godfather of surgery

Chapter 306 Are you kidding me?
Yang Ping took Xiao Su to the operating room, and the two just came out of the men's and women's changing rooms respectively, and met head nurse Jiang.

Xiao Su immediately greeted her, and the head nurse Jiang smiled: "Xiao Su, have you returned to your mother's house? You didn't feel wronged there, did you?"

Xiao Su smiled and said, "No, the head nurse has worked hard, Dr. Yang and I came to see the operation."

Head Nurse Jiang looked dignified: "Doctor Yang, you can't bully our Nurse Su, or we won't spare you."

Yang Ping just smiled, and the head nurse was very busy: "Go ahead, there are too many emergency operations today, I have to quickly deploy manpower, and I will go back to the office for a meeting."

After bidding farewell to the head nurse, Yang Ping took Xiao Su to the operating room of the spine surgery department. Director Qin and Dr. Wen were analyzing the reason. Such a large free intervertebral disc disappeared as soon as it could be seen, which was a bit scary.

"Doctor Yang!" Seeing Yang Ping coming in, Dr. Wen immediately saw hope.

Dr. Wen's understanding of Yang Ping has been relatively deep since Yang Ping performed surgery on Professor Zhang. At that time, he also participated in Yang Ping's small lectures and discussions.

Director Qin looked at the screen of the G-arm machine and studied the pictures of perspective positioning: "Start from the first picture, slow down, I haven't seen it clearly yet, what do you turn over, just turn it up if you tell me to."

Director Qin was a little angry, and his tone was not very good. This kind of minimally invasive surgery usually talks to the patient before the operation and explains it. In case of special circumstances, it may be converted to surgery.

But the intervertebral disc disappeared for no reason. Even after the operation, the intervertebral disc was not found. In the end, a switch operation was made, and the patient’s problem was not solved. I can't keep my face off.

Director Qin walked back and forth between the film reading light and the screen of the G-arm machine, and compared it, the CT and MRI clearly showed that the intervertebral disc the size of half a thumb was placed there, and the positioning was completely correct. Didn't see it at all.

"Oh, Xiao Yang, let's take a look together." Director Qin saw Yang Ping standing beside him.

Please invite Yang Ping to come here. This is Dr. Wen's suggestion. If you encounter difficult problems in the operation of the Department of Trauma and Orthopedics, it is not new to ask Yang Ping to discuss it.

However, this is the first time for spine surgery. Although they are all orthopedics, the specialties are completely different. The threshold for surgeons in spine surgery is higher than that of trauma orthopedics.

Ordinary simple surgery, not a senior attending doctor, is not qualified to do it; slightly more difficult surgery, only the deputy chief doctor can do it. After all, the surgery involves the spinal cord and nerve roots. If there is a mistake, it will either be paralyzed or disabled.

Yang Ping is a young man who has just been promoted to attending surgery. According to common sense, he would never have the opportunity to perform spinal surgery. Therefore, it is reasonable for Director Qin to have some thoughts and not be as humble as Director Gao.

Since Dr. Wen raised it on the operating table, Director Qin disagreed, and if something happened, it would be a matter of self-willed talk, so he still agreed to invite Yang Ping over.

"Eating? I'm sorry to disturb you." Dr. Wen saw that Xiao Su followed, and it was time to eat.

Yang Ping didn't care: "It's okay, I just received your call after eating."

After analyzing the images, Director Qin said helplessly: "Stop the operation, push it down 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 an image of one side at a time, while the G-arm machine can take two sides at a time.

The intervertebral disc is invisible under X-ray, so under the fluoroscopy of the G-arm machine, the intervertebral disc cannot be seen at all, only the vertebrae can be seen.The positioning is to determine the ordinal number of the segment of the intervertebral disc herniation by MRI and CT before operation, and then enter the segment of this ordinal number under the G-arm fluoroscopy.

Everything is going according to this procedure, and no mistakes have been found. Everyone has repeatedly checked the mistakes that may be made in normal times, and no such mistakes have occurred.

"Xiao Yang, thank you for your hard work. Let's push it down for an MRI. Let's go down and have a look?" Director Qin has already withdrawn the equipment, Dr. Wen sewed up the small incision on the back of the patient's waist, covered the incision with a dressing, and lifted the sterile sheet open.

This kind of operation is usually performed under local anesthesia, but this patient's pain symptoms are too obvious, it is impossible to keep the patient in pain during the operation, so he chose combined spinal and epidural anesthesia to anesthetize the lower body.

The patient was awake. Director Qin personally explained to him the special situation encountered during the operation. The patient was fine and understood. He solved the problem for him, and no one deliberately tricked him.

Before Yang Ping had time to read the video, everyone moved quickly, and the patient had already been passed on the flat car, and was about to be pushed to the imaging department for MRI.

Although it's a bit embarrassing and a bit embarrassing to deal with it like this, but for the safety and effect of the patient's surgery, Director Qin can only put his face aside for the time being.

The flat car was pushed to the MRI room of the Imaging Department. Everyone followed in muffled voices, not daring to speak. After all, it was the director who stumbled.

After several twists and turns, when we arrived at the MRI room, Director Meng was very generous and waited in the operating room himself. A machine was also vacated in advance, and the patient pushed it in. The doctors and nurses were busy checking contraindications, checking whether they carried magnetic metals, and whether they were loaded. After that, they will talk and sign, and then move the patient onto the platform.

"Old Qin, what's the matter, the intraoperative exploration and the preoperative imaging are not in the right direction?" Director Meng asked Director Qin to sit down, knowing that he had encountered a problem, otherwise there would be no one who would push the patient down for MRI after the operation was half done.

Director Qin looked unlucky: "The positioning is accurate, there is no problem at all, the intervertebral foramina mirror enters the spinal canal, and the free intervertebral disc can't be seen."

"Is there such a thing?" Director Meng asked nonchalantly.

Technicians and nurses are positioning the patient, and other doctors are waiting outside, only Yang Ping and Dr. Doctor, sit down!"

Director Meng is familiar with Yang Ping, especially when Yang Ping saw the dural arteriovenous fistula from the patient's MRI, he was overwhelmed with admiration, and he liked to call Yang Ping over to study together if there were any difficult cases.

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.

"The intervertebral foramina mirror has been done for almost ten years, and there should be two thousand cases. I have never encountered such a situation." Director Qin is 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 powerful magnetic field makes the spin direction of the hydrogen ions in the human body neatly face the same direction, and when the magnetic field is cancelled, the orientation of the hydrogen ions returns to a free and disordered state.

In this way, the recovery time is different, and the difference is produced. The difference is the basis of the image, and only the difference can compose the picture.

Just like a pencil, it makes use of the difference in the density of the lines to compose the image, and X-ray film uses the difference in the amount of radiation absorbed by objects of different densities to compose the image. If there is no difference, it will be white or black.

Some of the doctors in the imaging department were already wandering outside the door. Since Director Meng was inside, it was not easy to go in. Everyone came to see Yang Ping. Once a person gets up, there will be many legends. It has become like a myth, and everyone has a sense of height and distance towards him.

Let's not mention those awesome things before, 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 to go to the consultation for an operation.

It is also rumored that Yang Ping rubbed the great experts from Britain, Germany and Japan on the ground. The fee for this cross-border consultation was in the millions. Lin recently asked to buy a car, 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 people even wondered whether there would be a radiologist in the general orthopedics department. If they were lucky enough to join, they would follow suit. Pick up meat to eat.

Didn't Fatty Liang from the anesthesiology department follow Yang Ping too?Fucking the stewardess on the plane, who the hell spread the word, the fat man is looking for big mouths everywhere, every time at this time, Zhang Lin immediately advises him: Calm down, calm down, celebrities don't have any privacy.

The speed of light-speed magnetic resonance is extremely fast, and the image slowly takes shape. Director Meng stopped chatting, and Director Qin leaned over to look at it. The lumbar intervertebral disc is herniated. For these veterans, they can tell at a glance what segment and how much it protrudes, and they close their eyes. Can't go wrong.

That thing is still there, so obvious. Judging from the low signal, it is undoubtedly the nucleus pulposus of the intervertebral disc prolapse. It is still in the original position without any change. It is located in the spinal canal, behind the lumbar 1 vertebral body, and the intervertebral foramen The approach is just facing the intervertebral disc, no matter the 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 a few times, and it was indeed true. Well, what the hell, did the mirror stray into other tissues, just separating it from the intervertebral disc?As long as the intervertebral disc is still there, there is a way to explore it carefully.

"Send it to the operating room, re-sterilize the drapes, and continue the operation." Director Qin has a bottom line in his mind.

Although it's a lot of trouble, that's the way it is with surgery. Either you don't go on stage, and once you go on stage, if you encounter an unexpected situation, even if it's troublesome, you have to go through the trouble. Trouble on stage is better than trouble off stage.

"Director Meng, I'm sorry, let's continue with the operation." Director Qin said goodbye.

Director Meng got up and saw him off: "You're welcome, I'll contact you again if necessary."

"Xiao Yang, thank you for your hard work. Why don't you go back with us?" Director Qin left a way out, fearing that if there were any more problems, at least there would be someone who could help.

The patient was pushed to the operating room again, and the position was adjusted, and the segment was confirmed to be correct by fluoroscopy with the G-arm machine, and the drape was re-disinfected.

There is no problem with the original approach, the small incision is removed, and the original entrance is still used. The mirror is stretched in, and the vision is clear when the water is flushed.

The dural sac and nerve roots are clearly visible. After ten years of this kind of surgery, how can anyone be mistaken? The lens did not stray into other tissue spaces. It is clearly in the spinal canal. How can there be any intervertebral disc? Where is the intervertebral disc?

"Are you kidding me? Is that the MRI just now?" Director Qin wanted to confirm.

The doctor in the audience carefully checked the date: "That's right, it was just taken, and I just hung it up."

Fuck, director Qin cursed foul words in his heart, today's fight is a bit nonsensical, and the little confidence he just gained has been vented and deflated again!
Director Qin sorted out his thoughts, what is the problem?Where exactly?

"Turn on the screen, call 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 chief surgeon can operate the control panel and call up the required medical records through the sterile film. It's just that Director Qin is used to reading films on the reading light, so he didn't use this high-tech .

Through the sterile film, Dr. Wen turned on the screen, called up the images, found a few typical ones, opened them, and arranged them in comparison on both sides. There was nothing wrong with it. The intervertebral discs were still in their original positions, no matter if it was the previous films or the current ones.

But I obviously didn't mistake the segment, and the camera is also in the spinal canal, so why didn't I see the nucleus pulposus tissue of the intervertebral disc?I can't see it no matter how I adjust it.

"Damn it!" Director Qin fell into a daze again, sweat dripping from the old fritter's forehead.

(End of this chapter)