Chapter 1491: Chapter 1115: The Importance of the Garrison Station - Part 2

    When the patient was in despair, a doctor recommended Xu Songde to go to Sanbo Hospital, saying that Sanbo Hospital has been very famous in recent years and frequently performed top global surgical cases across various departments, so the thoracic surgery department definitely won’t lag behind. Hearing this, the patient immediately decided to go to Sanbo Hospital.

    Indeed, as the patient was brought into the operating room, immediately after being transferred to the bed, they experienced a sudden cardiac and respiratory arrest. If it weren’t for timely and effective rescue, there would be no chance for surgery now, so the doctors who were previously afraid to operate on the patient were correct in their judgment.

    Actually, the patient’s situation is very straightforward. Even if the patient is immediately sent to the ICU now, relying on medication and various equipment can indeed sustain them for a few days, but unless the tumor ceasing to press on surrounding organs, no medication can solve the problem of mechanical pressure, therefore the patient won’t survive a few days later. If the doctors take the risk and complete the surgery now, and if the patient can endure the surgery, their probability of survival will be significant.

    Pressure is the fundamental problem, and removing the tumor is the only way to solve the fundamental issue.

    The surgery began, Director He used the handle of the surgical knife to map out the exact center position of the sternum. This surgery must be performed using a fully opened median sternotomy approach, as only this approach can reveal such a massive tumor.

    "Anesthesiologist, I’m starting the surgery!"

    On the surface, Director He was reminding the anesthesiologist to report the patient’s current vital signs, but in fact, he was informing Professor Yang that he was really about to start, asking for assistance in keeping an eye on things.

    After the anesthesiologist reported the vital signs, they cautiously gazed at the monitor’s screen.

    "I’m officially starting the incision!"

    Director He repeated once.

    "Hmm! Go ahead!" Yang Ping responded.

    Upon hearing the response, Director He finally began to make the incision along the center of the chest, which he had measured dozens of times, making a long vertical cut at the sternum.

    After the skin was cut, the surgical knife was replaced with an electric knife. With the zizzling sound of the electric knife and the smell of burning human tissue spreading, the skin was already cut.

    "Electric saw! Open the chest!"

    For each step Director He called out the name, his voice loud and clear.

    Yang Ping was still analyzing the CT scan, facing the viewing lamp, with his back to the operating table.

    "Anesthesiologist, patient’s vital signs?"

    The anesthesiologist immediately reported, "Stable."

    Yang Ping then turned around, facing the operating table, looking at the surgical area from a safe distance, signaling to proceed boldly with opening the chest: "Hurry up with the thoracotomy, finish quickly but stay calm, don’t rush or panic."

    Director He immediately picked up the electric saw, and with a spray of blood mist, the sternum was sawed open from the midline into two halves. A deputy chief physician assisting nearby had tiny blood droplets all over his glasses, and he quickly turned away, and the patrolling nurse took off his glasses, wiped them clean, and put them back on.

    ’Why not wear goggles?’ Director He mumbled.

    "Chest opener!" Director He shouted.

    With the expansion of this chest opener, the split sternum was stretched apart, the chest cavity opened, revealing a massive tumor wrapped around the pericardium inside, covered with dense, winding blood vessels, blue veins bulging, red arteries pulsating, and because of the heartbeat, the huge tumor was also pulsating.

    The situation was more complicated than expected, and Director He’s back was slightly damp.

    After entering the chest cavity, Director He immediately stitched several No.10 silk threads around the dense connective tissue areas surrounding the tumor. The ends of these threads were clamped with vascular clamps, and their function was to traction and suspend the tumor. The vascular clamps on the ends of the threads were handed to the assistant who used them to suspend the tumor. The traction force of the threads balanced with the tumor’s gravity, preventing the tumor from continuing to press on the heart, organs, and left and right bronchi, thus avoiding severe threats to the patient’s cardiopulmonary function posed by such pressure.

    Previously, Director He had performed many heart, lung and major vascular surgeries with Yang Ping, accumulating rich experience, and now these valuable experiences began to play a role.

    Despite facing such a complex tumor, Director He was understandably nervous and lacked confidence, but the surgical steps were clearly mapped out in his mind, knowing each advance, purpose, and precautions.

    After completing the suspension of the tumor, Director He started to insert a catheter into the internal jugular vein, connecting it to the femoral vein sheath, performing blood circulation in the superior and inferior vena cava systems to ensure normal blood return to the head, preventing insufficient or ischemic head blood vessels during surgery.

    This step is crucial, as without it, the patient could easily suffer brain ischemia during surgery, even if the operation is eventually successful, the brain could be damaged due to lack of blood and oxygen, potentially resulting in a vegetative state.

    The start was smooth, Director He turned to glance at Yang Ping next to him, receiving encouragement: "Just do it this way, stay steady, take it one step at a time."

    The entire surgery included two parts, resection and reconstruction, to excise the tumor and the invaded parts of the organs, then reconstruct the excised organs, all processes being extremely complex with significant scale, without sufficient surgical experience, it would be difficult to manage this complex high-risk surgery.

    For convenience of operation, Director He sat while performing the surgery, several assistants positioned on both sides to help, and due to the constraints of position and space, Director He’s movements were very awkward, but there was no alternative, this type of surgery could only adjust to the position, and not the other way around.

    Next, Director He proceeded with exploration, after understanding the situation, he briefly stated the approximate surgical process, asking Yang Ping to verify if there were mistakes or omissions.

    Tumor excision, majority of the pericardial excision, ascending aorta sheath excision, aortic arch sheath resection, right innominate artery resection, right subclavian artery sheath excision, right common carotid artery sheath excision, left common carotid artery sheath excision, left subclavian artery sheath excision, superior vena cava resection, left and right innominate vein resections, left and right internal jugular vein cancer thrombus resection, blood clot removal, left upper lung anterior section resection, right upper anterior segment resection.

    The excision for this surgery included fifteen specific procedures, the sheer thought of which would make the average person’s scalp tingle; in the past, Director He might have had trembling hands from nervousness, but now, he was no longer the same, tempered by various bloody battles alongside Professor Yang.

    After mentioning the fifteen excision procedures, Director He swallowed a mouthful of saliva and continued.

    Innominate vein to right atrium artificial blood vessel replacement reconstruction, right innominate vein to right atrium artificial blood vessel replacement surgery + artificial material pericardium reconstruction surgery...

    Finally after reporting the expected surgical names, Director He was constantly sweating on his forehead, occasionally turning to the nurse next to him for help to wipe it, fearing that Yang Ping wasn’t paying attention to the surgery, constantly glancing at Yang Ping, feeling much more relieved seeing Yang Ping standing there all along.

    Initially, seeing such a complicated tumor, moreover in such an uncomfortable position, Director He’s hand movements were very stiff, but as he continued, he became more accustomed, although still not daring to move too quickly, at least no longer stiff and trembling.

    "Why not, Professor Yang, wash up, gown up and sit here to rest, I’ll feel more at ease." Director He squeezed out a smile as he said.

    Yang Ping thought it’s reasonable too, in case anything goes wrong, he could immediately step onto the stage to save the situation. Standing below the stage wastes time in urgent situations since he would need to wash and gown up.

    Having a technically superb and experienced mentor to support the operation, doctors’ surgical skills progress rapidly, whereas without such a guardian, their progress is much slower; this underscores the importance of such support.