The Godfather of Surgery

In the next segment, speak again! Director Qin is the chief swordsman, so he naturally has to show his courage in a critical moment.

If it is wrong, it will not go far, it should be one segment, and if there is an error, it will not go up, it should go down.

After removing the lens and the working cannula, Director Qin made another small opening on the left side of the next segment, punctured the open circuit, expanded the channel, placed the working cannula, and then inserted the lens, the plasma knife cleared the field of vision, and gradually entered the spinal canal.

There is nothing, everything is normal enough to make people panic!

I could still see the ruptured annulus fibrosus just now, but now the field of vision is completely normal. Director Qin's hope was dashed like a soap bubble. It is impossible to blindly punch two rows of holes in the back of the patient's waist.

In a hurry, Director Qin caught a glimpse of Yang Ping out of the corner of his eye. This kid said that he was crazy and didn't know how spinal surgery was going. With the mentality of trying: Xiao Yang, look, still no, what should I do?

At this time, for the sake of the patient, the price has been forcibly cut and sold. Although Director Qin is embarrassed, he still bites the bullet.

Although Director Qin himself understands that keeping him here is to wait for this moment to speak, but when it is time to speak, he is still a little uncomfortable.

Face is a wonderful thing. Even if you know that it is worthless, there is nothing you can do. You can only think about taking good care of it all the time, for fear of scratching the skin.

Yang Ping is watching the MRI film carefully: Prescribe an Omnipack, intraoperative myelography!

One sentence makes me startled. Why didn't I think of this? Since the popularity of magnetic resonance imaging, the examination of myelography has almost faded out of the brains of orthopedic surgeons. In this day and age, who still does myelography?

However, at this moment, spinal angiography is the best method. If you see such a big thing on the magnetic resonance imaging, could it still disappear out of thin air? If you do an angiography, you will understand it all, and then locate it according to the angiography.

Wipe my sweat. Director Qin moved his head out of the sterile area and printed it on the tissue of the traveling nurse.

The drums do not need heavy hammers. They are all experts. One sentence can point out the idea of ​​​​solving problems. This kid also has two brushes in spine surgery.

Director Qin felt much more relaxed, and immediately regained his confidence: Onepike, a 100ml bottle is useless.

Omnipac, iohexol injection, which Director Qin is still familiar with, is an iodine-based X-ray contrast agent. When he does percutaneous kyphoplasty, he often uses it for vertebral imaging. I've never used this method before, so I can't think of it.

Is it sterile? a doctor offstage asked.

Director Qin slapped his head and covered his face: usually the brain is used for multiple purposes. Injections can enter the blood vessels of the human body. Do you think it is sterile?

The doctor who asked the question blushed. Indeed, injections can be injected into the blood vessels of the human body. How could they not be sterile? Such an idiot question may have been muddled by his head just now.

The visiting nurse opened a 100ml bottle of Omnipac, and the equipment nurse took it out with a 50ml large syringe, took two full tubes, and put them away for later use.

The patient was lying on his stomach, and now it is a little inclined. Director Qin returned to the first approach, established a working cannula, inserted a lens, and injected Omnipac into the spinal canal. Wait for a while to allow it to spread evenly.

Perspective, look at the situation.

The G-arm machine was advanced, and the transmitter and receiver near the operation area were covered with sterile protective films. Dr. Wen instructed the operator to adjust the position.

Come on, avoid and avoid! Dr. Wen rushed out.

The operator stepped on the foot pedal at the door, and everyone filed in again. The angiographic graphics on the screen were clear, and the intervertebral disc appeared on the right back of the 4/5 lumbar space.

Unfortunately today, I have done this kind of operation for ten years, and I have never encountered such a case. The intervertebral disc moves in the spinal canal. During the examination, it moved to the position of 1/2 of the waist. During the operation, it ran to 4/5. Right back. Director Qin was dumbfounded.

If it wasn't for Yang Ping's advice today, he would have really fallen into a fixed mindset. In the end, this operation was made into a switch surgery, and he wanted to save face, and in the end all face was lost.

Dr. Yang, it's because you have an open mind. We were almost fooled by this guy. Director Qin is also a man of temperament.

Yang Ping reminded him: This kind of situation is really rare. Such a large piece can move at will in it. Be careful, or it will run away later.

The nerves that had just been relaxed were tensed again by Yang Ping's words, and now Director Qin was frightened and became a bird in shock.

The patient's upper body is not anesthetized and can move. It may have been lying on his back for a long time. The patient moved a little, and the anesthesiologist immediately shouted: Don't move around, tell me if you feel uncomfortable.

The puncture is made from the right side of the waist 4/5. This is not the high iliac crest. It should be better to open the circuit. Director Qin wants to take a break and let Dr. Wen puncture.

After thinking about it, I still do it myself: Wait, I'll do it. Director Qin took the puncture tool.

Fluoroscopy positioning, puncture, several fluoroscopy, no error in position, and then open circuit reaming, the working channel is established, and the lens is placed in the spinal canal.

No free intervertebral discs were seen! I just saw it on my spinal angiography.

I stepped on dog shit today, and Director Qin's hand was a little stiff: the contrast agent is still in there, let's see through it again!

Yang Ping is very calm. After seeing and doing a lot of this thing, he naturally does not panic. Director Qin can perform several thousand spinal endoscopic surgeries at most, which is still routine. I have 500,000 points in my hand, I don’t do a prodigal surgery simulation, I just train for surgery. No matter how I play now, I won’t make myself poor. I can just walk around in the system space if I have nothing to do. I can do all kinds of strange operations. calm.

Just like fighting a war, it is definitely different when you experience in the fire of war every day. There are shells exploding everywhere, bullets sticking to his hair, and he can calmly smoke a cigarette.

Add some contrast agent, see through! Someone was backing him up, and Director Qin's center of gravity was stable.

Looking at the perspective, everyone just wants to laugh. The intervertebral disc runs to the left rear of the lumbar 4/5 space. Is it necessary to go to the left side of this segment to open the hole?

Director Qin turned to Yang Ping for help: This problem! How to solve it?

Pull it from the opposite side, the spinal canal is just that big? Yang Ping thought it was a simple matter.

Blind exercise? It is absolutely forbidden under the foramen microscope.

If the ponytail is pulled and pulled out, it will cause a lot of trouble. Director Qin was very worried.

Can you tell the difference between the cauda equina and the nucleus pulposus of the intervertebral disc?

Yang Ping didn't understand a little, and suddenly remembered that he could do it with his own touch, but others definitely couldn't. He had extensive surgical training in a systematic space, and he was proficient in everything, so how could others compare with him.

Since the degree of activity is so large, it means that the pressure is not severe, why is the symptom so severe? The doctor in the audience did not understand.

Dr. Wen had no choice but to popularize: Some people do not get pregnant after sleeping for several years, and some people do get pregnant after sleeping once. What's the reason?

Don't move, big brother! Anesthesiologist, give me some sedative!

The patient moved again, exclaimed Dr. Wen.

How about I come?

Yang Ping took the initiative to ask Ying, and then go on, not to mention that in case the intervertebral disc gets stuck in that corner, just repositioning the fluoroscopy will cause the patient to eat more rays.

At this time, Director Qin wanted to open it. When the operation was really bad, it would be good to have an expert help him out.

I can't even get off the stage after the operation, so what face do I need.

Or? Doctor Yang, you come. Director Qin agreed.

Do you want me to come on stage? Xiao Su whispered.

Wait for me under the stage for a few minutes.

At this time, Xiao Su looked at Yang Ping. He was definitely the most handsome man in the world. No matter how difficult the operation was, he was as stable as Mount Tai and easy.

Brush your hands, get dressed, and go to the stage.

This kind of operation can be done by one person, not even an assistant.

Yang Ping took the stage and adjusted the working channel and lens slightly.

A nerve stripper was inserted into it, and it was gently fiddled a few times. For some reason, the free intervertebral disc appeared in the field of vision.

Then I replaced it with a nucleus pulposus forceps, and steadily, the whole piece was taken out at one time and placed in the saline gauze handed by the nurse. After rinsing, the plasma knife was used to stop the bleeding, and then the instruments and working sheath were removed.

Put the sheath tube into the left channel of the lumbar 1/2, insert the nucleus pulposus forceps from the back of the ruptured lumbar 1/2 annulus fibrosus, make one mouth on the left and one mouth on the right, and remove a part of the intervertebral disc. The formation of the annulus fibrosus, and finally the dural sac and the nerve root as the center, their cephalad, caudal, ventral, dorsal and contralateral sides are completely decompressed.

Director Qin was a little dazzled. Yang Ping's technique of intervertebral foramen mirror was more than capable of doing it. He simply pulled himself several levels.

The instrument is in the spinal canal, and you can operate it how you want. At this level, all the problems in the spinal canal can be solved under the intervertebral foramen microscope, and then with the percutaneous pedicle screw, the intervertebral cage is placed under the microscope. What about the spine surgery in the future?

It's over!

Yang Ping put down the equipment and solved the problem in a few minutes.

Director Qin had no choice but to accept that a genius is a genius. It is a bit predictable that he can become a legendary figure in the hospital. This intervertebral foraminator has not had more than ten years of surgical experience, so I am afraid that he will not be able to practice it. Little young, how can there be so many Surgery for him?

While Director Qin was thinking, Yang Ping had already started to take off his clothes and gloves. Xiao Su followed and helped.

So handsome!

Every time on the operating table, the invincible mode that Yang Ping shows is really handsome.

Rinse it again and sew it up. Yang Ping instructed.

Director Qin looked at the removed intervertebral disc, and the nerve roots that had been fully decompressed. The level of this surgery can be used as his own teacher. This is not traumatic orthopedics, but spine surgery. .

Dr. Yang - hard work -

Director Qin is sincerely grateful for letting him come to power early, so he probably doesn't need to be so tossed - face kills people!

This way of dealing with people, what kind of novice and tender person, it is simply the kind of wrinkled old.

I'm back at Corey—

Thank you!

I'll contact you later, and sit down together when you have time.

Yang Ping got off the operating table and left the operating room, with Xiao Su following behind.

Every time I see the invincible mode on your operating table, it's so handsome! Xiao Su said secretly.

Isn't it the second shift? What a difficult thing! Some things are like that, just think about it!

——It took a lot of effort, working overtime, and preparing some high-quality manuscripts to say this sentence with confidence. Thank you for your tolerance. From now on, it will be this specification, two updates a day, about 6,000 words, every night at 10 o'clock and 11 o'clock. Thank you all again, and thanks again to Brother Wolf's Silver Alliance.