The Godfather of Surgery

Fourteen wounded were successfully brought back to the hospital, and the pregnant woman picked up by helicopter was already on the operating table.

Yoshino lived up to his mission, and they were all alive for the time being.

As the doctor in charge of pre-hospital first aid, the moment the wounded entered the hospital and the handover was completed, Yoshino's work was over.

Of course, sometimes, the surgeon needs to understand the scene in detail, and will also go back to communicate with Yoshino. In any case, the main work is no longer done by Yoshino.

Let's have a cigarette, Yoshino came to the smoking room alone.

He knows that smoking is harmful to health, and he persuades others in the same way, but there must be a way to relieve stress.

Yoshino, great! Sasaki called.

In the ambulance, Yoshino took advantage of the simple conditions to decisively open the skull of the wounded, fully decompressed, and removed part of the hematoma.

His judgment based on symptoms and signs was very accurate, most of the hematoma was removed, and the brain herniation was treated in time, which won precious time for the rescue.

Otherwise, the helicopter will bring back not a living person, but a cold corpse.

A few years ago, in the same place, I hesitated, and finally I gave up. The wounded finally died. I have been in remorse and kept thinking about why. Today, I no longer hesitate, whether she survives or not. , I tried my best, now it's your turn.

Yoshino is just a cog in the whole system, every cog is functioning properly, the system will work well.

Yoshino and Sasaki are about the same age, Sasaki is already an associate professor, Yoshino is still a lecturer, but he doesn't care, saving people is the greatest joy.

The fetus is five months old and still has a fetal heart rate. We retrieved her previous case data. It took her five years to go to many hospitals before she became pregnant. It shows how much she longed to be a mother. I decided, Even the fetus was saved, Mr. Fujiwara agreed. Sasaki asked Yoshino to share their operation.

It's great, come on! Yoshino has a sense of accomplishment, and if he succeeds, he will have his own credit.

However, even saving the fetus is very risky and difficult. It is not surprising that Sasaki made such a decision. He is always creating miracles.

He is the enemy of the god of death, and I don't know how many lives he has taken back from the god of death.

It only took less than ten minutes from entering the emergency center, completing the examination, and going to the operating table for surgery.

Because I'm pregnant, the best test is an MRI, but a metal sheet is inserted into the abdomen.

After contacting the car manufacturer, it was confirmed that it is magnetic. If magnetic resonance is performed, the strong magnetic force will move the metal and pull it out, so the pregnant woman underwent a CT scan.

Although X-rays are harmful to the fetus, they are already five months gestational age and will not cause deformities. Relatively saving his young life, these are insignificant.

Hiroshi Arai is undergoing surgery, and infrared real-time monitoring, combined with images from CT scans, draws a 3D digital image of a human being suspended on a clear sharp plasma screen.

The three-dimensional transparent image can be rotated 366 degrees, the injured part is marked in yellow, and the blood vessel is marked in red.

The hemoglobin-friendly imaging agent reaches the whole body, the images of each bleeding site are captured, clear and accurate, and the system will prompt the main surgeon to prioritize which part and which blood vessel to treat.

Intracranial hemorrhage was also accurately visualized, as was brain tissue damage.

The infrared monitoring equipment calculates the degree of contusion of the brain tissue according to the change of the thermal parameters of the brain tissue and the change of the blood flow, and it is refined to each functional area.

Arai was very skilled. Using the gap of Yoshino's craniotomy as an approach, he carefully took out the remaining blood clot and completely stopped the bleeding until the red on the screen disappeared.

The edema of the brain tissue due to trauma will last for a period of time. During this time, the brain tissue needs a larger volume and cannot be subjected to any compression. The original volume of the cranial cavity cannot meet the requirements.

Arai fitted the patient with an artificial cover that fastened to the surrounding skull to protect the brain tissue and expand the volume.

After the edema is eliminated, the artificial cover is removed and the patient's calvaria is put back in place.

As for the contusion of the brain tissue, there is no way to deal with it, but to create conditions for it to heal itself.

This decompression method of uncovering the calvaria is much better than the ordinary decompression with bone craniectomy.

It originated from the Irizalov Hospital in Siberia, Russia. The Affiliated Hospital of the University of Tokyo sent two doctors to study for a year. After returning, they improved the technology.

Blue is better than blue, and their use of this technology has far surpassed Russia in terms of effect and safety.

Vital signs are stable!

The anesthesiologist said that the doctor likes this sentence the most.

All kinds of invasive and non-invasive monitoring, import data into supercomputer, the computer runs at high speed to complete the dynamic change of digital human.

This data can be calculated almost instantaneously for the mainframe of the hospital's trauma emergency system.

Complete cranial surgery and begin thoracic surgery.

Arai decided to use a thoracoscopic technique, where the mirror enters the chest cavity from the intercostal space, and the blood inside is washed away with saline.

Strong extrusion front and back, multiple rib fractures, and the broken ends of the fractures squeeze and pierce the lung tissue, causing serious lung damage.

Hemostasis and repair, the constant theme of trauma orthopedics.

With one-lung ventilation, the injured lung was stopped by the anesthesiologist and was in a collapsed state.

Arai is very skilled under the microscope. He calmly cauterizes the ruptured blood vessels one by one to stop the bleeding. For larger blood vessels, the cauterization can no longer achieve the purpose.

While hemostasis and exploration, there is no problem with the heart and aorta, and the bleeding point is completely eliminated.

The clean chest cavity is clearly displayed on the screen under the saline flush.

Start to repair the lungs, the lung tissue is soft and fragile, and repairing is more difficult.

However, Arai still tried his best to repair the cracks of various shapes and sutured them one by one to restore their proper shape.

The diaphragm also ruptured, and the pressure differential forced the abdominal organs into the thoracic cavity.

Arai opened the endoscope again in the abdominal cavity, and placed another set of lenses and instruments.

The screen of the endoscopic system begins to split, the left thoracic cavity and the right abdominal cavity.

The left hand uses a blunt push rod to enter through the thoracic cavity; the right hand uses atraumatic forceps to enter through the abdominal cavity.

With the cooperation of both hands, one push and one pull, with gentle movements, the part of the pancreas and small intestine that herniated into the thoracic cavity was sent back to the abdominal cavity, and then returned to its proper position.

The diaphragm was repaired under the microscope, and the thoracic cavity was flushed with saline again without bleeding.

The ventilation of the injured lung was restored, and there was no obvious air leakage, and the repair was qualified.

Under the same microscope, the ribs were repositioned, and a simple wire was used for minimally invasive fixation.

Ten ribs, all reset and fixed, and the lens of the thoracic cavity is pulled out.

Start laparoscopic hemostasis of the ruptured mesenteric artery, and then repair the intestinal rupture and pancreatic injury.

The liver and spleen were fine, avoiding the pressure of the seat. Even if the liver and spleen were ruptured, it would not be a problem for Arai. It was just a matter of adjusting the surgical sequence.

The liver and spleen injury was first treated under the microscope, and then the pancreas and small intestine were repaired.

Skilled endoscopic techniques make surgery no different from open surgery, but with better results and less damage.

For such a complex thoracoabdominal joint injury, Arai solved it with a few small holes as thick as a little finger.

The heartbeat of the fetus is still there, and the amniotic fluid leaks from the rupture of the uterine membranes.

Without amniotic fluid, the fetus cannot survive, and the assistant keeps injecting artificial amniotic fluid to supplement it.

A piece of steel plate, which should be the structure on the seat, pierced the abdomen of the pregnant woman, and pierced the body of the fetus from front to back.

Open surgery is necessary, and laparoscopy has been unable to complete this type of surgery.

Fetal trauma surgery is too rare, Arai is inexperienced, he has only done orthopedic surgery on the fetus.

A five-month-old fetus is only twenty centimeters long, a little longer than two fingers.

A microscope is required to perform the surgery successfully, which is probably the most difficult traumatic surgery in the world.

The heating lamp is adjusted to shine into the pelvis from different angles to keep the fetus warm.

Arai incised the abdominal cavity, opened the uterus, and stopped the bleeding while exposing it, in preparation for the removal of the metal sheet.

In normal fetal surgery, in order to expose the fetus, the fetus must be removed from the uterus, and it cannot be completely removed, otherwise the fetus cannot be kept warm, so only a part can be removed to facilitate the exposure of the surgical site, and it must be put back into the uterus after the operation.

The operation must be very careful, otherwise, once the placenta is separated, the fetus will be life-threatening.

The uterus opens and the fetus is revealed, poor little one.

Sir, it's my turn. Sasaki and Fujiwara have been sitting in the operating room.

Be careful, both have to get off the operating table alive. Fujiwara was very confident in Sasaki.

——

In Sanbo Hospital, whether it is the main venue or the branch venue, the surgery is live on the screen.

Hiroshi Arai, lecturer of orthopedics—

There is a brief introduction of the surgeon in Chinese and English on the screen.

Everyone concentrates, no one moves, no one makes a sound, and even drinking water will be controlled to a minimum.

From the head, to the thoracic cavity, to the abdominal cavity, a young mid-level doctor is so skilled in surgery.

In particular, the application of endoscopic techniques in trauma surgery, exploration without dead ends, meticulous repair, and carpet-style hemostasis, are like teaching demonstrations.

A computerized trauma surgery assistance system based on infrared monitoring, combined with CT scans, can actually reconstruct a digital human.

What an eye opener!

These are real technologies and skills, and I am afraid that a keyboard can't make up for it.

Some people have a dry throat, and after swallowing several times, they are still dry and uncomfortable.

Although it was originally planned to be a young mid-level doctor, but now it is fetal surgery, with a senior title, which is reasonable.

Young people with intermediate titles have performed very well, and they have shown world-class standards.

It's Sasaki's time!

Takahashi said to himself that he believed this junior.

This kind of operation requires a microscope, but the whole process of the operation with both hands hanging in the air is much more difficult than that of replanting a severed limb and replanting the elbows to support the table.

This kind of surgery is the pinnacle of microsurgery. What is a five-stage replantation? Takahashi said contemptuously.

The lens of the screen is clear and delicate, the uterus is opened, and the fetus is revealed.

Sasaki has already brushed his hands and is wearing a surgical gown. He is going to perform an operation that will shock the world.

The operation last night was until two o'clock, and today is also the operation during the day, so there was no update last night. The chapter I owe will be made up on Saturday. Sincere apologies! Thank you all for your tolerance!