Mission Peak is halfway up the mountain, a luxury manor, and an equestrian training ground.

Luo Ya was dressed in a black sportswear, and she was holding a "pearl white" horse in her hand.

She was originally going to go horseback riding, but when she received the news, she immediately called Zhou Qiao!

At this time, when he heard that Zhou Qiao was full of confidence, he was a little relieved.

After all, she had seen Zhou Qiao's medical skills, which was extremely magical, and she couldn't see such a serious injury now!

And after recovery, it didn't affect the flexibility of her hands in the slightest! Shooting, holding the reins, or even playing the piano, doesn't feel abnormal.

"If it's really difficult, it's probably still a matter of licensing."

Luo Ya groaned slightly, and then called several familiar members of the California Senate one by one, and mentioned what happened a little, and the other party said that they would go and ask. And let her rest assured that such a small thing does not have to be taken to heart.

After Luo Ya hung up the phone, she couldn't help but smile bitterly, her previous identity was not as powerful as that, and she couldn't imagine that even the councillors could be sent at will now. It's a bit of a thing that makes people not want to go back!

After making the call, looking at the green grassland, the sky was clear, Luo Ya couldn't help but feel happy, and beckoned to the distance, the black scorpion immediately ran over and shouted: "Boss, what are your orders?" ”

He rode a jujube red horse, and he was also a tall divine horse, but it was far worse than Luo Ya's "pearl white"!

If Zhou Qiao was here, he would definitely exclaim: ", shine on the jade lion at night!" ”

In the Tang Dynasty, there was a painter named Han Gan, who painted a "White Picture of the Night", two Dawan horses are snow-white, without half a variegated color, running at night, can reflect the surroundings as bright as snow.

Of course, this kind of horse is not suitable for war, only for pretending. If you ride into battle, you will only become a target.

Luo Ya turned over and said, "Let the people below keep an eye on that Kaiinzi, and report it immediately if there is a situation." ”

"Roger!" The black scorpion thought for a while, then couldn't help but make a gesture to wipe his throat and asked, "Boss, do you want to kill that bald man?" ”

Loya waved her hand, and now to kill him, it was too obvious that it was easy for people to connect the two things.

"Stare at it first!" Luo Ya waved her hand lightly, but she was very helpless in her heart, these big bosses know how to fight and kill all day long.

The person who kills the gangsters, the black eats the black, she doesn't have any psychological burden, but wantonly kills civilians? It may have an impact on her in the future, unless it is done airtightly.

However, you can't kill, but you can teach a lesson.

……

At one o'clock in the afternoon, the community hospital, operating room 1, was ready.

In the corner of the operating room, the Bose sound system hanging on the wall activates and starts playing soothing music, which is Scars On 45's Insecurity.

This tune was chosen by Ava to ease the tension during the surgery.

There are hundreds of music to choose from in the library, including passionate rock 'n' roll, but Ava prefers this lyrical song.

The operation was performed by Zhou Qiao, Elena, the instrumental nurse, Ava, the itinerant nurse, Nancy, the anesthesiologist, and in addition, two experts from the Medical Council, Professor Eric Pasente and Dr. Sam.

Of course, Professor Pasent and Dr. Sam will only be on the sidelines, not meddle.

In other words, the operation was basically completed by Zhou Qiao alone!

For such a major operation, it is not allowed to have four or five, or even more surgical assistants in China, but in the United States, due to the high cost of labor, even if it is a major operation, there are at most one or two assistants.

Zhou Qiao is more hard, and he doesn't have an assistant!

However, this did not bother him.

Another reason is that the Americans have invented a lot of assistive devices that are easy for one person to operate, such as retractors.

Super complicated retractor, on one pole, the kind of seven or eight "minions"!

After all, it is a foreign country, and there is a big difference from domestic nature, for example, when you first enter the door, there is usually an aunt in the domestic operating room (the intern is called the "door god"), who is responsible for distributing clothes, but in the United States, taking hand clothes is fully automatic, the same as vending machines, you can swipe the card and choose the size that suits you, the size of the jacket and pants can be combined in different combinations, and then you will pop up.

All because there are fewer Americans.

Its effective land area and cultivated land area are more than China's, but its population is only more than 300 million! Therefore, the United States is a big agricultural country, and China imports a large amount of grain from the United States every year.

Many people think that China is a big agricultural country, and we are not as good as the United States in terms of science and technology.

However, this is not the case, just look at the annual trade surplus between China and the United States.

Not only is the United States geographically superior, but it is also relatively safe on its own soil, and World War I and World War II were almost unaffected, unlike China, which is surrounded by wolves.

Of course, this kind of geography is bullied when it is weak, but at its peak, when all nations come to the court, all the little brothers are clustered, and various interests are projected, and it is easy to form a powerful alliance force!

This is not comparable to the United States' "lonely overseas."

Several other members of the medical board, as well as the owner of the Red-headed Gull Clinic, Kainz, watched the "live broadcast" from a monitoring room outside, mainly because the operating room was too small and would be too crowded and polluting if they all came in.

Kainz, who knew a member of the investigation team and was a whistleblower, had the cheekiness to follow him, so they didn't chase him. Anyway, it doesn't affect the investigation.

Mr. Clark was in the waiting area with a cup of coffee in his hand, and music was also playing.

It's similar to the airport waiting area, and the coffee is free and you can refill it as much as you want.

Mr. Clark was so nervous that he had only been sitting down for a few minutes and had several cups of coffee.

In normal times, he can taste one cup for about ten minutes, and no more than five cups a day, but today, from the morning to now, there are already seventeen cups! I guess I can't sleep properly at night.

It doesn't matter if you can't sleep, Mrs. Clark needs someone to take care of her after the operation anyway.

Pancreatic cancer is a very dangerous malignant tumor and is treated differently than benign cancer.

If it is located in the tail of the body, the tail of the pancreatic body, the invaded blood vessels, and the spleen are removed, and if it is located in the head of the pancreas, pancreaticoduodenectomy is indicated.

Mrs. Clark belongs to the latter group.

What Zhou Qiao wants to do today is the "total laparoscopic pancreaticoduodenectomy", which can be called the "Mount Everest" in general surgery.

The operation is difficult and risky, requiring not only multi-organ dissection and resection around the important blood vessels of the internal organs, but also high-quality reconstruction of the digestive tract, such as pancreatic jejunal anastomosis, bile duct-jejunal anastomosis, and gastrojejunal anastomosis......

In particular, "pancreatic-intestinal anastomosis", which surgeons call "the kiss of death", is the main source of surgical complications.

Compared with conventional pancreaticoduodenectomy, radical resection of pancreatic head cancer is more difficult.

Aseptic inflammation or vascular invasion around the tumor leads to the disappearance of the anatomical gap of the blood vessels, and the slightest carelessness will lead to fatal hemorrhage, which requires higher surgical skills and teams.

Due to the large trauma area, long operation time, and more bleeding in the surgical field, the anesthesiologist Nancy chose general anesthesia combined with epidural spinal nerve interference block.

In order to improve the patient's tolerance to anesthesia and surgery, a high-protein, high-sugar, and low-fat diet was also given before surgery, and water and electrolyte imbalances and acid-base imbalances were corrected.

Of course, for such a difficult operation, muscle relaxants and endotracheal intubation were naturally applied.

As for intraoperative monitoring of blood pressure, heart rate (rhythm), SPO2, PETCO2, CVP, invasive arterial pressure, urine output, body temperature, etc., they are all due and will not be described in detail.

In addition, because the pancreatic enzymes in the patient's body can decompose fat into fatty acids, and the saponification effect with calcium ions in the blood may lead to hypocalcemia, so calcium supplementation is required according to the situation during the operation.

"Doctor Zhou, anesthesia is ready!" Nancy glanced at Zhou Qiao and said loudly.

She never expected that Zhou Qiao was so young that she could carry out such a difficult operation alone.

Whether it can be done or not, whether it goes well or not, she feels that Zhou Qiao's courage is good!

Moreover, she secretly observed Zhou Qiao, and only felt that Zhou Qiao was calm and confident, and most of them were competent!

What's more, there are two "bigwigs" from the University of California School of Medicine and Stanford University Health Care on the side, who are "observing" and "supervising"!

Nancy felt that if she had changed herself, most of them would have been nervous like a deer at this time!

Zhou Qiao nodded and shouted, "Ava, Time Out!" ”

Ava immediately became energetic, reporting the basic information of the patient, the name, the planned operation, the position of the body, etc., and the crisp voice was like a jewel.

After she finished speaking, Nancy, the anesthesiologist, immediately picked up.

Then, Elena picked up, and her voice was exactly the same as Ava's, if it weren't for the different positions of the two, she would have thought that the same person was reporting.

Finally, Zhou Qiao will do it again!

The information of several people is exactly the same, and the operation has officially begun!