Chapter 1**8

"Boss, I think two hours is almost enough."

"But he couldn't stop for two minutes. The biceps brachii had begun to spasm involuntarily. The lactic acid level in the body was too high. It was bad for him to insist." Zheng Ren glanced at Professor Zhan and said.

"Yo, can you still see the lactic acid level? Tell me how to judge." Su Yun spoke, but his head was motionless, and his fingers moved slightly, cooperating with Zheng Ren's dissociation.

"It must be the disorder of sodium and potassium pump in the body. Now if you do a serum ion test, the potassium ion should be more than 5."

Professor Zhan was speechless.

I usually joke like this and talk nonsense about some specious things.

Just in front of the operating table, boss Zheng and his assistant are doing almost impossible surgery. How can they still have this idea.

"Director Ma!" Zheng Ren shouted, and then whispered, "it's director Ma."

"Yes."

"Oh, I just patronized the operation and didn't listen carefully."

Ma Liang threw president Li aside and ran over.

"Boss Zheng, what do you want?"

President Li looked at Ma Liang helplessly. It didn't look like a big director. He was a refresher doctor.

"Change the young and strong to pull the hook. Keep your hands steady and stick to changing people for 30 minutes." Zheng Rendao, "find more. The operation may take a long time."

"Oh, good!" Ma Liang went to arrange it immediately.

But Ma Liang himself was the first to come up.

Ma Liang will not miss this opportunity.

He replaced Professor Zhan, opened his internal organs, exposed the field of operation, and asked, "boss Zheng, do you think it's ok?"

"The back hand is a little higher." Zheng Rendao.

"Oh, OK." Ma Liang immediately did what Zheng Ren said.

But the back hand was higher, but there was no change in the operation area.

He was puzzled and asked, "boss Zheng, what's the advantage of doing this?"

"Haven't you pulled the hook?" Su Yun asked.

"More than twenty years ago."

"Your current posture can make your hook more stable, labor-saving and last longer. It can be maintained at about 4 & prime; and 12 & prime Zheng Ren continued the operation and explained to Director Ma Liang.

Ma Liang did not question Zheng Ren's statement. Even if it was accurate to seconds, he still had no doubt.

The operation continued. Zheng Renhe and Su Yun were freeing the tumor tissue, but the people who pulled the hook were constantly changing.

Microsurgery, there must be no shivering.

It is possible that the assistant just changed the shape of his hand and the operation failed.

Three hours and 34 minutes later, Su Yun finally took a piece of black abnormal tissue out of the patient's abdominal cavity with the hemostatic forceps in his hand.

"It's going well. Hey, did you make an appointment for intraoperative freezing?" Su Yun asked.

Professor Zhan nodded quickly.

The fatigue of the hook has just slowed down for several hours, but it hasn't slowed down.

"Yes, yes."

"Think it's a retroperitoneal paraganglioma. Send it to be frozen." Zheng Rendao, then began to deal with the surgical stump.

Seeing that the tumor tissue was cut off, everyone was in great spirits and gathered around to see the operation.

In the operation area, the dark tumor tissue disappeared and there was no blood, while a section of the inferior vena cava seemed a little thinner, but there was no bleeding.

President Li was puzzled and asked in a low voice, "Professor Zhan, how can the free tumor tissue? Isn't it heavily adhered to the inferior vena cava?"

"Some parts of the adventitia of inferior vena cava separated by boss Zheng have reached the middle membrane, and the outer layer of the middle membrane has been dissociated and cut off at several points." Professor Zhan looked at the operation area and guessed heartily.

"Er... What if the pressure of the inferior vena cava is high?" President Li asked.

Professor Zhan looked at him very speechless, sighed and said, "Dean Li, just now there was a stent with membrane."

Only then did President Li know how stupid his problem was.

Stop talking and make people laugh.

He glanced at the ECG monitoring, and the above value told him that director Jin's vital signs were stable, people were fine, and should be able to step down alive.

Zheng Ren also looked up at his blood pressure and didn't say a word.

The next step is to prepare to close the abdomen, President Li judged.

But Zheng Ren sighed and said, "show me the preoperative film."

"Er..." The doctor was stunned.

"Hurry up, the operation has taken a long time." Zheng Ren is a little unhappy.

No matter what you say, you can't do it at the first time. In your memory, the medical level of the provincial capital is very high. How is it different from your imagination?

"Boss Zheng, are you considering transfer?" Asked Professor Zhan.

"Yes." Zheng Ren looked at the value of ECG monitoring, "the resection of retroperitoneal paraganglioma is often accompanied by the reduction of blood pressure and other characteristics, which still needs to be further expanded."

"If there is persistent hypertension after tumor resection, or the blood pressure does not drop, suggesting that there may be another tumor or metastasis, we should try to find and remove the metastasis to reduce the functional tumor tissue. Extensive surgical resection is necessary."

"Alas, the blood pressure is still very stable. It is estimated that there is tumor tissue."

This news is really bad news. I thought the operation was over and the work was clean and beautiful, which can be called perfect.

But the magician said it wasn't finished yet

The film hung up. Zheng Ren put his hands under his arms and began to read the film.

Su Yun also leaned over and watched together.

Strangers are not allowed to enter within half a meter around them.

In case of accidents during operation, the operators are generally grumpy. And now it should be an accident. What if you get close and encounter sterile clothes?!

The performer has a bad temper and must scold.

"Boss, the lower pole of the right kidney looks wrong." Su yundao.

"Well, I can only cut it." Zheng Ren said, "Lao Gao!"

Gao Shaojie kept silent. He couldn't understand the surgery, so he didn't participate too much.

"Yes, boss Zheng." Gao Shaojie promised immediately.

"Bleeding after nephrectomy. Have you ever had embolization?" Zheng Ren asked.

"Yes." Gao Shaojie immediately gave Zheng Ren a positive answer.

"Then cut the kidney segment and try to minimize the damage." Zheng Ren then took a look at Professor Zhan and asked, "before the operation, tell the patient's family members about the intraoperative observation. Is it possible to cut off the right kidney or part of the right kidney?"

"Yes."

Zheng Ren is still quite pleased that the most basic things have not been omitted.

Return to the operating table and start nephrectomy.

This operation is fast. It is not careful to remove the tumor tissue attached to the inferior vena cava, but drastic.

Although Professor Zhan had some questions, he did not speak, but kept observing the patient's blood pressure.

After strangulation and resection, the blood pressure suddenly dropped from 110 mmHg to 75 mmHg.

Seeing the drop in blood pressure, Zheng Ren didn't worry. Instead, he breathed a sigh of relief, "close your stomach!"