Adjust it by fifteen degrees, making it at an angle of seventy-five degrees to the nerve root. If it is too small, it will slide; if it is too big, it will not be able to be inserted.
The angle calculated by Yang Ping is not just a random talk, but an accurate angle obtained by observing Su Nanchen's simulated puncture.
The systematic super training program has cultivated Yang Ping's composition ability, which has greatly improved the accuracy of both his brain and hands. This kind of accuracy is not just mechanical measurement, but also has a delicate and nuanced feeling.
The puncture was made at a seventy-five-degree angle to the nerve root, that is, it was adjusted fifteen degrees downward from vertical. How could it be so accurate? Su Nanchen wondered.
The navigation accuracy can be accurate to a few tenths of a millimeter, but that is only a theoretical accuracy. The three-dimensional reconstructed image itself will have certain distortion, and the reference point is not 100% accurate.
Just like the effective range of a sniper rifle is two thousand meters, it does not mean that it will definitely be able to hit the enemy within two thousand meters. There are too many factors that affect it.
"As long as it is at an angle of 75 degrees to the nerve root, we will definitely succeed." Yang Ping reminded in a low voice again, with a firm tone.
Su Nanchen didn't have much confidence and couldn't be so precise.
He tried several more times, but either the needle tip slipped away or the tube could not be inserted.
Professor Su also saw the problem. The puncture needle is hard, the guide wire is elastic, and if the direction is not optimal, the adhesion cannot be broken through. This requires a touch that is beyond human ability.
"There is no need to ask for perfection. After the puncture is successful, place the catheter directly and inject the medicine 24 hours later. The microcatheter and the surrounding nerve sheath will form a biological seal, and the possibility of leakage is very low!" Professor Su asked Su Nanchen to end it as soon as possible!
Surgery.
You don’t have to stick to one hundred percent, eighty percent is also a kind of success.
If the puncture is successful and the catheter is placed directly, the microcatheter will remain in the nerve root sheath, but the distance left is very short, which may cause drug leakage, and the microcatheter may withdraw when the patient moves.
Although the possibility is very low, it is still possible.
Su Nanchen didn't want to give up and wanted to strive for twenty more points to reach one hundred points.
It is not for himself, but for the patient. He can give one hundred percent, never ninety-nine. This is his philosophy.
"Are you sure?" Su Nanchen asked Yang Ping.
Yang Ping nodded.
The two had a brief conversation, exchanged glances, then turned around and exchanged positions back to back.
Su Nanchen let go and Yang Ping took the handle of the puncture needle that was exposed outside the body.
There are two puncture needles, one is thick, responsible for making a tunnel in the bone tissue, and one is thin, entering from the sheath of the thick needle, responsible for puncturing the nerve root sheath, and finally the microcatheter is covered with a guide wire
Then it passes through the hollow fine needle and enters the nerve root sheath.
Yang Ping holds the handle and twists the fine needle in his hand, looking for a feeling. The dynamic three-dimensional anatomical diagram in his mind is presented, and the details are improved bit by bit.
The needle in the hand also appears in the brain, and its relationship with the nerve roots is more realistic than navigation.
Adjust the direction of the fine needle and insert it into the nerve root sheath at an angle of 75 degrees.
Su Nanchen handed over the microcatheter, which had a guide wire threaded through it. It was inserted through the hollow needle, which was five millimeters, one centimeter, three centimeters, and entered smoothly without any bends.
This means that the guidewire and microcatheter have successfully broken through the adhesions, entered the nerve sheath, and penetrated three centimeters deep.
The balloon in the bony tunnel of the vertebral pedicle is inflated and the catheter is fixed.
What Su Nanchen tried several times and failed to complete was actually completed in one go.
Professor Su nodded slightly, turned his admiring gaze to Yang Ping, and his love for talents suddenly aroused.
The two turned around and exchanged positions again. Yang Ping returned the subsequent actions to Su Nanchen. Su Nanchen slowly withdrew the thin puncture needle and then the thick needle, and finally pulled out the guide wire to complete the puncture.
"Thank you!"
"I'm just helping you complete the fifteen-degree adjustment."
The two looked at each other and smiled.
This friend has been made, Su Nanchen thought.
The catheter is fixed outside the skin, connected to the analgesic pump, and the anesthetic is injected from the microcatheter into the nerve sheath of chest 2.
"Ning Tianxiong, how do you feel?" Dr. Su asked the patient.
The patient is under local anesthesia and can talk awake.
"It doesn't hurt anymore!" The patient was lying prone and struggled to speak.
"How is your breathing? Is it difficult?" Dr. Su asked again.
"It's always been a bit hard to lie down." Ning Tianxiong was very cooperative.
"Blood oxygen saturation, 100%!" said the anesthesiologist who was helping monitor the situation.
There is no respiratory depression, which means there is no leakage of the drug. The catheter has penetrated three centimeters and no leakage will occur.
"Lie on your back and observe for fifteen minutes. If there is no respiratory depression, then return to the ward." Professor Su told Su Nanchen.
Yang Ping and Su Nanchen helped the patient turn over to a supine position and observed him for fifteen minutes. There was no respiratory depression.
A super difficult puncture was successfully completed by two young people, and it was perfect. The technical content of this puncture was equivalent to the beheading operation of special forces in war. It was all technical work.
It's already past seven o'clock. Director Han looks at the time.
Director Zhao of the Medical Department ordered the internal restaurant to prepare meals. Professor Su had no intention of staying for dinner because he was too pressed for time.
Now he changed his mind and stayed for supper.
"Thank you for your hard work. Let's stay and have a casual meal before going back." Director Han insisted.
"Okay!" Professor Su said cheerfully.
"Call Xiao Yang too!" Su Jiao specially proposed.
Talented people respect and cherish talents more.
Several other directors also stayed with Professor Su. After all, the dean of the attached 1st hospital, the chairman of the Department of Orthopedics, and the future academician, no matter who they are, play an important role in the medical circle. This reputation cannot be refuted. Maybe he will find someone else next time.
Doing some work.
The dinner was held in the restaurant inside the cafeteria. Professor Su didn't drink alcohol, and everyone didn't drink either. Some had to drive, and some had surgery at night.
In addition to Director Han, Director Tian, Director Tan, Director Qin from the Spinal Surgery Department of Sanbo Hospital, Director Gao from the Sports Medicine Department, and Director Chang from the Joint Surgery Department all came to accompany me.
Dean Xia and Dean Sun have both come over. The dean of the attached first school is a big shot in the medical field and cannot be ignored. Besides, Dean Xia and Professor Su are from the same school and have worked together before, so they have a certain friendship.
Dean Xia and Director Han were with them, and Su Nanchen sat down with Yang Ping. The two of them had endless things to say about how the patient was able to accurately adjust the needle at fifteen degrees vertically, and how this angle was calculated.
of.
The dinner table was divided into two circles, one for Su Nanchen and Yang Ping, and another for everyone else.
Su Nanchen and Yang Ping kept chatting in low voices, discussing all professional topics, and even added each other on WeChat. Others ignored these two young people.
"Nan Chen, uncle is asking you something!" Professor Su reminded, and Su Nanchen just remembered that Dean Xia, Director Han and others were also present here.
"Nan Chen, come and play at home when you have time," Dean Xia said.
Dean Xia and Professor Su both graduated from Nandu Medical University, in the first year. Dean Xia was also transferred from the first attachment. When they were young, they both lived in the old dormitory of Nandu Medical University. At that time, Su Nanchen was still in elementary school.<
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Dean Xia's daughter is about the same age as Su Nanchen. They were classmates in elementary school. However, Dean Xia's daughter did not study medicine but studied law and worked in the provincial Department of Justice.
"Okay, thank you, Uncle Xia." Su Nanchen was generous and decent, then he picked up the teapot, poured tea for the seniors, and then raised his cup to offer tea to everyone.
Dean Xia and Professor Su talked about the farm of the First Affiliated Hospital, and the two discussed taking the time to go and have a look. The conditions used to be difficult, and the First Affiliated Hospital allocated a piece of land in the suburbs as a farm. Everyone took turns working when they had time to grow some food, fruits and vegetables.
, to make up for the shortage of living materials.
Later, this piece of land was never sold. Professor Su built a modern large farm in the hands of Professor Su. Every year, he would send some vegetables, fruits, etc. to the staff of the First Affiliated Hospital as a welfare.
Yang Ping felt that this dinner party was very relaxing and rewarding. He made a friend in Su Nanchen. Su Nanchen was knowledgeable but not arrogant. For a case, he humbly asked Yang Ping for every detail.
Forget it. He doesn’t have any of the second-generation arrogant bad habits.
"Please contact me when you have time!" After Su Nanchen left, he also sent a WeChat message.
"Professor Su appreciates you very much, Xiao Yang!" Director Han hummed, very happy.
After the dinner, the two went to the Overseas Chinese Building to see Mr. Ning. He was smiling and comforting his daughter: "Relax, don't make it so sad. Life will eventually end. It's just a matter of time. No one can escape." Seeing Director Han and Yang Ping come in, he was very happy: "Thank you both, the pain is gone and there is no problem breathing. I'm so grateful."
Pain is very disturbing to people and is the most unbearable symptom for patients. The World Health Organization has listed pain as the fifth vital sign after heart rate, respiration, blood pressure, and body temperature.
Eliminating pain has become the basic right of patients and the obligations and responsibilities of medical staff.
"I feel comfortable!" Mr. Ning leaned against the bedside, holding a "Visual Analog Pain Rating Scale" in his hand. The muscles on his face were very relaxed and there was no distortion as before.
"Thank you all! Thank you, Director Han, thank you Dr. Yang! Thank you, really!" Miss Ning stood up and bowed.
"Thank you, Professor Han! Thank you for taking the trouble!" Mr. Ning shook hands with Director Han.
When shaking hands with Yang Ping, he said: "Dr. Yang and Dr. Su helped me with the puncture. In the end, it seemed that the angle needed to be corrected, 15 degrees. Dr. Yang did it."
"I'm awake and listening all the time." Mr. Ning explained with a smile.
Under local anesthesia, he was lying on the operating bed, listening to the doctor's conversation, and was very clear about the operation process.
"Thank you very much for allowing me to sit here and talk with a smile." Mr. Ning is in good spirits.
"Well, go back and rest early after eating, and don't drink."
Before eating, Yang Ping and Xiao Su sent a WeChat message.
