The Godfather of Surgery

There is also a needle in the intervertebral space between the third cervical vertebra and the fourth cervical vertebra. This thin needle is reserved for the last, because it is the most difficult to get, even more difficult than the pericardial needle.

The structure that fills the intervertebral space is the intervertebral disc, and this needle is inserted into the intervertebral disc.

After flushing the abdominal cavity, the equipment was withdrawn, and Li Guodong sewed up three small incisions on the abdomen.

Yang Ping shifted the battlefield to the cervical spine. The baby's cervical spine is very small. Yang Pingyuan plans to use color ultrasound to locate it, and then take out the fine needle under the endoscope.

However, the Provincial Women’s and Children’s Hospital does not have an endoscope system that can be used in the neck. The equipment usually used for minimally invasive surgery on the adult cervical spine, such as the expansion tube system, cannot be used for infants, and the endoscope system for children’s otolaryngology is not suitable either. used here.

Yang Ping had no choice but to use a small open incision. The incision is not large, only one centimeter.

This needle is about 1.8 cm. According to logic, no matter from the front or back of the cervical spine, after the needle is inserted into the human body, the limit state is that the needle is submerged below the skin, and cannot go deeper after that. In the future, the position of the needle will change with the contraction of human muscles Wait for the move.

No matter how you move it, how can it be so coincidental that it can enter the intervertebral space?

Moreover, one end of this needle is pointed, and there is no abnormality, and the other end loses the roundness of the needle tail.

Could it be that a long needle is inserted into the intervertebral space, and then part of the needle breaks inside?

Yang Ping thought about this needle for a long time, and felt that this was the only reasonable explanation.

Dr. Jin operated overnight last night. He could have rested, but he wanted to observe Yang Ping's operation, and now he was standing by the side, so he had no idea of ​​resting.

Besides, in today's situation in the Department of Traumatology and Orthopedics, the rest will definitely come to naught. Dr. Jin decided to stay here so that he can see the operation and catch his breath.

Yang Ping plans to use a small incision, so it is difficult to avoid multiple positioning, and X-ray positioning is indispensable for this part.

Dr. Jin glanced around the operating room. Except for himself, Fatty Liang and Zhou Can, there was no one else in the audience. The army of trainees and interns all rushed to support the emergency trauma center.

Fatty Liang was sitting on the stool in a daze, don't expect him to do other work.

Zhou Can is a girl, Dr. Jin thought, it is unreasonable and unreasonable for Zhou Can to push his C-arm while he is a big man standing here.

So he quietly came to the storage room next door, and started to push the C-arm by himself. Student intern lad pushes.

Spine surgery is very important to the positioning of the segment and is indispensable.

When there was no C-arm machine in the past, positioning by experience sometimes happened to make mistakes in the segment, and Daniel is no exception.

When everything was ready, Dr. Jin asked again: "Professor Yang, the C-arm machine is ready, can I help you on stage?"

"Swipe your hands!"

Yang Ping was also unambiguous, since Lao Jin was so enthusiastic, let him participate on stage.

However, the C-arm machine is useless at all, and Yang Ping has no intention of using the C-arm machine for positioning.

The positioning of the C-arm machine is necessary from a procedural point of view, but Yang Pingyi is a bold man. In order to minimize the radiation of Xiao Minmin, he abandoned the C-arm machine.

For cervical spine surgery, X-ray projections cannot provide shielding protection to the thyroid gland, so try not to use it as much as possible.

"No C-arm! I use color Doppler ultrasound for positioning." Yang Ping began to disinfect the neck skin again before skin incision.

Do not use C-arm, use color Doppler ultrasound?

How to locate the segment? The segment cannot be located, how to complete this operation?

Dr. Jin was very puzzled. The old doctor and senior attending doctor couldn't think of how to locate the spinal segment with color ultrasound.

It's normal to be unexpected, because only Yang Ping dared to do this.

Yang Ping is very familiar with anatomy. He only needs to rely on the palpation of the cervical spinous process to accurately determine the corresponding serial number of the cervical spinous process. Then, according to the distance relationship between the spinous process and the intervertebral space on the original X-ray, he can accurately locate the cervical spine. gap.

Dr. Jin came to the stage with a question, and helped Yang Ping.

Yang Ping was going to use the anterolateral approach, and used a color Doppler ultrasound for a little positioning. He made a small incision, used a microvascular forceps to separate slightly, and then put in a microscopic skin retractor to let Li Guodong stretch the skin.

"Don't imitate me, you still use the C-arm machine for fluoroscopy positioning when you perform surgery."

Yang Ping reminded Dr. Jin and Li Guodong, especially Dr. Jin.

This reminder is necessary, just like every time there are dangerous actions on TV, the audience must be reminded: Do not imitate.

Once imitated, the consequences would be disastrous.

If it is Song Zimo, this kind of reminder is superfluous. Song Zimo is clear about what can be imitated and what cannot be imitated.

Pull the hook to retract the skin, Yang Ping's vascular forceps continue to separate, enter from the intermuscular space, avoid the blood vessels and nerves, and reach the anterolateral 3/4 space of the cervical spine.

"Deeper the hook!"

Yang Ping reminded Li Guodong to adjust the hook immediately.

Compared with Zhang Linxiaowu's gold and silver double hooks, there is a huge gap in Li Guodong's pulling hook technology.

"Get me a headlamp."

It is difficult for the light of the shadowless lamp to illuminate the narrow space in the small incision, and the help of the spotlight is needed to see clearly inside.

Yang Ping removed his head from the operating area, Zhou Can helped him put on the headlamp, and he returned to the operating table.

A beam of bright light from the headlamp just shone into the narrow space. Yang Ping used a microvascular forceps to clamp a corner of the gauze and stretch it in, sucking a small amount of blood.

Dr. Jin's eyes stared into the small incision, but he couldn't see anything? How do you get the needle?

The sharp knife pokes the anterior longitudinal ligament and the anterior ring of the intervertebral disc, then a straight microvascular forceps is inserted in, pulled back, and the last needle is pulled out and thrown into the curved disc.

Dr. Jin almost gave up his knees and knelt down directly.

I've always heard that this guy is a demigod, but I didn't expect it to be.

Veteran doctors, senior attendings, both theoretical and practical experience are also good.

I didn't understand how the operation was done at all, so I just opened a small opening, poked it in, and the needle was taken out.

The thirty-fourth needle is pulled out, and you're done.

Yang Ping checked the needle, the tail was not round, and there were old signs of breaking, it was likely that the long needle broke inside after piercing it.

Looking at the densely packed needles in the curved plate, Yang Ping felt relieved, all the little guy's needles were taken out.

"Don't imitate me!"

Yang Ping reminded again.

If he didn't want to reduce the child's X-ray radiation, Yang Ping would still follow the routine operation and use the C-arm machine for positioning, so as not to mislead others.

Xiao Su counted the number of needles again.

Yang Ping handed over the rest of the finishing work to Li Guodong, and he and Dr. Jin went to the operation center to support.

——

The Trauma Emergency Center has been fully fired today, and several operating rooms are full.

The nurses who delivered the blood were like a race, one just came out, and the other went in.

Yang Ping and Dr. Jin came to the operating room for counterpart support.

Two generals from the Institute of Surgery came out, the bleeding in the pelvis and thigh was stopped, and the blood pressure of the high school student was strongly stabilized.

Song Zimo looked up, saw Yang Ping, and was about to report, but Yang Ping signaled him not to be distracted and continued with the operation.

Song Zimo understood, didn't speak again, and continued with the operation, but there was nothing to say.

If the operation cannot be done, let the professor take the stage directly.

If you can win it, continue the operation, don't talk nonsense.

With a professor standing beside him, Song Zimo would not blink when the sky was falling.

Obviously, with the level of the number one champion in the Institute of Surgery, it is no problem to win this kind of surgery.

Dr. Jin has been following Yang Ping, watching Song Zimo fly the needle and thread, the operation is stable and fast, he can't help sighing, Mr. Song, the progress is really fast.

If he wasn't a few years older, he would have the cheek to beg Yang Ping to work under him.

Immediately, Dr. Jin felt a sad feeling.

"Teacher Zhang!!!"

Another intern asked timidly.

"What's up?"

"Did an intern just say that Dr. Li in the obstetrics department had a caesarean section?" Zhang Lin asked Xu Zhiliang.

Xu Zhiliang thought for a while and said, "It seems to be!"

"Dr. Li asked us to do the caesarean section?" Zhang Lin asked.

"Didn't you tell us to go for a consultation? No, bro, what's your wife's last name?" Xu Zhiliang seemed to have realized something.

Zhang Lin said smoothly: "My wife's surname is Li!"

Surname Li?

The two looked up at the same time and looked at each other!

Zhang Lin suddenly remembered, no way, isn't my wife about to give birth? It wouldn't be such a coincidence to push it to the operating room for caesarean section.

"Heartbeat stopped!"

The anesthesiologist called out.

"Ready for open chest compressions!"

Song Zimo roared.

Zhang Lin and Xu Zhiliang couldn't think of anything else, and immediately followed Song Zimo to join the rescue.

"Professor Yang, Lao Jin, hurry up, you go to the surgery room next door, Lao Bai can't hold it anymore, his pelvis is opened, and the blood inside is like a fountain, it can't be stopped."

The scene that had just stabilized a little bit fell into extreme tension again.

"What are you doing standing here? Don't help."

The itinerant nurse yelled at the intern who reported in the obstetrics department, he was in the way like an idiot.