Chinese medicine: When you do things to the extreme

Chapter 320 The first brave step! (Subscribe)

"Don't be anxious, don't be nervous!~"

"After we enter the operating room, we will confirm the affected limb with the patient again. There must be no mistakes."

"Whether it's functional reconstruction surgery or the functional rehabilitation surgery concept you proposed, they are all mature surgical procedures, so you won't be disturbed during the operation."

“Even a professor who can’t perform functional reconstruction can probably understand your surgical procedures.”

June 6, Sunday, 20: am.

After Professor Du Zhonghua brought Zhou Yanqing into the operating room, he spoke as he walked from the locker room to the floor where the operating room was located.

"Master, I have sent a message to Teacher Qu to explain everything." Zhou Yanqing said.

It's impossible not to be nervous.

Before this, Zhou Yanqing had never performed a live surgery in front of other colleagues in the province. His first live surgery was presented at the "national" mid-year academic conference.

How can I not be nervous?

Zhou Yanqing was certain that by then he could only exert 70% to 80% of his strength, not all of it.

It's not that Zhou Yanqing can't take the main seat, but that this academic conference is a heavyweight academic conference in the second tier of rigorous domestic conferences. Except for the annual orthopedic meeting, there is no other academic conference larger than it.

Du Zhonghua was of course aware that Zhou Yanqing was deliberately trying to change the subject, so he nodded and said, "Just do the surgery later, and Tan Zhongyu and I will handle the rest."

"Tan Zhongyu will be in the operating room soon. He is the person in the operating room communicating with the venue."

"Don't worry about it, the camera is not facing you!~"

"Yeah!" Zhou Yanqing nodded.

Then he entered the operating room with Professor Du Zhonghua.

In the operating room, Professor Ding Xiao and Associate Professor Huang Xianming were already waiting in line, and Brother Liu Qingshan did not go out this year.

Except for Yu Yue and Ning Zhu who went to participate in the competition, other doctoral seniors, such as Liu Wanqing, Ling Qiyuan, Tian Chao and others stayed in the department.

"Professor Du, can we start anesthesia?" Professor Dong Lunming, deputy director of the Anesthesiology Department, asked as Du Zhonghua entered.

For this live broadcast of the hand surgery operation, he personally came to the hand surgery department to work overtime to administer anesthesia, in order to ensure that the depth of anesthesia was just right for the operation and to control the overall situation.

Du Zhonghua waved his hand and approached the operating table: "Hello, your surgery today is on your right hand, right? Let's confirm it again?"

"Yes, there are surgical marks." The patient, a middle-aged man in his forties, nodded and smiled.

Although I was asked this question many times, I felt reassured that I was treated seriously in the hospital.

When seeking medical treatment, most patients hope that the doctor who sees them will be more rigorous.

"The operation will start at 12:10 noon. We will start anesthesia at 11:20, start disinfection at around 11:40, and plan to start skin incision at 12:00."

"In this way, at 12:10, the core operations of the operation can be exposed." Du Zhonghua described the surgical process in great detail.

When communicating with colleagues across the country during live surgical broadcasts, the timing must be just right.

Don’t be afraid that others can’t understand it. If they can’t understand it, that’s because their level is problematic. Just broadcast the key parts live, which is about an hour.

Others won’t watch it or don’t like to watch it!

Those who really don't understand can go home and take care of themselves. No one is obligated to teach them why they should do this or the basic principles of doing so. It is just to show other colleagues the purpose and benefits of doing so.

Dong Lunming nodded after hearing this and waited for a while before starting the brachial plexus block anesthesia under the monitoring of color ultrasound.

Zhou Yanqing once again went to the patient's film reader with Professor Du Zhonghua, carefully compared the patient's name and hospitalization number, and reviewed the diagnosis again.

Tian Chao closed the medical record book and came closer: "Brother, I checked the patient's preoperative examination again. Only the red blood cells are slightly lower than normal, with only a decrease of 0.1. The rest of the indicators are normal."

"The electrocardiogram is fine, and the chest X-ray is fine."

Zhou Yanqing nodded when he heard this. He did not answer Tian Chao's words, but said to his master: "Teacher Du, the main functional disorder of this patient is the limited abduction of the thumb, which belongs to the adduction flexion deformity."

"This is a typical sign of radial nerve injury, and his wrist joint is compressed, so during our operation, the first thing we need to do is to deal with the radial nerve..."

"The second batch is critical to dealing with the muscle layer associated with the wood abduction..."

"third……"

Zhou Yanqing himself felt a little annoyed, but he still said it out loud.

Du Zhonghua nodded: "Just be aware of it."

At 11:35, when the anesthesia was about to be completed, Tan Zhongyu hurried in from outside the operating room.

Liu Qingshan and Liu Wanqing have washed their hands and are ready to disinfect at any time.

Tian Chao also went out to wash his hands and get dressed, ready to lay the towel at any time to save time as much as possible.

At the same time, the live broadcast management team responsible for collecting the live broadcast signal from the venue also made an OK gesture: "The signal connection is complete and the video is smooth."

"The live broadcast signal is getting better and better now."

"Are all the video equipment fixed?" Tan Zhongyu happened to hear it and asked.

"Don't worry, Professor Tan, we are professionals. This time, our team is not only responsible for the live broadcast of Xiangya Hospital, but also for the live broadcast of Jishuitan Hospital and the scene. We can even achieve a smooth connection between domestic operating rooms and foreign hotels!~" The staff was very confident.

This was not something Tan Zhongyu was good at, so he nodded and stopped worrying about it.

After talking with Du Zhonghua for a while, he went out with Zhou Yanqing and Du Zhonghua to wash his hands and get dressed.

Because the circulating nurse and instrument nurse had been informed in advance of the surgical instruments needed, there was no need to elaborate.

The head nurse of the operating room personally brought three pairs of circulating nurses and instrument nurses into the operating room. There were sufficient people to deliver instruments, ensuring that the required instruments could be delivered to the operating room as soon as possible.

……

Twelve o'clock sharp.

After everything was done and the drapes were disinfected, Tan Zhongyu said, "At twelve o'clock, the skin will be incised and the operation will begin. Record the time of the operation!"

Dong Lunming from the Anesthesiology Department and the head nurse of the operating room were recording on the computer respectively, while another circulating nurse pressed the button to start the operation!
Zhou Yanqing picked up the scalpel and made the first incision without hesitation!
After smoothly cutting through the skin and subcutaneous tissue, the key anatomical structures were slowly found, and then the surgeon waited for the live broadcast of the surgery to be connected to the live broadcast signal of the venue before completing the other key parts.

Zhou Yanqing's incision was very smooth and round. It was originally estimated that it would take 20 minutes to open the anatomical structure, but Zhou Yanqing compressed it into 10 minutes, with three minutes of waiting time.

"It's connected! Professor Tan." said the person in charge of the live broadcast.

At the conference site, the voice of the conference host was heard: "Professor Tan, the screen is already displayed in the venue. Can you hear it over there?"

The host was Professor Teng Qinghe from Union Hospital, whose voice Zhou Yanqing was very familiar with. "I can hear you, Professor Teng, let's start." Tan Zhongyu gave the order and said, "The basic condition of our patient is wrist stiffness and thumb adduction and flexion deformity caused by radial nerve damage, and limited abduction function of the index and middle fingers..."

"We have opened up the radial nerve and we can see the muscles involved in abduction..."

As Tan Zhongyu was speaking, Zhou Yanqing followed Tan Zhongyu's explanation and began to show the local components after dissection to the people at the meeting.

It can be seen that the patient's abductor pollicis longus and brevis muscles are stiff and contracted, and the extensor digitorum muscles that control the index finger are also bunched up with the surrounding structures.

The patient suffers from muscle atrophy, muscle contracture, and a large amount of scar hyperplasia on the wrist joints.

"Our team's general habit is to dismantle the damaged structures one by one after viewing them, from the outside to the inside, slowly peeling them off layer by layer! ~"

"The order of our treatment is generally to treat the tendon first, and then go deeper to treat the nerve, explore the damaged location of the nerve, the nature of the damage, the cause of the narrowing of the nerve corridor, and match the anatomical compression with the results of the MRI."

"Professor Teng, our case data has been sent to the site. There is a very clear cross-section of the MRI. You can open it and compare it with the live broadcast."

Teng Qinghe said: "It's already opened."

Tan Zhongyu didn't say anything, but Zhou Yanqing's hands were constantly moving, cutting open some scar tissue without hesitation.

The sharpness of this cutting technique and the decisiveness of its handling demonstrate the master's style and the depth of his basic skills.

There was silence at the scene, so silent that one could even hear Professor Teng Qinghe's heavy breathing. It was obvious that after seeing the operation in the video, even he felt that this kind of incision was somewhat extraordinary.

The live broadcast of the surgery was not an argument, so there was no noise to interrupt.

The operation was able to continue.

Functional reconstruction surgery, if disassembled, is an organic combination of specialized surgical procedures such as muscle lengthening, muscle suture, tendon transfer, and tendon resection.

This is a routine first-class operation in hand surgery in addition to advanced surgeries. In principle, all teaching hospitals must have someone proficient in this, otherwise they will no longer be first-tier teaching hospitals.

Because if you are not proficient in this, you are not qualified to compete in functional reconstruction.

Therefore, the atmosphere of the live surgery broadcast is relatively good, without too many doubts or noise.

Until twenty minutes later, Teng Qinghe saw the live broadcast footage of Zhou Yanqing temporarily suturing an unimportant muscle. He thought carefully for a few seconds with a slightly gloomy face, and then looked at the reactions of the crowd.

Off the field, many professors were reflecting and wondering if they were too "ignorant" and therefore found it difficult to express their opinions.

There are many different suturing methods in hand surgery, almost like a hundred flowers blooming in full bloom. What if there is a mature suturing method that you are not familiar with, but other professors know it, and it would be a bit inappropriate to ask a question rashly.

As the operation became increasingly bizarre, Teng Qing and another guest host sitting next to him whispered, "Professor Teng, this suturing method is quite unusual. Have you seen it before?"

Teng Qinghe shook his head slightly and said, "Professor Tan, can I ask you the scientific name of the suture method you use?"

"It looks unfamiliar. It doesn't seem to be the ones we commonly use in clinical practice."

Tan Zhongyu's voice was relatively clear: "This is a new suturing method that our team has developed based on the tendon weaving and suturing of tendons in the Sports Hospital. It has not yet been named."

"Suture is nothing more than fixing the tendon. It's fine as long as it works." Tan Zhongyu's voice was light and he didn't delve into it.

Another nickname for academic conferences is the "show-off" conference. You think you're awesome if you show others what they can't do or what they can't learn.

Although everyone at the meeting had different expressions, there was no uproar.

The big guys who can sit here are at least local giants with top skills and vision. They know that the hands in the video are as dexterous as those of top experts.

The accumulation of basic skills has been consolidated to the point where no one dares to question it.

According to domestic regulations, associate professors can create their own suturing methods. It is not illegal for people with such solid basic skills to improve the suturing procedure.

That is, in the live broadcast of the operation, wasn’t it a bit too rash for Tan Zhongyu to demonstrate such a suturing method?
Or is there another reason?

It’s a pity that this is the last day of the conference, which started on Wednesday and lasted for five days in total.

However, even if you cannot ask in person, you can still ask after the operation is over.

In the video, except for the suturing technique which is difficult to understand, the other operations are almost smooth and impeccable.

There is no problem in using words like round, perfect, and silky to describe this operation.

With these lateral operations as a backup, even if the suturing technique is a little inferior, everyone knows that this functional reconstruction operation is very successful.

Xiangya Hospital can really carry out functional reconstruction surgery on a routine basis, and their operations have become among the most cutting-edge in the world in hand surgery!
This is everyone's reaction, and this is what Tan Zhongyu wants to tell them! ~
This cannot be ignored and we have to admire it.

The operation ended as planned after an hour.

Tan Zhongyu said: "Our surgery this time is based on the most basic principles of functional reconstruction. What remains is some finishing touches, so I won't waste your time."

"Professor Teng, Professor Huang, our live broadcast of the surgery has ended. If you experts have no other suggestions, please tell me."

"We declare the live broadcast of the surgery over." As Tan Zhongyu was speaking, Professor Zhou Yanqing and Professor Du Zhonghua had already begun to demonstrate the passive range of motion of the wrist joint and thumb after functional reconstruction in the video.

Compared to before the operation, it is much more active!

The passive activity room can maximize the potential of active functional training and the functional effect. The range of motion has been more than doubled compared to before the surgery.

As the saying goes, there are three thousand paths, but they all lead to the same destination. Functional reconstruction is not a specific procedure but a concept.

Therefore, the audience gave applause generously.

It is congratulations and admiration.

There are no more than ten hospitals in China that can routinely perform functional reconstruction surgery. Now Xiangya Hospital is one of them. It is in full view of everyone, no doubt! ~
Tan Zhongyu was also very satisfied with the on-site results and the results of the surgery: "Thank you professors for your encouragement, and see you next time."

"Professor Teng, Professor Huang, I'm going to turn off the screen first."

"Okay, Professor Tan." Teng Qinghe nodded.

There is no doubt about it. Functional reconstruction surgery is already a mature surgery internationally.

This operation was performed according to the principles and backed by strong basic skills. There is nothing wrong with the proficiency and we can only celebrate.

The live broadcast ends.

In the operating room, everyone had a subtle smile on their face.

Of course, people at the conference and from Xiangya Hospital would constantly send back images and questions after the live broadcast of the surgery.

"Close the incision and the operation is over." said Tan Zhongyu.

The live broadcast of the surgery was smooth and peaceful, which was the best presentation...

(Note: The index finger is the anatomical name for the index finger.)
(End of this chapter)