godfather of surgery

Chapter 230
The fourteen wounded were brought back to the hospital smoothly, and the pregnant woman picked up by helicopter was already on the operating table.

Yoshino fulfilled his mission, and they are all alive for the time being.

As a doctor in charge of pre-hospital first aid, the moment the wounded enter the hospital and complete the handover work, Yoshino's work is over.

Of course, sometimes, the surgeon needs to understand the scene in detail, and will go back to communicate with Yoshino. In any case, Yoshino will no longer do the main work.

Let's have a cigarette, Yoshino came to the smoking room alone.

He knows that smoking is harmful to health, and he also advises others like this, but there must be a way to relieve stress.

"Yoshino, good job!" Sasaki called.

In the ambulance, Yoshino decisively opened the skull of the wounded under the crude conditions, fully decompressed, and removed part of the hematoma.

His judgment based on the symptoms and signs was very accurate, most of the hematomas were removed, and the brain herniation was treated in time, which won precious time for the rescue.

Otherwise, it would not be a living person picked up by the helicopter now, but a cold corpse.

"A few years ago, in the same place, I hesitated, and finally I gave up. The wounded person died in the end. I have been regretting and thinking about why. Today, I no longer hesitate, no matter whether she can live or not. , I did my best, now it's your turn."

Yoshino is just one cog in the whole system, and the system will only work well if every gear is working properly.

Yoshino and Sasaki are about the same age, Sasaki is already an associate professor, Yoshino is still a lecturer, but he doesn't care, saving talents is the greatest joy.

"The fetus is five months old, and there is still a fetal heart rate. We called up her previous medical records. It took her five years and many hospitals to conceive the child. It shows how much she longs to be a mother. I decided, Fujiwara-san agreed." Sasaki asked Yoshino to share their operation.

"Great, come on!—" Yoshino has a sense of accomplishment, and if he succeeds, he will have his share of the credit.

However, saving even the fetus is very risky and difficult. It is not surprising that Sasaki made such a decision. He is always creating miracles.

He is the enemy of the god of death, and he does not know how many lives he has snatched back from the god of death.

It took less than 10 minutes from entering the emergency center, completing the examination, and going to the operating table for surgery.

Because she is pregnant, the best examination is MRI, but the metal plate is inserted into the abdomen.

After contacting the car manufacturer, it was confirmed that it was magnetic. If MRI is done, the strong magnetic force will move the metal and pull it out, so the pregnant woman underwent a CT scan.

Although X-rays are harmful to the fetus, the five-month gestational age will not cause deformities. Compared with saving his young life, these are insignificant.

Hiroshi Arai is undergoing surgery, real-time infrared monitoring, combined with CT scan images to draw a 3D digital human image, suspended on the clear Sharp plasma screen.

The three-dimensional transparent image can be rotated [-] degrees, the injured part is marked in yellow, and the blood vessel is marked in red.

The hemoglobin-friendly imaging agent reaches the whole body, and the images of each bleeding site are captured clearly and accurately, and the system will prompt the surgeon to give priority to which site and which blood vessel to treat.

Intracranial hemorrhage is also accurately displayed, as is damage to brain tissue.

Infrared monitoring equipment calculates the degree of contusion of the brain tissue according to the changes of the heat parameters of the brain tissue and the change of the blood flow, down to each functional area.

Arai was very proficient, using Yoshino's craniotomy gap as an approach, carefully pulled out the residual blood clot, and stopped the bleeding completely until the red color on the screen disappeared.

The edema of the brain tissue due to trauma will last for a period of time. During this period, the brain tissue needs a larger volume and cannot be subject to any compression. The original volume of the cranial cavity cannot meet the requirements.

Arai put an artificial cover on the patient and fixed it on the surrounding skull, which can protect the brain tissue and expand the volume.

After the edema disappears, the artificial cover is removed, and the patient's skull is put back in place.

As for the contusion of brain tissue, there is no way to deal with it, only to create conditions for it to recover by itself.

This decompression method of uncovering the skull cover is much better than ordinary craniectomy for decompression.

It originated from the Irizalov Hospital in Siberia, Russia. The Affiliated Hospital of the University of Tokyo sent two doctors to study for a year. After returning, they improved the technology.

Blue is better than blue, and their use of this technology has far surpassed that of Russia in terms of effectiveness and safety.

Vital signs are stable!

The anesthesiologist said that the doctor liked this sentence best.

All kinds of invasive and non-invasive monitoring, import data into supercomputer, and the computer runs at high speed to complete the dynamic changes of digital human.

This bit of data can be calculated almost instantaneously for the host computer of the trauma emergency system in the hospital.

Completed cranial surgery, began chest surgery.

Arai decided to use thoracoscopic technology. The mirror enters the chest cavity from the intercostal space, and the blood inside is washed away by normal saline.

The front and back were strongly squeezed, multiple rib fractures, and the broken ends of the fractures squeezed and pierced the lung tissue, causing severe lung damage.

Hemostasis and repair, constant themes in trauma orthopedics.

One-lung ventilation, the injured lung was stopped by the anesthetist and was in a collapsed state.

Arai is very proficient in the technique under the microscope. He calmly cauterized the ruptured blood vessels one by one to stop the bleeding. For larger blood vessels, cauterization could no longer achieve the purpose. He sent the silver clip in to clamp the broken end of the blood vessel firmly.

While hemostasis was detected, there was no problem with the heart and aorta, and all the bleeding points were eliminated.

The clean thoracic cavity is clearly displayed on the screen under the flushing of normal saline.

Start to repair the lungs, the lung tissue is soft and fragile, and it is difficult to repair.

However, Arai still tried to repair it as much as possible. The cracks of various shapes were stitched up one by one to restore their proper shape.

The diaphragm also ruptured, and the pressure differential pushed viscera from the abdominal cavity into the chest cavity.

Arai opened another laparoscopic entrance in the abdominal cavity and inserted another set of lenses and instruments.

The screen of the laparoscopic system began to split the screen, the left chest cavity and the right abdominal cavity.

Use a blunt-tipped pusher with the left hand to enter through the thoracic cavity; use atraumatic forceps with the right hand to enter through the abdominal cavity.

Cooperating with both hands, one push and one pull, with gentle movements, part of the pancreas and small intestine that had herniated into the chest cavity was sent back to the abdominal cavity, and then returned to its original position.

The diaphragm was repaired under the microscope, and the chest cavity was flushed with normal saline again, but there was no bleeding.

The ventilation of the injured lung was restored, there was no obvious air leakage, and the repair was qualified.

Under the same microscope, the ribs were reset and fixed with a simple wire minimally invasive.

The ten ribs are all reset and fixed, and the shot of the chest cavity is pulled out.

Laparoscopic hemostasis of the ruptured mesenteric artery was initiated, followed by repair of the ruptured bowel and damage to the pancreas.

The liver and spleen are fine, and they escaped the pressure of the seat. Even if the liver and spleen rupture, it is not a problem for Arai, it is nothing more than adjusting the order of operations.

The liver and spleen injury was treated under the microscope first, and then the pancreas and small intestine were repaired.

The skillful laparoscopic technique makes the operation look the same as the open operation, but the effect is better and the damage is less.

Arai solved such a complex thoracoabdominal joint injury with a few small holes as thick as little fingers.

The fetal heartbeat is still there, and the amniotic fluid leaks due to the rupture of the uterine membranes.

Without amniotic fluid, the fetus cannot survive, and the assistant kept injecting artificial amniotic fluid to supplement it.

A steel plate, which should be the structure on the seat, pierced the pregnant woman's abdomen, from front to back, and pierced the body of the fetus.

Open surgery is necessary, and laparoscopy can no longer complete this type of surgery.

There are too few fetal trauma operations, and Arai lacks experience, and he has only done fetal orthopedic operations.

The five-month-old fetus is only [-] centimeters long, just a little longer than two fingers.

To successfully perform the operation, a microscope is required, which should be the most difficult trauma operation in the world.

The heating lamp has been adjusted to shine into the pelvic cavity from different angles to keep the fetus warm.

Arai cut open the abdominal cavity, opened the uterus, and stopped the bleeding while revealing it, preparing for the removal of the metal sheet.

In normal fetal surgery, in order to expose the fetus, the fetus must be removed from the uterus, and the fetus cannot be completely removed, otherwise the fetus cannot keep warm, so only part of it can be removed to facilitate the exposure of the surgical site, and it must be returned to the uterus after the operation.

The operation must be very careful, otherwise once the placenta is separated, the life of the fetus will be in danger.

The womb opens and the fetus is revealed, poor little one.

"Sir, it's my turn." Sasaki and Fujiwara have been sitting in the operating room.

"Be careful, both of them will survive the operating table." Fujiwara was very confident in Sasaki.

-

In Sanbo Hospital, whether it is the main venue or the sub-venues, the surgery is broadcast live on the screen.

"Hiroshi Arai, lecturer in orthopedics—"

There is a brief introduction of the chief surgeon in Chinese and English on the screen.

Everyone was paying attention, no one moved, no one made a sound, and even drinking water was kept to a minimum.

From the head, to the thoracic cavity, to the abdominal cavity, a young mid-level doctor is so skilled in surgery.

In particular, the application of laparoscopic technology in trauma surgery, the exploration without dead ends, meticulous repair, and carpet-like hemostasis are like teaching demonstrations.

The computer-assisted trauma surgery system based on infrared monitoring, combined with CT scanning, can actually reconstruct a digital human.

What an eye-opener!
These are real technologies and skills, and a keyboard may not be able to make up for it.

Someone had a dry throat, and after swallowing several times, it was still dry and uncomfortable.

Although it was originally planned to be a young mid-level doctor, but now it is fetal surgery, and it is reasonable to be a senior professional title.

Young people with mid-level professional titles have performed very well, and they have shown world-class levels.

"It's time for Sasaki!"

Takahashi said to himself, he believed in this junior.

This kind of surgery requires a microscope, but the whole process is carried out under the microscope with both hands suspended in the air. Compared with replanting a severed limb and replanting the elbows to support the table, it is much more difficult.

This kind of operation is the pinnacle of microsurgery. What is a five-segment replantation, Takahashi said contemptuously in his heart.

The lens of the screen is clear and delicate, the uterus is opened, and the fetus is revealed.

Sasaki had already brushed his hands and was putting on his surgical gown. He was going to complete a surgery that would make the world astonished.

　The operation last night was until two o'clock, and today is also the operation during the day, so there was no update last night.The chapter that is owed must be made up on Saturday.Sincere apologies!Thank you for your tolerance!

　　
　
(End of this chapter)