godfather of surgery

Chapter 125 High Precision Puncture

When Tan Boyun shook hands with Professor Yu, Professor Yu said: "Director Tan is soaring into the sky now!"

Tan Boyun smiled heartily: "I must thank Director Yu for his hard work!"

The two were smiling on the surface, but if they didn't know the inside story, they would think that the two had a deep friendship and shook hands and greeted each other.

Those who know the inside story understand that there is something in each other's words and ridicule each other.

The relationship between the two is so bad, they are no longer in the same hospital, they have nothing to do with each other, and they have to compete with each other when they meet and shake hands.

For orthopedic robotic surgery, Affiliated One is at the forefront, with more than 500 surgeries performed. In terms of the volume of orthopedic robotic surgery alone, it is no problem to enter the top three in the country.

The Second Attachment has yet to carry out orthopedic robotic surgery, but has only carried out robotic surgery in thoracic surgery, general surgery, urology, and obstetrics and gynecology.

As soon as Tan Boyun arrived at Sanbo Hospital, with the strong support of Director Han, more than ten surgeries were carried out in just one month. According to the progress of the number of surgeries, the attached one has become a catch-up trend.

If Sanbo buys the second robot and conducts spine, joint and sports medicine, it will start a crazy catch-up mode.

Tan Boyun is full of energy and ambition, and dares to enter the cutting-edge field of the industry. He not only has the ambition to challenge the Department of Traumatology and Orthopedics, but also vows to take a place in the country.

He is under Director Han, and now he wants the wind to win the wind, and the rain to win the rain, without any constraints, and flexes his muscles.

"Director Tan made a late move, and developed more than a dozen units in one month." Professor Su praised.

Although Tan Boyun was defiant, he did not dare to show arrogance in front of Professor Su, not only because Professor Su's academic character was outstanding, but also because Professor Su had helped him.

"This robot is dedicated to our microtraumatology orthopedics department, so the use density is very high. There will be surgery tomorrow. This week, we have five robots in line. We need to learn more from Fuyi. Compared with Fuyi, we are still toddlers. "

Tan Boyun, as the host, introduced the recent development of Sanbo's robotic surgery. Before he introduced, he turned his eyes to Director Han to show respect and get approval.

"The dozens of surgeries we are currently carrying out involve the pelvis and limbs. Our goal is to use robots to perform all kinds of traumatic orthopedic surgeries." Tan Boyun introduced his blueprint.

These dozens of operations are just a warm-up, and the best show is yet to come.

Professor Su admired in his heart, Han Jiangong knows how to employ people, while Tan Boyun, a strong horse, can't walk two inches at a time, but he is making rapid progress in Sanbo. This man will make extraordinary achievements in the future.

Mr. Ning, a patient in the Overseas Chinese Building, has been sent to the operating room, just next to Director Tan's operation, because there is a navigation device - a computer-aided surgical navigation system.

Su Nanchen considered using a robot to complete the puncture, but gave up, because this kind of puncture not only requires precision, but also requires an excellent feel when entering the guide wire, and the direction of the guide wire can be adjusted according to the feel to successfully insert the tube.

The accuracy of robotic surgery is very high, but the lack of feedback on instrument contact, that is, the lack of feel, is the biggest shortcoming.

Su Nanchen completed the simulated puncture, mastered the best puncture point, puncture angle and depth from the simulated puncture, and knew the relationship between each anatomy clearly.

Yang Ping took Su Nanchen to the operating room, and Song Zimo followed.

Su Nanchen and Wen Rentao are the goals in Song Zimo's heart. He has been secretly working hard to surpass these people who are known as the stars of tomorrow.

Song Zimo followed behind without saying a word. He was not sociable, but lazy. He always acted like he had nothing to do with himself.

"The aunt I met in the garden just now had a weak right knee joint. Did you operate on her?" Su Nanchen took the opportunity to ask.

Yang Ping nodded: "I just finished the operation this morning, and I will be discharged from the hospital tomorrow. What's the matter, acquaintance?"

Su Nanchen said: "My old patient had the second operation at my place, and the effect was not good after the operation. I met her just now, and the symptoms were completely resolved this time."

Yang Ping didn't expect that this patient belonged to him. The patient mentioned that Dr. Su from the second operation attached to him did it for him, but Yang Ping didn't care about it either: "This patient is a cord synovial band stuck in the popliteus tendon rupture. I found the synovium of the popliteus tendon rupture and removed it, and the patient's symptoms were naturally relieved."

"Haven't heard of this disease?" Su Nanchen asked, with his profound knowledge, he didn't know about this disease.

Yang Ping smiled: "I've never heard of this disease, it's an abnormality found on her MRI."

"When we have time later, let's watch the MRI together?" Su Nanchen was eager to learn.

When the operating room arrives, change shoes, change clothes, and wear a mask and hat.

The patient has been placed in a prone position, Zhang Lin and Xiao Wu have helped to disinfect and lay the sheets, and the equipment is also ready.

Professor Su, Professor Yu, and Director Han had already put on lead clothes and sat inside chatting.

"Nanchen, hurry up and brush your hands!" Professor Su urged.

"Xiao Yang, brush your hands and set the stage for Dr. Su." Director Han ordered.

The two put on lead clothes and began to brush their hands.

Yang Ping and Su Nanchen chatted very speculatively. He didn't like that Song Zimo, who was aloof, showing a kind of arrogance all the time, and refused to be thousands of miles away.

Yang Ping is different, he has a strong self-confidence, but he is not arrogant and aggressive.

Masters are often lonely, and being able to find an opponent is a happy thing.

The sympathy between the young talents made Su Nanchen hate to meet Yang Ping late. When brushing his hands, the two kept chatting. From the patient who had the synovial strip stuck in the popliteal tendon rupture to this patient's puncture, it was like brushing his hands. The time is too short for two people to chat.

Everything was ready, the chief surgeon checked again, opened the table, performed local anesthesia, and implanted a space reference positioning needle percutaneously in the spinous process to provide coordinates for navigation.

Dr. Su's stage posture is very good, there are sitting postures, standing postures, walking postures, and eating postures when eating.

There are surgical postures during surgery. Some have standard postures and look very beautiful; , very crappy kneeling posture, I don't know if it's a special need, or it's the first surgery.

From Dr. Su's surgical style, it can be seen that Professor Su is strict with him at ordinary times. The folds of the large order are smoothed out, and the operating instruments are required to be placed neatly and arranged in sequence according to the frequency of use.

Keep your chest up and your head down, keep your hands at an appropriate distance from the operating table, and keep your movements within a limited range.If it can be limited to the fingers, try to use the fingers; if it needs the assistance of the wrist joint, control it at the wrist joint; even if it needs the assistance of the elbow joint, it is still a very small movement.

Every step, standard specification, looks very beautiful, the rhythm of the operation is clear, step by step.

The image on the navigation screen presents a three-dimensional anatomical structure, the reference point accurately displays the coordinate relationship between the instrument and the anatomical structure, and the navigation pointer indicates that the puncture needle with the sheath is moving toward the target accurately.

With simulated puncture and precise navigation, coupled with Dr. Su's talent and experience, the puncture is in place once, passes through the pedicle, and breaks through the cortex at the best position.

One step in place, without any mistakes.

Su Qingyun's son really lived up to his reputation. Professor Yu paid attention to the whole puncture process and had to admire him for training his son to be outstanding.

Even without Su Qingyun's help, Su Nanchen is fully qualified to enter the First Attached School, the Concorde eight-year program, which is the most valuable medical degree in the country.

What's more, Su Nanchen was the number one student in the science college entrance examination in Nandu Province, and entered Xiehe as the number one student. To Su Qingyun, no matter in terms of his academic status in the department or his personal success, Professor Yu felt ashamed.

The puncture needle is pulled out, and the sheath remains inside. The thin hollow puncture needle is passed out of the puncture sheath, and the needle tip touches the nerve root sheath. Even with navigation, this is an extremely difficult operation.

Young people are awesome!Everyone agrees.

The needle tip is ready to pierce the nerve sheath and enter the sheath. This step cannot be helped by navigation, but must be done by hand.Song Zimo sat next to him, and Su Nanchen really deserved to be a rising star on the same level as Wen Rentao, and had nothing to do with his father.

The needle tip pierced the thoracic 2 nerve root sheath, and the microcatheter with the elastic guide wire entered the sheath from the hollow needle tube, a little bit was exposed, but it was difficult to move forward.

The puncture was obstructed during the last step of catheterization.

Su Nanchen frowned, because of the invasion of tumor tissue, the adhesion between the sheath and the perineurium, the guide wire to enter the sheath is elastic, the original intention of the design is to fit the natural gap between the sheath and the nerve, but now this kind of The gap does not exist because of the adhesion.

Advancing again, the guidewire appears bent on the image, unable to break through the adhesion.

Professor Su got up and looked at the navigation picture on the screen. The puncture process was perfect, but the last step was blocked.

He believed that Su Nanchen could handle it, and Su Nanchen didn't panic, so he stopped operating and thought about the solution.

He had considered the adhesion before the operation, and to solve this problem, he had to adjust the angle of the puncture needle.

The puncture needle is now almost perpendicular to the direction of the nerve, and the angle of the needle tip needs to be adjusted so that the needle and the direction of the nerve present a certain angle, so that the guide wire can break through the adhesion in a better direction.

It's like splitting wood, it's very laborious to split it horizontally; split it vertically, and it can be split in half with an axe.

It is not bad for the missile to hit the teacup, but it is also required to hit the teacup from a specific direction, which is even more difficult.

The range that can be adjusted is very small. The diameter of the bony tunnel is inherently thin, and the finer puncture needle has a range of adjustment, but it is very small.

Withdraw the guide wire catheter and re-puncture the nerve root sheath.

Su Nanchen is very proficient in the anatomy of the spine. At a young age, just 30 years old, he has accumulated experience in hundreds of scoliosis surgeries, which is very rare.

He felt very good in his hands, the needle point was slightly adjusted, and the angle appeared, but the needle point had just touched the nerve root, and as soon as it was pushed, it slipped away.

"The angle is inaccurate, just adjust it by fifteen degrees."

Yang Ping reminded.

(End of this chapter)