Chapter 148 Morality is not enough, but justice is enough! (Second update, please subscribe!)
Dissociative motor and sensory disorders are originally neurological diseases. In these disorders, there is loss of movement or impairment of motor function, either as loss of movement or loss of sensation!
But later in the anesthesia field, this feature can be used to judge whether an anesthesia machine is good or not.
It is also a reflection of the professional level of a top anesthesiologist.
If I only want to lose your motor function, then you just can't move, but you can feel pain, itching and touch!
If I only want you to lose your feeling, then I will just block your pain feeling.
If your surgical site is below the knee joint, then I will only remove the pain below the knee joint. If it is above the knee joint, I will lose.
There is quite a sense that the King of Hell wants you to die at the third watch and does not dare to leave anyone alive until the fifth watch.
What is the anesthesia status of this patient?
Well, he still has a certain degree of pain in his calf, and his toes can still move!
But the pain in my thigh has disappeared——
This specific principle is quite complicated, but as a top professor, Qin Dingmo still roughly knows the basic principles completed by Yang Yifeng.
As far as the innervation of the lower limbs is concerned, the lumbosacral nerves such as the left femoral nerve and femoral nerve have already determined the distribution areas of sensation and movement before they are synthesized——
L1: Inguinal area (including the uppermost part of the thigh).
L2: Front of upper thigh.
L3: The front of the lower thigh.
L4: Anteromedial surface of the calf.
L5: Medial half of foot.
S1: Lateral half of foot.
S2: Outside the back of the calf.
S3: Behind the thigh.
The above is positioning. Dominant positioning means only controlling the target area, which is determined by anatomy.
Then, when the nerve roots come out, they can be divided into front and back roots. The control functions of the front and back roots are different, generally speaking!
The front root is for movement and the back root is for feeling!
So, Yang Yifeng, the wolf killer, directly removed the posterior roots of L1/L2/L3, but left the other positions untouched.
Moreover, in order to consider that the sensory control of L1/L2/L3 is not enough to block all the sensations in the thighs, he also performed a precise cutaneous nerve block!
Is this something people do?
Although it is theoretically possible, that is just theory. Normally, the spinal anesthesia is done from the L4/L5 gap. At most, one side of the thigh is numbed, while the function of the other side is still retained.
He is already a very skilled anesthesiologist.
As for how to determine whether movement and feeling are separated, the best way to prove it is.
A good anesthesia can be hard, but a bad anesthesia can be soft! (If you have experienced spinal anesthesia, you must know the feeling. No more below~——~)
Such precise anesthesia?
Qin Dingmo looked complicated!
I'm so stupid, what an anesthesia machine?
To actually be prepared to perform an operation on such a villain - it's simply God's fault!
How great would it be if other critically ill patients could have such good nerve block anesthesia?
Some patients with various complications are unable to undergo surgery because they cannot undergo anesthesia.
As the director of the anesthesiology department, Zeng Yi naturally noticed Qin Dingmo's examination at this moment. His pupils shrank instantly and his eyes widened. He was still thinking back one by one. How did Yang Yifeng kill those sensory nerves?
, which ones haven’t been finished yet!
"Is it okay?" Cai Dongfan asked Qin Dingmo.
The corners of Qin Dingmo's mouth twitched, which was blocked by the mask, and he nodded: "Okay, Director Cai, you can perform the surgery."
Yang Yifeng then said, "Then I'll wash my hands first! Director Cai, I'm going to insert the venous filter. It won't affect your surgical field. We can do it at the same time."
"But please help me disinfect the right groin."
Cai Dongfan, Luo Yun and others had naturally washed their hands, put on clothes, etc., and made all preparations before the operation.
"Okay, go and wash your hands." Cai Dongfan nodded immediately.
Zhang Zhengquan and Du Yanjun are doing the disinfection work.
After Yang Yifeng left the operating room, Cai Dongfan personally worked with Luo Yunzhoucheng to determine whether the preoperative surgical instruments were complete!
…
Soon, Yang Yifeng walked in again. At this moment, Zhang Zhengquan and Du Yanjun had just finished the disinfection work and were spreading towels.
After Yang Yifeng took the initiative to put on his clothes, he took a deep breath and calmed down the fluctuations in his heart.
Secretly saying to myself, this man is the lunatic who ‘drunk and drives’——
I just want to send him to where he belongs.
After thinking this, Yang Yifeng suddenly broke through some obstacle and opened his eyes.
Then he continued to apply drapes, because he wanted to do a venous filter implantation from the femoral vein to the inferior vena cava, so Yang Yifeng chose the right femoral vein.
For venous filter implantation, the commonly used routes are through the right femoral vein, the left femoral vein, and the right jugular vein.
Among them, the right femoral vein is the preferred route. Because the right femoral vein is straighter than the left side and has less anatomical variation. Therefore, choosing the right femoral vein approach will reduce unnecessary trouble during the operation.
After Yang Yifeng simply spread the towel, he took out the graduated puncture needle in the puncture bag.
Immediately afterwards, the circulating nurse pushed over the color ultrasound.
Femoral vein puncture is generally performed using the relatively safe Sedinger puncture guided by color ultrasound!
However, before the circulating nurse could reach Yang Yifeng's side, Yang Yifeng's hand had already taken the puncture needle and inserted it directly.
Blind penetration!
Cai Dongfan, Luo Yun and others were completing preoperative preparations on their left lower limbs, so they didn't see it. However, Qin Dingmo and others who saw Yang Yifeng's movements were gripping the ground with their toes, holding their breath, and their hearts seemed to be racing.
Jumped to the throat!
——
Brother, what are you doing is femoral venipuncture?
Not the chest, nor the venules!
Next to it is the femoral artery and the femoral nerve!
Qin Dingmo didn't know how to describe Yang Yifeng's behavior at this moment.
However, Yang Yifeng didn't feel anything. He chose a suitable angle, pushed the puncture needle in, and inserted a 14F arterial sheath catheter.
Although the puncture is a vein, arteriovenous catheters are universal, and Yang Yifeng has long considered inserting the filter into the inferior vena cava, which is the common pathway for venous return of both lower limbs!
So I chose the filter model in the inferior vena cava, which is 14F!
After the catheter is inserted, it’s time to place the guidewire!
During the process of placing the guide wire, Yang Yifeng did not start blindly in a frightening manner. Instead, he pushed the color Doppler ultrasound machine to his side, and then used the probe to accurately detect the vein shape and guide wire head, and then began to gradually place the guide wire.
Along the direction of the vein returning to the heart, it first enters the iliac vein and then returns to the inferior vena cava.
After roughly seeing that the distal end of the guidewire passed through the renal vein, Yang Yifeng stopped entering.
After roughly determining the lumen of the vein under color ultrasound, a bird's nest filter was selected.
Under the guidance of the exchange guidewire, the inferior vena cava filter is inserted...
This process was quite smooth. After putting it in, Yang Yifeng monitored it again for a while. After seeing that the blood flow was still smooth, he took out the guide wire, then removed the arterial catheter sheath and bandaged it with pressure.
However, after the pressure bandage, for the sake of stability, Yang Yifeng kept the ultrasound head in the filter position, continued to monitor, and said to Qin Dingmo: "Professor Qin, I will observe the blood again now."
It's so fluid that it's out of shape. If you need to monitor the fat particles in your heart later, you can just take it away."
Although Yang Yifeng had completed the operation, he was still a little worried.
After all, when he operated on his mother before, her mother died on the operating table. Although the risk of that operation was exponentially higher than the current operation, it was still a vascular operation!
If it weren't for sending this big brother in, Yang Yifeng felt like he wouldn't be able to pick up the operating equipment this time.
However, Yang Yifeng felt an unspeakable secret hatred in his heart when he thought that the murderer who caused the death of his parents was out on medical parole and free from justice.
Qin Dingmo nodded and said: "It's okay, you should check yours first. In orthopedic surgery, only when the bone marrow cavity is washed, a large amount of fat will drip back into the blood system."
"The patient himself does not have three types of fat, so he can do without it for the time being."
As a top professor, Qin Dingmo is quite familiar with the conditions of each department.
Fat embolism, in addition to mostly occurring in patients with high blood pressure, is more common in joint replacement surgery.
That's because during the process of polishing the medullary cavity, fat particles will enter the medullary cavity, and at this time, the stability of the fat droplets will be affected and may deposit and form thrombus.
If the theory is clear, you will naturally not be afraid. This is how to handle it.
Not a little more useless effort and preparation, just perfect.
However, about five minutes after Yang Yifeng finished the operation and walked under the timing panel next to him, Cai Dongfan, Luo Yun and others happened to reopen the patient's previously debrided and sutured incision.
The operating room door was stepped open.
Then Zeng Yi turned around and saw Huang Shinan, the director of the Department of Hepatobiliary and Pancreatic Surgery, but under the brand name of Vascular Surgery, walking in.
After he came in, he saw that the operation of Cai Dongfan and others had just begun, so he smiled and asked: "Director Cai, it seems that I came at the right time. Your operation has just begun?"
Cai Dongfan heard Huang Shinan's voice and still didn't turn his head. He just nodded: "Well, our operation has just begun."
When Yang Yifeng said that he was going to have intravenous filter implantation, he was actually a little panicked, so he called Huang Shinan and asked him to come to the operating room to take charge of the operation and make a judgment.
Otherwise, no one else would know how well Yang Yifeng did?
Cai Dongfan really worked hard for this patient.
However, Yang Yifeng had finished all the operations and Huang Shinan hadn't even arrived yet, so even if the job wasn't done well, there was no room for salvation.
I don’t know why Huang Shinan stepped in at this point.
However, Cai Dongfan didn't say anything. After all, Huang Shinan was also the director of the same department, so he had to show some mercy.
Only then did Huang Shinan see that there seemed to be an elastic compression bandage on the contralateral femoral sheath of Cai Dongfan and others, and there was a tall pile of sterile gauze and saline pad underneath.
This seems to be a sign that the war has ended?
Seeing this, Huang Shinan suddenly panicked and looked at the time. It had only been more than half an hour since Cai Dongfan called him. At that time, Cai Dongfan said he had just picked up the patient. Could it be that?
Then he glanced at Yang Yifeng and found that Yang Yifeng was already in meditation under the timing panel in the operating room.
"Director Zeng? Is the intravenous filter finished?" Huang Shinan asked in a low voice as he walked next to Zeng Yi who was making soy sauce.
Qin Dingmo couldn't figure out the origin of Huang Shinan, so he moved slightly away, but still gradually placed the color ultrasound probe at the heart, and opened the intravenous catheter in the upper limbs, ready to rescue the patient at any time.
preparation work.
Zeng Yi said "ang" and then looked at the surgical timing panel.
"It ended about four minutes ago, Director Huang." Zeng Yi is also the director, and he is also the chief director of the Department of Anesthesia. He is on the same level as Huang Shinan. They are all in the same position and are princes, so there is no need to be polite.
Then Zeng Yi saw the familiar look of confusion and astonishment in Huang Shinan's eyes.
This look had appeared on Yang Yifeng before when he was under anesthesia, so he was familiar with it. He smiled a little and felt balanced!
Because he was able to observe and learn, while Huang Shinan was only confused and stunned.
Huang Shinan suddenly complained secretly, rubbed his head, and silently turned away in embarrassment.
Just after leaving the operating room, Huang Shinan still couldn't figure out how Yang Yifeng put in the intravenous filter so quickly. He didn't see the process, so naturally he couldn't judge the filter implantation he did.
What's the level?
Of course, with such a fast speed, this guy must be able to penetrate blindly!
How much confidence do you have to have to put a filter into the inferior vena cava through blind puncture?
Or conceited?
It's hard for Huang Shinan to say, but from Cai Dongfan's tone and meaning, it can be heard that they have made the most extreme preparations in order to quickly discharge and turn around this patient.
If you don’t die, don’t go back to the ward, don’t enter the ICU, you will have to go directly from below to the prison through the 120 ambulance after getting out of the operating room!
One of the prerequisites for medical parole is that if the prison doctor cannot treat the condition, the patient must be transferred to a more professional hospital. However, post-operative care and medical instructions after the operation are still no problem.
…
Huang Shinan's departure, like his arrival, had no impact on the operation process.
Cai Dongfan and Luo Yun will assume the role of chief surgeons, which was discussed before.
The reason why Zhou Cheng hasn't started to take the stage yet is because, before it's time for him to take the stage, what Zhou Cheng has to do in preparation for this operation is the key part, and the key part won't be particularly long!
Therefore, after Cai Dongfan and Luo Yun completed the debridement, opened up the stumps of the femurs on both sides, and confirmed that there was no vascular damage, Zhou Cheng immediately used a measuring tape to measure the diameter of the upper and lower femoral stumps.
Although this operation can also be performed on plain films, after all.
The scope of the femoral bone defect is too large, and the upper and lower ends are stretched and deformed by the attached muscles, making it impossible to measure accurately and objectively.
After taking the measurements, Zhou Cheng exited the main stage of the operating table, then glanced at Yang Yifeng, lowered his voice and asked: "Brother Yifeng, I'm going to start titanium mesh shaping, do you want to discuss it together?
one time?"
When Zhou Cheng said this, he was actually a little hesitant. He actually wanted Yang Yifeng to learn the surgical plan design and techniques of bone transplantation for large segmental bone defects.
There are several main reasons.
First, Yang Yifeng is a doctor of trauma surgery. Although due to unexpected circumstances, his heart is no longer in medicine and he only thinks about writing novels. However, his talent and interest in medicine are still there.
Otherwise, he would not have been able to blow him up while simulating the copy, and he would have stayed with him all the way until he was fifty.
Yang Yifeng reset his life to zero again and embarked on the path of writing.
Second, since Yang Yifeng is interested in this, and the reality is that Zhou Cheng himself already has a perfect bone transplantation technique for bone defects, then he does not mind directly letting Yang Yifeng obtain a mature theory and finish him
The questions and regrets in my heart.
As for what Yang Yifeng would decide in the end, Zhou Cheng had no control over it.
However, with Yang Yifeng's talent, if he can enter the palace of medicine again, it will be a blessing for patients.
A single thread cannot make a strand, a single tree cannot make a forest, and the whole body is made of iron. How many nails can be driven?
There are many patients in the real world, and there are also many people in China.
Top-notch medical resources are always too empty.
Why are all the top hospitals so overcrowded today? It’s because top medical resources are severely lacking and demand exceeds supply. And Yang Yifeng is now someone who has gone very far on this road.
If he can continue to study, his future achievements will definitely be high.
When Yang Yifeng heard Zhou Cheng's invitation, he looked up at Zhou Cheng, smiled and said, "Okay, brother Zhou Cheng."
Yang Yifeng originally went to the operating room not only to save the patient's life and use the best anesthesia, but also to see Zhou Cheng's specific skills.
Now that Zhou Cheng actually dared to take off his outer shell, stand in front of him, and let him figure it out, that was naturally the best thing to do.
However, Yang Yifeng felt a hint of sincerity in Zhou Cheng's eyes. It seemed that Zhou Cheng sincerely invited him to discuss the surgical plan and mold together, and it was not just to show off or anything else!
Yang Yifeng stood 10 centimeters away from the equipment nurse's operating table, while Zhou Cheng stood in a corner. Then he put down the measuring ruler and started splicing the titanium mesh.
Titanium mesh, or medical titanium mesh, is a great tool for solving bone defects!
It has a strong structure, can be used to replace bone materials, and is cheap and affordable.
The most important thing is that the structure of the titanium mesh is very conducive to bone crawling and shaping.
Bone defect is also a type of fracture, and the principles of treatment are actually inseparable from the principles of fracture treatment itself.
First, reset.
Second, reliable fixation - it is necessary to borrow external fixation brackets for external fixation.
But the difference is that after a bone defect, in order for the bones to grow, a skeleton must be built, which is the skeleton for bone cells to crawl. Titanium mesh can provide just such a skeleton for bone cells to crawl.
However, the shaping of titanium mesh is very troublesome, because its conventional use process is generally acetabular capping, or bone-bonding internal fixation after femoral rupture. Bone defects like this need to be shaped with titanium mesh.
Forming a support is an extremely difficult method.
Yang Yifeng stared at Zhou Cheng's movements carefully, and then he saw that the originally strong titanium mesh was slowly shaped into a cavity shape under Zhou Cheng's hands, and the diameter was actually the same as Zhou Cheng's.
Measured, there is not much difference!
and!
Yang Yifeng's eyes were like those of a hawk. He noticed that the long titanium mesh structure formed a column structure, and the upper and lower lumens were still unequal. It seemed that the upper end was consistent with the fractured stump of the proximal femur.
.
The lower end is consistent with the fractured stump of the distal femur.
Yang Yifeng immediately had a ridiculous idea in his heart: "Brother Zhou Cheng, are you going to use titanium mesh to reshape a patient's femur?"
Yang Yifeng has a wide range of knowledge. There are methods currently used to reshape the patient's fracture according to the patient's fracture condition, but that is 3D printing!
That's a field!
3D printing is a combination of information technology and bone material technology. It can reshape a bone prosthesis according to the patient's own condition.
That's mechanized.
What can be made by mechanization can be made by our hands?
Yes, but can it be done so quickly?
Zhou Cheng nodded and said lightly: "Well, otherwise there is no other better way. Even if it is 3D printed, the prosthesis is not easy to place, so I can only use titanium mesh to make one myself."
The muscles in Yang Yifeng's limbs stiffened, and he held the phone tightly with his right hand, as if the outer shell of the phone was about to be broken by him.
Is this what you say is human language?
Do you think that the titanium mesh is just mud, and you can make a femur based on the patient's femur?
However, Zhou Cheng continued to knock, and then the traces of the outer femoral tube slowly emerged.
It seemed that in Zhou Cheng's hands, the titanium net was like the sand that a child plays with. It can be whatever he wants it to be.
Yang Yifeng couldn't see the specific details at this moment. He quickly checked the medical encyclopedia, then carefully observed the shape of the femur, and compared it with the titanium mesh jacket made by Zhou Cheng!
Then his eyes straightened instantly.
A layman can watch the fun, but an expert can watch the door!
If everyone's hands were as lucky and stable as Zhou Cheng's, would the treatment of large bone defects still become a constraint in the current medical field? Will it become a ceiling?
Won't!
However, when Yang Yifeng carefully looked at the titanium mesh shell, he discovered that Zhou Cheng had actually used the titanium mesh to pinch out a smaller titanium mesh sleeve at this moment!
Bone is a tubular bone.
The outer part is the bone cortex and the inner part is the bone marrow.
The medullary cavity is also a tubular structure.
Zhou Cheng's idea is easy to understand. He not only wants to reshape the bone shape, but also reshape the medullary cavity!
Is this a genius or a madman?
Yang Yifeng's mouth opened slightly.
The corners of his mouth began to tremble slightly. At this moment, he even felt that he was a little funny. Why on earth was he thinking about finding Zhou Cheng's flaws in the details?
Zhou Cheng's thinking is very normal, but it is also very abnormal and simply outrageous.
However, Zhou Cheng did not care about this. Instead, after comparing the two titanium mesh shaping, he felt that he was quite satisfied, so he took it to the operating table, and then said to Luo Yun and Cai Dongfan: "Mr. Luo, Cai Dongfan
Teacher, I’ve already done it here, let’s fix the titanium mesh first, shall we?”
In fact, the hospital below has already done the debridement of the patient, so there are not many debridement operations.
However, Cai Dongfan was not completely finished yet. He looked at Zhou Cheng, and then at Luo Yun, who was removing the autogenous bone from the iliac bone and making a pedicled bone flap from the fibula, and then started the iliac osteotomy.
He looked at Zhou Cheng: "Are you going to release it now?"
Zhou Cheng nodded and said: "Now, through the fixation and shaping inside the medullary cavity of the femur and outside the femoral cortex, the femur can roughly restore its original structure."
"After restoring the main body structure, the fixation with the external fixator will be more reliable and closer to the deformation of the femur itself!"
Zhou Cheng has completely let go of this operation and doesn't care about anything. Anyway, as long as Cai Dongfan dares to tell the truth, he will dare to do anything.
If they can still leave excuses and opportunities for patients to be released on medical parole, it can only be said that they are not strong enough!
The weight fell into the water, determined!
"Okay!" Cai Dongfan, whose scalp was numb, didn't ask much. Anyway, Zhou Cheng had brought him more than just this accident, and many of Zhou Cheng's operations and techniques had long exceeded Cai Dongfan's knowledge.
But maybe, what I know is not the limit.
On the other side, Yang Yifeng immediately threw his phone into his trouser pocket and ran out to wash his hands. He realized that his graceful and decisive step down before was too much for Meng Lang.
This is another peak in trauma surgery, another thing beyond the ceiling.
This thing pierced the deepest part of Yang Yifeng's heart.
He was interested and curious!
And because I was too anxious, I didn’t secure the phone securely and dropped it.
The circulating nurse shouted to Yang Yifeng: "Dr. Yang, I dropped my phone."
"Please pick it up for me!"
Didn't even look back.
Luo Yun also stopped taking the bones and said to Zhou Cheng: "Wait a while, Yi Feng obviously wants to see it."
Then he said to Zhang Zhengquan and Du Yanjun, who were frightened and confused at the moment: "You two need to watch and study hard. Today's surgery may not be repeated in the department for a long time."
"There are not many operating rooms across the country that can repeat such an operation."
"Same surgery? I checked the literature and found that the upper limit of bone transplantation for bone defects currently being performed is about 15cm!"
"Not much chance."
Luo Yun knew that this was a super-level IV surgery. With Zhou Cheng's temperament, he would never perform another surgery before getting a level IV surgery.
Moreover, Zhou Chenglai should not be allowed to proceed rashly, because Zhou Cheng's age and identity are still here after all. He has to accumulate slowly.
However, in order to provide snacks for Du Yanjun and Zhang Zhengquan, he had no choice but to sell Zhou Cheng.
Similarly, this was also said to Cai Dongfan, which means that it is better not to carry out such surgeries in departments. What Zhou Cheng has now obtained is only Level II surgical authority!
Du Yanjun and Zhang Zhengquan immediately took a breath of cold air, and made a negligible contribution to global air warming.
Turning his head to look at Zhou Cheng, he felt that Zhou Cheng was particularly strange.
Zhou Cheng silently licked his lips with his tongue, without saying a word. He was fully prepared for the operation, waiting for Yang Yifeng.
Yang Yifeng's interest and the roundworm in his stomach were brought out by him, and he brought it out deliberately, so he must be responsible for it!
Three minutes later, Yang Yifeng washed his hands and came on stage. After putting on two pairs of gloves, Zhou Chenggong began to install the inner titanium mesh into the medullary cavity!
Then after tying it securely!
Zhou Cheng transferred the battlefield to the fibula for bone retrieval.
However, Zhou Cheng's bone removal process immediately made Yang Yifeng and Luo Yun feel fear!
The reason why the fibula bone flap can be called a material for bone transportation is because the bone flap can be pedicled with blood vessels and can survive after transportation and transplantation.
However, most people take the part of the nutrient artery in the middle and upper part of the fibula.
However, Zhou Cheng shaved off the entire fibula and left at least six arteries around it.
???
Are there such arteries around the fibula?
Could it be that these arteries were usually tied off when I and others were doing dissection or surgery?
Can so many blood vessels and pedicles be removed from the fibula?
Zhou Cheng saw the doubts of Luo Yun and Yang Yifeng, and also saw that they had suppressed the churning of children with too many questions in their hearts.
My mind moved slightly.
In every subject, when it reaches the advanced level, most people will feel that they begin to become ignorant. What they know may not be the ultimate.
Zhou Chengdao said: "According to the existing anatomy reports, the normal fibula has one to two nutrient arteries on average, and the arcuate arteries have as few as 3 and as many as 10, with an average of about 6."
That’s all.
But this explanation was enough to enlighten Yang Yifeng and Luo Yun, but they still frowned.
Cai Dongfan felt bitter in his heart——
This team of your own?
Looks like he is the leader?
Du Yanjun and Zhang Zhengquan suddenly understood.
Oh, there are so many blood vessels, so that’s normal.
Don't you know that Zhou Cheng's words made Luo Yun and Yang Yifeng even more confused.
Because if there are so many arteries, where are they? What happens if they are usually separated by two during surgery?
This cannot withstand consideration.
The more you learn, the more afraid you become. This is the truth.
Zhou Cheng didn't explain too much, and it wasn't the time to explain too much.
The pedicled fibula that was finally removed was split open when carrying the bone flap. Although the split was split, Zhou Cheng did not damage its blood supply structure!
This tiny operation immediately made Yang Yifeng, Luo Yun and others feel numb again.
But they all had a tacit understanding and didn't ask any more questions.
It was agreed upon before. Although it was not stated explicitly, everyone made it clear that Yang Yifeng was responsible for the intravenous filter and anesthesia. No one asked him whether he knew how to do it and why.
Luo Yun is responsible for the reconstruction of the origin and insertion point of the tendon! I will not ask Luo Yun the principle behind it and why it is necessary to restore the origin and insertion point.
Zhou Cheng is responsible for bone transplantation.
Of course it’s not easy to ask too many questions.
After the fibula was cut open, Zhou Cheng placed it on all four sides of the titanium mesh, and then anastomosed the pedicled blood vessels one by one with the arterial stump in the femur!
After the anastomosis was completed, the proximal artery was opened and the blood vessels were filled immediately.
There are blood stains on the titanium mesh.
Comfortable!
It's like this. Ordinary doctors may be afraid when they see blood. They wonder whether people will die.
But real surgeons will feel relieved when they see blood.
Oh, the organization here has blood and will not die.
Of course, except for the surge of blood in the aorta.
——
Of course, this is not over yet.
Zhou Cheng continued to start the autogenous bone grafting of the iliac bone, and then used the low-priced bone grafting materials brought by the equipment dealer one by one to the periphery of the fibula block, and then covered the outer titanium mesh boxes one by one.
.
A reshaped femur is just finished.
Miraculously, it was completed!
Then, Zhou Cheng continued to perform external fixation with an external fixator. The upper part was fixed at the ilium, the upper part of the femur was fixed, and the lower part was fixed to the tibial tubercle.
The intact ilium and tibia were used to securely fix the femur, which had lost integrity and was unstable, and then the second step of the fracture surgery was completed.
Just, the treatment of bone defects.
It was reduced and replaced with bone grafting.
Fixed, internal fixation was replaced by external fixation bracket fixation.
Looking at bone transplantation for bone defects in this way is equivalent to understanding it.
After Zhou Cheng finished, he was not proud. After carefully making sure that the upper and lower parts of the femur were firm and reliable, he moved out of the way.
Then, it was finally Luo Yun's turn to take the stage.
Luo Yun doesn't know much about trauma, but he understands joints. The composition of joints is not just the joint structure, but also includes the re-fixation of the tendons near the joints.
After Luo Yun came up, he began to use Kirschner needles to create channels in the bones, and then began to return the starting and ending points of the muscles one by one.
This operation is also as smooth as a cloud...
This also slightly touched Zhou Cheng's knowledge blind spot, and he suddenly realized it.
Oh, it turns out that muscles can still be played like this?
Okay, learned!
Just go to the simulation at night, and you won’t get enough sleep if you don’t get it.
The volume of surgery determines the lower limit of surgical quality, but cognition determines the upper limit of surgical quality——
Gradually becoming less ignorant is the key to technological improvement.
...Outside the operating room, after Min Shi heard what Min Zhu said, the more he thought about it, the more something was wrong.
Then wait until Ding Meng leads people outside the operating room.
Min Shi reacted immediately.
But after he understood it, his face immediately became uncertain, and then he shouted: "No, no! Min Zhu, no."
"Can't operate, can't operate."
"We demand that the operation be stopped immediately! We will not perform the operation anymore." Min Shi began to shout to the operating room.
"It's a waste of human life. Come and see, everyone!" Min Shi started shouting and making a scene.
It's just that it's useless for Min Shi to shout like this.
Before the operation begins, the family members have the right to decide whether to operate, but once the operation begins, no one can stop the operation except the surgeon.
This is the power that the law gives to the operating room and the right to surgery.
Once the operation begins, neither the director nor anyone else can enter the operating room and interrupt the operation.
As long as the chief surgeon does not allow it, even if you are a god or a top professor, you will not be able to interrupt the chief surgeon's operation.
As long as it is written in the operating room that he is the surgeon, even if he makes a mistake, he cannot be forcibly interrupted!
That's the rule.
What's more, Ding Meng was here at this time, so he didn't even need to call the police.
The security guard immediately came forward to persuade: "Sir, this is an operating room. Please be quiet and don't disturb the patients inside for surgery. Otherwise, it will affect the progress of the operation and no one can take responsibility."
The operating room is a public area, even more special than the ICU, and any collision is strictly prohibited.
If you break in and cause the death of a patient inside, you will have to bear a heavy price. First of all, other family members of the patient will not agree.
There were many people waiting for the patient's operation to end. Someone immediately stood up and looked at Min Shi: "There must be something wrong with you. You are shouting outside the operating room at this time."
"They want to kill people, they want to take human life lightly, they want to be butchers in white clothes. They want to kill my brother-in-law."
"We asked to stop the operation, but we won't do it!"
"I have the right to ask to stop the operation!" Min Shi continued to shout, hoping to save one or two more.
However, it was obvious that Ding Meng and others did not give Min a chance. If he yelled at the door of the operating room like this, he could be taken back and imprisoned for a few days on the charge of seriously disturbing public order, and he could also be educated.
No other reasons are needed.
The operating room is a special public area!
This is not a place for messing around.
And by the time Min Zhu and others reacted, it was obviously even later.
Once the operation has begun, it cannot end midway.
At around six o'clock in the afternoon, Luo Sangen's operation ended fourteen minutes early. However, when he left the operating room, he was immediately taken over by the prison doctor brought by Ding Meng and others.
Moreover, Cai Dongfan and Zeng Yi personally escorted the transportation in the car~
After Luo Yun came out, he confessed to Min Zhu and others: "Hello, Luo Sangen's surgery has been successfully completed. The limb salvage surgery was extremely successful and his life is out of danger."
"If nothing happens and the patient recovers properly, he should be able to stand up in a year at the latest."
However, before Luo Yun could finish his words, Min Zhu, who was unexpectedly stopped by the security guard at the security line, hit Luo Yun on the head with his bag and even spat at Luo Yun!
Then she took off her shoes and threw them at Luo Yun.
"You are not worthy of being a doctor, you have no medical ethics, you are just a bunch of bastards."
"Human face and animal heart! Bah..." Then he was taken away by the security while being splashed around.
Luo Yun could only wipe the stains on his body feeling unlucky while continuing to explain to Luo Sangen's parents and others.
"We are just doctors. We are simply considering Luo Sangen's condition. We have gone to the limit of your limb preservation requirements."
"Recovering properly, then?"
But Luo Yun's words did not make Lao Ao and Lao Sua thank them. Instead, they pointed at Luo Yun and asked: "My son is gone, why should I keep his legs?"
"You are simply a bunch of cold-blooded animals!"
"Why do you want to operate on my son? Why? What good will it do to you?" Lao Si Si asked Luo Yun while covering his heart.
Luo Yun said: "He is a patient and came to our hospital to seek medical treatment. Naturally, we must do our best to provide him with medical services."
"No reason, just because we are doctors."
"After curing his disease, we will also feel happy because we have helped him solve his physical pain."
"As for the rest, we can't control it. The surgery is what you asked for. It's written in black and white, clearly."
"We were deceived, we were deceived!"
"You, you are a nest of snakes and rats, you?"
"You deliberately framed and deceived us. Is there any justice in this?"
"You clearly know that my son has to be transported away after surgery, why do you still need to operate on him?"
"Why?"
"Why are you?"
Luo Yun bowed slightly and bowed to Lao Nai: "I have completed what we doctors should do. Maybe you think we should treat illnesses and save lives, but in fact, we can only treat illnesses and save lives."
"I can't save anyone, I'm sorry."
After Luo Yun finished speaking, he turned around and looked back. His mood was actually quite complicated.
There is both happiness and disappointment...
However, when he entered the operating room dressing room, he saw Yang Yifeng, Zhou Cheng and others waiting for him, and prepared a lot of tissues for him, and Zhang Zhengquan also thoughtfully bought shower gel, shampoo and towels, etc.
back.
"Teacher Luo, go take a bath to get rid of bad luck." Everything is new and there is a bathroom in the operating room.
The corners of Luo Yun's mouth curved slightly and he nodded.
Doctors can't save people, they can only treat illnesses and save lives. The only one who can save people is himself. If Luo Sangen had not broken any laws or discipline, then he would not have been transferred to prison as soon as he got off the operating table!
However, when Luo Yun walked to the bathroom, he thought, if Luo Sangen did not kill anyone, given his family background.
Will such a perfect limb preservation technique be used today?
the answer is negative.
Yang Yifeng would not meddle in other people's business, and Zhou Cheng would probably not go beyond the level of surgery and come up with an unusual surgical plan.
Equipment manufacturers will not provide voluntary support, and patients will not be able to pay as much money as they originally need.