godfather of surgery

Chapter 343 The man on the mountain

Only three days after the preoperative discussion, Yu Shuilian's operation officially started.

For the operation, Yu Shuilian underwent a thorough intestinal cleansing three days ago, and was forbidden to eat at the same time. All nutrition was supplied by intravenous nutrition.

The purpose is to keep the intestinal tract free of any food residue during the operation and minimize the probability of infection.

The urine bag and feces bag are temporarily removed, and the drainage of urine will be connected to the urine bag by the sterile renal pelvis drainage tube placed during the operation.

Because there is no food, there is no feces for the time being, so there is no need to worry about fecal contamination of the operation area during the operation.

However, after this operation, for a period of time, the bladder and colon fistulas need to be kept, so that urine can be directly excreted from the kidneys through the drainage tube, so as not to affect the survival of the reconstructed urethra.

For at least one week after the operation, the nutritional needs of Yu Shuilian will be supplied by intravenous nutrition to prevent feces from contaminating the surgical site, even a little bit is not enough.

Just like a newly built road, vehicles are prohibited from passing until it is completed.

Sometimes, women are tougher than men. Yu Shuilian has accepted her half-human identity psychologically, and will live the rest of her life in this state.

For her, this is the normal state of life in the future, just like a paralyzed person in a wheelchair, a blind person using a cane to find his way, and a deaf-mute communicating with others in dumb language. This is a special state of life.

After the first life-and-death operation and the second operation, Yu Shuilian was very calm, without any hesitation or worry.

In the face of this blow, some people sink, but some people can re-understand life.

The husband and son kept holding her hand, followed the cart, and sent her to the door of the operating room. The son obediently kissed his mother's cheek, and clenched his fists: "Come on!"

It took a long time for the husband to let go of his hand: "We'll wait outside, don't be afraid—"

Anesthesia, body positioning, hand brushing, disinfection and laying sheets --- the process is repeated more than ten times a day, and dreams will never go wrong.

Song Zimo was assisted first, Takahashi was assisted second, and Xu Zhiliang was watching from the stage.

The knife was like a paintbrush, cutting open at the stump of Yu Shuilian's body.

Because of the tissue adhesion caused by trauma and surgery, the anatomical relationship was not normal in the second surgery, but the surgeon was still so proficient.

No matter whether it is the direction of the scalpel in the same plane or the step-by-step penetration across planes, it is not affected by any anatomical changes.

The direction and combination of the incisions make people confused for a moment, some are straight lines, some are oblique lines, some are arc lines, and some are still wavy lines.

Regardless of the direction and length, it seems as if you already have precise data in your heart, starting and stopping the knife is very satisfactory, and the knife is heavy and light, and the knife is accurate.

But why?
Until the incisions began to penetrate deep into the abdominal cavity, except for Song Zimo, who had been following him for a long time, he could see some clues, Gao Qiao was completely at a loss.

Why did it start like this, and where will the surgery go in the end?

I can't understand the beginning and can't guess the ending. This feeling is very tricky.

When the tunnel where the urethra, YinDao and anus were planned to be placed was opened, Takahashi finally got his hands on a part of the elephant.

The colon is not incised, but turned outwards from the end, and stops at a certain length; then, the remaining opening of the bladder neck is opened, just like the turning of the colon, like turning a sock, turning the inside out.

The lower part of the descending colon, the inner surface has been turned to the outside.

Under the microscope, the mucosa of the colon is peeled off bit by bit by Snake brand micro-scissors, not simply peeling off the mucosa. With the peeling off of the mucosa, the nerves that innervate the mucosa, the nerves that are thinner than the nerves of a baby's finger, one by one The exposed, also retains the connection with the mucosa.

The mucous membrane of the colon with its nerves was completely stripped off without a single hole. The mucous membrane was cut and the surrounding nerves were cut off.

When the recipient area is ready, the excising of the donor bladder mucosa is started.

In the same superb technique, the mucous membrane was cut with many nerves, and the two mucous membranes were exchanged to maintain the integrity of the respective mucous membranes.

The bladder mucosa with the pressure sensor was transplanted to the lower colon, no more, no less, just to fill the defect area just cut out, the nerves of the bladder mucosa were anastomosed with the nerves around the recipient area one by one, even if 12-0 Only two to four stitches can be sutured per nerve.

The colonic mucosa fills the defect area of ​​the bladder mucosa, and the nerves are also connected. Although the colonic mucosa has no baroreceptors, the baroreceptors in other parts of the bladder continue to maintain the urge to urinate.

The east wall was removed to make up for the west wall, but the east wall is still stable and can provide shelter from wind and rain.

Two pieces of fresh mucous membrane were cut out, and the exchange was completed without stopping, and the most delicate part of the operation was thus completed.

Takahashi didn't dare to blink his eyes under the microscope. The surgery that no one has ever been able to achieve is now realized under his own vision under the microscope.

The whole process is as smooth as water, just like doing a routine operation.

Under the microscope, the venous tube cut from the abdominal cavity is still a Snake brand micro scissors, bit by bit, the blood vessels are being peeled off layer by layer, and the blood vessel walls are actually peeled off layer by layer without damage according to the tissue layers. down until desired thickness.

This is like cutting a thin A4 paper into several layers, and each layer is a complete A4 paper, even if it is so thin that it is transparent, there is no break, and the complete plane is preserved.

Competent veins are inverted and anastomosed to the urethral stump at the neck of the bladder, along the established route, and buried in an open tunnel.

No wonder so many people failed, and finally had to give up the research on this kind of operation. Except for him, who else has such extreme knife skills.

The two most difficult steps have been completed, and the following steps, the colon reconstruction YD and the pectoralis minor muscle reconstruction of the sphincter, will not be difficult at all.

The preoperative [-]D printed mold was implanted into the reconstructed anus, urethra and vagina to prevent postoperative adhesions.

The suturing of the outer openings of the three reconstructed structures is very particular. The beautiful rings are everted and then sutured with the surrounding skin, just like a naturally formed transitional part.

The knife has not stopped yet, various enhancements to the incision, combination of various lines, let the skin and tissue flaps be turned up and reassembled one by one, some turned over, some embedded, and some folded.

Non-destructive cosmetic suture needles and threads are used wherever they go, like the magic brush Ma Liang's paintbrush, with the overlapping use of surgical techniques such as incision, suture, transplantation, and transfer.

The anus, urethra, and vaginal opening are arranged in a natural order, and WaiYin, which remodels the skin and tissue flaps, looks like real ones, and even artificial buttocks seams are created.

The remaining bilateral ilium has been rounded during the first operation to replace the original ischial tuberosity, and the remaining muscles were transferred to the bilateral artificial ischial tuberosity as much as possible.

In this way, half of the body can be erected with the help of two supporting points with muscle cushioning, and with the help of the hands, as if the buttocks are still preserved.

During the first operation, Yang Ping had already considered the second operation, and many steps made a perfect preparation for the second operation, such as the preparation of the muscles around various reconstruction channels.

It was only at this time that Takahashi realized that Yang Ping's ability to design surgeries was far from what he had imagined. He already thought that kind of out-of-order surgeries were unattainable.

But now, when Dr. Yang was racing against time, he had connected the two operations together. When the operation steps were sequenced, he had already surpassed the operation at that time, and his thinking had been connected to the second operation.

Unattainable above, and unattainable again!

Beyond the insurmountable mountain, there stands an even higher mountain.

If there is no infection or accident, Yu Shuilian will have a near-normal anus, urethra and penis, and half of her body will retain the most basic functions of the human body.

What she lost is only the ability to walk. If one day, she can really use a power brace, she can still walk upright like a normal person.

Trauma surgery, urology, general surgery, restorative and reconstructive surgery, and plastic surgery combined with top-notch surgeries in many specialties to complete this artistic masterpiece.

Putting any kind of operation into the corresponding specialty is beyond the reach of people.

But who knew that Yang Ping could only obtain these superb techniques by completing one devil training after another in the system space.

A space only for himself, a space for endless case analysis, surgical training, and anatomical study, requires a firm will to overcome loneliness and loneliness.

Only those who have the heart of becoming a god can be so tenacious.

"The man standing on the top of the mountain!"

Fujiwara Miyuki looked at Yang Ping, who was concentrating on the operation, and admired him sincerely.

At the end of the operation, among other things, Yu Shuilian's stump was absolutely symmetrical, and only Yang Ping could do it.

To achieve left-right symmetry, the bone grinding treatment of the residual ilium, the treatment of muscle padding, and the adjustment of skin sutures must all be taken care of.

This is not a requirement of the operation, but it reflects the precision of the chief surgeon, which is so precise that it cannot be added.

"The operation is over, you three, start practicing peeling grape skins under a microscope tomorrow, and only after dissecting the grape skins into three complete layers will you be qualified."

Yang Ping was talking about Song Zimo, Gao Qiao and Xu Zhiliang.

"Do you have any questions?" Yang Ping asked Xu Zhiliang.

Because his microsurgery skills should be the weakest, Xu Zhiliang nodded: "No problem."

"What about us?" Zhang Lin asked.

"Peel off two layers, and if there are no big holes, it is considered qualified."

"Also, you still need to practice pulling the hook. Only when you pull the hook with one hand for an hour without shaking your hand can you be considered qualified."

Yang Ping moved away from the position of the chief surgeon, and Song Zimo, Gao Qiao, and Xu Zhiliang bandaged Yu Shuilian's stump. This kind of bandaging was not casual and required superb bandaging skills.

Put a layer of Vaseline gauze first, and then dry sterile gauze. Some places should be loose and some places should be tight. When it should be separated, it should be separated, and the place that should be packed thick should be thick.

The last thing is to wrap the cotton pad bandage, wrap the stump well, not tight or loose, and the gauze bandage will not fall off easily.

"As for me, Dr. Yang, you haven't assigned my homework yet?" Miyuki Fujiwara offered.

Yang Ping almost forgot about her, she also came here for further study, Yang Ping thought for a while, she majored in sports medicine, she cannot be as comprehensive as Takahashi.

"Under the arthroscope, you use the olive nucleus to carve out the model of the knee joint. The contours of the distal femur, tibial plateau, and patella must be close to the anatomical shape, and the anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and menisci must have basic internal structures. "

Fujiwara Miyuki was stunned, this?Can it be done?
(End of this chapter)