stjorthotic Chapter 213
Chapter 213
Chapter 213
morning,
10:00,
The patient (baby + mother) is pushed into the operating room.
On the whole: this operation covers baby failure liver resection + mother’s left lateral lobe donor liver acquisition + left lateral lobe liver to the baby’s living donor liver transplantation…
A total of 3 major operations!
Each one is level four surgery!
In addition, due to the deterioration of the head surgery and the general condition of the three-month-old female baby, the difficulty of the operation has once again increased, and the difficulty is difficult to predict.
At the same time, liver transplantation may bring more complicated complications.
Such exaggerated surgical cases, not to mention those in provincial cities, even in the whole country and the world, are very rare operations!
so,
Doctors in a hospital in the whole city are very concerned about this operation!
The surgical team is very strong.
Just yesterday, the conference was attended by 32 senior doctors at the director level and deputy director level.
Today, Lin Feng is in charge of the operation, but the first aid, the second aid “Nine Four Three”, and the third aid are all experienced and skilled veterans who are the director and chief physician of the Hepatobiliary Department.
In addition, the brain department is also ready to monitor the baby’s brain in real time.
Not only the brain department, but also the directors of the endocrinology, anesthesiology, gastrointestinal, chest, and cardiology departments will join this operation.
I was afraid that something went wrong in the middle, and Lin Feng couldn’t deal with it.
When the family members of the patient knew that so many doctors worked hard to participate in the operation, they were grateful.
And the doctors watching and studying,
The dean, the deputy dean, all who can come are here.
In addition, there were no doctors at work, and they did not go out to play at this time. Instead, they returned to the hospital one after another to watch the operation.
The number of people, up to more than 200 people!
An unprecedented large-scale learning site!
Because there were too many people, I directly set up a large media conference room to broadcast the operation process.
Hehehe~~
Fortunately, I don’t have to go to work today, otherwise I would miss the operation.
Cool!
And those doctors who have to go to work,
Crying~~~
“I don’t want to go to work, I want to go to surgery!”
“This operation is the most difficult operation in the history of the City First Hospital, right?”
“Once this operation is successful, I am afraid that the City No. 1 Hospital will take off!”
“This opportunity to observe in person is so gone, I hate this shift today!”
Hate it!
Not reconciled!
…
…
Inside the operating room.
Two hospital beds, two patients, at the same time.
The first bed (baby):
· Lin Feng is the chief surgeon, and two chief hepatobiliary surgeons do one help and two help.
·Perform the baby’s failure liver resection + the left lateral lobe liver to the baby’s living donor liver transplantation.
The second bed (mother):
The director of hepatobiliary surgery is in charge, and two chief physicians of hepatobiliary surgery assist two.
Perform the acquisition of the mother’s left lateral lobe donor liver.
10:20…
Surgery anesthesia, over!
The operation officially begins!
…
Lin Feng’s side,
Surgical preparation:
In the supine position, place a temperature-variable blanket and anti-decubitus cushion under the body. Both lower limbs are wrapped with plastic sheet for heat preservation. The upper limbs are wrapped and pressed on the side of the body, protected by hand guards.
Urinary catheterization, external precision urine bag…
The left radial artery is punctured for invasive monitoring, and the external tee is convenient for intraoperative blood draw…
Puncture of internal jugular vein and subclavian vein…
Right femoral vein puncture for intraoperative lower limb venous pressure monitoring…
Start of surgery:
First of all: “failure liver resection”!
first step,
Open your chest!
“a!”
On the right lower rib, Lin Feng gestured and made an L-shaped incision…
Then saw the breastbone…
Frame hook, open the view…
free……
“Long-handled electric knife!”
Use an electrosurgical knife to free the perihepatic ligament and suture the bleeding point on the edge of the ligament.
Then dissect the first hepatic hilum…
Dissecting the second hepatic hilum…
Dissecting the third hepatic hilum…
Time goes by a little bit…
30 minutes……
40 minutes……
50 minutes……
After the dissection,
Next, is to disconnect the arteries and veins.
Line 4 is ligated and the portal vein is cut off…
Line 1 is ligated and the hepatic artery is cut off…
60 minutes……
70 minutes…
During the period, except for some conditions, it was okay, and everything was under control.
80 minutes…
90 minutes……
During this period, certain conditions have occurred, but…
Washing with heparin saline, anti-coagulation…
Isolate the hepatic vein…
Argon knife, treat the liver bed, cut clean, and suture the edge of the ligament…
this moment,
The baby’s entire diseased liver was removed!
The vacated position needs to wait for the operation next door and the arrival of a new donor liver.
Lin Feng deliberately slowed down the entire operation in order to match the speed of the director Wu Zhengye next door.
(Director Wu Zhengye: “…………” I feel offended!)
…
And at this time,
Next door, another operation (mother) 0 ……..
Director Wu Zhengye of Hepatobiliary Surgery has also opened his breastbone and is about to cut the liver.
How to cut the liver specifically, I have given my mother a radiography yesterday, and then during the consultation, I have had repeated discussions to determine the final liver cut position.
Director Wu Zhengye also repeatedly demonstrated more than a dozen times in his mind yesterday.
so,
The speed of cutting the liver is also very fast.
Pick the right place,
cut! !
soon,
A fresh piece of the left outer lobe of the liver was cut out.
Put it in a thermostat.
disinfect……
Sent to Lin Feng’s operating room.
Next, Wu Zhengye’s task is much simpler, suturing the liver, closing the chest, and then completing his mother’s surgery.
It’s very simple.
The most important tasks are all on Lin Feng’s side.
…
Lin Feng’s side.
The left outer lobe of the mother’s donor liver was sent here,
Lin Feng can proceed to the third operation:
“Living Donor Liver Transplantation”!
first step:
The donor liver’s posterior hepatic vena cava-recipient’s posterior hepatic vena cava, side-to-side anastomosis…
“Drip 500ml of 4 degrees Celsius balance solution through portal vein intubation to prevent air embolism…”
Lin Feng picked up the needle holder, round needle +4/0 blood vessel thread, fast suture…
120 minutes…
130 minutes…
Because the child is light in weight and has thin blood vessels, the operation is much more difficult.
Lin Feng’s speed has slowed down a lot.
Of course, Lin Feng is not a doctor who pursues speed, he pursues quality even more.
careful!
earnest!
Lin Feng 2.2 step by step, try to make the stitching as perfect as possible.
It took 40 minutes to complete the first step of stitching.
The second step: portal vein-portal vein anastomosis, washing with heparin saline, and sprinkling ice water on the surface of the transplanted liver…
The third step: hepatic artery-hepatic artery opposite end anastomosis, heparin saline flushing, heparin saline flushing, and warm water on the liver surface…
Step 4: Common bile duct-to-end common bile duct anastomosis…
340 minutes…
350 minutes…
Perhaps it was Lin Feng’s “lucky” that played a role, or perhaps God didn’t want to let this baby suffer any more. During the more than 5 hours of stitching all the arteries, veins, and common bile ducts, there was no physical fluctuation.
Smooth through…
The fifth step is to find all bleeding ports and stop the bleeding…
The sixth step, rinse with warm water, close the abdomen…
When Lin Feng sutured the last piece of skin,
The moment the stitches were cut!
Operation,
It’s officially over! !
. .