Chapter 2553: 2461 Inhuman Surgery (Alliance Leader Instant Noodle Flying Plane Bonus Chapter 1)

Entering the operating room, Zheng Ren saw Xie Yiren gently pointing at instruments with the circulating nurse. Although Xie Yiren wasn't looking at him, he still left a smiling face toward Yi Ren.

Putting on clothes and gloves, he went on stage; Hu Yan Hui put the live-stream glasses back on him, and the surgery officially began.

Zheng Ren silently wished for better luck, then reached out and slapped the willow-leaf blade into his palm.

The tattooed plum tree left only its trunk exposed in the operating field; Zheng Ren chose to open the chest in the middle, slightly offset from the scar of the previous surgery, cutting layer by layer.

He untwisted and pulled out the steel wire that had fixed the sternum during the previous surgery.

In the operating room, only the song "Good Luck Come" floated in the air; no one spoke. The medical team functioned like a machine, all communication relying on unspoken understanding and eye contact.

The electric saw whirred, and bone fragments and blood droplets spattered onto the sterile gauze in Su Yun's hands.

Carefully protecting the thymus, Su Yun suddenly asked, "Boss, is the chronic valvular disease from tattooing?"

"It's possible," Zheng Ren said while examining the pericardium, "Dr. D. K. Satchithananda of Papworth Hospital, Cambridge, UK, reported in 2001 a 28‑year‑old male patient with congenital bicuspid aortic valve who received a tattoo once a month for five years."

"There are many case reports; why would this kid tattoo such a huge plum tree on himself for no reason?" Lao He said.

Before extracorporeal circulation began, he still had time to chat a few sentences, letting his own tense nerves relax. Regarding Zheng Lao Ban not having won the Nobel Prize, Lao He also felt some regret. But since he was older and hadn't participated the whole time, the sense of defeat wasn't strong.

"For aesthetics, you old men wouldn't think about it, but imagine a woman with such a huge scar on her chest—how ugly it would be, she couldn't even wear a swimsuit," Su Yun said.

"Women's Friend" can view this issue from a female perspective, and tattooing is quite necessary.

Zheng Ren opened the pericardium, found no adhesions in the pericardial cavity, took a portion of the pericardium and handed it to Xie Yiren.

"Glutaraldehyde," Xie Yiren whispered.

The instrument nurse poured glutaraldehyde into an empty basin on the sterile tray, soaking the pericardial piece Zheng Ren had just cut.

Zheng Ren lowered his head to look at the "familiar" operating field, feeling some anticipation, hoping that the surgery's luck would indeed be better.

"Prepare for extracorporeal circulation!" Zheng Ren said.

Lao He did not let his assistant write the anesthesia record; for every surgery involving Zheng Lao Ban, he gave his all.

30 minutes before surgery, intramuscular injection of pethidine 75mg, scopolamine 0.3mg.

After entering the room, give mask oxygen, routinely monitor ECG and pulse oximetry, complete radial artery puncture catheterization to monitor arterial blood pressure, blood pressure on entry 143/74mmHg. For anesthesia induction, administer midazolam 3mg, etomidate 20mg, rocuronium bromide 10mg, sufentanil 150mg.

After intravenous injection, intubate and perform mechanical ventilation, set tidal volume 500ml, respiratory rate 12 times/min.

Looking at the anesthesia record, Lao He found it flawless.

He merely glanced over it, ruled out any problems, and his gaze returned to the operating field.

Zheng Lao Ban rarely goes on stage nowadays, especially rarely calling for himself. But whenever he is summoned to the stage, the surgery's difficulty is extreme.

This is trust in himself; giving his all still feels insufficient, so Lao He dare not lose focus.

"Prepare for heparinization," Zheng Ren said in a low voice.

As soon as he finished speaking, Lao He had already begun acting. He administered systemic heparinization, then proceeded with extracorporeal circulation.

They established extracorporeal circulation by cannulating the ascending aorta and the superior and inferior vena cava, occluding the ascending aorta, and drawing blood via the right superior pulmonary vein.

With extracorporeal circulation established, the next step was the surgery's most crucial part: detaching the aortic valve and stripping the abscess invading the heart and aortic wall.

Through an oblique incision in the aortic root, they perfused the left and right coronary artery openings with cardioplegic solution, achieving satisfactory cardiac arrest.

Zheng Ren focused completely, reached out, and slapped the hemostatic forceps into his palm.

Examining the aorta showed three leaflets; the left coronary leaflet bore a 15×10 mm vegetated mass, and beneath the left and non‑coronary leaflets, an abscess formed at the fibrous continuity between the aortic and mitral valves. The mitral valve had no vegetation.

After 16 minutes and 23 seconds, Zheng Ren had the outside technician call up the dynamic images of the patient's coronary angiography.

He lifted his head to look at the image, which was the same as displayed in the system operating room, recalling that he had just done dozens of hours of surgical training, with all the operations ingrained in his muscle memory.

According to the normal surgical protocol, the diseased aortic valve should be removed first. But because this is a redo surgery, local tissue has undergone abnormal hyperplasia, and with a huge abscess, the anatomic structure in that tiny space has become extremely complex.

Zheng Ren lowered his head, reached out, and slapped the willow‑leaf blade into his palm.

With one cut, he went 0.62 cm from the aortic valve, then slapped the willow‑leaf blade onto the patient's leg, and Xie Yiren placed the smallest endoscopic forceps into Zheng Ren's palm.

Zheng Ren began delicate dissection, starting from the root of the mechanical aortic valve, skillfully separating the heart tissue and "picking out" the distal and slightly thicker capillaries.

Only then did Su Yun understand what Zheng Ren had just intended to do with the coronary angiography.

This approach had not been absent in previous surgeries.

When making a gross specimen, the artery is perfused with fixative, then a opening is left in the vein to let excess fixative drain out.

Thus, the blood vessels of the gross specimen become hardened; afterward, a skilled dissection instructor dissects them, and even the capillaries appear lifelike.

Of course, producing such a gross specimen is not easy, mainly because skilled dissection instructors are hard to find.

I never expected the boss himself to demonstrate dissection on the spot, showing off his manual skill.

Su Yun was speechless—how could normal human blood vessels compare to those of a fixative‑perfused gross specimen instructor?

This level of dissection and surgical technique is off the charts! Moreover, that's not all; Su Yun knew the hardest part was using the fleeting contrast from coronary angiography to locate the actual capillaries in the dissection site.

The ability to read the images and the surgical skill are equally inhuman; Su Yun muttered to himself, "Damn inhuman."

"Electrocautery, don't zone out," Zheng Ren said with his head down, using forceps under the microscope to isolate a capillary. After a one‑second pause, seeing the electrocautery still not arrived, he spoke in a low voice.

Su Yun frowned; his mood was still somewhat bewildered.

He had also just looked at the coronary angiography images—the black contrast agent flashed and vanished, especially at the distal capillaries where sometimes only a faint, almost invisible black line appeared before disappearing.

The boss just glances and knows? That's too unbelievable.

But despite those thoughts, Su Yun did not delay the surgery; he cast aside distractions and surprise, and gently touched the electrocautery to the hemostatic forceps in Zheng Ren's hand.

A faint popping sound came, and a capillary was coagulated.