In the operating room, Tanglou, Guo Caier has been prepared, and the rest of the equipment, nurses and other medical staff are also present.

Guo Cai'er stood in the position of the first assistant, still a little panicked in his heart: "Tanglou, if it really can't go on for a while, don't force it, I will find a superior doctor to take over."

Tanglou ignored Guo Caier and signaled Chen Wenhao to start anesthesia.

Chen Wenhao completed the endotracheal intubation and general anesthesia very quickly. After finishing the procedure, he sat directly in a far corner and yawned.

"Put in a urinary catheter..."

Tang Lou gave the order, and Guo Caier nodded. He picked up the tweezers and iodophor cotton with his gloved hands. After scrubbing and disinfecting him, he used paraffin-lubricated cotton to tighten the rubber tube a few times. After lubricating it, he used

The tweezers are carefully sterilized again.

Guo Cai'er was also a little impressed. He was indeed a firefighter. Most people would have been frightened into submission at this time.

Guo Cai'er kept it at an obtuse angle and began to insert the catheter. It must be said that Guo Cai'er's technique was very professional and sophisticated.

After completion, place Dosanduo in a prone position with the abdomen kept in the air.

Afterwards, the surgical area is routinely disinfected and sterile surgical drapes are spread.

"X-ray machine... Kirschner wire... scalpel..."

Tanglou started the next step very quickly, and the equipment nurse tacitly provided the equipment in place.

Use a Kirschner wire to locate the fractured vertebral body under the X-ray machine. With the fractured vertebral body as the center, incise the skin, subcutaneous tissue and lumbar dorsal fascia in sequence.

For Tanglou, the three-star incision was done very neatly and simply.

"Blunt dissection of the multifidus and longissimus space."

Tang Lou gave further instructions. Guo Caier's basic skills were also very solid. Under Tang Lou's command, he cooperated very well.

"Expose the diseased vertebrae and the facet joints of adjacent vertebral bodies above and below."

Tanglou continued to issue instructions. Under precise control, Guo Cai'er felt as smooth as if he was performing surgery with the chief director at Union Hospital.

And there is no need to worry about any problems with the surgical operation. Every time you complete the steps by yourself, the next instructions have been accurately followed.

During the operation, Guo Cai'er glanced at Tanglou and was really surprised. How could this guy be so familiar with such a difficult technique?

"According to the point indicated by me, insert the positioning needle, take X-rays simultaneously, and confirm the position of the needle insertion point in the vertebral body..."

"Okay, Doctor Tang."

Guo Cai'er stopped his thoughts and completely entered the rhythm of Tanglou.

"Opener...pathfinder cone...probe..."

The equipment nurse is not to be outdone.

"The bony channel is determined during the operation and the pedicle screws are placed."

Seeing Tang Lou's very fast operation, Guo Caier's heart almost jumped out of his chest: "Doctor Tang, slow down, slow down."

At the same time, she used X-rays to verify. Normally, fine-tuning would be done after the first insertion, but after seeing the results, Guo Caier's mouth opened slightly, such precise length control!

"Intraoperative confirmation of pedicle screw position..."

Regarding Guo Caier's verification results, Tanglou took it as a matter of course and directly chose to insert the connecting rod.

Guo Caier's fearful simultaneous verification once again found that the length of the Tang Tower was perfect.

"This is so beautiful."

It took less than ten minutes to complete the extremely difficult entrance to the tenement building.

Next is the more dangerous anterior decompression and internal fixation of the phalangeal fusion.

"Electric knife..."

With Guo Caier's fear, Tanglou began to peel off the periosteum of the vertebral body forward and backward.

Due to the tight periosteum connection between the vertebral body and the intervertebral disc, it was very difficult to separate. After Guo Caier couldn't believe it, Tanglou boldly used an electric knife to make the incision, which was very fast and the separation was clean.

Guo Caier could only shout in his heart: Boss Niu Boyi (broken sound)!

Guo Caier was shocked when he saw Tang Lou's speed in identifying the relatively bulging intervertebral discs and sunken vertebral bodies. It was really fast.

With this kind of frequency and this kind of endurance, Guo Cai'er is convinced that this is true for whatever operation Dr. Tang performs.

Before she could react, Tang Lou had already started to carefully ligate the segmental blood vessels of the fractured vertebra and one normal vertebra above and below it in the middle of the vertebral body.

Seeing that Guo Cai'er was a little confused, Tanglou taught him:

"Resection of the intervertebral discs above and below the fractured vertebra, as well as the cartilage endplates below and above the upper vertebral body, is beneficial to the fusion of the finger bones."

Guo Caier seems to understand but not understand.

Tanglou was very patient and continued to add: "The crushed bone fragments of the fractured vertebra are easy to scrape out to achieve sufficient decompression in front of the dura mater. Of course, if you encounter an old fracture in the future, you will need a sharp osteotome and a drill to gradually remove it.

The vertebral body, especially the posterior wall of the vertebral body, must be resected very carefully, not only to achieve complete decompression, but also to avoid tearing the dura mater and damaging the spinal cord."

After Tanglou finished speaking, the operation on his hand was also very precise and perfect.

"Got it."

Guo Cai'er's eyes lit up, "I see. Before following the chief director, she was always so nervous that she didn't dare to breathe, for fear of making mistakes. It would be great if she could complete her first assistant's work. How could she go back and think about these issues that the chief surgeon was considering."

Under Tanglou's generous teaching, Guo Caier's understanding of the techniques has risen to a new level.

"Isn't it completely useless to follow this guy?"

Guo Caier muttered in his heart.

"Next, perform corrections, vertebral body spreaders...vertebral body screws..."

"Okay."

Guo Cai'er is like a silly girl, saying whatever Tanglou says is true.

The correction was completed quickly. Since the patient's anterior longitudinal ligament had contracted, Tanglou chose to cut off the annulus fibrosus and the anterior longitudinal ligament.

For bone grafting, Tanglou chose three-sided cortical iliac bone blocks of appropriate size. Of course, in principle, titanium mesh filled with bone fragments and artificial vertebrae can also be used.

Next is the most critical part of the entire operation besides the approach:

Z-plate fixed!

Guo Caier was also shocked. This was her first time using Z-plate fixation, and her palms were slightly sweaty.

Sensing Guo Caier's nervousness, Tang Lou said calmly: "Next, just follow my command, it's very simple."

Under the gift of listening and the head of the subject, and under Tang Lou's gentle and calm encouragement, Guo Caier's mind calmed down.

I have to say that in the operating room, Tang Lou is really very aura and has the ability to convince and reassure people.

"Confirm the removal of the fractured vertebral body and decompression of the front of the spinal cord..."

Guo Caier continued his work as a first assistant and provided assistance and confirmation for Tanglou.

"First, two screws were implanted in the posterosuperior corners of the upper and lower vertebral bodies. The screw entrances were 10mm away from the posterior wall of the vertebral body and 10mm below the upper endplate of the upper vertebral body. The screws were tilted 10° forward and fixed bicortically."

Tang Lou gave direct and precise instructions, and in cooperation with Guo Cai'er, the height of the vertebral body was restored by simultaneously spreading the screws.

"The bone block is implanted...the titanium plate is placed...longitudinal compression is performed between the screws..."

Under the control of Tang Lou, the bone blocks were quickly embedded and the fixation between the bolts and the titanium plate was completed.

"Cai'er, you did a great job. Leave the rest to me."

Tanglou praised him for starting the final locking between the bolts and the titanium plate. He screwed the two screws at the front of the upper and lower vertebral bodies through the titanium plate chute, and the locking was quickly completed perfectly.

It wasn't until this moment that Guo Caier realized that he and Tang Lou had actually performed such a difficult operation.

After that, it's just about the aftermath.

"Placing chest and retroperitoneal drains..."

After completing this step, Tanglou showed off the suturing of the diaphragm, closed the chest and sutured the wound.

...

...

At this time, Captain Huang was in the office of Vice President Yang Xiaodong. Chen Qilong, director of the Orthopedics Department of the Provincial Military Hospital, and Liu Shiliang, director of the Orthopedics Department of the Municipal First Hospital, rushed back to the hospital.

As soon as Captain Huang saw the two experts, he immediately shook hands and said, "Director Liu, Director Chen, I've been waiting for you. Thank you, thank you."

Director Chen smiled slightly: "Captain Huang, it's a big deal to say this. It's also an honor for me to be able to operate on our little firefighter hero. In this case, let's stop talking nonsense and hurry up to the operating room."

"Yes, yes, before I came, the doctor on duty had already arranged various examinations and preoperative preparations, and I was just waiting for the two experts."

Captain Huang himself was very anxious. When he saw that the two directors were really practical people, they were no longer pretending to be polite.

Accompanied by Dean Yang, two experts and Captain Huang rushed to the operating room.

Along the way, seeing Captain Huang's anxious look, Director Liu said: "Captain Huang, don't worry, Director Chen is very experienced and professional when it comes to thoracic fracture surgery. I can say this, as long as Director Chen operates,

We are sure to restore the little hero to more than 90%."

"Yes, and Director Chen is very knowledgeable about approaches. In addition to conventional percutaneous screw placement, he has successfully tried a more optimized transspinal muscle space approach many times in recent years. This approach can

It greatly avoids the shortcomings of the traditional approach. It can be said that there are less than three people in the province who can do this approach well."

As an old colleague of Chen Qilong, Yang Xiaodong certainly knows his research well.

"That's good, that's good."

After Captain Huang heard this, he finally felt relieved. Xiao Du, wait for Captain!

Soon the group arrived in front of the treatment room. Captain Huang saw Ma En and asked: "Doctor Ma, how are the preparations for the operation? The chief surgeon has arrived."
Chapter completed!