Chapter 1967: 1898 Blood pressure stable? This doesn't feel right!

1898 Blood pressure stable? This doesn't feel right!

Boss, I think two hours is about enough.

"But he can't even last two minutes; his biceps have started involuntary spasms, his blood lactate level is too high, and forcing himself to persist is bad for his body." Zheng Ren glanced at Professor Zhan and said.

"Yo, you can even tell the lactate level? Explain how you judged that." Su Yun said while speaking, her head remained still, her finger movements subtle, coordinating with Zheng Ren's dissection.

"It's definitely a disruption of the intracellular sodium-potassium pump; if we do a serum ion test now, the potassium level should be above 5."

Professor Zhan was speechless.

He often jokes like this, casually spouting off some half-baked nonsense.

Just on the operating table before them, Zheng Lao Ban and his assistant were performing a nearly impossible surgery; how could they still have the mind for this?

"Director Ma!" Zheng Ren shouted, then asked softly: "Is it Director Ma?"

"Yes."

"Oh, I was just focused on the surgery and didn't listen carefully."

Ma Liang flung Director Li to the side and came running over, panting.

Zheng Lao Ban, what are your orders?

Director Li looked at Ma Liang with helpless eyes; this doesn't look like a chief director at all, just a resident doctor.

"Get a young, strong person to handle the retractor; hands must be steady, persist for 30 minutes then switch." Zheng Ren said, "Find a few more; the surgery could take a long time."

"Oh, got it!" Ma Liang immediately went to arrange this.

But the first one to step up was Ma Liang himself.

Such an opportunity, Ma Liang would not miss.

He replaced Professor Zhan, retracted the viscera, exposed the operating field, and asked: "Zheng Lao Ban, does this look okay?"

"Raise the rear hand a bit higher." Zheng Ren said.

"Oh oh, okay." Ma Liang immediately did as Zheng Ren said.

But raising the rear hand a bit higher, he felt no change in the surgical area.

He had some doubts and asked: "Zheng Lao Ban, what's the benefit of doing this?"

"You've never handled a retractor before?" Su Yun asked.

"I handled one over twenty years ago."

"Your current posture will improve the retractor's stability, make it less tiring, and allow you to last a bit longer—about 4 minutes and 12 seconds." Zheng Ren continued the surgery, explaining to Director Ma Liang.

Ma Liang did not question Zheng Ren's statement, even though it was precise down to the second; he still had no doubt.

The surgery continued, with Zheng Ren and Su Yun dissecting the tumor tissue, while the person handling the retractor kept being swapped.

Microsurgery absolutely cannot tolerate the slightest tremor.

It's possible that if the assistant merely changes his grip, this surgery will fail.

After 3 hours and 34 minutes, Su Yun's hemostatic forceps finally clamped a piece of dark abnormal tissue, which she extracted from the patient's abdominal cavity.

"Not bad, hey, did you arrange an intraoperative freeze?" Su Yun asked.

Professor Zhan nodded quickly.

The fatigue from just handling the retractor hasn't eased even after a few hours.

"Arranged, arranged."

"It's likely a retroperitoneal paraganglioma; send it for frozen section." Zheng Ren said, then began processing the surgical stump.

Seeing the tumor tissue removed, everyone's spirits lifted, and they gathered around to watch the surgery.

In the surgical field, the dark tumor tissue disappeared, there was hardly any blood trace, and although a segment of the inferior vena cava seemed a bit thinner, it still did not bleed.

Director Li wondered and asked softly: "Professor Zhan, how was the tumor tissue dissected? Isn't it heavily adhered to the inferior vena cava?"

"The inferior vena cava outer layer that Zheng Lao Ban dissected has reached the middle layer in some places, and the outer layer of the middle layer at several points has also been dissected and cut away." Professor Zhan gazed at the surgical field, speculating freely.

"Um... what if the pressure in the inferior vena cava gets high?" Director Li asked.

Professor Zhan gave him a speechless look, sighed, and said: "Director Li, we just placed a stent-graft inside."

Only then did Director Li realize how stupid his question was.

Better not speak; it would just invite ridicule.

He glanced at the ECG monitor; the numbers showed that Director Jin's vital signs were stable, he was fine, and should be able to leave the table alive.

Zheng Ren also raised his head to look at the blood pressure, without saying a word.

The next step should be preparing to close the abdomen, Director Li judged.

But Zheng Ren sighed and said: "Give me a look at the preoperative images."

"Um..." the doctor on this side stared for a moment.

"Hurry up, the surgery time is already very long." Zheng Ren became a bit unhappy.

No matter what I say, I can never act immediately; I remember the medical standards in Sheng Cheng being quite high, so why don't they match my imagination?

"Zheng Lao Ban, are you considering metastasis?" Professor Zhan asked.

"Hmm." Zheng Ren looked at the numbers on the ECG monitor, "After removal of a retroperitoneal paraganglioma, low blood pressure often accompanies it, and further volume expansion is still needed."

"If postoperative hypertension persists or blood pressure fails to drop, suggesting another tumor or metastasis, we should seek and excise the metastatic lesion as much as possible, reduce functional tumor tissue, and extensive surgical resection is necessary."

"Sigh, the blood pressure is still stable; there must still be tumor tissue."

This news is nothing short of a disaster; we thought the surgery was over, done cleanly and beautifully, practically perfect.

But the surgeon actually said it wasn't finished yet...

The images were hung up, Zheng Ren placed his hands under his armpits, and began reading them.

Su Yun also came over and looked along.

Within half a meter around the two of them, no outsiders allowed.

Shou Bing encountered an unexpected situation; surgeons are usually irritable. And now this should count as an unexpected situation, right? If one gets too close and touches the sterile gown, what should we do?!

When the surgeon's temper flares up, they will surely unleash a torrent of foul abuse.

"Boss, the lower pole of the right kidney looks off," Su Yun said.

"Well, we can only cut it," Zheng Ren said, "Lao Gao!"

Gao Shaojie remained silent; he didn't understand the surgery, so he didn't participate much.

"Here, Zheng Lao Ban," Gao Shaojie immediately replied.

Zheng Ren asked, "After renal segment resection, if bleeding occurs again, have you done an embolization procedure?"

Gao Shaojie immediately gave Zheng Ren an affirmative answer.

Zheng Ren said, "Then let's do the renal segment resection, try to minimize damage." He then glanced at Professor Zhan and asked, "Before the surgery, when we told the patient's family about intraoperative observation, did we mention that we might resect the right kidney or part of it?"

"Said."

Zheng Ren was still relieved; as long as the basics weren't missed, that's fine.

Returning to the operating table, he began the renal segment resection.

This Shou Bing went quickly; there was none of the careful meticulousness from before when removing adhesions from the tumor tissue on the inferior vena cava, but rather a bold, sweeping resection.

Professor Zhan had some doubts, but he didn't speak; instead, he continuously observed the patient's blood pressure.

After clamping and resection, blood pressure suddenly decreased from 110 mmHg to 75 mmHg.

Seeing the blood pressure decrease, Zheng Ren didn't worry; instead, he let out a sigh of relief, "Close the abdomen!"