The Godfather of Surgery

Yu Shuilian's surgery officially started three days after the preoperative discussion.

For the operation, three days ago, Yu Shuilian underwent a thorough bowel cleansing, and at the same time, she was forbidden to eat, and all nutrition was supplied by intravenous nutrition.

The purpose is to make the intestines free of any food residues during the operation and to minimize the chance of infection.

The urine bag and fecal bag are temporarily removed, and the discharge of urine will be connected to the urine bag by a sterile renal pelvis drainage tube inserted during the operation.

Because there is no food, no feces are produced temporarily, so there is no need to worry about the feces contaminating the surgical area during the operation.

However, after this operation, for a period of time, the ostomy of the bladder and the ostomy of the colon need to be kept, so that urine can be directly discharged from the kidney through the drainage tube, so as not to affect the survival of the reconstructed urethra.

At least one week after the operation, the nutritional needs of Yu Shuilian are supplied by intravenous nutrition to prevent the feces from contaminating the surgical site, even a little bit is not enough.

Just like a newly built highway, vehicles are prohibited from passing until it is completed.

Sometimes women are tougher than men. Yu Shuilian has already accepted her half-human identity psychologically, and will spend the rest of her life in this state in the future.

For her, this is the normal state of life in the future. It is like a paralyzed person in a wheelchair, a blind person using a cane to explore the way, and a deaf-mute person using dumb language to communicate with others. This is a special state of life.

After the first life-and-death operation and the second operation, Yu Shuilian behaved very calmly, without any hesitation or worry.

In the face of this kind of blow, some people sink, but some people can re-understand life.

The husband and son kept holding her hand, followed the cart, and took her to the door of the operating room. The son obediently kissed his mother's cheek and held a small fist: Come on!

It took a long time for the husband to let go: We'll wait outside, don't be afraid—

Anesthesia, body position, hand brushing, sterilizing and laying the sheets -- repeating the process more than a dozen times a day, you can't go wrong in your dreams.

Song Zimo was the first assistant, Takahashi was the second assistant, and Xu Zhiliang was on the stage watching.

The knife was like a paintbrush, cutting open the stump of Yu Shuilian's body.

Because of the tissue adhesion caused by trauma and surgery, the anatomical relationship was no longer normal in the second operation, but the main surgeon was still as skilled.

No matter it is the direction of the scalpel on the same plane or the depth of the layer by layer across the plane, it is not affected by anatomical changes.

The direction and combination of the incisions make people unaware for a while. Some are straight lines, some are oblique lines, some are arc lines, and some are wavy lines.

Regardless of the direction and length, it seems that there is already accurate data in the heart. It is very happy to start the knife and stop the knife.

But why?

Until each incision had begun to penetrate deep into the abdominal cavity, except for Song Zimo, who had been following him for a long time, who could see some clues, Gaoqiao was completely at a loss.

Why did it start like this, and where does the surgery go in the end?

I can't understand the beginning, I can't guess the end, this feeling is very tricky.

When the tunnel where the urethra, YinDao, and anus were planned to be opened, Takahashi finally touched some part of the elephant.

The colon is not incised, but starts to turn out from the end, and stops at a certain length; then, the remaining opening of the bladder neck is opened, and the same as the inversion of the colon, the inside is turned out like a sock.

In the lower segment of the descending colon, the inner surface has been exposed.

Under the microscope, the mucosa of the colon is peeled off bit by bit with the snake brand micro-scissors, not simply peeling off the mucosa. Along with the peeling off of the mucosa, the nerves that innervate the mucosa, which are thinner than the nerves of a baby's finger, are one by one. exposed, but also retains the connection with the mucosa.

The mucosa of the colon carries nerves and is completely peeled off without a single hole. The mucosa is excised and the surrounding nerves are cut off.

When the recipient site is ready, the excision of the bladder mucosa from the donor site begins.

In the same superb technique, the mucosa with many nerve roots was excised. To maintain the integrity of the respective mucosa, the two mucosa were exchanged.

The bladder mucosa with the pressure sensor was transplanted to the lower colon, no more or less, just to fill the defect area just cut out, and the nerves of the bladder mucosa were anastomosed with the nerves around the recipient area, one by one, even if 12-0 With microscopic sutures, each nerve can only be sutured with two to four stitches.

The colonic mucosa fills the defect area of ​​the bladder mucosa, and the nerves are also connected. Although the colonic mucosa has no baroreceptors, the baroreceptors in other parts of the bladder continue to maintain the urge to urinate.

The east wall was removed to make up the west wall, but the east wall was still stable and protected from wind and rain.

Two fresh mucous membranes are cut out, and the exchange is completed without stopping, and the most delicate part of the operation is thus completed.

Under the microscope, Takahashi didn't dare to blink. The surgery that no one has ever been able to achieve is now realized under his own microscope.

The whole process was as smooth as water, like a routine surgery.

Under the microscope, the venous tube cut from the abdominal cavity is still a snake-brand micro-scissors. Little by little, the blood vessels are being peeled off layer by layer. The blood vessel walls are actually peeled off layer by layer without damage according to the tissue level. down until desired thickness.

This is like cutting a thin A4 paper into several layers, each layer is a complete A4 paper, even if it is thin to transparent, there is no break, and the complete plane is retained.

The qualified vein is inverted, anastomosed with the urethral stump at the bladder neck, along the established route, and buried in the open tunnel.

No wonder so many people failed, and finally had to give up the research on this kind of surgery, except him, who would have such extreme knife skills.

The two most difficult steps are completed. Next, the colon reconstruction of YD and the reconstruction of the sphincter of the pectoralis minor will not be difficult at all.

The preoperative 3D printed mold was implanted into the reconstructed anus, urethra and YD to prevent postoperative adhesions.

The outer openings of the three reconstructed structures are sutured with great care, with a beautiful ring everted and then sutured to the surrounding skin like a naturally formed transition.

The knife has not stopped yet. Various reinforcements of the incision and combination of various lines allow the skin and tissue flaps to be turned up one by one and reassembled. Some are turned over, some are buried, and some are folded.

No-damage cosmetic suture needles and threads, wherever they go, such as the magic brush Ma Liang's brush, are used with overlapping surgical techniques such as incision, suture, transplantation, and transfer.

The anus, urethra, and YD mouth are arranged in natural order. The WaiYin reconstructed by the skin and tissue flaps is actually fake, and even the artificial buttock seam is also shaped.

The residual bilateral ilium has been rounded in the first operation to replace the original ischial tuberosity, and the residual muscle was transferred to the bilateral artificial ischial tuberosity as much as possible.

In this way, half of the body can be erected with the help of two support points with muscle cushioning, and with the help of the hands, as if the buttocks are still preserved.

During the first operation, Yang Ping had already considered the second operation, and many steps made the perfect preparation for the second operation, such as the muscle preparation around various reconstruction pipes.

It was only at this time that Takahashi realized that Yang Ping's ability to design surgery was far from what he imagined, and he already thought that the kind of out-of-order surgery was unattainable.

But now, when Dr. Yang was racing against time, he had already linked the two surgeries together. When the sequence of the steps of the surgeries had gone beyond the surgeries at that time, his thinking had already been connected to the second surgeries.

Unattainable, yet unattainable!

In addition to the mountains that cannot be climbed, there is a higher mountain.

If there is no infection and no accident, Yu Shuilian will obtain a nearly normal anus, urethra and YD, and half of the body will retain the most basic functions of the human body.

The only thing she lost was the ability to walk. If one day, she could really use a power brace, and she could walk upright like a normal person.

Trauma surgery, urology, general surgery, prosthetic and reconstructive surgery, plastic surgery, and many top-notch surgeries in various specialties are combined to complete this artistic masterpiece.

Any kind of surgery that is placed in the corresponding specialty is unattainable.

But who knows, these fascinating technologies can only be obtained by Yang Ping after completing the system one after another devil training in the system space.

A space only for himself, a space for endless case analysis, surgical training, and anatomical learning, requires a tenacious will to overcome loneliness and loneliness.

Only those who have the heart of becoming a god can be so tenacious.

The man standing on the top of the mountain!

Fujiwara Miyuki looked at Yang Ping, who was focusing on surgery, and admired it sincerely.

At the end of the operation, if nothing else, Yu Shuilian's stump is absolutely symmetrical, and only Yang Ping can do it.

To achieve left-right symmetry, care should be taken for the grinding of the remaining ilium, the treatment of muscle padding, and the adjustment of skin sutures.

This is not a requirement of surgery, but it reflects the precision of the main knife, which is unparalleled.

The surgery is over, the three of you, start practicing peeling the grape skins under the microscope tomorrow, and dissect the grape skins into three complete layers to be considered qualified.

Yang Ping was talking about Song Zimo, Gao Qiao and Xu Zhiliang.

Do you have any questions? Yang Ping asked Xu Zhiliang.

Because his microsurgery skills should be the weakest, Xu Zhiliang nodded: No problem.

What about us? Zhang Lin asked.

Two layers are peeled off, and if there are no big holes, it is qualified.

Also, you still need to practice pulling the hook. Pulling the hook with one hand and not shaking your hand for an hour is considered qualified.

Yang Ping moved away from the position of the main knife, and Song Zimo, Gao Qiao and Xu Zhiliang bandaged Yu Shuilian's stump. This bandaging is not casual and requires superb dressing techniques.

Put a layer of Vaseline gauze first, and then dry sterile gauze. Some places should be loose, some places should be tight. When it should be separated, it should be separated, and the thick place should be thick.

Finally, the cotton pad bandage is wrapped, and the stump is wrapped well, neither tight nor loose, and the gauze bandage will not fall off easily.

What about me, Dr. Yang, you haven't assigned my homework yet? Fujiwara Miyuki asked.

Yang Ping almost forgot her, she also came to study, Yang Ping thought about it, she is a sports medicine major, she can't be as comprehensive as Takahashi.

Under the arthroscope, you use the olive nucleus to carve a model of the knee joint. The outline of the distal femur, the tibial plateau, and the patella should be close to the anatomical shape.

Fujiwara Miyuki was stunned, this? Can it be done?