After dealing with the blood vessels, the next step is the excision and reconstruction of the carina. This is the core step of the entire surgery and the part that tests technique the most. The anastomosis of the trachea and primary bronchi must be seamless: it needs to be tight and airtight without any tension. Yang Ping plans to use a 'side-to-end-to-side' approach — anastomosing the left primary bronchus to the side wall of the trachea, then anastomosing the right primary bronchus to the side wall of the left primary bronchus. This way, all three anastomosis sites have no tension and good blood supply.
Finally, it's the replacement of the pulmonary artery, selecting a suitably sized artificial blood vessel for end-to-end anastomosis. The anastomosis sites need to be sealed with bio-glue to reduce postoperative bleeding.
He would perform the entire surgery, estimating that two hours would suffice, but with Director He as the chief surgeon, it might take five to six hours.
