After a while, Director Liu came back after the surgery.

He asked Director Miao for instructions, then washed his hands again, and began to change the procedure and completed the unfinished operation again.

The operation is very simple, it is just a destructive nephrocancer resection. Director Liu's technique is delicate. Even if the old director stood behind him and watched, he still did not show any tension. He completed the entire operation in less than an hour.

With the skin sewing, the singing of good luck echoed in the operating room. Director Liu seemed to relax a little, and he asked: "Director, how do you guess come from?"

"The damage to the large blood vessels did not occur during the operation. The renal vein, lumbar vein, right phrenic vein and inferior vena cava are intact, and the damage causes the gas to absorb and enter the circulation. I think it should be that when the carbon dioxide is quickly inflated to establish the pneumoabdominal abdomen, carbon dioxide passes through the malformed blood vessels of the kidney tumor and then enters the circulation."

"The patient's blood pressure is not falling quickly. I look at the anesthesia record sheet. You have about 11 points to rescue." Director Miao said with his hands behind his back and clearly, "Do you remember I scolded you once?"

"Remember." Director Liu did not avoid this question and said frankly, "I had an operation and hem-o-lok was placed at the fork of the renal vein and failed to completely close the renal vein."

"Well, if that's the case, a large amount of carbon dioxide will enter the blood circulation with the pressure difference." Director Miao continued, "I guess this is the 50% mortality rate. The carbon dioxide in the pneumoclase enters the large blood vessels and causes irrescue death. In this case, a small amount of gas enters the malformed blood vessels and is still saved."

"Carbon dioxide enters the right atrium, right ventricle, and pulmonary artery along the pressure gradient through the open vein through the inferior vena cava, forming a gas clamp at the pulmonary artery, causing mechanical obstruction, causing blood flow to fail to enter the left ventricle, resulting in circulatory failure of the patient?"

"The amount of gas entering is not much, and this is also the finest way you do the surgery. There are some complications that cannot be prevented, just remember how to rescue them. Be careful before the operation, and it's nothing to say more."

Director Miao was still nagging like a senior director.

"Director, you need to blow the ventilator for a few days after the operation." Director Liu asked.

"It's OK in 1-2 days." Director Miao said confidently: "After going back, check the echocardiac at the head of the bed and find someone with good skills to do it. If there is no residual gas in the heart, you can be untuned in at most two days."

After saying that, Director Miao paused and said, "I remember to remind the nurse of IU to stay energetic at night and suck phlegm every 1 hour. If there is a lot of phlegm left in the lungs, there will be absent."

"Director, I will stay at IU to see patients at night." Director Liu said naturally, "Don't worry."

"Yes." Director Miao nodded, all this seemed to be justified.

"Director, thanks to your experience, I was stunned at that time." Director Liu said frankly. He did not hide his lack of experience and said frankly.

"It's good to have experienced it once." Director Miao said, "There is inevitable risk of gas thrombosis in establishing a pneumoid? The incidence of gas embolism is very low, about 0.002% to 0.02%. Once it occurs, its mortality rate can be as high as 50%?"

"In the past few years, there have been three cases in our science department, plus this one of yours."

Director Liu sighed a little that the 912 urology department is very powerful, otherwise it would be impossible for all the professors in the group to feel that they can compete for the position of director.

Indeed, everyone has this qualification, whether in terms of surgery level or other aspects. But that is normal. Once we encounter this kind of thing, Director Liu deeply feels the correctness of the saying that an old man is like a treasure in his family.

There are thousands of laparoscopic surgeries a year, but only three cases have occurred over the years. According to Director Miao’s meaning and Director Liu’s understanding, two cases occurred when he did not come.

"So when you have laparoscopic surgery, I should remind you to pay attention to the patient's condition. Quick diagnosis and timely and effective treatment are necessary conditions for success, because air embolism leaves too little time for rescue?"

“The management goal of gas plugs is to prevent further gases from entering the circulation and maintain hemodynamic stability, which is critical.”

"Once an abnormal situation occurs, the inflatration should be stopped immediately to reduce the pneumoabdominal pressure. Place the patient in the left lying position with his head lowered and his feet high, so that the bubbles entering the right ventricle gather at the apex of the heart to prevent it from entering the pulmonary artery."

"Card pulmonary resuscitation and defibrillation should be performed in time when cardiac arrest occurs, and the circulation can also flow air out of the pulmonary artery."

"He Junjin did a good job and used the central venous catheter to suck out the gas as soon as possible."

"I looked at the anesthesia record sheet. After He Junjin came, he increased the liquid input. I asked you why?" Director Miao's voice suddenly became cold, like a stern teacher asking a naughty student.

"Is it because of infusion of a large amount of liquid to increase the venous pressure, thereby preventing carbon dioxide gas from further entering the venous system?" Director Liu also had a solid basic knowledge and answered directly without thinking.

"Yeah, that's it."

Director Miao finished the last stitch, and he turned around with his hands behind his back to leave.

"Director, wait a moment!" Director Liu's hand speed increased, and he pierced the last needle, held the needle device and the tweezers in his hand and patted the patient's leg, and turned around to catch up with Director Miao.

"Hmm?" Director Miao nodded softly.

"Director, I went to see you a few days ago. Please consider what I told you." Director Liu said very seriously, "I don't have any heavy work to do when I get back to hire. Just take us to check the room one day a week. The key is... The key is that you are not here, and I feel unsure."

"Prosperity." Director Miao snorted coldly, "I have to leave sooner or later. Don't be afraid to do something because of one or two accidents. Go back and read the book and ask He Junjin. I remember that a gastrointestinal embolization occurred in a laparoscopic operation three years ago. That surgery was anesthetized by He Junjin."

When Lao He saw that Boss Zheng was about to leave, he pulled out the U disk and was busy talking. When Director Miao mentioned him, he smiled.

Zheng Ren glanced at Lao He. It was really not easy for this guy to live such a big life.

"director……"

"You guys do your best. I will retire if I retire and will not be rehired." Director Miao said firmly.

After saying that, he slowly left the operating room with his hands behind his back.

Zheng Ren glanced at Director Liu and then followed Director Miao's footsteps. He knew what Director Miao's last words meant, and Director Miao was still too kind-hearted.

...

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Chapter completed!