Chapter 233 Huh? What Are You Telling Me To Watch?
Chapter 233 Huh? What do you want me to see! (Please subscribe!)
Although Zhou Cheng's words surprised everyone, they did not cause commotion or special shock.
Zhou Cheng's strength has been obvious to all in the past few days, from Gui Lao, who is an academician, to graduate students and even interns. His clinical strength is undoubtedly the most powerful among all the young people present.
, he can even break the age limit and is even more powerful than Peng Peng.
As an imported talent with the ‘privilege’ to carry out ground-breaking qualitative surgeries on his own, Peng Peng can perform open reduction and internal fixation with small incisions that have never happened before in training courses.
Zhou Cheng's strength is not weaker than Peng Peng. Everyone has seen it. Naturally, no one thinks that there is anything wrong with Zhou Cheng's suggestion that this patient is suitable for hip preservation, or that there is something wrong with such a suggestion.
.
However, it is definitely not possible to simply put forward this concept. We are all not laymen. You can say it, but you have to persuade and give your own reasons. It is not the kind of thing where I say yes, or,
People in the past said it was okay.
It needs to be explained in an understandable way, or at least logical!
Although there was no commotion, mutual discussions were still inevitable, and many people began to turn on their mobile phones or search for literature.
Because what Zhou Cheng just said, although it was just a few simple words, contained a lot of content, and it was very difficult to remember it clearly.
Maybe they feel that they have missed something.
Then, as the subject of Zhou Cheng's questioning, Lu Qianzhou took a deep breath, looked at Zhou Cheng for a few times, and said, "You can choose to perform hip arthroscopy."
"Mr. Gui, I think that since Xiao Zhou has thought of using arthroscopy for hip preservation treatment, we should give him such a chance. After all, this training class is open in nature."
"Xiao Zhou is a person who has the ability and strength to express his own views and opinions, make his own innovations, and even create a genre."
"What's your opinion?"
Although Lu Qianzhou was surprised by Zhou Cheng's words, he did not suppress him at all because of Zhou Cheng's surprise. Moreover, as a person of Lu Qianzhou's level.
Naturally, we know that the reason why all surgeries exist is because non-surgical intervention cannot handle the problem well, so surgeries are introduced.
The reason why Level IV surgeries exist is because all surgeries under Level IV surgeries cannot meet the surgical requirements.
The fundamental purpose of all surgeries is not how beautiful it looks or how well it performs. It is about treatment.
However, whether Zhou Cheng is qualified to start the operation still depends on the opinion of the organizer.
In fact, deep down, Lu Qianzhou didn't really hope that Zhou Cheng could use hip arthroscopy to perform hip-preserving surgery.
After all, although the surgery Zhou Cheng is getting now is the lowest difficulty, if he can achieve the therapeutic effect by lowering the level of surgery, then the corresponding difficulty will be completely different.
However, although there is currently a concept of hip preservation, it is actually for femoral head necrosis.
Osteonecrosis of the femoral head (ONFH), also known as avascular necrosis or aseptic necrosis, is one of the most common causes of hip joint disability in young adults.
There are three stages of femoral head necrosis, namely 1. Ficat stage: also known as Ficat-Arlet stage, which can be divided into stages I-IV.
2.Steinberg stage I-VI,
3.ARCO stage I-IV.
Each of these three stages has its corresponding scope of application for hip preservation surgery.
Hip-preserving treatment, in terms of treatment methods, starts from the simplest, including lifestyle changes, and then drug treatment.
However, the indications for drug treatment and the drug treatment plan of the hip-preserving strategy involve a wide range of drugs, and currently no drug is widely recognized.
Currently, supportive drug therapy is used to preserve the hip, which has a certain therapeutic effect on Ficat stage I/II or Steinberg stage I/II/III ONFH, and can also be used as a supplement to other hip-preserving treatment options.
Currently, several hip-preserving surgeries are suitable for hip preservation, and they are generally suitable for Ficat stage I/II or Steinberg stage I/II/III, and ARCO stages I-C and II.
The cases selected by Zhou Cheng were staged beyond the current stages suitable for hip-preserving surgery.
If we really need to stage them separately, they should be Ficat transition stage, Steinberg IV stage A, and ARCO stage III A. It meets the surgical indications for total hip replacement, but does not meet the surgical indications for the eight commonly used hip-preserving surgeries.
.
Therefore, it was only after comprehensive consideration that total hip replacement surgery was performed.
The symptoms are obvious and the pain is very severe.
After looking at Zhou Cheng, Mr. Gui hesitated a little, but then looked at Pin Lu, as well as Su Min, Yu Heng and others next to Zhou Cheng with doubtful expressions and expectant eyes.
Then he even saw the students in his hospital looking forward to opening up and giving Zhou Cheng the freedom to perform surgery. He still nodded and said, "Okay."
"I agree. But this is a similar super-class surgery only this time!" Mr. Gui finished and added.
"If the subsequent surgical arrangements need to change, please inform us in advance and we will reduce the number of operations and the number of operations."
"We are responsible for the patients!" Mr. Gui said after careful consideration.
However, Mr. Gui's words immediately made Lu Qianzhou, who was also standing, slightly stunned and looked at Mr. Gui.
Understood everything.
Mr. Gui just said that this kind of super-class surgery is only happening once!
This means that yesterday's three small-incision open reduction and internal fixation surgeries were all arranged in advance and signed by the patients and their families.
In other words, Peng Peng was arranged, but the other two patients?
Is it Zhou Cheng who is also one of the potential challengers arranged by Mr. Gui?
If so, then why didn't Gui Lao and Zhou Cheng reach an agreement on today's surgical method?
In other words, Zhou Cheng and Gui Lao have nothing to do with each other?
When Zhou Cheng suddenly proposed this exceptional operation, one of the reasons why Lu Qianzhou supported Zhou Cheng so strongly was to test whether Zhou Cheng and Gui Lao could reach an agreement.
With Gui Lao at the ready, there is no need to make any special arrangements. First, see if hip arthroscopy can achieve the effect of hip-preserving treatment. If not, you can continue to switch to open surgery.
If it can be successful, then someone will come out of the operating room during the operation to discuss and communicate with the patient's family and inform them that the patient's current operation is not a major operation like hip replacement, but a minor operation. .
This is very troublesome, and there will even be more troubles later, but for Lu Qianzhou.
worth!
After Mr. Gui nodded in agreement, whether it was the joint surgeon in the operating room or Pin Lu and others, they all signaled to the circulating nurse in the operating room, asking her to cooperate with Zhou Cheng's ideas and requirements and get the instrument kit.
Different surgeries require different instrument packages.
Because the surgeries prepared in advance are different, if you want to change the surgical method, you need to change the instrument package and get it temporarily.
It was troublesome, but the traveling nurse was not unhappy.
Then, Pinlu went to explain to the director of joint surgery: "Lao Xin, I'm sorry, the accounting for this surgery is still in your department."
It seems like they just changed the way of surgery, but in fact, the things involved are very troublesome.
In the third hospital, joint surgery and sports medicine are separated, and sports medicine does not have joint surgery patients.
If such teaching is needed, then Mr. Gui must of course contact Director Xin of the Department of Joint Surgery. As an academician of sports medicine, it is not difficult for Mr. Gui to perform a few surgeries to demonstrate.
However, if you want to take patients from joint surgery and change the surgical method at will, it will not only increase the difficulty of the work of other departments, but also cause disputes over interests. Originally, the surgery fees for joint surgery have to be paid to their departments.
This is very realistic.
However, Professor Xin, who seemed quite wealthy, could only say something to Pin Lu: "It doesn't matter if he keeps accounts or not! Professor Pin."
"I just think that since these people come here to do sports medicine, they should just study sports medicine. Why should joint surgery be involved?"
Pinlu quickly understood the meaning of Professor Xin's words. During this training, none of their joint surgery staff showed up, and they did not get the opportunity to learn. And, more importantly, they came and were used as foils. .
Just two freaks, Peng Peng and Lu Qianzhou, it's simply a matter of who will fuck and who will die. Is there anyone in the country who can restrain them?
It's probably difficult.
Pinlu said: "Professor Xin, we don't have any students in our department. We will not show favoritism in this training class. All master's and doctoral students in our hospital are in large classrooms and there are no private classes."
"Besides, Professor Xin, if it was just a private lesson, then Lu Qianzhou wouldn't be talking about joint surgery courses."
"This is a very purely academic exchange."
Professor Xin rolled his eyes and didn't bother to pay attention to Pinlu's nonsense here.
It was purely an academic exchange, so you just had to fight directly. Of course, Professor Xin can also understand that people like Lu Qianzhou are not easy to mess with.
Mr. Gui was right not to choose people from his hospital as his students.
More importantly, Lu Qianzhou used to be Gui Lao's student, but now he is the top assassin in the country. It is really not easy to protect Lu Qianzhou and control him.
With such a talented student, it is a miracle that Mr. Gui can become an academician.
"I know, let's watch the surgery and listen to the lecture..." Professor Xin quickly ended the topic.
There is no favoritism in sports medicine. Pinlu came to plead for Zhou Cheng, not for Lu Qianzhou or anyone else. Moreover, Professor Xin is now also curious about what is going on with this young man named Zhou.
If possible, he is very interested in Zhou Cheng...
After all, if Zhou Cheng can win this operation, then this Lu Qianzhou will be regarded as a Waterloo.
Lu Qianzhou once said that whoever defeated him would return to his country and surrender.
Yesterday, perhaps due to an unexpected intrusion, Zhou Cheng heard that he almost raped Lu Qianzhou during the penultimate operation, which frightened Lu Qianzhou at the time.
Today, Lu Qianzhou deliberately used a small trick to give Zhou Cheng a case that he could never show off.
If Zhou Cheng performed a show in reverse.
If you don’t think this operation is easy, then I’ll just make it so that it doesn’t require total hip replacement. I won’t play with you.
However, my direction and realm are actually a level higher than yours.
Conquer the enemy's army without fighting.
However, Professor Xin looked at Lu Qianzhou's serious face and admired Lu Qianzhou quite a bit.
Although he was obviously reluctant, obviously already feeling a little guilty, and obviously very afraid that Zhou Cheng could show off his face, he could still stand up without changing his expression and ask Mr. Gui to give Zhou Cheng a chance. He was a werewolf.
And with the friendship between Gui Lao and Lu Qianzhou, he could actually ask Gui Lao to come forward and deny Zhou Cheng's suggestion.
However, Zhou Cheng’s current hip-preserving surgery, what is the probability of success?
Professor Xin shook his head again.
The odds can only be described as miraculous.
…
While waiting, Su Min, Yu Heng and others basically met the eyes of everyone on the scene.
Even though Su Min and Yu Heng were very used to being admired by the stars and being the center of attention, they felt a little unsure at this moment. It was not that they were not used to being surrounded like this.
Rather, they were not sure about the surgery they were going to show off next.
If you use something you are not sure of to show off, it is suicidal.
"Zhou Cheng, do you really want to do this?" Su Min was a little nervous. His skin was so white that he couldn't see much blood at all, and he didn't know if he was a little scared at this moment.
Going for surgery against the indications for surgery is not something that ordinary people can do.
Although small incision open reduction and internal fixation is an innovative surgery, it is not a surgery that reverses the indications for surgery. This should be clarified.
Innovation and the creation of indications for reverse surgery are different concepts and levels of difficulty.
Even the always arrogant Yu Heng was unsure: "Are you sure?"
"Almost. Don't worry, I'll just have to cooperate with you when the time comes."
"I have no time to explain the specific theory to you in detail. However, as far as the current situation of this patient is concerned, firstly, he is young, and secondly, his current osteoarthritis has severe symptoms and necrosis of the femoral head, but the acetabulum is There is not much to deal with in this area.”
"This provides us with the possibility of hip-preserving surgery..."
Su Min and Yu Heng both nodded and said, "Okay, you just have to be sure. We believe in you."
Since there is no way to retreat, it is natural to rush forward. It is not that we have not rushed forward.
Moreover, it would be quite comfortable if both Peng Peng, who was in his thirties, and Lu Qianzhou, who was in his forties, could be beaten up.
This is what Su Min and Yu Heng wanted to do but couldn't.
Even though the protagonist this time is not the two of them, but Zhou Cheng.
but?
…
Soon, the arthroscopy came.
As an essential tool for sports medicine, the supporting facilities for arthroscopy are quite complete, and in addition to the equipment nurses, there are also sports medicine specialist equipment nurses who have been invited.
If the technique has been changed, all supporting facilities must be professional.
Zhou Cheng and others are also very professional, and they are ready in three steps, five by five, and two. There is no time to prepare for the preoperative operation of hip arthroscopy here.
Then after everything was ready, the hip arthroscopy operation began immediately.
Zhou Cheng's operation is very smooth.
Because today's spectators are all relatively professional people, and the assistants are not ordinary people, so Zhou Cheng does not need to explain more——
Microscopic examination, very detailed——
"We can see the acetabulum, the labrum..."
"We can see the femoral head..."
"Next, let's proceed..."
Zhou Cheng, who has a perfect hip preservation treatment that redefines the level of hip joint, became very calm and composed at this moment. Every operation is not particularly fancy, and is much less ornamental than other operations.
operation.
However, the more calm and accurate micro-operations are more touching and touching.
It makes people believe even more that those hands with these steady operations will never mess up.
Then, very quickly, the critical part of the operation came.
Whether it is arthritis or collapse caused by femoral head necrosis, the essence is local ischemia caused by various reasons, which then leads to local necrosis and cartilage defects, narrowing of the joint space, collapse of the bone articular surface, etc.
The most commonly used surgery is actually cardiac decompression of the femoral head, but the staging of aseptic necrosis of the femoral head in this patient cannot be resolved.
The so-called bone grafting also needs to be done in an open manner. You cannot perform the so-called bone grafting under arthroscopy because there is not enough space for the operation.
Therefore, everyone is very curious about what Zhou Cheng is going to do.
There is no bone grafting and there is no space for medullary decompression.
If it wasn't Zhou Cheng who brought it up, Gui Lao and others would not allow anyone to come here to mess around, not to mention that they were still students.
I have given you enough attention, can you achieve it——
While everyone was still thinking about how Zhou Cheng should respond, Zhou Cheng's change came. After Zhou Cheng sent a channel similar to the medullary heart decompression technique, Zhou Cheng actually asked the circulating nurse for it.
A vascular surgical instrument...
Zhou Cheng did not perform pedicled bone flap transplantation, but he wanted to reconstruct blood vessels under arthroscopy. This is an alternative type of pedicled bone flap transplantation.
Restore blood circulation and re-graft bones.
Then everyone discovered that the tunnel that Zhou Cheng had made before actually entered the lumen of a nutrient blood vessel in the medullary cavity of the femoral head...
As soon as this discovery broke out, the scene immediately exploded.
Gui Lao and Pin Lu couldn't help but stand up. Lu Qianzhou also blinked and touched his hair.
Looking at Gui Lao and others.
How is this going?
You know, what Zhou Cheng was looking for at this time was the nourishing artery. How thin is this artery?
What is Zhou Cheng going to do this week?
As soon as this doubt arose, Pinlu panicked and immediately thought of a solution and asked Gui Lao and Lu Qianzhou: "Gui Lao, Xiao Lu, can you two understand what Zhou Cheng is doing now?"
"How about we find someone from the vascular surgery department to come over and explain it a little bit."
"Okay!" Lu Qianzhou gave in now!
This surgery was something he had never heard of.
However, there are interventional surgeries to perform thrombolysis in the femoral head vessels to treat stage I and II avascular necrosis of the femoral head.
But what is Zhou Cheng’s current operating mode?
What the hell?
"Then why don't you call?" Mr. Gui urged.
There is a specialization in the art, and there is a sooner or later time to achieve enlightenment.
There are certain interdisciplinary subjects between orthopedics and vascular surgery. It is naturally impossible for Mr. Gui to not understand vascular surgery at all, but he knows that the knowledge he has mastered is not even superficial in vascular surgery.
But in fact, being a deputy director or director in an ordinary prefecture-level city hospital is still more than enough.
…
The operation is still going on, but no one who can understand has come yet.
Moreover, even if Pinlu made the call, the other party had his own matters to attend to. The professor who was the quickest to step down arrived at the operating room more than 20 minutes later.
When he arrived at the operating room, there was already some fresh blood on the operating mirror.
Looking at the blood stains, Zhou Cheng took a long breath of relief, and then began to clean up some necrotic cyst areas in the femoral head...
The professor who came over was quite old, sixty-two years old, and was a top professor of vascular surgery. After he greeted Mr. Gui, he looked at him seriously for a minute.
Then he turned around and asked: "Lao Gui, Professor Pin, what are you asking me to come here to see?"
"Is this your sports medicine surgery?"
"Does the patient have a blood clot?"
When talking, Qin Xuansheng felt so innocent. He was already a sixty-year-old man. He originally wanted to call him to have a look. But after he arrived, he watched the operation for a while and didn't understand.
Mr. Gui suddenly felt a little embarrassed and said hurriedly: "Professor Qin, no, actually this is what happened. Before, Zhou Cheng..."
Although Gui Yuanping is an academician of orthopedics, he is the same generation as Qin Xuansheng, so he still treats Qin Xuansheng politely.
However, after Gui Yuanping finished speaking, Qin Xuansheng was completely confused.
He opened his mouth and said: "Then this access is made from the common access of your orthopedics department? It should be your orthopedics department to determine which bone flap is the nutrient or nutrient blood vessel?"
"Shouldn't it be a problem for our vascular surgery department? And I didn't see his operation process."
"Let me take a look. Is this what it is?"
"Instruments for thrombectomy..."
"I don't understand it either." Qin Xuansheng admitted his fear at first and said it very straightforwardly. He didn't understand it, nor did he understand it.
Qin Xuansheng has said this, so now the problem is awkward.
When they were doing vascular surgery, Qin Xuansheng didn't come. They didn't understand and didn't know how the surgery was going.
Now that people are here, Zhou Cheng starts to only perform orthopedic surgeries again, but he still doesn't understand.
These two confused people got together.
Moreover, Qin Xuansheng felt that he was very innocent. Why did he drag himself here?
After a few more minutes, Qin Xuansheng suddenly had a bad premonition and quickly stood up and said: "Lao Gui, why don't I go back first? There are still some things that have not been done in our operating room."
But how could Gui Yuanping let Qin Xuansheng go? He grabbed Qin Xuansheng enthusiastically and said, "Professor Qin, you are so old, it's time to let go. Don't do everything yourself, but pay attention to your health."
"Please sit down, please sit down, we still have many questions to ask..."
Qin Xuansheng can't leave, otherwise the situation will be even more embarrassing later.