The Godfather of Surgery

During the competition, Director Gao often went to the comprehensive orthopaedic department. In addition to observing the operation, listening to the case discussion, he also thoughtfully asked what help was needed here.

His concern did not stop in words, but in action. Lao Gao dispatched several young capable doctors to support the comprehensive orthopaedic department and help in writing medical records.

Knowing that arthroscopic surgery was the highlight of the first season of the national competition, Lao Gao mobilized doctors from the department to send out suitable cases to the comprehensive orthopedics department long in advance.

In such a competition, there are a large number of cases in the comprehensive orthopedics department to choose from.

After Lu Gang's surgery plan was determined, Yang Ping began to refine the details.

The embankment of a thousand miles was destroyed in the ant nest, and the operation was a work that paid attention to details.

One failing detail can destroy the entire surgical effort.

Yang Ping is a rational person. He has a passion. He never relies on blood to achieve his goals, but uses scientific methods to achieve them.

Based on Lu Gang's objective condition, he solved the details bit by bit, helping Lu Gang strive for the maximum surgical effect, and at the same time making the surgery as safe as possible.

Even with the system, Yang Ping didn't dare to be careless or relaxed in every operation.

Still maintain an attitude of walking on thin ice and riding a horse on a cliff.

Lu Gang's surgery requires general anesthesia, which requires endotracheal intubation.

So the first level, tracheal intubation is a difficult problem.

For the intubation of the first operation, the intubation must be completed while Lu Gang remains awake.

Lu Gang's cervical vertebrae were severely arched and rotated, and his twisted body made it extremely difficult for the catheter to enter the airway.

Although fiberoptic bronchoscopy can be used for guidance, there is also the possibility of intubation.

Once intubation is impossible, anesthesia cannot be administered. Without anesthesia, subsequent operations cannot be carried out.

Therefore, Yang Ping must not only solve the problem of surgery, but also help Fatty Liang to solve the problem of anesthesia.

When necessary, he himself takes action to complete the tracheal intubation.

Even if the intubation lasts only a few minutes, as long as it is inserted, it does not matter if it causes compression on the lining of the throat and trachea.

Quickly complete the osteotomy and release of bilateral knee joints and hip joints, so that the distance between Lu Gang's head and torso is increased.

In this way, Lu Gang can do the second step, the correction of the cervical spine.

After completing the cervical vertebra correction, obtaining a normal curvature, and raising Lu Gang's head, it is possible for him to achieve a suitable prone position.

The third step is to complete the correction of the thoracolumbar spine in the prone position.

The final fourth step is to perform artificial joint replacement of bilateral hip and knee joints.

Lu Gang's bilateral hip joints and knee joints, due to long-term contractures in the flexion position, have now formed double joint stiffness: extra-articular soft tissue contractures, and intra-articular bony fusion has been formed.

Only artificial joint replacement can allow him to obtain normal hip and knee joints and restore normal walking ability.

Every detail, Yang Ping pondered and perfected it repeatedly, trying to make it watertight.

Fatty Liang has not been idle these days. After get off work, he stayed in the laboratory to study Lu Gang's tracheal intubation.

Those rabbits suffered, and the fat man fixed the rabbits in a twisted and suffocated position, and used the baby tracheal intubation kit to repeatedly train the rabbits.

If animal protection people see this scene, they will be so angry that they will vomit blood, and they must beat the fat man.

Brother Rabbit, I'm sorry, in order to save people, I, Fatty Liang, have no choice but to do it. After the operation, I will definitely eat and drink to feed you, and I won't let you suffer any more. Fatty couldn't bear it anymore and kept talking.

After getting it for a long time, the rabbit squeaked, but still couldn't get in. The fat man was a little discouraged, and hid in the bathroom to smoke a soft Chinese root and continue to practice.

Using a live rabbit as a training model is more realistic. Fatty's fiberoptic bronchoscope is put in, and the rabbit can tolerate it. When the laryngoscope enters, it immediately bites the laryngoscope because of the irritation and struggles desperately.

Fatty repeatedly told himself that if Dr. Yang’s operation on Mount Everest was affected by the failure of tracheal intubation, then Fatty Liang’s reputation would be completely ruined. Now Fatty Liang’s reputation in the hospital is very well-known, and several head nurses want it. Introduce him to a girlfriend.

Yang Ping watched him fail many times, put on rubber gloves, walked over to help him, and taught him while demonstrating: You must have a spatial image from the mouth to the throat, and then from the throat to the trachea in your mind, and you must have a correct image in your hand. The anatomical touch, you see, the rabbit is bound by your twist, the airway is tortuous and complicated, and it is no longer intubation under normal conditions, let alone the catheter, it is difficult to enter the fiberoptic bronchoscope.

Fujiwara Miyuki was practicing arthroscopy in the laboratory, stopped the training, leaned over to listen to Yang Ping's explanation, and was very serious.

Yang Ping has tried many times in the system space, and he is now teaching Fatty how to complete intubation in this extreme situation.

Open the mouth a little, expose the epiglottis, see no, two holes, look for the holes, don't go wrong. The front is the airway, the back is the esophagus, the airway is curved, but there are still gaps, otherwise how can it breathe ?

Do you see the gap in the glottis? Yang Ping asked Fatty to look, and Miyuki also looked closer.

The fiberoptic bronchoscope is like a snake exploring the way in the deep and tortuous pipe.

On the screen, such as the first-person view of Counter-Strike, go forward, pause, go forward, pause again, and go all the way.

Under the guidance of the fiberoptic bronchoscope, Yang Ping held the laryngoscope in his left hand and inserted it lightly and quickly along the dorsal curvature of the tongue until the epiglottis cartilage was gently provoked at the base of the tongue, and the glottis was exposed on the electronic screen.

When it inhales, you go deeper, seize the moment of inhalation, and make the detailed movements smooth and free.

The rabbit inhaled, the glottis opened, and the tracheal tube in Yang Ping's right hand was quickly inserted into the trachea, 4 cm past the glottis, and looking at the scale of the tube, it was about 18 cm away from the incisors, which was very good.

Yang Ping pulled out the stylet, placed a tooth pad, and exited the laryngoscope and bronchoscope.

Stethoscope!

Yang Ping auscultated the lungs with normal breath sounds on both sides, confirmed that the intubation was correct, fixed the catheter and the tooth pad, and injected 5ml of air into the catheter balloon to close the gap between the catheter and the tracheal wall.

The endotracheal intubation was successfully completed, and Yang Ping took off his gloves: The difficulty is that the mouth, throat and trachea are not in a straight line, forming some bends, and some parts are in a flattened state, each bend must be carefully crossed, and each flattened must be Expand carefully.

The action should be gentle, try not to damage the inner wall, and reduce irritation even if there is topical anesthesia, because the topography of the airway is complicated, and the topical anesthetic is somewhat difficult to place. Due to insufficient anesthesia, it will still cause irritation.

The deeper you go, the more sensitive you are. The throat will cause the gag reflex, and the tracheal mucosa will cause the cough reflex. These reflexes cause agitation and contractures, making it impossible for you to go deeper. Sufficient proficiency and flexibility are the prerequisites for you to go deeper.

The equipment must be spiritual in the hand, adjust according to the pipeline, and do not rush in rigidly.

Yang Ping told Fatty clearly about the main points, and Fatty kept it in his heart.

In addition to the operation, Zhang Lin and Xiao Wu were also studying Lu Gang's body position, how to get over the bed during several operations, how to set the body position, and how to pull the hook to reveal it.

In this team, pulling the hook is not an easy thing.

The 3D printed models are more than a dozen large and small, including full-scale models of the entire human body, small models, models of the spine, and models of the upper cervical vertebra and the base of the skull.

Zhang Lin and Xiao Wu now use Lu Gang's full-scale model to demonstrate how to pose.

Zhang Lin and Xiao Wu had to study it repeatedly after several operations, each with a different body position.

Fatty had been practicing endotracheal intubation for a long time, and was a little tired. He wanted to rest for a while and study body position with Zhang Lin Xiaowu.

Fujiwara Miyuki put on rubber gloves, took over Fatty's equipment, and tried to practice intubation in this extreme state.

After several attempts without success, she asked Yang Ping for help, and Yang Ping had to turn around and teach her again, taking her bronchoscope.

Fujiwara opened the rabbit's mouth, and Yang Ping looked at the screen of the fiberoptic bronchoscope and instructed her: Try to pry it up and open it a little bit, otherwise it won't go in.

In the case of not damaging the teeth, the mouth should be opened as much as possible to expose the throat, and then intubation can be implemented. This special position requires high exposure skills.

Don't be afraid, open it a little more, yes, I'm going in, don't move around, it's fine, I'm going in.

Under the guidance of Yang Ping, Miyuki tried several times and finally succeeded.

Go in now, don't move around, feel it yourself. Yang Ping let her feel the feeling of the catheter going through the glottis and entering the trachea.

It hurts a bit! Miyuki held the catheter with another hand, moved her wrist, and began to fix the catheter.

In the tracheal intubation just now, many movements were very suffocating, and the range of motion of the wrist was large, reaching the limit. After several attempts, it was naturally sore and painful.

Too nervous, relax! Yang Ping comforted her.

Zhang Lin Xiaowu and Fatty figured out the best position and asked Yang Ping to go over to see if it was suitable.

Everyone did not rest after get off work. Song Zimo had to prepare for the surgery for the first season of the competition, and Xu Zhiliang had to plan the preparations for the operations in the following seasons.

Especially for robotic surgery, Xu Zhiliang will arrange a certain number of cases for Yang Ping to warm up, and Takahashi will help the two of them.

But Yang Ping forbade them to stay up late, preferring to slow down the operation a little bit, rather than staying up late to sacrifice their health.

Sometimes there is no way to be one thing. If you can adjust the situation, try your best to protect your health, so that you can work better.

Before ten o'clock in the evening, Yang Ping asked them to stop their work.

Yang Ping also has a full schedule, and he has to go to Boss Cheng for surgery every Saturday.

The Gleneagles Hospital in Malaysia also asked Yang Ping for the surgery. Yang Ping said that he would be free after the Golden Knife Award.

Although learning and training can be done in the system space, things in reality also need to be done one by one, so time management is very important.

The duel between Song Zimo and Lin Hao was also staged soon, and they were fully prepared.

In the first season, the arthroscopy of the six major joints of the whole body will be done again, and then the foraminal surgery will be done, and finally the multi-ligament reconstruction of the shoulder and knee joints will be done.

Doctors who love arthroscopy can't hold it anymore, Lao Gao is like this, very excited.

Especially the multi-ligament reconstruction of the shoulder and knee joints, everyone is looking forward to it.

This kind of surgery is at the tip of the pyramid of arthroscopic surgery, it is too difficult and the effect is so poor that it was not a competition before.

This year, it was added as a competition item, so everyone will wait and see.