godfather of surgery

Chapter 181

Dr. Yao and Dr. He are ready for the operation. Not only are the various pipelines connected, but also the focal length and dialogue of the lens have been adjusted.

Yang Ping came to the stage, tried the lens, and the adjustment was very suitable.

I am really in a hurry, since Su Nanchen has sent two equipment nurses and two doctors, don't be polite, try not to procrastinate while ensuring the quality of the operation.

The sharp knife opened the way, and made two small openings on the anteromedial and anterolateral sides at one time. Because he was too skilled, he directly pierced the skin, joint capsule and synovium with the sharp knife, and the three layers were in place in one step. Injury to any structure in the joint cavity.

Most people make one opening with a sharp knife, and after inserting the lens, open another opening under the guidance of the needle of the syringe, so that the other opening can be opened more accurately.

But Yang Ping didn't use it at all, and opened the two openings directly, because he didn't need a syringe needle to guide him at all, and he could open the opening in the best position.

Lin Hao frowned, this is not according to the standard, Ye Luzi.

The arthroscope goes in with the sheath. Dr. Yao has connected the water inlet and outlet pipes in advance. The mirror goes in without any resistance, which shows that not only the mouth is well opened, but also that the surgeon is very familiar with the path through the opening, and will not be affected by different layers. The relative movement is obstructed, especially the synovial membrane is more or less obstructed, so when the lens or instrument enters, it is necessary to test a little to find the direction of the path.

But Yang Ping didn't need to try, he entered the joint cavity at one time without any obstacles, and entered the joint cavity very easily. He started the arthroscopic examination, rinsed the joint cavity thoroughly, and Yang Ping closed the outlet pipe.

The size of the openings of the two openings is very particular. If the instrument is too thin, it is difficult to get in. If it is too large, the water in the joint cavity will flow out from the gaps around the instrument.

Yang Ping’s mouth was opened very well, and no drop of water flowed out from the gap, which means that the device just passed through, and the surrounding gap was just closed by the synovium. After the operation, it was clean. leaking water.

After some people's arthroscopic surgery, there is water everywhere on and off the stage, and it is a mess. Not everyone can grasp these details, and it is already a higher-level pursuit beyond surgery.

Starting from the suprapatellar bursa, every area in the joint will not be missed. Strictly follow the order, one by one. Every time the mirror moves, it is just in the gap, which will not cause wear and tear on the cartilage, and it will move to the end of the target area at one time. Ideal location for the best view.

Yang Ping himself held the lens with one hand and the patient's calf with the other, constantly adjusting his posture, and the coordination of both hands was impeccable.

Observing different positions requires different postures of the limbs. For example, the suprapatellar bursa needs to be straightened, while the medial joint space needs to be bent 20-40 degrees, abducted and externally rotated, and the lateral joint space needs to be placed in a 4-figure position.

Every time the camera is moved and the posture of the limbs is changed almost at the same time, the moving arthroscope will never be squeezed, blocked or rubbed due to the change of the limbs. Everything is very smooth, like a fish dexterously shuttling through aquatic plants, without bumping into A water plant.

"Doctor Yao, Doctor He, start weaving the tendons!" Su Nanchen commanded.

Without his command, no amount of people would be effective. These few people, especially the two nurses, didn't seem to realize that the pace was getting faster and faster.

"You are going to prepare the guide pin and electric drill for the tibial tunnel in the next step! You are going to report the size of the tendon!" Su Nanchen ordered the nurse and the doctor.

If it wasn't for Su Nanchen's reminder, everyone would not be able to react.

"Tibial tunnel, electric drill guide pin!"

Here, the electric planer and the plasma knife are alternately cleaning the intercondylar fossa, so Yang Ping informed them in advance to avoid wasting time.

As soon as the words fell, the intercondylar fossa had been cleaned, but the electric drill guide pin did not turn over, because there were several people supporting the stage, and Yang Ping didn't have the rhythm to take care of each other at all.

Yang Ping looked at the screen but did not look at the equipment table. He didn't get what he wanted with his outstretched hand, and then moved his palm up and down a few times to signal things to hurry up and not to grind.

When the electric drill guide pin arrived, Yang Ping immediately said: "Anatomical reconstruction of the eight-legged double bundle, report the size of the two tendons to be implanted in the anterior fork, and then drill the tibial tunnel with the electric drill."

Although Su Nanchen was directing just now, the two nurses didn't pay attention to it and didn't get into the mood. Now the rhythm is in a hurry and they want to catch up, but it is very difficult.This kind of cooperation, if one step is not well connected, it will affect the next step, unless the operator deliberately stops and waits.

faint!I just said I wanted something, but when I lost my voice, I really wanted something.

No tibial locator is needed, the guide pin directly opens the openings of the two tibial tunnels of the front fork, one for the anterolateral bundle and one for the anteromedial bundle.

Fork rebuild!There are many types, including single-bundle, double-bundle, isometric reconstruction, and anatomical reconstruction. The most advanced is the eight-strand double-bundle anatomical reconstruction, because research shows that the anterior fork is divided into two bundles in function and anatomy—anterior For the lateral bundle and the anteromedial bundle, only when the double bundle is reconstructed in an anatomical position can the function be restored to the maximum extent.

For double-bundle anatomical reconstruction, in order to ensure the strength of the ligaments, one bundle must be completed with the quadriceps tendon, two tibial tunnels, and two femoral tunnels must be opened, which is very difficult. They must be opened in the anatomical position without interfering with each other.

Dr. Yao and Dr. He were sweating on their foreheads. They were mentally prepared, and they were a little bit better. But neither of them had been on Yang Ping's stage. They just heard Su Nanchen repeatedly say that he had to keep up with the rhythm, and his surgery was very fast.

How fast is it? I have no experience in my heart. Now that the speed is so terrifying, I am naturally under pressure. After all, there are so many people staring at it, and the two of them can't keep up with the speed. How embarrassing.

Measure, measure now!Two bundles of tendons were woven and sutured by two people at the same time, and finally weaving was barely finished. This was prepared in advance, and it was done as soon as the stage started, and the tendon weaving in the next step would not be so fast.

Dr. Yao and Dr. He reported the measurements respectively, and they didn't dare to say a word when they dared to rest. Su Nanchen had already put the tendons they needed next, and immediately put his head back to work hard.

A row of large and small drill bits was spread out on the instrument table. The nurse began to look for the drill bits of the required size, and finally realized the pain of not being able to keep up with the speed.

The last two people greeted each other a few times in advance, but they didn't pay much attention to it. Su Nanchen was a little angry. He was well-preserved and wouldn't lose his temper with a nurse, but at least he was dissatisfied in his heart.

"You prepare the electric drill guide pin for the femur!" Su Nanchen ordered another nurse.

Today, there are more surgical instruments than usual, including several electric drills and two instrument tables.

Finally, the nurse installed the drill bit and handed it to Yang Ping. Yang Ping directly opened the two tunnels of the tibia, and soon the opening of the two tunnels of the femur. Because Su Nanchen ordered in advance, the guide pin of the femur was more timely this time. .

Yang Ping resisted the entry point of the femur, drilled in and out, drilled in and out again, just two times, within a few seconds, two tunnel paths came out, no need for anything, locator!what?Not at all now.

"Sounding!"

After Yang Ping measured the depth of the femoral tunnel, he determined the length of the thick and thin tunnels of the two femoral tunnels based on the tendon size reported by them.

"Rough diamonds! Fine diamonds!--"

It’s out of touch again. Two nurses prepare at the same time, one prepares the thick one and the other prepares the thin one. The femur and tibia are different. For each tunnel, the front part is thick to accommodate tendons; the latter part is thin to pass through the suspension Hanging plate and hanging wire.

"Give me both sets of drill bits?" Yang Ping stretched out his hand for too long, and the things haven't arrived yet, so he put down his hand and took a rest.

I haven't looked at this side for a while now. It turns out that it hasn't been done yet. They haven't done it well. If you keep urging them, it won't work. Su Nanchen will be embarrassed. He comforted: "It's okay, take your time, don't rush."

Two tunnels, two sets of drill bits, one thick and one thin, are prepared at one time, and four electric drills are prepared.

What Su Nanchen was worried about happened.It seems that when they were in Liquan Hospital, they already controlled the speed of surgery, and now they still control the speed. They didn't turn on full speed, and several people were equipped with the station, but they couldn't keep up. This is Fuyi, not Liquan Hospital, which is somewhat embarrassing .

At this time, the head nurse came in like a gust of wind: "Nan Chen, can you change the equipment nurse, and transfer the one from Professor Ye's side over here?"

What do you mean?
Although Su Nanchen is educated and has a good temper, he is still a human being. Originally, he couldn't keep up with the rhythm here, and the operation was delayed. He was a little dissatisfied, and now he wanted to replace him.

Su Nanchen grimaced and said, "We are still short of people here. Let's replace our people. Have a look?"

On the stand of the head nurse, the chief surgeon is waiting, and the doctors and nurses on the stage are busy. It can be seen that the stage supporters have not kept up with the rhythm. How many people are supporting the stage?Still can't keep up with the rhythm?what's the situation.

If it were someone else, she would be showing the authority of the head nurse at this time. The head nurses in the operating room are all very good, and they have the power to arrange operations in the operating room. .

But to Su Nanchen, lose your temper?

Can't, and dare not, my parents, a dean, and a director of the nursing department.

Not to mention his dean's father, even the three blue stripes on his wife's hat can't be offended.

The head nurse said in a low voice: "Professor Ye is very angry now, saying that the nurses are not cooperating well, and asked for another one, Nan Chen?"

Some professors have a good temper and some have a bad temper. When you meet a bad temper, the operation goes well, but the operation doesn't go well. The doctors and nurses on the stage are miserable. The operation doesn't go well. It's all because you didn't pull the retractor properly, and the legs didn't hold Well, the nurses did not match the station well.

"What's the key step here!" Su Nanchen said angrily.

"There's no need to change it, just transfer one over there. We only need one nurse, and it's still early." Yang Ping saw that the atmosphere was a little tense, so he tried to mediate it. He was a little embarrassed to take up two nurses here.

If it hadn't been necessary, the head nurse would not have come over to bite the bullet and make this request to Su Nanchen. When talking, her old face was always red, and her voice was still very low, as if she was always asking for advice.

These nurses are the most familiar with arthroscopic surgery, and they will be scolded on stage when they transfer other people. In fact, the one who assigned Professor Ye is already the best in business, even better than these two.

"Okay, you can arrange it!" Su Nanchen nodded.

Both parties were not easy to offend, and they were in a dilemma. After hearing Su Nanchen's agreement, the head nurse breathed a sigh of relief.

(End of this chapter)