Chapter 1898: 1831 The True Essence of Surgery (Alliance Leader shyn307 Bonus Chapter 4)

After opening the aorta, the intima of the aortic arch was torn in a flake‑like manner.

At the openings of the three brachiocephalic vessels, the intima had peeled off to form true and false lumens; the intima of the arch‑to‑descending segment was torn longitudinally over two‑thirds, and the false lumen measured 3.0 cm in diameter.

At the opening of the true lumen, most of the intima had collapsed, leaving a diameter of about 2.0 cm.

"Fugui'er!" Zheng Ren shouted.

"Mm." Professor Rudolf Wagner replied, "Shall we begin now?"

"Ready, wait a moment."

Having said that, Zheng Ren reached out and slapped a covered‑stent artificial blood vessel into his hand.

Stent: 28 mm × 100 mm; the length was still suitable.

Zheng Ren inserted the covered‑stent artificial blood vessel into the true lumen and released it, allowing the stent to fully expand.

Then they transected the left subclavian artery at its origin, and at its opening they cut the start of the descending aorta, excised a portion of the proximal end of the covered‑stent artificial vessel, and sutured the outer and inner layers of the proximal descending aorta to the suture margin of the covered‑stent vessel with interrupted stitches.

Using 3‑0 prolene suture, they anastomosed the 30 mm diameter quadrifurcation artificial blood vessel of the Datascope Intervascular to the proximal transected edge of the descending aorta together with the covered‑stent artificial blood

The suture margin of the tube was made into an end‑to‑end anastomosis.

They connected the standby arterial perfusion tube to one side branch of the quadrifurcation artificial vessel, slowly infused blood into the descending aorta, occluded the side branch near its proximal end with the quadrifurcation artificial vessel, and the descending aorta began to receive blood flow.

The perfusion flow rate was 20 ml/(kg·min).

Using 5‑0 prolene suture, they performed end‑to‑end anastomoses of the proximal ends of the left subclavian artery, left common carotid artery, and innominate artery to the corresponding branches of the quadrifurcation artificial vessel.

One hour and twenty‑two minutes into the surgery, the anastomosis of the aortic arch was proceeding in an orderly manner.

……

……

At that moment, in the observation room on the second floor, Dr. Charles sat in a chair, his eyes fixed on the images on the large screen.

"Doctor, is the surgery still going well?" Rudy felt a little anxious.

The surgery was going quite smoothly, yet the smoother it went, the more anxious he became.

A Bentall procedure, could it really go this smoothly?

The operative field was clean and clear, each step orderly, and the surgeon's movements were so swift they seemed inhuman.

Although things were progressing well, Rudy grew more and more terrified the longer he watched.

Moreover, it was said that the heart had stopped before the operation; surely there would be no brain death.

"Even now it's a perfect surgery, precise as a machine," Dr. Charles said.

His English carried an accent, but it did not hinder his communication with Rudy.

"Doctor, do you think the surgery could…" Rudy asked hesitantly; the situation had already surpassed his expectations, like a thawed wild dog wandering farther and farther down an immeasurable road.

Only when he met Dr. Charles returning did he realize the surgery had already begun, because the worsening brachio‑arterial tear and ensuing cardiac arrest had made delay impossible.

Upon hearing this news, Rudy nearly fainted.

In fact, he had not trusted Zheng Renye either; it was only after Dr. Charles arrived that Rudy placed his trust in Zheng Ren's side.

"I don't need to step in," Dr. Charles said. "I haven't performed surgery in many years; the peak of surgical skill was merely a thing of the past. What you see now is the current peak of surgery."

"…" Rudy stared in astonishment.

Dr. Rainer clenched his fists, standing slightly behind and to the side of Dr. Charles, feeling somewhat angry.

But it was only anger; he could find no fault in the surgical process shown on the screen.

If he himself were on the operating table, he likely could achieve no more than this.

Of course, this was merely Dr. Rainer's own opinion; deep down he was quite certain he could not reach the surgeon's level.

From the initial dissection, through occlusion, establishment of cardiopulmonary bypass, and opening of the aortic arch, every step was clean and straightforward.

The surgery was performed quickly, but not merely by rushing hand speed. Although fast, it was not chaotic; each step was deliberate and measured, as… Dr. Rainer knew, as if he himself were performing the operation with utmost seriousness while the speed was like fast‑forward playback.

Although he felt unconvinced inwardly, he could not refute it.

The anastomosis was obviously done with microsurgical technique; the needle holes were small, and there were no tears or signs of tearing in the vessel's inner or outer layers.

After completing each anastomosis, they moved the vascular clamp one position toward the proximal end of the quadrifurcation artificial vessel's anastomotic branch, ensuring that each already‑anastomosed vessel received blood promptly.

Each move was precisely standard, as if measured with a ruler.

Is this the peak? Rainer felt a bit dazed.

If he had judged a patient already dead who was then revived, Rainer knew his confidence would suffer an unprecedented blow.

"Rainer, vascular anastomosis has always been your weakness; I think you can learn a lot from this surgery," Dr. Charles suddenly said.

Dr. Rainer remained silent.

Although he knew this was the truth, he still refused to admit that his own surgery was inferior to that of the young yellow‑skinned person.

If the person before him were his teacher Dr. Charles, Rainer could still think that the teacher no longer performs surgery; even if his former level was higher, what would that mean?

Yet even this vague gloom imposed on Dr. Rainer an almost infinite pressure.

That is why he accepted Cleveland's invitation and left the Mayo Clinic.

This action indirectly caused the Cleveland Clinic's ranking in cardiac surgery to surpass that of the Mayo Clinic.

But the surgery before his eyes was something else entirely.

The surgeon was younger than he, and in an age when one should be accumulating experience, the surgeon had already climbed to such heights. What then? What kind of surgeon would he become?

Rainer felt a bit dazed, as if he had just graduated and were watching Dr. Charles perform surgery.

His heart filled with boundless respect and admiration.

But he quickly came to his senses, telling himself that the one performing the surgery was that younger surgeon.

The pressure brought by youth far exceeded that which Dr. Charles imposed on him.

Because the surgeon is younger, his limits are not confined here; because he is younger, he will dominate the field of cardiothoracic surgery for many years to come.

Just thinking about this made Rainer feel his own heart beginning to ache.

Hadn't even finished walking out of Charles's gloom, and I was already enveloped by another layer of heavier gloom that could never be shaken off?

「Leina, do you still remember me telling you that a good surgeon can perform cross-discipline Shou Bing? 」 Charles, while looking at the Shou Bing, asked.

「Title: Teacher, I remember. 」 Laina answered in a daze, the hand that had been tightly clenched didn't know when it had already loosened.

「This is why. 」 Charles, looking at the image on the screen, said: "The purpose of the Shou Bing is simple Clarity; as long as you understand the anatomical structure, actually there is no Shou Bing that cannot be done. But all of this is rooted in one point—hand feel."