Those years when I hung up and upgraded in the hospital

Chapter 152 Temporary giving up and asking for help (please subscribe)
When Fang Yun was operating, he discovered that the 30° pointed needle holder was unable to assist in completing the thread crossing!
In desperation, Fang Yun had no choice but to use the lumbar needle again, bring the ferrule end of the silk thread into the joint cavity again, and then use a 30° pointed needle holder to feed one of the anchor threads into the joint cavity. into the exposed coil at the tip of the lumbar puncture needle.

After pulling in the double wire from the outside, the ferrule directly brings out the pinched wire.

After bringing it out, Fang Yun was not in a hurry to tie the knot.

Because the length of the rotator cuff tear is a bit long, a single row of anchors cannot achieve the final treatment effect.

Therefore, this may require the use of double rows of anchors, and the number of inner rows of anchors must be two!

Double row sutures require anchors with double threads and outer row anchors without threads.

What Fang Yun had just inserted was the first inner row of anchors with wires, and the outer row of anchors was without wires.

According to the size of the wound tear, Fang Ziye continued to insert the second inner-row anchor, which was slightly different from the bone surface of the footprint of the first inner-row anchor at the edge of the joint surface. About 1cm, Fang Ziye put down the second anchor...

After threading the needle again and letting the suture pass through the tear in the rotator cuff, Fang Yun stopped temporarily.

After taking two deep breaths, Fang Yun turned around and said, "Director Hu, I want to give up the opportunity to continue the assessment. With this kind of SLAP injury, I am currently unable to determine whether my own operations are up to standard."

"However, the placement and order of the inner and outer row anchors should be correct, but for the subsequent SMC suturing, I hope to let the professors complete it, or give me guidance to help complete it."

SMC suturing is a special form of suturing in sports medicine suturing.

The simple operation is——

Select one tail line of the suture as the column line and the other tail line as the wrap line.Tighten the two tail wires, wrap the wrap wire around the two tail wires clockwise, then wrap around the column line once, and finally pass the wrap wire through the middle hole.By pulling on the column thread, the knot can be pulled into the tendon surface and tightened, and by pulling on the circumferential thread, the suture knot can be locked so that it will not loosen.Then make two half knots in the same direction and one half knot in the opposite direction, that is, the knot can be knotted reliably...

Fang Yun's words were unexpected by Director Hu Jun and others.

However, this is in line with Fang Yun's own situation.

He originally thought that the principle of treatment of SLAP injuries was similar to that of a simple rotator cuff tear, or a little more difficult. However, after the actual operation, Fang Yun realized that he could not determine what the final operation would be. What a mess!

Instead of asking the professors to come back and process it again, it is better for him to give up his position before the most critical suturing step. Otherwise, if his position or sutures are wrong, he will need to revise them again. , the trouble is big.

Bad luck, special circumstances, this is fate.

But getting permission to perform surgery is not just for showing off.

Fang Yun is very calm, if he can, he will, and if he can't, he won't.

When Hu Jun heard this, he was a little disappointed, but it was hard to say anything.

This time, Fang Yun was selected for such a patient. His responsibility was unshirkable, but the chance of such an accident happening was too small.

The MRI scan is missing the SLAP level, so there is nothing we can do about it.

But after hearing what Fang Yun said, neither Professor Zhu nor Professor Li, nor even Director Zhang and others, instead of feeling annoyed or amused, were very surprised.

Professor Zhu put a lid on his rating scale and asked: "If I tell you that your current processing is very good, you only need to complete the SMC knot fixation and add three ordinary knots after each knot. The knot is fixed, can you continue to operate?"

Fang Yun turned around and nodded: "Are all the lines I have now sorted out?" Fang Yun really didn't know. He had only seen it in the literature and had no experience of witnessing other people's operations. and experience, this is a lack of knowledge!

Perhaps Fang Yun can have a high degree of confidence when the rotator cuff suture reaches level 4, but now, Fang Yun still doesn't have it.

"Yeah." Professor Zhu didn't say anything more. Instead, he wrote something by hand on the rating scale after subtracting a certain score.

When Fang Yun heard that Professor Zhu recognized it, he stopped talking.

Immediately operate the bar line and loop line, make standard SMC knots, and also use ordinary knots to fix them.

Here, Fang Yun learned that in the sports medicine profession, in addition to the importance of puncture, the level of knotting is also very important.

Just for sliding knots, you need to pass the two tail lines of the suture through two half knots in the same direction to form a sliding knot, pull the column thread to tighten the knot on the surface of the tendon, and then complete the fixation with a half knot in the opposite direction.

This kind of operation is much more difficult than the ordinary knot-tying technique under direct vision. If your knot-tying technique has not reached level three, you can only stare blankly at the moment.

The operation sounds simple, but it took Fang Yun more than 20 minutes to figure out these knots one by one.

After finally pushing the thread shears to complete the thread cutting operation, Fang Ziye breathed a sigh of relief as he looked at the post-operative effect of knitting the sutures like a knitted bag.

After using the probe hook to find that the labrum is stable, we start injecting 'cocktail' analgesia.

It is a standard 'cocktail' general formula, which Fang Yun specially configured after consulting the literature.

Immediately afterwards, Fang Yun closed the wound with a wry smile. He didn't know what the final result would be, but Fang Yun knew that once he opened his mouth, the result would not be important.

After the suturing was completed, it was covered with gauze and sterile cotton pads. Fang Yun installed the special movable brace for the shoulder joint that the patient purchased online. After getting into bed, he could wait for the patient to wake up from anesthesia and return to the ward.

When Fang Yun took off the sterile surgical gown, the back of the hand-washing gown was completely soaked with sweat.

Fang Yun was also under a lot of pressure. The completion of the operation could only be said to be barely satisfactory. If his operation skills were not solid enough, Fang Yun might have given up on giving up the arthroscope as soon as he discovered the slap injury. .

Fang Yun clasped his fists slightly: "Teachers, I'm sorry, my clothes are wet. I have to go down and change. After changing, I will come back to listen to criticism and corrections."

In addition to his back being sweaty and dripping with sweat, Fang Yun's pants were also a little wet, making him particularly uncomfortable.

The operation must be completed, but it is ultimately disrespectful to face the professors and directors with wet clothes.

Just after Fang Yun clasped his fists and left, Professor Zhu glanced at Associate Professor Li: "I think the assessment can continue. That thing is the culprit for this diagnostic error!"

Associate Professor Li’s full name is Li Xun.

Li Xun's face was definitely a little younger than Professor Zhu's, and he was quite calm. He touched his head at this moment: "Professor Zhu, it is very difficult for me to complete this operation alone. Dr. Fang can do this, I think it should Give Rongqing."

“With a responsible attitude toward patients, we can never be too cautious!”

(End of this chapter)