Rebirth 90: I opened a hospital in Shencheng

Chapter 247 Reading, reading, reading!

Ma Dongqing could not help nodding secretly when he heard this profound question posed to Nie Chen by his disciple Marianne Froude.

This is true.

When Professor Ma Dongqing returned to Cambridge Medical School a few weeks ago, he had already discussed with all the students of the medical school based on the Aihua repair method proposed by Nie Chen and applied to the outpatient Liu Hongxia for bilateral cleft lip repair.

In the end this fix was feasible and groundbreaking.

But there is a problem, that is the preoperative preparation, how to determine how much to remove and make up in the repair process?
And to make the operation smoothly present the perfect effect that needs to be presented, can it be done in advance before the operation?
After all, once too much tissue is removed, it will cause irreversible damage to the entire operation, and it can even be called a failure of the operation.

Professor Ma Dongqing is also very interested in the question raised by Marian Froude.

"Since Dr. Froude has raised this issue, let's simply talk about this condition during this consultation process."

Nie Chen pulled over the small mobile blackboard next to the film reader, and on the small blackboard brushily drew the three views of Zhong Jiajia's vascular CT images.

"The vascular CT imagers we see are planar, but we can reconstruct three views with consistent proportions according to the conditions given by the CT images."

Nie Chen's unique skill of reading images and constructing three views in his mind is not a skill he possessed after rebirth.

Before rebirth, you can read the CT images and construct a three-dimensional view in your mind.

Nie Chen used to think that everyone knew this ability, but it was only when he struggled all the way in the emergency room and rushed to the position of attending doctor by relying on his skills that he realized that this skill was really only his own talent.

At this time, Nie Chen didn't show off too much, and drew the three-view image on the blackboard with the correct proportions. At the same time, he opened the other two CT angiograms of the face in different directions for the patient.

"This kind of thinking of reading films needs to force yourself to visually imagine from the beginning, and then restructure in your mind. After all, we also need to restructure the patient's blood vessels during the operation. If there is no overall If you can’t form a restructured thinking from the three views, then this operation should not be performed. Even if you have the best technique, you will still stitch an ugly monster out.”

Nie Chen talked non-stop, and drew on the blackboard the top view, left view, and front view based on the three Cs and the T contrast.

Then, Nie Chen connected the broken orbicularis muscle in the CT images together, and reconnected the broken pure blood vessels after a few millimeters.

In the end, the beauty effects such as the red lip line, upper lip bead, nose column, nose wing, and nose tip can be reassembled after his delicate and just right tendon skin flaps are unfolded.

With one stroke at a time, Nie Chen redraws the schematic diagram of Zhong Jiajia's three angiographic CT angiography in different directions after the operation.

There was silence in the consultation room.

A moment later, there was a soft sigh from Tang Yongqin.

"It's incredible. If Dr. Nie hadn't demonstrated it to us, even if I had completely mastered the Mulliken repair method for unilateral cleft lip without alar created by Dr. Nie, I would have ended up like a ghost painting, causing irreversible damage to the patient during the surgery. harm."

Tang Yongqin sighed.

"Dr. Nie's ability to read images, and the ability to reconstruct images after reading, is already a genius beyond the reach of ordinary people! You have to work hard and practice more, so that you can barely keep up with Dr. Nie. Learned for nothing!"

After sighing.

Professor Yang Haikun said so in a stern tone to the interns surrounding the film reader.

"It is a genius like Dr. Nie that makes medicine so interesting!" Liu Yueqian flattered her.

"Dr. Song will still be the first assistant in this operation, the second assistant will be Yue Qian, and Ronghua will be the third assistant."

After changing into his hand-washing clothes, Nie Chen stood upright on the cool stainless steel operating table and made post adjustments to the three intern assistants.

Liu Yueqian was overjoyed: "That's great!"

Lin Ronghua nodded silently and took the position of the third assistant.

This operation was the same as in the past. Nie Chen cut the lip flap at the first cut, and repaired the orbicularis muscle first.

For the repair of the orbicularis muscle, Nie Chen would not hand it over to the first and second assistants for suture cooperation.

At this time, Lin Ronghua, who was adjusted by Nie Chen to be the third assistant, had enough free time and a wide enough field of vision to observe Nie Chen's technique of suturing the orbicularis oris tendon more intuitively.

"Every tendon, as well as the deformed nerve lines, must be repaired one by one."

According to the three views he showed to everyone during the consultation, Nie Chen went straight to demonstrate the tendonectomy.

First, the orbicularis oris tendon is completely removed, and a small part that is not needed is completely removed, so that the length of the orbicularis oris muscle is shortened, so that the entire upper lip can be made more compact.

After all, the lip flap with cleft lip appears to be insufficient, but after repair, as long as the incision is aligned neatly and the entire red lip line is completely repaired, it is completely sufficient for the aesthetic function of the upper lip to cover the teeth. of.

Then the next requirement is to make the upper lip have a beautiful upturned outline, and even outline the complete and delicate red lip line like a small cherry mouth that even ordinary people's lips do not have.

When Nie Chen performed bilateral cleft lip Aihua repair method for Liu Hongxia on the first machine, and when he performed the surgical structure of the patient's plastic surgery, he was working towards this aspect.

If it weren't for this, the pre- and post-operative comparison photos of patients with cleft lip repair made by Nie Chen would not make all the experts and professors who have seen the photos exclaim in surprise.

While suturing the orbicularis muscle, Nie Chen explained the main points of suturing the tendon and repairing the tendon with three assistants standing on the operating table, Tang Yongqin and Marian Froude standing outside the operating table.

"The suture of lip blood vessels cannot be sutured with mattress-style continuous suture, but with mattress-style interrupted suture."

Nie Chen took the trouble to carefully introduce the cleft lip repair blood vessel requirements that he had introduced to Lin Ronghua and Liu Yueqian several times.

After all, there were Song Dongyang, Tang Yongqin, and Marianne, three interns who had not repaired the cleft lip with him, by his side.

time flies.

In the operating room where the temperature was kept at 10 degrees, the chubby Professor Ma Dongqing sat on a high stainless steel stool and looked at the surgeon on the operating table. He stretched his neck for 10 minutes and shortened it for another [-] minutes.

Repeatedly, like a turtle stretching its neck, he didn't move any other parts of his body until the whole operation was over.

This operation shocked Ma Dongqing a lot.

The biggest shock was Nie Chen's depth of understanding of CT imaging and his ability to read images.

Ma Dongqing felt that based on Nie Chen's understanding of film reading during the consultation just now, he could hold a separate course on film reading for in-depth interpretation.

And even general surgeons who are not strong enough to read images can still perform surgery based on the opinions given by specialists who have strong ability to read images.

In the 90s, the whole world did not have much requirements for radiology doctors in terms of ability to read films.

As for Nie Chen, a genius doctor who was able to finally make a schematic diagram of the postoperative effect based on CT radiography, it can be said that it is rare and rare.

But Nie Chen's idea is feasible.

It is possible to exercise repeatedly and cultivate professional doctors with strong film reading ability.

Professors Ma Dongqing and Yang Haikun, who focus on medical education, have obviously realized this.

Right now, it seems impossible to create another Dr. Nie Chen.

Then it is feasible to break down Nie Chen's ability and allow a professional doctor to achieve a certain ability of Nie Chen.

Ma Dongqing and Yang Haikun suddenly realized and nodded secretly.

After the operation is complete.

Nie Chen is very satisfied with the rhythm of his operation.

It's good to be young. In the past, the afternoon was the time when I was least energetic.

But now in the afternoon, it is the most stable time for physical function and energy.

Nie Chen and the interns returned to the consultation room and asked everyone the postoperative question: "Ronghua, as the third assistant in this operation, you have the broadest vision. Do you have any conclusive thoughts after this operation?" ?”

Concluding thoughts?

All the interns, who were lowering their heads and writing down the operation records, stopped their pens at the same time, and looked at Lin Ronghua, who had dark, heavy and stable skin.

Lin Ronghua looked relieved.

Obviously, he was a little petty about Nie Chen's arrangement of him as the third assistant, but Nie Chen's question dispelled all his thoughts.

"The key to this operation is to construct the postoperative effect in advance based on the preoperative film review." Lin Ronghua thought for a long time, and expressed his summary thoughts on this operation.

Everyone nodded at the same time.

(End of this chapter)