Chapter 306: You’re teasing me
Yang Ping took Xiao Su to the operating room. The two happened to come out of the men's and women's locker rooms respectively and met Head Nurse Jiang.
Xiao Su said hello immediately, and Nurse Jiang smiled: "Xiao Su, have you returned to your parents' home? You didn't feel wronged there, did you?"
Xiao Su smiled and said: "No, thank you for your hard work, head nurse. Dr. Yang and I came over to see the operation."
Nurse Jiang looked majestic: "Dr. Yang, you can't bully our Nurse Su, or we won't be able to spare you."
Yang Ping just smiled. The head nurse was very busy: "Go ahead. There are too many emergency surgeries today. I have to quickly allocate manpower and go back to the office for a meeting."
Saying goodbye to the head nurse, Yang Ping took Xiao Su to the operating room of the spinal surgery department. Director Qin and Dr. Wen were analyzing the cause. It was a bit scary that such a large free intervertebral disc disappeared without even noticing.
"Dr. Yang!" Dr. Wen saw hope when Yang Ping came in.
Dr. Wen's understanding of Yang Ping has been profound since Yang Ping performed surgery on Professor Zhang. At that time, he also participated in Yang Ping's lectures and participated in the discussion.
Director Qin looked at the screen of the G-arm machine and studied the perspective positioning pictures: "Start from the first one, slow down, I haven't seen it clearly yet, you can turn it over as you please."
Director Qin was a little angry and his tone was not very good. This kind of minimally invasive surgery is usually explained to the patient before the operation. In case of special circumstances, it may be converted to surgery.
But the intervertebral disc disappeared inexplicably. Even if the operation was performed, the intervertebral disc could not be found. In the end, an on-off operation was performed. The patient's problem was not solved. After the operation, the patient was still rolling on the floor in pain. The patient was in trouble, Director Qin said. I can't even keep it on my face.
Director Qin walked back and forth between the reading light and the G-arm machine screen, comparing them. The CT and magnetic resonance imaging clearly showed that half of the intervertebral disc as big as a thumb was resting there. Didn't even see it at all.
"Oh, Xiao Yang, help us take a look." Director Qin saw Yang Ping standing nearby.
Invite Yang Ping over. This is Dr. Wen's suggestion. If you encounter difficult problems in the trauma and orthopedic surgery, it is not new to consult Yang Ping.
But this is the first time for spine surgery. Although they are both orthopedics, their specialties are completely different. Spine surgery has a higher threshold for surgeons than trauma orthopedics.
For ordinary simple surgeries, those who are not senior surgeons are not qualified to perform them; for slightly more difficult surgeries, only deputy chief surgeons are required. After all, the surgeries involve the spinal cord and nerve roots. If something goes wrong, you will either be paralyzed or disabled.
Yang Ping was a young man who had just been promoted to chief physician. According to common sense, he would never have the opportunity to perform spinal surgery, so Director Qin had some ideas and was not as modest as Director Gao, which was reasonable.
Since Dr. Wen proposed it on the operating table, Director Qin disagreed. If something happened, he would be said to be stubborn, so he still agreed to invite Yang Ping over.
"Eating? Sorry to disturb you." Dr. Wen saw Xiao Su following him. It was time to eat.
Yang Ping didn't care: "It's okay, I got your call just after I finished eating."
After analyzing the images, Director Qin said helplessly: "Stop the operation and do another MRI to see where the intervertebral disc is."
The G-arm machine is the same as the C-arm machine. It is actually a mobile X-ray machine. The difference is that the C-arm machine can only take images of one side at a time, while the G-arm machine can take images of both front and sides at a time.
The intervertebral disc is not visible under X-ray, so under the perspective of the G-arm machine, the intervertebral disc cannot be seen at all, only the vertebrae can be seen. The positioning relies on magnetic resonance and CT to determine the segment number of the herniated disc before surgery, and then enter the segment number under G-arm machine fluoroscopy.
Everything was in accordance with this procedure, and no mistakes were found. We also repeatedly checked the mistakes that we might make in daily life, and there were no such mistakes.
"Xiao Yang, thank you for your hard work. Let's go down and do an MRI. Let's go down and take a look?" Director Qin has already withdrawn the instruments. Dr. Wen sutured the small incision on the patient's back, covered the incision with a dressing, and lifted the sterile drape. open.
This kind of surgery is usually performed under local anesthesia, but this patient's pain symptoms were too obvious and it was impossible to keep the patient in pain during the surgery, so he chose combined spinal-epidural anesthesia to anesthetize the entire lower body.
The patient was awake. Director Qin personally explained to him the special circumstances encountered during the operation. The patient was okay and understood. They all solved the problem for him. No one was deliberately playing tricks.
Before Yang Ping had time to read the imaging film, everyone moved quickly and had already put the patient on the flat car and pushed him to the imaging department for magnetic resonance imaging.
Although it was a bit embarrassing and a bit embarrassing to deal with it this way, for the safety and effectiveness of the patient's surgery, Director Qin could only put aside his face temporarily.
The flat car was pushed towards the MRI room of the Imaging Department. Everyone followed in a muffled voice and did not dare to speak. After all, it was the director who was in trouble.
After several twists and turns, when we arrived at the MRI room, Director Meng was very generous and waited in the operating room in person. A machine was also vacated in advance. The patient was pushed in. The doctors and nurses were busy checking contraindications, checking whether they were carrying magnetic metal, and whether they were installed. like a pacemaker, then talk and sign, and move the patient onto the platform.
"Old Qin, what's wrong? The intraoperative exploration and the preoperative images are wrong?" Director Meng asked Director Qin to sit down, knowing that he had encountered a problem. Otherwise, how could anyone complete the operation halfway and push the patient down for MRI.
Director Qin looked unlucky: "The positioning is accurate, no problem at all. The transforaminal scope entered the spinal canal, but no free intervertebral disc can be seen."
"Is there such a thing?" Director Meng asked.
The technicians and nurses were positioning the patient, and the other doctors were waiting outside. Only Yang Ping and Dr. Wen came in, and Xiao Su followed Yang Ping. When Director Meng saw Yang Ping coming, he was very polite and immediately pulled up the chair himself: "Yang "Doctor, sit down!" Director Meng was familiar with Yang Ping, especially when Yang Ping saw the spinal dural arteriovenous fistula on the patient's MRI. He was so impressed that he liked to call Yang Ping over if he had any difficult cases. Research research.
Almost ready, Director Meng looked into the examination room through the thick glass wall. The technician and nurse had already come out, and the door of the examination room was closed.
"I have been doing transforaminal endoscopes for almost ten years, and I think I have done 2,000 cases. I have never encountered this kind of situation." Director Qin was still immersed in helplessness.
During the conversation, the technician skillfully adjusted the parameters on the operating platform, pressed the switch, the platform moved, and the patient was slowly sent into the black hole.
The strong magnetic field makes the spin direction of the hydrogen ions in the human body neatly move in the same direction. When the magnetic field is withdrawn, the direction of the hydrogen ions returns to a free and chaotic state.
In this way, the recovery time varies, and differences arise. Differences are the basis of images, and only with differences can composition be achieved.
Just like a pencil, the difference in density of lines is used to compose a picture.
Several doctors from the imaging department were already wandering outside the door. Since Director Meng was inside, it was difficult to get in. Everyone came to see Yang Ping. Once a person becomes famous, there will be many legends. When these legends are added to the story, they become... It has become like a myth, giving everyone a sense of height and distance from him.
Let’s not mention the awesome things before, but just talk about the most recent one. On the sixth day of the first lunar month, I heard that Yang Ping was invited by a wealthy Malaysian businessman for consultation and surgery.
It is also said that Yang Ping pushed the top experts from Britain, Germany and Japan to the ground and rubbed him. The fee for this cross-border consultation was in the millions, and the younger brothers who followed him all received one or two hundred thousand. The specific amount is not clear, but I saw Zhang Lin was planning to buy a car recently, so he knew that the number was close to ten.
As things piled up one by one, Yang Ping gradually became a myth in the hearts of these people and became a legend. Some even wondered whether comprehensive orthopedics would need an imaging doctor in the future. If they were lucky and could join, they would follow suit. Pick up meat and eat it.
Didn’t Fatty Liang from the anesthesiology department also become as awesome as Yang Ping? Who the hell spread this word about flirting with a stewardess on the plane? The fat man is looking for big mouths everywhere. Whenever this happens, Zhang Lin immediately advises him: calm down, calm down, celebrities don't have any privacy.
The speed of light magnetic resonance is very fast, and the image is slowly taking shape. Director Meng stopped chatting, and Director Qin leaned over to take a look. The lumbar disc was herniated. For these veterans, they could tell at a glance what segment and how much the protrusion was, with their eyes closed. Neither is wrong.
That thing is still there, so obvious. Judging from the low signal, it is undoubtedly the nucleus pulposus of the intervertebral disc. It is still in its original position without any change. It is located in the spinal canal, behind the lumbar 1 vertebral body, and the intervertebral foraminal microscope The approach is exactly opposite to the intervertebral disc, no matter in sagittal or cross-section, there is no positioning error.
"That's right, the intervertebral disc is here!" Director Meng pointed to the picture.
Director Qin flipped through the picture several times. It was indeed correct. It was really good. Damn it. Did the mirror accidentally penetrate into other tissues and be separated from the intervertebral disc? As long as that intervertebral disc is still there, there is a way, let's explore it carefully.
"Send to the operating room, re-sterilize the drapes, and continue the operation." Director Qin felt confident.
Although it took a lot of trouble, that's what surgery is all about. Either you don't go on stage. Once you go on stage, if something unexpected happens, even if it's troublesome, you have to finish it despite the trouble. It's better to be in trouble on stage than off stage.
"Director Meng, please, let's continue the operation." Director Qin said goodbye.
Director Meng stood up and said goodbye: "You're welcome, please contact me if you need anything."
"Xiao Yang, thank you for your hard work. Why don't you come back with us?" Director Qin left a way out, fearing that if there was another problem, at least there would be someone who could help.
The patient was pushed to the operating room again, where he was put into position, and the G-arm machine was used to confirm the correct segment by further fluoroscopy, and the drapes were re-sterilized and draped.
There is no problem with the original entrance. To remove the small incision, we still go in through the original entrance. When the mirror is inserted, the water flushes out and the view is clear.
The dural sac and nerve roots are clearly visible. After ten years of this kind of surgery, how could there be any mistake? The lens did not stray into other tissue gaps. It was clearly in the spinal canal. How could there be any intervertebral disc? Where is the intervertebral disc?
"Are you kidding me? Is that the magnetic resonance imaging just now?" Director Qin wanted to confirm.
The doctor in the audience carefully checked the date: "Yes, it was taken just now, and I just hung it up."
Damn it, Director Qin was swearing in his heart. It was a bit ridiculous to do this today. The little confidence he had just gained was deflated again!
Director Qin sorts out his thoughts. What is the problem? Where exactly?
"Open the screen, bring up the previous MRI and the one just taken, and zoom in!"
This operating room is a multi-functional operating room with a large screen. The surgeon can operate the control panel by himself through the sterile membrane and call up the required medical records. However, Director Qin is used to reading films with a reading lamp and does not use this high technology. .
Dr. Wen opened the screen through the sterile membrane, called up the images, found a few typical ones, opened them, and compared them with each other. There was nothing wrong. Whether it was the previous film or the current one, the intervertebral disc was still in its original position.
But I clearly didn’t mistake the segment, and the lens was also in the spinal canal. Why didn’t I see the nucleus pulposus tissue of the intervertebral disc? No matter how you adjust it, you can't see it.
"What the hell!" Director Qin fell into confusion again, sweat dripping from his forehead.
(End of chapter)