Chapter 14 Genius
Yang Ping ate a piece of chocolate, quickly compressed the cookies and rushed to the operating room.
Director Han, Song Zimo, Director Tian, Zhang Lin, and Fang Yan have all arrived. There are also many young doctors and interns who came after hearing the news. They all want to see this replantation of a severed finger of a baby. After all, it is rare. A very difficult operation, sometimes you may only encounter such a case in your lifetime.
The circulating nurse scolded the unruly interns: "There are so many people? Who is the teacher? Please stay away and pay attention to the concept of sterility!"
Fortunately, the orthopedic surgery operating room is relatively spacious, so it doesn't seem too crowded even if there are many people.
"Divided into two groups, Tian Yuan led Fang Yan and Chen Xiaobo to debridement the free severed finger and search for blood vessels, nerves and tendons; Song Zimo led Yang Ping and Zhang Lin to debride the proximal wound and search for blood vessels, nerves and tendons; then the transplant was led by Song Zimo and Yang Ping is in charge, and the rest are the reserve team." Director Han is very organized.
"Which nurse is on stage today?"
"Su Yixuan!"
"That nurse who specializes in orthopedic surgery?"
"Yes, Director."
The circulating nurse replied that Su Yixuan had already washed her hands and was preparing to go on stage.
Liang Jing, the anesthesiologist, is a fat man. She graduated with a doctorate from West China University of Medicine. The hand-washing clothes she wore were obviously ill-fitting, especially the pants that were too short. The lower third of her entire calf was exposed, giving her the feeling of a cropped trousers.
Fatty Liang's skills were very good. He gently pried open the baby's mouth, and then carefully inserted the tracheal tube. He pulled out the guidewire and placed the stethoscope on the chest to confirm that it had entered the trachea. Then connect the anesthesia machine.
"Well, let's brush our hands." Liang Jing sat on the side of the child's head, recording and staring at the monitoring data on the display.
"It's too difficult to pick up this one today. It's so small that even if the microscope is magnified fifty times, it's not easy to handle. If your hand shakes just a little, the blood vessel will break."
"Yes, I heard that the most difficult thing to replant after severed fingers are those of babies. The blood vessels are probably like hair."
"Director Han should do it. Director Han used to work at the Sixth Hospital of Shanghai, which is the birthplace of replantation of amputated limbs in the country. The first case of replantation of amputated limbs in the world was in that hospital."
"Really? No wonder Director Han is so powerful."
"No, it was Senior Brother Song who did it."
"Senior Brother Song, wow!"
"He is very powerful. I heard he is a genius. Didn't you see that Director Han always takes him with him?"
"He is tall, handsome, highly educated, and so good. I heard that many girls like him."
Some female interns started gossiping secretly.
"I'm sure. I heard that my family is very rich."
"No way, he gets all the good things."
Once the gossip box is opened, there is no end.
"Quiet, keep quiet if you are watching! Replanting a severed finger requires a high degree of concentration. Turn on the video system next door, and when the show starts, go next door -" The head nurse inspected the operating room, came in to take a look, and found this There are so many students, so naturally we can’t just sit back and do nothing.
This operating room is the main operating room. There are supporting rooms on both sides. One side is a storage room and the other side is a demonstration classroom. Half of the partition wall from the demonstration classroom is a transparent glass wall. The demonstration classroom is equipped with a high-definition screen and is connected to the operating room microscope. Or the high-definition camera on the shadowless lamp can play the entire surgical video in real time when needed.
Su Yixuan had already washed her hands, raised her hands in front of her chest, picked up a sterile gown, stood on the side of the open space, facing the sterile table, shook her hands slightly, and her hands went deep into the inner cuffs. The circulating nurse immediately stood behind her and helped her pull up her clothes and tie the belt behind her.
Then put on gloves and start counting the instruments and dividing them into sections.
Two operating tables.
On this side, Song Zimo and Yang Ping washed the wounds.
On the other side, Tian Yuan and Fang Yan were also rinsing the severed finger, cautiously, for fear of losing it and not finding it.
After rinsing, everyone went to wash their hands and dress. Usually the first assistant disinfects the sheets, but Song Zimo asked Yang Ping to get dressed and disinfected the sheets himself.
The microscope was pushed over and set aside.
Begin debridement on both sides, which is to remove foreign matter, necrotic tissue and loss of vitality from the wound, and then trim the skin edges neatly.
The young doctors and interns who were observing rushed to the next door like the head nurse herding sheep.
Five fingers, starting from the thumb, Fang Yan brought the thumb that had been debrided and rinsed. Song Zimo used an electric drill to drill the steel needle into the phalanx, and connected the bones first, so that the general support was established.
The next step is to find blood vessels, nerves, and tendons and suture them together. Simply put, these are the steps. Blood vessels are the most difficult to find and suture; nerves are second; tendons are easy to find and suture, and any orthopedic resident can suture them very skillfully.
The microscope was pushed to the surgical area, fixed, and the focus, interpupillary distance, and magnification were adjusted. The blood vessel was too thin and was magnified fifty times.
Song Zimo used micro tweezers in his left hand and micro scissors in his right hand and began to debridement and search for blood vessels under the microscope. His operation under the microscope was really good. Under the fifty times larger field of view, his hands did not shake and he was very skilled in the operation.
This guy has pride and capital, Yang Ping had to admit.
"The blood vessels are too thin, so keep your hands steady and calm down." Director Han encouraged Song Zimo.
Song Zimo remained silent, quietly manipulating the microscopic instruments and searching for blood vessels, nerves and tendons under the microscope.
In addition to the large screen on the wall next door, there is also a screen in the operating room, which is not as big as the one next door. Director Han sat in front of the screen and stared at it.
The blood vessels of the thumb were successfully found, and then the nerves and tendons were found. Next, the broken ends of the blood vessels were debrided and trimmed to make the broken ends of the blood vessels clean and standard. There should be no impurities in the lumen, let alone damage.
Rinse with normal saline.
Wire!
The thinnest double-needle non-damaging blood vessel suture needle is only a few tenths of the diameter of a child's hair.
Cut it in the middle, give half to Song Zimo, and half to Su Yixuan for safekeeping.
Song Zimo began to suture the arteries.
However, this baby's blood vessels are smaller than expected. The diameter should be much less than 0.1 mm, and the visual inspection should be about 0.05 mm.
Song Zimo took a deep breath, calmed down, and tried to keep his hands as slow and steady as possible. At this time, he was challenging the pinnacle of microsurgery.
The first stitch begins.
"Slow down, don't rush." Director Han told Song Zimo.
Even if I want to hurry up now, I can't get up quickly. The blood vessels are not only small, but also have relatively thin walls, not at all like the walls that arteries should have.
Song Zimo's first injection was very slow, much slower than his usual training speed. The tweezers lifted the outer membrane of the blood vessel wall. This kind of wall is very easy to tear, which is a test of his skill.
The needle gently penetrates the wall of the tube at the right position, then passes through the wall of the tube at the other end. It is gently pulled and knotted, and the first stitch is perfectly sutured.
Director Han nodded slightly. Song Zimo's talent is indeed very high. He has been growing rapidly recently. He has become so proficient in suturing blood vessels down to 0.05 mm.
Yang Ping was about to cut the thread, but Song Zimo refused, so he picked up the microscissors and cut the thread himself.
The blood vessels are too thin. If the hand moves unsteadily under the microscope and shakes a little, the sutured blood vessels may be easily cut.
The second needle, the third needle, and until the sixth needle, his rhythm was very smooth, the needle margin was very beautiful, and the first blood vessel was connected smoothly.
If the operating room hadn't needed to be quiet, the people watching the operation next door would have applauded enthusiastically.
(End of chapter)