Chapter 736 Bone tissue can also be frozen sectioned
After many twists and turns, Lu Jiangbei’s surgery finally began.
The anterior and posterior surgeries were performed simultaneously in a sitting position. Even August had never seen such an operation before, and he wanted to see how the surgery was done.
Although Robert majored in sports medicine, orthopedics and even surgery have many things in common, so he was also very interested in this surgery and wanted to know how to complete the anterior and posterior approaches at the same time while sitting.
Ivan is just a spectator. His interest has always been in plastic surgery. His goal this time is bone plastic surgery technology, and now he has another goal---skin culture technology.
After I finish my shift in the morning, the surgery begins.
Lu Jiangbei first lay on his back on the operating bed. In this position, he will be placed with an external fixator to temporarily fix his head and cervical spine.
Routine hand washing and disinfection.
The stent used for surgical fixation was opened and placed on the operating table. Yang Ping was going to insert this stent. With the protection of the stent, his head, cervical spine and body were firmly fixed on the operating table.
After being properly fixed, the electric operating table is adjusted into a beach chair style. The patient sits on the operating table with the buttocks as the fulcrum, and the slightly backward leaning backrest is close to the back, and then the shoulders and above are all freed up, which facilitates surgical operations.
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Although the fixed stent also interferes with the operation, it is an empty structure after all, and the room for operation is very large.
The sitting position has been set, and the mouth is kept open with the help of the spreader.
Disinfect the sheets again.
The operating light shone into the mouth and illuminated the posterior wall of the pharynx. Yang Ping looked inside and then asked the circulating nurse to turn off the operating light.
He planned to use an endoscope to assist in completing the operation, and the endoscopic system of the otolaryngology department was borrowed for this operation.
August's eyes widened: Endoscopically assisted transoral approach, Shenma uses this method to perform surgeries, and the professor always does what ordinary people cannot do. Calling him a demigod is not an exaggeration at all. Under the idea of open surgery, a very difficult operation becomes much easier with the assistance of an endoscope.
On the high-definition screen, the image seen by the lens is transmitted to the screen in real time, and then Yang Ping watches the screen and operates.
Cut the posterior pharyngeal wall, expose the front side of the upper cervical vertebrae, and then separate it bit by bit, all the way up, you can clearly see the base of the skull, between the base of the skull and the atlas, and between the atlas and the axis.
All the ligament structures were broken, and the horsetail-shaped crack showed that this was some kind of stretching or torsional force that tore all the ligaments.
Then all the force stopped abruptly after the ligament ruptured, that is, the violence stopped until the ligament ruptured, and did not spread or extend anymore.
What a good luck it is to be like this. As long as the violence is not resolved at all, if it continues, the atlanto-occipital joint and the atlanto-axial joint will be damaged under the twisting or stretching force. This is why such patients are prone to damage.
Cause of most on-site deaths.
And this boy, after violently tearing off his ligament, stopped extending it, just like a car that lost control and rushed towards the cliff, relying on the friction of the ground, it actually stopped on the edge of the cliff.
The images captured by the endoscopic camera were very clear. August was surprised at the child's luck, while Robert was searching his brain and finally found a sentence: "This is the smoke coming from the ancestral grave."
Everyone turned their heads and looked at Robert who spoke astonishingly. They were astonished after three days apart. This kid's Chinese proficiency has reached this level.
Before the exclamation was over, Robert said again: "It's not enough to smoke, I guess I have to breathe fire."
With the help of an endoscope, Yang Ping has completely revealed the upper cervical spine and the first half of the occiput. The atlas has indeed been shattered and cannot be fixed at all. He bites off the front arch of the atlas bit by bit.
After dealing with the bone fragments and soft tissue on the front side, for the sake of safety, the entire atlas bone was temporarily abandoned. The bone cyst of the atlas was located on the left lateral mass of the atlas. Before confirming the nature of the tumor, Yang Ping only
It can be regarded as a malignant tumor, and extra care should be taken during the operation to prevent the spread of tumor cells.
This is the tumor-free technology of oncology surgery, which aims to prevent tumor cells from contaminating surrounding tissues during surgery, causing tumor cells to scatter like seeds.
A small piece of soft gauze is stuffed in, then spread out around the surgical target site, and then inserted into the rongeur with a long handle and a sharp tip. The pliers open their mouth and bite off the bone in small bites, each time biting off the bone.
When the quality was brought out, it was stable and not a single bit of debris was scattered.
The operation was steady, brisk and easy. After the bone fragments were taken out, a larger piece of bone tissue was taken out.
"One more person comes in, opens a new instrument table, opens the bone tissue, and the cyst is inside. The bone tissue is sent for postoperative paraffin sectioning, and the cyst fluid inside and scrapings from the cyst wall can be used for frozen sectioning.
, we are waiting for the frozen pathology results to decide whether to recycle the atlas." Yang Ping did not loosen the pliers in his hand.
The circulating nurse has set up a sterile instrument table. Yang Ping placed the rongeur and the bone block on the sterile table together and changed the gloves himself.
Zhang Lin and Xiao Wu in the audience began to wash their hands and came on stage, and began to process the bones according to Yang Ping's requirements.
Soft tissue is suitable for frozen section. Frozen section can usually produce results in half an hour, so intraoperative pathology is all about frozen section, while paraffin section takes several days, so it is not suitable for intraoperative pathology but is suitable for postoperative pathology.
For tumor surgery, intraoperative frozen sections can clarify the nature. The surgical methods for benign and malignant tumors are completely different. Surgeons often need to decide the next surgical plan based on the pathological examination results.
The surgeon can wait on the operating table for half an hour, but it is impossible to wait for several days.
"See Wen Ru for frozen sections! Call him." Yang Ping ordered.
Dr. Wen Ruzheng, a doctor in the Department of Pathology, is famous in Sanbo Hospital. He once made a bet with Yang Ping and ran around the hospital naked in his underwear. Because of this streaking, Dr. Wen in the Department of Pathology became famous and everyone knew about it. Frozen section is a test of a doctor's ability. In order to reduce the possibility of errors, Yang Ping chose Dr. Wen himself.
Dr. Wen's professional skills are beyond praise. He likes to be sharp. After losing to Yang Ping last time, he worked even harder. It is said that he has been engaged in some scientific research recently.
Robert in the audience has completely regarded himself as a member of the General Surgery Department. As soon as Yang Ping finished speaking, Robert took out his mobile phone and called Dr. Wen.
August looked at this socially awkward patient. He looked like an old employee of Sanbo Hospital, and he actually had the pathologist’s phone number.
"Professor, Dr. Wen said that he can also freeze bone tissue. Just send it over and give you the results within half an hour." Robert replied after calling.
"Bone tissue can also be frozen sectioned?" Xu Zhiliang felt that Wen Ruzheng was bragging.
Song Zimo said: "He has been mysterious recently. I heard that he is always asking for bone fragments in the operating room for scientific research. Could it be that he is studying bone tissue and making frozen sections?"
"Yes, I heard that he went around saying hello and collecting bone tumor specimens during surgery, leaving no one behind." Li Guodong added information.
This guy can do frozen sections of bone tissue. It would be great if he could do it. The nature of the cyst can be more accurately determined during the operation. I'm afraid this guy is bragging.
"Ask him if he is bragging. Human lives are at stake in this kind of thing. If he is bragging, it is not as simple as running naked." Song Zimo asked Robert to call the phone again and he said.
The call was dialed: "Old Wen, it's me, Song Zimo! ---"
A gentle and upright voice came from inside: "Have the specimens been sent? Shit, I doubt my level, Song Zimo, let me tell you, I am a gentle and upright gentleman, I don't brag, I don't lie, I don't fall in love without getting married, I don't ---" <
