Before the operation, Yang Ping had to have a brief communication with Guo Jingyao, and Dr. Huang and Dr. Lin were both at the bedside.
In Yang Ping's eyes, Guo Jingyao is just one of his many patients.
The doctor must get on the operating table clearly, and it is best for the patient to get on the operating table clearly. This is the purpose of communication.
Even if he has a net worth of hundreds of billions, he is no different from an ordinary person on the operating table. His body is still composed of anatomy and operates according to physiology.
Ancient people often wrote books about famous people who were born with different appearances. Either their arms reached above the knees, or their ears were so big that they drooped over their shoulders. From a medical point of view, this should be considered a deformity.
Like ordinary patients, Guo Jingyao longs to regain feeling and strength in his legs, and to stand up without having to rely on a wheelchair.
He asked a lot of questions about the details of the operation, some of which were very childish and even laughable, but Yang Ping still patiently explained that he did not want his patients to go to the operating table in an uneasy mood.
At nine o'clock the next morning, Guo Jingyao's surgery officially began.
The operation is arranged in a 100-level laminar flow hybrid operating room, which facilitates postoperative DSA angiography to confirm whether the fistula is truly closed.
A team of Chinese doctors recharged their batteries and entered the operating room under the leadership of Dr. Huang.
Dr. Huang and Dr. Lin accompanied Yang Ping, helping to open the door, get slippers, and take out clothes.
Zhang Lin not only has a new hair style, but also new clothes, belts and shoes. The clothes also have a faint machine smell from new fabrics.
This operation requires entering the spinal canal, and there is also the possibility of performing intraspinal vascular anastomosis. In order to reduce the probability of infection, unrelated personnel are prohibited from entering.
Except for Dr. Huang, Dr. Lin, the anesthesiologists and nurses who assist the Tiantuan Group, other personnel are not allowed to enter the operation. If you want to watch the operation, you can only watch it through video in the viewing area of the operating room.
Among those barred were Augustus and Milton.
Yang Ping is the chief surgeon, and he has the absolute power to make some regulations. These regulations have only one purpose: to make the operation as perfect as possible!
Guo Jingyao was lying on the operating table, his body was shaking a little, and his heart rate was also accelerated, reaching 105 beats/min.
"Don't be nervous!" Fatty comforted him.
His voice was also trembling: "I'm not nervous, but I just can't control it."
Not nervous? Your body doesn’t lie. Fatty pushed the sedative through the vein and started the induction of anesthesia.
Under the influence of the sedative, Guo Jingyao's body stopped shaking and his heart rate fell back to the normal range: 87 beats/min.
The tracheal intubation was successful and the anesthesia machine was connected. The Zeus anesthesia machine uniquely realized the integrated integration of the information processing engine system and the vital signs monitoring system.
The patient ingests anesthetics through breathing, and through the circuit system, the anesthetics are sent into the alveoli, enter the blood from the alveoli, and then flow along the blood in the blood vessels. The anesthetics diffuse to all parts of the body, shielding the perception of the central nervous system, achieving
The purpose of general anesthesia.
Guo Jingyao's spontaneous breathing was temporarily suppressed by the anesthetic, and his breathing was taken over by the anesthesia machine.
The fat man made a handsome gesture of OK: "The anesthesia was successful!"
Dr. Lin is in the audience and Dr. Huang is on the stage. For this kind of surgery, all the surgeons cannot be foreign doctors with temporary licenses. There must be doctors with normal licenses.
The interventionist, Dr. Zhou, performed one femoral artery puncture and cannulation on Guo Jingyao in the lateral decubitus position, leaving it for post-operative DSA.
After the femoral artery catheterization is completed, the patient changes from the lateral decubitus position to the prone position, lying on a special prone frame for spine surgery.
Zhou Can, a circulating nurse, protected the bony protrusions with soft pads; the abdomen was suspended in the air to avoid squeezing and causing congestion of the spinal venous plexus; the eyes were fixed and protected by glue in the closed position; the urethra was checked to be unobstructed and the genitals were not compressed.<
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If every detail is perfect, the whole composed of details will be perfect.
Hand-washing and disinfection drape, 3M disposable sterile drape, cover it one by one, exposing only the surgical part.
Song Zimo connected the sterile handle to the shadowless lamp, and used the sterile handle to adjust the height and angle of the shadowless lamp to the optimum.
"Start pre-operative pause check!"
Everyone immediately concentrated and stopped everything they were doing.
"Surgery patient Guo Jingyao, male, 60 years old, hospital number ---"
"Correct---"
The doctors and nurses participating in the operation unanimously said that if they have any objections, they must raise them on the spot. This is a right and an obligation.
"Very good! I'm going to start the operation now, knife! ---"
Preoperative check-up is a serious task and should not be taken lightly. It is a final determination of the surgical patient, surgical site, and surgical method.
A surgical patient needs to be checked three times before entering the operating room from the ward for surgery, once when picking up the patient in the ward, once before entering the operating room for anesthesia, and again before the surgeon operates.
Taking the trouble to check, we will minimize the mistakes of doing the wrong patient, wrong part, and wrong surgery.
On the screen in the viewing area, during the pre-operative check-up, August, Milton, and Atsushi Kobayashi stood straight and respectful, as if they were actually there.
This sense of ritual can always remind the surgeon to remain in awe of surgery and life.
The yellow line on the floor next to the operating table is a prohibited line. People observing the operation must stay outside the yellow line.
If you cross the yellow line, it will easily cause contamination in the operation. Once contaminated, there is a risk of infection. Infection is a catastrophic consequence for any operation, especially orthopedics, which is simply devastating.
In the barbaric era of surgery, there was no disinfection, no anesthesia, and no hemostasis and blood transfusion. In this three-no surgery era, even a simple amputation operation had a mortality rate of 50%, including death from pain, death from bleeding, and death from infection.<
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It is hard to imagine that at that time, in order to stop bleeding after amputation surgery, doctors would press the bloody limbs into boiling water or boiling oil, and the patients would often faint from the pain.
At that time, being alive after surgery was a lucky thing. Whether you could survive or not depended on which side of the coin was tossed.
After solving the three major technologies of disinfection, hemostasis, blood transfusion, and anesthesia, surgery officially entered the modern era.
Dr. Lin Mingyuan, the only on-site observer, consciously stood outside the yellow line.
The noise from the air handler and air conditioning system, as well as the "breathing" sound of the anesthesia machine, have become the background sound in the operating room, and everyone has long been accustomed to it.
Yang Ping was wearing a surgical gown, a sterile cap and a mask, and his exposed eyes were also protected by goggles. Song Zimo stood opposite, and Zhang Lin Xiaowu stood next to them.
The knife in the hand is like a pet that has been kept for many years, possessing spirituality.
A ten centimeter longitudinal incision was made, the skin was cut through with one knife, and the deep fascia was cut with an electric knife. The bright red bleeding spots were eliminated by double-click electrocoagulation at the initial stage.
Perform subperiosteal dissection along one side of the spinous process to reduce bleeding.
The paravertebral muscles are peeled off from the spinous process and lamina, close to the bone surface.
Snow-white gauze was held in Song Zimo's hand, ready to be used to compress and stop bleeding, but it never came in use.
The less surgical bleeding, the less interference with the patient's physiological functions, and the better it can reflect the surgeon's surgical level.
Several cameras on the shadowless lamp shoot the surgical area from different angles and transmit the images to the screen.
There is no unnecessary movement, and every step is extremely concise.
In less than three minutes, the surgeon exposed the lamina without blood, the automatic retractor was put in, and the surgical space was revealed.
The surgery seemed very easy and the movements were extremely precise. This kind of surgery has entered another realm.
"Can you do this? After entering the lamina, you haven't used gauze yet?" August asked.
Milton shook his head: "I can't do it, and you can't do it either."
"Does he have magic that can temporarily stop the patient's blood flow?" August always has some weird ideas.
"Remember, you are a doctor." Milton reminded.
"Doctors are divided from wizards."
"Why didn't you say you were a barber?"
"The first doctors in Europe were barbers. The red, white and blue marks at the door of the barber shop originally represented blood, the white cloth used to wipe blood, and veins."
"If a window is opened in the lamina, doesn't he need to use some anatomical landmarks or imaging methods to locate it?"
"If the route is extremely familiar, why bother navigating?"
"Opening windows with lids is my specialty."
Opening the window requires excellent techniques. The window is opened from the lamina. The outer surface and the inner surface of the lamina are different in size. It is the same as the principle of a manhole cover. The outer opening is large and the inner opening is small. After the operation is completed,
The cover can be reset and it just fits in without sinking in.
In this way, the back of the vertebrae is protected, there is no bone defect, and the stability of the spine is better.
The lid was lifted and the thecal sac was exposed.
In the middle of the spine is a hollow bony tube, which contains the spinal cord. The spinal cord, like the brain, is the nerve center of the human body, but the brain is a high-level center and the spinal cord is a low-level center.
The spinal cord is similar to soft tofu, very delicate. It is covered with several layers of membranes, the outermost layer of which is the dura mater. This operation must be performed outside the dura mater.
"The fistula has been found, just under the window." Milton looked at the screen.
"With such precise positioning, he is at least five years ahead of us." August sighed.
"No, there is no one else here, it's just us. We can be bolder, so why not ten years." Milton was very serious.
"Oh my god, the blood vessel is really domineering in front of the arteriovenous fistula, and it can't be retracted, damn thing."
"Only a little gap can be exposed. It is very difficult to complete the operation in the gap."
Under the microscope, two small rubber strips gently stretched the blood vessels a little, revealing the space for operation.
The surgical target was lying quietly under the window. It was cunning and cunning, and escaped rounds of case analysis, and finally fell into Yang Ping's hands.
"It would be great if there were surgical robots for microsurgery. Only with sophisticated robotic arm terminal instruments and 360-degree movement directions can we cope with this kind of surgery."
"Could it be that Dr. Yang's wrist and fingers can move 360 degrees?"
