Chapter 2119

With the magnetic ring of vascular anastomosis, Zheng Ren quickly shortened the time of anhepatic period to an incredible extent.

The former "world record" was like a piece of paper, which was broken in one poke. The obstacle of sudden cardiac arrest and seemingly insurmountable was also successfully overcome by Zheng Ren.

Dozens of surgical training, the shortest operation time in anhepatic stage, 8 minutes and 12 seconds.

This is undoubtedly a huge breakthrough, but it is only the beginning.

Zheng renningshen's operation, installation of vascular anastomosis magnetic ring and opening of portal blood flow. Here is the most difficult step in Zheng Ren's mind.

Suddenly restore the blood supply to the heart, and the patient already has heart failure. Whether the heart can hold, this is a problem.

Sure enough, within 3 seconds of restoring the portal blood supply, the subject's heart stopped suddenly.

After nearly 30 hours of surgical training, Zheng Ren came to the conclusion that the operation must be completed as soon as possible under the condition of cardiac compression.

But cardiac compression and violent tremor affect the operation. The trauma of open chest direct vision cardiac compression is too great. Even if Zheng Ren reluctantly completes the operation, the degree of completion of the operation is not high.

This means that it is difficult for patients to survive the perioperative period.

Zheng Ren didn't even dare to go out of the door of the system operating room. Su Yun's goods were staring at him outside.

Opening the portal blood flow will indeed lead to sudden changes in blood pressure, which Zheng Ren can't solve.

You can't change the position of the liver when you use a "replacement" skill like a magician.

Vascular anastomosis magnetic ring can solve the problem of too long anhepatic period, and also help the patients in front of them, but it can not solve all the problems.

Zheng Ren tried ten operations. Finally, at the end of his tether, he left the operating room of the system.

It seems that several krypton gold chests have not been opened before.

Zheng Ren, who has always had no love for luck, got the box and forgot it.

In fact, most of these boxes are experience values.

He glanced at the skill tree of general surgery, which was still a long way from the peak.

Even if a large number of experience values are given in several boxes, they can't make their general surgery skills reach the peak level and make qualitative changes.

Zheng Ren out of the system space.

This is really a tangled operation. After repeated tossing and turning, Zheng Ren did not get a satisfactory solution.

"Boss, you don't think you can have a liver free period of 15 minutes? Do you want to go to heaven?" Su Yun said contemptuously, "the standard time for an operation is 3-4 hours. I believe you can finish it in 2 hours. But the time of anhepatic period is at least 30 minutes before. Are you really going to shorten it to 10 minutes?"

"The key is not here." Zheng Ren's voice was a little hoarse and said hoarsely, "have you seen the patient's recent echocardiography?"

"Yes, it's in bad shape."

"Well, I think after opening the portal blood flow, the change of pressure will lead to cardiac arrest." Zheng Ren entered the state of jumping over the wall. He didn't think about any flaws and loopholes. All his attention was focused on how to let the patient end the operation safely.

"Stop jumping... Do you want to open your chest?" Su Yun asked after pondering for a few seconds.

"Cardiopulmonary resuscitation under direct vision is the last step. There are many problems after liver transplantation. It is best not to open the chest and cause greater trauma." Zheng Ren said firmly, "is there a magnetic ring for vascular anastomosis in the hospital?"

"Let me contact." Su Yun said, "cardiac arrest... Outside the chest... No, we opened the abdominal cavity."

Zheng Ren was stunned and immediately said, "diaphragm!"

The method of cardiac resuscitation by lifting and squeezing through diaphragm is very rare in clinic, which belongs to an unconventional operation under special circumstances.

After all, there is not enough experience. Zheng Ren, reminded by Su Yun, tries to piece together the possibility of success.

Fuck!

Zheng Ren finally found a complete way this time, and the rest is practice.

He immediately came to the system space, bought the system operation time and entered the operating room.

This time, he practiced transdiaphragmatic lifting and squeezing CPR. It is very difficult, especially without affecting the operation. But Zheng Ren did it. The last successful pressing method was learned from fan Tianshui.

When he went out to dinner and met a patient with spontaneous pneumothorax, fan Tianshui poked a straw into the waiter's chest. The way of exerting force is to gather the force at one point and then burst out.

Zheng Ren remembers that Su Yun consulted with fan Tianshui after that. He also tried to do it a few times, just like it.

If you really look at the goods, it should be no problem. Zheng Ren can only hope on Su Yun. If not, then we'll have to have gad woods operate and do cardiac compression by himself.

Lin Yuan listened with silly eyes. What's going on?

He has done liver transplantation at Harvard, with a procedure of about 3 hours, which belongs to the advanced level of the world surgical community.

The anhepatic phase varies in length according to the level of the operator. It takes 30-40 minutes.

In a word, Su Yun shortened the anhepatic period to 15 minutes.

This is not the most critical. Boss Zheng seems not satisfied with this time!

And it is expected that cardiac arrest will occur when the portal blood flow is opened

Liver transplantation, opening the portal blood flow and cardiac arrest are not rare complications. Although Lin Yuan has not seen them with his own eyes, they always exist.

Boss Zheng is a prophet, or is his level high enough to kill himself directly... It's not a matter for him to kill all the tutors and professors of Harvard Medical School directly.

The next step is to find the dummy and try the technique? Lin Yuan was a little confused. At first she could barely say a word or two, but now she can't keep up with her ideas.

"For the state of the patient, the pressing frequency should be at least about 100-120 times / min." Su Yun said, "the key is when to start."

Zheng Rendao, "after the arterial anastomosis begins, the patient's condition should be relieved."

"It is estimated that it will take 1-2 minutes to restore the normal physiological and anatomical structure under the action of drugs." Su Yun pondered.

Zheng Ren looked up just Su Yun.

"What are you looking at me for?"

"Do you remember learning how to use force with Lao Fan?" Zheng Ren asked.

"Of course." Su Yun looked at Zheng Ren suspiciously. "Do you want such a special press? I'll go! Boss, I can barely do it. I can't last too long!"

Zheng Ren is very pleased to hear Su Yun say so.

"Boss Zheng, I can do it!" Lin Yuan said.

"Don't be ridiculous. What can your little arms and legs do?" Su Yun habitually rejected the past.

"What can't be done for cardiopulmonary resuscitation through diaphragm!" Lin Yuan angrily said.

"Tell me how to do it."

"The right hand extends below the diaphragm from the surgical incision, puts 2-5 fingers together on the diaphragm attachment surface behind the heart, and the left palm is fixed at the middle and lower third of the sternum. The coordinated movement of the wrist shoulder joint of the right elbow drives the 2-5 palm fingers of the right hand to lift and squeeze rhythmically and impulsively towards the sternum, so as to move the diaphragm up 4-5cm, and then relax quickly to return the diaphragm to its original position." Lin Yuan said skillfully.

"Tut tut." Su Yun looked contemptuous.

"What?" Lin Yuan raised his head and shook his horse's tail.

"The basic theory is very solid." Su Yun said, "it's not the key. It's really not good. I can open my chest and press directly. The problem is the frequency of 100-120 presses per minute. How long can you last?"

"...." Lin Yuan said nothing.

It's physical work, like carrying a thigh in orthopedic surgery.

It doesn't sound difficult. Ordinary people have also been in contact with extrathoracic heart compression, and high-frequency compression can be maintained for a few minutes.

But whether the action is right or not is not certain.

But that's conventional chest compressions, not diaphragmatic cardiac resuscitation. This unconventional pressing requires the right hand and left hand to cooperate with each other. The posture is strange and difficult.

But this is not the most critical.

Because the patient's condition is critical, the operation process must be shortened and the normal physiological and anatomical structure must be restored.

Cardiac compression should be performed simultaneously with anastomotic blood vessels.

The right hand is under the diaphragm, and the operator should also anastomose the blood vessels. It should not only have great strength, but also can not make the patient's whole body move.

One can imagine the difficulty.

With Su Yun, Zheng Ren thinks this operation should be able to be taken down. Think carefully, there seems to be no deviation.

"I will as soon as possible." Zheng Ren said solemnly.

"Nothing." Su Yun said with a smile, "chest opening instruments must be prepared. I'll call Zhao Yunlong to come. Once I come here... Your operation time is relatively long, maybe you have to open your chest."

"Yes." Zheng Ren nodded.

Be prepared, this is something that must be considered.