circulation for the body without the heart.

There is a chronology of major events in extracorporeal circulation equipment. The first type of implantable left ventricular assist device failed in 1963, and then continued to fail in 1966. In 1970 and 1978, assistive devices transitioned to heart transplantation. In 2000, the first clinical series of implanted whole heart assist devices was Device successful.

Here, has the doctor's skill improved? Absolutely, but compared with the rapid improvement of equipment, the improvement of the doctor's skill is somewhat dispensable.

For example, in the extracorporeal circulation in 1963, the blood oxygenation of arterial blood and venous blood was not well combined, but the extracorporeal circulation in 2000 was already computer controlled.

Even the blood circulation under computer simulation is almost indistinguishable from that of a real heart.

But, just like that, the failure rate of heart surgery is as high as 7%, which is not a small number!

Such a high failure rate also makes cardiac surgeons more and more valuable.

This can also be said conversely. The equipment has improved so accurately, but why has the surgical technology not improved by leaps and bounds?

The surgical method proposed by Zhang Fan is theoretically possible, but no one has done it yet. Why? It’s because of the high standards for doctors’ skills.

The operation begins and the chest cavity is cut~!

There is a large incision directly under the xiphoid process, and the ribs are as soft as cookies under the rongeur.

Open the heart and begin to establish external circulation.

Then

"Cool down! Stop the cycle!"

At the same time as every word was spoken, the sound of surgical hemostats clicking in the operating room was clearly remembered.

Every major blood vessel carrying the heart outward, named or unnamed, was clamped shut.

Every step here is dancing on the dangerous edge of bleeding. He is a big blood vessel and an old man.

Sometimes, accidents almost accompany the entire operation process. For example, an undetected vascular dissection can explode on the operating table as soon as the forceps are removed.

"Rewarming, cerebral perfusion!"

The operation was very fast. It could almost be said that the best doctors in cardiac surgery in northern China were gathered on this operating table.

Although Zhang Fan has the right to use the scalpel, electric knife, scissors and other sharp instruments, the cooperation of the assistants is also quite impressive.

Zhang Fan didn't need to worry about blunt dissection, preparation, hemostasis outside the wound margin, or blood vessel protection. They created a very comfortable surgical position for Zhang Fan.

Can't even fault it.

"Tilt the operating table!" The operation entered the heart. At this time, the serious operation had just begun.

How to describe the heart? The heart is as big as a fist, and the blood vessels that pop out are all for supplying other body organs.

The blood vessels that supply the heart are several hearts in golden armor attached to the surface of the heart.

This golden armor is fat. Because the heart is a cardiomyocyte, it is not wear-resistant. Therefore, when many people eat animal hearts, they will find fat. In fact, this fat acts as a wear-resistant agent.

Cut open, enter. If it enters the heart from outside the chest, the members of the surgical team are like a demolition team, using whatever roughness is needed.

For example, a rongeur, how big is this thing? The pliers used to build tree branches are similar to large rongeurs.

But after entering the heart, Zhang Fan and the others acted like thieves.

The pliers are all for ophthalmology.

Entering the heart, if looking down from the direction of the operating light.

At this time, my heart is like a birthday cake for a five-hundred-year-old lady. The places visible to the naked eye are filled with metal pliers.

The metal pliers are placed one by one on the heart like birthday candles.

At this time, the speed must be fast and stable.

First repair, patch, like a piece of patch taken from gray stockings and placed on Zhang Fan's hand.

Zhang Fan's hands were as nimble as his tongue, and he had already gotten in before he even noticed how it moved.

Professor Amano Atsushi's heart clenched violently, because although he could see this place clearly, he still didn't understand how Zhang Fan did it.

Outside the surgical observation room, a group of directors could not even see clearly.

By the time they came to their senses, the repair was complete, and the inner edge of the heart was like a repaired membrane, flickering in and out.

Then reconstruction began.

This operation is very difficult. To put it simply, an anal fistula can make doctors and patients think deeply.

Trying to move the anus is so difficult that 99% of doctors are at a loss.

Heart reconstruction is even more difficult.

There can be no trace of bleeding here. Once there is bleeding, the blood will agglomerate here and it will become a super plate.

And the heart muscle is different from other muscles. It has super endurance. From birth to death, a person's heart almost never stops.

It's malleable, but it's too brittle.

If it has both endurance and flexibility, just like the cavernous body, it is estimated that myocardium will be used for cavernous body repair in the future.

But, it's too crispy. Even a slight touch may cause a small pit to appear in the heart muscle.

The operation lasted from morning to noon, and from noon to afternoon.

The doctors on the operating table changed from relaxed at first to heavy.

The diaper between the thighs went from warm to cold, and the skin that had started to be irritated by uric acid even stung a little.

The sweat on my head can be wiped by the nurse, but there is nothing I can do about the pain in my legs, I can only endure it.

The leaders of the observation room came and went, and came and went.

Cut, build, measure.

To be honest, heart surgery requires more precision than brain surgery.

Brain surgery is like carving a pattern on a tofu, while heart surgery is performed in a small water pump. The casing must fit tightly between casings.

Moving slowly, Zhang Fan's hands moved almost invisible to the naked eye while sewing.

Many doctors in the observation room couldn't help but imitate Zhang Fan's operations with their own hands.

"It's too difficult. How did Zhang Yuan train himself?" Experts can tell the degree of difficulty at a glance.

Although they cannot perform this kind of surgery, it does not delay them in evaluating the difficulty of this kind of surgery and the quality of the operation.

Finally, everything is finished.

Zhang Fan straightened his body slightly, and there seemed to be inaudible bones snapping all over his body.

"exhaust!"

This exhaust is not farting, but shaking the heart to remove gas from the left and right atrium of the heart. Because the normal heart is filled with blood, extracorporeal circulation causes air to enter the heart.

One plier after another slowly withdraws.

Extracorporeal circulation begins to withdraw.

Visible blood slowly enters the heart.

At this time, not only Zhang Fan's heart was aroused, but everyone in the operating room was also aroused.

Blood enters, and the beating heart begins to pump blood beyond the body.

Once, twice, the equipment alarms sounded one after another.

"Blood oxygen rises!~"

"No bleeding!~"

"Elevated blood pressure and normal heart rate!"

One minute, two minutes, ten minutes.

At this time, the doctors on the operating table remained motionless, quietly observing the beating of the heart, and data feedback from the anesthesiologist kept coming to their ears.

The suffering at this time is even more difficult than during surgery.

At this time, it is like a gambler opening a fortune. No one can say whether it is big or small.

Finally, the loop is completed, so the data obtained is normal.

"Close your chest!"

Zhang Fan said softly. Although there was no sound in the operating room, everyone could clearly feel that the air pressure had decreased countless times.

In the observation room, "It was successful, leader, Zhang Yuan's surgery was successful, and all vital signs are normal!"

The director of Capital Hospital excitedly reported to his superiors.

His tone was excited and his expression was excited. In fact, he didn't know how many times he had undergone such operations, but he didn't even have a single ripple in his heart.

Because he didn't do the surgery, he was the reporter.

"Okay, okay, okay, you are all heroes. I will report to my superiors now and make sure to make a list of all surgical personnel!"

"Yes!" At this time, the dean's heart was slightly rippled.

Outside the operation, the director of Chasu Cardiology Department stayed close to Zhang Fan.

Because the operation took too long, he was afraid that Zhang Fan wouldn't be able to stand.

"I'm a little tired and I'm going to take a rest later. But before I take a break, you can send me some digital tablets and three-dimensional simulation positioning systems from your hospital to Chasu."

The director of the Capital Hospital thought Zhang Fan was joking, so he held Zhang Fan's hands and said thank you with a smile: "This is for tea, you can't ship it back!"

Zhang Fan said with a serious face: "It's okay!" Then he turned to Wang Hong and said: "Contact the Border Residency Office and ask them to come now!"

Wang Hong immediately called.

this……

The dean of the capital was dumbfounded, not only shocked by Zhang Fan's shamelessness, but also shocked by Zhang Fan's influence, because Zhang Fan gave him the feeling that he was from the frontier.

At this time, the deputy director of Fuwai said to his director with admiration, "Yuan Zhang is so awesome. Living in the first office is like being run by his dean."

The director of Fuwai let out a long sigh, "You just know, do you think he stayed at the border just for the sake of two taels of raisins?

Others waited for their superiors to give them to them after their surgeries, but he asked for them directly. Do you believe it or not, the equipment that Zhang Fan asked for today will definitely be sent to Zhang Fan by his superiors. Even if the Capital Hospital is demolished, it will be sent to him. "

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