godfather of surgery

Chapter 576 Dissect out a handful of hair

Yang Ping asked them to touch and feel, to let them feel the tactile texture of teratomas. Unexpectedly, this product has rich imagination.

The tumor in the pelvis and the tumor in the sacral canal form a dumbbell shape, except that one end is larger and the other end is smaller.

In order to completely remove the tumor, Yang Ping plans to divide the tumor into two parts, and first remove the large tumor in the pelvic cavity. In this way, without the obstruction of the large tumor, the sacral canal can be opened in an open space, and the small sacral canal can be slowly removed. tumor.

One after another, the blood vessels were ligated and cut off, after these ties were lifted.

Yang Ping ligated and cut off the connecting part between the tumor and the sacral canal, then removed the entire tumor from the pelvic cavity, handed it over to Xiao Su, and placed it on a special sterile table.

The structure of the sacrum is complex, with a sacral canal, a sacral foramen, and nerves extending from both sides of the sacral foramen.

Yang Ping sorted out the anatomical structures here, which ones are normal tissues, which ones are teratoma structures, the knife is ruthless, if anything goes wrong and the nerves are injured, it will cause neurological symptoms.

After sorting out, Yang Ping marked the tumor connections that had just been cut off one by one. These tissues were all the same as the tumors in the sacral canal. Whether the tumor originated outside the sacrum or inside the sacral canal is unclear now.

If the tumor is in the spinal canal or sacral canal, the bony canal must be opened, otherwise the tumor cannot be exposed.

Yang Ping used an ultrasonic osteotome to open the sacrum from the front, and formed the section of the cut bone into a trapezoid, so that the isolated bone was large on the outside and small on the inside.

The reason for cutting it this way is to cover the bone block back later without sinking and compressing the nerves in the sacral canal.

The front side of the sacrum is much thicker than the back side, so opening the window from the front side makes it easier to make the bone block of this manhole cover principle.

Besides, opening the window from the front can also reduce the occurrence of postoperative sacrococcygeal pain.

The bone block looks curved and square as a whole, with a trapezoidal cross-section. A total of three such bone blocks were cut out.

The bone block was uncovered, and the tumor hidden in the sacral canal was fully exposed.

This way of revealing is completely different from the textbook.

Song Zimo and Xu Zhiliang witnessed the way Yang Ping entered the sacral canal, and kept the whole process in mind. Next time, they can also use this method.

The advantages of this method are obvious. It is not only practical, but also beautiful. After surgery, the bone fragment can be fixed back to its original position with plate screws.

Moreover, every time Yang Ping operates, the steps are clear and the anatomy is clear, which is naturally teaching.

I have followed Yang Ping for a long time to perform surgery, and both anatomical knowledge and surgical methods have improved rapidly, many of which cannot be learned in textbooks.

Zhang Lin and Xiao Wu, while pulling the hook, occasionally poked their heads to see what was going on inside when they could see.

Most of the time, the hook man has no vision, and can't see what's going on inside at all. After a long time with the hook, it's easy to get sleepy and doze off.

Therefore, one of the most basic qualities of the hook man is not to doze off.

Zhang Lin and Xiao Wu are not ordinary Lagou heroes, but great heroes, so naturally they will not doze off. In the near future, the monograph on Lagou co-authored by the two will be published.

"Xiao Wu, the hospital basketball game is about to start. I get off work in the afternoon and go to draw lots. Are you going or should I go?"

"Your bad luck, let me go."

"Brother, let me go. I've been very lucky recently. If I buy Wanglaoji, I'll buy another bottle every now and then."

This kind of thing represents the most promising department, and participates in the lottery as a young talent. As a generation of king, how can Zhang Lin miss it.

The basketball game has been prepared for a long time, and it will start soon.

In the preliminaries, the teams most unwilling to meet were the emergency department and the administration department. Xiong Shihai from the emergency department basically had no opponents on the court.

In the administration department, a group of chief executives, vice presidents, directors of the medical department, etc., are not skilled enough, especially Dean Xia is simply the king of fouls.

"Principal Xia, I blow the whistle personally every game, so I can't keep an eye on him!"

"Elder Zhang!"

Professor Zhang stood behind his back with his hands behind his back. Sometimes Director Han would also help out on outpatient visits, which made Professor Zhang's time quite loose.

What kind of special operation, the old man came up and walked around. The 80-year-old man, who didn’t go to the operating room for a few days, was very panicked, feeling like he had no roots.

As long as you turn around and do nothing, your heart will be at ease.

In fact, surgeons spend more time in surgery than at home, and it is natural for them to get used to it.

"Old Zhang is mighty!"

Others are called Mr. Zhang, but these bastards are called Mr. Zhang, Professor Zhang is not angry.

The few brothers who often eat chicken together behind closed doors, Lao Zhang and Lao Zhang are used to it.

"Brother Fat, I heard that you are not in a good mood recently. What's the matter? The swan flew away?" Professor Zhang made a detour and turned to Fatty Liang.

The intern hurriedly moved the stool for Mr. Zhang to sit on.

The fat man lowered his head, faltering.

The shape of the sacrum is very irregular, and there are many corners. The tumors in these corners are difficult to remove, and these places are full of blood vessels and nerves.

This kind of operation is as difficult as fighting urban street warfare.

The basis of surgery is anatomy. If you are familiar with anatomy, the operation will be easy.

The irregular teratoma in the sacral canal was completely removed by Yang Ping while talking and laughing.

Two tumors, one large and one small, one spherical and the other irregular, were placed on the sterile table.

"Send it to make a frozen section!"

Intraoperative quick frozen section can quickly carry out pathological diagnosis.

The doctor can wait for the results of the pathological section on the operating table. If it is benign, just remove the tumor; lymph node dissection.

In European and American countries, the operating room is equipped with a pathology room exclusively for surgeons. The chief surgeon takes off the tumor specimens, takes off the surgical gown, and goes to the pathology room to see the frozen section in person, confirm the nature of the tumor, make a grading and staging, and then re- Swipe your hands on the stage and continue the operation.

But in our country, surgeons do not have the tradition of looking at pathological slides.

"Anyway, let's cut it open, let's see it?"

Song Zimo was very interested in the structure inside the teratoma.

Anyway, to get specimens, after incision, take multiple specimens according to different tissues, and then send them to the pathology department separately.

The meat balls were placed on the sterile table, Song Zimo and Xu Zhiliang, one fixed the meat balls, and the other performed the task of cutting.

The swelling of the meat ball indicates that there is still a certain tension inside.

In order to prevent the incision liquid from splashing, Song Zimo asked everyone to stay away from the sterile table.

The capsule was cut open, and a pile of fat bulged out, followed by a greasy viscous liquid overflowing, mixed with black messy things. Song Zimo took a little fat and kept it as a specimen, and then continued the dissection.

The black, messy thing turned out to be hair-like hair. Song Zimo clamped it with a vascular forceps and gently pulled it out, pulling out a half-meter-long black hair.

This scene is a bit intrusive, what is the concept of a pile of hair growing in the stomach.

It's not just a little hair, but a lot of it. These hairs are no less than the long hair cut off by an adult woman. No wonder the meatball is so bulging. For a better diagnosis, Song Zimo also took part of the hair as a standard.

The tissue inside the meatball is very complex, and in order to make a clear diagnosis, multiple specimens must be taken.

Except for bone tissue that cannot be frozen, other soft tissues can be frozen.

In addition to the hair, there are tooth-like structures inside, one by one.

The spine shown on the image is not a complete spine, but neatly arranged spine-like bones.

There is also irregular muscle tissue around, and even skin tissue and nerve tissue were found.

(End of this chapter)