Animals all over the world love me

To undergo lung tumor resection, the Tibetan Mastiff needs to continue to undergo other examinations, so that Zhuang Mu can further accurately grasp the physical condition of the Tibetan Mastiff.

After the final diagnosis, Zhuang Mu arranged the operation of the Tibetan Mastiff in the morning three days later.

Because the Tibetan Mastiff was too old, Zhuang Mu had to be cautious.

It was arranged three days later in order to adjust the physical condition of the Tibetan Mastiff to the most suitable state for surgery.

People in Zhenchong Hospital were very surprised when they learned that Zhuang Mu was going to operate on an old Tibetan mastiff.

It is well known that whether it is a human or an animal, the older you are, the lower the success rate of surgery and the lower the survival rate after surgery.

Although animal medical treatment is no better than human medical treatment, even if the result of the operation is not good, the harsh punishment received by the doctor will be correspondingly much lighter.

However, given the choice, most doctors will try to avoid all factors that may lead to surgical failure.

This is why no doctor is willing to operate on Hong Shiyao's Tibetan Mastiff.

The lifespan of dogs is not long, so what if the operation is done well, but if it is not done well, there may be troubles.

----

Inside the vice president's office.

"Zhuang Mu, are you sure you want to do lung tumor surgery for Tibetan Mastiff?" Ren Huachuan asked.

"Well, sure." Zhuang Mu nodded.

"Elderly dogs are prone to accidents during surgery, and postoperative complications are easy to cause. Have you thought about these?" Ren Huachuan asked again.

"I thought about it. In fact, as long as the operation is well controlled, the probability of postoperative complications can be greatly reduced. As for the various accidents that may occur during the operation, I will do a detailed preoperative inspection to ensure I know it well. I believe that with my ability, I can do this operation well." Zhuang Mu said flatly, his face brimming with confidence.

"Okay, then I won't say much, let's do it!" Ren Huachuan said with a smile.

In fact, although lung tumor surgery is difficult, general practitioners can do it.At most, there is a difference between the success rate of surgery and the survival rate after surgery.

And the old age of the affected dog is not a particularly big problem.

The reason why Ren Huachuan paid more attention this time is mainly because pet owners who can generally afford a large bulldog like a Tibetan mastiff and travel to many hospitals to seek treatment for the old Tibetan mastiff must have good financial strength.

Moreover, people who like to raise Tibetan mastiffs must have a hardline personality.

If the operation is successful, everyone will be happy, but if it fails unfortunately, a tough and rich pet owner is really not sure what will happen.

However, Ren Huachuan still has great confidence in Zhuang Mu.Since Zhuang Mu said he could do it, he chose to believe it.

Even if there is an accident in the operation, at worst, I will help Zhuang Mu carry it together.

Having been in the industry for decades, Ren Huachuan still has a lot of experience in dealing with doctor-patient disputes.

After leaving the vice president's office, Zhuang Mu walked slowly back to his consulting room.

I just ran into Wu Zhexiang on the road.

Or, to be more precise, Wu Zhexiang came here specifically to find him.

"Doctor Zhuang, can I ask you a favor?" Wu Zhexiang asked.

"Tell me." Zhuang Mu was a little puzzled, and after a pause, he nodded.

"That's right, I want to be your assistant for the Tibetan Mastiff lung tumor resection operation." Wu Zhexiang said.

"You, will you be my assistant?" Zhuang Mu was taken aback for a moment, a little suspicious that he had heard it wrong.

"Yes, can you?" Wu Zhexiang nodded.

"Of course you can. But why did you suddenly think of being my assistant?" Zhuang Mu asked.

Wu Zhexiang suddenly said that he would be his assistant, Zhuang Mu was still a little surprised.

After all, Wu Zhexiang is considered an old man in the South Campus.

In Zhenchong Hospital, a doctor of Wu Zhexiang's level can already be the chief surgeon.Therefore, under normal circumstances, they are not very happy to be assistants to other doctors.

Even if he wanted to be an assistant, he would still be an assistant to the famous doctors of the North Hospital.

"I want to learn from you up close." Wu Zhexiang said.

Zhuang Mu was a little stunned after hearing this.

Wu Zhexiang was so frank, he felt a little embarrassed.

"Okay, come here on time at seven o'clock in the morning on the 25th! Let's have a preoperative meeting then." Zhuang Mu scratched his forehead and said with a smile.

"Okay." Wu Zhexiang nodded.

----

The etiology of hypertrophic pulmonary osteoarthropathy is often related to primary or metastatic lung tumors.

Because of lung disease, the vagus nerve is excited, resulting in a rapid increase in the blood flow into the lower limbs, causing local passive congestion, causing periosteal hyperplasia of the phalanges or metatarsal bones, and will continue to develop to the upper end.

However, hypertrophic pulmonary osteoarthropathy is only a small problem. As long as the tumor is successfully removed, the bone hyperplasia will stop.

At that time, just do some repair surgery on the line.

Of course, this Tibetan mastiff is too old after all.Even with revision surgery, it is unlikely that the bone hyperplasia will return to its original state.

----

Three days passed in a flash.

At seven o'clock in the morning on the 25th, Zhuang Mu and Wu Zhexiang arrived at Zhenchong Hospital on time.

The two held a preoperative meeting in the consulting room.

"Judging from the situation on the film, it is estimated that the tumor should adhere to the chest wall or ribs. After the tumor is removed, chest wall reconstruction may be required." Wu Zhexiang pointed to the X-ray photo on the light box and said.

Zhuang Mu nodded after listening. To be honest, he felt more at ease with Wu Zhexiang as his assistant.

Although, animal surgery is not as strict as human surgery.However, an experienced assistant is undoubtedly of great help to improve the success rate of the operation.

After all, no one can predict what will happen during the operation.

Zhuang Mu didn't dare to say that he could completely control the entire operation process.

After the preoperative meeting, Zhuang Mu, Wu Zhexiang and another assistant entered the operating room together.

If it is a human operation, then an entire surgical team is required. Major operations generally include anesthesiologists, chief surgeons, first assistant physicians, second assistant physicians, third assistant physicians, itinerant nurses, and hand washing nurses.

For minor and medium operations, the number of corresponding assistants will be reduced.

However, in any case, the division of labor of the entire surgical team is very strict.

And because of staffing reasons, the division of labor in animal surgery is relatively less clear.

Therefore, whether it is the chief surgeon or an assistant, there are more problems that need to be taken into account during the operation.

----

operating room.

Everything is ready.

Zhuang Mu held the scalpel and prepared to start the operation.

Because the tumor in the Tibetan mastiff was in the middle lobe of the lung, Zhuang Mu chose to open the surgical access in the sixth intercostal space on the right.

After performing the intercostal incision, Wu Zhexiang immediately used a chest opener to expand the incision to make the operative field clearer.

Observing that the tumor had indeed adhered to the chest wall, Zhuang Mu had no choice but to cut off the ribs to provide more room for the next tumor resection.

After the wound was opened, Zhuang Mu carefully peeled off the tumor from the chest wall.Then, the lung lobe to be removed is wrapped with gauze soaked in saline and moved to the wound.

The next operation was actually a lobectomy, and Zhuang Mu had done it many times, so he was already familiar with it.

Separate the adhesion between the lung lobe and the pleura, and confirm the direction of the pulmonary artery and pulmonary vein accompanying the bronchi.

Then, proceed to dissect the blood vessels on the lung lobe using blunt-tipped scissors.

……

Zhuang Mu was doing every step of the lobectomy methodically.

Soon, he removed the tumor and the adherent lung tissue near the tumor.

----

The demonstration classroom next door.

A group of doctors were watching Zhuang Mu's operation inside.

Because Ren Huachuan was also present, everyone was very quiet, unlike before, discussing while watching.

Although Ren Huachuan had confidence in Zhuang Mu, he couldn't help but come to see the operation process with his own eyes before he could rest assured.

He nodded secretly while looking at the screen.

Zhuang Mu's method of peeling off the tumor from the chest wall just now was steady and fast.

Seeing Zhuang Mu's actions, he let go of a lot of stones in his heart.

Fu Yu was also in the classroom, sighing secretly while looking at the screen.

In fact, he also wanted to have surgery with Zhuang Mu.It's just because of face, he really can't say this idea.

In fact, it is a very cool thing to be able to learn from a doctor with excellent medical skills.

The things that can be learned from the side of big boss doctors are definitely more than self-study.

It's a pity that in Zhenchong Hospital, because the doctors in the North Hospital knew what Chu Shanxing was planning, they were reluctant to take the initiative to bring low-level doctors to the operating table to learn.

The doctors in the North Hospital have trained their own team, and once determined, they will not change easily.

Therefore, if the young doctors in the South Hospital want to learn, at most they will go to the demonstration classroom to see the operation.

However, watching the screen and participating in the scene are completely different things.

Thinking that Wu Zhexiang was in the operating room at this moment, Fu Yu felt a little uncomfortable.

----

operating room.

After bandaging to stop the bleeding, Zhuang Mu put the lungs back into the chest cavity of the Tibetan Mastiff. Just as he was about to do the final abdominal closure, the Tibetan Mastiff suddenly had difficulty breathing.

"Pulmonary embolism?" Wu Zhexiang frowned.

Zhuang Mu looked at the electrocardiogram and found that the P wave increased, and the QRS complex showed the waveform of right ventricular hypertrophy.

Suddenly, a thought flashed through his mind.

In the next second, he put his hand into the chest cavity of the Tibetan mastiff, bypassed the lungs, and gently pressed on the right ventricle of the Tibetan mastiff.

really!

"It's cardiac insufficiency caused by pulmonary valve stenosis," Zhuang Mu said.

----

In the classroom.

When Ren Huachuan saw that there was an accident during the operation, he couldn't help but thumped in his heart.

In fact, with his qualifications, it is unlikely that he would feel flustered because of an accident during the operation.

It can only be said that Zhuang Mu's position in his heart is too important.

Therefore, it is inevitable that concern will lead to chaos.

"If there is pulmonary valve stenosis, shouldn't the right ventricular channel expansion operation be performed first, and then the tumor resection be performed?" A doctor asked doubtfully.

"Yes! Otherwise, it would be easy to die due to breathing difficulties." Another doctor said.

"Doctor Zhuang missed it, right? Otherwise, he should have opened the surgical access from the front just now. Then the pulmonary artery and the tumor can be treated at the same time." The previous doctor continued.

"Minor pulmonary stenosis has no clinical symptoms." A general practitioner who has practiced for five years glanced at them coldly.

"Don't open your mouth if you don't understand." Fu Yu took over the words and said.

The two doctors just now were interns, and because they had heard of Zhuang Mu's name for a long time, they came here to observe him.

The two interns were cocked by Fu Yu and the others, and they quickly shut their mouths.

At the same time, taking a peek at Ren Huachuan, he secretly regretted that he shouldn't have spoken casually.

In fact, they mainly spoke just now to impress Ren Huachuan.

It's just that it's not enough to show off your knowledge, but it shows that you are not good at learning.

Ren Huachuan didn't feel much about their actions just now.

He had seen a lot of fledgling young doctors trying to express themselves.

----

operating room.

"Then what do we do now?" Wu Zhexiang asked.

"Just expand the outflow channel of the right ventricle." Zhuang Mu replied.

"I know, but shouldn't the supine position be used for right ventricular outflow channel reconstruction?" Wu Zhexiang was taken aback.

"You can also lie on your right side, but it will be a little more difficult." Zhuang Mu said.

The corner of Wu Zhexiang's mouth twitched slightly after hearing this, it's not just a little more difficult, is it much more difficult?

Cardiovascular surgery itself is a difficult operation.

Even right ventricular outflow channel reconstruction can only be regarded as an entry-level procedure in cardiovascular surgery.But in any case, it is also a middle-level operation.

Moreover, they usually open the surgical access from the middle of the chest for this type of surgery.

As the saying goes, it is better to be cooked than to be raw.

It is not easy to perform surgery in the supine position, let alone in the lateral position.

Of course, this is just the clinical experience of ordinary doctors like them.

For Zhuang Mu, a doctor who is obviously close to evildoers, Wu Zhexiang just muttered a few words in his heart, and immediately agreed with Zhuang Mu's thoughts.

After all, the thoughts of the great gods are beyond their comprehension by these little shrimps.

Since Wu Zhexiang decided to learn from Zhuang Mu, he has adjusted his mentality.

Unlike Fu Yu, he didn't have so many thoughts in his mind, he just wanted to improve his medical skills.

Immediately, under Zhuang Mu's instructions, he began to cooperate with Zhuang Mu to perform channel dilation surgery on the Tibetan Mastiff's right ventricle.

Zhuang Mu put his hand into the chest cavity of the Tibetan Mastiff, carefully adjusting the position of the heart.

He had to take care of many things, besides the right lung that had been resected just now, there were also various closely connected tissues and blood vessels in the chest cavity.

There is a reason why you choose the supine position for heart surgery, because you can see the heart very intuitively, and it can also avoid touching other organs during the operation.

The lateral position is completely different. Once the position changes, many things have to be reconsidered.

Zhuang Mu's clinical experience is indeed amazing, but in a short time, he adjusted his heart to the best position for right ventricular outflow channel reconstruction.

Once the heart is in place, the rest is much simpler.

After Zhuang Mu blocked the blood circulation of the right ventricle, he made a longitudinal incision across the annulus in the outflow channel of the right ventricle, and cut off the hypertrophic muscle of the outflow channel to fully dredge the channel.

Then, the thickened atresia pulmonary valve was resected, and the channel was widened with a single valve artificial vascular patch.

In order to widen the channel as much as possible, Zhuang Mu specially cut the annulus patch into a snake head shape.

After confirming that the outflow channel of the right ventricle was unobstructed, Zhuang Mu reopened the blood circulation of the right ventricle.

"It's done." Zhuang Mu said with a smile.

Wu Zhexiang watched the whole operation process, and suddenly had an illusion that this operation is so simple!

Three seconds later, he woke up.

The reason why he thought the operation was easy was because Zhuang Mu performed it too quickly and smoothly.

In fact, right ventricular outflow channel reconstruction is not difficult if performed in the supine position.

But the problem is that Zhuang Mu is using the side lying position this time, and because the Tibetan mastiff has just had a tumor removed, coupled with his old age and frailty, the combination of various factors has added a lot of difficulty to this operation.

"Doctor Zhuang, have you practiced right ventricular outflow channel reconstruction in this position before?" Wu Zhexiang asked.

"No, I'm used to lying on my back," Zhuang Mu said.

Me too!Wu Zhexiang strongly agrees.

only……

Wu Zhexiang asked himself, if he is given three days, he is 80.00% sure that he can find a suitable surgical access to complete the reconstruction of the right ventricular outflow channel while lying on his side.

But, it's the first time I do it, and it's so fast...

----

show the classroom.

"It's the first time!" one of the two interns just now exclaimed.

Ren Huachuan couldn't help showing a smile on his face.

Fu Yu secretly tugged at the corner of his clothes, with a serious expression on his face.