Chapter 153 You don’t want to come
Every day's surgery starts more accurately than clockwork.
The anterior cruciate ligament reconstruction surgery started on time at 8:30.
In order to make this surgery more beautiful, Yang Ping used his spare 6,000 points, took out 2,000 points, and bought another 100 anterior cruciate ligament reconstruction surgeries in the system space for special training, transforming this single surgery from a specialized Refined to the level of perfection.
Director Han is very confident about Yang Ping. Every operation he performs is both speed and quality, impeccable.
However, people are always curious. The meniscus suturing last time was not enough. This time for the anterior cruciate ligament reconstruction, Director Han decided to go and have a look again.
Huang Jiahui didn't come. Zhou Can called several times, but she didn't answer. Zhou Can placed the sterile packaged consumables on the equipment cart.
Not seeing Huang Jiahui, Song Zimo frowned, but Yang Ping didn't say anything, and Song Zimo didn't plan to express his opinion for the time being. He would talk to the little girl afterwards. If he didn't come if something happened, he should have a phone call.
"Operation time?"
Every time he encounters a new type of surgery, Fatty will habitually ask.
"Half an hour!"
Yang Ping looked at the magnetic resonance imaging of his left knee and the plain CT scan of both knees + three-dimensional reconstruction on the reading light. He found that the intercondylar fossa of the left knee had been severely deformed, and intercondylar fossa formation was required during the operation.
The intercondylar fossa is like an arch-shaped cave. Now that the cave has collapsed, it needs to be rebuilt and restored. How can it be restored without its original appearance? I have to refer to the one on the right side. The right side and the left side are mirror images.
"It is very difficult to form this intercondylar fossa!" Song Zimo pointed out the intercondylar fossa in the picture.
"The patient went to an outside hospital and was not given surgery because he was afraid that the surgery would not be done properly and cause problems. If the surgery was not done properly, there would be an impact after reconstruction, and the surgery would completely fail; if the surgery was over-shaped, the patellofemoral joint would lose its stability, and new troubles would arise." Yang Ping explained to Song Zimo.
Song Zimo took out a folded piece of paper: "Look, this is the intercondylar fossa of the left knee that I drew based on the three-dimensional CT reconstruction of the intercondylar fossa of the right knee, at a one-to-one ratio."
Song Zimo unfolded the paper and Yang Ping took it. He did draw well.
If you just make a rough outline of the shape, many doctors can do it, but they have to draw a specific and accurate picture of the left side based on the right side. This kind of spatial imagination ability is absolutely rare, very rare.
Not everyone has this kind of spatial imagination ability. It requires talent, and it is not an exaggeration to say that it is only one in a million.
Song Zimo played blind Go all morning without missing a chess piece or making a mistake. What kind of ability is this? Memory and spatial imagination that are beyond the reach of ordinary people.
The thinking of ordinary people is language, while the thinking of geniuses is composed of a large number of pictures. Song Zimo is a genuine genius, verified!
"Bring a pen!" Yang Ping gave impromptu instructions to Song Zimo.
Song Zimo asked Zhou Can for a blue and black gel pen, and Yang Ping called up the three-dimensional diagram that had been constructed in advance in his brain. This time it was much easier than the last time. The graphics can be effectively stored in the brain for a longer period of time, but still There were some slightly blurred areas. Yang Ping immediately filled in the blurred areas based on the CT picture in front of him. It was not that laborious. Although it was still difficult, at least he would not sweat.
Yang Ping sketched a new drawing under his drawing: "When doing three-dimensional CT reconstruction, some graphics will be deformed due to the interference of artifacts, and we need to correct them. You see, it shouldn't be protruding here, it should be smooth. ; here, it should be a little deeper; and the arc needs to be slightly corrected. ”
Song Zimo could only smile bitterly. He could only make a mirror composition based on the three-dimensional CT reconstruction image, and could not reconstruct it on the drawing using the original cross-section.
But Yang Ping can do it. Mr. Ning from Huaqiao Building did not do 3D reconstruction at that time, but only CT scan. Yang Ping only relied on the scanned pictures and carried out hand-drawn 3D reconstruction on the drawings. How terrible mental power this requires. This is not human power. Achievable.
But Yang Ping did exactly that, and Song Zimo saw him do it with his own eyes.
If Song Zimo knew that Yang Ping in front of him actually didn't need drawings at all. He could compose the picture in his mind, he would probably grab Yang Ping and take a CT scan and MRI of his head to see if there was anything similar to a chip inside.
"Are you discussing the formation of the intercondylar fossa?" Director Han put his phone on the shelf next to him and walked over.
Although Director Han completely let go, he still knew the condition of Corey's patients very well, which was a kind of responsibility.
He came over to look at the drawings. These two boys actually used the intercondylar notch on the unaffected side to draw the correct image of the intercondylar notch on the affected side. In one of them, the artifacts of the reconstructed image were processed.
——
Huang Jiahui didn't sleep well all night. She kept having a fever. In a blur, she reached out to touch the mobile phone on the bedside and reluctantly opened her eyes: "It's eight forty! It's eight forty!"
The operation started at 8:30, so he should have arrived in the operating room early. Now he should be in the operating room, standing next to the instrument cart.
She suddenly woke up as if a basin of ice water had been poured from her head. Her muscles ached all over her body, and her lower abdomen was in severe cramping.
My brother had something to do last night and never came back, otherwise he would have woken her up.
Jiahui almost cried. She got up immediately, dragged her heavy body and rushed to wash up. No, make a phone call first.
The operation has started. Who should I call? Song Zimo. It seems that Dr. Yang has left all these things to him.
——
On the shelf, Song Zimo's cell phone vibrated.
Zhou Can picked up the phone: "Song Zimo, Huang Jiahui's phone number?"
"You pick up!" Song Zimo was busy.
Zhou Can answered the call and relayed it to Song Zimo after listening clearly: "Huang Jiahui said I'm sorry. She had a cold last night and had a high fever. She's still running a high fever now. She's late. She'll come right away."
"Tell her not to come over!" Yang Ping inspected the knee joint, confirmed that the anterior cruciate ligament was ruptured, and began to prepare to remove the tendon, semitendinosus and gracilis on the same side. "Little girl, you worked so hard. You had to come here even if you had a high fever. In fact, she won't be needed for future surgeries." Yang Ping said while doing it.
Zhou Can understood what Yang Ping meant and said into the phone: "Doctor Yang said you don't need to come here anymore."
This level of communication is definitely not up to standard in Chinese. Do "Don't come here anymore" and "Don't come here" mean the same thing? ——
What do you mean you don’t have to come here anymore? Just be direct and get out! You don’t want to do this business anymore!
Missing the surgery without any advance greeting is a serious mistake. This is what happened to my colleagues. I angered a great professor. This is what the professor said - you don’t need to come here anymore. In order to appease the professor, the company directly fired the doctor. colleagues.
Jiahui no longer even wanted to wash her face and brush her teeth. Tears flowed out. Now she was in trouble and had a big problem. He immediately dialed his brother's phone to ask for help, but there was a busy signal.
She had no choice but to bite the bullet, wash up quickly, and change her clothes.
Ignoring the pain all over her body and lower abdomen, she rushed out with a reusable bag. A gust of wind outside made her shiver, and she involuntarily crossed her arms and hugged herself.
——
The movements were a bit exaggerated. He made a transverse incision of just one centimeter on the inner side below the knee. Song Zimo could not see clearly at all. He only saw the vascular forceps, sharp knife, and tendon stripper, operating in the small incisions one after another.
The two tendons were taken out one by one by Yang Ping, and the lengths they took out reached the limit. The semitendinosus and gracilis tendons both exceeded 30 centimeters.
"Process the braided tendons!" Yang Ping handed the two tendons to Song Zimo, and Song Zimo sat on the sterile instrument table to process the tendons.
At the same time, Xiaowu supported the leg and Yang Ping continued to deal with the knee joint.
The lens is repositioned, the necessary trimming of the meniscus is performed, and formation of the intercondylar notch begins.
The drill rotates at high speed, like a carving knife, and the patient's severely deformed intercondylar fossa is like a blank. Slowly, a perfect normal intercondylar fossa is carved out by the drill.
The plasma knife is then used to perform radiofrequency ablation on the inner wall of the formed intercondylar notch to achieve hemostasis and deactivation, thereby preventing the intercondylar notch from continuing to proliferate osteophytes in the future and causing re-stenosis.
"Tibial Positioner!"
Before Yang Ping could say anything, the instruments were already in his hands. He and Su Yixuan looked at each other knowingly for a moment and continued the operation.
Insert the adjusted tibial positioner, pass the electric drill with the guide pin through the tibial platform, and drill a tunnel; release the electric drill and hand it to Su Yixuan, install the second guide pin, and drill out the second tunnel.
"Have the tendons been treated well? Tell me the size!" Yang Ping was waiting.
"Professor Yang! The 8-strand double beam is being rebuilt! Can you not do it so quickly?" Song Zimo said this without showing any weakness in his hands. As Yang Ping's assistant, who else would he rather be than me?
"The length is 8 centimeters, the diameter at the tibia end is 7 millimeters, and the femoral end is 8 millimeters. The two bundles are the same!" Song Zimo could keep up with the rhythm.
"7mm tibial tunnel drill bit!"
With a rustling sound, the electric drill accurately opened two tibial tunnels.
"8mm Femoral Tunnel Drill!"
Yang Ping quit the electric drill, Su Yixuan took it and immediately replaced it with an 8 mm femoral drill bit.
Without intending to stop for a moment, two femoral tunnels were opened, and the thick tunnels were prefabricated to a length of 25 mm.
"Measure the length of the femoral tunnel!"
The ruler was handed over, but it had been placed in advance.
"Two tendons, the anterolateral bundle has a thick tunnel of 25 mm and a thin tunnel of 25 mm at the femoral end; the posteromedial bundle has a thick tunnel of 25 mm and a thin tunnel of 20 mm at the femoral end. Prepare the tendons, hurry up!"
Song Zimo raised his hand speed to the top and held his breath. A few seconds after Yang Ping finished speaking, he had already adjusted the hanging length of the button steel plate.
The most critical steps of this surgery are the formation of the intercondylar fossa and the precise double-bundle tendon tunnel. Once the location of the tunnel is wrong or inaccurate, the surgery will fail, and some may cause mobility impairment.
But Yang Ping opened it in just a few minutes, and the next step was even faster: pulling the tendon into the femoral tunnel, waiting for the button plate to pull out of the femoral cortex, and then pulling it back to flip the plate. The tendons are then introduced into the tibial tunnel and the tibial ends are fixed with absorbable compression screws for both tendons.
In this way, the two ends of the two tendons are implanted in the bone tissue, allowing them to survive and play the role of the original ligaments in the future.
The entire surgery is equivalent to making a new ligament to replace the broken ligament, simulating the work of the original ligament.
"It's over?"
It’s okay if you don’t look at it. Every time you look at it, your eyes dangle.
Director Han had just studied the CT scans for a while, turned around and sat down, ready to take a good look at Yang Ping's surgery, but the surgery was completed.
Huang Jiahui ran in at this time and saw that everyone was bandaging and was about to lift the sterile drape.
It's over, it's all over!
Jiahui felt cold in her heart.
(End of chapter)