The Godfather of Surgery

The lead door for radiation protection was closed, and Director Ji worked hard inside for an estimated time of about six hours.

After such a hard struggle, it is still possible that the bamboo basket was empty and nothing was found.

The human body is complex and mysterious, and modern medicine, whether it is basic medicine or clinical medicine, is still far from developed, and it can be said that it has just started.

For many diseases, the textbooks say: the mechanism is unknown, symptomatic treatment, there is no effective drug and so on.

While there was nothing, Yang Ping went to the system space to see if there was any training for interventional surgery. There was no training for the time being. At present, it was all bone disease training, mainly bone tumors. The next stage is orthopedic training.

The three major orthopaedic surgeries, trauma, bone disease, and orthopaedics should be advanced, and then there will be side-branch surgical training, such as interventional, robotic surgery, and so on.

Yang Ping picked up some surgical training in thoracoscopy, laparoscopy, and foramenoscopy. Many bone disease operations involve the spine, and these endoscopes are needed for minimally invasive spine surgery. make up.

It took so much effort, what do you think if you can't find it? Zhang Lin asked worriedly.

Xiao Wu was also very worried: I think Fang Xiaoyun's mother is likely to be in trouble. It's not easy to be a doctor. On the one hand, you have to deal with these complex diseases, and on the other hand, you have to deal with the sinister people's hearts.

This is the daring of Senior Brother Yi, if it is someone else, under this situation, how can they dare to take risks.

Zhang Lin, are you planning to have a child? I'll help you after the operation, and you're in charge of taking pictures.

It's okay, I don't dare to ask for this for two or three years, at least I dare to ask for it after I have been promoted to the main doctor.

Yang Ping was closing his eyes and resting, Song Zimo was thinking about this disease, dural arteriovenous fistula, such a rare disease, if it is placed on a patient alone, it is considered a serious diagnosis. Now it is covered up by spinal tuberculosis, but Yang Ping discovered it. This diagnostic capability is too powerful.

Time is really hard, especially if I don't know the result, I don't know how long to wait, this kind of waiting is a torment.

Fifth brother, do you want to smoke a cigarette? Zhang Lin suggested.

In fact, Zhang Lin didn't smoke when he was working. He worked late nights. Sometimes, after emergency surgery, it would be an all-nighter. Smoking was only to refresh himself and relieve fatigue.

Pick one, just pick one.

Xiao Wu originally wanted to quit smoking. After all, he was going to be a father. He would smell cigarettes in the future, for fear that the little guy would dislike it.

There is no smoking room in the interventional operating room, and it is difficult for the two of them to look for a smoking room in their washcloths, so they have to hide in the toilet and turn on the exhaust fan.

The electronic clock on the wall shows that it has passed 22:00, and there is no good news from it.

Even if the fistula is successfully found within six hours, surgery will be required later, and the surgery will be done under a microscope.

It hurts the body to stay up all night like this, but there is no way to do it. It is said that the training of resident doctors in the United States is very cruel, regardless of day or night.

Physical strength alone will eliminate many people. Some people say that this is intentional. People with poor physique will naturally be eliminated. A good doctor must have good physical fitness, be able to stay up late, be able to hold back urine, and be able to starve.

Xiaowu Zhanglin smoked a cigarette and felt much better. The two went to the door of the operating room from time to time, but the door was still closed.

Go inside and have a look, did you find it? Song Zimo instructed Zhang Lin to go in and have a look.

Don't panic, everyone will sleep for a while, and there will be surgery later. With Director Ji's level, you should be able to find this fistula. There is Professor Zhang next to him. He is very experienced.

Yang Ping squinted his eyes. He came out of the system space and felt a lot of energy. He suspected that the air inside had some special effect, such as boosting energy.

After twelve o'clock, there was still no movement.

Zhang Lin and Xiao Wu were like two furry monkeys, unable to calm down, they were told to sit on chairs to sleep for a while, but they couldn't fall asleep and kept walking around.

No, I have to go in and have a look. Zhang Lin was restless.

Xiao Wu grabbed him: I'll go in, you'll be here for a while.

Xiao Wu took a lead coat from the shelf where the lead coat was placed, put it on, went in, and came out in about ten minutes: I haven't found it yet!

Haven't found it for six hours?

Is it really necessary to draw water from a bamboo basket?

If you really can't find it, the patient will understand it well, but if you don't understand it, you will worry about it, spend a whole night of tossing, and spend more money, but in the end there is no result.

Therefore, for some diseases, whether the patient understands and cooperates, the outcome is completely different.

Only with understanding and cooperation can doctors dare to take risks. Without understanding and cooperation, doctors have no courage to work hard.

If you don't work hard, how can you get the best results.

Terrible!

Zhang Lin patted his forehead.

Xiao Wu comforted him: Stay calm, or, why don't you smoke another one?

It was almost one o'clock in the morning when the heavy lead door finally opened.

found it!

The nurse who opened the door shouted excitedly.

Like the midwife in the delivery room, he opened the door and shouted to the mother's husband who was waiting anxiously outside: It's born!

Everyone stood up like a spring - found it!

A communication fistula was found in the left intercostal artery and vein of chest 8-9. In this place, abnormally tortuous and thickened veins around the medullary can be clearly seen. Can surgery be done? Director Ji's voice was a little hard to pronounce.

It was really a dural arteriovenous fistula, and the probability of lightning strikes was stepped on by Fang Xiaoyun.

Like Fang Xiaoyun, the overlapping of two diseases is the probability of two lightning strikes!

In the prone position, don't pull out the catheter. In case you can't find a fistula during the operation, please ask Director Ji to help you punch Meilan into the catheter. Yang Ping asked Director Ji to rest.

Looking at the time, for more than six hours, there are twenty-four blood vessels, and the lead coat is airtight. Director Ji's back is all wet, but he doesn't dare to take it off for the time being. Yang Ping has to undergo surgery, and he may be needed during the operation. Help, inject methylene blue into the catheter and locate the fistula.

Yang Ping, Song Zimo, Zhang Lin and Su Yixuan washed their hands and came to the stage.

Director Ji, why don't you take a break? Yang Ping said politely.

It's okay, I'll sit next to it. The nurse moved a stool, and Director Ji sat and rested.

Yang Ping's surgery was done quickly and well, which is famous in the hospital. If Director Ji takes off his surgical gown now, he will have to brush his hands and get dressed again after a while, which is troublesome.

Xiao Zeng, give me a call to my wife, the phone is on that table.

Lao Ji felt very guilty. He accompanies his wife to dinner. Now he is on the operating table, leaving his wife aside.

He wanted to make a phone call to announce the good news to his wife. He encountered a rare case. There are only 300 cases in the world. blow what?

This is not to say, what a rare case back then, only 300 cases were found in the world, and one of them has its own credit, one-third of the world, what concept.

It's after one o'clock in the morning, and I still call at this time. Nurse Xiao Zeng is a little hesitant: I still call my sister-in-law at this time?

Hit! She hasn't slept yet, let her rest early, don't wait for me, she won't be able to go back in a while, come here, I'll tell you the gesture password.

The nurse had to call for help: Hey, sister-in-law, Director Ji can't go back now, yes, I'm here tonight, no, I mean, he's with me tonight, no, sister-in-law, I mean—

Staying up all night has made people confused, unable to speak properly, and corrected a sentence several times without making it clear.

You say this, stay with you, fortunately Director Ji's wife is more familiar with the situation, otherwise it will be a big mess.

The nurse hung up the phone and said to Director Ji in surprise, Is my sister-in-law outside the operating room?

Director Ji, this is Cha Gang?

Check what post, I haven't eaten yet. She has brought food. Let her wait and talk about it after the operation.

A good operation, what dog food is sprinkled.

Yes, I haven't eaten yet. Xiao Su ordered a lot of takeout, but she forgot to eat it. Everyone was hungry at this point.

It's fine if you don't talk about it, as soon as you talk about it, this stomach growls! Zhang Lin swallowed.

Hold on, brother, you're not starving alone! The grunt was so loud that Xiao Wu heard it.

In the posterior approach, in order not to destroy the stability of the posterior column of the spine, Yang Pingcai used a technique similar to the opening of the cervical spine, cutting the lamina into a rectangle on three sides, leaving one side to break to protect the periosteum, and then opening it like a door. The lamina can be closed to prevent instability from the destruction of the posterior column.

This technique requires very delicate techniques, otherwise it is easy to fail. When the lamina is opened, the veins are indeed a little thicker and tortuous. Because patients with spinal tuberculosis do not routinely perform DSA angiography, it is necessary to detect this vascular malformation on magnetic resonance imaging. Not too possible.

This is not a problem of level, but a problem of technology itself, just like black and white photos cannot find color.

The fistula is in this vein. This is to find a point from one side, one blood vessel to another, and it can be found, but it takes time to confirm whether it is a fistula or not.

Yang Ping stopped: Director Ji, please help us inject Milan into the arteriovenous fistula just now.

The catheter inserted from the femoral artery hadn't been pulled out yet. Director Ji came to the stage to help inject Meilan: Then I'll give medicine!

Meilan followed the catheter. It didn't take long for the venous plexus to appear blue at a point, but it slowly expanded. Yang Ping found that point, there was only one fistula, and the diameter of the blood vessel was about three millimeters. It was necessary to separate the arteries and veins under a microscope, and then Suture the breach.

Okay, it's alright, Director Ji, I found it, the catheter is still there, and I will do an angiography to confirm it after the operation.

microscope!

Zhou Can advanced the microscope, which was covered with a sterile protective cover. Yang Ping adjusted the focal length and pupil distance by himself, and began to separate blood vessels and repair the fistula under the microscope.

A small fistula has such a big impact on the human body? It can actually cause paraplegia. It seems that the human body has not evolved well. The fault tolerance rate of the parts is too poor. Zhang Lin looked at the small fistula, but it was only 3 mm. Fistulas in blood vessels.

Originally, arteries were arteries, veins were veins, bridges return to bridges, and roads return to each other. The two systems circulate independently. The proximal end is connected by the heart, and the distal end is connected by capillaries. The middle is isolated from each other. Now they appear between A channel connects, which is an arteriovenous fistula.

Just like a highway, there is an isolation belt for the coming and going lanes. Now there is a gap in the isolation belt, and the cars coming and going through the isolation belt are mixed together, and it will be a mess.

The same is true for humans. Once an arteriovenous fistula occurs, arterial blood flows into the veins, and venous blood flows into the arteries. In this way, the arterial blood is mixed with venous blood, and the blood oxygen content decreases. cause bruising.

It was precisely because of venous congestion that Fang Xiaoyun's spinal cord edema could not be relieved, and it continued to aggravate. He lost the parabolic trend of postoperative spinal cord edema.

Spinal tuberculosis abscesses compress the spinal cord, causing spinal cord edema and paraplegia; dural arteriovenous fistulas cause venous congestion, which can also cause spinal cord edema and paraplegia.

The two conditions are intertwined, one covering the other, which naturally increases the difficulty of diagnosis.

After the operation, the surgical area was rinsed and a drainage tube was placed.