I can see the status bar

Chapter 143 Axis Replacement (3)

Just cleaning the broken and free axis and the broken bone cement is boring and tedious.What's more terrible is that Wang Yifei can only always bend over and operate the endoscope in a very awkward posture.Moreover, there should be no out of shape or mistakes in this movement. Once the sore waist shakes a little, the high-speed rotating hand drill may cut off Song Hualin's internal carotid artery, or smash his spinal cord into a paste.

"It will be exhausting to carry on like this." After working without saying a word for two hours, and stopping for the ninth time to let the nurse wipe the sweat, Wang Yifei temporarily put down the endoscope in his hand, stretched his stiff neck, and Sore shoulders. "Who is that...Yaran, take my phone and play a tune."

The equipment nurse nodded, took out the plastic-sealed mobile phone from Wang Yifei's pocket, and skillfully turned on the bluetooth to connect to the stereo.

In this demonstration operating room, there is a BOSE Bluetooth speaker.The stereo is not small, and it is specially placed on the wall shelf on the side away from the anesthesiologist.In order to ensure sterility, before each operation, there will be a nurse to replace the above plastic package.

"This song?" The equipment nurse named Ya Ran tapped Director Wang's mobile phone, and the lyrics of "Wanquan River is clear and clear" immediately rang in BOSE.

"This kind of song is not suitable for surgery." Director Wang shook his head as if relaxing his cervical spine, "Keep looking down, the rock list is good."

"Then...listen to this song?" The equipment nurse tapped the phone a few more times, and a rock music that most young people are familiar with rang.The famous song from the Australian rock band AC/DC, "Highway to Hell" sounded.

"This one is not bad." Wang Yifei laughed, "We are really on the highway of hell, and we are still driving the patient in the opposite direction on the overtaking lane." He stopped his relaxing movement, raised his hands slightly, looked at the lying On the bed, Song Hualin's mouth was wide open, "Continue!"

The sound of bones being ground by a hand drill was harsh and toothache, bone meal and bone cement were crushed into powder, and the nurses next to him continued to be busy following Wang Yifei's instructions. "Hemostat, prepare bone wax!" Wang Yifei suddenly stopped his hands.Sun Li'en, who stood aside until his feet hurt, suddenly opened his eyes wide.

The state of "arterial rupture" appeared above Song Hualin's head, and Sun Lien looked at the operating bed with a worried face. Could it be that the internal carotid artery was injured by electric grinding just now?

"The unknown arteriole ruptured." Wang Yifei manipulated it for a long time before he relaxed a little.Human arteries sometimes proliferate with some small arterial branches, and these branches often bring some small shocks to the operation.When Wang Yifei was cutting a relatively large piece of bone cement just now, a small piece of bone cement bounced back, cutting through the proliferated small artery.Although the blood gushes out, fortunately, the diameter of the arteriole itself is very limited, and even if the proliferated arteriole is ligated off, it will not have any effect on the original function of the human body.

Wang Yifei also heaved a sigh of relief. Although he is very sure about the operation itself, this small artery will always surprise the doctors.Fortunately, the surgical field was thoroughly exposed at the beginning, and the artery was in a position where it was easier to be ligated.After Wang Yifei clamped the small artery with a hemostat, the alarm was lifted.

"The bleeding is estimated to be about 150ml." The instrument nodded towards Wang Yifei, "Just suck the blood away, and don't need plasma for now."

The alarm was lifted, and everyone present breathed a sigh of relief.Sun Li'en looked at Hu Jia, who was shaking slightly, and then remembered that his girlfriend basically ran back and forth outside today.And it doesn't look like I took a nap.He touched Hu Jia lightly, "If you are tired, just lean on me for a while."

Hu Jia glanced at Sun Lien and nodded.Then he rested his head on Sun Lien's shoulder.

"Continue." Wang Yifei breathed a sigh of relief. It has been almost five hours since the operation.From the fracture line at around [-]:[-] of the axis to the rear of the anterior longitudinal ligament at [-] o'clock, basically all the vertebral body and bone cement have been removed.And to continue to clean up the rest of the axis bone, you have to deal with this ligament first.

Life is an amazing thing.During developmental evolution, organisms evolved a skeletal system to support and protect themselves.And in order for the bones not to impede movement, it was necessary to evolve a system that would allow the skeletal system to move without dislocating each other.Ligaments are an important part of this system.

It's a pity that even with the advancement of science and technology today, people still can't make ligaments that are as useful as the original ones, and even the connection between ligaments and bones cannot be replicated.The ligament reconnection scheme that will be used in surgery, except for the suture after the middle rupture, there is only one way-directly nail the ligament to the bone with nails.It is impossible for ordinary nails to work at this angle. After all, it is physically impossible to swing a hammer in such a small space.Therefore, orthopedic carpenters adopted a combination of titanium alloy screws + orthopedic electric drill + reserved mounting holes for the prosthesis.Temporarily separate the longitudinally dissected ligaments with retractors.Then grind off the remaining axis vertebrae, replace the prosthesis, loosen the ligament, replace it with a suitable titanium screw, and twist the ligament into the reserved hole on the prosthesis.

Song Hualin's anterior longitudinal ligament was cut longitudinally with a scalpel, and Wang Yifei used a retractor to separate the ligament to both sides. The final cleaning work was relatively easy.In about an hour, Wang Yifei removed the remaining part of the axis that could be seen through the transoral approach.The posterior longitudinal ligament hidden in the vertebral body was also treated according to the regulations, and two retractors were used to separate it.

"Okay, bring the prosthesis at the front end." The "Highway to Hell" played in the operating room has been repeated countless times. Dr. Pascal has fully explained from the beginning of being a little interested, to now being a little numb. That's the problem - not many people enjoy listening to a song over and over for more than two hours.And Wang Yifei probably got tired of listening to it, so he asked to change the song by name, "Let's play "Back In Black"."

Rock carpenter Wang Yifei continued his operation while humming.He has performed the operation for six hours in a posture that is difficult for ordinary people to maintain.Although he is much younger than his teacher, Academician Qiu, Wang Yifei is almost 50 years old.Every muscle screamed at him, warning the rock doctor—"We're going to strike!"

"Anesthesia, bring me a stool." The prosthesis has gone through several rounds of polishing and disinfection, but Wang Yifei insisted on checking it with the naked eye before installing it. "Just right behind my ass."

Academician Qiu frowned, and Sun Lien also noticed something unusual.

"Wang Yifei, male, 47 years old, with muscle lactic acid accumulation." The status bar indicated that Wang Yifei, who was undergoing surgery, had basically reached his physical strength limit.

"Yifei, let me take over." Academician Qiu walked to Wang Yifei's side and whispered, "You've been doing this for too long, and your physical strength can't keep up."

"It's hard for me to do it from this angle, and it's even more unbearable for you to do it." Wang Yifei rejected the suggestion of his mentor. "I know my physical strength, and there is no problem with installing the prosthesis."

Academician Qiu no longer insisted, but continued to observe Wang Yifei's surgical laparoscopic perspective through the screen.Almost half of the vertebral body was removed, exposing the spinal dura mater inside.And this part looks good so far, with no signs of damage or edema at all.

Half of the prosthesis was carefully placed obliquely above the exposed dura mater.The exposed space is just enough for Wang Yifei to use a universal screwdriver to fix the posterior longitudinal ligament on the prosthesis.

The universal screwdriver was originally only used in the field of aircraft maintenance.Its principle is actually very simple, replacing the extension rod on the original screwdriver with a soft but extremely torsion-resistant soft rod.As long as you pay attention to fix the bending head during use, you can tighten the screws that cannot be directly twisted with a rigid screwdriver.If there is no such good thing, it is impossible to install the 3D printed axis prosthesis in the first place.

Two screws were quickly twisted on the inside of the prosthesis, and Song Hualin's posterior longitudinal ligament was screwed on the prosthesis.Then it is a quick return to the front, screwing the anterior longitudinal ligament on the prosthesis.This action, Wang Yifei only took 1 minute.

When the last screw was installed in place, Wang Yifei steadily pulled out the electric screwdriver in his hand, and carefully checked that his surgical gown was not in contact with the endoscope bracket.Only then did he feel relieved, and stuffed the electric screwdriver in his hand into the assistant's arms.And he wrapped his arms around the somewhat loose surgical gown to prevent the surgical instruments from being scratched, and then sat down on his buttocks.

"I'll take a break first." Wang Yifei said weakly to his student and the first assistant for this operation, "Bring a bottle of water."

Academician Qiu stood behind Wang Yifei, "Go and lie down for a while, I'll fix it."

Wang Yifei intends to save academician Qiu some energy, but the current situation does not allow him to continue to be brave.The precision of the operation in the axis area is too high, and his hands are shaking now. It is almost impossible to complete the fixation of the prosthesis, the atlas and the C1 segment.He could only nod his head, "Excuse me."

"It's just about installing four screws." Academician Qiu patted his apprentice on the shoulder, "When I had the operation, you were still sleeping in the junior high school classroom!"

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In fact, the most troublesome part of the whole operation has passed.Academician Qiu removed Song Hualin's C02-C03 intervertebral disc with nucleus pulposus forceps, and then fixed the lower end of the prosthesis on the C03 vertebral body with two screws.The anterior atlantoaxial ligament and the atlantoaxial joint capsule were also fixed to the prosthesis.Finally, the upper end of the prosthesis was fixed on the atlas vertebral body with two screws, and the operation of the transoral approach was officially completed.

"Okay." Academician Qiu is old after all, and maintaining this weird angle is also a difficult task for his waist. "You sew up." Academician Qiu instructed Yizhu, "Remember to sew slowly."

3D printing prosthesis axis replacement surgery, the part of the transoral approach is officially over here.

Nine hours had passed since the operation.

　It was supposed to be three o'clock today, but... I'm sorry!I broke my promise!
　　Lack of sleep, coupled with the content being too professional, has seriously affected my writing speed... I'm really sorry everyone.

　　The operation will be over in the next chapter, and then we will return to the "relaxed" emergency and daily life.

　　
　
(End of this chapter)