Surgery Godfather

Chapter 2240: Chapter 1458: Confidence (3)

In the surgical field, three openings appeared: the severed end of the trachea, the severed end of the left main bronchus, and the severed end of the right main bronchus. The three circular openings resembled three black holes, with airflow rushing out from them with each breath.

"Anastomose!" Director He said softly.

He picked up an absorbable suture and began the anastomosis of the trachea to the left main bronchus. This was the first anastomosis site, and it was also the most critical. The diameter of the trachea is larger than that of the left main bronchus, making direct end-to-end anastomosis unsuitable due to poor alignment. Therefore, he adopted the "side-to-end-to-side" anastomosis method suggested by Yang Ping, first attaching the left main bronchus to the side wall of the trachea, and then attaching the right main bronchus to the side wall of the left main bronchus.

Director He’s movements were very slow, each stitch carefully considered. Suturing, knotting, suturing again, knotting again... each stitch was as precise as embroidery.

Yang Ping watched from the side, secretly approving in his heart.

The improvement of Director He was visibly evident. A year ago, when he performed such a complex trachea surgery, his hands trembled a bit and his stitch distances were uneven. But today, his hands were as steady as a precise instrument, with nearly equal spacing for each stitch and just the right knotting tension, neither too tight to cause tissue ischemia nor too loose to allow air leakage.

The first anastomosis was completed. Director He asked the assistant to flush it with saline, then asked the anesthesiologist to inflate the lungs to check for air leaks at the anastomosis site.

"There’s a small one," Director He frowned, "here, on the posterior wall of the left main bronchus, there’s a small needle hole."

He picked up a fine needle and patched it with a single stitch at the hole. Inflating the lungs again revealed no air leaks this time.

"Good!" Yang Ping said, "Proceed."

The second anastomosis, between the right main bronchus and the side wall of the left main bronchus. This anastomosis was more technically challenging because the directions of the two bronchi formed an angle rather than a straight line. Director He trimmed the severed end of the right main bronchus into an oblique plane, then made a longitudinal incision on the side wall of the left main bronchus, aligning the oblique plane with the incision, and began suturing.

This time, he stitched even more slowly. Each stitch angle was first estimated, and then the needle was placed after confirming accuracy.

Yang Ping noticed Director He’s hands were slightly trembling. Not out of nervousness, but fatigue. The surgery had been going for nearly four hours, maintaining intense concentration and meticulous operation would make anyone’s hands tremble.

"Do you need a break?" Yang Ping asked softly.

Director He shook his head, without looking up or stopping his hand movements.

"No need, it’s almost done."

The last few stitches were made with Director He almost holding his breath.

After knotting, the lungs were inflated again for inspection. This time, there was no air leak.

Director He straightened up and let out a long breath.

"The anastomosis is done, next is pulmonary artery replacement." Yang Ping said, "You’ve practiced it in simulation, just follow the procedure, I am here."

Director He nodded, accepting the artificial blood vessel handed over by the assistant to start the end-to-end anastomosis.

The replacement of the pulmonary artery was less technically difficult compared to the tracheal reconstruction, but it was still not without challenges. The pulmonary artery wall is thin and fragile, prone to tearing if not careful during suturing. Additionally, the patient’s pulmonary artery had some degeneration due to long-term tumor compression, making the texture more brittle than normal pulmonary arteries.

Director He changed to a finer needle and began suturing. The first stitch passed through the sleeve of the artificial blood vessel and then through the pulmonary artery wall, knotting. The second stitch, operated the same way. The third stitch, the fourth stitch... stitching one by one, as evenly and steadily as a sewing machine.

Yang Ping noticed that this time Director He’s hands did not tremble.

Perhaps because the most difficult tracheal reconstruction was done, the psychological pressure was relieved. Or maybe he felt confident performing an operation he was familiar with. Whatever the reason, Director He’s condition was significantly better than before.

"Open the blood flow!" Director He said after finishing the last stitch to the anesthesiologist.

The clamp was released, and blood flowed through the artificial vessel into the pulmonary artery system. Director He watched the anastomosis site carefully for any bleeding.

"There’s some slight bleeding at the right pulmonary artery anastomosis site, spray a little bit of bio-glue." Yang Ping reminded.

Director He took the bio-glue and sprayed a small amount at the bleeding site. The glue solidified instantly upon contact with the blood, stopping the bleeding.

"Okay, close the chest."

Yang Ping glanced at the clock on the wall: 18:25. The surgery from start to finish had already taken over four hours. It was a bit faster than Yang Ping had expected.

"Well done." Yang Ping patted Director He on the shoulder, "You completed this surgery independently; I just stood here and watched. In the future, you’ll have the confidence to do such operations by yourself."

Director He turned his head, a complex light in his eyes above the mask.

"Professor Yang, if it wasn’t for you being here, I might not have done it so smoothly. With you by my side, I have peace of mind."

Director He was speaking from the heart; with Professor Yang standing by even for such a high-difficulty surgery, his confidence soared. After a few more of such operations, he would be able to proficiently take the lead himself.

Yang Ping smiled lightly.

"Alright, you close the chest, I’m leaving. Postoperative management needs to be followed up; air leaks at the anastomosis and bleeding at the pulmonary artery anastomosis are the most dangerous postoperative complications – monitor closely."

"Understood!"

Yang Ping walked out of the operating room, changed out of his scrubs in the changing room, and put on his white gown again.

He washed his hands, dried them with a paper towel, then walked out of the surgery center.

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