Doctor's Life Simulator

Chapter 303 Director Chen Arrives, The Surgery Is Over

When Lu Yu entered the operating room again, Du Ming was lying down, squinting with his eyes, reluctantly preparing to sign and agree to the operation.

"Qin Lang, are you sure?"

Lu Yu still did not give up.

Before Qin Lang could speak, Du Ming spoke to Lu Yu.

In fact, when Du Ming was in the county hospital before, he heard the hesitation and refusal of the director of the department. He didn't dare to treat himself.

Therefore, he was very aware of Director Lu's concerns.

After thinking about it for a while, Du Ming was completely beyond the maturity of his age. Facing Director Lu, Qin Lang said:

"Director Lu, Dr. Qin, I know that you are as young as me. I also know that my condition is very complicated and serious. An old doctor did not dare to operate on me before, but Dr. Qin was willing to operate on me and told me My situation. Of course, I hope it can be cured. If there is an accident during the operation, I will not blame Dr. Qin. Director Lu, I believe him, don’t you believe him instead? "

"I"

Looking at the tolerant and sensible Du Ming, Lu Yu didn't know what to say, and his nose was a little sore.

Du Ming scribbled a few strokes, and smiled a little embarrassedly: "I'm really not used to writing while lying down, it's so ugly."

Throwing the pen away, Du Ming's immature face showed an indomitable determination.

Lu Yu was in a daze for a moment, as if he saw the heroic and fearless figure in the sea of ​​swords and flames. Lu Yu only hated his lack of academic skills.

"Doctor Qin, Director Lu, I'll leave it to you guys!"

In the operating room, Qin Lang and Lu Yu were ready, and the rest of the equipment, nurses and other medical staff were also present.

Lu Yu stood in the position of the first assistant, still panicking in his heart: "Qin Lang, if you really can't go on for a while, don't force it. I will go to Director Chu to take over."

Qin Lang ignored Lu Yu, but signaled the anesthetist to start anesthesia.

The anesthesiologist quickly completed the endotracheal intubation and general anesthesia. After finishing, he sat in a far corner and yawned.

"Insert a urinary catheter"

Qin Lang gave the order, Lu Yu nodded, picked up tweezers and iodophor cotton with gloved hands, scrubbed and disinfected him, then lubricated the cotton with paraffin to strangle the rubber tube a few times, after lubricating, use tweezers Carry out a careful disinfection again.

Lu Yu kept it at an obtuse angle and began to insert the catheter. It has to be said that Lu Yu's technique is still very professional and sophisticated.

After finishing, put Du Ming in the prone position, keeping the abdomen in the air.

Afterwards, the surgical area was routinely disinfected and sterile surgical drapes were spread.

"X-ray machine Kirschner wire. Scalpel"

Qin Lang started the next step very quickly, and the equipment nurse tacitly provided the equipment in place.

Under the X-ray machine, a Kirschner wire was used to locate the fractured vertebral body, and with the fractured vertebral body as the center, the skin, subcutaneous tissue and lumbar dorsal fascia were incised in sequence.

For Qin Lang, under the master-level technique, the completion is very neat and straightforward.

"Blunt Dissection of the Multifidus and Longissimus Compartment."

Qin Lang gave further instructions, and Lu Yu's basic skills were also very solid. Under Qin Lang's command, he cooperated very tacitly.

"Expose the diseased vertebra and the facet joints of the upper and lower adjacent vertebral bodies."

Qin Lang continued to give orders, and under precise control, Lu Yu had a smooth feeling of being in Jishuitan Hospital, following the chief director for surgery.

And there is no need to worry about problems with the operation. Every time I complete the steps by myself, the next instruction has been accurately followed.

During the operation, Lu Yu glanced at Qin Lang, really surprised, how could this guy be so familiar with such a difficult technique.

"According to the point I instructed, insert the positioning needle, take X-ray films simultaneously, and confirm the position of the needle insertion point in the vertebral body"

"Okay, Doctor Qin."

Lu Yu stopped his thoughts and completely entered the rhythm of Qin Lang.

"Opener Pathfinder Cone. Probe"

Equipment nurses are not to be outdone.

"The bony channel is determined during the operation, and the pedicle screws are placed."

Seeing Qin Lang's very fast operation, Lu Yu's heart was about to jump out: "Doctor Qin, you, slow down, slow down."

At the same time, she used X-rays to verify. Under normal circumstances, fine-tuning would be done after the first insertion, but after seeing the results, Lu Yu opened her mouth slightly, so precise length control!
"Intraoperative Confirmation of Pedicle Screw Position"

Regarding Lu Yu's verification results, Qin Lang took it for granted and directly chose to insert the connecting rod.

Lu Yu's fearful simultaneous verification revealed once again that the insertion length of the Qin corridor was perfect.

"This is too beautiful."

Qin Lang completed the extremely difficult approach in less than 10 minutes.

The next step is the more dangerous anterior decompression and internal fixation of phalanx fusion.

"Electric knife"

Under Lu Yu's apprehension, Qin Lang began to peel off the vertebral periosteum forward and backward.

Since the periosteum at the interface between the vertebral body and the intervertebral disc is tightly connected, separation is very difficult. After Lu Yu couldn't believe it, Qin Lang boldly used an electric knife to incision, which was fast and clean.

Lu Yu only shouted in his heart: Boss Niu Boyi (broken sound)!
Seeing how quickly Qin Lang identified the relatively bulging intervertebral discs and sunken vertebral bodies, Lu Yu was stunned, really fast.

This frequency, this endurance, Lu Yu is sure that Dr. Qin does all the operations.

Before she could react, Qin Lang had already begun to carefully process and ligate the segmental blood vessels of the fractured vertebra and the upper and lower normal vertebrae in the middle of the vertebral body.

Seeing that Lu Yu was a little confused, Qin Lang taught while operating:

"Removal of the upper and lower intervertebral discs of the fractured vertebra, as well as the cartilage endplates below and above the upper vertebral body, is beneficial to the fusion of the phalanges."

Lu Yu seemed to understand, after all, she only dabbled in orthopedic surgery.

Qin Lang was very patient and continued to add:

"The broken bone fragments of the fractured vertebra are easy to scrape out to achieve sufficient decompression in front of the dura mater. Of course, if you encounter old fractures in the future, you need a sharp bone knife and a drill to gradually remove the vertebral body, especially the posterior wall of the vertebral body The resection must be very careful, not only to achieve complete decompression, but also to avoid tearing the dura mater and damaging the spinal cord."

Qin Lang's voice fell, and the operation in his hand ended very precisely and perfectly.

"understood."

After all, Lu Yu has a pure heart and a heart, so with a little bit of coaching, it will work.

Lu Yu's eyes lit up, so it turned out that she was always nervous with the chief director before, not daring to breathe for fear of making mistakes, and it would be nice to be able to complete her first assistant job, so why go back and think about these issues considered by the chief surgeon.

Under Qin Lang's full teaching, Lu Yu's understanding of the art has risen to a higher level.

"Isn't it completely useless to follow this guy?"

Lu Yu murmured in her heart, and she was also tempted by Director Xie's suggestion before, should she really invite Qin Lang to join her new project, but can he really find another way and give herself a new idea?

"Next, for correction, vertebral body spreader. Vertebral body screws"

"Good."

Lu Yu was questioning in her heart, her body was like a silly girl, what Qin Lang said was what.

The correction was completed quickly. Because the patient's anterior longitudinal ligament had contracted, Qin Lang chose to cut off the annulus fibrosus and the anterior longitudinal ligament.

For bone grafting, Qin Lang chose a three-sided cortical iliac bone block of appropriate size. Of course, in principle, titanium mesh and artificial vertebral bodies filled with bone fragments can also be selected.

Next is the most critical part of the whole operation except for the approach:
Z-plate fixed!
Lu Yu was also shocked. This was the first time she used the Z-plate fixation, and her palms were slightly sweaty.

Sensing Lu Yu's nervousness, Qin Lang said calmly: "Next, just follow my instructions, it's very simple."

Under the dominant aura, under Qin Lang's gentle and calm encouragement, Lu Yu's mind settled down.

I have to say that in the operating room, Qin Lang is really very aura and the ability to make people feel at ease.

"Confirm the resection of the fractured vertebral body and decompress the front of the spinal cord"

Lu Yu continued his work as a first assistant and confirmed the assistant for Qin Lang.

"Firstly, two screws were implanted in the upper and lower posterior corners of the upper and lower vertebral body respectively. The screw entrances were 2mm away from the posterior wall of the vertebral body and 10mm below the upper endplate of the upper vertebral body.

Qin Lang gave direct and accurate instructions, and with the cooperation of Lu Yu, the height of the vertebral body can be restored by simultaneously stretching between the screws.

"Bone block implantation. Longitudinal compression between screws by placing titanium plate"

Under the control of Qin Lang, the bones were quickly embedded, and the bolts and titanium plates were fixed.

"Director Lu, you've done a very good job, leave the rest to me."

Qin Lang praised, that is to start the locking between the last bolt and the titanium plate, screw the two screws in the front of the upper and lower vertebral bodies through the titanium plate chute, and quickly and perfectly complete the locking.

It wasn't until this moment that Lu Yu realized that he and Qin Lang had performed such a difficult operation.

After that, it's just aftermath.

"Placement of Chest and Retroperitoneal Drains"

After finishing this step, Qin Lang showed another stitch of the diaphragm, closed the chest and sewed up the wound.

At this time, Captain Wang was in the office of the vice president of Hangzhou. Chen Qilong, the director of the orthopedics department of the Provincial Military Hospital, and Chu Tianxiong, the director of the orthopedics department of the Municipal First Hospital, rushed back to the hospital.

As soon as Captain Wang saw the two experts, he immediately shook hands and greeted him: "Director Chen, Director Chu, I have waited for you. Thank you, thank you."

Director Chen smiled slightly: "Captain Wang, it's a shame to say that. It's also my honor to be able to operate on our little firefighter hero. Now, let's stop talking nonsense and go to the operating room."

"Yes, yes, before I came, the doctor on duty had already arranged various inspections and preoperative preparations, and I just waited for the two experts."

Captain Wang himself was very anxious. Seeing that the two directors were indeed people doing practical things, they were not pretending to be polite.

Accompanied by Dean Hang, two experts, Captain Wang, and a group rushed to the operating room.

Along the way, seeing Captain Wang's anxious appearance, Dean Hang said: "Captain Wang, don't worry, Director Chen is very experienced and professional for thoracic fracture surgery. I can say this, as long as Director Chen performs surgery , we are sure to restore the little hero to more than [-]%."

"Yes, and Director Chen has a lot of experience in the approach. In addition to the conventional percutaneous nail placement, he has successfully tried the more optimized approach through the paraspinal muscle space many times in recent years. This method can It greatly avoids the shortcomings of the traditional approach. It can be said that there are less than three people in the whole province who can do this approach well.”

Dean Hang, as Chen Qilong's old colleague, of course knows his research well.

"That's fine, that's fine."

After Captain Wang listened, he was finally relieved, Xiao Du, wait for the captain!

Soon the group arrived in front of the treatment room. Captain Wang caught sight of Liu Peichun and asked, "Doctor Liu, how is the preparation for the operation? The chief surgeon has arrived."

Liu Peichun was taken aback when he saw Dean Hang and Director Chu, then looked at the strange Chen Qilong, and paused: "The operation has already started."

"What did you say? The operation started? Who told you to start it. Who's in there!"

Dean Hang was also a little caught off guard, he arranged two experts with great pains, rushed over here without hesitation, and told me that it had already started?

What are you doing?
Chen Qilong's complexion also turned ugly all of a sudden. He knew very well that apart from Chu Tianxiong, there was no doctor in the First City Hospital who could perform such a complicated operation perfectly.

Of course, he wasn't angry because he was robbed of the operation, but he was worried about the safety of the patient. If the surgeon is not good enough, Du Ming will be paralyzed!
"Don't you know the difficulty of anterior decompression, internal fixation, bone grafting and fusion for lumbar thoracic fractures?"

Director Chu, as the director of the Department of Orthopedics, saw how the emergency department was doing things, and immediately cursed: "That's how Zhuang Tong taught you how to deal with patients? How does he manage the department, do you understand?"

Liu Peichun was scolded to be a coward, but when he heard Chu Tianxiong criticize Director Zhuang so much, Liu Peichun frowned and insisted:

"I don't think there is a problem with our department's handling. Our emergency department has the right to give priority to emergency surgery. And it's not up to your orthopedic department to dictate."

The emergency department of the city's first hospital adopts a 24-hour consultation system and a first-diagnosis responsibility system, so there is nothing wrong with Liu Peichun's words.The emergency department can handle it, so there is no need to trouble the orthopedics department.

"What did you say?"

Chu Tianxiong was 1.9 meters tall and had an astonishing momentum. It was also unexpected that Liu Peichun, a small resident doctor, would dare to talk back like this.

"Our department performed the operation completely according to the procedures. After various inspections, the pre-operative preparations were complete, and we also communicated with the patient and signed for confirmation. Dr. Qin is also very confident about the operation, and Dr. Qin's judgment After that, if the operation is not urgent, Du Ming's condition may not be 100% cured."

Liu Peichun said very affirmatively according to the procedures and regulations.

Hearing Liu Peichun's response, several directors also looked at each other in blank dismay, and the air suddenly froze.

According to the routine patients, of course there is no problem in this way, after all, the trust and signature of the patients have been obtained.

But in the current situation, isn't Captain Wang of the fire brigade personally looking for Dean Hang, and the experts arranged by the dean to do the surgery?
Dean Hang was also very embarrassed, but he couldn't find any major faults for a while.Moreover, it is difficult for him to punish the person who takes the main knife. After all, he is Qin Lang.

He just stole the limelight at the seminar, and won such a great honor for the city's first hospital. It's too late for rewards, so how could he suppress it.

But, when will this Qin Lang know orthopedic surgery again.

Dean Hang's mind was like lightning, and he began to think about countermeasures, which was really not worrying.

On the contrary, as an expert in this field, Chen Qilong pointed out Liu Peichun's mistakes very bluntly:
"I'm not good at judging the process, but Dr. Liu said that Dr. Qin operated ahead of time for a 100% recovery. It makes people laugh out loud. Even if I come to the operation, I dare not say 100% recovery , in Du Ming's situation, being able to recover 90.00% is already the limit."

Chu Tianxiong also reacted in the same way, but this person was Qin Lang, and he couldn't speak seriously for a while, but he was a little confused: "Is this really what Qin Lang said? Does he know that this operation is performed?" level of difficulty."

Hearing what Director Chen said, Captain Wang's heart sank again. To be honest, he respected and liked Qin Lang very much.

However, Dr. Qin is not in the field of burns and hand surgery. What is the situation?

Captain Wang felt aggrieved, but he couldn't say anything. If Qin Lang was the one who did the trick, and something went wrong, it would be difficult for him to criticize him, so he tried with luck:
"Dean Hang, Director Chu, is it possible that Dr. Qin really knows how to perform this operation? After all, Dr. Qin is still very good."

Chu Tianxiong wanted to say it was impossible, but this person was Qin Lang, so he was really not sure.

Chen Qilong looked at the reactions of several people very surprised, and also tasted something:
"Dean Hang, Director Chu, and Captain Wang, it seems that you have a high opinion of Dr. Qin?"

ps ah ah ah, I finally see some hope, first pay back the debts of the dangerous boss of the tunnel machine, and then there is the 6th update of the boss, I finally see some hope ~ go and continue to code.

(End of this chapter)