godfather of surgery

Chapter 123
The silence was brief, and the discussion continued, tense and intense.

For academics, there are not so many detours. Sometimes everyone will quarrel, slap the table, and everyone will be red-faced, and no one will accept the other.

With Professor Su sitting in charge of this meeting, naturally such an explosive situation would not occur, but disputes were inevitable.

"Director Han, what do you think?" Director Zhao asked.

Director Han stood up straight, like a general meeting before a battle: "The best way is to block the nerve root, but to avoid the leakage of anesthesia, the nerve root sheath must be punctured and placed. It is very difficult, but it is still feasible. sex."

The problem was drawn to the nerve root block. The director of the cancer hospital slid the tablet with one hand and rested his chin on the other hand, and looked at it for a while: "This nerve root block is really too difficult. I see that the tumor tissue is very rich in blood vessels. The patient’s blood coagulation function is not very good. If it is mistakenly pierced into the tumor tissue, it will cause uncontrollable bleeding, form a hematoma in the spinal canal, compress the spinal cord, and cause respiratory depression. In the end, it is still a failure and needs to be put on a ventilator. Look, the surrounding soft tissues It is full of tumors, and the gap left for puncture is too small, so it is easy to puncture by mistake and cause bleeding."

"Well, that's true. This kind of puncture is just like a sniper. It must be hit in one shot, and there can be no mistakes. If you make a mistake, the consequences will be serious." Director Yu, director of the Orthopedics Department of the Second Attachment, agreed with the opinion of the Cancer Hospital.

There is a plan - nerve root block, it seems that no one can come up with other plans except this one, but there are difficulties ahead, and it is not a small difficulty.

Everyone looked at Professor Su and handed over the problem to Professor Su.

Professor Su supported the tablet with his left hand, propped his right elbow on the table, took off his glasses, looked up and said: "Everyone has explained it in detail. It seems that nerve root block is the only option, and everyone has no objection. The difficulty lies in the difficulty of puncture. , It is indeed very large, but it is not impossible, we have to use the [-]D reconstruction of CT and MRI to find a way to choose a correct puncture approach. With the help of computer-aided navigation technology during the operation, the puncture can be realized!"

Puncture is very difficult, but it can be achieved, which is the conclusion of Professor Su.

"What should I do if it fails? What are the rescue measures?" Director Yu of Attachment [-] had different opinions.

Professor Su took a lens cleaning cloth, wiped his glasses and said: "This question is very good. Any medical operation has risks. In the face of risks, we must try our best to prevent them and have backup rescue measures. If the puncture fails, enter If the tumor caused bleeding, we gave up the puncture and placed a drainage tube in the puncture path, which can bring negative pressure to draw out the blood and prevent the formation of a hematoma that compresses the spinal cord."

Professor Su's thinking is active and meticulous. In a short period of time, the selection of the plan, the control of risks, and the rescue method for the worst result are all arranged, and Director Yu admires it in his heart.

This puncture is far less simple than imagined. How to realize it can reveal a person's thinking ability and accumulation of usual knowledge and experience.

Just like firing a sniper rifle, it is not as simple as pulling the trigger. Every time the trigger is pulled, it is the result of thousands of years of hard work.

"Any other comments?" Director Zhao asked as the moderator.

Director Han smiled and said, "You two young lads, do you have any comments? Please also say a few words, don't keep silent."

Originally, on such an occasion, it was inconvenient for Professor Su to let Su Nanchen speak, so it would be good to attend.Now Director Han proposed that it would be okay to let young people exercise. Professor Su said to Su Nanchen next to him, "Senior gave such a precious opportunity, what good ideas do you have?"

Su Nanchen was confident, without arrogance, and said calmly: "Thank you, Professor Han, for giving this junior the opportunity to speak! This puncture is indeed like a sniper, and the enemy is still hiding in the bunker. The puncture must avoid both tumors and bone tissue. The choice of puncture path is very limited. If possible, 3D printing technology can be used to print out the reconstructed spine, tumor, and nerve vessels, and use a one-to-one accurate printing model to design the puncture approach, simulate the puncture, and even temporarily design the positioning In this way, if the navigation device is used again during the operation, the success rate of the puncture will increase a lot.”

This young man is really good at thinking, he can combine cutting-edge 3D printing technology with puncture, and according to what he said, the success factor can indeed be multiplied.

Several directors looked at Su Nanchen with admiration. Even without Su Qingyun's help, he could still make achievements in medicine.

Professor Su put on his glasses again: "Xiao Yang, what do you think?"

Professor Su has a good memory. Director Han only introduced it once, and he remembered the name. Whether it is caring for young people or reciprocating, he should call the name and let others speak.

Director Han encouraged: "Professor Su has called the roll, let's say a few words."

"Xiao Yang, tell me your opinion?" Director Zhao also encouraged.

Yang Ping also said calmly: "Thank you, Professor Su, thank you everyone! I think that the puncture does not need to avoid the bone tissue, but directly passes through the bone tissue and the pedicle. Instead, the bone tissue is the safest. As long as the puncture needle is in the In the bone tissue, there is no risk of damaging blood vessels, and you don’t need to know where the reefs are, you just need to know where there are no reefs.”

The pedicle is the bony canal connecting the front and back of the vertebrae, with hard cortical bone on the outside and loose cancellous bone on the inside.

This view is novel and unconventional.

"Since the enemy is hiding in the bunker, it is the blind spot of our ballistics. We will accurately calculate the position of the enemy in the bunker, shoot and hit the wall of the bunker, penetrate the wall, and let the bullet pass through the hole in the wall to snipe the enemy. Thank you Everyone." Yang Ping finished.

Professor Su looked at the [-]D reconstruction image on the tablet again. This idea is really imaginative. The whole puncture path is in the bone tissue, and the last step is to penetrate the bone tissue. This way, the possibility of mistaken puncture is not reduced, but completely solved. The possibilities are almost nonexistent, what remains is how to hit the enemy.

Pedicle puncture is a basic technique for any spine surgeon. Pedicle screws are performed every day, and the possibility of failure is extremely low.However, the conventional pedicle approach cannot be used, and it needs to be tilted. The ultimate goal is the spinal canal, not the vertebral body.

Professor Su was very interested: "Xiao Yang, your idea is very imaginative and very feasible."

"Through the bone and pedicle puncture, if combined with Dr. Su's 3D printing to simulate the puncture, the success rate will be very high, and there will be no problem with the feasibility." Director Han combined the opinions of the two people.

The director of the Cancer Hospital laughed: "Young people are still imaginative. One brought out 3D printing, and the other proposed partition walls. It's interesting. It seems that we are getting old."

Director Yu joked: "I saw that you just drank two bottles of water for a while, and didn't have any intention of going to the bathroom at all. I really didn't see how old you were."

Everyone laughed, which was a relaxation of the tense discussion.

"The puncture path is clear, and there are ways to improve the success rate of puncture. The rest is action. Do you have any other opinions?" Professor Su asked everyone.

The issue has been discussed so far that it is already very clear.

"Through the bone puncture, there is no possibility of accidentally injuring the tumor, and the possibility of bleeding is also minimized, but the bleeding cannot be completely avoided. The puncture path is all cancellous bone, and bleeding will occur. In the end, the puncture needle does not enter the vertebral body, but breaks through obliquely. When the bone tissue enters the spinal canal, the blood may flow into the spinal canal along the puncture channel, forming hematoma compression, the possibility is rare, but it is still possible, and a coping plan is needed.” Director Yu found a loophole in the plan.

"This kind of bleeding is different from blood vessel rupture. It is bleeding from the bone surface. A catheter with a local balloon is used to calculate the distance. The outer surface of the balloon is coated with bone wax. The balloon part is placed in the bone tunnel, and the catheter is inflated and compressed. Stop the bleeding." Professor Su said immediately, without much thought, the countermeasures he came up with on the spot showed how extensive his knowledge is usually.

"Wonderful!" Director Yu blurted out.

There are also unexpected remedial measures, and the plan is very perfect.

"Professors, do you have any questions?" Director Zhao asked.

Everyone shook their heads and drank water.

Director Zhao finally concluded: "Then make a plan: thoracic 2 nerve root block, catheterization through bone puncture, preoperative 3D printing simulation puncture, and intraoperative computer navigation assistance!"

"Professor Su, look, is this okay?" Director Zhao asked Professor Su's opinion. He was only the administrative host, and he still made up his mind professionally.

"Okay, just use this partition wall sniper plan!" Professor Su made a final decision.

　Thanks for the reward for playing badminton!Happy holidays everyone!Every update is very late, I am very sorry, because I only have time at night.

　　
　
(End of this chapter)