godfather of surgery

Chapter 333
The reading light was very bright, and Takahashi looked at it for a long time, but he didn't see the dead bones that Yang Ping said.

Yang Ping had already pointed out that there was a slight abnormality in that part, but in Takahashi's understanding, it was vascular indentation, a typical vascular indentation, how could it be regarded as a sequestrum, obviously sequestrum and vascular indentation are two wind The concept that horses and cattle are not related has now become a differential diagnosis put together.

Staring at the bright light for too long, Takahashi's vision began to blur, his eyes were sore, tears were forced out, and he had to look away temporarily.The eyes looked elsewhere, and there were spots of light everywhere in the field of vision, and people flickered.

"This kind of high-level skill cannot be mastered in a short time. Even if Dr. Yang pointed at the mosquito and said that it is a male genitalia and this is a female genitalia, we can't tell the difference. We will study it slowly when we have time later." Song Zimo took the film Put it away for now.

This operation looks simple, but it is actually quite difficult to operate.

The key is positioning. If you don’t use a navigation system and rely solely on the doctor’s operating experience, you need to open a window at the lower end of the right tibia, and then dig out a large piece of bone tissue to dig out the infected sequestrum.

The sequestrum of this infection must be thoroughly dug out, as long as a little is left, it is equivalent to leaving the source of infection. After a period of time, the infection will recur, and the previous efforts will be in vain.

Therefore, when excavating the sequestrum, it is necessary to excavate the surrounding normal bone tissue together, so as to ensure thoroughness.

This operation is like digging a sweet potato. A sweet potato is buried deep in the soil. Open surgery is equivalent to digging a big hole and finally digging out the sweet potato.

Minimally invasive surgery is equivalent to using a hollow bamboo tube, inserting it into the soil, knocking it in hard, inserting it to a certain extent, and then pulling it out. The bamboo tube is filled with soil, and the sweet potato is in the bamboo tube at this time.

"Do you want to use the Tianji surgical robot and make an appointment with the operating room over there in advance?" Song Zimo felt that such a small dead bone, at the millimeter level, would be difficult to complete minimally invasive surgery without the assistance of navigation technology.

Tianji surgical robot has its own navigation equipment, and the navigation accuracy can reach 0.8 mm.

If a robot is used for this operation, the child will have to undergo a new CT scan, import the CT data into the navigation system of the surgical robot, and use the robot's CT scan for positioning during the operation, and the child will naturally receive a lot of radiation.

"I have done a lot of X-rays and CT scans of the child. Forget it, and then use the robot to navigate, and the child will have to take X-rays. Try to simplify it, and I will do it in our operating room." Yang Ping looked at that. A large bag of video pictures has given the sick child a lot of radiation, so the radiation can be reduced as much as possible.

"Schedule the operation today, rush it to the stage, and do it under local anesthesia. He will be discharged from the hospital tomorrow, and he will not participate in strenuous exercise for three months." Yang Ping told Song Zimo that the operation was too simple for him.

"So simple?"

The child's father thought he heard it wrong. In his impression, after the operation, he would have to recuperate at home for at least one month and had to use crutches for three months. He was ready to take a long vacation.

I originally planned to bring him to see a doctor during the summer vacation. During this period, the child complained of pain every night, especially in the past few days, the pain was so painful that he couldn't sleep, it didn't look like it was pretending.

There was no other way, so the father took the child to the community health station to see it. The doctor at the health station suggested to go to Sanbo Hospital to see it.

When I arrived at Sanbo Hospital, I didn’t see Dr. Yang’s outpatient clinic, so I randomly registered an orthopedic outpatient doctor. The doctor said that it was an intractable disease and I needed to be hospitalized for treatment. My father appointed Dr. Yang for diagnosis and treatment, and the child received comprehensive orthopedics.

Hearing the words intractable diseases, the parents of the children were so frightened that their hearts were pounding. It wouldn't be a big deal, would it?

Hearing what Yang Ping said now, he will be discharged from the hospital the next day after finishing the work, and he can walk normally without using crutches.

What I thought was particularly troublesome, is now easier than circumcision, and circumcision still has to grit your teeth and walk like a duck for a few days.

Talking before the operation, signing and signing, a series of pre-operation preparations are done, and the operation will be arranged at the back.

"No need for navigation? Okay—why?" Xu Zhiliang asked.

Song Zimo has no doubts: "You have not been here for a long time, and you will gradually adapt to it in the future. Dr. Yang is a person who keeps creating miracles. He will help you expand your brain hole and keep expanding it."

After the room check, everyone except those on duty went to the operating room. After a few operations, it was the child's turn. Song Zimo took Xiao Wu's disinfection sheet and performed local anesthesia on the surgical site according to Yang Ping's request.

Takahashi borrowed a magnifying glass from some student, facing the film reading light, using the magnifying glass to read the film, almost touching the magnifying glass with his nose, watching for a while, rubbing his eyes, and continuing to read.

Yang Ping washed his hands and dressed, pondered for a while before looking at the film, made a final positioning in his heart, and then started.

He made a small longitudinal incision of 1 cm on the skin on the inner side of the lower end of the right tibia, reaching the periosteal bone, separated from the periosteum, and then used vascular forceps to open the small incision, exposing a small part of the inner surface of the tibia.

Put the trephine against the bone surface, adjust the direction, then slowly drill in, stop at a certain depth, and then pull out the trephine with the stuffed bone.

In the flushing area, calcium sulfate containing vancomycin is mixed into a dough, and the small tunnel just dug is filled. The vancomycin can be slowly released locally, killing the bacteria that may remain inside.

The tunnel was stuffed firmly, with a small incision of 1 cm, only one needle was needed, starting from the periosteum, sutured in layers, a small sterile dressing was pasted on it, and the work was over!

Takahashi timed the time from coming on stage to sewing the skin in one minute and 22 seconds. Is this the solution?

"See through?" Yang Ping took off his surgical gown and gloves.

Fluoroscopy is only a short exposure, and compared with multiple or continuous exposures in navigation surgery, the amount of radiation is much less.

After the fluoroscopy, compared with the pre-operative images, the tunnel drilled by the trephine just surrounded the point mentioned by Yang Ping, no more, no less.

Song Zimo took out the cylindrical bone tissue in the trephine. Except for a small amount of cortical bone at one end, most of the cylindrical bone tissue is cancellous bone.

He carefully cut the cylinder into circular thin slices. It was not difficult to cut the cancellous bone. Sure enough, he saw the section of the lesion.

The section is like a sandwich, with necrotic bone the size of a rice grain in the center, infected bone tissue surrounding the rice grain, and a circle of normal bone tissue outside.

Looking at this section, Song Zimo can be sure that the lesion has been completely removed. The accuracy of this positioning is higher than that of the surgical robot.

"Do another CT after surgery." Yang Ping ordered.

Postoperative CT is unavoidable, and evidence must be left to confirm that the lesion has been completely removed.

"Keep it as a specimen and send it to the pathology department for pathological examination. I'm going to the pathology department to have a look under the microscope in person. Are you interested?" Song Zimo put a few slices into the specimen bag for pathology examination.

"Wait! Show me." Takahashi was still wondering just now, how did Yang Ping manage to get the lesion accurately at one time without using the navigation system.

Song Zimo had already given the specimen bag to Zhou Can: "Wait until we go to the pathology department, let's take a look under the microscope slowly, sandwich the lesions, and remove them precisely in one go."

The child followed the doctor out of the operating room. Song Zimo told his parents that he could walk normally, that strenuous physical activity was prohibited for three months, that he could be discharged from the hospital and go to school tomorrow, that his medicine was changed every three days, and that the stitches were removed every ten days.

"This is the excavated lesion. There are dead bones and infected bone tissue. Take a look." Song Zimo showed the child's father the picture on his phone.

The child's father can't understand it, but he can understand the general idea. This is the root cause of the disease. Now the doctor has dug out the root cause of the disease.

"Will it hurt if the bone is dug?" the child's father asked worriedly.

"There are very few pain-sensing nerves in the bone tissue, so you won't feel too much pain. Pain is also a wound pain. I will give you some painkillers at night." Song Zimo explained.

"Will the hole that was dug be filled later?"

"Generally, it will be filled with new bone tissue after three months."

"I dug out the root this time, won't it recur?"

"Generally not, but no one can guarantee [-]%."

"What should I pay attention to in terms of diet, and what are the taboos? Or what supplements are good for him to grow bones? Is it okay to make bone soup?"

"Normal diet is enough. If you like to drink bone soup, you can cook it for him. It is neither good nor bad for this disease."

"Is it okay to make some Tianqi soup? Promote blood circulation and remove blood stasis!"

The child's father and Song Zimo asked and answered these questions in detail before the operation, and now the child's father asked them again.

"Tian Qi is a traditional Chinese medicine, and it has side effects. Don't take it casually, just eat a normal diet. Your family's normal diet, is it okay to eat Tian Qi every day?" Zhang Lin got impatient and interjected.

"Can you send me a copy of the photo?" The child's father was embarrassed by Zhang Lin and changed the subject.

Song Zimo gave him a copy of the photo. The father was very active. He took the photo and sent it to Moments: The root of the child's disease has finally been dug out, and he can sleep peacefully tonight.

Trouble came, and when the child’s father’s circle of friends posted it, many people responded one after another, asking which hospital he was in and which doctor he was looking for.

Someone even called for consultation. The child's father glanced at Dr. Yang and said in a low voice, "I'm busy now, let's talk later."

(End of this chapter)