godfather of surgery

Chapter 546 Needle retrieval is a technical task
Sometimes simple things become complicated for some reason.

A patient's family member suffered acute myocardial infarction in the hospital, and the doctor stayed up all night to rescue him. This was originally a very positive thing.

But I don't know what's going on, but it makes all the departments of the hospital feel extremely nervous.

Dean Sun is quite worried about this matter, and Director Zhao is the same, and even more worried.

During working hours the next day, Dean Sun completed the work of the general duty, and the matter was handed over to the medical department for handling.

The general on duty is held by the leaders of the administrative department in turn. During the off-duty hours at night or on holidays, the administrative leaders are always in a state of rest. The general on duty is the temporary top leader of the hospital to deal with emergencies, such as coordinating large-scale rescue and handling various disputes.

Once it is time to go to work, the duty of the general on duty is automatically cancelled.

Director Zhao learned about the incident in detail and attached great importance to it, thinking that there was a sign of dispute in this incident.

When judging potential disputes, Director Zhao has never been emotional, and has his own method. He designed a scoring table by himself, and each risk factor is given a certain point value, and the incident is scored against the table. If it exceeds a certain point value , is judged as high risk.

When I went to work in the morning, Director Zhao looked at the form, like divination, and scored items one by one. After scoring, Director Zhao saw that it was a high-risk event.

For Xiao Minmin's operation, logically, it should take a while to see the direction of the matter.

Regardless of whether the old lady's condition is stable or not, the key to disputes is their son.

Their son is currently being held in a detention center. Whether he will be convicted or not is still unknown. If he is not convicted, it is very likely that he will use this matter to make trouble with the hospital. The purpose is very simple, to extort a sum of money.

How could a grown man who lives on his old age, has no proper job, and is idle, let go of this opportunity.

In fact, all medical disputes that are unwilling to take formal channels, without exception, are directly aimed at money.

If you don't take the formal way, you will naturally choose to go to the doctor.

No matter what they say it is not for money, but for justice, but the ultimate goal must be for money.

Because they know very well in their hearts that they can't make money by going through formal channels, conducting medical appraisals, and making judgments through the courts.

I had no choice but to gamble and make a fuss, hoping to make some money.

Yang Ping is unwilling to postpone the operation, so the medical office must escort him.

Director Zhao sorted out the matter, asked the officer to notify the neighborhood committee where the old man lived, and the police station that handled Xiao Minmin's case, and then asked the officer to go there in person.

The hospital's lawyers from the legal department, the director of the publicity department, and the head of the security department were all invited to the office by Director Zhao to intervene in advance and make preparations to prevent real disputes from happening, and they are in a passive position.

Doing good deeds requires strength and skill. Sometimes without strength and skill, doing good deeds can easily cause trouble.

In the past, Sanbo Hospital did not have any legal department, and the security department only had a few security guards in their 50s and [-]s.

In order to strengthen the hospital's ability to deal with medical disputes, President Xia set up a legal department and a security department. The legal department not only has full-time lawyers, but also cooperates with a big-name law firm with the most experience in handling medical lawsuits in this city.

The Security Department recruits all young veterans to build a disciplined and effective team.

Not for anything else, just to prevent doctors from being beaten and hacked.

When an outstanding young professor of ophthalmology in the imperial capital was hacked into a disability by a patient, Dean Xia's heart skipped a beat, and he sent four strong security guards to the building where Yang Ping worked that day, two in the lobby downstairs and two in the ward upstairs.

This is why the building where Yang Ping works has full-time security guards.

A rare talent, such a sad thing must not happen, Dean Xia is a little scared when he thinks about it.

This is also a helpless move. To survive and develop in a complex environment, there must be a way.

After finishing shifts, Yang Ping took Song Zimo and Xu Zhiliang to visit Minmin's grandmother in the CCU. The rescue was timely, and things were fine. The old lady was awake and could have a simple conversation.

She recognized Yang Ping immediately, and asked if Minmin's operation had been done, and Yang Ping said that he would do it later.

The old lady said that Professor Yang must be bothered.

Yang Ping reassures her that she can recuperate at ease.

When Yang Ping returned to the department, Minmin had already been sent to the operating room.

Zhang Lin's wife, Dr. Li from the Department of Pediatrics, was about to leave with a full stomach and an empty lunch box. She was bringing breakfast for Zhang Lin.

Seeing Yang Ping, Dr. Li called out respectfully: "Professor Yang!"

"Still working now? No rest?" Yang Ping greeted.

Zhang Lin took over the words: "Cory asked her to take a vacation, but she didn't want to. The pediatrics department is short of manpower. She is not on duty now, and she usually goes out to the clinic. If she is really about to give birth, she will go directly to the delivery room."

Head nurse Cai came over at this moment and held Dr. Li's hand: "When is the due date?"

"Just a few days!" Zhang Lin said.

The head nurse said to Zhang Lin: "You always talk about the past few days, almost half a year."

"It's really just these few days." Zhang Lin chuckled, and the voice of the soon-to-be father was a little less hostile.

The head nurse blamed Zhang Lin: "You are about to give birth, and you still ask your wife to bring you breakfast?"

Dr. Li said with a smile: "I have nothing to do. Walking around is more conducive to delivery. He is working hard."

Several people stood in the corridor of the ward and chatted for a while, then hurried to the operating room.
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Xiao Minmin's operation started as usual, and she was relieved of pain early.

Fatty Liang moved quickly, asked Minmin to inhale a little anesthetic, quickly completed intubation, and connected to the anesthesia machine.

Zhou Can made an indwelling needle for Minmin's scalp, and put the color Doppler ultrasound machine beside her early.

Sanitize your hands, spread the sheets, and get dressed. Everyone chatted and opened the stage, and the atmosphere was very relaxed.

First easy and then difficult, the fine needles in the limbs are relatively easier to take than the fine needles in the chest and abdomen.

The groin of the thigh is also the place where the nerves and blood vessels are concentrated. The femoral artery, femoral vein, and femoral nerve cross here.

The ultrasonic probe used in the operation is sterile, and the coupling agent is also sterile. Yang Ping applied the coupling agent on the sensitive skin, and the ultrasonic probe was pressed to the groin, and the sound of blood flow came immediately.

Subcutaneous, fascia, muscle, blood vessels and nerves, various images appeared on the screen. Slowly, the needle also appeared on the screen. Following the planned pulling direction, Yang Ping made a 0.5 cm incision with a sharp knife.

Mosquito vascular forceps were inserted through the small opening. Under the monitoring of the color Doppler ultrasound, the tip of the forceps firmly avoided the nerves and blood vessels, tightly clamped the tail of the thin needle, and then slowly withdrew from the mosquito forceps. The first needle Appears in the bend.

Color Doppler ultrasound images are flat, and it is actually very difficult to locate the thin needle in the three-dimensional space based on the flat image.

Even the open surgery would not go so smoothly, but Yang Ping did it right the first time.

A needle is like a fish in water. If the fish swims in the water, the picture obtained by people has no stereoscopic vision, but only a plane image, so all fish, no matter how deep or shallow, swim on the same plane, and the person who catches the fish cannot It becomes very difficult to distinguish its depth and catch fish.

The tissue of the human body is not water, but layers of solid tissue. These solid tissues are a flat image on the color ultrasound screen. It is difficult to find a needle hidden in any layer.

That's why in the operation to remove small foreign bodies, the X-rays look close at hand, but they can't be found.

The surgical area is irrigated, the small incision is closed, and a fine needle is taken from the other side of the groin.

Make a small incision, insert the mosquito clamp, hold the tail of the needle, and then pull out the fine needle. The movement is done in one go, and there is no need to repeat any action twice. The fine needle of the entire lower limb is easily taken out by Yang Ping in this way.

Next, four fine needles were taken from the chest cavity, and the special thoracoscopic instrument for pediatric surgery borrowed from the Provincial Women and Children’s Department came in handy. First, use color Doppler ultrasound to detect and locate, and made a small opening in the intercostal space on the left side of the chest, and inserted the lens. Yang Ping was careful. Under the ground microscope, the pericardium was cut bit by bit, a few millimeters, and separated slightly.

Under the microscope, a little needle tail can be seen, and the incision of the pericardium is just at the needle tail.

Song Zimo and Xu Zhiliang looked at the young professor at the same time, they were amazing, how could they have such a strong positioning ability.

No matter how many times he had to look for it, it was completely in place at one time, as if the needle was inserted by him.

It's like going to a hidden object game, a small toy is hidden in the room for you to find, and you can find the toy directly.

Either you hid this toy, or you watched someone else hide it, or you have to look for it anyway.

And this is not a needle, the needles in the limbs are like this, and now the needles in the pericardium are also like this.

Can you behave a little more normal?

Song Zimo drew 1 question marks and exclamation marks in his heart.

Grab the tail of the thin needle with the forceps, carefully pull it out, and place it in the curved plate.

Sure enough, the needle was rusty, and the tip had pierced the heart wall by at least two millimeters. It was good to pull out the needle in time, otherwise it would slowly and possibly go deeper and deeper with the contraction of the myocardium, and finally penetrate the heart wall. broken heart.

"How did the needle get in? From the intercostal space? How could it be so deep?" Zhang Lin asked.

Xiao Wu replied: "The needle is not static after it enters. With the breathing movement of the thorax and the contraction of the heart, the needle will continue to move, and the current position is not the original position."

Two good buddies stood on the operating table with nothing to do.

The patient was a baby, and there was no place to stand when there were so many people, so the two brothers stayed away from the operating table and simply chatted.

Larger, blunt foreign objects, such as shrapnel, rarely move.

But this kind of sharp thin needle is easy to move, and some needles will enter blood vessels, which is life-threatening.

According to the location of color Doppler ultrasound, Yang Ping used thoracoscopy to find three other needles, one hidden in the mediastinum, one in the space between the two lobes of the right lung, and one attached to the wall of the aorta.

The remaining three in the chest were found, especially the thin needle attached to the wall of the aorta, which made everyone sweat.

"Damn Xipi, how dark is this heart, that you can lay hands on such a young child?" Zhang Lin cursed.

Xu Zhiliang raised his head and turned to look at Zhang Lin.

Zhang Lin thought that Lao Xu was going to scold him again, so he immediately put on a smile.

"His grandma's, this is not human at all!" Xu Zhiliang cursed, then lowered his head to perform the operation.

The operation continues and begins taking thin needles from the abdominal cavity.

At this time, Director Zhao came in: "How about it, Professor Yang!"

"Oh, it's really a thin needle in it? It makes my scalp tingle."

Director Zhao looked at the curved plate on the instrument table, there were already twenty or thirty needles, and he was very uncomfortable.

"There are still six abdomens that have not been removed, and they are about to be removed."

Song Zimo sewed up several small openings in his chest, and Yang Ping was using color Doppler ultrasound to locate six thin needles in the abdominal cavity. Sure enough, two of them were in completely different positions.

Regarding Professor Yang's address, in fact, every time these big shots call him, Yang Ping will say: "Call me Xiao Yang, or Doctor Yang."

But it seems that doing so has no effect, even Dean Xia is like this, and he still treats Professor Yang one by one.

Yang Ping simply stopped being polite, it was just a title.

However, Professor Yang's title is more pleasing to the ear.

"Taking needles is a technical job, don't worry, take your time." Director Zhao said politely.

Dr. Jin from the Department of Traumatology and Orthopedics appeared behind Director Zhao at some point, and said, "It really is."

The voice happened to be close to Director Zhao's ear, which startled Director Zhao, and when he looked away, Dr. Jin suddenly appeared behind him.

"I used to take a thin needle, and the worker used a high-pressure air gun to shoot it into the right upper arm. The patient had no obvious symptoms, but he asked to take it out. There was no way, so I had to cut it open, and repeated C-arm X-ray machine fluoroscopy. For four or five hours, I couldn’t find the needle. I saw the needle in this position, but I couldn’t find it. It was really annoying. Later, I touched it with my hands, layer by layer, and touched it for more than an hour, but still nothing. , I had to give up the operation, and the patient was discharged from the hospital and came to me for a follow-up visit. He said that he didn’t feel uncomfortable at the time, but now sometimes the right arm is not in the right position, and the tiger’s mouth area of ​​the right hand is numb, as painful as acupuncture.”

"Could it be that the thin needle ran from the upper arm to the tiger's mouth? Is it so evil?" Zhang Lin was in high spirits.

Dr. Jin continued: "I also thought at the time, it's not so evil. Later, I went to Director Han for advice, and Director Han said, take another X-ray. If the needle is still on the right upper arm, it is likely to be there. Inside the radial nerve."

"Later, I followed Director Han's instructions. The position of the needle did not move, and it was still in place. I performed palpation on the projection of the radial nerve on the upper arm of the patient. Sure enough, the patient's right radial nerve innervated area was abnormal. Feeling, especially in the tiger's mouth, he said it was as numb as a needle prick."

"I immediately suggested another operation to the patient. The patient was obedient and agreed to the operation. This time, I opened the radial nerve membrane at that part according to the location on the X-ray. My dear, the very small needle was lying vertically. There."

Lao Jin described this clinical case with ups and downs.

At this time, Yang Ping had already prepared the pneumoperitoneum, inserted a laparoscope, and began to search for the six needles in the abdominal cavity.

(End of this chapter)