It will be easier to sew the back opening first, and then sew the front vascular anastomosis after the heart is in the correct position.
The surgeon held the needle and forceps and tweezers and sewed the sutures through the blood vessel wall. Experienced surgeons sewed very quickly. After a while, the first and most difficult left pulmonary vein group was sutured, and they came to the right pulmonary vein group that also belonged to the posterior wall of the left atrium.
There seems to be a little problem here.
Several assistants had been helping with the suction, hook pulling, and thread cutting. Now, when the main surgeon paused, everyone's heart was hanging in the air.
I've said that the whole heart method is difficult, and it's even more difficult when it comes to children's cases. Dr. Cheng Yuchen sighed inwardly. I don't know if my boss didn't do this kind of surgery often and was forced to lower his vigilance in this regard. You know, Mu Yongxian next door has done three cases this year and never dared to use the whole heart method.
Don’t think that the recipient’s pericardial cavity is dilated and the donor heart can be put in, so it is a perfect fit? Definitely not. The human body has its own details. Now one person’s heart is placed in another person’s body. This donor heart is definitely not an original accessory. It is not only different in size at the anastomosis, but also in shape and spacing. You can trim the shape and size differences, but the spacing difference is the most fatal. Think about the operation on the child who was electrocuted last time. Can you say that Dr. Duan’s repeated failures in suturing are due to his poor touch? He can also be regarded as a child of the Cao family. He failed because of the distance.
Why do many doctors like to use the bicaval method to kick out the left atrium? It is because the two anastomotic openings are on the posterior wall, which makes the operation field too tricky. Secondly, in order to reduce the anastomotic operation, they are directly trimmed and cut, which means that a large part must be cut short first. If the distance between the two trimmed cuffs of the donor heart just doesn't match the distance between the two openings of the recipient, there is no room for you to force it. It is better to leave half of the left atrium for easy transfer.
It is impossible to say that a big guy like Brother Shenxian would not have considered this in advance. Maybe he thought it was about right, but after actual operation, he found that the spacing was a little larger than the visual estimation, just that little bit short, which was tricky.
The scary thing about this operation is that it didn't leave the doctor extra time to think. Why did I say that the operation on the child who was electrocuted was relatively simple last time? By comparing this operation, we can see that the time limit for the operation is a high threshold for surgeons.
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A decision must be made as soon as possible, as soon as possible, on what to do next.
All the staff in the operating room were sweating.
At this moment, the numbers ticking every second on the electronic clock on the wall seemed to be announcing the countdown to death.
"Teacher Cao, I think we can sew the inferior vena cava first." Xie Wanying said.
The eyes of others quickly dropped to her face.
Inferior vena cava? Why? If the inferior vena cava is sutured first, the heart will be in the right position, and the vision will be obstructed. How can we continue to sew the anastomosis behind? It doesn't sound right.
"One stitch." The surgeon said.
"Yes. Sewing a stitch, determine the fulcrum. You need to calculate the maximum tension the suture can withstand."
It's not easy to get a feel for Xie's brain. The group of people were confused. It seemed that countless stars were swirling above the head of the third assistant, Wei. Looking at the first assistant, Dr. Cheng Yuchen, his brows were filled with despair: How could he not understand what this student was saying?
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