godfather of surgery

14 Genius
Yang Ping ate a piece of chocolate, quickly compressed the biscuits, and rushed to the operating room.

Director Han, Song Zimo, Director Tian, ​​Zhang Lin, and Fang Yan have all arrived, and many young doctors and interns who have heard the news all want to see the replantation of this baby's severed finger. After all, this is rare. The difficult operation of the patient may sometimes be encountered in a lifetime.

The itinerant nurse is scolding the unruly interns: "So many people? Who is the teacher? All stand away and pay attention to the concept of sterility!"

Fortunately, the orthopaedic operating room is relatively spacious, and it is not very crowded with many people.

"Divided into two groups, Tian Yuan led Fang Yan and Chen Xiaobo to debride the free severed fingers and search for vascular nerve tendons; Song Zimo led Yang Ping and Zhang Lin to debride the proximal wound and search for vascular nerve tendons; and then replanted by Song Zimo and Yang Ping is in charge, and the rest are the reserve team." Director Han was well organized.

"Which nurse is on stage today?"

"Su Yixuan!"

"That orthopaedic surgery nurse?"

"Yes, Director."

The itinerant nurse replied that Su Yixuan had already washed her hands and was about to take the stage.

Liang Jing, an anesthesiologist, is a fat man and a doctorate from West China Medical University. The washcloth he wears is obviously ill-fitting, especially the pants are too short.

Fatty Liang's technique was very good. He gently pried open the baby's small mouth, and then carefully placed the tracheal intubation. After drawing the guide wire, he placed the stethoscope on his chest to confirm that it entered the trachea.Then connect to the anesthesia machine.

"Well, let's brush your hands." Liang Jing sat on the side of the child's head, staring at the monitoring data on the display while recording.

"It's too difficult to pick up today, it's so small, even if the microscope is magnified [-] times, it's not easy to get it right. If you shake your hand a little, the blood vessels will be broken."

"Yes, I heard that the most difficult thing to replant a severed finger is the baby's, and the blood vessels are probably like hair."

"It's Director Han who did it. Director Han used to be from the Sixth Hospital of the Magic Capital, which is the birthplace of the replantation of severed limbs in the whole country. The world's first replantation of severed limbs was in that hospital."

"Really? No wonder Director Han is so powerful."

"No, Senior Brother Song did it."

"Senior Brother Song, wow!"

"He is very powerful. I heard that he is a genius. Haven't you seen Director Han always take him?"

"He is tall and handsome, highly educated, and so good. I heard that many girls like him."

A female intern started to gossip secretly.

"Yes, I heard that the family is very rich."

"No, he will take care of all the good things."

Once the gossip box is opened, it is endless.

"Quiet, keep quiet for those who observe! Replantation of severed fingers requires a high degree of concentration. Turn on the video system next door, and go to the next door when the stage opens—" The head nurse inspected the operating room and came in to take a look, and found that There are many students, so naturally we cannot sit idly by.

This operating room is the main operating room. There are supporting rooms on both sides. One is the storage room, and the other is the classroom. The partition wall between the classroom and the classroom is half a transparent glass wall. The classroom is equipped with a high-definition screen and is connected to the operating room microscope. Or the high-definition camera on the shadowless lamp can play the surgery video in real time throughout the whole process when needed.

Su Yixuan had already washed her hands, raised her hands on her chest, picked up a sterile garment, stood on the open side, facing the sterile table, shaking her hands lightly, her hands just penetrated into the inner cuffs.The itinerant nurse immediately stood behind her and helped her pull up her clothes and fasten the straps behind her.

Then put on the gloves and start counting the instruments, partitioning the instruments.

Two operating tables.

On this side, Song Zimo and Yang Ping washed the wound.

On the other side, Tian Yuan and Fang Yan were also washing the severed fingers, cautiously, for fear that they could not find it after falling.

After washing, everyone went to wash their hands and get dressed.

Usually, the first assistant sterilizes the sheets, but Song Zimo asked Yang Ping to wear clothes and disinfected the sheets himself.

Push the microscope and put it aside.

Debridement is started on both sides, which is to remove the foreign body, necrotic tissue and lost tissue from the wound, and then trim the skin edges neatly.

The young doctors and interns who observed it rushed to the next door like the head nurse herding sheep.

Five fingers, starting from the thumb, Fang Yan sent the thumb that had been cleaned and rinsed, Song Zimo used an electric drill to drill the steel needle into the phalanx, and first connected the bones, so that the general support was established.

The next step is to find the blood vessels, nerves, tendons, and sew them up.In a nutshell, these are the steps.Blood vessels are the hardest to find and the most difficult to sew; nerves are next; tendons are easy to find and suture, and any orthopaedic resident can suture very skillfully.

The microscope was pushed to the surgical area, fixed, and the focal length, interpupillary distance and magnification were adjusted. This blood vessel was too thin and was magnified fifty times.

Song Zimo used microscopic tweezers in his left hand and microscopic scissors in his right. He began to debride and search for blood vessels under the microscope. His operation under the microscope was really powerful. Under the [-] times larger field of view, his hands did not shake, and the operation was very skilled.

This guy is proud to have capital, Yang Ping has to admit.

"The blood vessels are too thin, keep your hands steady and keep your breath." Director Han encouraged Song Zimo.

Song Zimo didn't speak the whole time, and quietly manipulated the microscopic instruments, looking for blood vessels, nerves and tendons under the microscope.

In addition to the large screen on the wall next door, there is also a screen in the operating room, which is not as big as the next door.Director Han sat in front of the screen, staring at the screen.

The blood vessels of the thumb were successfully found, and then the nerves and tendons were found. Next, the broken ends of the blood vessels were debridement and trimmed, so that the broken ends of the blood vessels became clean and standard, and the lumen should not have any impurities, let alone any damage.

Rinse with normal saline.

Wire!
The thinnest double-needle suture without damage to blood vessels has a diameter of only a few tenths of a child's hair.

Cut it from the middle, hand half to Song Zimo, and Su Yixuan keeps the other half.

Song Zimo began to suture the arteries.

However, the blood vessels of this baby are smaller than expected, the diameter should be much less than 0.1 mm, and the visual inspection should be about 0.05 mm.

Song Zimo took a deep breath, calmed down, and tried to keep his hands slow and steady. At this time, he was challenging the pinnacle of microsurgery.

The first stitch begins.

"Slow down, don't worry." Director Han said to Song Zimo.

If you think about it now, you can't get up too fast.The blood vessels are not only small, but also have relatively thin walls, which are not at all like the walls of arteries.

Song Zimo's first needle was very slow, much slower than his usual training speed. The tweezers held the adventitia of the blood vessel wall, which was very easy to tear, and it was a test of skill.

The needle gently pierces the wall of the tube at the right position, and then goes out from the wall of the tube at the other end, pulls it gently, ties the knot, and the first stitch is perfectly sutured.

Director Han nodded slightly. Song Zimo's talent is indeed very high. He has grown very fast recently, and he has become so skilled in suturing down 0.05mm of blood vessels.

Yang Ping was about to trim the thread, but Song Zimo refused, so he picked up the micro-scissors and trimmed the thread himself.

The blood vessels are too thin. If the movements of the hand are unstable under the microscope and shake a little, it is easy to cut the sutured blood vessels.

The second stitch, the third stitch, - until the sixth stitch, his rhythm was smooth, the stitch margins were beautiful, and the first blood vessel joined smoothly.

If it weren't for the need for quiet in the operating room, the people watching the operation next door would have applauded enthusiastically.

(End of this chapter)