It has been nearly 5 hours since the operation, and it is a highly concentrated mental state, and it is impossible to say that I am not tired.

Acute pulmonary embolism, still in the right pulmonary artery, is the most risky primary thrombectomy.

But at this moment, there is no way to retreat, and we must move forward with a heavy load and fight against the water!

"Teacher, it's up to me and Brother Mo Yan to take over."

Seeing the exhaustion of Song Dong and Wang Ji, Xia Xingran took a deep breath, tried to bloom a bright smile from his eyes, and took the initiative to take over the baton.

In an instant, the operating room full of gloom seemed to be sprinkled with daylight again, becoming dazzling and warm.

Pulmonary artery thrombectomy is different from previous surgeries in that it needs to last for 16 to 6 hours at a constant temperature of 7 hours.

The operating room quickly cooled down, and Xia Xingran's body was already cold, a temperature she had never experienced.

After the temperature was suitable, Bai Moyan took over first and successfully opened the extracorporeal bypass. Then handed it to Xia Xingran.

The first step in removing a blood clot from a pulmonary artery is to cut the pulmonary artery.

Xia Xingran chose to make a longitudinal incision of the right pulmonary artery, and after the incision, Bai Moyan immediately cooperated to dilate the blood vessels.

Everyone couldn't help but be stunned when they saw it.

The patient's right pulmonary artery and its anterior, posterior, and basilar arteries are filled with a large number of blood clots.

Xia Xingran observed carefully and found that these blood clots were huge, like small plugs, blocking the blood vessels tightly.

"Xia Xingran, separating and removing blood clots is an extremely meticulous job, you are a girl, you have natural advantages, do it well!"

Song Dong and Wang Ji wanted to tap Xia Xingran's hidden potential, so they were willing to take a huge risk and let Xia Xingran try it alone.

Xia Xingran let out an "um" sound and began to carefully separate and completely remove the blood clot.

Just when everyone thought it was going to be done, Xia Xingran made a decision that surprised everyone.

She did not stop the operation and chose to close her chest, but continued to go deeper and deeper to prepare for a new round of surgery.

"Xia Xingran, what are you doing?!" Song Dong and Wang Ji shouted. Look at the book

"Teacher, after the blood clot is removed, if the distal blood vessels are not opened, it will not play a role."

In the process of just clearing the pulmonary artery thrombosis, Xia Xingran carefully found that the patient still had a serious multivascular embolism.

If it is just according to the preoperative plan, it is a palliative treatment at all. It does not completely solve the patient's problem.

So she exchanged glances with Bai Moyan and temporarily adjusted the surgical plan.

"The next thing I have to do is to peel off all these intima at the distal end, like a vascular tree, to strip out all the intima that extends into the small blood vessels of the lungs, the intima that proliferates, and the intimal tissue that blocks the blood vessels."

Xia Xingran's calm tone seemed as if she was not performing an operation on the heart at this moment, but an appendix operation.

But everyone in the operating room exploded in an instant. This is equivalent to escalating from pulmonary artery thrombectomy to pulmonary artery thromboendarterectomy.

Don't look at the addition of a few words in just a few words, just these few words are enough to suddenly increase the difficulty and risk factor of the whole operation by more than several times!

"Xia Xingran, how dare you ......?"

Song Dong and Wang Ji were angry and shocked by Xia Xingran's attitude of "disobeying military orders abroad".

Zhou Wei hurriedly pulled the angry two people over and comforted, "Little brother, don't panic in case of trouble, let's take a look first. Take 10,000 steps back and say, with the four of us here, even if something goes wrong with the children, there is nothing to be afraid of. Can't you still trust yourself?"

Song Dong and Wang Ji were helpless, after all, the operation had already begun, and they couldn't stop it, so they could only hang their hearts and stare closely at Xia Xingran and Bai Moyan's operation.

"Brother Mo Yan, enlarge the pulmonary arteries, and enlarge the heart." Xia Xingran was not affected at all, and cooperated with Bai Moyan in an orderly manner.

There is a straight line on the monitor, and the heart is already in a state of stopping.

Bai Moyan is quite there

tacitly revealed the pulmonary artery on the right side of the patient to Xia Xingran.

"Xiao Ran, why don't you stop the cycle." Bai Moyan suggested after observing the state of the operation.

"Okay, then I'll count one, two, three, and you can stop it." With Bai Moyan by her side, Xia Xingran felt both relieved and relaxed.

Song Dong and Wang Ji on the side were stretched forward and stretched because of the huge shock. Even when the two of them didn't dare to temporarily adjust the operation, they also took such an extremely risky operation as stopping the cycle.

And Xia Xingran and Bai Moyan, two children who are not as old as them combined, actually proposed a surgical plan to stop the circulation so lightly.

When the patient enters the deep and low temperature circulation, it is equivalent to entering a state of "death", and the blood of the whole body is stagnant.

At first, they wanted to avoid this option as much as possible, but the blood clot in the patient's body was far more complicated than they had initially estimated.

As a doctor, the flexibility to change the most suitable surgical plan is an essential skill.

Circulatory arrest creates a clear view of the operation. However, every time the circulation is stopped, as much blood clots in the patient's veins as possible should be removed within 20 minutes, and these life-threatening bombs should be dismantled.

What kind of confidence and confidence do you have to have in your own medical skills to dare to do this!

Bai Moyan had already put on an ice cap on the patient in advance to protect his brain tissue activity to the greatest extent.

Four experienced doctors sat in front of the cardiopulmonary bypass machine, staring at the timer to protect them. Once more than 20 minutes have passed, even if the operation is successful, the patient will have brain death and irreversible damage to multiple organs.

The first time the cycle was stopped, 19 minutes and 38 seconds, Zhou Wei immediately reminded the two. After getting the response, he resumed cardiopulmonary bypass.

It should be circulated for at least 10 minutes to restore blood supply to the brain and organs. When the recovery is complete, the second cycle is stopped.

Stopping the circulation is to completely remove the blood clots, and resuming the circulation is to protect the organs. This is Xia Xingran's process plan for the second setting of this operation.

The blood clot in the patient's body was severely blocked, and the circulation was stopped for the first time, and only a small piece of blood clot was removed. It's too early to completely strip away. Everyone knows in their hearts that every time the cycle is stopped, the risk of surgery increases by one more point.

This requires that Xia Xingran's speed and efficiency must be improved at the same time.

A quarter of an hour later, the second stop cycle begins.

Bai Moyan first blocked the proximal end, and then Xia Xingran began to peel off the blood clot.

"Long thick tongs. Pulmonary artery intimal trunk."

"Long slender pliers. Hurry."

"Another long thick pliers."

Xia Xingran and Bai Moyan cooperated very tacitly, so that the four old guys couldn't help but want to applaud them.

Zhou Wei glanced at the time and reminded again, "There's still a minute, kids."

But Xia Xingran was peeling off the biggest blood clot at the moment, and she hurriedly said to Zhou Wei, "Director Zhou, don't open it yet, there is still time!"

"There's only a little blood clot left, just give me another minute or two!" Brother Mo Yan, give me another long thick tongs, quick!"

Xia Xingran visibly quickened the movements of his hands. She wanted to minimize the number of cycle stops so that there would be as little damage to the patient as possible.

With close monitoring of brain oxygen and vital signs, Zhou Wei extended the time to stop circulating by one minute.

And it was in this one minute that Xia Xingran cut off the largest thrombus in the patient's pulmonary artery.

Zhou Wei and the four of them immediately got up to look at it and couldn't help but sigh: "Don't talk about you, even we are the first time to see such a large blood clot, blocked so hard, and completely blocked the blood vessels."

The third stop is to peel off the intimal hyperplasia in the small blood vessels.

This step is the most difficult and critical step of this operation. It not only tests the endurance of the doctor, but also tests the fineness of the doctor's operation.

Once the tiny blood vessels are peeled and bleeding, there will be no chance of remediation. The operation will be terminated and declared a failure.

Bai Moyan probed in advance and reminded, "Xiao Ran, be careful, this person's vascular lining is very

Very thin. Old blood clots and intimal adhesions are very tight. The level of detachment is the gap between the intima and the medial."

"I know, Brother Mo Yan." Xia Xingran exhaled a long breath and took out 120 points of spirit.

Most of these blood vessels are only a few millimeters, which are very thin, and Xia Xingran has to peel them far away, and they have to be peeled clean.

First, ensure that the peel is sufficient, and second, ensure the safety of the peel.

While Xia Xingran was peeling off, Bai Moyan was observing the aftermath for her, constantly assisting her in checking and filling in the gaps, and telling her where there were still unpeeled blood clots.

"Water, long pincers." No matter what Xia Xingran needed, Bai Moyan would react and hand it to her one step faster than the others.

Finally, after nearly 6 hours and three cycle-stops, the patient's blood clots were finally cleared!

The room began to heat up, and the four old doctors began to stitch together the tissue they had taken out to examine the specimens to see if there were any problems.

The patient's body temperature slowly began to recover, and Xia Xingran and other doctors began to gradually remove cardiopulmonary bypass, so that the patient's heartbeat could be restored.

Just when Xia Xingran stopped the bleeding of the patient, closed the sternum, and wore a tightrope to end the operation, the most worrying thing happened.

"The patient has a sudden ventricular fibrillation!"

"Defibrillation has been performed quickly, but there is no significant improvement!"

The atmosphere in the operating room instantly became tense again.