Chapter 2833

Dean Yan chatted with Mr. Peng. A few minutes later, Mr. Gu of the chest Department caught up.

Lao he was busy performing without objects while listening to what they said. At this time, it's all big guy level chat. It's too boring for an anesthesiologist to come up and talk.

But he wondered how boss Zheng took such a big job. At ordinary times, other doctors are more cautious about the operation of important people. I just heard that boss Zheng advised me.

From the dialogue, Lao he can tell that Gu doesn't really agree with the operation. He often stops talking. He should go to the handsome house for consultation the day before yesterday and participate in the diagnosis.

However, Gu's opinion is not important. Lao he has nothing to worry about. Now he has a nearly blind worship for the level of boss Zheng.

Boss Zheng's high level is certain, and the key is stability! No matter what rare surgery, boss Zheng will take it down steadily. Lao he has an "illusion", just like boss Zheng has done this surgery countless times.

It may be an "illusion", Lao he thought to himself. He was just curious. After expert consultation, Mr. and Mrs. Peng also gave up the operation and prepared to go back to their hometown. How confident did boss Zheng keep them.

Soon, the flat car sounded and the patient was sent in.

Lao he helped carry the patient to the operating table and asked softly, "boss Zheng, do you have any special needs?"

"Lie on the left side, tilt forward 30 °, and enter the chest on the right side." Zheng Ren said in a deep voice. As he spoke, he inserted the patient's film into the film reader, habitually looked at the film with his arm in his arms, and had no idea of talking to Mr. Peng at all.

"OK." Lao he lowered his voice and answered.

"Anesthesia, I'll brush my hands right away." Zheng Rendao.

In such a hurry? Lao he was in a trance.

"The operation starts from anesthesia and needs to be completed within 45 minutes. Try to minimize the impact of the operation. When the elderly are old, they can be fast." Zheng Ren explained with a smile.

Lao he knew why Gu felt that the operation was unnecessary, which was determined by the patient's own physical conditions.

Including 45 minutes of anesthesia, even endoscopic surgery is too fast. Boss Zheng really dares to think.

Seeing boss Zheng brush his hands, Lao he glanced at Su Yun. Seeing that Su Yun had installed the hand rack and other auxiliary equipment, he whispered, "Brother Yun, I'm starting?"

"Start, after you plug in, I start to put myself in position." Su Yun's voice reached Lao he's ears through the three-layer mask. It was a little stuffy. Lao he knows that maybe Brother Yun is also a little nervous today. After all, even if President Yan drives away a group of people, there are still many big man level tasks to prepare for the viewing platform.

Intubation, anesthesia and body position. After 4 ′ 22 seconds, Zheng Ren has finished brushing his hands, laid a sterile sheet and stood in front of the operating table.

Lao he stared at boss Zheng's movements and started left one lung ventilation at the most appropriate time.

Zheng Ren placed thoracoscopy at the 7th intercostal hole of the right posterior axillary line, and the 3rd intercostal hole of the axillary midline and the 8th intercostal hole of the scapular line were operation holes. After poking the card and shooting the camera, Lao he breathed a long breath. The one lung ventilation was perfect, which did not affect the operation time of boss Zheng.

However, boss Zheng did not directly attack the mediastinum, but began to free it skillfully with long head pliers. Soon, the azygos vein arch appeared in the operation field.

A straight-line cutting suture device was patted in Zheng Ren's hand. After cutting off the azygos vein arch, it began to free the mediastinum. Soon, a huge diverticulum appeared on the screen.

Free the esophagus at the carina level and lift it around the belt. Zheng Ren dissociates upward along the esophagus and exposes the lower end of the diverticulum.

In the operating room, only the song of good luck was floating. Others stood behind Zheng Ren and looked at the operation skilled to the bone. No one spoke. They just occasionally looked up at the electronic clock hanging on the lintel.

12 ′ 22 ″, the diverticulum has been completely exposed.

For endoscopic surgery of esophagus, this is a time for all operators to be dumbfounded.

Normally, the only thing that can be done in such a short time is that the anesthesia is completed and the body position is placed. The medical group that is a little slower is afraid that even the operation sheet has not been paved. But boss Zheng has seen the esophagus.

Soon, but not enough.

Gu glanced at the time and frowned under his sterile hat.

The real operation has not started until now. Can boss Zheng finish it?

He did not disapprove of boss Zheng's operation plan, but he doubted whether the operation could be completed within one hour. Although it is said that the oldest patient he has ever operated on is 104 years old, it is the case that his physical conditions meet.

Dr. Zheng's operation seems to be a little menglang.

Time is not a problem for Zheng Renlai. After exposing the diverticulum, he used an electric knife to punch a small hole at the lower end of the diverticulum into the diverticulum, sutured it for 2 stitches and pulled it away. The limitations of endoscopy do not seem to affect Zheng Ren's technique. The suture is clean and neat, and the cooperation with assistants and instrument nurses has been perfect.

After sewing, Su Yun clamped the suture with a pair of pliers and kept it for lifting.

Another small hole was made in the horizontal right esophageal wall at the bottom of the flat diverticulum, which was also sutured for 2 stitches and pulled away.

Then Zheng Ren used an endoscopic cutting and suturing device to enter the esophageal cavity and diverticulum through the esophageal opening and diverticulum opening respectively, and cut and sutured the diverticulum and the lateral wall of the esophagus side by side.

The cutting and suturing device creaks. Although it is clean and neat, it still makes everyone's heart tremble.

Boss Zheng didn't even make a comparison. He started directly after he got off the cutting stitcher. It's too confident.

The operation time was 23 ′ 54 ", and the diverticulum was fully opened.

The diverticulum and esophageal crest were incised to form a common cavity between the diverticulum and the compressed upper thoracic esophagus.

This method of relieving esophageal compression is rare, but looking at the anatomical structure, 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 this is fistula.

Then the diverticulum and esophageal incision formed after cutting and suture were sutured intermittently.

Gu's eyebrows are getting tighter and tighter. Now it is the most critical part of the operation.

No matter how fast and fine the previous operation is, once there is an esophageal fistula after the operation, it is an unbearable blow for an 84 year old man in poor condition.

The anatomical structure and blood supply of the esophagus itself suggest that the probability of esophageal fistula is very high.

Just intermittent suture?

It seems not enough. If so, even jejunal nutrition after operation is difficult to ensure the healing of esophagus.

Boss Zheng sewed carefully, which took a lot of time. When Gu looked at the electronic clock again, the operation time had taken 33 minutes.