socalfunplaces Chapter 211
Chapter 211
morning
10：00，
The patient (baby + mother) is pushed into the operating room.
Overall: this operation covers the liver resection of the baby's failure + the acquisition of the mother's left lateral lobe donor liver + the left lateral lobe liver to the baby's living donor liver transplantation...
3 major surgeries in total!
Each one is a grade 4 surgery!
In addition, due to the three-month-old baby girl, the head surgery and the deterioration of the general condition make the difficulty of the operation once again increased, and the difficulty was difficult to predict.
At the same time, liver transplantation may bring more complicated complications.
Such exaggerated surgical cases, let alone in provincial towns, even in the whole country and the world, are very rare operations!
So
The doctors of the entire city's first hospital are very concerned about this operation!
The surgical lineup is strong.
Just yesterday, a total of 32 senior doctors at the director level and deputy director level participated.
And today's operation, Lin Feng is the main knife, but the first assistant, the second assistant, and the third assistant are all the director and chief physician of the hepatobiliary department, and experienced and skilled old doctors.
In addition, the brain department is also in strict readiness to monitor the baby's brain condition in real time.
Not only the brain department, but also the directors of endocrinology, anesthesiology, gastroenterology, thoracic and extracardiac must join this operation.
I was afraid that something would go wrong halfway, and Lin Feng couldn't handle it.
When the patient's family knows that so many doctors are working together to participate in the operation, they are grateful.
And the doctors who watched and learned,
Dean, vice president, everyone who can come is coming.
In addition, the doctors who did not go to work did not go out to play at this time, but returned to the hospital one after another, to watch and learn about the operation.
The number of people, up to more than 200 people!
An unprecedented large-scale learning scene!
Because there were too many people, I directly set up a large media conference room to broadcast the operation process live.
Hehehe~~
It's good that I don't have to go to work today, otherwise I would have missed this operation.
Refreshing!
And those doctors who have to go to work,
Crying chirp~~~
"I don't want to go to work, I want to go to surgery!"
"This operation is the most difficult operation ever performed by the First City Hospital, right?"
"Once this operation is successful, I am afraid that the first hospital of the city will take off!"
"This opportunity to observe in person is gone, I hate today's shift!"
Big hate!
Unwilling!
......
......
Inside the operating room.
Two beds, two patients, at the same time.
First bed (baby):
Lin Feng is the main surgeon, and 2 chief physicians of hepatobiliary surgery do one assistant and two helps.
Perform hepatectomy for baby failure + left lateral lobe liver transplantation to the baby's living donor liver.
Second bed (mom):
The chief surgeon of hepatobiliary surgery is the chief surgeon, and the chief physician of 2 hepatobiliary surgery is one assistant and two assistants.
Perform a procedure to obtain the mother's left lateral lobe donor liver.
10：20......
Anesthesia for surgery, finished!
The operation has officially begun!
......
Lin Feng's side,
Preparation for surgery:
Supine position, temperature blanket and anti-bedsore pad under the body, both lower limbs wrapped in plastic cloth insulation, both upper limbs wrapped and pressed to the side of the body, hand guards to protect.
Catheterization, external precision urine bag...
Left hand radial artery puncture for invasive monitoring, external tees to facilitate intraoperative blood draw...
Internal jugular vein, subclavian vein puncture...
Right femoral venous puncture with intraoperative venous pressure monitoring of the lower extremities...
Surgery begins:
First of all: "liver resection of failure"!
Step 1,
Open your chest!
"High-frequency electric knife!"
On the lower rib on the right side, Lin Feng gestured and made an L-shaped cut...
And then sawed the sternum ...
The frame pulls the hook and opens the view...
Free......
"Long-handled electric knife!"
With an electric knife, free rupture of the perihepatic ligament, suture the bleeding point at the edge of the ligament.
Then dissect the first liver gate ...
Dissection of the second hepatic phylum ...
Dissection of the third liver gate ...
Time passes little by little...
30 minutes...
40 minutes...
50 minutes...
After the dissection,
Next, there is the disconnection of the arteriovenous veins.
Line 4 ligation, cut off the portal vein...
Line 1 ligation, breaking the hepatic artery...
60 minutes...
70 minutes...
During this period, except for some conditions, but fortunately, they were all under control.
80 minutes...
90 minutes...
There have been certain situations during this period, but ...
Heparin saline flushing, anticoagulation...
Break off the hepatic vein...
Argon gas knife, treat the liver bed, cut clean, and suture the ligament edge...
At this moment,
The baby's entire sick liver was removed!
The vacated space needs to wait for the operation next door, the arrival of a new donor liver.
In order to cooperate with the speed of Director Wu Zhengye next door, Lin Feng deliberately slowed down the entire operation process a lot.
(Director Wu Zhengye: ".................." Feel offended!)
......
And at this time,
Next door, another surgery (mom).
Wu Zhengye, director of the Department of Hepatobiliary Surgery, has also opened the sternum and is preparing to cut the liver.
The specific how to cut the liver has been done for the mother yesterday, and then in the consultation, a repeated discussion has been done to determine the final location of the liver cut.
Director Wu Zhengye also repeatedly demonstrated it more than a dozen times in his mind yesterday.
So
The speed of cutting the liver is also fast.
Choose the landing point,
Cut!!
soon
A piece of fresh left outer lobe of the liver was cut out.
Place in an incubator.
Disinfect......
It was sent to Lin Feng's operating room.
Next, Wu Zhengye's task is much simpler, suture the liver, close the chest, and complete his mother's operation.
Very simple.
The most important task is all on Lin Feng's side.
......
Lin Feng's side.
Mom's donor left outer lobe of the liver, sent over,
Lin Feng can then proceed to the third operation:
"Living donor liver transplantation"!
Step 1:
The donor hepatic posterior vena cava - recipient of the posterior hepatic vena cava, line lateral anastomosis...
"Transportal cannula drip 4 degrees Celsius balance solution 500ml, anti-air embolism..."
Lin Feng picked up the needle forceps, round needle +4/0 vascular line, and quickly sutured...
120 minutes...
130 minutes...
Because the child is light in weight and has thin blood vessels, the operation will be much more difficult.
Lin Feng's speed slowed down a lot.
Of course, Lin Feng is not a doctor who pursues speed, he pursues quality more.
Observant!
Conscientious!
Step by step, Lin Feng tried to make the stitching as perfect as possible.
It took 40 minutes to complete the first step of suturing.
Step 2: Portal vein-portal vein contradictory anastomosis, heparin saline rinse, ice water sprinkling on the surface of the transplanted liver...
Step 3: Hepatic artery-hepatic artery contradictory anastomosis, heparin saline rinse, heparin saline rinse, warm water sprinkling on the liver surface...
Step 4: Common bile duct - common bile duct contratoposis ...
340 minutes...
350 minutes...
Perhaps Lin Feng's "luck" played a role, or perhaps God did not want to let this baby suffer anymore, and there were no signs fluctuations in the process of suturing the entire arteriovenous and common bile duct for more than 5 hours.
Smooth through...
Step 5, look for all bleeding openings, stop the bleeding...
Step 6: Rinse with warm water, close the abdomen...
When Lin Feng stitches up the last piece of skin,
The moment you cut the stitches!
surgery
It's officially over!!
。