The Godfather of Surgery

At noon, after eating with Xiao Su in the cafeteria, I slept in the duty room of the department for an afternoon.

In addition to the usual daily rewards, the points have reached 51,000 points, and the surgical training can be advanced.

Yang Ping spent 10,000 points to purchase 500 surgeries for cruciate ligament reconstruction, and another 20,000 points to purchase 500 surgeries for multi-structure reconstruction of the knee joint, with 21,000 points remaining. It took more than ten days in the system space to complete the training for this thousand operations.

There are a lot of surgical training packages in the mall, almost everything you want, as long as you have enough points, you can buy as many as you want. The only downside is that the training is advanced, and it must be done step by step. After you complete an advanced training, you can proceed to the next step.

Yang Ping completed surgery training, and then conducted anatomical training in the system space, using anatomical knowledge to train the human body composition of the brain.

It was after 4 o'clock in the afternoon when he woke up. Song Zimo was drawing a picture in the office, a picture of the injured knee joint. He drew the reconstructed structure on the picture. After he finished drawing, he crossed it off and drew it again.

I've done quadruple reconstruction for ordinary people, and five-joint reconstruction for professional athletes. This balance is really difficult to grasp. How can the starting and ending points of these ligaments be accurate? How can the tension be adjusted with so many ligaments? Song Zimo was very annoyed.

In this operation, there are many reconstructed structures, such as double anterior fork, double posterior fork, three posterolateral structures, three posteromedial structures, the joint capsule needs to be repaired, the lateral retinaculum of the patella needs to be released, and the medial retinaculum needs to be tightened. After rebuilding so many structures, it is not finished yet, and the tension of these structures is adjusted to a satisfactory level, and each other is adjusted to a balance.

Not to mention doing it, a sports medicine doctor will have a swollen head when he sees this operation, and most of them don't want to do it. In the face of this kind of operation, the confidence that most doctors usually accumulate will be shattered.

Not to mention that Song Zimo usually encounters very few, even Su Nanchen, who is attached to the first, seems to be unable to do what he wants. After all, the number is too small, and it is difficult to gather a small number into a large number. Only a national sports medicine center like the Third Hospital of the Imperial Capital can gather a large number of cases. .

For example, Song Zimo was able to win the quadruple reconstruction of ordinary people, and Su Nanchen's quadruple reconstruction of professional athletes was only one step away from the big guys of the Imperial Capital's Third Court.

You'll be able to see one by then. Let Jiahui prepare all the instruments. This operation is a bit big, and at least 10 allogeneic tendons will be prepared for reconstruction. Yang Ping explained to Song Zimo.

As soon as the patient came in, I notified her that she had already prepared the equipment. I have prepared 20 allograft tendons, from the Shanxi Medical Tissue Bank, which is in our hospital's supplier catalog and can be used directly. Sports Medicine The center uses them. Huang Jiahui has a cold, has a high fever, and is in the emergency department for infusion. I told her not to follow the stage. She is very persistent and must come. Song Zimo kept the preparations for the operation without leakage, and Yang Ping was not needed at all. worry.

Is the Singaporean's surgery going well? Yang Ping asked with concern.

Song Zimo was very confident: It went well. The reexamination film is out. You can take a look when you have time. I drew a 3D reconstruction map before the operation to simulate the removal of the sequestrum. The sequestrum should be scraped clean during the operation.

Not bad! Yang Ping gave a thumbs up.

Song Zimo was a little embarrassed: You have to learn something. Compared to you, my spatial positioning ability is not a little bit worse.

This is indeed a major surgery. It is addicting to see Yang Ping's surgery. It feels like a village where the willows are hidden. Director Han is addicted now. How long has the comprehensive orthopaedics been opened, and the five-joint injury and reconstruction have moved out.

On Saturday, Xiao Su did not go home. Yang Ping accompanies Xiao Su to play tennis on the court in the hospital. Xiao Su is a professional, while Yang Ping has only been in contact with him in college. Xiao Su once became a coach.

On Sunday, Xiao Su went home, and Yang Pingwo stayed in the house and did not go out. He read and studied, and borrowed some materials about Hai Fudao to go back to study.

On Monday, Director Han arrived in the operating room early, and usually only came to see when the stage was open.

Xiao Wu, adjust the video system a little better, and then take a picture. I will make a poster of this operation and hang it on the wall of the ward. This operation and the reconstruction of multi-directional instability of the shoulder joint are side by side with the difficulty in sports medicine. The biggest surgery. Director Han sat there and directed Xiao Wu.

In the last reconstruction of the anterior cruciate ligament, the intercondylar fossa was formed. It was like a sculptor sculpting. The drill was grinded and grinded, and a perfect intercondylar fossa was milled out unconsciously.

Director Han watched the surgery video several times, and he firmly believed that Yang Ping had learned sculpting, and he also practiced the sculpting of the intercondylar fossa with a drill. Otherwise, how could it be so perfect.

Director Han's guess is not wrong. Yang Ping has practiced it before, but in the system space, the operation is practiced casually in the system space. If it is done badly, there will be no adverse consequences. As long as you have points, it will provide you with a steady stream of cases. As long as you have enough points, let alone five injuries, six, seven, and eight, you can use as many joints as you want, which may never be encountered in reality. Cases are simulated for you.

At the beginning, I really practiced the formation of the intercondylar fossa with a burr in the system. I read a lot of books on carving before practicing, and thoroughly figured out the principle of sculpting. Then I used the burr as a carving knife, and the patient's intercondylar fossa was a blank. Sculpture.

Now if Yang Ping is asked to do cosmetic surgery, he can definitely use this trick to set up a plastic surgery signboard.

Xiaowu is very concerned about these medical equipment. He has played with this video system more than the manufacturer's engineers. There was a problem with the video system last time. It is said that there is a bug in the software. The person sent by the manufacturer checked it, but I said sorry a few times with my smiling face, and then the video was still stuck, the problem was not solved, and Xiao Wu finally solved it.

Huang Jiahui is no longer feverish, but she looks very haggard. She is standing beside the equipment cart. Yang Ping passes by her equipment cart. She bows: Hello, Teacher Yang!

Is the cold better, no fever, if not, go back to rest, it's fine. Yang Ping said with a smile.

Huang Jiahui thought that she was really lucky. She ran into such a good-tempered doctor. Last time she was late, she didn't have much dissatisfaction.

The reconstruction of the front fork and the rear fork is similar to the previous operation. The eight-strand double-bundle used for the front fork needs to be anatomically reconstructed. Only the anatomical reconstruction can restore the function to the maximum. The posterior cruciate ligament is also a double-bundle anatomical reconstruction. The location is different.

This operation, how should I put it, has reached the point where it is easy to lift weights. A major operation, it feels like a minor operation, if you don't know it, you will think it is a minor operation.

After the anterior and posterior cruciate ligaments are reconstructed, the posterolateral and posteromedial structures are reconstructed. There are three posterolateral structures that need to be reconstructed: lateral collateral ligament, popliteus tendon, and popliteal ligament. There are also three posteromedial structures: the medial collateral ligament, the posterior oblique ligament, and the popliteal oblique ligament.

After rebuilding these eight structures, the joint capsule should be repaired, the lateral retinaculum of the patella should be released, and the medial retinaculum should be tightened to correct the trajectory of the patella.

These ligaments cross vertically and horizontally, from the femur to the tibia, or from the femur to the fibula. Each one is implanted into the bone tunnel. The shape must be precise, the tension must be appropriate, and each other must be taken into account. A little looser or a little tighter, and the surgery is discounted, and discounting means failure.

In the daze, the rustling sound of the electric drill stopped, and the allogeneic tendons were handed over one by one, turning into ligaments on the patient's body, covered with implanted tendons.

The person doing it is very relaxed, and the person watching it is very comfortable. After finishing the test, the stability of the knee joint is tested. The stability is very good. The tension and balance are really perfect at one time. Song Zimo has 10,000 question marks in his heart.

The patient was pushed out by Xiao Wu Zhanglin. This time, Fatty was very conservative. He was afraid that the operation would take a long time and the amount of anesthesia would be relatively large. When the patient went out, the operation leg was still numb.

Song Zimo secretly came over and said, Where do you do so many operations like this? Can you give me an answer that can convince me, not too fanciful.

Yang Ping is copying the video and taking a picture: Do you know Gauss?

You know, does this operation have anything to do with Gauss? With Song Zimo's IQ, he didn't guess the mystery.

Yang Ping stopped the hand that operated the mouse: Gauss was studying at the University of Göttingen at the age of nineteen, and his tutor routinely assigned him three questions every day. On this day, the teacher only assigned two questions, but due to a mistake, he A small note was clipped into his textbook. The note was also a question. The first two questions were easily solved by Gauss. Only the questions on the note were difficult for him, and it took him an entire night. , I solved the problem. When I handed my homework to my tutor the next morning, he felt a little guilty and self-blame. He said to the tutor, I worked all night to solve the third question you gave me. I have failed your cultivation of me. After reading his solution process and results, the tutor stared at Gauss for a long time, and said in a trembling voice that this is a mathematical unsolved problem for more than two thousand years, which Archimedes did not solve, and Newton did not. You didn't solve it, but you solved it in one night?

After Yang Ping finished copying the video and pictures, he stood up. Song Zimo had been petrified, and the answer was all in this story.

Yang Ping patted him on the shoulder: Some people will do things like surgery after reading it once, like you; there are people who can complete the surgery just by reading the book once, like me, believe it or not?

The secret is only one sentence. For the reconstruction of a single structure in this kind of surgery, the location of the tunnel is the most important, and for the reconstruction of multiple structures, the position of the tunnel is balanced, and one is indispensable. How to adjust the balance depends on the talent, not the few in the book. A centimeter, it's useless, find the balance yourself, I guess you can understand what I said today after you build a few sets.

Yang Ping asked Su Nanchen for an e-mail address on WeChat, and sent him the video of the operation, not to show off, but to give him a reference. His patient will soon have a similar operation.