Chapter 300 Flat Surgery
Yang Ping controlled the microscopic instruments with three fingers: thumb, index finger and middle finger, and was able to maneuver in a small space with ease.
The instrument seemed to be attached to his fingers by some kind of force. No matter how he changed his position, it would not escape the control of a few fingers.
Every operation is precise, meticulous and just right. These operations are completed with the hands hanging in the air and the arms without any fulcrum.
The arteries and veins were successfully separated, but the fistula was large. If simply repaired, it would cause arterial stenosis. The stenosis would cause blood vessel blockage and lead to spinal cord blood supply impairment.
The only way to do this is to cut off the fistula and then anastomose the blood vessels end-to-end. Such a difficult operation seemed extremely simple and easy in Yang Ping's hands.
Microscissors neatly cut off a short section of the artery and vein, the fistula is removed, and the two ends of the blood vessel are slightly freed, so that the healthy ports can be joined without tension.
The microsuture needle thread is firmly clamped on the needle holder. In a small space, it can be moved and turned to allow the needle to be inserted and removed at any angle.
The tip of the forceps lifted the outer membrane of the blood vessel, and the needle penetrated and pierced easily, and then tied a beautiful surgical knot. The two instruments cooperated perfectly and did not interfere with each other due to crowding.
The assistant's third instrument, the microscissor, also reached in and trimmed the thread accurately. In the small space, the three instruments did not collide or block each other.
After one side of the blood vessel is anastomotic and it is necessary to suture the opposite side of the blood vessel, the assistant's tweezers hold the long threads at both ends and gently turn the blood vessel over. The other side of the blood vessel is exposed. When the opposite side is also sutured, only one circle of the blood vessel is considered. Finished sewing.
The artery anastomosis was completed, and the veins were precisely anastomized end-to-end in the same way. Several instruments, whether from the surgeon or the assistant, appeared at the best time, and the harmony between them would not be disrupted by being late or leaving early.
Seeing such a superb surgical operation, the medical team in the viewing area finally understood why Yang Ping rejected August's application for an assistant and insisted on transferring his own team from across the country.
In this kind of surgery, the operating space is extremely narrow, and the surroundings of the operating space are still mutated arteries that must be protected. If the assistant's cooperation is slightly poor, even if there is an error in grasping the timing of the instrument entering the field of view, the instrument will fight. Once there is a fight, even if it will A little tear in the blood vessel may push the operation into despair.
"Do you know why you were rejected? If you become an assistant, you will definitely fight with the surgeon's instruments, either damaging the mutated artery that needs to be protected, or damaging the arteriovenous fistula that needs to be treated." Milton ridiculed August.
August sneered: "Could it be that if you come on stage as an assistant, your ending will be better than mine? Will the equipment get along as harmoniously as it does now?"
Having been hit on a soft spot, Milton was unable to refute and selectively ignored August's words, pretending to watch the operation carefully and not hearing what he said.
As fate would have it, Boss Cheng sat with two European experts again. August glanced at Boss Cheng, saw his focused look, and asked curiously: "Can you understand the surgery?"
"I can't understand the surgery? Am I staring at the screen and counting sheep?" Boss Cheng complained.
"Any suggestions?" August wanted to test the Chinese chef.
Boss Cheng commented: "The positioning is precise, and the lamina opening directly exposes the arteriovenous fistula; operating in a small space increases the difficulty of the operation, which is also a helpless move. The mutated spinal cord feeding artery must be protected; the quality of the vascular anastomosis is very good , end-to-end, slightly everted, there is no need to worry about the formation of embolism at the anastomosis; what is even more amazing is that the instrument is like taking root in the hands of the surgeon, and the posture can be adjusted at will. Without such flexibility, My ability to operate instruments, I’m afraid this operation will be very awkward!”
August looked at Boss Cheng suspiciously, and then at Milton. Milton shrugged habitually. The Chinese chef's comments were very professional and there were no loopholes.
The first arteriovenous fistula operation was successfully completed. We started to open a window in the upper lamina and followed the method of treating the first arteriovenous fistula. This window was still accurate. When we opened the "manhole cover", we found the arteriovenous fistula in the center. This artery The venous fistula opening is not large and can be repaired directly. The whole operation is unremarkable and has no suspense.
It was the same as the American push tactics in the late World War II. Aircraft bombing, artillery fire cover, and then mechanized army push, destroying the enemy. The process was quite smooth without any twists and turns.
"A smart doctor can turn danger into safety, and the even better state is that he will not be in danger at all."
August believes that Yang Ping is a higher realm.
"The operation was uneventful and didn't look exciting enough. This is exactly what I wanted. I'm glad I canceled my flight." Milton kept suppressing his breathing. After watching the entire operation, some of the dangers he was worried about did not appear.
Several instruments went in and out. Milton was afraid that an accidental movement would damage the blood vessels and make the operation more difficult, but nothing happened until the two arteriovenous fistulas were processed and double-click electrocoagulation was used to stop the bleeding in the spinal canal. There were no collisions with the instrument.
"Dr. Zhou, please do a DSA to verify whether the fistula has been successfully treated." Yang Ping gently put the instruments back into the bend and took good care of the surgical instruments. This is a surgeon's professional ethics.
Everyone moved away from the operating table and rested in a nearby area. Dr. Zhou and his assistant had already put on surgical gowns and were waiting. This time, they directly superselected the target blood vessels, not for investigation. This was the second time to do it, so naturally they were much more skilled.
Soon, Dr. Zhou completed the DSA. After waiting for a few minutes, the contrast agent returned to its original state without secretly flowing from the artery into the vein. The operation was very successful.
The surgical area is flushed with normal saline. Small holes are drilled on the four sides of the lamina bone block, and then they are firmly buckled on like a road manhole cover. The sutures on the four sides are tightened and knotted. After three months, this window will heal as before and will not No questions remain.
Layered hemostasis, layered suturing, automatic retractor removal, automatic paravertebral muscle return, and even drainage are unnecessary. This is extremely confident in your own hemostatic effect.
Yang Ping and Song Zimo turned around, and Zhang Lin and Xiao Wu were back to back with them, exchanging positions. It was their job to sew.
"One floor per person?" Xiao Wu suggested.
Zhang Lin nodded: "Deal!" Xiao Wu sewed the deep fascia, and Zhang Lin sewed the skin. They were both Director Lu and Director Zhang in the future. They made an unpleasant fuss over the suturing of the skin, which was beneath their status.
Whether it is deep fascia or skin, the suturing is done very carefully. After all, there are more than a dozen doctors staring at the close-ups on the screen, and any irregular movement will be magnified.
Fortunately, Yang Ping usually had very strict requirements on their surgical basics, and Song Zimo often took them to practice surgical operations in the department's laboratory.
Zhang Lin sewed the skin, and Xiaowu cut the thread. Each thread was left only one centimeter. If you use a ruler to measure it, there won't be much error. The stitch length is very standard, and the skin is neatly aligned, even the final alignment. No skin is needed, the sterile dressing is directly applied.
It's so smooth!
August stretched a little. As an international expert in spinal surgery, he could not escape the degeneration of the intervertebral disc.
Fortunately, the operation didn't take long. He moved his psoas muscles and the slight pain was immediately dissipated.
"Does Dr. Yang perform other spinal surgeries in the same way?"
Milton had a magical idea in his mind. He wanted to leave Yang Ping's contact information and ask Yang Ping to go to the UK for surgery so that he could study.
He pretended not to think about anything and just said lightly: "The operation is over!"
He didn't want to accidentally remind the German guy, otherwise he would also go to Dr. Yang to get his contact information.
In the Internet era, Britain uses Whatsapp. I don’t know what similar software the Chinese use. Milton secretly took out his mobile phone and started searching on Google, wechat! Download it decisively, then register and study how to use it.
August looked away from the screen, and Milton immediately put away his phone like a thief. August's reaction to the British was a bit puzzling.
Just playing with your phone, are you so nervous?
"Schedule the operation for next week!" Milton found an excuse to cover up.
August looked at him holding the phone with an unnatural expression on his face and said suspiciously: "You look abnormal, as if you are chatting with your lover?"
"So what, are you doubting my fighting ability?" Milton followed suit.
August shook his head: "No, how can I doubt your fighting ability? Viagra can be bought everywhere."
Kobayashi Atsushi watched the entire operation and was convinced. Especially when performing microsurgical operations in a small space, some operating angles are impossible for ordinary people to do. However, the angle of the instruments on Yang Ping's fingers can be changed at will.
What Yang Ping said during the consultation was not just bragging. Other doctors really couldn't complete this operation smoothly. Even if it could be completed, it wouldn't be so fast or perfect, and there would definitely be many difficulties along the way.
Director Zhu was also in the viewing area. After watching the operation, he was a little excited. Yang Ping helped him a lot this time. Anning Insurance stood out among many high-end insurance companies, showing its strong ability to organize medical resources.
The operation was over. Boss Cheng wanted to use the restroom in the conference room for convenience. Milton took the opportunity to follow him all the way to the restroom. When Boss Cheng stood still and was about to unzip the zipper, he saw Milton standing next to him, holding his hand. I picked up a mobile phone inside, my heart suddenly trembled, and I stopped immediately.
Milton blushed and spoke: "Hello, Mr. Chef!"
"Hello, what's the matter?"
Boss Cheng asked carefully, "It's just peeing. You are standing next to me with your mobile phone. Who are you trying to scare?"
Milton thought for a while: "Mr. Chef, can we add a WeChat account?"
This British guy actually wants to add WeChat? Will he add WeChat?
Milton is also an internationally renowned expert, and Lao Cheng runs a hospital. It's not a bad thing to know someone more.
"Shall I scan your code?" Boss Cheng took out his mobile phone.
Milton looked ashamed: "I'm not very proficient yet, can you teach me? How to add others to WeChat or let others add me to WeChat?"
Boss Cheng briefly pointed out to Milton that social tools and principles are similar. Milton finally understood. After adding Boss Cheng’s WeChat account, he didn’t even go to the bathroom and happily returned to his seat.
"You didn't wash your hands?" August frowned.
Milton said lightly: "It's dried."
(End of chapter)