With Chen Cang''s order.


    All the medical personnel are preparing for the war.


    "Deep vein catheterization is over!"


    "The monitor is over!"


    "The blood is ready!"


    ……


    The anesthesiologist is not the director of the anesthesiology department, but Zhou he!


    Zhou he is good at anesthesia for cardiovascular surgery and has a good grasp of patients. If it weren''t for the struggle of the Department, he might have been a director in the original hospital.


    Wu Tongfu personally invited him here and was also a candidate for the anesthesia department.


    To keep the patient in the lateral position, the whole side of the heart needs to be exposed and a one meter long arc incision needs to be made!


    Because there are many branches of thoracoabdominal artery to be replaced, at least six anastomoses shall be made for intercostal artery supplying spinal cord, bilateral renal artery, celiac trunk, superior and inferior mesenteric artery, bilateral common iliac artery!


    After Chen Cang drew the line, the wound almost split a person.


    Start from the third rib of the left axillary midline, bypass the anterior chest area, go down to the center of the sternum, straight to the lower navel, and then to the anterior superior iliac spine.


    The length of the whole incision looks very ferocious!


    Moreover, the most important thing is that patients have no time to do accurate examination methods such as CT, Mr, X-ray and angiography.


    It is very difficult to complete the operation accurately only by echocardiography, ECG and X-ray examination.


    Zhou he couldn''t help asking, "Dr. Chen, do you want to do hypothermic cardiopulmonary bypass?"


    This problem has become the first problem in front of everyone!


    Is hypothermic cardiopulmonary bypass used?


    If used, it means that the complications of cardiopulmonary bypass, including bleeding, brain and lung complications, greatly increase the mortality of postoperative patients.


    However, the total thoracoabdominal aortic replacement surgery performed by some heart centers is very traumatic, time-consuming and uses a lot of blood!


    If it is performed with the assistance of cardiopulmonary bypass and deep hypothermic circulatory arrest, it can effectively reduce the risk of surgery and ensure the stability of surgery.


    The first contradiction baffled everyone.


    Chen Cang handed the marking pen to ge Huai and shook his head: "using normal temperature non cardiopulmonary bypass technology, block the operation in sections!"


    Zhou He nodded and immediately began to prepare.


    He doesn''t need to doubt Chen Cang''s technology. Chen Cang is the only handsome in this war!


    Even if the emperor came to the battlefield, he could only be used as a "mascot" to watch the commander arrange troops!


    Wu Tongfu said nothing from beginning to end. Everything depends on Chen Cang.


    As we all know, once the normal temperature off-pump technology is carried out, the survival probability of patients will increase, but the pressure of the surgeon will increase geometrically.


    Especially when dealing with thoracic aortic replacement, the beating of the heart and the progress of circulation will become an obstacle to the operation.


    This requires the surgeon to have enough ability!


    Zhou he never doubted Chen Cang, at least not now.


    But Li Baoshan and Xu Ziming wanted to stop talking.


    Finally clenched his fist and decided to fight!


    That''s it


    The moment Chen Cang took over the scalpel also means that the operation officially began!


    The incision is very long. It does not need to be exposed all at once. It needs to be carried out gradually according to the operation stage.


    However, the patient is an exception. The operation must first carry out end-to-side anastomosis of iliac artery, so as to ensure that during the regional operation of ascending aorta, ischemia and necrosis caused by blocking blood in areas such as kidney and abdominal organs can be avoided.


    In this way, the large blood vessels in the chest must be treated, so the operation may require a large-scale operation to fully expose all the thoracic and abdominal aorta.


    Actively take all rescue measures!


    In case of rupture of ascending aorta during operation, it can be stopped in time.


    End to side anastomosis of bilateral iliac artery artificial blood vessels has become the first step of the operation!


    Different from simple abdominal aortic replacement, it is necessary to establish a retrograde blood perfusion pathway of descending thoracic aorta, artificial vessel and left iliac artery, so as to ensure the blood supply of other organs when anastomosing intercostal artery, abdominal artery and lower limb artery.


    However, in this way, the operation time needs to be accurately controlled, and the time for anastomosis of blood vessels and artificial blood vessels is very limited.


    With the help of Li Baoshan, the abdominal tissue forceps controlled the surrounding surgical field. Xu Ziming exposed the location of the aortic aneurysm and began to separate the surrounding abdominal omentum layer by layer.


    At this time, Chen Cang gave Ge Huai a series of instruments such as probe, separation forceps, scalpel and curettage spoon.


    "Take it for me."


    After that, Chen Cang took the lead in getting a scalpel.


    The doctors around looked at Chen Cang holding so many things at a loss. What are you doing?


    Even the instrument nurses feel a little blushed. Does this mean they don''t trust themselves?


    However, after the operation began, we realized that Dr. Chen may really need someone who can quickly deliver his instruments anytime, anywhere.


    When Xu Ziming separated the area of aortic dissection.


    A dissecting aneurysm with a length of seven or eight centimeters appeared in front of everyone. Chen took a deep breath.


    "Block!"


    After that, quickly start cleaning, cut open the aorta and start cleaning the tumor cavity.


    The whole process is fast and accurate!


    At this time, Chen Cang constantly changed instruments in Ge Huai''s hands.


    While probe, while tweezers, while separation forceps, while scraping spoon.


    Even Wu Tongfu was blinded by Chen Cang''s operation!


    Is this... A little exaggerated?


    But when Li Baoshan saw it, he was a little shocked.


    Because he found that Chen Cang''s choice seemed to be the best choice.


    He can always clean things with the most appropriate equipment.


    It looks simple, even troublesome!


    However, in this way, it can undoubtedly effectively complete the cleaning and even better protect the intima of blood vessels.


    Li Baoshan cooperated carefully, while Xu Ziming stared at every step of Chen Cang''s operation.


    Dare not relax at all.


    At this time, the instrument nurse was stunned.


    Because she found that Dr. Chen didn''t look down on himself, but because he needed to change the equipment quickly at any time.


    Even... She felt that what Dr. Chen needed was a special instrument nurse.


    Otherwise, it''s not enough to maintain his operation.


    Ge Huai is very involved at this time!


    Originally thought Chen Cang called himself to take the equipment because he didn''t look up to or humiliated himself.


    Now it seems that this is not the case!


    Compared with the people around him, Ge Huai found that... It seems that he can only do such a job.


    Moreover, his angle can even just see Chen Cang''s operation.


    Think carefully, in fact, Chen Cang is helping himself!


    For a time, Ge Huai also had mixed feelings.


    However, he didn''t dare to think much. Since Chen Cang helped himself so much, he had to do his own job!


    Hand over the equipment!