The Godfather of Surgery

Concord's Song Yun, except Wen Rentao, he didn't think anyone would be his opponent.

Even with Wen Rentao, Song Yun is very confident.

Some hospitals are stronger than Xiehe in some specialties, but in terms of overall strength, Xiehe is a well-deserved overlord, and its fine tradition has made generations of Xiehe people tireless and keep improving.

Now, Song Yun is fighting against Yang Ping, and Yang Ping, who has never played in the previous tournament, uses this Everest-level case. To be honest, this kind of case is in Xiehe, even his director dare not take over. .

Medicine is not a place of competition, and it is not shameful to dare not to take over, but to be responsible to the patient.

The more brilliant the doctor, the more he knows where the boundaries of medicine lie.

But what did Yang Ping rely on, so arrogant, to accept this kind of case, but also to do it in the competition.

From the analysis of the surgery video from Sanbo Hospital, Song Yun has to admit that Yisuke's strength is already on the same level as himself in a single round of basic surgery. It is misunderstood that it is from the Special Surgery Hospital of New York, USA.

If it wasn't for the fact that the inspection team announced the truth, Song Yun would not have believed that it was Sanbo Yang Ping's initiative. In addition to talent, Song Yun would not have believed that it was Sanbo's initiative. In addition to talent, it also required a large number of cases, which Sanbo did not have anyway.

This kind of mystery of Yang Ping puts Song Yun under great pressure. Can he really complete this operation?

If it can't be done, why do it? Those who can create new spells must not be treated lightly.

As for the remarks shouted on the Internet, what is crazy, what is inflated, what is carried away.

How could it be possible? Song Yun didn't believe these remarks at all. From the quality shown in the operation of the first assistant, it could be inferred that the chief surgeon must be a calm and experienced person, and his surgical quality was excellent.

It's just that Song Yun didn't understand why Yang Ping won such a difficult operation, which was simply impossible.

Why?

Not only Song Yun has such doubts, but orthopaedic doctors all over the country are also doubting, the judges are also doubting, and several spine bosses are also doubting.

When the second season starts, Yang Ping is fully prepared, and his condition changes at any time. The experience accumulated in simulated surgery, the sooner the better.

Yang Ping didn't plan to wait for anyone, and he didn't deliberately want to be the first to open the stage. In short, for the sake of the patient and the safety of the operation, he wanted to open the stage as soon as possible.

Before the operation, Yang Ping once again had a preoperative conversation with Lu Gang and his mother.

The risk of surgery is very high, and there are possibilities of death, paralysis, infection, etc. Doctors can only go all out to reduce the risk, but it cannot be completely avoided.

No matter how big the risk is, I have to take a risk. Now he suffers a little bit, it's okay to take a little risk. In the future, when I'm old, who will take care of him. He went from elementary school to college. You don't know how hard it is. Every day, I have to use a wheelchair to push him to the school and pick him up. The university can only rent a house next to the school, pick him up every day, and even pick him up for lunch at noon and eat at home. Lu Gang's mother said while wiping away tears.

Lu Gang just kept silent, even if it was an ordinary thing, it was very difficult for him to do it.

For example, eating, something that is normal for ordinary people, is extremely difficult for Lu Gang.

Without a mother, let alone college, even survival is a problem.

For more than ten years, his mother took him everywhere to seek medical treatment, which cost him a lot of travel expenses, but no hospital dared to perform surgery. Now Dr. Yang is willing to perform surgery, even if he takes risks.

Until Yang Ping asked again: Are there any other questions?

Lu Gang's mother and son really couldn't think of any other questions. What should be explained has been repeatedly explained and made clear. Both Lu Gang and his mother solemnly signed.

Informed consent for surgery, informed consent for blood transfusion, informed consent for anesthesia, and power of attorney.

This kind of complex and high-risk surgery may have unplanned events during the operation. Once such an event occurs, the patient is under anesthesia and has no autonomy. A person is required to act on his behalf. Lu Gang entrusts such rights with a power of attorney. to his mother.

The operation is unpredictable, Yang Ping is confident to control the blood loss within 200ml, but he still prepares autologous and allogeneic blood transfusion. The more prepared the better, even if it is not used.

Director Han and Professor Zhang sat beside him, and the flat cart pushed Lu Gang into the operating room.

After crossing the bed, Xiao Wu Zhanglin practiced many times, and they were very familiar with the road. They brought Gui Pearson to pass Lu Gang to the operating table.

Fatty started tracheal intubation. Although he practiced on Lu Gang's model for a long time, and practiced with a rabbit for a long time, he still wasn't sure.

The fat man slowly inserted the fiberoptic bronchoscope in, and the mouth, throat and trachea from the first perspective were slowly revealed, and then he stopped his vision at the glottis fissure.

The laryngoscope was gently inserted, the endotracheal tube was placed, the fat man's hand was very steady, the catheter went over the glottis, the fat man held the tube in one hand, and the stethoscope in the other hand to auscultate both lungs, and then made an OK gesture.

It went very smoothly, the intubation was successful, everyone applauded, and the first level was passed.

Zhang Lin Xiaowu stuffed various position pads into the gaps around Lu Gang's body, posing in a strange position.

Yang Ping plans to do hip and knee joint release and joint replacement first, so that the hip below can move freely and it is convenient for the next position.

It is very difficult to complete bilateral hip and knee replacements in this curled position.

Even in a normal position, performing bilateral hip and knee replacements at the same time is a challenging procedure.

In this extreme position, it is difficult and difficult to complete the operation.

Even Professor Zhang and Director Han had to wonder how he could quickly complete the replacement of these four joints.

How to operate, Yang Ping is skilled enough to form muscle memory. He has performed nearly 100 operations on Lu Gang of the system, and has also performed many research-style pathological anatomy.

Song Zimo sterilized the sheets and moved very quickly.

For the last check before the operation, the stage was opened. Yang Ping took a minimally invasive hip replacement incision, and the deep hip joint was exposed in a few minutes. A few acetabular hooks were put in place, and Zhang Lin Xiaowu was supported.

Zhang Lin Xiaowu didn't know where the pull hook was and what was inside, but they only needed to hold the pull hook firmly. They are fully capable of this job. According to Yang Ping's request, they firmly hold on to the hook.

The femoral neck osteotomy is in place at one time, and the deformed femoral head is easily removed by the head pick.

Director Han was worried that it would be difficult to remove the severed femoral head. Xiao Su had already taken the femoral head and put it in a metal basin.

Usually, the diameter of the femoral head needs to be measured with a caliper to guide the selection of the type of artificial joint prosthesis. Now because the femoral head has been deformed, there is no guidance at all.

Where is Lu Gang's acetabulum?

The pelvic and acetabular area on CT three-dimensional reconstruction has no real acetabulum, and the shallow dent is meaningless.

For more than a decade, his hip has been dislocated, and the femoral head has floated in soft tissue without an acetabular socket to accommodate it.

Usually, when joint surgeons deal with the acetabulum, in order to make the direction of the acetabulum correct, they use the patient lying on the back as a reference to find the angle.

Now Yang Ping wants to make an acetabulum for Lu Gang again. The position, direction and depth of the acetabulum must meet the anatomical requirements. Lu Gang's body position is extremely irregular. To find an angle in this position requires the doctor to have a strong spatial imagination. .

Xiao Yang— Professor Zhang just wanted to give him some advice.

The acetabular rasp had been inserted, rustling, and through the goggles, the blood mist rose.

The high-speed electric drill with the acetabular file has not yet completed the work, and Yang Ping directly reported the model parameters of the acetabular prosthesis.

Huang Jiahui immediately opened the package and placed the prosthesis on the instrument table.

The competition procedure requires a mold trial, otherwise Yang Ping doesn't need a mold trial at all. After a hundred operations, it's still a kind of mold trial, which is a waste of time.

After Yang Ping went through the mold trial process, he directly asked Xiao Su to open the prosthesis.

Lu Gang used bone cement prosthesis because of insufficient activity and osteoporosis.

The bone cement is opened and mixed under the stirring of the special dissolving solution, and the fragrant smell fills the entire operating room.

The acetabulum is rinsed, the gauze is stained and dried, and the acetabular prosthesis with the dough-phase bone cement is accurately inserted into the artificially excavated acetabular fossa and compressed.

Immediately afterwards, the femoral end was reamed, the medullary cavity was flushed, and the mold trial was also a walking process. The bone cement gun was injected into the femoral medullary cavity, and then the real femoral end prosthesis was implanted into the medullary cavity and compressed.

A little excess bone cement was completely removed, and the artificial prostheses for the joint head and joint socket had been installed. The rest was to completely stop the bleeding. There was no bleeding at all, and even drainage was not needed.

Under the lens responsible for close-up magnification, observe for a few minutes, there is no obvious bleeding.

Because of the minimally invasive approach, various important structures, such as the piriformis muscle, are not damaged, and the bleeding on the bone surface has long been stopped by the compression of the joint prosthesis and bone cement, so there is no bleeding.

Rinse, suture layer by layer, and just replace one hip.

Young man, your surgery is like playing a game, and Professor Zhang doesn't dare to blink. The kung fu in this hand is still not human.

Originally, I wanted to communicate with Yang Ping a few words, but the hip joint on the other side started again. The movement was too fast, and the brain couldn't keep up with Yang Ping's rhythm. Professor Zhang and Director Han ran with Yang Ping in their hearts.

The hips were replaced on both sides without stopping, and then the knees were replaced.

It was the first time that Song Zimo was struggling to be an assistant, but he could barely keep up with the rhythm. Zhang Lin Xiaowu didn't see how the operation was done during the whole process. Every time Yang Ping put the retractor in place, they just mechanically supported him.

But fortunately, after so long training, the two brothers are first-class in pulling the hook.

Knee replacement tests the osteotomy and soft tissue balance techniques. Yang Ping's movements are too fast. Whether it is the members involved in the operation, or Professor Zhang and Director Han who are observing the operation, everyone dares not even relax a little, how can they speak? A little hesitation, you will be thrown off the rhythm.

Expose and clean up the synovium of the knee joint, release the ligaments and joint capsule, osteotomy of the tibial and femoral ends, which are also the requirements of the surgical procedures. Otherwise, Yang Ping needs some osteotomy template. level below.

After the locator is installed and the tibial osteotomy template is assembled, the osteotomy is completed in a few steps, and the femur osteotomy is completed in a few steps. After the osteotomy was completed, the tibial end prosthesis and the femoral end prosthesis were implanted successively, and the bone end was firmly fixed on the bone end by bone cement.

The smell of fragrant bone cement is getting stronger and stronger, the artificial joint replacement of both knee joints is completed, sutures, and dressings cover the incision.

Re-positioning, disinfection and laying of sheets, and osteotomy and correction of the cervical spine are the most dangerous steps, especially for the treatment of upper cervical skull base deformities.

Xiao Yang, don't be in a hurry, slow down, you can install it in installments. Director Han almost held his heart in his hands.

Professor Zhang was also worried. For an 80-year-old man, seeing a young man doing this surgery would be considered a good heart, otherwise he would be scared of myocardial ischemia.

Slow down, slow down— Professor Zhang was choked when he spoke.

However, Yang Ping has been completely immersed in the operation. He has to walk at his own pace, just like an athlete who is running, and cannot be stopped suddenly by others.

The sooner the surgery is done, the lower the risk.

After the incision and exposure are completed, the nails are nailed first, and then the osteotomy is performed.

If it wasn't for the 3D model used before surgery, Yang Ping led everyone to train repeatedly, and no one could keep up with his rhythm.

The lateral mass screw of the atlas and the pedicle screw of other cervical vertebrae are the pedicle screws of the cervical vertebra. If the vertebral artery is damaged, the arterial blood will soar to the ceiling.

There are vertebral arteries around the cervical spine, and the pedicle is small, not as thick as the thoracic and lumbar spine. Doing cervical pedicle screw is a high-risk operation.

Now Yang Ping is like digging soil and planting beans, planting screws one by one, completely ignoring the risks.

My little master, can you slow down, Director Han stood looking at the screen, feeling a little uneasy, his legs were uncomfortable, he kept shouting in his heart and swallowed his saliva again and again.

Professor Zhang simply moved the stool in front of the screen. Standing and watching it was too exhausting, and watching the operation was also a laborious task.

It's really fast, it's like the streets are full of people, and you put on the Fast and the Furious, who sees not the heart beating drums.

Several cameras, with different focal lengths and different directions, can take pictures of the surgery clearly.

The bone was cut again, and the ultrasonic water jet cut the bone, just like playing.

Oh my god, young man, slow down, slow down, slow down, one in his eighties, one in his fifties, who has never seen such an operation before, you are doing somersaults on a wire.

I can't help you, the chief knife is now walking according to the rhythm of his heart!

After the osteotomy is completed, it is now necessary to reassemble the cervical vertebrae. This step is the highest risk in the entire operation. If a little carelessness occurs, the upper cervical spinal cord will be damaged, and the patient will die directly on the operating table.

Song Zimo, take off the surgical gown and adjust the head immobilizer, Zhang Lin Xiaowu, pay attention to the position of the automatic hook, and the anesthesiologist pays attention to the patient's vital signs.

At this step, Yang Ping slowed down.

Before the operation, they used the model to practice every step, especially in this step, Yang Ping decomposed Song Zimo's movements into a dozen steps, how to adjust, how much to adjust, very precise.

Song Zimo took off the surgical gown and gloves and put on new gloves. Everyone performs their duties and concentrates.

Are you ready?

Ready!

1, 2, 3, start adjusting.

Yang Ping didn't need to see how Song Zimo adjusted, he only needed to watch the movement of each segment of the cervical spine. Song Zimo adjusted the head immobilizer, Yang Ping began to orthopedic the cervical spine, and the two cooperated tacitly.

The truncated cervical vertebrae began to undergo spatial displacement on three axes, and the cervical spinal cord in the spinal canal also began to be affected, but Yang Ping has planned the best spatial displacement trajectory, which has the least impact on the cervical spinal cord.

Carry out precise displacement on the predetermined trajectory, no one dares to relax, Lu Gang's life is pinched in the hands of Yang Ping and Song Zimo, a small mistake, Lu Gang will never be able to get off the operating table.

stop!

Cervical vertebrae orthopaedics are completed, physiological curvature is formed, rods are up, internal fixation is firmly locked, and cervical vertebra orthopaedics are successfully completed.

Old Han's back was already wet, and he breathed out a long breath in his chest.

Professor Zhang rubbed his eyes, and the stool was wet with sweat.

Watching the operation also sweated, which the two did not expect.

After the cervical vertebra correction was completed, after a short slow pace, the fast-paced operation began.

It is necessary to adjust the body position and re-sterilize the sheets.

In thoracolumbar orthopaedics, the twist will be loosened and reshaped to restore the S-physiological curvature of the spine before and after.

At this time, it will not only affect the spinal cord, but also affect the organs of the thoracic and abdominal cavity. Although it is much better than the orthopedic treatment of the cervical spine, the risk is still very high.

Professor Zhang wanted to take a break, and his mental and physical strength was too much. Director Han couldn't support it, so he moved a stool and sat next to Professor Zhang.

The two just looked at each other and didn't speak.

It was revealed that the pedicle nails were like beans, and Song Zimo followed Yang Ping's rhythm. Although he was pulled away by Yang Ping, it was already very good.

Dozens of screws were implanted into the pedicle, and it was another osteotomy. This time, Professor Zhang and Director Han felt much more comfortable and less anxious. After all, they had passed the most dangerous level.

This time I still need Song Zimo's assistance. Every time Yang Ping corrects one place, Song Zimo tightens the internal fixation device and uses the internal fixation device to fix the severed spine in a new position. Step by step, there is no unnecessary step, and the thoracic and lumbar spine is reorganized again. .

When the last screw is locked.

perspective!

Wait for a 3D CT scan reconstruction? Director Han reminded.

This was the first time Yang Ping heard Director Han speak, and he suddenly remembered that Director Han and Professor Zhang were next to him.

Row!

The surgical procedure requires that a C-arm or G-arm fluoroscopy must be performed in the operating room after surgery; while CT scans can be completed in the operating room if conditions permit, and can be returned to the ward after surgery and then in the radiology department.

On the screen of spinal cord bioelectricity monitoring, the amplitude has been stable and there is no abnormal change.

After the fluoroscopy is completed, the CT 3D reconstruction is performed.

pretty!

Others generally pursue moderate orthopaedic surgery. This surgery restores the normal S physiological curvature and maximizes the effect of the surgery.

Each screw is in the best position, and the length and thickness are very suitable.

Wake up test!

The amount of anesthesia used by Fatty Liang was very particular. Yang Ping told him that four hours, that is, four hours, three hours for the operation, and a single hour for several disinfections in the middle.

Slowly, Lu Gang woke up. Before the operation, Lu Gang had been trained repeatedly in this area.

Move your toes, yes, up, down, very good!

The surgery was a success, quite a success!

This operation was originally planned to be carried out in two chapters. Think about it, let’s solve it in one big chapter and make it smoother! This chapter has more than 5,000 words, brothers, please encourage me properly!