The Godfather of Surgery

The reading light was very bright, and Takahashi looked at it for a long time, but did not see the dead bones that Yang Ping said.

Yang Ping has already pointed out that there is a slight abnormality in that part, but in Takahashi's understanding, that is the vascular indentation. How can a typical vascular indentation be regarded as a sequestrum? Obviously sequestrum and vascular indentation are two different things. The concept that horses and cattle are irrelevant is now put together as a differential diagnosis.

Staring at the bright light for too long, Takahashi's vision began to blur, his eyes were sore, and tears were forced out, and he had to look away temporarily. His eyes looked away, and there were spots of light everywhere in his field of vision, and people were flickering.

This high-level skill cannot be mastered in a short time. Even if Dr. Yang pointed to the mosquito and said, it is male genitalia and female genitalia, we can't tell the difference. We will study it slowly when we have time. Song Zimo took the film Temporarily put away.

This operation may seem simple, but it is actually quite difficult to perform.

The key is positioning. Without the help of the navigation system and the doctor's operating experience, it is necessary to open a window at the lower end of the right tibia, and then dig out a large piece of bone tissue to dig out the infected dead bone.

This kind of infected dead bone must be completely dug out. As long as a little is left, it is equivalent to leaving a source of infection. After a period of time, the infection will recur, and the previous efforts will be in vain.

Therefore, when digging dead bones, it is necessary to dig out the surrounding normal bone tissue together to ensure thoroughness.

This operation is like digging a sweet potato. A sweet potato is buried deep in the soil. Open surgery is equivalent to digging a big hole and finally digging out the sweet potato.

Minimally invasive surgery is equivalent to using a hollow bamboo tube, inserting it into the soil, knocking it hard, inserting it to a certain extent, and then pulling it out. The bamboo tube is filled with soil, and the sweet potato is now in the bamboo tube.

Would you like to use the Dimensity surgical robot and make an appointment with the operating room over there in advance? Song Zimo felt that such a small dead bone, measuring in millimeters, would be difficult to perform minimally invasive surgery without the assistance of navigation technology.

The Dimensity surgical robot has its own navigation equipment, and the accuracy of navigation can reach 0.8 mm.

If a robot is used for this operation, the child will have to re-do CT, import the CT data into the navigation system of the surgical robot, and use the robot's CT scan for positioning during the operation, and the child will naturally eat a lot of rays.

I've done a lot of X-rays and CT scans of the child. Forget it, and then use the robot to navigate, and the child has to eat radiation. Try to simplify it as much as possible. It's in our operating room. I'll do it. Yang Ping looked at that A large bag of images and pictures has taken a lot of radiation for this sick child. It can reduce the radiation as much as possible.

The surgery is scheduled today, expedited access to the stage, performed under local anesthesia, and he will be discharged from the hospital tomorrow. He will not participate in strenuous exercise for three months. Yang Ping explained to Song Zimo that the operation was too simple for him.

So simple?

The child's father thought he had heard it wrong. In his impression, after the operation, he would rest at home for at least a month and use a cane for three months. He was ready to take a long vacation.

I originally planned to bring it to see a doctor during the summer vacation. During this time, my child complained of pain every night. Especially in the past few days, the pain was so painful that I couldn't sleep. It didn't seem like I was pretending.

No way, my father took the child to the community health station to see, and the doctor at the health station suggested to visit Sanbo Hospital.

When I arrived at Sanbo Hospital, I didn't see Dr. Yang's outpatient clinic, so I randomly hung up an orthopaedic outpatient doctor number. The doctor said that it was a difficult and complicated disease, and I needed to be hospitalized for diagnosis and treatment. My father appointed Dr. Yang for diagnosis and treatment, and the child received a comprehensive orthopaedic department.

Hearing the words incurable diseases, the children's parents are so frightened that their hearts are pounding, wouldn't it be a big deal?

Listening to what Yang Ping said now, he was discharged from the hospital the next day after the procedure, without using crutches, he could walk normally immediately.

What I thought was very troublesome at first, now it is easier than circumcision, and circumcision has to walk a duck's foot for a few days.

After the preoperative conversation, the signature, and a series of preoperative preparations, the operation will be followed in the back.

No need to navigate? Yes - no? Xu Zhiliang asked.

Song Zimo didn't doubt: You haven't been here for a long time, and you'll get used to it gradually. Dr. Yang is a person who constantly creates miracles. He will help you expand your mind and keep expanding.

After checking the room, except for those on duty, they all went to the operating room. After a few operations, it was the child's turn to operate. Song Zimo brought Xiao Wu to sterilize and spread the sheets. According to Yang Ping's request, local anesthesia was also done at the surgical site.

Takahashi borrowed a magnifying glass from some student, facing the reading light, using the magnifying glass to look at the film, his nose almost pressed against the magnifying glass, looking at it for a while, rubbing his eyes, and continuing to watch.

Yang Ping washed his hands and dressed, pondered on the film for a while, made the final positioning in his mind, and then started.

He made a 1 cm longitudinal incision on the inner skin of the lower end of the right tibia, reaching the periosteal bone, and separated it from the periosteal layer, and then opened the small incision with a vascular forceps to expose a small part of the medial side of the tibia.

Hold the trephine against the bone surface, adjust the direction, then slowly drill in, stop at a certain depth, and then pull out the trephine with the stuffed bone.

In the irrigation area, calcium sulfate containing vancomycin is adjusted into dough like a dough to fill the small tunnel just dug. Vancomycin can be slowly released locally to kill the bacteria that may remain inside.

The tunnel was stuffed firmly, with a small 1cm incision, just one stitch, starting from the periosteum, sutured in layers, covered with a small sterile dressing, and done!

From taking the stage to sewing the skin, in one minute and twenty-two seconds, Takahashi timed it, and it was solved like this?

Perspective? Yang Ping took off his surgical gown and gloves.

Fluoroscopy is only a short exposure, and the radiation dose is much less than the multiple or continuous exposures of navigable surgery.

After the fluoroscopy, comparing the preoperative images and pictures, the tunnel drilled by the trephine was just at the point that Yang Ping said, just surrounded that point, no more or less.

Song Zimo took out the cylindrical bone tissue in the trephine. The cylindrical bone tissue, except for a small amount of cortical bone at one end, was mostly cancellous bone.

He carefully cut the cylinder into circular slices, and it was not difficult to cut the cancellous bone. Sure enough, he saw the section of the lesion.

The cross section is like a sandwich, with necrotic bone the size of a grain of rice in the center, infected bone tissue wrapped around the grain of rice, and a circle of normal bone tissue on the outside.

Looking at this section, Song Zimo can be completely sure that the lesion has been completely removed. The accuracy of this positioning is higher than that of a surgical robot.

Do a CT after surgery. Yang Ping ordered.

Postoperative CT is unavoidable, and evidence must be left to confirm that the lesions have been completely removed.

Keep it as a specimen and send it to the pathology department for pathological examination. I want to go to the pathology department and go to the microscope to take a look. Are you interested? Song Zimo put a few thin slices into the specimen bag for the medical examination.

Wait! Show me. Takahashi was still struggling just now, how did Yang Ping do it, without using the navigation system, to accurately retrieve the lesion at one time.

Song Zimo had already given the specimen bag to Zhou Can: Wait for the pathology department, let's take a look under the microscope slowly, sandwich the lesions, and remove them with one precision.

The child followed the doctor out of the operating room. Song Zimo told his parents that he could walk normally, and that strenuous physical activity was prohibited for three months. He could be discharged from the hospital tomorrow and go to school as normal.

This is the excavated lesion. There are dead bones and infected bone tissue. Take a look. Song Zimo showed the picture on his mobile phone to the child's father.

The child's father can't understand it, but he can understand that this is the root of the disease. Now the doctor has dug up the root of the disease with a pair of smart hands.

Will it hurt if I dig a bone? the child's father asked worriedly.

There are very few pain-sensing nerves in the bone tissue, and it won't feel too painful. If you want to have pain, it is also a wound pain. I will give you some painkillers at night. Song Zimo explained.

Will the hole dug be filled later?

It's usually filled with new bone tissue after three months.

I dug up the root this time, so it won't recur, right?

Generally not, but no one can guarantee 100%.

What should I pay attention to in terms of diet, what are the taboos? Or what is good for him to grow bones? Is it okay to make bone soup?

Just eat a normal diet. If you like to drink bone soup, just boil it for him. It will not do any good or harm to the disease.

Can I make some Tian Qi soup? Promote blood circulation and remove blood stasis!

The child's father and Song Zimo asked and answered questions. These questions had been discussed in detail before the operation, and now the child's father took it out and asked it again.

Tianqi is a traditional Chinese medicine, and it has side effects. Don't take it casually, just eat a normal diet. Your family's normal diet, you can eat Tianqi every day? Zhang Lin listened impatiently and interjected.

Can you send me a copy of the photo? Zhang Lin was embarrassed by the child's father and changed the subject.

Song Zimo gave him a copy of the photo. The father was very positive. He took the photo and sent it to the circle of friends: The root of the child's disease has finally been dug up, and he can sleep peacefully tonight.

Trouble came, the child's father's circle of friends was posted, and many people responded one after another, asking which hospital to find and which doctor to look for.

Someone even called for consultation. The child's father glanced at Dr. Yang and whispered, I'm busy now, let's talk back.