Chapter 0385 - Bare Hands Rock Climbing
The people in the observation area, seeing the scene just now, all left their chairs with their buttocks, and cardiac arrest suddenly occurred during the operation, which is a severe test of clinical experience and psychological quality for any surgeon.
"Heartbeat?"
"Defibrillation!"
---
"There it is!"
"There it is."
In the noise and exclamations, everyone saw the normal heart waves on the screen, exhaled a long breath, and someone reached out and touched the chair and sat back down.
People with palpitations crawl out of the thrill and adjust their emotions.
"Dr. Yang was a generation ahead of us in the study of this tumor, and he had long expected cardiac arrest."
"We are still in the primitive exploration stage, and in our opinion, the problems that cannot be overcome for the time being seem to have become the norm for him."
The huge waves that had just stirred up in Johannathan's heart slowly calmed down, but the aftermath was surging.
Griffin was no better, and was also scared.
The medulla oblongata is part of the brainstem, and the numerous nuclei of the brainstem are located in this area, which was previously off-limits to surgery.
In recent years, because of the progress of brainstem anatomy, the advancement of microscopic operation technology, and the application of various advanced examination and surgical equipment and navigation equipment, surgeons have entered the forbidden area.
However, the operation is also limited to the safe area, in the gap between the nerve nucleus and the conduction tract, and Feng Lao's tumor has been tightly adhered to the vital nucleus, and it is still forbidden to operate.
Yang Ping's hand is very stable, like a precision machine, better than the machine, good tactile feedback, so that the operation force is very appropriate, which is currently impossible for any machine to do.
Wen Rentao, who is good at operating under the microscope, saw Yang Ping's operation, and had to admit that the gap with Yang Ping could not be narrowed.
Under the magnifying microscope, the operation is very easy, and the maximum precision is always maintained, and the movements are not out of shape at all.
Beyond the first danger zone, the tumor is further separated, and the bleeding is stopped while isolating.
Tumors without an envelope seem to have some kind of invisible capsule in Yang Ping's eyes, and Yang Ping can separate on the surface of this capsule.
He really climbed with his bare hands, and there were five falls during the whole climb, and after the fall, he had to regain his grip on the rock and continue to climb up.
One miss is a catastrophe.
"This is the limit of human beings, and his hands have been stable without any signs of slack fatigue."
"Success or failure, this surgery should become a classic."
"Oops, the adhesion is too tight, and it's dangerous, the accuracy of 0.1 mm can't meet the needs of this operation, and there will be another fall, oh my God."
ββββ
The more I can see it, the more nervous I feel.
Johanneson covered his mouth and almost made a sound, and Griffin and Woodhead were already huddled together, as if that would give them a sense of security.
The laser scalpel head, emitting a faint bright light, entered the death zone again, where Yang Ping made a short pause, communicating with the assistant in advance, and prompting what was going to happen next.
"Attention, everyone, the second cardiac arrest is coming soon, cheer up." Yang Ping's clear and calm voice.
Everyone reunited all their spirits and waited for the second coming of death.
With an uncontrollable scream in the conference room.
A second cardiac arrest appeared, this time faster and without any warning.
Without delay, with rapid action, the sterile sheet covers the protective surgical area, lifts the sterile sheet on the back, and evacuates the electrodes and wires of ECG monitoring.
First defibrillation, failed -
The right side of the screen in the observation room shows a panoramic view of the operating room and various monitoring parameters.
Second defibrillation, failed---
Johanneson followed the people in front of him and got up, and everyone got up, and failed the second time.
Time passes by second, this kind of electrical disorder, if defibrillation fails in the early stage, the chance of later is slim, and Johanneson understands the risks.
As if the patient was in front of him, Johanneson could not help, his hands clenched into fists.
"Come on, come on!"
He clenched his fists, his fingers clasped deeply into his palm, and there was a piercing pain.
Go on---
How much rescue Dr. Wu has experienced, how much snatching with death has been experienced, and when the second time failed, his hands began to tremble slightly.
At this time, the doctor's good professionalism was vividly displayed, and even so, he pressed the electrode plate to the exact position with the fastest action and no deformation to complete the third defibrillation.
"There it is!"
The anesthesiologist kept staring at the ECG waves on the defibrillator screen, and behind the dense ventricular fibrillation, the familiar sinus heart rate waveform jumped out.
"There isβ" Everyone almost cheered.
The anesthesiologist didn't notice it himself, and when he shouted "Yes", he had two teardrops on his face.
Not only because of Feng Lao, the doctor does not want any patient to leave in his hands, and life slips away from his hands, which is a spiritual impact for any doctor.
Life and death, at this very moment, life and death, are between the three defibrillation actions.
Heartbeat recovery---
The itinerant nurses wiped the sweat from everyone's foreheads one by one.
Outside the door of the operating room, Han Jiangong and Hong Zhigang have been waiting at the door, and from time to time doctors from other departments look at this side, but they dare not come.
They knew that as long as the operating room door wasn't opened earlier, the inside would continue.
Han Jiangong and Hong Zhigang, their hearts are like fire, what is going on inside, they can also see through the small window that they have passed the second ghost gate.
Professor Zhang stood still and walked around with his hands behind his back, and a neurosurgeon brought in a stool and asked Professor Zhang to sit against the wall.
Professor Zhang waved his hand, signaling not to sit, but to sit down and tremble all over, but it was comfortable to walk.
Dean Chen sat in the locker room, leaning on the back of his chair, never going in, touching his mobile phone in his hand, and checking from time to time to see if there were any missed calls.
"Got it, God, he caught it again."
Everyone sat down again, Johanneson gasped for breath and let go of his whitened fingers, and Woodhead and Griffin clasped hands together.
Senior surgeons, observing this kind of surgery, are frightened step by step, especially when the heart stops, for fear that they will not be able to resuscitate.
This kind of heartbeat and breathing stops, and breathing is suppressed spontaneously because of general anesthesia, and breathing is completely taken over by a ventilator, so it cannot be expressed.
The heartbeat will be reflected immediately, and if it cannot be rescued, even if ECMO is used to temporarily replace the heart to promote blood circulation, it will have no effect.
Because the patient's vital areas of the brain are already disordered, brain death is inevitable.
"Everyone adjusts their emotions, is there anyone who wants to be replaced?"
Yang Ping asked everyone, countless devil training, so that his heart was like iron and stone during the operation, extremely rational, like a robot, rational to the point of being unkind.
In the face of this kind of surgery, no mood swings, any impassionedness, will help.
Everything is done according to the laws of science, and all choices and judgments must be rational in order to get the closest to success.
After two cardiac arrests and two battles with death, it consumed a lot of mental energy.
Under Yang Ping's inquiry, no one spoke, and the quality of the doctors in the Sixth Hospital of the Demon Capital was worthy of being first-class in the country.
"There are a few more times in the future, everyone cheers up, the Grim Reaper is beside us, reaching out at any time, we can't miss every time, check the power of the defibrillator." Yang Ping told everyone.
The operating table was rearranged, gloves were changed, and the operation continued.
The chief surgeon's firm will is focused on the tip of the scalpel, and it is fearless and continues to move forward.
The surgery has already entered the most dangerous area of the medulla, and the third heartbeat stops, which will come more suddenly.
Yang Ping must judge in advance, give other doctors enough time, five seconds, a little hesitation, or a delay, will lose the opportunity.
Five seconds, the god of life only gives five seconds each time.
"How can Dr. Yang accurately determine which step of cardiac arrest occurred?"
"It shows that he has studied the anatomy and physiology of the brain stem very thoroughly."
"In China, brainstem surgery is the job of a neurosurgeon."
"I heard that when he studied tumors in the upper cervical spine, it extended up to the medulla oblongata, and the research came from there."
"Our trip to China has advanced the surgical level of upper cervical spinal cord tumors and brainstem tumors by at least ten years."
"The Chinese are so crazy, they don't seem to have a problem that they can't overcome."
"Sir, don't forget, the world's first case of amputated limb replantation appeared in this hospital."
Johannathan, Griffin, and Woodhead sat all the time, not even going to the bathroom.
The same goes for everyone else in the observation room, no one goes out, and they are all focused.
One-third of the surgical subjects the size of thumbs are all fragile tender tofu, with countless blood vessels and many nerve nuclei in it, creating a world full of dangers in its own right.
The deeper you go, the more difficult it is to separate, and mistakes in judgment and operation can be fatal.
The laser knife follows a precise trajectory, without a trace of shaking, without a trace of deviation, the main knife is like knowing the boundary between the tumor and normal tissue, even if there is no boundary, he can separate the boundary.
As the separation deepened, the third cardiac arrest was getting closer and closer.
"The third cardiac arrest is coming soon, this time it will be very stubborn, it may take more than a dozen rounds of cardiac compressions and defibrillation to succeed, everyone has to hold on."
Wen Rentao listened, he could predict more than a dozen rounds of cardiopulmonary resuscitation, and he could be so calm, this is a demigod and a half-human guy.
"This time, you want to peel out the tumor from the superficial layer of the nerve nucleus?"
Johannesen's hairs stood on end all over his body, and this was the real death zone.
If it was said that the previous operation was on the verge of death, this time it is directly stepping on the death operation.
This is something that any neurosurgeon in the world would not dare to do, operating in the interspace, has reached the current limit, and now it is necessary to enter the superficial nerve nucleus? Even the plucking of tweezers can cause death.
Yang Ping adjusted his sitting posture, this time there were two dangerous operation points connected together, Yang Ping was ready to cross it once, and he could only cross it once. Cross it in two parts, and the success rate will decrease.
If the nerve nucleus is a dense reef in the vast ocean, it was swimming between the reefs in the past, and now it has to collide with the reefs.
At this time, the 0.1 mm laser knife also appears to be less confident.
This time crossing the danger zone, two operational risk zones, it is necessary to draw a curve in succession, and any pause will increase the time the tip stays, resulting in an increase in the heat accumulation effect, causing irreversible consequences.
"Everyone, pay attention, when you hear my order, you don't have to look at anything, you can do direct defibrillation, and the defibrillation and cardiac compressions are alternated, and you can't stop until you succeed."
There is only one chance, and one must succeed.
In "Extreme Thief", riding a motorcycle across the canyon and falling on the peak of isolation, there is only one chance, failure means death, and now Yang Ping has to cross two canyons in a row.
The suction device in Wen Rentao's hand didn't dare to move at all, and now there was no bleeding, even if it was bleeding, he didn't dare to reach in to suck blood.
"Take a break, are you scared?" Yang Ping asked Wen Rentao.
Wen Rentao tried to calm himself as much as possible: "The object of your operation should be the heartbeat center?"
"That's right, I'm going to go into the superficial inner core and peel out the part where the tumor entered." Yang Ping told him.
"If this is possible, there is only one chance, there is no time to wait, the beginning must end, and there is only one chance to succeed." Wen Rentao understands the danger of the next operation.
"Everyone take a break, adjust their emotions, and the next recovery will be more challenging, and believe me, we will be able to get through it." Yang Ping cheered everyone on.
Yang Ping took a short rest, and after gaining a buffer, he continued the operation.
He adjusted his breathing several times, and the laser knife in his hand kept adjusting, looking for the best feeling, like a sniper, looking for the best time to shoot.
The laser head began to move, changing from the previous impatience, and the small bright spots quickly crossed the predetermined curve at the junction between the brain tissue and the tumor.
Once, twice, three times, four times, each time with a precise overlap, deepens the separated parts.
Finally, the two death zones were crossed, and when the last operation was completed, Yang Ping put down the instrument and directly ordered: "Cardiac compression, electrical defibrillation!" β
As soon as the words fell, the wavy line disappeared, and the heartbeat stopped, this time it was a flat straight line, not a ventricular fibrillation wave, although Yang Ping told everyone in advance, everyone was still shocked by the sudden change.
A straight line is more dangerous than ventricular fibrillation.
Cover the surgical area, lift the sterile sheet, and start trans cardiopulmonary resuscitation.
In the ICU, Dr. Wu's movements are very standard, the amount of pressure on the back is pushed back by the sandbag in the lower sternal section of the ventral side, and the sandbag compresses the lower sternum, causing the chest to sink, forming an artificial pump, squeezing the heart, and driving the blood to circulate the body with oxygen.
Johanneson was so nervous that he could do such a bold operation, but if he didn't do it, there was no hope that the operation would be successful.
His pores constricted, his muscles spasmed, and he leaned back in his chair, motionless.
"Anesthesiologist, continue the adrenaline push."
"There it is!"
Ventricular fibrillation is present, and it is a fine fibrillation.
"Anesthesiologist, turn it into a coarse tremor, quick!"
Another adrenaline rush static push.
Fine tremor waves are very dangerous and difficult to defibrillate successfully.
With the efforts of the anesthesiologist, the fine flutter wave immediately turned into a coarse flutter wave, like a rope that shakes rapidly.
"Wen Rentao, prepare to defibrillate, quick!"
Wen Rentao did not hesitate at all, and the electrode plate in his hand had already been coated with conductive paste and pressed against Feng Lao's back.
Yang Ping looked at the screen calmly, his heart like a rock.
Defibrillation failed! Continue heart compressions.
"Go on, don't be discouraged, you can definitely be saved, you can definitely do it." Yang Ping's firm tone.
"Defibrillation again!"
Failed again.
Outside the door, Han Jiangong and Hong Zhigang saw through the small glass window that they were being rescued inside, and their hearts fluttered, and a tight feeling of contraction came from their chests one after another.
Professor Zhang sat on the stool, squinting his eyes, he couldn't stand up anymore, whether he could survive or not depended on the old man's life.
Cardiac compressions and defibrillation alternate.
Third, fourth, fifth, sixth, seventh---
There was no sign of success, Johanneson looked at the screen, his eyes did not blink, extremely painful, hoping for the appearance of sinus rhythm waves, hoping for the appearance of QRS complexes.
The QRS complex, which anyone has, is now out of reach for Professor Feng.
"God---" Griffin kept making crosses.
Woodhead was cold, and he gripped Griffin's hand tightly, and his body had slipped off his chair and was reclining.
"Hurry up, hurry up!"
I don't know who in the observation room is crying.
Fifteenth, electrical defibrillation.
Professor Ma, an anesthesiologist, looked at Yang Ping, and everyone didn't stop.
"Cardiopulmonary resuscitation substitution, Zeng Ran immediately replaced Wen Rentao."
Zeng Ran played.
"Not strong enough!"
Yang Ping immediately replaced Zeng Ran, originally he was going to command the whole thing, but there is usually less trans CPR training, and even if the assessment is in the supine position, Zeng Ran is a little unskilled.
Yang Ping pressed his back rhythmically, the pressure on his back and the squeeze of the sternum sandbag, the chest was deformed, the heart pumped the blood out, let go of the hand to let the chest rebound, and the blood of the whole body returned to the heart.
"Continue defibrillation!"
Wen Rentao performed the eighteenth defibrillation, and he almost despaired, it had already been eighteen.
"Go on, don't panic, you can definitely do it, you can definitely ---"
Yang Ping's tone was firm and confident, giving everyone strong courage and confidence.
Finally, after the twenty-first round, sinus rhythm was restored.
After the death storm, there is silence, looking at the sinus rhythm wave chart on the defibrillator screen.
Connect the ECG monitor again, and the long-lost QRS wave reappears on the screen, and the curve is like the most beautiful music in the world.
The rest of the life after the catastrophe was relaxed, everyone gasped and turned their heads to look at Yang Ping, now in their eyes, he is a god, not a human.
"Wipe the sweat, brush your hands again on stage, continue the operation, is there anything to replace?"
Everyone shook their heads and encouraged each other.
There were three cardiac arrests on the operating table, and this time it took 21 rounds to be rescued, and every doctor just felt exhausted, but now he was in good spirits.
"Don't be afraid, remember, all actions are under my command, you will definitely be rescued, if I guess correctly, there will be a cardiac arrest, I will tell everyone in advance."
"Successful rescue again?"
Griffin wakes up Johanneson with his eyes closed, and a surprising sinus rhythm wave appears on the screen.
"I love you---"
The world's top neurosurgeon gave a flying kiss to the QRS complex on the screen.
The gentleman who was crying was a student of Professor Feng who had rushed back from Germany.
He sobbed like a child, and someone handed him a tissue.