There were few patients and the ward rounds were quick. After the ward rounds, Zhang Lin and Xiao Wu sent the patients to the operating room.
Meniscus suturing and cruciate ligament reconstruction are landmark surgeries of knee arthroscopy. Although Director Han is very reassured about Yang Ping, he still has to go and have a look at these landmark surgeries to see how powerful Yang Ping's arthroscopic surgeries are.
Huang Jiahui was waiting in the operating room early, waiting for the instrument cart. She neatly stacked twenty individually sterilized meniscus suture guns on the instrument cart, and locked the instrument cart in an out-of-the-way corner next to it.
This corner was the best place she found after thinking over and over again.
It is convenient to observe the progress of the operation without hindering the personnel in the operating room.
She originally had enviable long hair, but since joining this industry, she decisively cut it short, just short enough to tie it up.
Today, she tied up her hair, covered it with a net, and put on a sterile cap. When she put on a sterile cap, no hair was exposed. To train to wear a sterile cap, she practiced countless times in front of the mirror at home until no hair was exposed.
Anesthesia has been applied. Song Zimo hung the patient's X-rays and MRI films on the reading lamp, guided Xiao Wu and Zhang Lin to get into position, and then went to wash his hands, disinfect the sheets, and make preparations for every detail.
All meticulous.
When Yang Ping washed his hands and came in, everything was ready and waiting for the stage to start.
When Yang Ping was putting on surgical gown, Director Han came in.
"Hello, director!" everyone greeted.
"Hello, Professor Han!" Jiahui greeted Director Han who came in and bowed.
"Hello!" Director Han saw that she was holding a laser pointer in her hand and guarding the sterile boxed equipment, and knew that it was the equipment dealer who was following her.
"Which company are you from? New here?"
Director Han has never seen this little girl before.
"Professor Han, I'm new at Ruixing Medical, which makes sports medicine products." Jiahui introduced herself.
Director Han picked up a separately packaged meniscus suture gun and looked at it: "Ruixing! Domestic products should be supported more. This suture gun sometimes jams, so be careful!"
"The connection between the first and second needles is not precise. Sometimes the strength is not well controlled, resulting in an error of 0.5 millimeters. The first needle has not yet come off the gun, and the second needle is eager to enter the advancement track, causing the gun to jam. First
After the needle is injected, you cannot release the trigger. You still have to squeeze the trigger, and then step back until the first needle is confirmed to come out of the gun, then release the trigger and then inject the second needle. This way there will be no jamming of the gun. This design
needs improvement."
Yang Ping has studied Ruixing's equipment very deeply. Before Huang Jiahui reminded him, he had already known about this flaw and already had countermeasures. He just didn't care.
"You are right to have a deep research on medical devices. Doctors must be proficient in researching medical devices themselves and cannot rely on explanations from manufacturers and TV stations." Director Han appreciated Yang Ping's attitude very much.
"What's going on with this patient?" Director Han asked while watching the film.
"Male, fourteen years old, professional football player, suffered a compound tear of the medial meniscus of his left knee. The tear was located in the back corner and body." Yang Ping introduced Luo Xiaohu's condition to Director Han.
"Yes! Looking at the magnetic resonance imaging, the meniscus is severely torn and the suturing technique is difficult. Do it slowly and don't rush." Director Han told Yang Ping.
Huang Jiahui moved a stool and asked Director Han to sit on it.
Complete the preoperative check, drive out blood, and inflate the tourniquet.
Yang Ping started to open with a sharp knife, and skillfully opened the outside. The puncture awl entered with the sheath, then straightened the knee joint, entered the suprapatellar bursa, pulled out the puncture awl, and inserted the lens.
While talking, the arthroscopic exploration of the knee joint was completed. The medial meniscus was torn. No other obvious abnormalities were found. The medial meniscus was sutured.
Director Han moved to the side of the screen and looked at the video image above: "The tear is very serious. One piece has turned up. Is it freshly torn?"
"It's only been two days since the tear. This is the patient introduced by Su Nanchen, an athlete from the provincial youth football team." Yang Ping began to insert the needle on the inside to guide the opening.
After opening, insert the probe into it. The probe is an extension of the arthroscopic doctor's fingers. You can further understand the structural lesions and injuries by fiddling, touching, etc.
Yang Ping closed the water inlet pipe, which could reduce the agitation of the torn meniscus by the running water, and used a probe to push the torn meniscus back into place and smooth it out. If it is a fresh tear, it can be sutured directly. There is no need to freshen the edge of the tear.
deal with.
"Sewing gun!"
Xiao Su also researched the manufacturer's equipment in advance. When Huang Jiahui asked her to take the sterility knowledge filing test, she also asked Huang Jiahui for details on these equipment.
Yang Ping took the suturing gun, entered from the medial port, and began to suture the posterior corner of the meniscus. The muzzle of the gun was pointed at the planned puncture point, and the trigger was pulled. The needle tip penetrated the meniscus with the thread anchor until it penetrated the meniscus attachment part.
of the joint capsule, and the wire rivet remains outside the joint capsule.
He held the trigger tightly without letting go, pulled it back slightly, and the first needle came out smoothly. At a distance of 0.5 centimeters from the first needle, the muzzle of the gun was pressed against another planned puncture point of the meniscus, and he pulled the trigger.
The second needle goes in smoothly and the gun is pulled back.
Tighten the suture. The two thread anchors were inserted vertically. Now when you pull it, they become transverse. They are pinned behind the joint capsule and become the anchoring point of the thread. The knots are prefabricated and irreversible. They can only be
Tighten, cannot relax.
Use the knot pusher to move the knot to the appropriate position, use the thread cutter to cut the thread, and the first stitch is completed. It is very beautiful, with appropriate tightness and accurate position.
The tear opening is complex and irregular, and the suture gun needs to enter from different directions. Sometimes it is easier to enter through the inner opening, and sometimes it is easier to enter through the outer opening.
Yang Ping had already planned how many stitches to sew and how to distribute them. He first sewed up the stitches on the inner port. Then he moved the camera to the inner port, entered the suture gun from the outer port, and sewed the needles on the outer port.
Each stitch was placed quickly and at once, very easily and skillfully. There were six stitches in total. After the stitches were completed, horizontal, oblique, radial, flap-shaped, and several cracks were all sutured.
The meniscus was perfectly put back to its original appearance. If you look at the video of the suture, it seems that a few stitches were sutured on a normal meniscus.
This chapter is not over yet, please click on the next page to continue reading! Open the water inlet pipe to flush the joint cavity. Then close the water inlet pipe to attract water from the joint cavity and exit the camera. Yang Ping steps away while Song Zimo does the finishing work.
Dry the water on the surface of the knee joint with dry gauze, disinfect the skin with 75% alcohol, sew two small incisions, and sew one stitch on each side. Apply pressure bandage with cotton pad and elastic bandage, loosen the tourniquet, and the operation is completed.
Director Han stared at the screen. In just ten minutes, the operation was over, and the conversation topic was not even opened.
The stitching was perfect. A broken meniscus was restored to its original shape step by step. It was smooth and neat. The edges of the wound were neatly aligned. There were no wrinkles after stitching. It gave an artistic visual enjoyment.
This kind of effect cannot be achieved without a lot of surgical experience. To achieve smoothness and no wrinkles, the tension of each needle must be well controlled. It is not to control the tension of each needle independently, but to coordinate several needles.
, to achieve tension balance.
"Perfect!" Director Han gave him a thumbs up.
Huang Jiahui was standing aside just now. She had been very nervous and silently thought to herself not to jam the gun.
She watched the entire operation process, and Yang Ping's proficiency with the suture gun was as if he designed the instrument. It was even more perfect than the company's surgery demonstration video.
Just now I heard Yang Ping talk about how to deal with a jammed gun in an understated way. It turns out that he already had countermeasures. He still used his own products even though he knew about this flaw. I couldn't help but feel a little more grateful.
"Teacher Yang, are our instruments still handy?" Jiahui asked fearfully, and quickly went over to help Yang Ping untie the straps on the back of the surgical gown.
“Not bad, very good!”
"Thank you, Teacher Yang!"
"You should also prepare the equipment and consumables for anterior and posterior cruciate ligament reconstruction." Yang Ping told her.
This little girl hurriedly asked her brother to ask her out last night just to tell her about the shortcomings of the meniscus suturing gun. Whether it was because she was really honest or for other reasons, at least she was very attentive and would not treat people who are attentive.
"Okay, I'll send it over right away, together with the information." Jiahui was very excited.
The surgery center actually has some prepared, but since Yang Ping brought it up, Jiahui would definitely not say that the surgery center has them and ask others to get them.
If you are told to deliver it, deliver it! Don't leave the trouble to the customer, try to keep the trouble on your own side. This is what my brother told me.
"Is this domestic equipment okay?" Director Han asked.
Yang Ping said: "It's very convenient! It's no worse than imported ones."
"If you need equipment and consumables, please tell me at any time so that you can complete the operation with peace of mind." Director Han will do a good job in ensuring the operation at all times.
After the operation, the anesthesia faded, and Fatty Liang's skills became deeper and deeper. Zhang Lin helped the patient put on a knee brace, and Song Zimo gave the patient a pair of crutches to use: "Don't bear weight on this leg for six weeks, and recovery will begin in the afternoon."
Training, the doctor will explain the precautions to you in detail later."
The instructions in the operating room only focus on the key points, and the patient will not be able to remember them if they say too much.
Xiaowu captured several pictures of key nodes in the video system, then got them on his mobile phone and sent them to Yang Ping and Song Zimo. Song Zimo would communicate with the patient's family later.
At the door of the operating room, family members were waiting. When they saw Luo Xiaohu coming out on crutches, his parents immediately came to help him.
"The operation is so fast, how long did it take to go in?"
Father Luo asked worriedly.
Are you worried that something might go wrong if the operation lasts a long time? Are you worried that the operation might be done carelessly if the operation is too short?
Song Zimo showed the picture on his phone: "Dr. Yang is very skilled in doing this kind of surgery, so he did it quickly. Look, this is the meniscus before the operation, and this is the one after the operation. It's sutured. How beautiful!"
Father Luo looked at the pictures carefully and was very satisfied. There were messy cracks before suturing, and the meniscus was flat and flawless after suturing. It was almost impossible to see a crack in the meniscus. He was not a doctor, but he had an intuitive understanding.
Just like the quality of wound suturing, patients can see it even if they don't understand it. Good suturing is neat and the skin is evenly aligned, which is beautiful. Poor suturing is long and short, staggered, and the skin is unevenly aligned, which is ugly!
This level was finally passed, and Father Luo was relieved of his worries.
Yang Ping sent the picture to Su Nanchen, with a text briefly describing what he saw during the operation. He was recommended by others, and he wanted to hear back after the operation.
