The Godfather of Surgery

After the small class of unpacking surgery, everyone was still not satisfied, and asked to play the surgery pictures a little slower.

The thoracic cavity is split from the middle of the sternum and opened to both sides, and the spine is explored from front to back, all the way to the back side, with no dead ends and no omissions; similarly, the abdomen is also a longitudinal incision, fully opened to both sides, fully revealing the injury site .

There are two short nails on the wooden stake in this case, and the nails hooked through the abdominal aorta. Looking at the pictures, when the injured part of the aorta was exposed, the nails were still hooked in the abdominal aorta.

The picture of the abdominal aorta injury was enlarged, and everyone was frightened and sighed. If the stake was pulled out directly, the nail would continue to pull the aorta, and the patient who breathed a breath would die instantly due to massive blood loss, and there was no chance for surgery at all.

Time is life! This kind of surgery can decide life and death in one second! Yang Ping added while standing on the podium.

Hurry, hurry, hurry! It's the rhythm of this rescue operation.

Countless places are bleeding, just like countless faucets are broken, all spraying water, it is impossible to turn off all of them at the same time, it is necessary to make a judgment as to which one to turn off first.

Turn off the fastest spray first, and then turn off the latter ones in turn. That's the way of thinking. This is the priority of surgery.

After solving the sequence problem, the next step is how to stop the bleeding. For example, if the spleen is ruptured, a splenectomy is performed. Before the removal, it still has to bleed. In order to reduce the bleeding and control the risk to a minimum, vascular occlusion surgery appears, which solves this problem. contradiction.

Like so many faucets spraying water, I also know which one to close first and which one to close later. But no way, there is water everywhere, I can't see where the taps are at all? It's hard to see clearly, and I'm in a hurry, and I can't be busy.

In this way, turn off the main gate first, and stop the water for all the taps under the jurisdiction of the main gate, so that you can see clearly which one is the largest and which is the smallest, in order, and calmly close these taps. direct close direct close.

The main gate can't be closed for too long, others still need to use water, so try to complete the operation within the allowed time. After that, open the main gate again, and the faucet will not spray water.

Tan Boyun looked at the screen intently. He is best at traumatic orthopedics, and has many achievements in this field. This kind of operation is indeed difficult and high-risk. The operator must not only move very fast, but also be very familiar with the anatomy. In this case, the aorta is blocked at a relatively high position. After the branch of the brachiocephalic trunk, the blocking time Only lasts about twenty minutes.

Look at the introduction, the operation was completed in 20 minutes. In just 20 minutes, it involved complex exploration, repair of the aorta, repair of the liver, repair of the pancreas, repair of the duodenum, repair of the diaphragm, and Ligation of blood vessels at multiple sites to stop bleeding.

This kind of proficiency in dissection is unimaginable to what extent it is possible to complete this series of operations in twenty minutes.

Temporary vascular bridging techniques or implantation of artificial blood vessels must be used to stop the bleeding of the abdominal aorta, so that there is time to do the next steps slowly.

If it weren't for the meeting today, if this case was presented, Director Tan would not have known that Yang Ping was so powerful, and that this kind of operation was so easy to handle.

The fat boy raised his hand, he scratched his head and said, Doctor Yang, you can be so powerful, but not everyone is so powerful. After you talk about this operation, even if you encounter the same case, I still can't do it to you. Is that so? Is there a way to make the operation of this kind of trauma patient easier, such as taking pictures, what focal length and lighting for a professional camera, it's so complicated, just click on a point-and-shoot camera, although not as good as a professional camera , but also a qualified photo.

Yes, the fat boy came to the point and raised the question that everyone was thinking about. Everyone was waiting for Yang Ping to answer, and the fat boy's eyes narrowed into a line, also waiting for the answer.

Director Bai next to him said, Yes, Xiao Yang, the operation must be replicated in batches. If it cannot be replicated, it cannot be promoted. You have to find a way to lower the threshold of this operation so that more people can be saved.

Director Han said with a smile: This is the topic that Xiao Yang wants to talk about, and it is also the improvement we need to improve the entire trauma emergency process. Xiao Yang has spent a lot of effort to create a modular surgical process, which will be available later. Come out and discuss it with everyone, don’t be impatient, let’s watch the video of the large-scale trauma rescue at the University of Tokyo Hospital first, shall we?”

Yang Ping returned to his seat to rest, and Dr. Zhong took the stage and called up the video on the computer: This is the rescue of a large-scale car accident. The whole video starts from the emergency department and ends the operation. That's fine, don't record it, don't spread it, because it was made privately by friends who were studying there, and they shoot videos to regularly improve the shortcomings and keep improving.

The doctor who just took pictures and videos with his mobile phone put away his mobile phone, and everyone began to watch the video carefully, which represents the world's top trauma rescue level.

Play the video at normal speed first, then play it slowly, and when it's played slowly, Director Tan will explain it to everyone. Director Han instructed Director Tan.

Director Tan said: Okay, Director! Everyone should read it carefully, so that I can have a good idea when I explain it later.

The video began to play, and one after another, the emergency flat cars that sent the wounded were sent to the lobby of the emergency center. The patient's clothes were all cut off and only covered with special blankets.

The doctors and nurses in the emergency department are already waiting in the lobby. As soon as the wounded appear, they are responsible for their own wounded immediately. The doctor makes a preliminary judgment on the wounded person and arranges the next step of diagnosis and treatment; the nurse measures the wounded person's vital signs and conducts blood transfusion and rehydration. There was almost no pause, everything seemed to be ready in advance, and it was all done as the flat car moved forward.

The flat carts began to be shunted in the hall and pushed to different areas. Those who needed emergency surgery were sent to the operating area; those who did not need emergency surgery were sent to another area.

The screen traces a wounded in an emergency operation, enters the operation area, the door is opened in advance, and enters the area, the first stop seems to be the CT room, and the emergency CT scan is performed.

The height of the flat car and the CT platform is the same, which has been adjusted a long time ago. The flat car is connected to the CT platform, and the wounded is quickly and smoothly pulled to the platform.

The wounded began to undergo high-speed CT scan. After the scan was completed, the patient immediately transitioned from the other end of the CT platform to the connected flat car, directly pulled the stretcher, and arrived on the flat car, and was pushed to the next station - the operating room.

The operating room and the CT room are connected by a corridor, which is connected in a straight line. The wounded comes in from one side of the CT room, and after the examination, goes out to the other side, and goes through the corridor directly into the operating room. The open door of the operating room is greeted by doctors and nurses. , it is enough to push the flat cart to the door and hand it to them.

The connection between the two stations is completely open and straight, without any obstacles, without any bewildering, and the direct access is smooth. When the wounded entered the operating room, the flat car and the bed were flush and docked again. The wounded was pulled to the operating table, and the detachable stretcher was disassembled from both sides at this time.

The doctors involved in the operation had already put on their surgical gowns and were waiting. The assistants began to sterilize the sheets, and the chief surgeon read the CT scan reports and images of the wounded.

The efficiency is very high. This side has just been sterilized. The CT room has already transmitted the pictures and reports. The CT images and reports of the wounded appear on the LCD screen. The control panel of the screen is covered with a sterile film.

The chief surgeon directly controls and accesses emergency medical records and CT data, reads the report first, obtains information quickly, and then looks at the 3D reconstructed image. At the same time, there is also a reference for the surgical procedure, telling you where the injury is, where to do it first, and then do it later Where, including specific techniques have been given guidance.

This patient had aortic tear, spleen rupture, and multiple ruptures of the duodenum. The chief surgeon first blocked the aorta, then repaired the aorta, performed splenectomy, loosened the aortic block, and then performed the liver Rupture, duodenal rupture, and other injuries are treated. The surgical procedure is quite scientific, and the final operation is successfully completed.

From the appearance of the emergency flat car in the emergency department, the whole process, the cooperation of doctors and nurses is like precise gears, it is like repeated drills, no matter how you look, you can't see what is unreasonable, what is improperly connected, and where time is wasted.

The whole process is a little more than an hour, most of the time is on the operating table, and the time is concentrated after the aortic occlusion is completed, so most of the time, the patient is in a controllable state, that is, in the hands of the doctor Later, the patient stabilized.

From the emergency hall to the operating table, including the CT scan in the middle, it took less than ten minutes, that is, a few minutes to get on the operating table, and an examination was done, the injury was clarified, and a mature surgical plan was designated.

This is just a rescue operation for a wounded, and several other rescue scenes are also switched out one by one. The rescue of each wounded is almost the fastest without any delay. It is simply filmed deliberately. The whole process, The whole picture is smooth and tidy, without a trace of clutter. Even after the operation, even the garbage in the operating room is put into buckets, and there is no trace of clutter.

One of the wounded, as soon as he was admitted to the emergency department, underwent aortic occlusion with a balloon to temporarily stop the bleeding; another had multiple rib fractures, tension pneumothorax, and cardiac arrest, and his chest was opened directly in an ambulance. Perform chest compressions.

After the screen was played, everyone breathed a sigh of relief, and the whole venue fell silent. The doctor who was joking just now said impatiently and privately: What Japanese videos are you watching——, and stopped talking.

Some people suspect that this is fake, right? Was it deliberately photographed for everyone to see? How could it be so fast and cooperate so perfectly? The rescue would be a bit messy and a waste of time.

This is one of their daily trauma emergency surgery videos!

Director Tan's words broke the silence and dispelled everyone's doubts.

It's just their general doctor who participated in the operation. There was a picture just now. The person who rescued a ruptured liver and spleen was just a lecturer, which is equivalent to our attending physician. His operation took 12 minutes. , rupture of the liver and spleen, rupture of the duodenum, the operation took an hour, and it was also performed by a lecturer.”

Every doctor at this level of them has this level. Professor Masao Fujiwara, this kind of operation has not been performed yet. He simply repairs the aorta, and it never takes more than two minutes!

If there is no comparison, there will be no difference. If there is a difference, it is not scary. What I am afraid of is that I will hide my ears and steal the bell and not admit the difference. I just heard someone say that they are very busy with surgery. What Japanese surgery videos are watching, and they are better than us. ? See it now? Do you know where the bullshit is?

Director Han stood up and said word by word.

Being stronger than others, you have to do it with your hands, not your mouth, you know?

Thanks to the leader of the wolf sleigh for the reward! There is pressure, and the update can't keep up, but I will still work hard. I will take my time to add more updates to the leader of the alliance. I hope to understand, really, there is no manuscript!

Thank you George for your many 5,000 coins!

Thank you Chenxi Muyan, --- ooooo for the reward (I can't type your name, I don't know where to copy it, it's a bit similar, sorry)!

Thanks for the valuable comments from the Nuclear Explosion Infantry. Indeed, those details are too rough and have been revised. I hope to give more opinions to help improve the work.

The previous chapter about double steel penetration injuries appeared in Grey's Anatomy, not Dr. House. I read it for too long and confused it, and it has been corrected.

The penetrating injury of the wood post operated by Yang Ping, the source is restored from a real case, a masterpiece of a senior teacher, the operation time was shortened, and the operation process was almost restored according to the original operation records. In order to restore the details, the senior helped to refer to more than 20 years ago. 's medical records. The wooden stake is still kept in their hospital. At that time, the means were very limited, and it was not easy to succeed in this kind of operation. Even now, rescuing this kind of case is extremely challenging and requires rich experience and superb surgical skills. Salute to this esteemed teacher!