“Boss, did old he feel like he missed something when he wasn’t here?” Su Yun stood in the operating room and asked with a smile as she prepared the equipment.

“Yes, I’m used to it.” Zheng Ren nodded and said.

However, he couldn’t bring the entire medical team with him every time he went out, right? that didn’t make sense.

“You bragged about old he in Guangzhou. I heard from him that there’s going to be an anesthesia academic conference this weekend. Director Qiu from Guangzhou will definitely come and meet old he.” Su Yun said.

“I’m not bragging. Old he’s definitely very good. ” Zheng Ren said,”otherwise, we wouldn’t have been able to perform the heart-conjoined twins separation surgery.”

“I was scolded by you.”

“When did I ever scold old he?”

“It’s an artistic exaggeration. Don’t be so mean, okay?” Su Yun adjusted the operating table and asked,”the angle of the semi-reclining position can only be this. Do you think it’s okay?”

Zheng Ren nodded.”As long as the patient can accept it.”

Generally speaking, a patient should lie flat during surgery. However, the patient in front of him had a blocked respiratory tract and inhaled little oxygen, so he could not lie flat because of cardiac function problems.

This was also a common feature of many patients with late-stage lung cancer. It was also called sitting cross-legged breathing.

It was impossible to lie down for the surgery, so the surgeon could only try his best to deal with it. He changed the position of the surgery and chose a semi-reclining position.

Soon, the patient was sent in and was carried to the operating table. He was placed in a half-lying position and had an oxygen mask on. The oxygen level was 10 liters per minute.

​ Seeing that the patient’s blood oxygen saturation level was good, Zheng Ren performed an operation and brushed his hands together with Su Yun to prepare for the operation.

A 28F vein catheter was impaled through perceptual puncture on the right femoral vein for drainage, and a 20F artery vein catheter was impaled through perceptual puncture on the left femoral artery for infusion.

After that, he waited quietly for 30 minutes to activate the VA ECMO.

After the ECMO was activated, Zheng Ren made a hand gesture.

However, he immediately realized that they were not in China. Old he was not with him.

Su Yun noticed it and laughed,””Boss, you’ve already forgotten about it.”

“Yeah, I’m really used to it.” After Zheng Ren finished speaking, he began to communicate with the anesthetist of burta.

He administered basic anesthesia and sedatives on the patient’s vein, then changed the patient’s position to a prone position. The patient, who was originally unable to lie down, did not show any abnormal reaction when he entered the lying state under the influence of ECMO.

The blood oxygen saturation level was good, and her vital signs were stable. Everything was going smoothly.

Only then did Su Yun heave a sigh of relief. Doctor Nicole, who was standing in the operating room, felt a sense of loss.

This idea was very simple. Why didn’t he think of it? The same thought appeared in both of their minds at the same time.

“Su Yun, you keep an eye on ECMO. I’ll do the surgery with Fugui ‘er.” Zheng Ren said.

“Yes, boss.” Professor Rudolf Wagner replied cheerfully.

Su Yun didn’t say anything and just stared at the machine. The circulatory system was prepped with 100 ml of fresh blood, 400 ml of ringers ‘solution, 2 mg/kg of heparin, and MAP and SaO2 were monitored during transfusion. The blood flow speed was 2.5 L/min, and the OO2 was maintained above 90%.

Everything was perfect. He made a hand gesture, indicating that Zheng Ren could start.

Zheng Ren was also very satisfied with the data displayed on the electrocardiogram. The patient inserted a firbowentrist tracheostomy tube through the nose.

Through the screen, Zheng Ren saw that the middle trachea was narrowed due to external pressure, and there was a new creature in the trachea. The trachea was basically blocked. He started to choose a guide wire and slowly inserted it into the patient’s windpipe.

As predicted, the airway was different from the esophagus. As long as the patient was still alive, it was impossible for the main airway to be completely blocked.

Even though the airway was distorted, Zheng Ren easily inserted the guide wire.

“Boss, do you want to step on the line or use a tracheostomy tube?” Su Yun asked.

“Step on the line.” Zheng Ren still chose the most secure method.

Looking at the patient’s condition, it was also possible to observe the stent through a tracheostomy tube, but it would not be as intuitive as the one seen by the medical associate Chief physician, Machine Man.

The 18mm x 40mm nickel-iron tracheal stent was placed in place, followed by the release of the stent and the pulling out of the stent implant. Zheng Ren began to draw blood secretions and adjusted the position of the stent with a biopsy clamp. Under the NSA machine, he could see that the tracheal stent was open, and the airway was back to normal.

“You can stop the rolling of ECMO now.” Zheng Ren said.

Su Yun then began to communicate with the anesthetist on the other side. She used the fish essence and protein to neutralize the drug and stopped the circulation of the ECMO.

The actual operating time of the ECMO was only 12 ‘ 26 seconds, and the surgery was completed in a simple manner.

A surgery that was deemed impossible by burta was completed without any surprises.

Zheng Ren was not in a hurry to send the patient back. He observed the patient in the operating room for a full 30 minutes, which was even longer than the actual operation.

Su Yun was very impressed by how cautious he was.

“Doctor Zheng, your way of thinking is really amazing.” Doctor Nicole walked into the operating room and spoke to Zheng Ren. Doctor Zheng’s surgical skills could not be seen in this surgery. It was mainly because of the alternative use of ECMO, which opened up Nicole’s mind.

“Hmm, the surgery process is still a little slow, and there are some problems with their cooperation.” Zheng Ren’s eyes kept moving back and forth between the electrocardiogram and the patient.

“Their cooperation is already very good!” Dr. Nicole said in surprise. Was Dr. Zheng for real? He spent the longest time in the entire surgery observing the patient after the surgery.

“If my anesthetist were to come, the turning point for ECMO can be controlled within about six minutes.” Zheng Ren did not even look at doctor Nicole and was just casually chatting.

Six minutes …

The number surprised doctor Nicole.

Only a well-trained medical team could control the activation time of the ECMO within 15 minutes. For example, the activation time before doctor Zheng’s surgery was 30 minutes.

It wasn’t a long time, and it was just normal.

But six minutes, was that really okay?

“Oh my God …” Dr. Nicole was surprised by Dr. Zheng’s surgery and thinking, but she did not expect him to be talking to her about the launch time of ECMO.

Could it be that Dr. Zheng was telling him that his medical team was better than his and Botha Private Hospital’s in all aspects?

Su Yun glanced at her boss and smiled.””Boss, won’t old he get proud if you keep praising him like this?”

“I’m telling you the truth,” Zheng Ren said,”he’s recovering well. Get ready to send him back to the ward.”

In the operating theater with the system, the assistant who cooperated with the surgery should be based on old he. Indeed, only six minutes were used for the warm-up stage of the ECMO. Zheng Ren was just telling the truth without any exaggeration.

“Doctor Zheng, is there anything I should take note of after the surgery?” Asked Dr. Nicole.

“Review the CT scan one day later to see if the windpipe is unobstructed, and how the stent position is. Two days later, I’ll check the tracheostomy tube again to see if the middle tracheostomy tube has been completely restored. ” Zheng Ren said,”there’s nothing else. The patient’s breathing difficulties have been resolved. All that’s left is to rest for a few days. Once his body has recovered, we can proceed with the next treatment.”

With that, Zheng Ren left the operating table, turned around, took off his sterile gloves, and threw them into the bucket of medical waste.

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