Just cleaning the broken and free pivot vertebrae and broken bone cement is boring and boring. What's more terrible is that Wang Yifei can only bend over and operate the endoscope in a very awkward posture. And this action
There must be no deviation or mistake. Once the sore waist shakes a little, the high-speed rotating hand drill may cut off Song Hualin's internal carotid artery or crush his spinal cord into paste.
"It will be exhausting to do this." After working in silence for two hours, and after stopping for the ninth time to let the nurse wipe his sweat, Wang Yifei temporarily put down the endoscope in his hand, stretched his stiff neck, and
Aching shoulders. "Who is that... Yaran, take my phone and play some music."
The equipment nurse nodded, took out the plastic-sealed mobile phone from Wang Yifei's pocket, and skillfully turned on the Bluetooth to connect to the stereo.
In this demonstration operating room, there is a Bose Bluetooth speaker. The speaker is quite big and is specially placed on the wall shelf far away from the anesthetist. In order to ensure sterility, a nurse will go there before each operation.
Replace the plastic package above.
"This song?" The medical nurse named Yaran clicked Director Wang's cell phone, and the lyrics of "The water of Wanquan River is clear and clear" immediately rang in Bose.
"This kind of music is not suitable for surgery." Director Wang shook his head as if to relax his cervical vertebrae, "Keep searching, the ones in the rock list are good."
"Then...listen to this song?" The equipment nurse clicked the phone a few more times, and a rock music familiar to most young people rang. The famous song "Highway Hell" from the Australian rock band AC/DC rang.
"This song is good." Wang Yifei laughed, "We are really on the highway of hell, and we are still driving in the opposite direction in the overtaking lane with the patient." He stopped his relaxing movements, raised his hands slightly, and looked at the lying
On the bed, Song Hualin opened his mouth widely, "Continue!"
The sound of bones being ground away by hand drills was harsh and sour. Bone powder and bone cement were beaten into powder, while the nurses next to them continued to be busy following Wang Yifei's instructions. "Hemostatic forceps, prepare bone wax!" Wang Yifei suddenly stopped.
He stopped moving his hands. Sun Lien, who stood aside until his feet hurt, suddenly opened his eyes wide.
The state of "arterial rupture" appeared above Song Hualin's head. Sun Lien looked at the operating bed with a worried look. Could it be that the internal carotid artery was damaged by the electric abrasion just now?
"Unknown small artery rupture." Wang Yifei operated for a long time, and then relaxed a little. Human arteries sometimes proliferate some small arterial branches, and these branches often bring some small shocks to the operation. Wang Yifei just cut a piece
When the bone cement was larger, a small piece of bone cement fragment bounced back and cut the proliferated small artery. Although the blood spurted out, fortunately the diameter of the small artery itself was very limited, and this
Even if these proliferated arteries are ligated, they will not have any impact on the original functions of the human body.
Wang Yifei also breathed a sigh of relief. Although he was very confident about the operation itself, this small artery always gave doctors a sudden attack. Fortunately, the surgical field was completely exposed at the beginning, and this artery was in a relatively easy position.
The ligated position. After Wang Yifei clamped the small artery with a hemostatic forceps, the alarm was lifted.
"The bleeding is estimated to be about 150ml." The instrument nodded towards Wang Yifei, "Just suck the blood away. There is no need to add plasma yet."
The alarm was lifted, and everyone present breathed a sigh of relief. Sun Lien looked at Hu Jia, who was shaking slightly, and then remembered that his girlfriend had basically been running back and forth outside today. And it didn't look like he had taken a nap. He lightly
He touched Hu Jia lightly and said, "If you are tired, just lean on me for a while."
Hu Jia glanced at Sun Lien and nodded. Then he rested his head on Sun Lien's shoulder.
"Continue." Wang Yifei breathed a sigh of relief. Almost five hours had passed since the operation. The fracture line located at about 10:20 of the axis, all the way to the back of the anterior longitudinal ligament at 12 o'clock, basically
All the vertebral bodies and bone cement have been removed. To continue cleaning the remaining axis bones, this ligament must be dealt with first.
Life is a very magical thing. During development and evolution, organisms have evolved a skeletal system to support and protect themselves. In order for the bones to not hinder movement, it is necessary to evolve a structure that can allow the skeletal system to move without dislocating each other.
system. And ligaments are an important part of this system.
It's a pity that even with such advancements in science and technology today, people still cannot make ligaments that are as useful as the original ones, and even the connection between ligaments and bones cannot be replicated. The ligament reconnection scheme used in surgery, except for the middle
Apart from suturing after rupture, there is only one way to nail the ligament directly to the bone with nails. It is impossible for ordinary nails to work at this angle. After all, in this small space, it is physically difficult to swing a hammer.
Impossible. Therefore, the orthopedic carpenters used a combination of titanium alloy screws + orthopedic electric drills + reserved mounting holes for the prosthesis. Use retractors to temporarily separate the longitudinally cut ligaments. Then grind off the remaining axis and replace it.
After the prosthesis is installed, loosen the ligament, replace it with appropriate titanium screws, and twist the ligament into the hole prepared on the prosthesis.
Song Hualin's anterior longitudinal ligament was cut longitudinally with a scalpel. Wang Yifei used a retractor to separate the ligament to both sides. The final cleaning work was relatively easy. In about an hour, Wang Yifei removed the transoral access canal.
The remaining part of the pivot vertebra was seen. The posterior longitudinal ligament hidden in the vertebral body was also treated according to the regulations, and two retractors were used to separate it.
"Okay, bring the front-end prosthesis." "Highway Hell" played in the operating room has been played countless times. Dr. Pascal's performance from the beginning to the slightly dull tone has fully explained the problem.
Not many people would like to listen to a song over and over for more than two hours. Wang Yifei was probably tired of listening to it, so he asked someone to change the song, "Let's play "ck"."
Rock carpenter Wang Yifei hummed a song while continuing his surgery. He had been operating for six hours in a posture that was difficult for ordinary people to maintain. Although he is much younger than his teacher, Academician Qiu, Wang Yifei is also almost fifty years old.
All the muscles in his body were screaming at him, warning the rock doctor, "We're about to go on strike!"
"Anesthesia, bring me a stool." The prosthesis has gone through many rounds of polishing and disinfection, but Wang Yifei insisted on checking it with the naked eye before installing it. "Put it directly behind my butt."
Academician Qiu frowned, and Sun Lien also noticed something unusual.
"Wang Yifei, male, 47 years old, has accumulated lactic acid in his muscles." The status bar prompts that Wang Yifei, who is undergoing surgery, has basically reached the limit of his physical strength.
"Yifei, let me take over." Academician Qiu walked to Wang Yifei and whispered, "You have been doing it for too long and your physical strength cannot keep up."
"It's hard for me to do it from this angle, and it's even more unbearable for you to do it." Wang Yifei rejected his mentor's suggestion. "I know my physical strength well, and there is no problem with installing the prosthesis."
Academician Qiu no longer insisted, but continued to observe Wang Yifei's surgical endoscopic view through the screen. After nearly half of the vertebral body was removed, the spinal dura mater inside was exposed. This part currently seems to be in good condition and has no damage at all.
and signs of edema.
Half of the prosthesis was carefully placed diagonally above the exposed dura mater. The little space exposed was just enough for Wang Yifei to use a universal screwdriver to fix the posterior longitudinal ligament to the prosthesis.
Universal screwdrivers were originally only used in the field of aircraft maintenance. Its principle is actually very simple. It replaces the extension rod on the original screwdriver with a soft but extremely torsion-resistant rod. Just pay attention when using it.
By fixing the bending head, you can tighten the screws that cannot be tightened directly with a rigid screwdriver. If this good thing did not exist, the 3D printed pivot prosthesis would not have been installed in the first place.
The two screws were quickly twisted on the inside of the prosthesis, and Song Hualin's posterior longitudinal ligament was screwed to the prosthesis. Then he quickly returned to the front and screwed the anterior longitudinal ligament to the prosthesis. Wang Yifei only used this action
One minute.
After the last screw was installed in place, Wang Yifei steadily took out the electric screwdriver in his hand, and then carefully checked that his surgical gown was not in contact with the endoscope stent. Only then did he feel relieved and took the screwdriver in his hand.
The electric screwdriver was stuffed into the assistant's arms. He wrapped his arms in a somewhat loose surgical gown to prevent scratches from the surgical instruments, and then sat down.
"I'm going to take a rest first." Wang Yifei weakly said to his student, who was also the first assistant in this operation, "Bring me a bottle of water."
Academician Qiu stood behind Wang Yifei and said, "Go lie down for a while and I will fix it."
Wang Yifei wanted to save Academician Qiu some energy, but the current situation really does not allow him to continue to be brave. The precision of the operation in the axis area is too high, and his hands are shaking now. He has to continue to complete the prosthesis, atlas and c1.
Fixing Duan was an almost impossible task. He could only nodded, "Sorry to trouble you."
"It's just a matter of tightening four screws." Academician Qiu patted his apprentice on the shoulder, "When I performed the operation, you were still sleeping in the junior high school classroom!"
In fact, the most troublesome part of the entire operation is over. Academician Qiu used nucleus pulposus forceps to remove Song Hualin's c02-c03 intervertebral disc, and then used two screws to fix the lower end of the prosthesis to the c03 vertebral body. The anterior atlantoaxial ligament and
The atlantoaxial joint capsule was also fixed on the prosthesis. Finally, two screws were used to fix the upper end of the prosthesis to the atlas vertebral body, and the transoral approach surgery was officially completed.
"Okay." Academician Qiu is old after all. Maintaining this weird angle is also an arduous task for his waist. "You come and sew." Academician Qiu told Ichisuke, "Remember to sew slowly."
a little."
The transoral approach part of 3D printing prosthetic vertebral replacement surgery is officially over at this point.