Chapter 230 We all have to live
Fourteen injured people were successfully taken back to the hospital, 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, Yoshino's work is over the moment the wounded enter the hospital and the handover is completed.
Of course, sometimes, the surgeon needs to know the scene in detail and will communicate back with Yoshino. In any case, the main work is no longer done by Yoshino.
Let's smoke a cigarette, Yoshino came to the smoking room alone.
He knows that smoking is harmful to health, and he advises others in this way, but there must be a way to relieve stress.
"Yoshino, good job!" Sasaki called.
In the ambulance, Yoshino took advantage of the simple conditions to decisively open the skull of the injured person, fully decompress him, and remove part of the hematoma.
His judgment based on the symptoms and signs was very accurate, most of the hematoma was removed, and the brain hernia was treated in a timely manner, which bought valuable time for rescue.
Otherwise, the helicopter would pick him up now not as a living person, but as a cold corpse.
"A few years ago, in the same place, I hesitated, and finally gave up. The wounded person died in the end. I have been regretting it and thinking about why. Today, I no longer hesitate, regardless of whether she can survive or not. , I tried my best, now it’s your turn.”
Yoshino is just a cog in the entire system. Only when every cog operates normally can the system operate well.
Yoshino and Sasaki are about the same age, Sasaki is already a quasi-professor, and Yoshino is still wandering around as a lecturer, but he doesn't care, saving people is the greatest joy.
"The fetus is already five months old and still has a fetal heartbeat. We retrieved her previous case information. It took her five years and several hospitals to get pregnant. This shows how much she longs to be a mother. I decided, Even the fetus was saved, Mr. Fujiwara agreed. "Sasaki asked Yoshino to share their operation.
"Awesome, come on! -" Yoshino has a sense of accomplishment. If he succeeds, he will have his own share of the credit.
However, even saving the fetus is very risky and difficult. It is not surprising that Sasaki makes such a decision. He always creates miracles.
He is the enemy of the God of Death, and he has snatched back many lives from the God of Death.
From entering the emergency center, completing the examination, to going to the operating table for surgery, it only took less than ten minutes.
Because she is pregnant, the best test is magnetic resonance imaging, but the thing inserted into the abdomen is a metal piece.
After contacting the car manufacturer, it was determined that it was magnetic. If an MRI was performed, the strong magnetism would move the metal and pull it out, so the pregnant woman underwent a CT scan.
Although X-rays are harmful to the fetus, they are already five months pregnant and will not cause deformities. Compared with saving his young life, these are insignificant.
Hiroshi Arai is performing an operation. Infrared real-time monitoring is combined with the CT scan image to draw a 3D digital human image, suspended on the clear Sharp plasma screen.
The three-dimensional transparent image can be rotated 36 degrees. The injured part is marked in yellow and the blood vessel is marked in red.
The hemoglobin-loving 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 which site and which blood vessel to treat first.
Intracranial hemorrhage is also accurately displayed, as is damage to brain tissue.
Infrared monitoring equipment calculates the degree of brain tissue contusion based on changes in brain tissue thermal parameters and changes in blood flow, down to each functional area.
Arai was very skilled. He used the gap in Yoshino's skull as an entry point to carefully remove the remaining blood clots and completely stop the bleeding until the red color on the screen disappeared.
The edema of the brain tissue due to trauma will continue for a period of time. During this period, the brain tissue needs a larger volume and cannot be subjected to any compression. The original cranial cavity volume 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 is eliminated, the artificial protective cover is removed and the patient's skull is returned to its original position.
As for the contusion of brain tissue, there is no way to deal with it except to create conditions for it to recover on its own.
This decompression method of uncovering the skull is much more effective than ordinary craniectomy decompression.
It originated from the Ilizalov Hospital in Siberia, Russia. The University of Tokyo Hospital sent two doctors to study for a year and perfected the technology after returning.
Their application of this technology, both in terms of effectiveness and safety, has far surpassed that of Russia.
Vital signs are stable!
The anesthesiologist said that the doctor liked this sentence the most.
Various invasive and non-invasive monitoring methods import data into a supercomputer, which operates at high speed to complete the dynamic changes of digital humans.
This data can be calculated almost instantly for the hospital's trauma emergency system host.
The cranial surgery is completed and the thoracic surgery begins.
Arai decided to use thoracoscopy technology, in which a mirror is inserted into the chest cavity from the intercostal space, and the blood inside is flushed away with saline.
Strong squeezing from front to back caused multiple rib fractures, and the broken ends of the fractures were squeezed and pierced the lung tissue, causing severe lung damage.
Hemostasis and repair are constant themes in orthopedics of trauma.
In one-lung ventilation, the injured lung is stopped by the anesthesiologist and is in a collapsed state.
Arai was very skilled in microscopic techniques. He calmly cauterized the ruptured blood vessels one by one to stop the bleeding. For larger blood vessels, cauterization could no longer achieve the goal. He inserted a silver clip and clamped the broken ends of the blood vessels firmly.
After stopping the bleeding and exploring at the same time, there was no problem with the heart and aorta, and all the bleeding points were eliminated.
The clean chest cavity is clearly displayed on the screen after being flushed with saline.
Start repairing the lungs. The lung tissue is soft and fragile, making repair difficult.
But Arai still tried his best to repair it, and the cracks of various shapes were sutured one by one, restoring them to their proper shape.
The diaphragm also ruptured, and the pressure difference pushed the abdominal organs into the chest cavity. Arai opened another portal for the laparoscope in the abdominal cavity and inserted another set of lenses and instruments.
The screen of the endoscopic system began to split, with the chest on the left and the abdomen on the right.
Use a blunt-ended push rod with your left hand to enter through the chest; use a non-abrasive forceps with your right hand to enter through the abdominal cavity.
Using both hands together, pushing and pulling with gentle movements, part of the pancreas and small intestine that had herniated into the chest were returned to the abdominal cavity, and then returned to their positions and straightened out.
The diaphragm was repaired under the microscope, and the chest cavity was flushed with normal saline again. 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 are reduced and fixed minimally invasively with simple steel wires.
Ten ribs, all reset and fixed, and the chest is extracted.
Laparoscopic hemostasis of the ruptured mesenteric artery was initiated, followed by repair of intestinal rupture and pancreatic damage.
The liver and spleen were fine and had escaped the squeeze of the seat. Even if the liver and spleen were ruptured, it would not be a problem for Arai. It would just be an adjustment in the order of the surgery.
The liver and spleen injuries are treated microscopically first, and then the pancreas and small intestine are repaired.
Skilled laparoscopic technology makes the surgery look the same as open surgery, but with better results and less damage.
For such a complicated thoracoabdominal joint injury, Arai solved it with a few small holes as thick as his little finger.
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, so assistants constantly inject artificial amniotic fluid to supplement it.
A steel plate, presumably the structure of the seat, pierced the pregnant woman's abdomen, piercing the fetus' body from front to back.
Open surgery is necessary, and laparoscopy can no longer complete this type of surgery.
There are too few fetal trauma surgeries, and Arai lacks experience. He has only performed fetal orthopedic surgeries.
A five-month-old fetus is only 20 centimeters long, just a little longer than two fingers.
To successfully perform the surgery requires the use of a microscope, it is probably the most difficult trauma surgery in the world.
The heating lamp was adjusted to shine into the pelvic cavity from different angles to keep the fetus warm.
Arai incised the abdominal cavity, opened the uterus, and stopped the bleeding while exposing it in preparation for removing the metal piece.
In normal fetal surgery, in order to expose the fetus, the fetus must be removed from the uterus, and it must not be completely removed, otherwise the fetus cannot be kept warm, so only part of it can be removed to facilitate the exposure of the surgical site, and it must be put back into the uterus after the operation.
The operation must be very careful, otherwise once the placenta is detached, the fetus' life will be in danger.
The uterus opens and the fetus is revealed, the poor little guy.
"Sir, it's my turn." Sasaki and Fujiwara had been sitting in the operating room.
"Be careful, both of them have to get off the operating table alive." Fujiwara was very confident in Sasaki.
——
In Sanbo Hospital, whether it is the main venue or the branch venue, the surgery is live on the screen.
"Hiro Arai, Lecturer of Orthopedics——"
There is a brief introduction of the surgeon in Chinese and English on the screen.
Everyone is attentive, no one moves around, no one makes a sound, and even drinking water is kept to a minimum.
From the head, to the chest, to the abdominal cavity, a young mid-level doctor operated so skillfully.
In particular, the application of endoscopic technology in trauma surgery, with no blind spots for exploration, meticulous repair, and carpet-like hemostasis, is like a teaching demonstration.
A computerized trauma surgery assistance system based on infrared monitoring, combined with CT scans, can actually reconstruct a digital human.
What an eye-opener!
These are real technologies and skills that may not be compensated for by a keyboard.
Some people have dry throats. Even after swallowing several times, they are still dry and uncomfortable.
Although I originally planned to be a young mid-level doctor, now I am doing fetal surgery and it is reasonable to get a senior professional title.
The performance of young people with intermediate professional titles has been very good, and they have demonstrated world-class standards.
"It's Sasaki's turn!"
Takahashi said to himself, he believed in this junior.
This kind of surgery requires a microscope, but the whole process is performed with the hands suspended in the air. It is much more difficult than replanting a broken limb with both elbows to support the table.
This kind of surgery is the pinnacle of microsurgery. A five-segment replantation is nothing, Takahashi said contemptuously in his heart.
The footage on the screen is clear and delicate, the uterus opens and the fetus is revealed.
Sasaki has already brushed his hands and is putting on a surgical gown. He is about to complete an operation that will shock the world.
The operation last night was until 2 o'clock, and the operation was also during the day today, so there was no update last night. The chapter I owe will be made up on Saturday. Sincerely apologize! Thank you all for your tolerance!
(End of chapter)