The Godfather of Surgery

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

In academia, there are not so many twists and turns. Sometimes people will quarrel, slap the table, and all face red, and no one will accept the other.

With Professor Su in charge of this meeting, naturally there won't be such an explosive situation, but arguments are inevitable.

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

Director Han's body is upright, just like a general's meeting before the war: The best way is to perform nerve root block, but to avoid leakage of anesthetics, the nerve root sheath must be punctured and placed, which is very difficult, but it is still feasible. sex.

The problem was drawn to the nerve root block. The director of the tumor hospital slid the tablet computer with one finger and held the cheek with the palm of the other hand. The patient's coagulation function is also not very good. If it is accidentally pierced and enters the tumor tissue, it will cause uncontrollable bleeding, form an intraspinal hematoma, compress the spinal cord, and also cause respiratory depression. In the end, the success is unsuccessful, and the ventilator is required. Look, the surrounding soft tissue All are tumors, and the space left for puncture is too small, and it is easy to accidentally puncture and cause bleeding.

Well, it's true. This kind of puncture is like a sniper. It must be hit with one shot, and there can be no mistakes. If a mistake is made, the consequences will be serious. Director Yu, Director of the Department of Orthopaedics in Attached Two, agrees with the opinion of the Cancer Hospital.

The plan is in sight - nerve root block, it seems that no one can come up with other plans except this, but the difficulties are also in front of them, and it is not a small difficulty.

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

Professor Su held the tablet with his left hand, rested his right elbow on the table, took off his glasses, raised his head and said, Everyone has already 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 puncturing. , is indeed very large, but it is not infeasible. We need to use the three-dimensional reconstruction of CT and MRI to find a way to choose a correct puncture approach. Using computer-aided navigation technology during the operation, the puncture can be achieved!

The puncture is difficult, but it can be achieved, this is Professor Su's conclusion.

What if it fails? What are the measures to save? Director Yu in Attached 2 has a different opinion.

Professor Su took a lens-cleaning cloth and wiped his glasses and said, This problem 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 the If the tumor causes bleeding, we give up the puncture and place a drainage tube in the puncture path, which can bring negative pressure to draw out the blood and avoid the formation of a hematoma compressing the spinal cord.”

Professor Su is active in thinking and meticulous. The choice of the plan in a short period of time, the control of risks, and the rescue method for the worst result are all arranged, and Director Yu admires it.

This puncture is far from simple as imagined. How to achieve it can show a person's thinking ability and the accumulation of knowledge and experience in ordinary times.

Just like firing a sniper rifle, it is by no means as simple as pulling the trigger. Every time the trigger is pulled, it is the result of a thousand trials and tribulations.

Any other opinions? Director Zhao asked as the host.

Director Han said with a smile, You two young guys, do you have any comments? Say a few words too, don't be silent.

Originally, it was inconvenient for Professor Su to let Su Nanchen speak on this occasion. Now Director Han has offered to let the young people exercise. Professor Su said to Su Nanchen next to him: Senior gave you such a precious opportunity, what are your good ideas?

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

This young man has a really good mind and can combine cutting-edge 3D printing technology with piercing, 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 to love young people or to reciprocate, they should be named and let others speak.

Director Han encouraged: Professor Su has named him, let's say a few words.

Xiao Yang, talk about your own views? 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 through the bone tissue, through the pedicle, the bone tissue is the safest, as long as the puncture needle is in the In bone tissue, there is no risk of damaging blood vessels, you don't need to know where the reef is, just know where there is no reef.

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

This idea is novel and out of the ordinary.

Since the enemy is hiding in the bunker, which is the dead end of our ballistics, we accurately calculate the enemy's position in the bunker, shoot the bunker wall, 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 3D reconstructed image on the tablet again. The idea is indeed imaginative. The entire puncture path is in the bone tissue, and the last step is to penetrate the bone tissue. This way, the possibility of accidental puncture is not reduced, but completely solved. There are few possibilities, and all that remains is the question of how to hit the enemy.

From pedicle puncture, this is a basic technique for any spine surgeon, and the possibility of failure is extremely low when pedicle screws are used every day. However, the conventional pedicle approach cannot be used, it needs to be inclined, and 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.

Transbone, transpedicular puncture, if combined with Dr. Su's 3D printing to simulate puncture, the success rate is very high, and there is no problem with feasibility. Director Han combined the opinions of two people.

The director of the cancer hospital laughed: It's still young people who have imagination. One has moved out 3D printing, and the other has proposed partition wall sniping. It's interesting. It seems that we are getting old.

Director Yu joked: I see that you have only been so for a while, drank two bottles of water, and have no intention of going to the bathroom at all. I really don't see how old you are.

Everyone laughed, relaxing 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.

At this point, the issue is already very clear.

Through bone puncture, there is no possibility of accidentally injuring the tumor, and the possibility of bleeding is minimized, but bleeding cannot be completely avoided. The puncture path is all cancellous bone, and it will also bleed. In the end, the puncture needle does not enter the vertebral body, but penetrates obliquely. Bone tissue enters the spinal canal, and blood may flow into the spinal canal along the puncture tube, forming a hematoma compression.

This kind of bleeding is not the same as bleeding from blood vessel rupture. It is bleeding from the bone surface. A catheter with a local balloon is used to calculate the distance. The outside of the balloon is coated with bone wax, and the balloon is partially placed in the bone tunnel. Stop the bleeding. Professor Su immediately said that he didn't think much, and the countermeasures he came up with on the spot showed how extensive his knowledge is.

Wonderful! Director Yu blurted out.

Unexpected remedies are also available, and the plan is 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: 2nd thoracic nerve root block, transbone puncture catheter placement, preoperative 3D printing simulated puncture, intraoperative computer navigation assistance!

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

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

Thank you for the reward for playing badminton! Happy holidays everyone! I'm very sorry for the late update every time, because I only have time in the evening.