The Godfather of Surgery

The opening of the operation table every day is more accurate than the clock.

The surgery for the reconstruction of the anterior cruciate ligament starts on time at 8:30.

In order to make this operation more beautiful, Yang Ping used the spare 6,000 points, took out 2,000 points, and bought another 100 ACL reconstruction surgeries in the system space for special training. Refinement to perfection level.

Director Han was very reassured about Yang Ping. In every operation, he achieved both speed and quality, impeccable.

However, people are always curious. The last meniscus suture was not enough. This time, the ACL reconstruction, Director Han decided to go up and have a look.

Huang Jiahui didn't come, Zhou Can called several times, but she didn't answer, Zhou Can put the sterile packaged consumables on the equipment cart.

Not seeing Huang Jiahui, Song Zimo frowned, but Yang Ping didn't say anything, and Song Zimo didn't plan to express his opinion for the time being. He wanted to talk to this little girl afterward, and if he didn't come, he should have a phone call.

operation time?

Every time I encounter a new category of surgery, the fat man will habitually ask.

Half an hour!

Yang Ping looked at the MRI of the left knee and the CT scan + 3D reconstruction of both knees on the reading lamp. The intercondylar fossa of the left knee has been severely deformed, and the intercondylar fossa needs to be reconstructed during the operation.

The intercondylar fossa is like an arch-shaped cave. Now this cave has collapsed and needs to be rebuilt. How can it be restored without its original appearance? Had to refer to the right side, the right side and the left side are mirror images.

It is very difficult to form this intercondylar fossa! Song Zimo pointed out the intercondylar fossa in the picture.

The patient went to another hospital, but he didn't do it for him because he was afraid that there would be problems if the shaping was not good. If the shaping was not in place, the reconstruction would cause a bump, and the operation would fail completely. If the shaping was too much, the patellofemoral joint lost its stability, and new troubles arose. Yang Ping explained it to Song Zimo.

Song Zimo took out a folded piece of paper: Look, this is the intercondylar fossa of the left knee that I drew based on the CT 3D reconstruction of the right knee intercondylar fossa, in a one-to-one ratio.

Song Zimo unfolded the paper, Yang Ping took it, and he did a good job.

If you make a rough outline, many doctors will, but you have to draw a specific and accurate picture on the left according to the right side. This kind of spatial imagination is absolutely rare, very rare.

Not everyone has the ability to imagine this kind of space. It requires talent, and it is not an exaggeration to say that it is one in a hundred thousand.

Song Zimo played blind chess for a whole morning without missing a chess piece or wrong a chess piece. What kind of ability is this? The memory and spatial imagination are beyond the reach of ordinary people.

The thinking of ordinary people is language, and the thinking of genius is composed of a large number of pictures. Song Zimo is a genuine genius. The verification is complete!

Bring a pen! Yang Ping improvised Song Zimo.

Song Zimo asked Zhou Can for a blue-black gel pen. Yang Ping called out the three-dimensional map constructed in advance in his brain. This time, it was much easier than the last time. For some slightly blurred areas, Yang Ping immediately filled in the blurred areas based on the CT images in front of him.

Yang Ping sketched a new drawing below his drawing: When CT is doing 3D reconstruction, there will be some distortions of the graphics due to the interference of artifacts. We need to correct it. You see, it should not be prominent here, it should be smooth. Yes; here, it should be a little deeper; and this arc needs to be corrected a little.

Song Zimo could only smile bitterly. He could only make a mirror composition based on the CT three-dimensional reconstructed image, and there was no way to use the original cross-sectional image to reconstruct it on the drawing.

But Yang Ping can. Mr. Ning from the Overseas Chinese Building had not done 3D reconstruction at that time, only CT scan. Yang Ping only used the plain scan pictures to carry out hand-painted 3D reconstruction on the drawings. This requires much terrifying brain power, this is not manpower achievable.

But Yang Ping just did it, Song Zimo saw him do it with his own eyes.

If Song Zimo knew that Yang Ping was in front of him, he didn't need any drawings at all. He could compose the picture in his brain. He would probably grab Yang Ping to take a CT and MRI of his head to see if there was anything similar to a chip inside.

Are you discussing the formation of the intercondylar fossa? Director Han put the phone on the shelf next to him and walked over.

Although Director Han completely let go, he still knew the condition of Keli's patient like the back of his hand, which is a kind of responsibility.

He leaned over to look at the drawings. The two boys actually used the intercondylar fossa on the unaffected side to draw the correct image of the intercondylar fossa on the affected side. One of them even dealt with the artifacts of the reconstructed image.

——

Huang Jiahui hadn't slept well all night. She had been feeling feverish and vague. She reached out to touch the mobile phone by the bedside and barely opened her eyes: It's 8:40! It's 8:40!

The operation started at 8:30, and I should be in the operating room ahead of time. Now I should be in the operating room, standing next to the instrument cart.

As if a basin of ice water was poured from the top of her head, she suddenly woke up, her muscles were sore, and her lower abdomen was even more cramped.

My brother had something to do last night and never came back, otherwise he would definitely wake her up.

Jiahui was about to cry, so she got up immediately, dragged her heavy body, and rushed to wash up, no, make a phone call first.

The operation has already started. Who should call? Song Zimo. It seems that Dr. Yang is entrusting him to do all these things.

——

On the shelf, Song Zimo's phone vibrated.

Zhou Can picked up the phone: Song Zimo, Huang Jiahui's phone number?

You pick it up! Song Zimo was busy.

Zhou Can answered the phone, and after hearing it clearly, relayed to Song Zimo: Huang Jiahui said I'm sorry, she had a high fever last night, and she still has a high fever now. She's late, she will come right away.

Tell her not to come here! Yang Ping checked the knee joint, confirmed the rupture of the anterior cruciate ligament, and began to prepare the tendon, the semitendinosus and gracilis on the same side.

Little girl, she's working too hard. She has to come over when she has a high fever. In fact, she doesn't need to come for the operation in the future. Yang Ping said while doing it.

Zhou Can took Yang Ping's meaning and said to the phone, Doctor Yang said, you don't have to come here in the future.

The proficiency of this communication, Chinese is definitely not a pass, don't come in the future, and don't come, do they mean the same thing? ——

What do you mean you don't have to come over in the future, just be direct, get out! You don't do this piece of business!

There is no advance greeting, and the absence of surgery is a serious mistake. I have a colleague like this, angering a big professor, the professor said this - you will not use it in the future, the company directly fired the professor to appease the professor. colleagues.

Jiahui didn't even have the heart to wash her face and brush her teeth. Tears flowed out. This time it was troublesome, and a big basket was thrown. He immediately called his brother for help, but there was a busy tone.

There was no way, she bite the bullet, wash up quickly, and change her clothes.

Ignoring the pain all over her body and lower abdomen, she rushed out with a reusable bag. There was a gust of wind outside, and she shivered. She crossed her hands involuntarily and hugged herself.

——

The movements were a bit exaggerated. Song Zimo made a horizontal incision of only one centimeter on the inner side of the knee. Song Zimo did not see it clearly at all. He only saw the vascular forceps, the sharp knife, and the tendon stripper, which were operated successively in the small incision.

The two tendons were taken out by Yang Ping one by one, and the lengths they took out reached the limit. Both the semitendinosus and gracilis tendons exceeded 30 centimeters.

Treat the braided tendons! Yang Ping handed the two tendons to Song Zimo, who sat on the sterile instrument table to handle the tendons.

At the same time, Xiao Wu supported his leg, and Yang Ping continued to deal with the knee joint.

The lens is reinserted, the meniscus is trimmed as necessary, and the formation of the intercondylar notch begins.

The burr rotates at high speed like a carving knife. The patient's severely deformed intercondylar fossa is like a blank. Slowly, a perfect normal intercondylar fossa is carved out by the burr.

The inner wall of the formed intercondylar fossa is then ablated by radiofrequency ablation with a plasma knife to achieve hemostasis and deactivation, and prevent the intercondylar fossa from continuing to grow osteophytes and cause restenosis.

Tibia Locator!

Before Yang Ping could say anything, the equipment was already in his hands. He and Su Yixuan looked at each other for a moment and continued the operation.

The adjusted tibial locator was placed, and the electric drill passed the guide pin through the tibial plateau to drill a tunnel; released the electric drill and handed it over to Su Yixuan, the second guide pin was installed, and the second tunnel was drilled.

Have the tendons been handled well, report the size! Yang Ping was waiting.

Professor Yang! The 8-strand double-beam reconstruction! Can we not be so fast? Song Zimo said so with his mouth, and he did not show weakness in his hands. As Yang Ping's assistant, who is it?

The length is 8 cm, the diameter at the tibia end is 7 mm, and the femoral end is 8 mm, the two bundles are the same! Song Zimo could keep up with the rhythm.

7mm Tibial Tunnel Drill!

With a rustling sound, the electric drill accurately opened two tibia tunnels.

8mm Femoral Tunnel Drill!

Yang Ping quit the drill, Su Yixuan took it, and immediately put on an 8mm femoral drill.

He didn't intend to stay for a moment, and opened two femoral tunnels, with a prefabricated length of 25 mm.

Measure the length of the femoral tunnel!

The ruler was handed over, and everything was placed in advance.

Two tendons, anterolateral bundle with 25 mm thick tunnel at the femoral end and 25 mm thin tunnel; posteromedial bundle, 25 mm thick tunnel at the femoral end and 20 mm thin tunnel, prepare the tendons, hurry up!

Song Zimo raised his hand speed to the top and held his breath. A few seconds after Yang Ping's words fell, he had already adjusted the hanging length of the button steel plate.

The most critical steps in this operation are the formation of the intercondylar fossa and the precise double-bundle tendon tunnel. Once the location of the tunnel is wrong, or the location is inaccurate, the operation will fail, and some will cause movement disorders.

But Yang Ping started it in a few minutes, and the next steps were even faster, pulling the tendon into the femoral tunnel, waiting for the button plate to pull out the femoral cortex, then pulling it back and flipping the plate. The tendon is then introduced into the tibial tunnel and the tibial end is secured with absorbable compression screws, both tendons.

In this way, both ends of the two tendons are implanted in the bone tissue, allowing them to survive and play the role of the original ligaments later.

The entire operation is equivalent to doing a new ligament to replace the ruptured ligament, simulating the work of the original ligament.

It's over?

It's okay not to look, every time I look, I shake my eyes.

Director Han just studied the CT film for a while, turned around and sat down, ready to take a good look at Yang Ping's operation, but the operation was completed.

Huang Jiahui ran in at this time and saw that everyone was bandaging and was about to open the sterile sheet.

It's over, it's over!

Jiahui felt cold in her heart.