Back in 2002 as a doctor

Nurse anesthetist?What the hell is that?

Is there still this position in the operating room?

He carefully observed Huang Lao's expression, and thought that it was not intentional to contradict himself, but something happened.

Academician Chu wanted to ask a question, but at this time Chu Yuntian's operation had already started, and he stared intently at the screen showing Chu Yuntian's operation, and the corner of his mouth smiled more and more.

Both Zhou Congwen and Chu Yuntian chose patients who underwent right upper lobectomy.

Sleeve resection is the easiest way to divide and anastomose the right upper lobe bronchus, which is determined by the anatomical structure of the human body.

It is understandable that two people choose the same patient for open surgery.

If you really encounter patients with tumors in other parts of the clinic, you can make specific choices according to the conditions and circumstances at that time.

When bronchial sleeve lobectomy is performed for lung cancer patients, if the tumor invades the pulmonary artery trunk, angioplasty may be performed at the same time.Due to anatomical reasons, left upper lung sleeve lobectomy and angioplasty are most commonly performed clinically.

However, sleeve resection including blood vessels is called double-sleeve resection, which is a very difficult operation in thoracic surgery.

Chu Yuntian's patient was in the "jackknife position" on the left side, which was the same position as Zhou Congwen's patient undergoing esophageal cancer surgery.

This position opens up the intercostal space as much as possible, making the procedure a little easier.

Although there is only one point, it has become a necessary choice in the operation in which every bit of advantage must be striven for.

楚云天选择了右侧腋前—腋中线第4肋间3cm切口，右腋中线第7肋间切口1.5cm，右肩胛下角线第7肋间3cm切口。

The image was quickly established, and the card was punched in. He had already started to investigate in Chu Yuntian's surgical field.Academician Chu glanced at the screen next to him. The anesthesia had just ended, and Zhou Congwen was still laying down the sterile drapes.

Hehe, the anesthesia alone was left behind for nearly 5 minutes. It seemed that the winner would have been decided before the operation was finished, academician Chu thought happily.

In the top-level surgery, the difference in the operation time of the operator is not more than a minute and a second, and this half position will definitely be the winner in the end.

Turning his eyes back to Chu Yuntian's surgical field, he cut off the inferior pulmonary ligament, freed it up to the level of the inferior pulmonary vein, processed the arteriovenous veins of the upper lobe of the right lung as usual, and completely separated the horizontal fissure and the dorsal segment between the upper lobe and the lower lobe.

Even if it is a large thoracotomy, free interlobar fissures are still a difficulty, let alone laparoscopic surgery, Academician Chu knows this.

He also knew that Chu Yuntian's primary criteria for selecting patients was to choose the ones that were thinner and had better development of interlobar fissures in imaging.

This section should be about 10 minutes faster than Zhou Congwen, Academician Chu evaluated in his heart.

Seeing that Chu Yuntian performed the surgery very proficiently, and that the things and difficulties that thoracic surgeons complained about in the past were completely fine under his hands, Academician Chu showed a gratified smile on his face.

Especially when he heard the surprised sounds from behind and the whispering among the doctors, Academician Chu was extremely happy.

My son has grown up, and he is already able to take the lead in performing such a difficult operation alone. He is indeed a Mayo boy!Academician Chu thought with a smile.But he must be his son first, and the Mayo boy second.

Huang Lao's expression must be very embarrassing, Academician Chu took a peek at Huang Lao from the corner of his eye.

When his gaze passed the screen next door, he froze suddenly.

On the screen of Zhou Congwen's operation, the interlobar fissure had been mobilized, and he began to explore and mobilize the arteriovenous veins of the right upper lobe.

And Chu Yuntian is still free from the leaf gap at this time!

Academician Chu was stunned, when did Zhou Congwen finish freeing from the lobes? !

Suddenly, Academician Chu thought that Zhou Congwen's patient was selected by Mr. Huang. He had performed thousands of lung lobectomy operations in his life. Lie's understanding must be far superior to Chu Yuntian's.

Alas, I didn't expect to lose to Huang Lao by one step here. Not only did Zhou Congwen recover the time wasted by the anesthesiologist, but he also took a small lead.

Academician Chu sighed softly, watching the operation intently, feeling a little apprehensive.

This time his field of vision was no longer limited to Chu Yuntian's screen, but looked back and forth between the two screens.

Zhou Congwen had freed the right upper pulmonary artery, and Chu Yuntian was freeing the interlobar fissure.

Zhou Congwen had freed the right upper pulmonary vein, and Chu Yuntian was freeing the interlobar fissure.

Zhou Congwen has already inserted the cutter closer from the poke card, ready to close the right upper pulmonary vein, while Chu Yuntian is still freeing the interlobar fissure.

The more academician Chu watched, the more anxious he became. He didn't expect that Chu Yuntian would be stuck in the step of freeing the interleaved leaves, so that Zhou Congwen was so far ahead.

Is it going to fail?

Academician Chu was at a loss.

Before the operation, he always believed that his son Chu Yuntian's statement was correct. Mr. Huang was already old. Although he was engaged in laparoscopic surgery, his peak period had already passed.

The world belongs to young people.

but!

Mr. Huang "casually" picked up a young man in Jianghai City, and the operation was faster than the Mayo boy... how can there be reason!

Just when Academician Chu was in a daze, Zhou Congwen had freed the main trunk of the right pulmonary artery and put a thread on the root of the right pulmonary artery for backup.The interlobar artery was exposed, the superior lobar artery branch was ligated and dissected, and the interlobar artery was set aside.

At this time, Chu Yuntian had finally freed Ye Jianxie, Academician Chu heaved a sigh of relief.

It is estimated that Zhou Congwen's operation must be worse than his own son's. Academician Chu comforted himself if he could recover.

"Ok?"

Academician Chu suddenly heard Huang Lao make a dull voice.

He was slightly taken aback, feeling a little joy in his heart. It should be that Zhou Congwen did something wrong with the operation, so Huang Lao was dissatisfied.

After all, Mr. Huang has rich experience. Although his hands cannot keep up with his eyes, his full clinical experience makes his operations look more regular and more beautiful than those of the little boys.

However, in the next second, Huang Lao turned his head and asked, "I called you and suggested a replacement operation, which patient did you choose?"

"..."

Academician Chu was taken aback.

The patients selected by Chu Yuntian were consulted by experts from the Mayo Clinic, and they all said that there was nothing wrong with them.Moreover, both Mr. Huang and Mr. Li are vague. Is there really a problem?

Chapter 0582 I've Lost

When academician Chu had countless thoughts in his mind, Huang Lao sighed, "Sure enough, there is a problem with blood vessels."

"Ah?!" Academician Chu was dumbfounded, his eyes widened as he looked at Chu Yuntian's screen.

The screen was bloody, and at this point, the local anatomical structure was complicated, and academician Chu, an academician of internal medicine, could not understand it in detail.

He watched for a few seconds, but he didn't see Zi Chou Yinmao coming.

"Old Huang, what's the matter?" Academician Chu lowered his voice and asked anxiously.

He tried to stay calm, but his voice trembled slightly.

Mr. Huang called before the operation. Academician Chu knew that Mr. Huang was a man, so this call must not have been made indiscriminately.And I also consulted Mr. Li, and the old man also said that the images were not beautiful.

Both of them are top-level existences in the relevant departments, and they have the same opinion... Is it true that something happened?Academician Chu didn't look at the operation, but stared sideways at Huang Lao's eyes.

"What a nonsense..." Huang Lao was slightly angry, and stared at Academician Chu with an expression of indisputable anger.

"Old Huang, Yuntian consulted with the Mayo Clinic's expert team and said it's all right." Academician Chu defended in a low voice.

"There is tumor erosion in the right upper pulmonary artery." Huang Lao said in a deep voice.

"..." Academician Chu was a little confused.

How to do this kind of surgery!

If this is the case, double sleeve resection is necessary after the operation, not only bronchial anastomosis, but also pulmonary artery anastomosis.

Thoracoscopy... definitely won't work, and it will definitely be switched to open thoracotomy.

Academician Chu had a sore nose and almost didn't cry.

He never expected that Mr. Huang was so upright. After Chu Yuntian had committed the following crimes, Mr. Huang would not care. Instead, he reminded himself to tell Chu Yuntian that there was something wrong with the patient he chose.

Mr. Huang...

Academician Chu looked at Huang Lao. At this time, Huang Lao had already turned to watch the operation.

I hope nothing happened, Academician Chu also looked back at Chu Yuntian's operation.

Chu Yuntian's operation process was no longer as smooth as before, but rather stuttering, as if there was a problem with the signal transmission.

Suddenly, his operation stopped completely.Academician Chu hoped that it would be Yuntian's teacher, Professor David Smith, who would take the stage and prepare to be an assistant or directly participate in the public surgery.

Although academician Chu knew that this was cheating, as long as the operation could be done and the chest was not opened, it would be fine.It's all embarrassing, maybe it's better to be so embarrassing.

Chu Yuntian's surgical field was completely still, and the thoracic surgeons who were watching the operation behind him burst into an uproar.

"Is the tumor invading blood vessels? How is that possible!"

"Yes, I read the materials before the operation, and there is no problem with the images!"

"I'm going, the surgeon's luck is really bad, how could this happen. I also encountered a similar situation some time ago. I didn't dare to do sleeve incision with a large chest. Very few people can do it.”

"Tumors that are invisible on imaging are often encountered in the clinic, and his luck is really bad. If you are doing surgery at home, you should go out and explain the condition to the patient's family at this time. .”

Academician Chu had mixed feelings as he listened to the exchanges between doctors, professors and directors from various hospitals behind him.

From everyone's judgment, Academician Chu knew that not only Chu Yuntian was wrong, but almost everyone was wrong. No one said that they could see that the pulmonary artery was affected by the tumor by looking at the data before the operation.

If this is the case, it's okay, at least it's bad luck, it's not that the technology is not good enough, Academician Chu thought to himself.

But even though he thought so, Academician Chu knew that this was definitely not the truth.

Whether it is Huang Lao or Li Lao, they have been reminded before.

not beautiful.

MD!

What an argument!Academician Chu was inexplicably anxious.

"What are you doing on Mayo's side?" A doctor wondered, "Could it be that a replacement came up halfway."

"Change it, just change it, as long as the operation can be done."

"Double-sleeve cut! This is double-sleeve cut! It needs to be done with a laparoscopy. Today is really eye-opening!"

Zhou Congwen didn't know the situation next door, so he concentrated on the operation. Academician Chu watched Zhou Congwen's operation go smoothly in his field.

他游离患肺叶动脉和静脉，并用切割吻合器离断，至奇静脉弓左侧达主肺动脉窗水平，随后开始清扫第7、8、9组淋巴结；暴露胸膜反折处及肺门，清扫右侧第4、5、6组淋巴结，左侧第2、3、4组淋巴结和第10组淋巴结。

Turn up to expose the distal end of the pulmonary vein, and fully free the bronchi after dissecting the 11th group of lymph nodes.

The surgery... is really awesome!

Although Academician Chu has never undergone surgery, he can feel a sense of flowing beauty just by watching Zhou Congwen's surgery process.

Zhou Congwen is not performing surgery, but conducting a top orchestra to play a symphony, the beauty of art is naturally revealed.

The surgical field is clean, and the anatomical structure...is extremely clear, as if it was a specimen of a local anatomy teacher who lectured to students in a university class.

The chattering doctors behind him gradually quieted down. Academician Chu knew that everyone was watching Zhou Congwen's operation.

After Zhou Congwen cleaned the lymph nodes, the surgical field on Chu Yuntian's side suddenly moved.

Academician Chu sighed.

He no longer wants to win or lose. Losing is a certainty. He just hopes that the loss will not be so ugly.

Once thoracoscopic surgery was converted to open thoracotomy, not only my son, but also Mayo's face was lost to grandma's house.

In the operative field on one screen, the operator is struggling to dissociate; in the operative field on the other screen, the operator has separated the left upper lobe bronchus, left lower lobe bronchus, and left main bronchus, and cleaned the surrounding enlarged lymph nodes.

After Zhou Congwen freed the blood vessels and trachea, he used laparoscopic vascular blocking clips on the interlobar arteries invaded by the tumor to block the left pulmonary artery.

Zhou Congwen used scissors to cut off the main trunk of the right pulmonary artery and the interlobar artery, and cut off the right main bronchus and right lower lobe bronchus at the proximal and distal ends where the tumor invaded the right airway.

The next step is to match, Academician Chu knows very well.

Zhou Congwen's operation was so clean that even a "layman" like Academician Chu could see it clearly.

Academician Chu is also very convinced that the surgery can be done to this extent.

No wonder Zhou Congwen rejected him that day very simply and without delay. It turned out that his surgical talent was so high that he couldn't imagine it.

He was so tall that even his own son and Mayo boy couldn't match...No, his son was just unlucky, academician Chu defended Chu Yuntian in his heart.

He seemed to have forgotten the fact that two top experts, Mr. Huang and Mr. Li, had reminded him before the operation that there was something wrong with the patient's image.

In Zhou Congwen's operative field, the tumor had been resected, and the margins were clean according to the naked eye. Then he completely resected the right upper lung and the tumor, and took them out in a specimen bag.

It's time for the most critical step!

Chapter 0583