Start From Emergency Doctor

Chapter 270

Generally speaking, after starting an operation, for a long time, no one else is qualified for the operation, so they can only wait and see and learn from a distance.

Let’s take the analogy of Academician Chen Jingyu, the father of lung transplantation in Country Z.

Since he was engaged in lung transplantation, he has successfully set numerous records, including:

Asia’s first sequential double lung transplantation under off-pump circulation, the country’s first lung transplantation to treat chronic obstructive emphysema, the country’s first single lung transplantation combined with contralateral lung volume reduction to treat emphysema, the country’s first to solve donors and recipients It does not match the technical difficulties of lung transplantation, the first application of extracorporeal membrane oxygenation technology in the country for perioperative cardiopulmonary support during lung transplantation, and the self-developed lung perfusion preservation solution obtained national patent.

He alone led the team to fill the gap in lung transplantation in country Z for more than 40 years, but so far, how many people can do lung transplantation?

After all, lung transplantation is still a very difficult operation. Many hospitals want to carry out lung transplantation, but it is really difficult. The survival rate is too low. Many people do not have the courage to persist.

Therefore, many lung transplants across the country were actually performed by Academician Chen Jingyu or his team. From the time he took time to perform four operations between the National Congress of the People’s Republic of China in 19 years, it can be seen how talented this operation is.

Undoubtedly, Chen Jingyu is the absolute pioneer of lung transplantation, but it has not been promoted so far.

And Zhou Yuan, after bringing the extremely difficult toe transplantation to reconstruct the thumb, directly handed over the reduced difficulty version to the public, so that more doctors have the opportunity to perform this operation…

Shen Yuanjing also saw that Zhou Yuan had reduced the difficulty of the finger reconstruction operation a lot, and was shocked.

“Doctor Zhou, I would like to ask… the plantar-palm vein after the anastomosis walks on the surface of the toe-digital extensor tendon after the suture. Why is the intermittent inversion suture chosen for the tendon suture here?”

Generally speaking, the Bunnell tendon suture method is commonly used for tendon suture. The method is to make two sutures perpendicular to the tendon fiber on the proximal stump of the tendon with steel wire, and then draw the stump in the direction parallel to the tendon fiber. The distal stump was penetrated in a parallel direction about 2 cm and then passed out of the surface of the tendon, and then passed out of the skin in situ and fixed it with a button.

Or it is the figure-of-eight stitching, cross stitching and so on.

Zhou Yuan was stunned for a moment.

Although he knows Bunnell’s tendon suture method, he is definitely not as good as the master-level butt suture method, and at that time he has not learned the inner figure eight suture method, only the intermittent inversion suture method can be selected…

Of course, Zhou Yuan chose this way for a reason. After a moment of silence, Zhou Yuan said: “The surface of the sutured tendon stump is smooth, which can reduce the stimulation of the blood vessel by the suture and the tendon end, but also reduce the postoperative finger extension Tendon adhesions.”

Richard, who had been on the sidelines, looked at Zhou Yuan in horror.

There shouldn’t be any problems to stump him? !(Read more @ wuxiax.com)

Is this the first time that the concept of reinventing fingers has been proposed? Zhou Yuan is the same as having thoroughly studied the reconstructed fingers!

He couldn’t help but stood up, “If vasospasm occurs in the reconstructed finger, because the blood vessel itself is anastomosed, it will be difficult to deal with. Moreover, at this time, the blood vessel has undergone morphological changes due to the transplantation. How do you determine that the blood vessels have spasm and how to deal with the spasm?”

Zhou Yuan hesitated for two seconds.

Because… if he were to do it, vasospasm would be completely avoided now, and there would be no vasospasm at all.

But he still thought about it for a while, and then replied: “After the free toe transplantation is finished, the tourniquet will be loosened due to the mechanical stimulation of the blood vessel during the operation, or other factors such as low temperature in the operating room and insufficient anesthesia. Arterial vasospasm, if it is found that the arteries are not pulsating or the pulsation is weakened, and the toes become pale or grayish purple after the tourniquet is released, it can be judged that the toes have vasospasm and are in a transient state of ischemia.

“At this time, we must first relieve the external factors that caused the spasm, such as the tension of the suture, the external pressure, etc., and then use a 5ml syringe to draw 30mg of papaverine and instill it along the surface of the artery, that is, apply poppy to the blood vessel. At the same time, use Bathe the toes with a small gauze cloth soaked in warm salt water of about 35C to restore blood supply to the toes and relieve vasospasm.”

Richard’s eyes widened and looked at Zhou Yuan incredulously.

The problem that I have been thinking about is solved in just a few words? !

For the academic problem, only one or two hundred words are really a few words. Any surgical procedure in the medical field may require thousands or tens of thousands of words to demonstrate. Zhou Yuan’s one or two hundred words explanation is indeed condensed. To the extreme…

“I thought it would be an operation that you alone or I could try, but I found out that I was wrong…” After a long time, Richard stood up again…

He stared at Zhou Yuan’s eyes firmly, with awe and respect in his eyes.

He always thought that Zhou Yuan was at the same level as his own, except that Zhou Yuan was young and dared to try, so he was able to come up with the concept of reinventing fingers and succeeded.

But now, he found himself completely wrong!

Zhou Yuan not only surpassed himself in innovation ability, but also far surpassed him in academic insights!

“Before this, even if you know the method of anastomosis, none of the people in this room can complete this operation. But now, you have reduced the difficulty to the level where 80% of the experts here can do it!”

Richard was old in tears.

What does this mean?

There will be thousands of patients in the world who can perform operations in their own countries by experts in their own countries!

Moreover, this is only the first step. With the development of science and technology, the improvement of doctors’ level, and the gradual improvement and simplification in the promotion of reconstruction surgery, this surgery can one day become like a severed limb replantation. Four-level surgery that can be done!

“Toe transplantation recreates the thumb, born in your hand, perfected in your hand, and carried forward…” Richard said with trembling lips.

His beard was shaking. This was also the time he talked the most. In the past international conferences of hand surgery, although he was a veteran, he never bothered to speak.

Today is the exception.

Before he died, he witnessed a great leap in the field of replantation of severed limbs in hand surgery! This is the lifelong wish of countless people groping in this field, and it is also the light in the dark!

Richard wiped away his tears, already a little impatient to try.

Suddenly, he seemed to think of something, and said: “I have heard a sentence from your country Z, I think it is especially suitable for you, the sky does not give birth to Zhongni, the eternal life is like night-the sky does not give birth to Zhou Yuan, medicine will last forever Like night!”

This high praise did not interrupt Zhou Yuan’s contemplation.

After a long time, Zhou Yuan raised his head and said faintly: “Don’t worry, I still have a concept of cosmetic finger reconstruction that I haven’t come up with.”.