When the Doctor Uses A Hack
Chapter 1136 - 1139: Chen Cang Must Have a Profound Meaning

With Chen Cang's command,

All medical personnel entered a state of readiness.

"Deep venous cannulation complete!"

"Monitor ready!"

"Blood preparation complete!"

...

The anesthesiologist was not the head of the anesthesia department, but Zhou He!

Zhou He excelled at anesthesia for cardiovascular surgery and had a good grasp of patient care, and would have been the head of the department had it not been for departmental struggles.

He was personally invited by Wu Tongpu, and he also is a candidate for the anesthesia department.

The patient was kept in a lateral position, needing to expose the entire heart area for a curved incision one meter in length!

Because many thoracoabdominal aortic branches needed replacement, including intercostal arteries supplying the spinal cord, bilateral renal arteries, celiac trunk, superior and inferior mesenteric arteries, and bilateral common iliac arteries, at least six anastomoses had to be made!

After Chen Cang marked the incision, the wound seemed to split a person open.

Starting from the left axillary midline at the third rib, wrapping around the chest to the front, down along the sternum's center directly below the navel, then to the anterior superior iliac spine.

The entire length of the incision looked ferocious!

Moreover, the most crucial part was that the patient had no time to undergo precise examinations like CT, MR, X-ray, or angiography.

Just relying on echocardiography, electrocardiogram, and x-ray examinations to precisely complete the surgery was very challenging.

Zhou He couldn't help but ask, "Dr. Chen, should we use hypothermic cardiopulmonary bypass?"

This question became the first major issue at hand!

Whether to use hypothermic cardiopulmonary bypass?

If used, it would mean an increased risk of complications from the cardiopulmonary bypass, including bleeding, and brain and pulmonary complications which could significantly increase postoperative mortality.

However, some heart centers that carry out thoracoabdominal aorta replacement surgery face huge trauma, long duration, and high blood usage!

If assisted by cardiopulmonary bypass under deep hypothermic circulatory arrest, it can effectively reduce the risk of surgery and ensure the stable progress of the procedure.

The first contradiction stumped everyone.

Chen Cang handed the marking pen to Ge Huai and shook his head, "Use normothermic non-cardiopulmonary bypass technique, and segmentally block during surgery!"

Zhou He nodded and immediately began preparations.

He had no need to doubt Chen Cang's skills; in this battle, Chen Cang was the sole commander!

Even if the emperor himself came to the battlefield, he could only act as a "mascot," watching the commander deploy his troops!

Wu Tongpu didn't utter a word from beginning to end, clearly leaving everything up to Chen Cang.

Everyone knew that once the normothermic non-cardiopulmonary bypass technique was used, the patient's chances of survival might increase some, but the pressure on the lead surgeon would grow exponentially.

Especially during a thoracic aorta replacement surgery, the heart's beating and circulation would hinder the operation.

This required the lead surgeon to have sufficient capability!

Zhou He had never doubted Chen Cang, at least not now.

Li Baoshan and Xu Ziming hesitated.

Finally, clenching their fists, they decided to give it their all!

Just like that...

The moment Chen Cang took the scalpel, it also signified the official start of the surgery!

The incision was long, which ostensibly didn't need to be fully exposed at once and had to be progressed gradually according to the surgical stages.

However, this patient was an exception; the surgery had to first start with the end-to-side anastomosis of the iliac artery to ensure during the ascending aorta surgery later, avoiding ischemia necrosis due to blood block in the kidney, abdominal organs, and other areas.

Thus, major vessels in the chest had to be dealt with, so the surgery might need a wide incision to fully expose all the thoracoabdominal aortas.

Aggressively make all the preparative rescue measures!

In case the patient's ascending aorta ruptures during surgery, it can be stopped immediately.

The end-to-side anastomosis of the bilateral iliac arteries with the artificial blood vessels becomes the first step of the surgery!

Unlike a simple abdominal aorta replacement, it is necessary to first establish a retrograde blood perfusion pathway from the descending thoracic aorta to an artificial blood vessel and then to the left iliac artery, to ensure the blood supply to other organs while anastomosing the intercostal, abdominal, and lower limb arteries.

However, this also means that precise control over the duration of the surgery is needed, as the time for anastomosing the vessels and artificial blood vessels is very limited.

With Li Baoshan's help, the abdominal tissue forceps controlled the surrounding surgical field well, and Xu Ziming exposed the position of the aortic aneurysm to start layer by layer separation of the surrounding omentum.

Meanwhile, Chen Cang handed over a series of instruments such as probes, separation forceps, surgical knives, scrapers... to Ge Huai.

"Help me hold this."

After saying that, Chen Cang first tied over the surgical knife.

The doctors around were somewhat puzzled watching Chen Cang holding so many things, wondering what he was planning to do.

Even the instrument nurse felt a bit embarrassed, questioning if he didn't trust her?

But, once the surgery began, everyone realized: Doctor Chen might really need someone who can quickly hand him instruments anytime, anywhere.

After Xu Ziming separated the region of the aortic dissection.

A dissection aneurysm about seven to eight centimeters long appeared before everyone's eyes, and Chen took a deep breath.

"Block it!"

After saying that, he quickly began to clear the aorta and started cleaning the lumen.

The whole process was rapid and precise!

At this time, Chen Cang was continuously changing instruments in Ge Huai's hands.

A probe one moment, forceps the next, then separation forceps, then a scraper.

Even Wu Tongpu was puzzled by Chen Cang's operations!

This... seemed a bit too exaggerated?

However, when Li Baoshan watched, he was somewhat shocked.

Because he realized that Chen Cang's choices seemed to be the best possible.

He was always able to clean with the most suitable instruments.

It looked simple, even cumbersome!

But this way, it could undoubtedly effectively complete the cleaning and even better protect the vascular endothelium.

Li Baoshan cautiously coordinated, while Xu Ziming's eyes were fixed on every step of Chen Cang's operation.

Not daring to relax in the slightest.

At this moment, the instrument nurse was also stunned.

Because she realized that Doctor Chen didn't look down on her, but because he needed to change instruments quickly.

She even felt that Doctor Chen needed a dedicated instrument nurse.

Otherwise, it simply wouldn't suffice to maintain his operations.

But Ge Huai was very engrossed!

Initially, he thought Chen Cang called him over to handle instruments as a way of looking down or humiliating him.

Now it seemed that wasn't the case!

Compared to others around, Ge Huai realized... he might only be able to do such a job.

Moreover, his angle could even perfectly view Chen Cang's operations.

Upon reflection, he realized that Chen Cang was actually helping him!

For a moment, Ge Huai was overwhelmed with mixed feelings.

However, he didn't dare to overthink; since Chen Cang was helping him, he too had to do his own job well!

Hand over the instruments well!