The Godfather of Surgery

After the hematoma is removed, the bones at the base of the skull are roughened, and the bones on the surface of the posterior column of the axis are also roughened to facilitate the healing of the implanted bone fragments.

This time it was Song Zimo and Xu Zhiliang's turn to deal with the atlas bone fragments. They trimmed the bone fragments and filled the artificial atlas with a titanium mesh structure with bone fragments and bone fragments.

Yang Ping irrigated the surgical area under the microscope, completed hemostasis again, implanted the internal fixator between the posterior skull base and the posterior column of the axis, applied pressure up and down, implanted screws, and fixed the bone fragments and bone fragments in the titanium mesh structure. It firmly supports the base of the skull and the vertebral body of the axis. As an auxiliary load-bearing column in the two connecting columns of the base of the skull and the axis, the construction has been completed. In the future, it and the front bone column will become the support for the head. The head that had been placed everywhere was finally placed firmly on the spine.

"knock off!"

Yang Ping withdrew his gaze from the screen. Song Zimo and Xu Zhiliang stepped forward and began to complete the finishing work: closing the surgical incision.

"Actually, it's nothing. It just expands the scope of laparoscopic surgery. The anterior transoral surgery is also done under the microscope. Since the anterior approach can be done under the microscope, why can't the posterior approach be done? Theoretically, all surgeries can be done under the microscope. "

Yang Ping looked at everyone who was surprised and immediately explained a few words.

Before the operation, Yang Ping forgot to tell everyone that the posterior approach was also going to be done under the microscope, let alone that two lenses would be used to complete the operation. Now that he said it so easily, how could the doubts on everyone's faces disappear all at once.

"Sorry, I forgot to tell everyone before the operation." Yang Ping apologized to everyone.

But the apology was of no use. Everyone still stared at Yang Ping with expectant and confused eyes. Even Song Zimo and Xu Zhiliang had no intention of closing the incision immediately.

"Why are you looking at me? Is there any problem?" Yang Ping sat down to rest.

"Professor, you have to give me an explanation, right? You just used two screens to complete an unfamiliar cervical spine surgery on the skull base in a split field of view!" Song Zimo had to speak clearly.

No wonder these guys looked at him eagerly. Yang Ping suddenly realized that for him, it might be a very ordinary operation, just using two endoscopes casually, but for others, it might be a technological innovation, and it was A superb new surgery.

Maybe he was too involved, and there was no explanation during the whole process. The professor was a bit rough. Yang Ping sorted out his thoughts and said:

"If the transoral surgery of the anterior cervical spine on the skull base is completed with the aid of an endoscope, the operation will be much easier, and under the endoscopic field of view, the operating space will be larger and the safety factor will be higher." Yang Ping is very particular about his words. Use a laparoscope when you need a laparoscope, and use an endoscope when you need to use an endoscope. Never mix them.

There is a difference between an endoscope and a laparoscope. What enters through the natural channels of the human body is called an endoscope. For example, gastroscopy, colonoscopy, and ureteroscopy and cystoscopy in the Department of Urology are all endoscopes.

Take the gastroscope as an example. It enters the human body through the mouth, then passes through the pharynx, esophagus, and finally enters the stomach. From the entrance to the entire passage, it is a natural passage.

However, laparoscopy requires artificially poking a hole in the human body as an entrance for the lens and instruments. For example, laparoscopy requires one or several small holes in the stomach to enter the lens and instruments. The same is true for arthroscopy, which requires poking. hole to enter.

“Most surgeries on the cervical spine above the skull base only require an anterior transoral approach. Therefore, we can train in transoral endoscopic surgery in the future to make transoral endoscopically assisted surgery on the cervical spine above the skull base a routine operation. "

"And it is not difficult to complete posterior open surgery under the microscope. It's just that I used two sets of endoscopic equipment to complete the surgery today. The cooperation requirements of the hand, eye and brain are indeed a bit high. If you do this kind of surgery in the future, if you encounter Various reasons lead to poor visual field exposure and insufficient operating space. You can try to complete the surgery under the microscope. Of course, don’t follow me and use two split screens. You should use a wide-angle camera and place it in a suitable position. One camera and one The operation can be completed with the equipment. If a wide-angle lens is not used, two lenses can be used, and then a computer can be used to integrate the images of the surgical area and display them on one screen. This requires further design of the equipment."

"In fact, there are precedents for open surgery under the microscope, such as the replantation of severed fingers in microsurgery. Using a traditional microscope and staring at the eyepiece with both eyes can easily cause eye fatigue. However, a microscope with a high-definition camera can The field of view is transmitted to the screen, and the surgeon does not need to stare at the microscope's field of view, but directly looks at the screen, and uses hand-eye separation technology to operate, making the entire operation very easy."

"Of course, to do this, we need to train hand-eye separation operations and skilled hand-eye separation operation techniques."

"Professor, can you train us so that we can perform endoscopic surgeries as you like just now? Even all surgeries can be done endoscopically as long as necessary." August became excited.

He could imagine that if he mastered this technique, one day in the future, he would demonstrate this kind of operation under the microscope at the European Congress of Spine Surgery. Whether it is through the mouth of the road or the conventional approach through the back, it is all done under the mirror. Then, how will the British guy Milton react? He will definitely be shocked.

Damn old guy, he's got a TMJ dislocation, I bet August was feeling pretty smug.

Song Zimo and Xu Zhiliang were closing the incision, and Yang Ping began to take off his surgical gown.

"If you are interested, we can train you to complete open surgery under the microscope tomorrow. In fact, if there is a suitable surgical robot for today's surgery, the surgery will be easier with the help of the surgical robot. Unfortunately, the existing surgical robots are all There is no way to complete this kind of surgery. Da Vinci's several robotic arms are very flexible and have the potential to complete this kind of surgery. However, they lack terminal equipment for orthopedic surgery. Of course, at its current level, it is impossible to connect all orthopedic terminals, so It can only stay in the thoracic, abdominal cavity, urology and obstetrics and gynecology departments. Although the Dimensity robot can perform orthopedic surgeries, the flexibility of its robotic arms is far from enough. It can only complete simple orthopedic surgeries or certain aspects of the surgery. For some steps, such as nail placement, it does not even have the ability to perform the entire surgery and can only be an assist."

Yang Ping imagined how it would be great to have a surgical robot with very flexible robotic arms that could be replaced with robotic arms of different thicknesses to adapt to various scenarios, and that could also be connected to various powered orthopedic terminals.

Ruixing Medical is also researching surgical robots, but it will take time to achieve some breakthroughs.

If there were such a robot, surgery would be easy for today's patients regardless of their position, and doctors would not be so passive.

The field of surgery in the future will inevitably be dominated by surgical robots, which overcome all the shortcomings of surgeons and broaden the operating space and field of vision.

Song Zimo and Xu Zhiliang completed the closure of the surgical incision, and Zhang Lin and Xiao Wu, the two master retractors, could finally rest. Their arms must have been extremely sore and numb.

From the time the retractor was inserted to the time it was withdrawn, the two masters remained motionless during the entire process, fully worthy of the title of master retractor.

"When will your two books be published? Has the manuscript been revised many times?" Yang Ping asked Zhang Lin and Xiao Wu.

Zhang Lin couldn't help sighing: "After all, it is a world-class book. With a rigorous academic attitude, we decided to revise it a few more times to keep improving."

Xiaowu also had a serious face: "There are some things that need to be considered in this global gap-filling monograph. For example, we have not yet reached a consensus on whether we should briefly mention the training method of hook retraction technique or introduce it in detail."

"If you introduce it in detail, it will inevitably reveal some top-secret training methods. If you mention it briefly, you will not have the conscience to be a scholar." Zhang Lin was full of sorrow.

"It's difficult!" Xiao Wu looked in a dilemma.

With such a solemn tone, the two of them are not pretending at all. They really attach great importance to this monograph. This is their hard work and this is their ideal.