medical road high rise

Chapter 184 Excess Thrombosis

Chapter 184 Thrombosis

Qin Feng directly separated the trunk of the great saphenous vein with curved forceps, and then came to a very important step.

"Cut off a branch of the great saphenous vein."

In this step, once there is a mistake or the blood vessel ruptures, fatal situations such as inseparability and bleeding will occur during blood vessel transplantation.

"Vascular clamp."

Qin Feng reached out for the device, blocked the blood vessel, and the vein trunk along the great saphenous vein began to separate.

In the great saphenous vein, there are branches such as the superficial circumflex iliac vein, superficial abdominal wall, and superficial external sound part. To find these branches, they must be ligated and cut off one by one before the branches of the great saphenous vein are considered complete.

Fortunately, finding branches and ligating and cutting them off is a piece of cake for Qin Feng, so naturally he didn't waste time on it.

"It's time to intercept the great saphenous vein." Qin Feng reminded.

Everyone nodded, all focused on it.

Qin Feng picked up the scalpel, and directly peeled it off under the surprised eyes of everyone.

"Fuck, Brother Qin, why don't you just peel off the connective tissue instead of dealing with it?" Zhao Qi spoke first.

This kind of direct stripping of blood vessels is prohibited in the Department of Vascular Surgery. After all, you can think about it. When you strip the blood vessels, because the connective tissue is not processed, you can see dense connective tissue when you pull the blood vessels, which makes you panic.

Qin Feng didn't answer Zhao Qi's words, and continued to do what he was doing, directly removing a piece of blood vessel connected with connective tissue and placing it in the tray.

"Wait, this doesn't seem to be a direct peeling, but a blood vessel peeling technique. I kind of forgot the name." Zhao Qi's eyes widened.

Qin Feng smiled and said: "Yes, this is the new foreign surgical No-touch technology, which is used to intercept blood vessels, which can greatly reduce the incidence of blood vessel stenosis, and the success rate of blood vessel transplantation will also increase."

"But, Brother Qin, your blood vessels seem to have been cut a little longer." Zhao Qi said.

"This is not truncated. This is the requirement of this technology. After the great saphenous vein is taken out from the body, it will retract. If it is as long as expected, it will be found to be shorter when it is anastomosed in the body. One section, generally 2-3cm longer than the expected length is better." Qin Feng explained.

Zhao Qi nodded half-understood, Qin Feng looked at Zhao Qi, a little funny said: "When the time comes, I will teach you."

"Thank you Brother Qin." Zhao Qi's eyes sparkled.

Qin Feng took the heparin saline handed over by Lin Xue, which was poured directly into the great saphenous vein to detect whether there was infiltration in this section of the great saphenous vein.

Heparin saline was injected into it, and Qin Feng ligated it. With the increase of heparin saline, the great saphenous vein filled up, and it became vigorous and swollen from a shrunken appearance.

After observing for about 1 minute, Qin Feng found that no infiltration had occurred, so he put the great saphenous vein into diluted heparin saline for temporary storage.

"Qin Feng, the next step is the subcutaneous tunnel, right?"

"Ah."

The role of the subcutaneous tunnel is similar to that of the venous channel. A channel is opened at the thrombus and inserted into the great saphenous vein to connect the thrombus with the lateral upper arm vein.

The position of the opening has been fixed by Qin Feng before, and there is also a general direction made by a marker on it. Qin Feng can just follow the marked line.

Incisions of about 3 cm were made at the thrombus site and the upper arm vein on the outside, and then the two incisions were turned towards each other, and a U-shaped subcutaneous tunnel was quickly formed between the two skin incisions.

"Preparing for saphenous vein anastomosis."

Zhao Qi quickly took out the great saphenous vein in the heparin saline, and Qin Feng pinched off the blood vessel connecting the thrombus site and the upper arm vein again.

With the unfolding of the great saphenous vein, Qin Feng stuffed it directly into the subcutaneous tunnel after seeing that the blood vessel was not twisted.

Both ends should be anastomosed separately, one end should be connected to the thrombus site, and the other end should be connected to the perforating vein.

Because there is a certain gap between the great saphenous vein and the two blood vessels, Qin Feng trimmed the great saphenous vein. The place where the great saphenous vein connects to the upper arm vein was thinned by 12.00mm before it successfully anastomoses with the upper arm vein.

After finishing this step, Qin Feng let out a sigh of relief.

The anastomosis of blood vessels sounds simple, but it is still very tiring to do. After all, blood vessels are so thick and thin, and bleeding and penetration may occur if there is a slight deviation.

"Open upper arm vein."

Hearing Qin Feng's command, Zhao Qi opened the upper arm vein, and the blood in the vein poured into the great saphenous vein, and the blood vessel began to pulsate regularly.

At the anastomosis, there was obvious tremor, but fortunately, there was no bleeding.

"The fit is good, take the thrombus directly." Qin Feng breathed a sigh of relief.

"I'll go, there must be too many blood clots."

"It's densely packed, at least there are hundreds of pieces."

Zhao Qi and Lin Xue exclaimed in surprise.

Before Qin Feng breathed a sigh of relief, in Zhao Qi's opened blood vessel, there were black blood clots in the blood vessel densely like a long snake.

Because of excessive thrombus, the vascular endothelium at the thrombus site is also severely damaged, blood flow slows down, and blood viscosity also increases.

The densely packed small thrombus is formed because the large thrombus is not treated, which leads to the continuous washing and falling off by the blood flow.

But Qin Feng has to deal with these small thrombi, otherwise they will slowly form a large thrombus, which will fall off again, resulting in more and more small thrombi.

Although small thrombi and thrombus fragments will not affect large blood vessels, they will directly block capillaries when they enter capillaries.

It’s okay if the number is small, but if the number is too large, the capillaries will be blocked, let alone surgery, you can just wait to die.

Taking the thrombus is also a technical job for Qin Feng, so it must be fast and accurate.

Taking a deep breath, Qin Feng adjusted his emotions, lowered his head with a serious expression and started the operation.

Firstly, the cephalic vein at the elbow was cut, and then the cephalic vein near the heart was clamped with vascular blocking forceps to prevent intraoperative bleeding and effectively prevent thrombus from being washed into other blood vessels during thrombectomy.

"Zhao Qi, remember to press the anastomotic vein."

Zhao Qi nodded, and carefully pressed on the vein at the anastomosis.

"Brother Qin, what do you need?" Lin Xue asked.

Although Lin Xue knew the equipment for removing thrombus, but with so many blood clots, conventional thrombus removal equipment would definitely not work. It only depends on whether Qin Feng has any good ideas.

"F5-Fogarty balloon catheter."

Qin Feng thought for a while, and said the name of the equipment he needed.

Lin Xue recalled this instrument instantly in her mind. Fortunately, Lin Xue had sufficient preparations, and all kinds of catheters were prepared, so there would be no shortage of instruments during the operation, but it would not lead to bloated instruments.

This is an excellent equipment nurse, which can save the operator a lot of time.

(End of this chapter)