During the competition, Director Gao often went to the Orthopedics Department. In addition to observing surgeries and case discussions, he also thoughtfully asked what kind of help was needed.
His concern was not just verbal, but was implemented in action. Lao Gao assigned several young and capable doctors to support the comprehensive orthopedics department and help with writing medical records.
Knowing that arthroscopic surgery was the highlight of the first season of the national competition, Lao Gao mobilized outpatient doctors in the department long in advance to send suitable cases to the comprehensive orthopedics department.
During such competitions, Comprehensive Orthopedics has a large number of cases to choose from.
After Lu Gang's surgical plan was finalized, Yang Ping began to refine the details.
A thousand-mile embankment is destroyed by an anthill. Surgery is a job that pays attention to details.
One failed detail can destroy the entire operation effort.
Yang Ping is a rational person, he is full of passion, but he never relies on passion to achieve his goals, but uses scientific methods to achieve his goals.
Based on Lu Gang's objective condition, he solved the details bit by bit to help Lu Gang achieve the maximum surgical effect while making the surgery as safe as possible.
Even with the system, Yang Ping did not dare to be careless or relaxed at all for every operation.
Still maintaining an attitude of walking on thin ice and walking on a cliff.
Lu Gang's surgery required general anesthesia, and tracheal intubation was necessary for general anesthesia.
Therefore, tracheal intubation is a difficult problem at the first level.
The intubation for the first operation must be completed while Lu Gang remains awake.
Lu Gang's cervical spine was severely recurved and rotated, and his twisted and folded body made it extremely difficult for the catheter to enter the airway.
Although fiberoptic bronchoscopes can be used for guidance, there is a possibility that intubation will not be possible.
Once the intubation fails, anesthesia cannot be performed. Without anesthesia, subsequent surgeries cannot be carried out.
Therefore, Yang Ping not only has to solve the problem of surgery, but also helps Fatty Liang solve the problem of anesthesia.
When necessary, he would perform tracheal intubation himself.
Even if the intubation only lasts for a few minutes, as long as it is inserted, it will not cause pressure on the inner wall of the throat and trachea.
The osteotomy and release of bilateral knee joints and hip joints were quickly completed to widen the distance between Lu Gang's head and trunk.
In this way, Lu Gang can do the second step, the correction of the cervical spine.
After completing the correction of the cervical vertebra and obtaining a normal curvature, Lu Gang's head can be raised so that he can achieve a suitable prone position.
The third step is to complete the correction of the thoracolumbar spine in the prone position.
The final fourth step is to perform artificial joint replacement of bilateral hip and knee joints.
Lu Gang's bilateral hip and knee joints have developed double joint stiffness due to long-term contracture in the flexion position: soft tissue contracture outside the joint, and bony fusion has formed within the joint.
Only artificial joint replacement can allow him to regain normal hip and knee joints and restore normal walking ability.
Yang Ping has repeatedly thought about and perfected every detail, trying his best to make it watertight.
Fatty Liang has not been idle these days. After get off work, he stays in the laboratory to study Lu Gang's tracheal intubation.
Those rabbits suffered. The fat man fixed the rabbits in a twisted and uncomfortable position, used an infant endotracheal intubation kit, and repeatedly trained the rabbits.
If animal rights activists saw this scene, they would be so angry that they would vomit blood and have to beat the fat man in a group.
"Brother Rabbit, I'm sorry. In order to save people, I, Fatty Liang, have no choice. After the operation, I will provide you with good food and drink, and I won't let you suffer anymore." Fatty couldn't bear it and muttered.
After doing it for a long time, the rabbit was squealing, but still couldn't get in. The fat man was a little discouraged, so he hid in the bathroom and smoked a soft Chinese penis, and continued practicing.
Using a living rabbit as a training model is closer to reality. The fat man's fiberoptic bronchoscope can be put in, and the rabbit can tolerate it. But when the laryngoscope is put in, it immediately bites the laryngoscope due to stimulation and struggles desperately.
Fatty repeatedly told himself that if Dr. Yang's Everest-level surgery was affected by the failure of endotracheal intubation, then Fatty Liang's reputation would be completely ruined. Now Fatty Liang's reputation in the hospital is well-known, and several head nurses want to
Introduce him to his girlfriend.
Yang Ping saw him fail many times, put on rubber gloves, walked over to help him, and taught him while demonstrating: "You need to have a spatial image from the mouth to the throat, and then from the throat to the trachea in your mind, and you also need to have a pair of objects on your hands.
The touch of anatomy, you see, the rabbit is tied up with twists and turns, the airway is tortuous and complicated, it is no longer intubation under normal conditions, let alone the catheter, it is difficult to insert the fiberoptic bronchoscope."
Miyuki Fujiwara was practicing arthroscopy in the laboratory. She stopped training and leaned over to listen to Yang Ping's explanation, very seriously.
Yang Ping has tried many times in the system space, and he now teaches Fatty how to complete intubation in this extreme situation.
"Open the mouth a little and expose the epiglottis. Do you see the two holes? Look for the entrance of the hole and don't go in wrong. The front is where it enters the airway, and the back is where it enters the esophagus. The airway is curved, but there are still gaps. Otherwise, how can it breathe?
?
"Do you see the gap in the glottis?" Yang Ping asked the fat man to look, and Miyuki also came closer to take a look.
The fiberoptic bronchoscope is like a snake exploring the path in a deep and tortuous tube.
On the screen, like Counter-Strike from the first perspective, move forward, pause, move forward again, pause again, and go deeper all the way.
Under the guidance of the fiberoptic bronchoscope, Yang Ping held the laryngoscope in his left hand, inserted it lightly and quickly along the curvature of the back of the tongue, and gently lifted up the epiglottis cartilage at the base of the tongue, exposing the glottis to the electronic screen.
"When it inhales, you go deeper, seize the moment of inhalation, and make the detailed movements smooth and free."
The rabbit inhales and the glottis is open. The tracheal tube in Yang Ping's right hand is quickly inserted into the trachea, 4 cm beyond the glottis. Looking at the scale of the tube, it is about 18 cm from the incisors, which is very good.
Yang Ping pulled out the stylet, placed a dental pad, and withdrew the laryngoscope and fiberoptic bronchoscope.
"Stethoscope!"
Yang Ping auscultated the lungs on both sides and found that the breath sounds were normal, confirmed that the intubation was correct, fixed the catheter and the dental pad, injected 5ml of air into the catheter balloon, and closed the gap between the catheter and the tracheal wall.
Tracheal intubation was successfully completed. Yang Ping took off his gloves: "The difficulty is that the mouth, throat and trachea are not in a straight line, forming some bends, and some parts are flat. Every bend must be crossed carefully, and every flattening must be done carefully."
Be careful about expansion."
"The movements should be gentle, and try not to damage the inner wall. Even if there is topical anesthesia, irritation should be reduced. Because the topography of the airway is complex, it is difficult to get the topical anesthetic in place. Due to insufficient anesthesia, irritation will still be caused."
"The deeper you go, the more sensitive you become. The throat will cause a gag reflex, and the tracheal mucosa will cause a cough reflex. These reflexes cause restlessness and contracture, making it impossible for you to go deeper. Sufficient proficiency and flexibility are the prerequisites for you to go deep."
"The instrument should be flexible in the hand, adjust it according to the pipe, and don't rush in stiffly."
Yang Ping told Fatty clearly the key points, and Fatty kept it in his heart.
Besides Zhang Lin and Xiao Wu's surgeries, they were also studying Lu Gang's posture, how to cross the bed during several surgeries, how to position himself, and how to pull the hook to expose.
In this team, pulling the hook is not a simple matter.
There are more than a dozen 3D printed models, large and small, including full-scale models of the entire human body, small models, models of the spine, and models of the upper cervical spine and skull base.
Zhang Lin and Xiao Wu now use Lu Gang's full-scale model to demonstrate how to pose.
After several surgeries, the positions of each surgery were different, so Zhang Lin and Xiao Wu had to study it repeatedly.
Fatty has been practicing endotracheal intubation for a long time and is a little tired. He wants to take a rest and study postures with Zhang Lin Xiaowu.
Miyuki Fujiwara put on rubber gloves, took over the instrument from the fat man, and tried to practice intubation under this extreme state.
After inserting it several times without success, she asked Yang Ping for help, and Yang Ping had to turn around and teach her again and took over her bronchoscope.
Fujiwara opened the rabbit's mouth, and Yang Ping looked at the screen of the fiberoptic scope and guided her: "Pry it up as much as possible and open it a little, otherwise you won't be able to insert it."
Without damaging the teeth, the mouth should be opened as much as possible to expose the throat before intubation can be carried out. This special position requires high exposure skills.
"Don't be afraid. Open it a little more. Yes, we're going in. Don't move around. Very good. We're in."
Under Yang Ping's guidance, Miyuki tried several times and finally succeeded.
"Now go in, don't move around, and feel it for yourself." Yang Ping asked her to feel the feel of the catheter passing around the glottis and entering the trachea.
"It hurts a little!" Miyuki changed her hand to hold the catheter, moved her wrist, and began to fix the catheter.
During the endotracheal intubation just now, many movements were very painful, and the range of movement of the wrist was large, reaching the limit. After several attempts, I naturally became sore and painful.
"I'm too nervous, relax!" Yang Ping comforted her.
Zhang Lin Xiaowu and Fatty figured out the best position and asked Yang Ping to go over and see if it was suitable.
Everyone has no rest after get off work. Song Zimo has to prepare for surgery in the first season, and Xu Zhiliang has to plan for surgery in the following seasons.
Especially for robotic surgery, Xu Zhiliang has to arrange a certain number of cases for Yang Ping to do warm-up training, and Takahashi has to help them both with their work.
But Yang Ping forbids them to stay up late, preferring to slow down the operation rather than staying up late and sacrificing their health.
Sometimes there is nothing you can do. If you can adjust, try to protect your health so that you can work better.
Before ten o'clock in the evening, Yang Ping asked them to stop what they were doing.
Yang Ping also schedules a full schedule and has to go to Boss Cheng's place for surgery every Saturday.
Gleneagles Hospital in Malaysia also wants to invite Yang Ping to perform surgery. Yang Ping said that he will not be available until after the Golden Knife Award.
Although learning and training can be completed in the system space, things in reality also need to be done one by one, so time management is very important.
The duel between Song Zimo and Lin Hao also took place quickly, and each was fully prepared.
In the first season, arthroscopy was performed on the six major joints of the body, followed by transforaminal endoscopic surgery, and finally multi-ligament reconstruction of the shoulder and knee joints.
Doctors who love arthroscopy can't hold it in anymore. Lao Gao is like this, extremely excited.
Especially multi-ligament reconstruction of shoulder and knee joints, everyone is looking forward to it.
This kind of surgery is at the tip of the pyramid of arthroscopic surgery. It is too difficult and the effect is very poor. It was not a competition event in the past.
It has only been added as a competition event this year, so everyone will wait and see.
