Surgery Godfather
Chapter 936 - 807: Debut Special Technique_2

Chapter 936: Chapter 807: Debut Special Technique_2

"Prepare for extracorporeal circulation and cardiac arrest!"

Connect the extracorporeal circulation, inject the cardiac arrest fluid, and cause the heart to stop.

During the extracorporeal circulation process, gradually lower the infant’s body temperature until the core temperature reaches 15°C, then turn off the extracorporeal circulation machine and stop all blood circulation. This is DHCA—deep hypothermic circulatory arrest technique.

Because infants cannot withstand long durations of extracorporeal circulation, this technique must be used.

Under deep hypothermic circulatory arrest, the heart is arrested, and blood flow is paused, so it resembles "death," albeit a controlled, reversible "death" that can be "revived" under certain conditions.

Those conditions stipulate that this state cannot last more than 45 minutes; revival is possible within 45 minutes, but past this duration, revival isn’t possible, so the surgery must be completed within 45 minutes.

"Should we combine antegrade perfusion via the head and arm arch artery with retrograde perfusion through the superior vena cava for cerebral protection?" Academician Wang suggested.

Adding this step to protect the brain could extend the time of deep hypothermic circulatory arrest to 60 minutes, creating more ample time for the surgery.

"No need, I will try to finish the surgery in 20 minutes," Yang Ping said without hesitation.

minutes, what a joke, but now Academician Wang had no doubts. One could not apply ordinary thinking to this young man.

Yang Ping began to quickly inspect the heart and the connected blood vessels. The aorta was very narrow, presenting severe stenosis, and now Yang Ping had to cut off the aorta and widen it to restore normal caliber.

When the aorta was cut, and its severed end was exposed, Academician Wang took a deep breath.

This mirrored two failed cases from years past; the vascular walls were as thin as paper and lacked elasticity. Perfect suturing couldn’t ensure uniformity with each stitch, and if it wasn’t uniform, weaknesses existed, focusing stress at these weak points and causing blood pressure to burst these fragile parts, tearing the vessel from these spots.

In the first case years ago, seeing such blood vessels, Academician Wang felt disheartened; it seemed impossible to suture, and although he did his best, he couldn’t achieve the desired uniformity.

"Do we need an artificial blood vessel?"

Academician Wang asked.

An artificial blood vessel was a good solution; it could bear the stress and protect the suture site, but it had a fatal flaw: infants grow over time, whereas the diameter of the artificial blood vessel doesn’t change, making it unsuitable for minors, especially infants. This flaw required the removal of the artificial blood vessel after a certain period.

"Not necessary!"

Yang Ping decided to use his sophisticated suturing skills to address the issue. Since the vessels could withstand the blood pressure before being cut, achieving ideal uniformity in suturing could still hope for success.

Not only did the suturing need to be uniform, but the spacing and margins also needed careful design. He absolutely couldn’t plan according to normal vessels; if the spacing and margins were incorrect, each stitch would bear too little force, and even perfect suturing would be in vain.

In principle, the denser the suturing, the better, as this disperses the stress on each stitch to a minimum. However, the denser the stitches, the more punctures made, reducing the strength of the vessel. Thus, finding a balance between the two was essential.

This kind of suturing wasn’t just about the technique; many factors had to be considered.

Academician Wang’s two failed experiences made him extremely apprehensive. This surgery truly was like walking on the edge of a knife; not a single mistake could be afforded.

Yang Ping was very careful but also swift in his movements; indeed, when one reaches a certain level of proficiency, speed and slowness are only relative.

First, he ligated and cut off the arterial duct between the pulmonary artery and the aorta, then cut the pulmonary artery above the pulmonary valve, and used a patch to close the side opening of the pulmonary artery.

He took a segment of a vein, Yang Ping opened up the vein and used it as a patch to enlarge the aorta’s diameter; each of his stitches in and out was calculated precisely, each movement completed in one attempt, inserting the needle at a 90-degree angle to the suture face and then, with a sudden flick of his wrist, driving the needle tip swiftly through the vessel wall. If the puncture hole in the vessel wall were enlarged, its edges would appear even, causing minimal damage.

Academician Wang noticed that during suturing, each of Yang Ping’s sutures moved from in to out very smoothly, the vessel wall seemed still, without a trace of pulling.

After enlarging the aorta’s diameter, Yang Ping connected it to the recently severed base of the pulmonary artery from the right ventricle, effectively linking the aorta to the right ventricle.

At this step, Academician Wang noticed, the diameter of the aorta matched perfectly with the residual pulmonary artery base of the right ventricle. Thus, when Yang Ping was enlarging the aorta’s diameter, he had already considered keeping it consistent with the diameter of the adjoining pulmonary artery base.

Such meticulous attention, absolutely airtight.

The diameter of the anastomosis was just as precise, every stitch perfectly in place on the first attempt, with no need for repeats or reduced quality.

After suturing, the diameter matched up perfectly and was very well sealed.

The resection of the interatrial septum opened up the left and right atria into one large chamber.

The next step was the most challenging, bridging the pulmonary artery to the aorta. This bridging wasn’t a matter of directly connecting them, since the aorta had already been connected to the right ventricle; rather, it involved using an artificial blood vessel to temporarily link the pulmonary artery with the aorta.

For this temporary bridge, Yang Ping chose a branch of the aorta—the anonyma artery, which is not nameless but actually called the anonyma artery.

The heart was smaller than a walnut, the aorta also small, hence one could imagine that its branch, the anonyma artery, was very small. Yet, even if small, it was thicker than an infant’s finger’s blood vessels, and to Yang Ping, this was no challenge at all.

Vascular anastomosis on small vessels tested steadiness of hands, especially when the arms are suspended in the air, but for Yang Ping, this was not an issue; indeed, it was his trademark skill.

Suspended arm small vessel anastomosis, when performed at the Mayo Clinic, drove the doctors there crazy.

As assistants, Academician Wang and Professor Chen tried to breathe evenly, and during critical maneuvers, they even held their breaths, and after relaxing, they made an effort to control their breaths to avoid taking deep inhalations or exhalations, so as not to disturb Yang Ping’s operation.

The bridging was completed with ultimate proficiency in vascular anastomosis technique, with 5 minutes still remaining out of the 20 minutes, that is, using just 15 minutes, Yang Ping completed the entire suturing, thanks to his unparalleled vascular anastomosis prowess.

Academician Wang didn’t know what to say, completely amazed by the speed of the surgery.

"Restore body temperature!"

Warming needed to be done gradually, slowly restored; it couldn’t be too rapid. After repositioning, the extracorporeal circulation technician restored the extracorporeal circulation, making the blood flow again in the baby’s body.

Then it was time to remove the extracorporeal circulation and restart the heart. Once cardiac function resumed, the true self-circulation centered on the heart began.

This step was the most thrilling; the scene from those years was still etched in Academician Wang’s mind—when the heart started beating, soon after, bleeding points emerged one after another, followed by spurts of blood, and eventually, jets of blood filled the entire thoracic cavity, complete chaos ensued; in the urgency, it was simply impossible to stop the bleeding, and the more stitching they attempted, the worse the blood vessels got, ultimately resorting to blocking major vessels to stem the blood flow, but this was futile, a temporary block could not last forever.

"I am starting to restart the heart, let’s see how the sutures hold," Yang Ping announced.

Academician Wang and Professor Chen watched the heart, holding their breaths, the heart began to beat, they felt nervous, wondering if it would spray blood everywhere like before, ultimately causing all sutures to come undone.

One minute, two minutes, three minutes, four minutes, five minutes—still no sign of bleeding, not even one bleeding point, let alone spurting or jetting blood.

"Let’s observe for another ten minutes, if there are no issues, we can close the chest."

Yang Ping put down the instruments in his hands.

"Song Zimo, finish up!"

"Right!"

Having been somewhat marginalized, Song Zimo and Xu Zhiliang immediately perked up; they too had been watching the operation on the screen in the operating room, which was also being broadcast live.

"Professor, it seems that your famed re-implantation technique for infant’s severed fingers hasn’t deteriorated," Song Zimo said with a smile.

Back then? It hasn’t been that long, but it sounds like ancient history.

"This was my debut skill, can I just lose it?"

Yang Ping vacated the chief surgeon’s position, handing over the finishing tasks to his assistant.

Meanwhile, seated beside the operating room screen, Li Zehui was also in shock, that the main steps of the surgery were completed in just 15 minutes without a single issue—a unique skill indeed, unmatched anywhere in the world.