Back in 2002 as a doctor

It's okay to say from the outside, the root of the tricuspid valve must be stuck in a mess.

It is extremely difficult to separate smoothly.

Moreover, the operation had to be completed with the heart beating non-stop. The more Chu Yuntian looked at it, the more serious his expression under the mask became.

Seeing this, Chu Yuntian came to a relatively certain judgment, the operation was no different from what he estimated, and it was extremely difficult.

Let's see what Zhou Congwen did.

Zhou Congwen's hand was very steady, even if he encountered the resistance of the scar when he cut the right ventricle wall, it would be difficult for a surgeon of Chu Yuntian's level to detect any abnormalities.

Opening the right atrium, Chu Yuntian frowned after seeing the tricuspid valve replaced more than ten years ago.

This operation... he could do it by himself if he had a thoracotomy, but with a thoracoscope... Chu Yuntian felt that he couldn't do it.

Not to mention completing the operation while the heart is beating.

There is heartbeat interference... Chu Yuntian wanted to give up as soon as he glanced at it, if he was standing in the position of the surgeon.

Chapter 1116 I secretly "saw" the operation performed more than ten years ago

For the first valve replacement patients, this position is at the junction of red and white. Just cut off the narrow tricuspid valve and cut along the position of the junction of red and white.

The junction of red and white is the natural dividing point between the valve and the heart.

Red is myocardium, white is chordae, etc., which are easy to identify.

But more than ten years ago, Mr. Huang had already cut off the narrow tricuspid valve along the red-white junction.

The current position of the bottom of the tricuspid valve is completely different from that described in the textbook due to postoperative edema, adhesion, and organization.

And here it can be said that every valve replacement surgery and every patient has a different anatomical structure.

It has something to do with the technique of the surgeon during the operation at that time, and also has something to do with the recovery of the patient himself.

All in all, it's a rather complicated situation.How to do it depends on the level of the surgeon, there is no unified conclusion.

Why do many surgeons fear the second valve replacement?The reason is here.

As for the situation Zhou Congwen was facing... Chu Yuntian could see it clearly.The red-white junction does not exist at all, and the red and white under the tricuspid valve are intertwined, which seems to be provocative to the daring surgeon.

The key is that the heart is still beating, opening and closing, which continues to increase the difficulty of the operation.

"In the past, heart surgery was considered a forbidden area. Xiao Chu, do you know why?" Mr. Huang was not nervous, but talked about an old-fashioned stalk.

Chu Yuntian did not laugh at Huang Lao, but replied honestly, "It is because the heart is beating, which increases the difficulty of the operation. If this is the case, the doctors at that time would not be able to complete the operation."

"Well." Huang Lao said, "The current technology has basically overcome this difficulty. If you can do it without the arrest operation, you will definitely not do it. Zhou Congwen, what do you think?"

As he said that, Huang Lao's topic turned to Zhou Congwen, and he asked directly without switching.

"It should be fine, I think it's fine." Zhou Congwen replied very easily.

Chu Yuntian was shocked.

But he knew that in terms of Zhou Congwen's previous operations, it should not be too difficult to perform a second valve replacement operation.

Even with thoracoscopy + heart beating, Zhou Congwen should be able to complete it... right?

But what he said was too easy, which made Chu Yuntian feel very uncomfortable.

If it is a thoracotomy, the problem may be solved in an hour; but if it is a laparoscopic surgery, even if the heart stops beating, Chu Yuntian feels that it will take 1 hours... 2 hours to finish it.

And Zhou Congwen, facing his beating heart, said it so simply, hum!

Chu Yuntian snorted coldly in his heart.

Zhou Congwen just said a word to his boss, and then the endoscopic scissors and electric cautery were sent in along the poking card, and he operated with Director Deng Mingdeng.

Electric coagulation cut, blunt dissociation, beyond Chu Yuntian's expectation, Zhou Congwen did not hesitate at all, as if he was not worried about damaging the patient's heart muscle, he directly began to dissociate and cut off the root of the valve.

Why so fast, did he do this operation before?A hallucination appeared in Chu Yuntian's heart.It seems that Zhou Congwen is not the first time to perform this operation. He knows all the messy and abnormal positions of the patients.

Chu Yuntian's pupils on both sides shrank again, as large as pinpoints, even with a normal dose of atropine, the pupils could not be dilated.

Because he understood, he was astonished to the extreme.

Zhou Congwen's speed was not fast, but he did not hesitate at all, as if he could somehow see the traces left by his boss's operation more than ten years ago.

Following this trace, Zhou Congwen dissociated and cut off slowly.

What's happening here?

Although Chu Yuntian had the idea that Zhou Congwen could "see" Huang Lao's operation more than ten years ago, he knew that this was just an idea, and it could not exist in reality.

Who can clearly remember the details of an operation more than ten years ago?

Even if it was me, I completely forgot the details of the first surgery, the first thoracic surgery, and the first cardiac surgery.

What's more, the operation more than ten years ago was not performed by Zhou Congwen at all, but by Mr. Huang standing behind him.

Even if Huang Lao comes up, he probably won't have any memory of the previous surgery.

how can that be!

Huang Lao nodded slightly when he saw this.

"Zhou Congwen, it went well." Huang Lao said lightly.

"It's okay, boss, your surgical habits have not changed, so my surgery is much simpler. If you come from Changyeluzi to do valve replacement surgery, I guess I have to be more cautious and cautious about this, and it will not go so smoothly."

Zhou Congwen's answer was simple and straightforward, which confirmed Chu Yuntian's idea from the side - Zhou Congwen could indeed "see" the operation performed more than ten years ago!

In fact, he didn’t see it, but Zhou Congwen had a deep understanding of his boss’s surgical habits, and then brought himself into it, what would happen if he performed an operation himself.

Zhou Congwen was not the first time to operate, but he became the operator of the operation more than ten years ago.

This feeling was extremely strange. In an instant, Chu Yuntian's brain seemed to be splitting open, and his headache was about to split.

Is this the tacit understanding of needle removal surgery?Chu Yuntian thought for a moment of the surgery performed at the Mayo Clinic not long ago.

Huang Lao and Zhou Congwen seemed to be operating alone again before his eyes.

Chu Yuntian silently watched Zhou Congwen's operation.

skilled?

This is no longer a simple proficiency, but seems to be a soul exchange. Huang Lao has a young body and is currently undergoing the second surgery of his own valve replacement more than ten years ago.

It felt inexplicably weird, but Chu Yuntian believed for a moment that this feeling actually existed.

Soon, Zhou Congwen cut off the roots of the anterior and posterior tricuspid valves and kept the septal valve.

Huang Lao nodded and got off the high stool with his hands behind his back.

Chu Yuntian was startled for a moment, but then he realized that the most difficult part of the operation had already been completed by Zhou Congwen overnight, and Mr. Huang really had nothing to look forward to.

But what should I do?Should I follow Mr. Huang, ask some technical details, and apologize in due time, or should I continue to watch Zhou Congwen perform the operation?

Chu Yuntian immediately began to hesitate.

Zhou Congwen's operation was not fast, it was rigorous, just like a teaching operation, clean and clear.

This is the hardest part, Chu Yuntian understands.

Some surgeons perform the operation quickly, but it gives people a feeling of panic.But Zhou Congwen is not like this, every step is very clear, with ease.

Is it better to see the operation, or go out with Mr. Huang?

Chu Yuntian began to struggle.

However, his entanglement was only for a moment. Huang Lao did not leave the operating room, but stood beside the equipment nurse with his hands behind his back.

"It's the first valve replacement surgery under thoracoscopic surgery. I'm very nervous." Huang Lao asked gently.

"..." Chu Yuntian was really speechless this time.

Why is Mr. Huang in the mood to chat with the equipment nurse?

Chapter 1117 Such a Simple Surgery

The equipment nurse nodded nervously, for a moment he didn't know whether to look at Zhou Congwen and the operating table, or Huang Lao.

"You are busy with your work." Huang Lao said, "Don't be nervous, Zhou Congwen won't eat you."

Hearing what Huang Lao said, the equipment nurse squinted her eyes and smiled. Director Zou looked up at Huang Lao, then at Zhou Congwen and continued to look at the screen and hold the mirror.

"Next, rinse with 0.9% sodium chloride solution, and remember to suture the transfer valve suture on the tricuspid annulus."

"Otherwise, the operator may lose the connection if he takes it. Just remember this. If you encounter an operator with a bad temper, no matter how unsuccessful the operation is, you may be scolded."

The equipment nurse nodded nervously.

"Use a valve measuring device to measure the valve diameter, because the blood flow velocity of the tricuspid valve is slow, in order to reduce the risk of stuck valve, the current tricuspid valve uses a biological valve, and the stuck valve does not exist."

"Do you know mechanical flaps?" Elder Huang asked leisurely

The equipment nurse shook her head.

Chu Yuntian was speechless, it was really hard to imagine that what was done on stage was such a difficult technique that he had to look up to.

Mr. Huang actually watched Zhou Congwen go to teach the equipment nurse after cutting the tricuspid valve. There was a little nervous and serious atmosphere.

It's like... like... Zhou Congwen is performing an appendectomy.

"If a patient has a mechanical valve installed, it sounds like a clock when auscultating. There is no such sound with a biological valve, so it is easy to distinguish."

Seeing that Mr. Huang spoke softly, the tension of the equipment nurse was relieved a lot.

"Why do you say you are nervous? It's just an operation." Huang Lao chatted with his hands behind his back.

"It's said that Professor Zhou has a bad temper." The equipment nurse explained sarcastically.

"Who said that, I have a very good temper." Zhou Congwen took a break from his busy schedule and replied.

"Zhou Congwen, look, I'm not the only one talking about it." Huang Lao said with a smile, "Be nicer in the future, or everyone will know."

"Boss, I must have had a bad temper when I was a little doctor, because anyone could come up and step on me. But is it different now? Don't worry, I will definitely tighten my tail."

"After double checking by the equipment nurse and the itinerant nurse, the itinerant nurse will open the biological valve on the sterile table, and the equipment nurse will wash the valve three times with 0.9% sodium chloride solution, and then put it in the glutaraldehyde soaking the valve. .”

"As for why you use glutaraldehyde, you can go back and find out yourself. I won't repeat the precautions for using glutaraldehyde."

Chu Yuntian was a little helpless, Huang Lao said that he would stop being long-winded, but...he was too long-winded.What do the elderly think about teaching nurses to use glutaraldehyde?

"If it's a thoracotomy, at this time you use the valve holder to fix the valve and pass it to the second assistant, and pass the short needle to the chief surgeon and the first assistant to suture the valve, and pour water on the valve at the right time to keep it moist."

"But now it's a laparoscopic surgery, and all the instruments are on it. You just use the valve holder to give the valve directly to Deng Ming, and Deng Ming will do the rest of the operation by himself."

Mr. Huang explained to the equipment nurse along the steps of the operation without haste.

There seemed to be a wave of power in his words, hitting people's hearts directly, and calming down the nervous equipment nurse.

"If it is a thoracotomy, after the valve is placed in the proper position, hand the 0.9% sodium chloride solution to the surgeon to wash his hands."

"When tying the knot, push the knotter back, and draw water on the knotted hand of the chief surgeon at the right time. The syringe, preferably 20ml. When pushing, be careful not to cover the surgeon. This point... Cough cough cough, there was one time A little nurse fumbled and slapped me with salt water, but fortunately, she flashed so fast and didn't fall into the operation area."

"I was really angry that time."

"..." The little nurse was taken aback.

"Don't be nervous. I'm just saying that this kind of situation is very difficult to happen. But if you do a lot, you will encounter everything."

"After the knot is finished, rinse with 0.9% sodium chloride solution and observe the opening and closing of the artificial valve."

"Do you know why the equipment nurse has to observe the opening and closing of the artificial valve?" Huang Lao suddenly asked.

"Because I need to pay attention..." The equipment nurse replied according to the normal procedure.

Mr. Huang shook his head, "You don't need to be so formal. I'm not your head nurse. I'm testing your operation. What I mean is that you should pay attention to whether the operation is successful. If it is successful, you can relax and tell a few jokes. If If you fail, just bow your head and work quickly, if you encounter a bad-tempered practitioner, you may be angered."

"Boss, I think you're connoting me." Zhou Congwen laughed.

"Connotation you? Well, the word connotation is better." Huang Lao said, "Will your operation fail?"

"Such a simple operation should not."

Chu Yuntian's mood had gradually calmed down as Huang Lao chatted with the equipment nurse, but when he heard Zhou Congwen say this, he suddenly tightened up again.

Such...simple...operation!

Why is Zhou Congwen so crazy! !

Chu Yuntian slandered in his heart, but then his mouth became dry and astringent.