Is there no limit to this doctor's skills?

Chapter 180 I happen to have some technical skills!

Inside the operating room, the overhead lights and shadowless lamps were both extremely bright.

There were quite a few people standing around the operating table, but there were only a handful of surgeons.

After seeing the general surgeons take over the patient's abdomen, Guo Ziyuan looked up decisively and asked, "Director Lu, shall we begin?"

Guo Ziyuan didn't bother to figure out what Lu Guoan's expression meant at this moment.

Because Guo Ziyuan himself doesn't know how far he can go.

But the worst outcome is amputation.

Guo Ziyuan performed a final rescue on the body, which was covered in limbs.

Guo Ziyuan truly lacks confidence in how far things will go and what steps they can take.

But this is indeed one of the surgeries that Guo Ziyuan has wanted to do since his rebirth.

Perhaps, the "why" without any apparent reason is Guo Ziyuan's driving force.

Guo Ziyuan loves performing surgery, and he has come to love the feeling that surgery can bring healing to patients and the invasive nature of the treatment.

"Okay!" Lu Guoan didn't say anything more.

His ideas were somewhat similar to Guo Ziyuan's.

The worst-case scenario for this patient is amputation of both lower limbs; that is a given fact.

Try anything, even if it seems hopeless.

Even though I'm too old to take risks myself, I can still provide a safety net for a young person who dares to take risks.

The main point is that Guo Ziyuan wasn't just fooling around!

If Guo Ziyuan were just a simple master's student, or a simple resident training student...

Guo Ziyuan wouldn't receive this phone call in the middle of the night...

After Lu Guoan nodded, Guo Ziyuan picked up the scalpel.

The entire process is like using scalpels; there's no need for electrocautery!

There was no bleeding.

There was also no blunt separation.

Once the tissue deforms, the septa between the muscles disappear, making blunt separation impossible.

Lu Guoan first stopped the operation performed by Wu Qiong, the deputy chief physician on the other side.

Wu Qiong looked up and saw Lu Guoan shake his head at him, and then Wu Qiong understood what Lu Guoan was thinking.

This is a silent, tacit understanding.

Everyone in the operating room wanted to save his legs, but no one spoke up or took action because no one had a clear idea.

It's not that they're unwilling!

……

After Guo Ziyuan had already taken action, Zhou Yong, the director of the emergency department, arrived late.

"The signed documents have been received, and the duty officer has already given the authorization."

"The patient's family is still on their way."

"The diagnosis is clear..."

When Zhou Yong and the head of the burn and plastic surgery department entered, they discovered that the surgery being performed on the operating table, the surgery he had spoken to and signed for, was not what it seemed...

The incision for amputation should be horizontal, not vertical.

However, this may also be Guo Ziyuan's way of investigating necrotic segments.

Therefore, Zhou Yong did not cause any further trouble.

With Guo Ziyuan's basic skills, performing an amputation would be a piece of cake!

Of course, as the director of the emergency department, Zhou Yong was certainly qualified to know what was happening in the operating room.

After a surgical director pulled Zhou Yong aside, he gave him a brief explanation.

This is Dr. Zhao Mengshan, the director of the Hepatobiliary Surgery Department. He concluded by saying, "Dr. Guo from your department is very shrewd."

Zhou Yong trembled upon hearing this.

The mask concealed his grimacing, but his eyes darted around a few times: "Go ahead and do it, just think of it as learning anatomy."

"Director Zhao... this matter will cease to exist once we leave this operating room."

Zhao Mengshan asked curiously, "Who is this Dr. Guo?"

"Where are you from, second-generation rich kid?"

Zhou Yong laughed: "A direct disciple of Hua Tuo."

"Huh?" Zhao Mengshan was genuinely taken aback by Zhou Yong's sudden change of topic.

"I was blessed with natural talent!"

"Definitely a second-generation rich kid."

"He's capable. He won't act recklessly." Zhou Yong didn't know how far Guo Ziyuan would go, but he knew he would.

Given Guo Ziyuan's personality, once he starts doing it, he should be mentally prepared.

At least, as Guo Ziyuan said, it won't cause any trouble for the department.

……

Guo Ziyuan is rapidly cutting open the patient's tissue to expose the blood vessels and check whether the blood inside has denatured and coagulated.

To be honest, exposing transgender tissue is more difficult than exposing living tissue!

Especially the muscle tissue, it has a kind of gritty feel.

Once the muscle loses its own tension, the feel of cutting it is not very good.

However, this deep sense of scumbagism did not last long.

While Guo Ziyuan was examining the femoral artery, he unexpectedly discovered that the rectus femoris muscle on the femoral side had regained its normal color.

According to the chef's understanding, this is the layered appearance of "white-cut chicken" after its first soaking in water!

It is not fully cooked from the inside out; some parts are still completely raw.

The soft tissue layer of the thigh is very thick.

Moreover, the fat layer has good heat insulation properties.

Furthermore, this guy was only putting out a fire, not jumping directly into boiling water, otherwise he shouldn't have come back alive...

However, a fresh appearance of the muscle does not necessarily indicate bleeding.

When Guo Ziyuan opened the femoral artery, he found that the blood inside had stopped flowing.

However, the lumen of the artery remained full!

At this moment, the proximal end of the femoral artery has been completely clamped and lost connection with the proximal end!

Therefore, the blood circulation system of the femoral artery is completely separated from the human body.

This portion of circulating blood volume is considered relatively ineffective blood volume.

Once it's gone, it's gone.

Based on this, Guo Ziyuan took a very bold step: he directly cut the femoral artery.

The artery wall immediately ruptured.

But no arterial blood was seen gushing out.

After gushing out bright red blood for a while, it completely stopped flowing.

Inside the blood vessel lumen, only dark red blood streaks remained.

This health bar isn't the health bar from a game; it's just the literal meaning of the word.

It's like pig's blood. If you leave it in a bamboo tube, the blood will coagulate and water will seep out, completing the solid-liquid separation.

Guo Ziyuan held out his hand: "Instructor of equipment, give me a hook, any kind of hook will do."

The scrub nurse, who was focused on her work, immediately handed Guo Ziyuan the instruments that could hook blood vessels.

Guo Ziyuan picked it up, inserted it into the blood vessel, and pulled out all the clotted strips inside...

The thrombus strip in the proximal femoral artery has a limited length and a gradually decreasing diameter, resulting in a smaller coefficient of friction, which is why Guo Ziyuan was able to pick it out directly.

The distal thrombus bar remained completely still.

After completing these steps, Guo Ziyuan directly chose to clamp the proximal femoral artery at the incision site.

"Increase the ECMO pressure, but lower it a bit. One machine is enough to maintain pressure. Let's get started. We'll conduct a more proximal exploration and debridement!" Guo Ziyuan gave the instructions.

At this time, ECMO is not connected to the patient's systemic circulation, so it does not need to supply the body with blood oxygen.

Therefore, it is possible to temporarily interrupt the procedure without affecting the patient's vital signs!

After Guo Ziyuan finished speaking, he immediately felt that the femoral artery near the clamp became more engorged!

This is tension filling caused by the liquid, not the solid filling of the previous thrombus strip!

Then, Guo Ziyuan began the operation.

Guo Ziyuan is still cutting, but this time, his cutting is not as wide and sweeping as before!

Guo Ziyuan's cutting angle is incredibly tricky!

With Guo Ziyuan's current "national-level" level of surgical incision, he can control the scalpel in his hand with great ease.

With effortless control, Guo Ziyuan can reach any place he wants to go.

Guo Ziyuan performed the incision of the small arteries and nutrient arteries in the muscles of the proximal thigh, based on the patient's basic anatomical structure.

Adipose tissue layer, necrosis, arterial coagulation!

Muscle proximal degeneration, arterial coagulation!

Guo Ziyuan shook his head and continued to probe downwards.

Guo Ziyuan opened up the patient's middle muscle layer!

Perhaps it was fate that was on the young man's side, because Guo Ziyuan discovered the blood flow in the arterial lumen.

Moreover, with the infusion of blood, the originally pale tissues turned blood-red!

Based on basic medical knowledge.

In medical preparations, such as the preparation of heat-denatured red blood cells for spleen imaging, the standard denaturation temperature is controlled at 49.5–50.0℃.

Muscle degeneration: Temperature. Major proteins in muscle (such as myoglobin and myoglobin) begin to denature significantly at 60–70°C!

According to this principle, if the red blood cells in a region do not undergo degeneration, the muscle generally will not undergo degeneration!

Guo Ziyuan saw blood flowing out from the severed end of the nutrient artery!

His eyes seemed to shoot out a sharp light.

Surgeons like to see blood!

As we all know, seeing blood is necessary to open the passage to life.

Upon seeing this, Guo Ziyuan immediately stopped the incision and changed the direction of the scalpel to longitudinal!

It can be observed that the degeneration of the proximal muscle tissue is shallower!

The depth of degeneration in the distal muscle tissue remained at a certain level!

At the same time, Guo Ziyuan was pleasantly surprised to discover that the patient's lower limbs were not heated evenly, but only locally burned.

The patient's inner thigh muscle degeneration is very superficial!

With these discoveries, Guo Ziyuan's expression became quite excited.

Guo Ziyuan immediately stopped the incision and exploration on the thigh and moved to the calf.

The same incision, the same exploration.

Guo Ziyuan also made similar discoveries.

The depth of denaturation on the inner and posterior sides is less than that on the front and outer sides!

"His dorsalis pedis arteries are not degenerated!" Guo Ziyuan said.

"It's due to degeneration of blood vessels in the thigh and calf, causing blood to stagnate and coagulate in the distal parts of the leg!"

"This led to the arrest of the dorsalis pedis artery."

Guo Ziyuan immediately started shouting, "Bring the heparinized saline solution to the stage!"

The head of general surgery specializing in vascular procedures remained silent: "If this patient has arterial embolism in multiple segments..."

"That means multiple arterial embolisms."

"It's also meaningless!"

Guo Ziyuan looked up: "If it's multiple arterial embolisms, we'll remove them one artery at a time!"

The head of vascular surgery knew what Guo Ziyuan was going to do: "This will take a long time."

"The window for ischemia and necrosis in both lower limbs is only so long."

However, Guo Ziyuan moved as soon as he finished speaking.

Guo Ziyuan quickly drew the knife in his hand, making it long and sharp, like a butcher cutting pork.

Guo Ziyuan made a single cut, penetrating directly from the middle of the thigh down to below the knee joint.

Then, Guo Ziyuan made one large and sweeping cut after another, as if he were making exceptionally precise cuts into the patient's fat and muscle layers!

It only took a minute.

Then everyone saw the course of the patient's arteries, veins, and nerves.

When these organizations were exposed to the public, the tip of Guo Ziyuan's scalpel was no more than three millimeters away from them.

However, it is such a tiny distance.

Guo Ziyuan's knife, however, continued its wide and sweeping motion for nearly thirty centimeters.

Without hesitation!

No errors, no jitter!

This is not over yet.

After exposing the vascular pedicle, Guo Ziyuan made another incision to completely separate the vascular pedicle.

This time, Guo Ziyuan's knife was not far from the arteries, veins, and nerves.

But Guo Ziyuan's cut still extended more than thirty centimeters!

Less than a minute had passed since Guo Ziyuan started making the cut!

Guo Ziyuan is showing off his skills.

Purely showing off skills!

Absolutely dazzling skill!

This technique is so advanced that almost no one can understand it, and no one dares to repeat it!

There were no frills or acrobatics.

No knife decoration.

There's only advancing the knife, moving the knife, and withdrawing the knife!

Stop.

After completing these steps, Guo Ziyuan asked, "Teacher, in this situation, can you perform an arterial thrombectomy?"

The head of vascular surgery clicked his tongue and pursed his lips: "There's more!"

Guo Ziyuan interrupted him: "I will expose the first-level dorsalis pedis artery and the first-level dorsalis pedis vein."

The chief physician of vascular surgery trembled: "You're insane! You're fucking insane! If you had told me beforehand that you were going to do this, I definitely wouldn't have agreed!"

Guo Ziyuan reported to him after he had done it.

Guo Ziyuan's idea is extremely crazy.

He was going to cut out all the arteries and veins in this patient's lower limbs!

Guo Ziyuan was going to expose the person's arteries and veins, just like removing bones, even when all the soft tissue was still there!

Then, the vascular surgeons perform the thrombectomy under direct vision.

The theory is easy to understand.

Where's the blockage? You fucking take the blood clot out of there!

but?

Those are human blood vessels!

Many surgeons may not be able to fully understand all the specific directions on a cadaver.

On a living body, you need to examine them one by one and then remove them.

This isn't theoretically impossible; it just requires the ultimate technique!

Only a knife skill so exquisite that it is considered a work of art by outsiders can achieve this level of craftsmanship.

In theory, a potato can be carved into anything a chef wants!

For example, it can be carved into the shape of "Nicky Wu" or into the shape of a phoenix coronet and embroidered robe.

The prerequisite is that you have exceptional knife skills and enough time.

If you want to save time, then your knife skills must be unparalleled, even incredible.

Guo Ziyuan is racing against time!

If Guo Ziyuan intends to do this, then it means that Guo Ziyuan is actively telling these people.

Don't judge my cutting technique by your imagination.

Guo Ziyuan wasn't just talking; he actually put his words into action: "Teacher, regardless of whether the surgery is successful or not, I'll treat you to a late-night snack."

"We'll try anything, even if it fails, we'll just be reviewing the anatomy of blood vessels."

"Thanks a lot."

"We will do our best, with all our might, and then we will have a clear conscience!"

The chief physician of general surgery was trembling and could hardly contain himself: "I have a clear conscience."

Guo Ziyuan gave him a smile and said sincerely, "So, I implore you, teacher, to give me a chance to have a clear conscience."

"One of the purposes of a teacher is to help students resolve their inner conflicts."

"Isn't that right?"

Guo Ziyuan's eyes were sincere, and his smile was sincere.

The reasons are also quite down-to-earth.

You have a clear conscience, so can I also have a clear conscience?

I happen to have some technical skills...

Guo Ziyuan's actions.

The surgery is progressing at this pace.

Guo Ziyuan's tone and the way he asked for help.

It seems no one dared to refuse!

The director laughed: "Interesting Dr. Guo."

I will remember you for the rest of my life.