Auto chess in the operating room

Chapter 311 Still Became Professor Liu's Doctoral Student

In the operating room, when the temperature of the nasopharynx of Tang Lou and others dropped to 32°C, he immediately issued an order:
"Block the aorta and the superior and inferior vena cava, and perfuse the aortic root with HTK solution to protect the myocardium."

First Assistant Director Qian Gang immediately began to cooperate, and the nurses also provided perfusion fluid at the same time, and the whole operation was arranged in an orderly manner.

Tang Lou continued to clarify the details of the operation: "Perfuse HTK solution at 4°C with a single perfusion dose of 30 ml/kg. During the perfusion process, use a suction tube to suck away the HTK solution from the coronary sinus, and start the perfusion pressure at about 100 mm Hg. After cardiac arrest, the perfusion pressure decreased to about 50 mm Hg, and the total perfusion time was 6 minutes."

"Okay, Doctor Tang."

Under Tang Lou's clear instructions, the rest of the medical staff began to follow suit. In the observation room, several doctors were envious of their strong ability to control the field.

Only then did Tang Lou look up at the monitor, and explained to Professor Liu Juzi on the other side of the screen:

"Conventional cold-blooded cardioplegia is not impossible, but because it requires multiple infusions, it has certain risks and increases the difficulty of the operation. So I used a more optimized HTK solution."

"HTK solution was invented by German Professor Bretschneider and his colleagues in 1975, and was improved in 1979 by adding histidine/histidine salt buffer system and α-α-ketoglutarate on the basis of low sodium and microcalcium. ,"

"The "balance effect" is a remarkable feature of HTK solution. It can completely perfuse the intravascular space and tissue space, and finally lead to the balance of temperature, ion and oxygen metabolism inside and outside the cells. It is desired to achieve a better perfusion effect. Because the cells It takes 3-5 minutes for internal and external ion balance, 2-4 minutes for internal and external temperature balance of cells, and 5-7 minutes for oxygen metabolism balance. Therefore, when the perfusion time of HTK solution is maintained for 6-8 minutes, the best myocardial protection effect can be achieved.

Moreover, the biggest advantage of HTK solution is that it only needs to be infused once to achieve the myocardial protection effect for 2~3 hours. It is convenient, long-lasting and does not affect the operation of the surgeon. The only disadvantage is that it is relatively expensive. "

After listening to Tang Lou's analysis, Professor Liu Juzi was silent for a while. She didn't know the shortcomings of cold-blooded cardioplegia, but since learning this technique, she has been operating according to the industry's gold standard. It seems that as long as the proficiency is improved, it can be avoided as much as possible for a veteran like her, and she is even proud of making up for the shortcomings of the technique with her own skills.

She never thought that she could directly replace it with HTK solution like this. Based on her clinical experience, she knew that this small step directly reduced the difficulty of this operation by an order of magnitude.

After one infusion of HTK solution, there is a 2-3H myocardial protection effect, which makes it possible for many attending physicians to operate this operation.

For the hospital, being able to carry out this operation several times at once is undoubtedly a great boon for patients who are hard to find.

"Doctor Tang, you are doing very well."

Professor Liu praised it sincerely.

In the operating room, Tang Lou devoted himself to the next operation, began to cut the left atrium longitudinally along the inter-atrial groove, and started the ablation route of the left atrium.

Seeing Tang Lou's operation on the screen, the doctors in the observation room were amazed.

Especially Tanglou’s switching and connection between bipolar ablation forceps and single-stage pen.

For the ablation of the isthmus of the left atrium, the bipolar ablation forceps could not reach the mitral annulus, so Tang Lou switched to a monopolar radio frequency pen for "supplementary ablation" to make the ablation line reach the mitral annulus.

Afterwards, the heart is turned upwards, and the ablation line of the mitral valve isthmus is extended by using a monopolar pen on the epicardium to fully ablate the coronary sinus.

"Suture Scalpel"

After completing the ablation of the main body, Tanglou began to treat the left atrial appendage.

Soon Tang Lou completed the excision, suture, suturing, ligation, and inner suturing.

After 10 minutes, Tang Lou completed all the ablation lines.

"One help, complete the valve forming."

Tang Lou issued an order.

Qian Gang was slightly taken aback, and the rest of the doctors in the observation room were also slightly taken aback.

Usually, after the main operation is successfully completed, the remaining small work of valve formation is a gift from the chief surgeon.

However, the current situation is that Yizhu is Director Qian Gang.

Tang Lou was also a little guilty, and whispered, "I'm not very skilled in valvuloplasty."

Qian Gang glared at Tang Lou, I believe you are a ghost!
The Cox maze IV surgery has been done so fast, this little valve can't be formed yet?
However, Director Qian Gang is in a very good mood now, and his hands are really itchy, so he took the initiative to take over this small job.

Tang Lou is very innocent in success and failure, and he really doesn't know how to make valves.

Another 10 minutes later, the entire operation was officially completed.

"Clap clap clap!"

In the observation room, Professor Liu Juzi took the lead in applauding, and Director Huang was also unsatisfied, and some of them were hesitant to talk.

Deputy Director Qian immediately understood, licked his face and said to Director Qian Gang: "Director Qian, after the video of this operation, can you send it to me so that the young doctors in our department can study hard."

Director Qian Gang was really flattered to hear that the director of the Cardiovascular Department of Zijingang Hospital even asked for the video of the operation.

"Of course, of course."

Director Qian Gang immediately nodded. It has to be said that Tang Lou really improved the status of the Cardiovascular Medicine Department of Hecheng First Hospital by himself, with only one operation.

When Director Huang and Deputy Director Qian were playing Tang Lou's surgery video, Professor Liu Juzi directly thought about Tang Lou's idea.

"Director Qian, like this, after the operation is over, I want to have a video conference. I want to invite Dr. Tang Lou to share his experience with our department doctors. The improvement of this operation method is really shocking. .”

"Of course!"

Qian Gang had a dignified face, but he was already happy in his heart.

"Okay, let's connect via video later."

Liu Juzi quit the video directly, and then thought about going back to the office to dress up a bit.

"Professor Liu, who do you think needs to participate in the video conference?"

Director Huang was a little unclear about Professor Liu's thoughts, and asked sideways.

"Ah, no need, you all go away. If you are a doctor with spare time, you can ask for Dr. Tang's video later to study and study. After that, I will communicate with Tang Lou in person."

Liu Juzi ruthlessly declined the participation of the others, and then walked towards her office with a light figure.

Director Huang and the others were left bewildered.
It’s not that I agreed to share it with everyone, I, Lao Huang, also have a lot of questions for Tang Lou.

On the contrary, the delicate deputy director Qian Zheyu rolled his eyes, and a thought flashed: "Director Huang, do you still remember that Professor Liu is still short of a doctoral student?"

Director Huang blinked a pair of ox eyes, and glanced at the back of Qian Zheyu's somewhat sparse head from the corner of his eye. You can think of it all, you deserve to be bald!
At this moment, Professor Liu Pingguo is leading Ma Shuya to make rounds.

Suddenly, the cell phone rang. Seeing that it belonged to my elder sister, Liu Juzi immediately answered the call: "Hello, elder sister."

"Apple, have you told him what I told you about rejecting Tanglou?"

Liu Pingguo didn't understand, so I didn't know why my sister asked such a question, so I could only answer truthfully: "I don't have the nerve to tell Tang Lou that the recommendation failed, and I have to face it, old lady, but I said you really don't think about it, Tang Lou Really excellent."

But before Liu Pingguo finished speaking, there was a hearty chorus from the other end of the phone, and then said coldly: "What I told you that day, just pretend it never happened, don't let my obedient student Tang Lou know .Did you hear me!"

Without giving Liu Pingguo a chance to respond, Liu Juzi hung up the phone directly.

Liu Apple: "Meow meow?"

Are you hallucinating yourself?
At this time, the nurse waiting on the side urged: "Professor Liu, why hasn't today's doctor's order come out for so long, hurry up!"

Liu Pingguo was depressed, and drove the car angrily: "Why don't you say speed up when you are with your husband?"

Nurses are easy people: "But the critical moment should be fast or fast"

Professor Liu: "."

The well-behaved and sensible Ma Shuya's eyes lit up, alas!
Seeing Professor Liu being deflated, the experienced nurse teased, "Professor Liu, my mouth was worn out last night just to get my husband to buy me a bag. Guess what I said?"

Ma Shuya asked curiously, "What did you say?"

Professor Liu shook his head, and tapped Ma Shuya's head: "What are you talking about with her, what else can you say, of course you didn't say anything."

"what?"

Ma Shuya rubbed her brain, suddenly, her eyes lit up again, hell!
　Hahaha, I just want to drive a car, and soon I will go to Hangzhou to develop drugs and make a fortune
　　
　
(End of this chapter)