godfather of surgery

Chapter 907: Little Plum, your hands must be steady!
Because the pain of the old dean was so severe that it could sometimes kill someone, Yang Ping immediately sent a car to pick him up without any delay. Li Min and Li Guodong went with the car to Guandu Town in Beiqiao County.

The trip from the provincial capital to Beiqiao County is almost 300 kilometers, and the round trip takes more than six hours. It is only around five o'clock now, and I estimate that I will have to return to the hospital around twelve o'clock in the middle of the night.

Before departure, Yang Ping asked Li Guodong to bring some medicine, one each of ropivacaine and depotazine. When he arrived at Guandu Hospital, he immediately performed sciatic nerve sealing on the old director, which could immediately relieve pain and allow the old director to be pain-free. I came to Sanbo Hospital comfortably.

Partial closure is a very effective symptomatic treatment method, especially suitable for primary hospitals. If mastered well, all kinds of joint pain can be treated with one shot.

Yang Ping has handed over various local sealing methods to Dr. Li Min, including local sealing methods for sciatic nerve pain, which Li Min has mastered proficiently.

The journey went very smoothly. At about midnight, the old director was taken to Sanbo Hospital. Because Li Min had already performed partial sealing of the sciatic nerve on him, the old director was safe and comfortable all the way. There was no pain at all. I slept in the car in submission.

So when we arrived at Sanbo Hospital, the shaking of the stretcher woke up the old director who was sleeping soundly. The old director said confusedly: "Where is this?"

"This is Sanbo Hospital." Li Min said.

"Sanbo Hospital? What are you doing here?" The old director was a little confused for a moment.

Li Min said: "Didn't I pick you up for treatment? Have you forgotten?"

The old dean rubbed his eyes and tried to get up: "It doesn't hurt anymore. I'm fine now. Why else should I be cured?"

Li Min held him down: "That's a partial sealing effect. Once the effect of the medicine wears off, you will have to roll around on the ground again."

The old dean thought for a while, and it seemed like this was the case. When he came, Xiao Lizi was given a series of partial sealing injections. Xiao Lizi was very promising, and now he can even perform partial sealing injections on the sciatic nerve. The old dean could only give him injections. Simple partial closure of superficial soft tissue.

Now that he's here, let's treat him honestly. It's rare for Xiao Lizi to be filial and take him all the way to Sanbo Hospital.

In order to make a clear diagnosis as soon as possible, with the help of Yang Ping, the old dean completed an MRI examination even in the middle of the night. The lumbar spine MRI showed that although the old dean also had intervertebral disc herniation at lumbar 4/5 and lumbar 5/sacral 1, it was not As for causing such severe pain.

On the MRI image of the lumbar spine, there is an abnormal signal in the anterior branch of the right lumbar 5 nerve root.

In the past, Li Min didn't know how to read MRI at all, but Li Min is different now. Through Yang Ping's step-by-step training during this period, Li Min has mastered the basic reading knowledge of X-rays, CT, MRI and color ultrasound. He saw This abnormal signal immediately made a judgment: schwannoma.

Such severe symptoms of right sciatic nerve pain in the lumbar spine are not caused by lumbar disc herniation at all, but by schwannoma of the left lumbar 5 nerve root.

坐骨神经是由腰4、腰5、骶1、骶2、骶3神经根前支组成的，它是人体最粗的神经，组成的它的这几根神经根一旦出现压迫或刺激就会引起坐骨神经疼痛。

Of course, the sciatic nerve has a long path. After it emerges from the spinal cord in the waist, it passes through the waist, buttocks, back of the thigh, posterolateral calf, and all the way to the foot, controlling skin sensation and muscle movement along the way.

If it is compressed or stimulated along its path, it will also cause pain or numbness at the distal end. For example, at the outlet of the piriformis muscle in the buttocks, the sciatic nerve is easily compressed and causes pain.

For identification, the old director also completed an MRI of the outlet of the piriformis muscle in the buttocks, and there was no compression of the sciatic nerve in this area.

''Schwannoma of lumbar 5 nerve root? Li Min asked.

Yang Ping nodded: "So for the evaluation of patients with low back pain, X-rays are unreliable. X-rays can only see bones and have little ability to distinguish soft tissues. The final identification still needs to rely on MRI. From the image performance Look, schwannomas are most likely. If it is indeed a schwannoma, it is benign." Yang Ping pointed to the MRI picture and said.

"No wonder the pain is so obvious and the straight leg raising test is negative."

Li Min couldn't help but feel a little regretful. If he had given the old director a detailed examination earlier, he wouldn't have been in pain for so many years. He had been treated as a lumbar disc herniation for so many years.

"I don't need to tell you what's going to happen next. I'll leave the old dean's illness to you. Can you handle it?" Yang Ping asked Li Min.

Surgery is the only treatment for this disease. Based on Li Min's current level, there is no problem in doing this surgery.

This is a simple lumbar spine tumor surgery. Li Min felt that he could also complete this surgery. When he heard Yang Ping said that he would do this surgery, he felt very happy and felt a sense of accomplishment. He could actually perform it for the elderly hospital. Chief surgeon.

It happened to be that I reported my study progress to the old dean in this way, which showed that I studied very hard and the old dean did not value me in vain.

''You need to be patient when performing this operation. The tumor must be completely removed while protecting the spinal cord and nerve roots. "Yang Ping told Li Min.

"Well, I must be careful." Li Min was a little excited.

Now that the test results have come out, Yang Ping took Li Min to explain the condition to the old dean. The old dean was resting in bed, with a rehydration bottle hanging next to the bed. Maybe he hadn't slept in the past few days. I sleep very soundly now.

"How about letting him rest for a few hours tonight and do the surgery tomorrow morning? If the pain occurs again, add an additional injection to seal it?" Li Min saw that the old dean was sleeping so soundly that it was hard to disturb him.

Yang Ping agreed with Li Min: "I haven't eaten anything for several days. Pay attention to the balance of water and electrolytes later. Make up for the fluids tonight. Let's do the surgery tomorrow morning."

At this time, the old dean woke up. He rubbed his eyes in a daze and saw that the doctors doing rounds in front of him were Professor Yang and Xiao Lizi.

"Professor Yang, look, I'm bothering you so much. We, Xiao Li, have already troubled you enough by studying here. Now I have to trouble you again. I'm so sorry." The old dean got up and leaned against the bed.

Yang Ping and Li Min helped him sit upright. Yang Ping said, "You should have a good rest and don't get up. The test results have come out. It's not a lumbar disc herniation, but a schwannoma of the fifth lumbar nerve root. This disease requires surgery. We We plan to operate on you tomorrow morning. You should have a good sleep at night and don't eat or drink. We will operate on you tomorrow morning."

"Schwannoma? Isn't it a lumbar disc herniation? Don't you think this is a capsized boat in the gutter?"

The old dean sighed, it was really embarrassing that he had been suffering from a herniated lumbar disc for so many years because he was a doctor.

Li Min said to the old director: "This disease requires surgery, there is no other way."

The old dean nodded: "Let's just do surgery. This surgery requires entering the spinal canal and operating the knife on the nerve root."

Yang Ping said to him again: "Then we won't disturb your rest. We will come to see you tomorrow morning. Dr. Li Min will perform the surgery on you tomorrow."

It was fine just now, but when the old dean said these words, his heart suddenly jumped violently. Li Ming, this guy, can do this kind of surgery?
Immediately, the old dean cast a suspicious look at Li Min.

In the impression of the old dean, Li Min could only perform some simple operations, such as appendicitis, cesarean section, debridement and suturing, etc. This kind of lumbar surgery that entered the spinal canal, not to mention Li Min, the old dean himself also Never done it before.

The old dean knew that lumbar spine surgeries were major surgeries and could paralyze people if they were not careful.

"Little Li?"

The old dean asked uncertainly. "Yes, I will perform the surgery on you tomorrow, don't worry."

Li Min said happily that he thought the old director was surprised that he could perform such a high-level surgery, so he looked full of confidence.

Surgery is no joke. Li Min couldn't have asked for it himself. Normally, he has nothing to say to Li Min. He treats Li Min like a son and has not offended this boy. He will not seize this opportunity to practice on him. Bar?
"Xiao Lizi? Are you trying to practice with me?"

The old dean asked cautiously.

Li Ming found the old dean's cautious tone funny in his heart, because the old dean was usually more optimistic and acted like an old naughty boy, often joking with others. Li Min thought that the old dean was joking again.

"Old Dean! I've been here to study for so long and never had the chance to do anything. Do you have to give me this learning opportunity?" Li Min followed his words.

As expected, the old dean's heart felt cold.

This kid really uses his own skills to practice, so what! Let him practice his hands.

"How about conservative treatment first? I think it's quite relaxed now. After all, I've been through it for so many years. What if I can't stand it again? I'm afraid my bones won't be able to withstand this knife." The old dean felt that there was something more. A glimmer of hope.

Yang Ping said clearly: "There is no way to treat this disease conservatively. At this point, if you want to cure it without pain, you must have surgery."

It seems that I can't escape even if I want to. I am already meat on the chopping board. Little Plum, can you do it? Don't be paralyzed. There will be no place to talk about it when the time comes.

The old dean's heart skipped a beat when he thought of Xiao Lizi undergoing spinal surgery.

The old director is still aware of these matters of further training. Back then, the old director also received advanced training in the county hospital. It would be great to be able to go on stage to pull hooks. There is no chance of being the chief surgeon.

The old dean had no choice but to bite the bullet and said, "Okay, I'll give you some practice."

Li Ming usually works more seriously and down-to-earth, unlike the other two boys at Guandu Hospital who are careless. If it were those two boys, the old director would go home on crutches now.

"Don't worry! Li Min can definitely perform this operation, and he will definitely do it beautifully." Yang Ping gave the old dean confidence.

"Well, I'm sure I'm relieved."

The old dean said incoherently, speaking calmly, but in his heart he was actually panicking.

Li Min's professional skills are good, and this kid studies hard, but a grassroots doctor is a grassroots doctor after all. Li Min weighs a few pounds. How can his old director not know how long he has been here, how can he perform such an operation? Besides, In this kind of provincial doctor's training, there is no chance to do surgery. They are just doing odd jobs.

After Yang Ping and Li Min left, the old dean asked for two sleeping pills, otherwise how could he fall asleep.

This kid has been taught about appendicitis by himself. He has only been here for a short time, and now he is performing lumbar spine surgery on himself. No one can sleep at this time.

The next morning, the nurse inserted a urinary catheter for the old dean, but the old dean refused. An old doctor who often performed obstetrics and gynecology surgeries actually refused the nurse to insert a urinary catheter. In the end, Li Min inserted the urinary catheter manually.

"You've been doing obstetrics and gynecology surgeries for decades, so why are you so shy when asking a nurse to insert a urinary catheter?" Li Min usually has a good relationship with the old director, so he doesn't have any scruples about what he says.

The old dean said seriously: "Can it be the same?" I was the doctor then, now I am the patient. Little Lizi, there are no outsiders now. I ask you whether you can really perform lumbar spine surgery. Don’t force it. I know you have good intentions and you are doing it for my own good. My old man is still in good health and this leg will still be used for a few years. You need to be steady and your hands must not shake. "

''Look what you said, who do you think has his hands shaking willingly? Can he control his hand shaking? "Li Min said while collecting the catheter bag.

"Little Plum, your hands must be steady!" The old dean took Li Min's hand.

"Old Dean, don't worry. Professor Yang has taught me a lot. This kind of surgery is a piece of cake. Not to mention my current level. Not long after I came here, the few experimental pigs I just made were... Running all over the place.”

You bastard, you confessed to yourself that you have never done this surgery on humans, you have only done it on pigs.

"Have you had this surgery?"

"Of course I did."

"I mean in people, not pigs."

"It's been done to people."

nonsense! It would be useless to ask him.

Which doctor would honestly say to his first surgery patient: I have never done this surgery, and you are the first surgery I have performed. The patient was not so frightened that he was discharged directly.

''The first operation, sending the patient! "

A nurse's urging voice sounded outside the door.

The old dean was pushed to the operating room on a flat cart. The old dean had seen this scene for decades, and now it was his turn to lie on it. The surgeon was still a novice. Why was he always so anxious?

Forget it, it’s not easy for Little Plum. As a doctor, there is always a process of growing up. No one wants to be the first, so who will be the first? Little Plum is also excusable. It’s definitely not good for strangers. Go ahead, this acquaintance is easy to do.

Thinking this way, the old dean felt much calmer, and his state of mind improved instantly.

Li Min also accompanied the nurse to take the old dean to the operating room, and the old dean kept talking to him.

"Xiao Lizi, if you see a schwannoma during the operation that is difficult to cut, just give up if it doesn't work. We won't force it!"

"Little plum! You must see your nerves clearly. Don't panic. Keep your mind clear. I usually teach you to be bold and careful. You must be careful, but you can't be too courageous."

"Old Dean! Don't worry, don't be nervous."

"Of course I'm relieved. How can I be worried? Why am I nervous? Aren't I very relaxed? I'm just chatting with you. We haven't seen each other for so many days, why don't we just chat?"

''Little plum, your hands must be steady! "

(End of this chapter)