Itâs burnt, so we had to ask someone to send another one. As a result, she didnât have time to eat lunch, and she rushed into the operating room to learn. Thinking of this, Cao Yong glanced at the person not far away.
The others seemed to be able to sense who he was looking at.
Xie Wanyingâs gaze was tracking the Chief Surgeonâs movements.
Teacher Zhang was likely feeling for the thyroid cartilage and suprasternal notch, which are the usual incision points for a tracheotomy.
The thyroid cartilage is the most prominent point on the midline of the neck when the head is extended. Below the thyroid cartilage, you can feel several tracheal rings. This child is not overweight, making it easy for the doctor to palpate.
While observing, Xie Wanying adjusted the parameters in her brain based on the previous feeling she had when probing inside the childâs trachea with forceps, to see if anything changed. She too needed to judge whether she was right or wrong.
"Any thoughts?" Zhang Huayao asked her, sensing that her concentrated attention might have brought up an idea.
Clinically, teachers enjoy engaging in academic collisions with talented students, whether they are big shots or not.
"If we cut from here, the obstruction is in the right bronchus, roughly parallel to the fifth and sixth thoracic vertebrae, a certain distance away. We might need a custom tool to extract it," Xie Wanying shared her thoughts, "Currently, Iâm most afraid not of failing to extract it, but ofâ"
"Once itâs extracted, there could be massive bleeding, and by then, the surgical site wonât be at the bleeding point, making it hard to stop the bleeding," Zhang Huayao didnât need her to say more, because this was also a concern for the teachers.
The reason a tracheal hemorrhage can cause asphyxiation is due to the bodyâs coagulation mechanism. Bleeding leads to the formation of clots, which can directly cause asphyxiation by blocking the trachea again.
Fu Xinheng, as the First Assistant, was already prepared, holding a suction device.
Liu Yu and the anesthesiologist both sighed. This is the oral surgery room, not accustomed to cardiothoracic surgeries, and lacks the specialized instruments and equipment needed for support. The whole surgery is actually a bit risky.
The instrument nurse reported to the bosses, "We donât have a cardiothoracic surgery pack here."
The bosses were well aware of the risks. If the surgery isnât done, the patient could die; if it is, the doctors take on immense responsibility and risk. The waiting family members outside are a group of difficult people who wonât understand the doctors. If it werenât for this innocent young life at hand, doctors unrelated to the situation could simply walk away.
"Start," Zhang Huayao commanded the nurse.
The nurse handed over the scalpel.
The surgical field was in the anterior triangle of the neck, an inverted triangle, with the mandible as the upper boundary, the suprasternal notch as the lower boundary, and the sternocleidomastoid muscles on either side. The incision could be vertical or horizontal; considering the need to remove a foreign object, the Chief Surgeon chose a vertical incision.
The first cut went from the previously located lower border of the thyroid cartilage to the suprasternal fossa.
Like other surgeries, you first cut the skin, then the subcutaneous tissue, layer by layer. The neck has many structures, so this must be done very carefully and not too quickly, which is also why small surgeries can take a long time.
Xie Wanying thought of the slow-paced pediatric surgeon Teacher Nie.
Treating children requires slowness and meticulousness. Operating on a childâs body is akin to carving ivory, embroidering tiny flowers, insects, and bees. General surgeons are not usually accustomed to this. Fortunately, todayâs surgeon is a cardiothoracic surgeon. Though Guoxieâs cardiothoracic surgeons are not pediatric surgeons, due to the funding constraints in domestic top comprehensive hospitals, the pediatric surgery departments arenât subdivided into specialties like pediatric cardiothoracic surgery, they have still done many pediatric surgeries. As for Zhang Huayao, heâs a boss among bosses, definitely experienced in pediatric surgeries as well.