In fact, Xia Tao's estimate of how difficult it is is still a conservative one.

Tracheal reconstruction surgery is a term that was not coined until 1997, and it has only been about a year since this type of surgery began.

The surgery was new and the technology was difficult, which was like an insurmountable mountain for the thoracic and cardiovascular surgery department at that time.

In fact, a director like Xia Tao only mastered this technology this year.

Most of the tracheal reconstruction surgeries he performed were only one or two centimeters of circumcision, and the longest one was no more than five centimeters.

But for the current one, which required an eight-centimeter tracheal circumcision, Xia Tao thought it was impossible.

"Director Xia, I just took a look. The tracheal injury is near the aortic arch. It can be directly lifted up for anastomosis. The length should be enough."

At this time, Xiao Chenguang's eyes never left the ruptured trachea.

His brain was working quickly, reproducing the graphics and simulating every surgical step of tracheal reconstruction.

In fact, the principle of tracheal reconstruction is the same as the repair of ruptured water pipes in normal times.

Cut off the split lumen from one end and discard it, then suture the intact lumens on both sides and reuse them.

However, the trachea is a part of the human body, and it is not like a cold object that can be cut at will.

If you cut too little, the suture will not be strong, and complications such as tracheoesophageal fistula are likely to occur.

If you cut too much, the length is not enough and it is impossible to anastomose, which will directly lead to the failure of the entire operation.

Anyway, there are too many things to consider, which undoubtedly increases the difficulty of the operation.

"Xiao Xiao, will the method you mentioned work?"

Just now, Xia Tao was also thinking about it, trying to use his many years of clinical experience to find a suitable surgical plan.

But no matter how hard he racked his brains, he still didn't get a good result.

Seeing Xiao Chenguang's suggestion at this moment, Xia Tao hesitated.

Eight centimeters is already the limit of cutting.

Even if the tracheal ring is ductile, pulling it too long will inevitably lead to a decrease in elasticity and tracheal tearing and bleeding.

At that time, even if the operation is over, if the patient accidentally raises his head, it is very likely that the trachea will be broken again.

By then, it will be too late to rescue on the spot.

"Is a simple suture repair okay?"

"No."

Xiao Chenguang shook his head.

The trachea is composed of circular cartilages and thin membranes, and the cartilages are clearly divided from top to bottom. It is simply a fantasy to want to suture directly with needles and threads.

"Director Xia, Dr. Li's blood oxygen saturation is still decreasing."

The director of the anesthesiology department reminded on the side.

In any case, a plan must be discussed now. Dr. Li on the stage is not in a good condition.

Long-term hypoxia will inevitably cause irreversible damage to internal organs.

At this moment, the operation has reached a dilemma.

"Then... we can only take it one step at a time."

The tracheal reconstruction of this operation is very demanding, whether it is the cutting technique or the suturing technique.

It even has to be accurate to millimeters to ensure the successful completion of the operation.

With Xia Tao's current state, no, even if he is in full condition, he certainly does not have this strength. As for Xiao Chenguang...

Perhaps now, only he dares to do this operation.

"Prepare the retractors and traction. I need to make an incision in the mediastinum for the approach."

After the plan was finalized, Xiao Chenguang took the lead in the operation.

Time was tight, so Xiao Chenguang began to give orders.

At this moment, Wang Jingang, Lin Gaoyang, and Xia Tao were all on the stage, acting as his assistants.

"Mediastinal incision, is this a new procedure?"

Everyone knows how to do the assistant work, but only the hands are familiar with it.

But Xia Tao, as the director who has carried out this technology, was stunned when he saw Xiao Chenguang holding a scalpel and entering the mediastinum.

When he did tracheal reconstruction, he always made a transverse incision in the neck. He had never seen the mediastinal incision that Xiao Chenguang used now.

He was even more unsure.

But Xia Tao had never seen it, which did not mean that Xiao Chenguang's operation had problems.

On the contrary, for this operation, making a mediastinal incision is the best choice.

It is also a surgical approach often used in later generations.

The surgical effect is also safer and more effective.

This is also a key reason why Xiao Chenguang dared to say that this operation could be done.

"Insert the tracheal tube another 3 centimeters."

"Got it."

After hearing this, the anesthesia director released the air bag and, according to Xiao Chenguang's instructions, inserted the tube another 3 centimeters into the hilum of the lung.

Urgently inflate the air bag to prevent aspiration.

"Prepare to free the trachea, hemostatic forceps, straight forceps."

Faced with the exposed tracheal cavity, Xiao Chenguang needed to completely free the surrounding connective tissue and expose the entire trachea to the surgical field.

In fact, according to the standards of later generations, such a risky operation would have required extracorporeal circulation.

Use instruments to replace the human heart and lung function.

So as to better complete the operation.

It's just thatNow, one is that the patient's condition does not allow it, and the other is that there is no equipment.

After all, the extracorporeal circulation machine is expensive and the technology is difficult. Usually, hospitals that introduce technology need to send personnel to study for a year before they are qualified to perform this operation.

Perhaps after passing the hospital grade review in the future, they will consider introducing this technology.

But now these are too far away for Shengli Hospital.

Blunt separation, Xiao Chenguang holds the instrument, opens the bow left and right, and separates the surrounding tissues step by step.

Avoid the nerve plexus, stay away from the recurrent laryngeal nerve, and ligate the bleeding small blood vessels.

Xiao Chenguang's movements are still very fast, and gradually a thick milky white trachea appears in front of everyone.

At this time, Dr. Li's blood pressure is a little low.

Although Xiao Chenguang has tried his best to control the bleeding, some anatomical structures are full of tiny blood vessels, and bleeding is inevitable.

"Ask the blood transfusion department, is there any blood stored?"

"Director Xiao, the first batch of people who voluntarily donated blood have completed blood tests and should be delivered soon."

The circulating nurse told Xiao Chenguang the news.

"Okay."

"Prepare for tracheal circular resection + tracheal end-to-end anastomosis."

"Give him another 1,000 colloid fluids."

Xiao Chenguang was not going to wait any longer. He glanced at the blood oxygen saturation on Dr. Li's monitor.

85%

According to experience, the arterial oxygen partial pressure should be above 60 mmHg.

As long as it is greater than this value, it is acceptable.

The scalpel was handed to Xiao Chenguang again.

Under the watchful eyes of the crowd, Xiao Chenguang began to cut the tracheal ring.

The bright tip of the knife looked extremely sharp under the reflection of the shadowless light.

Xiao Chenguang held the knife like a pen, and the tip of the knife began to repair and cut on the broken tracheal ring.

The operating room was quiet. Everyone held their breath at this moment. No one dared to disturb Xiao Chenguang at this time.

The latter's blade turned, cutting in a circle, along the direction of the aortic arch, and separated the tracheal ring.

There was only the beeping sound of the monitor at the scene.

Everyone was very nervous. After all, the circumcision is close to the aortic arch, which is the largest artery in the human body.

Every year, many patients with aortic dissection die.

And one section is the location of the aortic arch.

It can be said that as long as it is broken, there is no chance to go to the operating table.

At this moment, the tip of the knife is walking on the aorta, just like walking on a tightrope on a cliff. If you are not careful, you will lose everything.

But Xiao Chenguang on the stage did not change his face, and even his breathing was very even.

His hand was as steady as Mount Tai, and the tip of the knife moved slowly on the aortic arch, separating the nearby tracheal rings.

Everyone at the scene had their hearts hanging in their throats.

Time passed by minute by minute.

I don’t know how long it took, but Xiao Chenguang’s hand suddenly raised.

An eight-centimeter tracheal ring was cut off, and the nearby aortic arch was safe and sound, without any damage.