godfather of surgery

Chapter 159 The Story of Gauss

At noon, I had dinner with Xiao Su in the cafeteria, and slept in the duty room of the department in the afternoon.

Including the usual daily rewards, the points already reached [-] points, which can further advance the surgical training.

Yang Ping spent [-] points to purchase [-] cruciate ligament reconstruction operations, and then spent [-] points to purchase [-] knee multi-structure reconstruction operations, leaving [-] points for the remaining points.It took more than ten days in the system space to complete the training for the thousand surgeries.

There are a lot of surgical training packages in the mall, almost everything you want is available, as long as you have enough points, you can buy as many as you want.The only disadvantage is that the training is advanced and must be done step by step. You can only enter the next step after completing an advanced training.

Yang Ping completed the surgical training, and then conducted anatomical training in the system space, using anatomical knowledge to train the human body composition of the brain.

After waking up at four o'clock in the afternoon, Song Zimo was drawing a picture in the office. He drew the picture of the five-joint injury of the knee joint. He drew the reconstructed structure on the picture.

"I have done quadruple reconstruction for ordinary people, but it is really difficult to master the balance of five-unit reconstruction for professional athletes. How can the starting and ending points of these ligaments be accurate? How can the tension be adjusted with so many ligaments?" Song Zimo was very annoyed.

In this type of surgery, many structures are reconstructed, including double-bundle anterior fork, double-bundle rear fork, three posterolateral structures, and three posteromedial structures. The joint capsule needs to be repaired, the lateral retinaculum of the patella needs to be loosened, and the medial retinaculum needs to be tightened. After rebuilding so many structures, it is not yet finished, but also to adjust the tension of these structures to a satisfactory level, and to adjust each other to balance.

Not to mention doing it, a doctor specializing in sports medicine will feel his head swell when he sees this operation, and most of them have no intention of doing it. In the face of this kind of operation, the self-confidence accumulated by most doctors will be shattered.

Not to mention that Song Zimo usually encounters very few people, even Su Nanchen who is attached to the first one seems to be unable to do what he wants. After all, the number is too small to gather more. Only a national sports medicine center like the Third Hospital of the Imperial Capital can gather a large number of cases. .

For example, Song Zimo was able to win the quadruple reconstruction of ordinary people, and Su Nanchen's quadruple reconstruction of professional athletes was only one step away from the boss of the Imperial Capital Third Hospital. It was not easy, and they were already extremely talented.

"At that time, you will be able to see one. Let Jiahui prepare all the instruments. This operation is a bit big. At least 10 allogeneic tendons will be prepared for reconstruction." Yang Ping explained to Song Zimo.

"As soon as the patient came in, I informed her, and she had already prepared the equipment. I prepared twenty allogeneic tendons, from the Shanxi Medical Tissue Bank, which are in our hospital's supplier catalog, and can be used directly. Sports medicine The center uses theirs, Huang Jiahui has a cold, a high fever, and is in the emergency department for infusion, I told her not to follow the stage, she is very persistent, she must come." Song Zimo made the preparations for the operation impeccable, and did not use Yang Ping at all worry.

"Is the Singaporean's surgery going well?" Yang Ping asked with concern.

Song Zimo was very confident: "It went well. The re-examination film came out. Take a look when you have time. I drew a [-]D reconstruction picture before the operation to simulate the scraping of the sequestrum. During the operation, the sequestrum should be scraped clean."

"Not bad!" Yang Ping gave a thumbs up.

Song Zimo was a little embarrassed: "I have to learn something from you. Compared with you, I am not a little bit inferior in spatial positioning ability."

This is indeed a major operation. Watching Yang Ping's operation will be addictive. There is a feeling that another village will be brightened. Director Han is addicted now. It has only been a long time since the comprehensive orthopedics department has been opened, and the five joint injury reconstruction has been moved out.

On Saturday, Xiao Su did not go home, Yang Ping played tennis with Xiao Su on the hospital court, Xiao Su was a professional, but Yang Ping had only been in contact with him in college, so he knew a thing or two, so naturally he was completely abused by Xiao Su, and let Xiao Su became a coach for a while.

On Sunday, Xiao Su went home, and Yang Ping stayed in the house, reading and studying, and borrowed some information about Haifu Knife to study.

On Monday, Director Han arrived in the operating room early, and usually came to see it when the stage opened.

"Xiao Wu, adjust the video system a bit better. I need to capture pictures when the time comes. I'm going to make a poster of this operation and hang it on the wall of the ward. This operation and the reconstruction of the multi-directional instability of the shoulder joint are listed as difficult in sports medicine. The biggest operation." Director Han sat there directing Xiao Wu.

In the last reconstruction of the anterior cruciate ligament, the intercondylar notch was formed, just like a sculptor was carving, grinding and grinding with a drill, and a perfect intercondylar notch was ground unconsciously.

Director Han watched the operation video several times, and he firmly believed that Yang Ping had learned how to sculpt, and even practiced the sculpting of the intercondylar fossa with a drill, otherwise how could he have done it so perfectly.

Director Han's guess is not wrong, Yang Ping has practiced before, but in the system space, the operation is practiced casually in the system space, and if it goes wrong, there will be no adverse consequences, at worst, it will be done again.As long as you have points, it will continuously provide you with cases, as long as you have enough points, not to mention five joint injuries, six joints, seven joints, eight joints, you can have as many joints as you want, which may never be encountered in reality Cases are simulated for you.

At the beginning, I used the drill to practice the formation of the intercondylar notch in the system. Before the practice, I read a lot of books about engraving and thoroughly studied the principles of carving. Then I used the drill as a carving knife. Sculpture.

Now if Yang Ping is asked to do cosmetic and plastic surgery, he can definitely use this trick to set up a plastic surgery sign.

Xiao Wu is very concerned about these medical equipment. He is more familiar with this video system than the manufacturer's engineers. Last time there was a problem with the video system. It is said that there is a bug in the software. The manufacturer sent people to check and check it. I said sorry a few times with a smiling face, and then the video was still stuck. The problem was not solved, and Xiao Wu finally solved it.

Huang Jiahui didn't have a fever anymore, but she looked very haggard. She stood by the equipment trolley, and Yang Ping passed by her equipment trolley. She bowed: "Mr. Yang!"

"The cold is gone, no fever. If it doesn't work, go back and rest, it's fine." Yang Ping said with a smile.

Huang Jiahui thought, she was really lucky to meet such a good-tempered doctor, and she didn't have much dissatisfaction when she was late last time.

The reconstruction of the front fork and rear fork is similar to the previous operation. The anatomical reconstruction of the eight-strand double-bundle used for the front fork can restore the function to the maximum. The posterior fork ligament is also double-bundle anatomical reconstruction. The operation principle is similar, except for the bone tunnel. The location is different.

This operation, how should I put it, has reached the point where the weight is taken lightly. A major operation feels like a minor operation abruptly. If you don't know it, you will think it is a minor operation.

After the reconstruction of the anterior and posterior cruciate ligaments, the reconstruction of the posterolateral and posteromedial structures begins. There are three posterolateral structures that need to be reconstructed: the lateral collateral ligament, the popliteus tendon, and the popliteal ligament.There are also three posteromedial structures: the medial collateral ligament, the posterior oblique ligament, and the popliteal oblique ligament.

After rebuilding these eight structures, the joint capsule needs to be repaired, the lateral retinaculum of the patella should be loosened, and the medial retinaculum should be tightened to correct the trajectory of the patella.

These ligaments cross vertically and horizontally, from the femur to the tibia, or from the femur to the fibula, each of which is implanted into the bone tunnel. If it is looser or tighter, the operation will be compromised, and compromise will mean failure.

In the dazzle, the rustling sound of the electric drill stopped, and the allograft tendons were handed over one by one, turning into ligaments on the patient's body.

It is very easy for people who do it, and it is very comfortable for people who watch it. After the work, the stability of the knee joint was tested, and the stability was very good. The tension and balance were really perfect at one time. Song Zimo drew 1 question marks in his heart.

The patient was pushed out by Xiao Wu Zhang Lin. This time the fat man was very conservative, fearing that the operation would take a long time and the amount of anesthetic was relatively large. When the patient went out, his leg was still numb after the operation.

Song Zimo came over secretly and said, "Where do you do this kind of surgery so much, can you give me an answer that can convince me, don't be too fantasy."

Yang Ping is copying the video, grabbing a picture: "Do you know Gauss?"

"I know, is this operation related to Gauss?" With Song Zimo's IQ, he did not guess the mystery of this.

Yang Ping stopped his hand operating the mouse: "Gauss was studying at the University of Göttingen when he was 19 years old. His tutor routinely assigned him three questions every day. This day, the teacher only assigned two questions, but due to a mistake, one The small note was caught in his textbook, and there was also a question on the small note. Gauss solved the first two questions easily. Only the question on the small note was difficult for him, and he spent the whole night. Only then did he solve the problem, and when he handed in his homework to the tutor the next morning, he felt a little guilty and blamed himself. He said to the tutor, I worked all night to solve the third question you assigned me. I have let down your cultivation of me. After reading his solution process and results, the instructor stared at Gauss for a long time, and said in a trembling voice, this is an unsolved mathematical problem of more than 2000 years. Archimedes did not solve it, and neither did Newton. You actually figured it out overnight?"

Yang Ping stood up after copying the video and pictures. Song Zimo had already been petrified, and the answer was all in this story.

Yang Ping patted him on the shoulder: "Surgery is something that someone can do after reading it once, such as you; there are also people who can perform perfect surgery as long as they read the book once, such as me, believe it or not?"

"The secret is only one sentence. For the reconstruction of a single structure in this operation, the position of the tunnel is the most important thing. For the reconstruction of multiple structures, the position of the tunnel and the balance are indispensable. How to adjust the balance depends on the talent. Don't read a few books. One centimeter, it’s useless, find the balance by yourself, I guess you can understand what I said today after building a few sets.”

Yang Ping asked Su Nanchen on WeChat for an e-mail address to send him the video of the operation, not to show off, but to give him a reference. His patient will also undergo a similar operation soon.

(End of this chapter)