medical simulator

Chapter 148 Morality is not good, but justice is fine! (Second update, please subscribe!)

Dissociative motor and sensory disorder, originally a neurological disorder in which there is a loss of movement or impairment of motor function, either as a loss of movement or as a loss of sensation!

But later in the anesthesia process in the anesthesia field, according to this feature, it can be used to judge whether an anesthesia is good or not.

It is also a reflection of the professional level of a top anesthesiologist.

If I only want your motor function to be lost, then you just can't move, you can feel pain, itching and touch!

If I only want your sense of loss, then I just block your pain.

If your operation site is below the knee joint, then I will only get rid of your pain below the knee joint, but if it exceeds the knee joint, I will lose.

There is quite a feeling that the king of Hades wants you to die on the third watch, and dare not keep anyone until the fifth watch.

What is the anesthesia for this patient?

Well, he still has a certain degree of pain in his calf, and he can still move his toes!
But the pain in the thigh has disappeared——

The specific principle is quite complicated, but, as a top professor, Qin Dingmo still roughly knows the basic principle of Yang Yifeng's completion.

As far as the innervation of the lower extremity is concerned, before the lumbosacral nerves such as the left femoral nerve and the femoral nerve are synthesized, the distribution area of ​​sensation and movement has been determined——

L1: The groin (including the uppermost part of the thigh).

L2: Front of upper thigh.

L3: Front of lower thigh.

L4: Anteromedial aspect of the lower leg.

L5: Medial half of the foot.

S1: Lateral half of the foot.

S2: Outside the back of the calf.

S3: Behind the thigh.

The above is the positioning.Dominant positioning means only controlling the target area, which is anatomically determined.

Then, when the nerve root comes out, it can be divided into anterior and posterior roots, and the dominance functions of the anterior and posterior roots are different, generally speaking!

The front root belongs to movement, and the back root belongs to sensation!
So, Yang Yifeng, the wolf extinguisher, directly messed up the back roots of L1/L2/L3, but left the other positions untouched.

Moreover, in order to consider that the sensory control of L1/L2/L3 is not enough to block all the sensations in the thighs, he also precisely blocked the cutaneous nerve!
Is this what people do?
Although it can be done in theory, it is a theory. Usually, the intraspinal anesthesia is performed from the L4/L5 gap. At most, one side of the thigh is numb, and the function of the other side is still preserved. He is already a very good anesthesiologist.

And how to determine whether movement and feeling are separated, the best way to confirm it is.

Good anesthesia can be hard, bad anesthesia can be soft! (Book friends who have experienced spinal anesthesia must know that feeling, no more below~——~)

Such precise anesthesia?
Qin Dingmo's expression was complicated!
I am sub-Austrian, such a wolf-killing anesthesia?
To actually plan to give such a villain an operation - it's simply God's eyes!

How good would it be if other critically ill patients could have such good nerve block anesthesia?
Some patients, with various complications, are unable to undergo surgery because they cannot go through anesthesia.

As the director of the anesthesiology department, Zeng Yi naturally noticed Qin Dingmo's examination at this moment, his pupils shrank instantly, his eyes stared straight, and he was still thinking about going back one by one, Yang Yifeng finally killed those nerves and sensory nerves Now, which ones haven't been killed yet!
"Is it possible?" Cai Dongfan asked Qin Dingmo.

The corner of Qin Dingmo's mouth twitched, blocked by the mask, and nodded: "It's ok, Director Cai, you can perform the operation now."

Only then did Yang Yifeng say, "Then I'll wash my hands first! Director Cai, I'll insert the venous filter. It won't affect your surgical field. We can do it at the same time."

"But please help me disinfect my right groin."

Naturally, Cai Dongfan, Luo Yun and the others had already washed their hands, put on their clothes, etc., and fully prepared for the surgery.

"Okay, go wash your hands." Cai Dongfan immediately nodded in agreement.

Zhang Zhengquan and Du Yanjun are doing the disinfection.

After Yang Yifeng left the operating room, Cai Dongfan and Luo Yunzhou personally made three people to determine whether the preoperative surgical instruments were ready!
……

Soon, Yang Yifeng walked in again. At this moment, both Zhang Zhengquan and Du Yanjun had just finished disinfection and were spreading towels.

After Yang Yifeng took the initiative to put on his clothes, he took a deep breath to calm down the fluctuations in his heart.

He secretly said to himself, this master is the psychopath of 'drunk driving'——

I just want to send him where he should go.

After thinking this way, Yang Yifeng opened his eyes as if breaking through some obstacles.

Then he spread the drape on his own, because he was going to implant the venous filter from the femoral vein to the inferior vena cava, so Yang Yifeng chose the right femoral vein.

For the implantation of venous filters, the commonly used routes include the right femoral vein, the left femoral vein, and the right jugular vein.

Among them, the right femoral vein is the preferred route.Because the right femoral vein is straighter than the left, and has less anatomical variation.Therefore, choosing the right femoral vein approach will reduce unnecessary troubles in the operation.

After simply spreading the drape, Yang Yifeng took out the graduated puncture needle in the puncture bag.

Immediately afterwards, the itinerant nurse pushed the color Doppler ultrasound over.

The puncture of the femoral vein, under normal circumstances, uses the relatively safe Seidinger puncture under the guidance of color Doppler ultrasound!

However, before the itinerant nurse came to Yang Yifeng's side, Yang Yifeng's hand was already directly pierced with the puncture needle.

Blind wear!

Cai Dongfan, Luo Yun and others were finishing preoperative preparations on the left lower limbs, so they didn't see them, but Qin Dingmo and the others who saw Yang Yifeng's movements were holding their toes on the ground, and they were holding their breath, as if their hearts were racing. Jumped to the throat!
-

Brother, what you did was femoral venipuncture?

Not the chest cavity, and not the venules!
Next to it is the femoral artery and the femoral nerve!
Qin Dingmo didn't even know how to describe Yang Yifeng's behavior at the moment.

However, Yang Yifeng didn't feel anything, chose a suitable angle, and pushed the puncture needle into the back.A 14F arterial sheath catheter was placed.

Although the puncture is a vein, the arteriovenous catheter is universal, and Yang Yifeng has long considered putting the filter into the inferior vena cava, the inferior vena cava is the common path for the venous return of both lower extremities!

So I chose the filter model in the inferior vena cava, which is 14F!

Once the catheter is in, it's time to place the guide wire!

In the process of placing the guide wire, Yang Yifeng did not start blindly, but pushed the color Doppler ultrasound instrument to his side, and then used the probe to accurately detect the shape of the vein and the guide wire tip, and then began to gradually insert the guide wire. Follow the direction of the vein back to the heart, first enter the iliac vein, and then return to the inferior vena cava.

After roughly seeing the distal end of the guide wire pass through the renal vein, Yang Yifeng stopped entering.

Under color Doppler ultrasound, after roughly determining the lumen of the vein, a bird's nest filter was selected.

Under the guidance of the exchange guide wire, the insertion of the inferior vena cava filter...

This process was also quite smooth. After putting it in, Yang Yifeng monitored it again for a while, and after seeing that the blood flow was still unobstructed, he took out the guide wire, pulled out the arterial catheter sheath, and bandaged it with pressure.

But after the pressurized bandage, Yang Yifeng left the ultrasound head on the filter for the sake of stability, continued to monitor, and said to Qin Dingmo: "Professor Qin, let me observe the blood pressure again now." It’s out of shape, if you want to use the monitoring of fat particles in the heart later, you can just take it away.”

Although Yang Yifeng had completed the operation, he was still a little apprehensive.

After all, when he operated on his mother before, her mother died on the operating table. Although the risk of that operation was exponentially higher than the current one, it was still a vascular operation!

If it wasn't for sending the eldest brother in, Yang Yifeng felt that he would not be able to pick up the operating equipment this time.

However, Yang Yifeng felt an unspeakable hatred in his heart when he thought of the murderer who caused the death of his parents to be released on bail for medical treatment and get away with it.

Qin Dingmo nodded, and said: "It's okay, you should look at yours first. Orthopedic surgery, only when the bone marrow cavity is washed, will a large amount of fat drip back into the blood system."

"The patient himself does not have the three high fats, so he can use it temporarily."

As a top professor, Qin Dingmo is quite familiar with the situation of each department.

Fat embolism, in addition to mostly occurring in patients with three highs, is more common in joint replacement in joint surgery.

That's because during the process of grinding the bone marrow cavity, fat particles will enter the bone marrow cavity, and at this time, the stability of the fat droplets will be affected, and they may be deposited as thrombus.

If you have a clear theory, you will naturally not be afraid. This is how to handle it.

Not a little more useless work and preparation, just right.

However, about 5 minutes after Yang Yifeng finished the operation and went to the next timing panel, Cai Dongfan, Luo Yun and others happened to reopen the patient's previously debridement and suture incision.

The door of the operating room was kicked open.

Then Zeng Yi turned his head and saw Huang Shinan, the director of the Department of Hepatobiliary and Pancreatic Surgery, but with the brand name of Vascular Surgery, walked in.

After he came in, he saw that the operation of Cai Dongfan and others had just started, so he asked with a smile: "Director Cai, it seems that I came at the right time. Your operation has just started?"

Cai Dongfan didn't turn his head when he heard Huang Shinan's voice, but just nodded: "Well, our operation has just begun."

When Yang Yifeng said that he was going to have a venous filter implantation operation, he was actually a little flustered, so he called Huang Shinan and asked him to come to the operating room to take the helm and judge for a while.

Otherwise, no one else would know how Yang Yifeng is doing?
Cai Dongfan really took great pains for this patient.

It's just that Yang Yifeng has finished all the operations, and Huang Shinan hasn't come yet, so even if he didn't do well, there is no room for salvation.

I don't know why Huang Shinan stepped in at this point.

But Cai Dongfan didn't tell the truth, Huang Shinan is also the director of a department after all, so he should be sympathetic.

Only then did Huang Shinan see that there seemed to be an elastic compression bandage on the opposite side of the femoral sheath of Cai Dongfan and others, and there was a tall pile of sterile gauze and saline pad underneath.

This seems to be a sign that the war has ended?

Seeing this, Huang Shinan panicked a little, and looked at the time. It was only half an hour since Cai Dongfan called him. At that time, Cai Dongfan said he was only picking up patients, could it be?

Then he glanced at Yang Yifeng, and found that Yang Yifeng was already under the timing panel in the operating room, and the old monk was in meditation.

"Director Zeng? Is the venous filter finished?" Huang Shinan asked in a low voice as he walked to Zeng Yi who was making soy sauce.

Qin Dingmo couldn't figure out Huang Shinan's origin, so he stepped aside a little bit, but he still put the probe of the color ultrasound at the heart position, and opened the venous catheter of the upper limbs, ready to rescue the patient at any time preparations.

Zeng Yi let out an "ang" and looked at the operation timing panel.

"It ended about 4 minutes ago, Director Huang." Zeng Yi is also the director, and he is also the chief director of the anesthesiology department. He is on the same level as Huang Shinan.

Then Zeng Yi saw the familiar confusion and astonishment in Huang Shinan's eyes.

When Yang Yifeng was under anesthesia, he also showed this look, so he was familiar with it, and he smiled a little, feeling balanced!
Because he was able to observe at any rate, and Huang Shinan was left with only confusion and astonishment.

Huang Shinan suddenly groaned secretly in his heart, rubbed his head, turned around and walked away silently in embarrassment.

Just out of the operating room, Huang Shinan still couldn't figure out how Yang Yifeng put the venous filter in so quickly. He didn't see the process, so naturally he couldn't judge the filter implantation he did. How is the level.

Of course, with such a fast speed, this guy must be blind piercing!
How much confidence do you need to put a filter in the inferior vena cava blindly?

Or conceited?

It's hard for Huang Shinan to say, but from Cai Dongfan's tone and meaning, it can be heard that they made the most extreme preparations in order to allow this patient to be discharged from the hospital quickly and turn around.

If you don't die, don't go back to the ward, don't go to the ICU, you have to pass the 120 ambulance directly from below when you get off the operating room, and then transfer to the prison!
One of the prerequisites for medical parole is that if the prison doctor cannot treat the situation, it must be transferred to a more professional hospital. However, post-operative care and doctor's orders after the operation are still no problem.

……

Huang Shinan's departure, like his coming in, did not have any impact on the operation process.

Cai Dongfan and Luo Yun will take on the role of chief surgeon, which has been discussed before.

The reason why Zhou Cheng hasn't started to take the stage yet is because, before he takes the stage, what Zhou Cheng needs to do to prepare for the operation is the key part, and the time for the key part will not be particularly long!
Therefore, after Cai Dongfan and Luo Yun completed the debridement, opened up the ends of the femurs on both sides, and confirmed that there was no blood vessel damage, Zhou Cheng immediately used a measuring stick to measure the diameters of the upper and lower femur ends.

Although this operation can also be carried out on flat film, but after all.

The scope of the femoral bone defect is too large, and the upper and lower ends are stretched and deformed by the attached muscles, making it impossible to measure accurately and objectively.

After finishing the measurement, Zhou Cheng withdrew from the main stage of the operating table, then glanced at Yang Yifeng, lowered his voice and asked, "Brother Yifeng, I'm going to start titanium mesh shaping, do you want to come and discuss it together?" a bit?"

When Zhou Cheng said this, he was actually a little hesitant in his heart. He shouted so that he wanted Yang Yifeng to learn the surgical plan design and skills of bone grafting for large segmental defects.

There are several main reasons.

First, Yang Yifeng is a doctor of trauma surgery. Although due to an accident, his heart is no longer in medicine, and he only thinks about writing novels.However, his talent, his interest in medicine, is still there.

Otherwise, it would be impossible for him to blast him out during the process of simulating the dungeon, and he would have accompanied him all the way until he was 50 years old.

Yang Yifeng reset his life to zero again and embarked on the road of writing.

Second, since Yang Yifeng is interested in this, and the reality is that Zhou Cheng already has a perfect bone graft for bone defects, then he doesn't mind letting Yang Yifeng obtain a mature theory directly, leaving him alone. Doubts and regrets in my heart.

As for how Yang Yifeng will choose in the end, Zhou Cheng has no control over it.

However, with Yang Yifeng's talent, if he can enter the palace of medicine again, it will be a blessing for the sick.

A single thread does not form a thread, a single tree does not form a forest, how many nails can be driven by a body covered in iron?

There are many patients in the real world, and there are also many people in Huaguo.

The top medical resources are always too empty.

Why are all the top hospitals overcrowded these days?It is because of the serious shortage of top-level medical resources, and the supply exceeds the demand.As for Yang Yifeng, he is already on this road, and he has traveled far and tall.

If he can continue to study, his future achievements will definitely not be low.

Yang Yifeng heard Zhou Cheng's invitation, looked up at Zhou Cheng, smiled and said, "Okay, brother Zhou Cheng."

Yang Yifeng originally went to the operating room, in addition to saving the patient's life and using the best anesthesia, the purpose was to see Zhou Cheng's specific level.

Now that Zhou Cheng dared to take off his own shell, stood in front of him, and let him figure it out, that was naturally the best thing.

However, Yang Yifeng felt a trace of sincerity in Zhou Cheng's gaze.It seems that Zhou Cheng sincerely invited him to discuss the operation plan and modeling together, not for showing off or anything else!
Yang Yifeng stood 10 centimeters away from the equipment nurse's operating table, while Zhou Cheng stood in a corner, and after putting down the measuring ruler, he began to cut the titanium mesh.

Titanium mesh, or medical titanium mesh, is a great tool to solve bone defects!
It has a strong structure, can be used to replace bone material, and is inexpensive.

The most important thing is that the structure of titanium mesh is very conducive to the crawling and shaping of bone.

Bone defect is also a kind of fracture, and the principle of treatment cannot be separated from the principle of fracture treatment itself.

First, reset.

Second, firm fixation - it is necessary to borrow external fixation brackets for external fixation.

But the difference is that after a bone defect, in order for the bone to grow, a skeleton must be built, that is, a skeleton for bone cells to crawl.Titanium mesh can just provide such a framework for bone cells to crawl.

However, the shaping of titanium mesh is very troublesome, because its routine use process is generally for acetabular capping, or bone-fitting internal fixation after a femur is broken. For bone defects like this, titanium mesh should be used for shaping. It is extremely difficult to form a support.

Yang Yifeng stared carefully at Zhou Cheng's movements, and then saw that under Zhou Cheng's hands, the originally strong titanium net was slowly shaped into a cavity shape, and the diameter was the same as Zhou Cheng's. As measured, there is not much difference!
and!

Yang Yifeng noticed with his eyes like a falcon that the column structure formed by this long section of titanium mesh structure, the upper and lower lumens are still different, as if the upper end is consistent with the fracture stump of the proximal femur .

The lower end is consistent with the fracture stump of the distal femur.

Yang Yifeng immediately had an absurd thought in his heart: "Brother Zhou Cheng, are you going to use titanium mesh to reshape a patient's femur?"

Yang Yifeng has a wide range of knowledge. According to the fracture situation of the patient, there are some methods to reshape the patient, but that is 3D printing!

That's a field!
3D printing is a combination of informatics technology and bone material technology, which can reshape a bone prosthesis according to the patient's own condition.

That's mechanized.

What can be made by mechanization, can be made by our hands?
Yes, but can it be done so quickly?

Zhou Cheng nodded, and said casually: "Well, otherwise there is no other better way. Even if it is 3D printing, the printed prosthesis is not easy to install, so I can only make one myself with a titanium mesh."

The muscles of Yang Yifeng's limbs became stiff, and his right hand held the phone tightly, as if the shell of the phone was about to be broken by him.

What are you talking about?
Do you think titanium mesh is mud, and you can make a femur based on the patient's femur?
However, Zhou Cheng continued to tap and tap, and then slowly, the traces of the outer femur tube emerged.

It was as if, in Zhou Cheng's hands, the titanium net was like sand for children to play with, it could be whatever it wanted to be.

Yang Yifeng couldn't see the specific details at the moment, so he quickly read the medical encyclopedia, and then carefully observed the shape of the femur, comparing it with the titanium mesh coat made by Zhou Cheng!

Then the eyes straightened in an instant.

Laymen watch the excitement, experts watch the way!

If everyone's hands were as stable as Zhou Cheng's, then the treatment of large bone defects would still become a hindrance in the medical field?Become the ceiling of it?
will not!

It's just that when Yang Yifeng carefully looked at the titanium mesh casing, he discovered that Zhou Cheng had actually squeezed out a smaller titanium mesh cover from the titanium mesh at this very moment!
Bone is a tubular bone.

Outer is cortical bone, inner bone marrow.

The marrow cavity is also a tubular structure.

Zhou Cheng's thinking is easy to understand, he not only wants to reshape the shape of the bone, but even the bone marrow cavity!

Is this a genius or a lunatic?

Yang Yifeng's mouth opened slightly wider.

The corners of his mouth began to tremble slightly. At this moment, he even felt that he was a little funny. What was he thinking, to find Zhou Cheng's mistakes in the details?
Zhou Cheng's thinking was normal, but it was also very abnormal, outrageous.

However, Zhou Cheng didn't care about these, but after comparing the two titanium mesh shapes, he felt quite satisfied, so he took it to the operating table, and then said to Luo Yun and Cai Dongfan: "Mr. Luo, Cai Teacher, I have already done it here, let's fix the titanium mesh first, shall we?"

The debridement of patients has actually been done in the following hospitals, so there are not many debridement operations.

However, Cai Dongfan was not yet fully finished. He looked at Zhou Cheng, and then at Luo Yun, who was going to take the ilium autologous bone and make the fibula pedicled bone flap, and then started the ilium bone harvesting operation.

Looking at Zhou Cheng: "Should we let it go now?"

Zhou Cheng nodded, and said: "Now, through the fixation and shaping of the femoral bone marrow cavity and the femoral cortex, the femur can roughly restore its original structure."

"After the main body structure is restored, the fixation with the external fixation bracket will be more reliable, and it will be closer to the shape of the femur itself!"

Zhou Cheng had completely let go of this operation, and he didn't care about anything. Anyway, as long as Cai Dongfan dared to tell the truth, he would dare to show anything.

But if they can still give the patients reasons and opportunities to be released on parole for medical treatment, it can only be said that they are not strong enough!
The weight fell into the water, determined!

"Okay!" Cai Dongfan, whose scalp was tingling, didn't ask too much. Anyway, Zhou Cheng brought him more than one surprise, and Zhou Cheng's many operations and techniques had already surpassed Cai Dongfan's cognition.

But maybe, what I know is not the limit.

On the other side, Yang Yifeng immediately threw the phone into his trouser pocket, and ran out to wash his hands. He found that it was too aggressive for him to step down decisively and gracefully before.

This is another peak in trauma surgery, another thing beyond the ceiling.

This thing pierced into the deepest part of Yang Yifeng's heart.

He is interested and curious!

And because I was too anxious, the phone was not plugged in securely and dropped.

The itinerant nurse yelled at Yang Yifeng, "Dr. Yang, I lost my phone."

"Please pick it up for me!"

I didn't even look back.

Luo Yun also stopped taking the bones, and said to Zhou Cheng, "Wait a while, Yi Feng obviously wants to see it."

Then he said to Zhang Zhengquan and Du Yanjun, who were trembling and confused at the moment: "You two should watch carefully and study hard. Today's operation may not be repeated in the department for a long time."

"And such an operation, there are not many operating rooms in the country that can repeat it."

"The same surgery? I checked the literature casually, and the upper limit of bone defect bone grafting that is currently being performed is about 15cm!"

"There are not many opportunities."

Luo Yun knew that this was a super IV surgery. With Zhou Cheng's temperament, he would never perform the surgery again until he got the IV surgery.

Moreover, Zhou Chenglai should not be allowed to develop rashly, because Zhou Cheng's age and identity are still here after all.It has to be accumulated slowly.

However, in order for Du Yanjun and Zhang Zhengquan to serve snacks, he could only sell Zhou Cheng.

Similarly, these words were also addressed to Cai Dongfan, which means that it is better not to carry out such operations in the department. What Zhou Cheng has obtained now is only a level II operation authority!
Du Yanjun and Zhang Zhengquan immediately took a deep breath, and made an insignificant contribution to global warming.

Turning his head to look at Zhou Cheng, he felt that Zhou Cheng was extremely strange.

Zhou Cheng silently licked his lips with his tongue, without saying a word, he was in the state of preparing for the operation, waiting for Yang Yifeng.

Yang Yifeng's interest, the roundworm in his stomach, was hooked out by him, and he hooked it out on purpose, so he must be responsible for it!

After 3 minutes, Yang Yifeng washed his hands and went on stage. After using two pairs of gloves, Zhou Chengcheng began to put the titanium mesh on the inner wall into the bone marrow cavity!
Then after firmly strapping!

Zhou Cheng transferred the battlefield to the fibula again.

However, Zhou Cheng's bone harvesting process immediately made Yang Yifeng and Luo Yun feel fear!

The reason why the fibula bone flap can be called a bone transport material is because the bone flap can have a vascular pedicle, and it can survive after being transported and transplanted.

However, most people take the part of the nutrient artery in the middle and upper part of the fibula.

However, Zhou Cheng shaved off the entire fibula, and left at least six arteries around it.

???

Are there such arteries around the fibula?

Could it be that these arteries were pricked off by myself and others during autopsy or surgery?
Can so many blood vessels and pedicles be removed from the fibula?
Zhou Cheng saw the doubts of Luo Yun and Yang Yifeng, and also saw that they were forcibly suppressing the churning of children with too many question marks in their hearts.

My mind moved slightly.

Every subject, when it reaches the depths, most people will feel that they have become ignorant.What I know may not be the end.

Zhou Chengdao: "According to the existing anatomical reports, a normal fibula has an average of one or two nutrient arteries, and an arcuate artery has as few as three, as many as 3, and an average of about six."

That's all for this.

But this explanation is enough to enlighten Yang Yifeng and Luo Yun, but they are still frowning.

Cai Dongfan felt bitter in his heart——

Your own team?
Looks like his head?

Du Yanjun and Zhang Zhengquan suddenly realized.

Oh, there are so many blood vessels, so it's normal.

Unexpectedly, what Zhou Cheng said made Luo Yun and Yang Yifeng even more confused.

Because if there are so many arteries, where are they? What happened to two of them during the operation?
This is unbearable.

The more you learn, the more afraid you become, that's the reason.

Zhou Cheng didn't explain too much, and it wasn't the time to explain too much.

The pedicled fibula that was finally removed was split open to transport the bone flap. Although the split was split, Zhou Cheng did not hurt its blood supply structure!
This tiny operation immediately made Yang Yifeng, Luo Yun and others' scalps tingle again.

But they all agreed without asking too much.

It was agreed before, although it was not stated clearly, but everyone made it clear that Yang Yifeng was in charge of the intravenous filter and anesthesia, no one asked him if he would, and why.

Luo Yun is responsible for the reconstruction of the starting and ending points of the tendon!I don't ask Luo Yun the reason why he restores the starting and ending points.

Zhou Cheng is in charge of bone grafting.

Naturally, it is not easy to ask too many questions.

After the fibula was cut open, Zhou Cheng placed it on all sides of the titanium mesh, and then anastomosed the pedicled blood vessels with the arterial stump in the femur one by one!
After the anastomosis was completed, the clamp at the proximal end of the artery was opened, and the filling of the blood vessel was immediately seen.

The titanium mesh was stained with blood.

Comfortable!

That's right, ordinary doctors may be afraid when they see blood.I wonder if people will die.

But a real surgeon will be relieved when he sees blood.

Oh, the tissues here have blood supply and won't die.

Of course, except for the surging blood in the aorta.

-

Of course, it's not over yet.

Zhou Cheng continued to start the bone grafting of iliac crest autologous bone, and then used the low-cost bone grafting materials brought by the equipment dealer one by one around the fibula block, and then put the outer titanium mesh on the box .

A remodeled femur is done.

So unbelievably, it's done!
Then, Zhou Cheng continued to perform external fixation with external fixation brackets. The upper part was fixed at the position of the ilium, the upper part of the femur was fixed, and the lower part was fixed to the tibial tuberosity.

The intact ilium and tibia were used to securely fix the unstable femur, which completed the second step of the fracture surgery.

Just, the treatment of bone defects.

Reduction was replaced by bone grafting.

Fixed, internal fixation was replaced by external fixation bracket.

Treating the bone grafting of bone defects in this way is equivalent to learning to understand.

After Zhou Cheng finished, he was not proud. After carefully confirming the firmness of the upper and lower femurs, he stepped aside.

Immediately afterwards, it was finally Luo Yun's turn to play.

Luo Yun doesn't know much about trauma, but he understands joints. The composition of joints is not just the joint structure, but also includes the re-fixation of tendons near the joints.

After Luo Yun came up, he began to use Kirschner wires to make a tunnel in the bone, and then began to return the starting and ending points of the muscles one by one.

This operation is also like flowing water...

This also slightly touched Zhou Cheng's knowledge blind spot, and he suddenly realized it.

Oh, it turns out that muscles can still play like this?
Well, learned it!

Go to the simulation at night, if you don't get a good night's sleep.

The volume of surgery determines the lower limit of surgical quality, but cognition determines the upper limit of surgical quality——

Gradually not ignorance is the key to technological improvement.

...Outside the operating room, after hearing what Min Zhu said, Min Shi felt more and more wrong.

Then wait until Ding Meng leads people outside the operating room.

Min Shi immediately reacted.

It's just that after he understood, his expression became cloudy and he shouted: "No, no! Min Zhu, no."

"No surgery, no surgery."

"We demand that the operation be stopped immediately! We will not perform the operation." Min Shi began to shout to the operating room.

"It's a waste of life, everyone come and see!" Min Shi began to shout and make a scene.

It's just that it's useless for Min Shi to shout like that.

Before the operation begins, the family members have the right to decide whether to perform the operation, but once the operation starts, no one can stop the operation, except the operator.

This is the power that the law confers on the operating room and the right to surgery.

Once the operation starts, no matter whether it is the dean or anyone, it is impossible to enter the operating room and interrupt the operation.

As long as the chief surgeon does not allow it, even if you are a god or a top professor, it is impossible to interrupt the chief surgeon's operation.

As long as it is in the operating room and it says that he is the chief surgeon, even if he makes a mistake, it is impossible to forcefully interrupt it!

This is the rule.

What's more, Ding Meng was there at this time, so there was no need to call the police.

The security guard immediately came forward to persuade: "Sir, this is an operating room, please be quiet and don't disturb the operation of the patients inside, otherwise, it will affect the progress of the operation, and no one can take responsibility."

The operating room is a public area, even more special than the ICU, and any collision is strictly prohibited.

Trespassing and causing the death of the patient inside will have to bear a heavy price. First of all, other family members of the patient will not agree.

There were quite a few people waiting for the patient's operation to end, and someone immediately stood up and looked at Min Shi: "There is something wrong with you, you are yelling outside the operating room at this time."

"They're going to kill people, they're going to be butchers in white clothes. They're going to kill my brother-in-law."

"We asked to stop the surgery, we didn't do it!"

"I have the right to ask to stop the operation!" Min Shi continued to shout, hoping to save one or two more.

However, it was obvious that Ding Meng and the others didn't give Min a chance to try. He yelled at the door of the operating room like this, and he could be taken back and locked up for a few days on the charge of seriously disturbing public order, and he could still be educated.

No other reason is needed.

Operating theaters are special public areas!
Not the place to mess around.

And when Min Zhu and the others reacted, it was obviously even later.

The operation has already begun, and it is impossible to end it halfway.

At 4 o'clock in the afternoon, Luo Sangen's operation ended [-] minutes earlier. However, when he left the operating room, he was immediately taken over by the prison doctor brought by Ding Meng and others.

What's more, Cai Dongfan and Zeng Yi personally escorted and transported them in the car! ~
After Luo Yun came out, he confessed to Min Zhu and the others: "Hello, Luo Sangen's operation has been successfully completed. The limb salvage operation was very successful, and his life is out of danger."

"If there are no accidents and the recovery is proper, he should be able to stand up in a year at the latest."

However, before Luo Yun finished speaking, Min Zhu, who was stopped by the security guard at the safety line, directly threw his bag over Luo Yun's head, and even spat at Luo Yun!

Then she took off her shoes and threw them at Luo Yun.

"You are not worthy to be doctors, you have no medical ethics, you are a bunch of bastards."

"Human face and animal heart! Pooh..." Then she was taken away by security guards while being snarled.

Luo Yun, on the other hand, could only wipe the stains on his body as if he was unlucky, while continuing to explain to Luo Sangen's parents and others.

"We are just doctors. We are only considering Luo Sangen's condition. We have reached the limit of your limb salvage requirements."

"If it recovers properly, then?"

But Luo Yun's words did not make the old woman and Lao Diai thank you, but pointed at Luo Yun and asked, "My son is gone, why should I keep his leg?"

"You are simply a bunch of cold-blooded animals!"

"Why do you want to operate on my son? Why? What good will it do you?" Lao Diaia asked Luo Yun while clutching his heart.

Luo Yun said: "He is a patient, and he came to our hospital to seek medical treatment. Naturally, we must do our best to provide him with medical services."

"No reason, just because we are doctors."

"When he is cured, we will also feel happy, because we helped him solve his physical pain."

"As for the rest, we can't control it. The operation is what you requested. It's written in black and white, clearly."

"We were deceived, we were deceived!"

"You, you are a nest of snakes and mice, you?"

"You deliberately framed and deceived us, is there any reason?"

"You clearly know that my son will have to be transported away after undergoing surgery, why do you still need to operate on him?"

"why?"

"Why are you?"

Luo Yun bowed slightly, and bowed to Lao Diaia: "I have done what we doctors should do. Maybe you think we should treat diseases and save lives, but in fact, we can only treat diseases and save lives."

"I can't save people, sorry."

After Luo Yun finished speaking, he turned around and looked back, his mood was actually quite complicated.

Both happy and disappointed...

However, when he entered the dressing room of the operating room, he saw Yang Yifeng, Zhou Cheng and others were waiting for him, and prepared a lot of tissues for him, and Zhang Zhengquan thoughtfully bought shower gel, shampoo, towels, etc. back.

"Ms. Luo, go take a bath, and get rid of bad luck." Everything is new, and there is a bathroom in the operating room.

The corners of Luo Yun's mouth curved slightly, and he nodded.

A doctor can't save people, he can only treat diseases and save lives, and the only one who can save people is himself. If Luo Sangen hadn't broken any laws and disciplines, then he wouldn't have been transferred to prison right after he got off the operating table!
However, when Luo Yun walked to the bathroom, he thought again, if Luo Sangen didn't kill anyone, it would be due to his family background.

Will such a perfect limb salvage technique be used today?
the answer is negative.

Yang Yifeng won't meddle in other people's business, and it is estimated that Zhou Cheng will not leapfrog surgery and propose an out-of-the-box surgery plan.

Equipment manufacturers will not provide obligatory support, and patients will not be able to pay as much money as they originally needed.

No one will take risks for morality.

But for justice can...

(End of this chapter)