After the small lesson on unpacking surgery, everyone was still not satisfied and requested that the surgery pictures be slowed down and played again.
The chest cavity was split from the middle of the sternum and opened to both sides, and the spine was explored from front to back, all the way to the back, without any blind spots or omissions; similarly, the abdomen was also made longitudinally and opened completely to both sides, fully exposing the injured area.
.
In this case, there were two short nails on the wooden stake, and the nails hooked into the abdominal aorta. Looking at the picture, when the aortic injury was exposed, the nails were still hooked into the abdominal aorta.
The picture of the abdominal aorta injury was enlarged, and everyone was horrified and lamented. If the wooden stake was pulled out directly, the nails would continue to tear the aorta. The patient who was still breathing died in an instant due to massive blood loss, and there was no chance for surgery.<
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"Time is life! With this kind of surgery, one second can determine life or death!" Yang Ping added while standing on the podium.
Hurry up, hurry up, hurry up! This is the rhythm of this kind of rescue surgery.
Countless places are bleeding, just like countless faucets are broken and they are all spraying water. It is impossible to turn them all off at the same time, so you have to make a judgment on which one to turn off first.
Turn off the one that sprays water fastest first, and then turn off the following ones in sequence. This is the idea. This is the priority of the operation.
After solving the problem of sequence, the next step is how to stop the bleeding. For example, if the spleen ruptures, splenectomy is performed. Before the resection, it will still bleed. In order to reduce bleeding and control the risk to a minimum, vascular occlusion has appeared, which solves this problem.
Contradiction.
Just like there are so many faucets spraying water, I also know which one to turn off first and which one to turn off last. But there is no way, there is water everywhere, and I can't see where these faucets are? I finally saw it clearly, but I was in a hurry again.
Too busy.
In this way, first turn off the main gate and stop the water from all the faucets under the jurisdiction of the main gate. In this way, you can see clearly which one is the largest and which one is the smallest. You can then calmly close these faucets in order and repair what should be repaired.
Close directly. Close directly.
The main gate cannot be closed for too long. Others still need to use water. So try to complete the operation within the allowed time. After completion, open the main gate again and the faucet will stop spraying water.
Tan Boyun looked at the screen attentively. He is best at traumatology and orthopedics, and has made many achievements in this field. This kind of surgery is indeed difficult and risky. The surgeon must not only move very quickly, but also be very familiar with anatomy. This
In this case, the aorta is blocked at a relatively high position, after the brachiocephalic trunk is separated, and the blocking time can only last about twenty minutes.
According to the introduction, this operation was completed within twenty minutes. In just twenty minutes, it involved complex exploration, repair of the aorta, repair of the liver, repair of the pancreas, repair of the duodenum, repair of the diaphragm, and
Blood vessels are ligated at multiple locations to stop bleeding.
It is unimaginable how skilled this kind of anatomy is to be able to complete this series of operations within twenty minutes. If I were to perform the surgery myself, I would definitely not be able to complete it within twenty minutes.
Temporary blood vessel bridging technology or artificial blood vessel implantation must be used to stop the bleeding in the abdominal aorta so that there is time to slowly perform the following steps.
If it hadn't been for the meeting today and this case was presented, Director Tan would not have known that Yang Ping was so powerful and that this kind of surgery could be done so easily.
Fatty raised his hand, scratched his head and said: "Dr. Yang, you can be so powerful, but not everyone is so powerful. After you explain this operation, even if I encounter the same case, I still can't do it for you.
Is that so? Is there a way to make the surgery for such trauma patients simpler, such as taking pictures? What is the focal length of a professional camera and focusing on the light? It is extremely complicated. A point-and-shoot camera can just click on it, although it is not as good as a professional camera.
, but it is also a qualified photo."
Yes, Fatty got to the point and asked a question that everyone was thinking about. Everyone was waiting for Yang Ping to answer. Fatty narrowed his eyes and was also waiting for the answer.
Director Bai next to him said: "Yes, Xiao Yang, the operation must be able to be copied in batches. If it cannot be copied, it cannot be promoted. You must find a way to lower the threshold of this operation so that more people can be saved." Director Han said with a smile: "This is the topic Xiao Yang is going to talk to you about below, and it is also the improvement we want to make to the entire trauma first aid process. Xiao Yang has spent a lot of effort and made a modular surgical process, which I will get to you later.
Come out and discuss with everyone, please be patient and let’s watch the video of large-scale trauma rescue at the University of Tokyo Hospital first, shall we?”
Yang Ping returned to his seat to rest. Dr. Zhong came on stage and called up the video on his computer: "This is the rescue of a large car accident. The entire video starts from the emergency department and ends with the operation. It is a live video, and the whole process is tracked and filmed. Please watch
Just do it, don’t videotape it, don’t spread it, because this was done privately by friends who were studying there, and they also took the video to regularly improve on the shortcomings and strive for excellence."
The doctor who had just taken photos and videos with his mobile phone put away his mobile phone, and everyone began to watch the video seriously. This represents the world's top level of trauma rescue.
"First play the video at normal speed, and then play it at slow speed. When the video is played at slow speed, Director Tan will explain it to everyone." Director Han instructed Director Tan.
Director Tan said: "Okay, Director! Everyone should read it carefully so that I can be on target when I explain later."
The video started to play, and the ambulances carrying the injured were delivered to the lobby of the emergency center one after another. The patients' clothes had been cut off and only covered with special blankets.
The doctors and nurses in the emergency department who have been divided into groups are already waiting in the lobby. As soon as the wounded appear, they immediately take charge of their own injuries. The doctors make a preliminary judgment on the injury and arrange the next step of diagnosis and treatment. The nurse measures the vital signs of the wounded and performs blood transfusion and fluid replenishment.
There was almost no pause, everything seemed to be prepared in advance, and it was all completed while the flat car moved forward.
The flat cars began to be diverted in the lobby and pushed to different areas. Those who needed emergency surgery were sent to the surgery area; those who did not need emergency surgery were sent to another area.
The screen follows a wounded patient undergoing emergency surgery. He enters the surgical area, and the door is opened in advance. When entering the area, the first stop seems to be the CT room, where an emergency CT scan is performed.
The flat car and the CT platform are at the same height. This has been adjusted a long time ago. The flat car is connected to the CT platform, and the injured person is quickly and smoothly pulled to the platform. The stretcher does not need to be dismantled, and it can be used for X-rays and CT.
The wounded person began to undergo a high-speed CT scan. After the scan was completed, he immediately transferred from the other end of the CT platform to the connected flat car, directly pulled the stretcher, and then arrived on the flat car, and was pushed to the next stop - the operating room.
The operating room and the CT room are connected by a corridor in a straight line. The wounded come in from one side of the CT room. After the examination, they go out from the other side and are pushed directly into the operating room through the corridor. Doctors and nurses are waiting at the open door of the operating room to receive them.
, just push the flat cart to the door and hand it over to them.
The connection between the two stations is completely open and linear, without any obstacles or twists and turns. The wounded person enters the operating room, the flat car and the bed are flush with each other, and the wounded person is pulled to the operating bed, which is detachable.
The stretcher was then dismantled from both sides.
The doctors involved in the operation have already put on surgical gowns and are waiting. The assistants begin to disinfect and spread the drapes, and the surgeon reads the CT scan reports and images of the injured.
The efficiency is very high. This place has just been disinfected. Images and reports have been transmitted from the CT room. CT images and reports of the injured appear on the LCD screen. The control panel of the screen is covered with sterile film.
The surgeon directly controls and accesses emergency medical records and CT data. He reads the report first, quickly obtains information, and then looks at the three-dimensional reconstructed image. At the same time, there is also a surgical reference opinion that tells you where the injury is, what to do first, and what to do later.
Instructions have been given everywhere, including specific techniques.
This patient suffered from a torn aorta, ruptured spleen, and multiple ruptures in the duodenum. The surgeon first blocked the aorta, then repaired the aorta, then performed splenectomy, loosened the blockage of the aorta, and then performed the liver transplant.
Rupture, duodenal rupture, and other injuries were treated. The surgical process was quite scientific, and the operation was successfully completed.
From the moment the flat ambulance appeared in the emergency department, the entire process was like a precision gear. It was as if it had been rehearsed over and over again. No matter how you looked at it, you couldn't tell where it was unreasonable, where the connections were improper, or where time was wasted.<
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The whole process takes a little more than an hour. Most of the time is spent on the operating table, and the time is concentrated after the aorta is blocked. Therefore, most of the time, the patient is in a controllable state, that is, in the hands of the doctor.
Finally, the patient became stable.
From the emergency room to the operating table, including the CT scan in between, it took less than ten minutes, that is, only a few minutes to get to the operating table. An examination was performed, the extent of the injury was clarified, and a mature surgical plan was specified.
This is just a rescue operation for a wounded person. Several other rescue scenes are also switched out one by one. The rescue of each wounded person is almost as fast as possible without any delay. It is simply shot deliberately. The whole process,
The whole picture is smooth and neat, without a trace of clutter. Even after the operation, even the garbage in the operating room is put into its own bucket, without a trace of clutter.
One injured patient was treated with balloon interventional aortic occlusion to temporarily stop bleeding as soon as he entered the emergency department; another patient had multiple rib fractures, tension pneumothorax, and cardiac arrest, and his chest was opened directly in the ambulance.
Perform chest compressions.
After the scene was played, everyone took a deep breath and the entire venue fell silent. The doctor who had just made a joke said impatiently privately: What Japanese video are you watching--- and stopped talking.
Some people suspect that this is a fake, deliberately photographed for everyone to see? How could it be so fast and with such perfect cooperation? The rescue would be a bit messy and a waste of time.
"This is a video of one of their daily trauma emergency surgeries!"
Director Tan's words broke the silence and dispelled everyone's suspicion.
"Only their ordinary doctors participated in the operation. There was a scene just now of rescuing a patient with a ruptured liver and spleen. The surgeon was just a lecturer, who is equivalent to our attending physician. His operation took twelve minutes. The surgeon who performed the surgery just now had a ruptured aorta.
, for ruptured liver, spleen, and duodenum, the operation took one hour and was performed by a lecturer."
"Every one of their doctors of this level has this level of skill. Professor Fujiwara Masao has not yet performed this kind of surgery. He only repairs the aorta, and it never takes more than two minutes!"
"There is no gap without comparison. There is nothing to be afraid of if there is a gap. What is scary is hiding one's ears and not acknowledging the gap. Just now I heard someone say that they are very busy doing surgery. How can they watch Japanese surgery videos? How are they better than us?
?Now you see it? Do you know where the awesomeness is?"
Director Han stood up and spoke word by word.
"To surpass others, to be strong, you have to do it with your hands, not your mouth, you know?"