crazy scalpel

Feng Daqiang was still the anesthetist for this operation.This time, Xie Ke didn't invite him on purpose, but he took the initiative to take over the job after he heard about it.

The doctors in the anesthesiology department also found it quite strange. Needless to say, Feng Daqiang's professional skills are top-notch.However, people are too lazy, unless it is a challenging major surgery, or Cai Tianqiao's surgery, he generally doesn't pay much attention to it.

Xie Ke performed the spinal fusion this time, and the patient's signs are very suitable, so it stands to reason that he does not need to appear in person.

However, he spoke earnestly to the anesthetist who was going to perform the operation: "The operation of spinal surgery is generally more complicated, it takes a long time, the trauma is heavy, and the bleeding is heavy. The requirements for the anesthetist are very high! I think I should go to the anesthesiologist." Bar."

What he said is reasonable. In addition to sometimes assisting the surgeon in the rescue, the anesthesiologist also needs to monitor the evoked potential and take blood protection measures to reduce intraoperative bleeding.Such as controlled blood pressure reduction, intraoperative autologous blood salvage, acute isovolumic hemodilution, etc.In addition, in neurosurgery, anesthesiologists must also ensure the oxygen supply to the brain and spinal cord at the same time to avoid or aggravate spinal cord injury.This requires spinal cord function monitoring or wake-up tests during the operation to determine whether the spinal cord function is damaged.

Of course, we must pay attention to any operation, not to mention the complications related to blood transfusion.

But, who is it who blows up Xie Xiaoke in front of his colleagues all day long?Who keeps saying that Xie Xiaoke is No.1 under Cai Tianqiao?Who patted his chest and said that Xie Xiaoke's surgery lowered the requirements for anesthesiologists?

It's not all about you, Feng Daqiang!

The anesthetist who did not perform this operation curled her lips, slandering her inwardly.This time the operation was scheduled for him, and he was still eager to try it, but he didn't expect Feng Yaojin to kill him halfway, and took away the big meal that was in his mouth.

Feng Daqiang has a very good relationship with Xie Ke. He knew that this patient was someone Xie Ke knew, so he took the initiative to "intercept" the operation.

Generally, if it is not really needed, Xie Ke would not deliberately go through the back door to ask the anesthesiologists and nurses he is familiar with, and they all come according to the schedule.One is that he has excellent skills and doesn't particularly care about the details of these cooperations, and the other is that he is not willing to be special.

After all, the chief surgeons with their own fixed team are all relatively prestigious doctors.

However, Xie Ke is too young, but he has already gained a lot of limelight, and many people are already gossiping behind his back. If he continues to be special like this, it will only stimulate their opposition even more.

Of course, if the anesthesiologist took the initiative, it would be a different matter.Feng Daqiang was originally a rebellious person, and everyone has gotten used to it over the years, and he often has whims and so on.

However, no matter when, if you can partner with a good anesthetist, it is something that every surgeon likes to see.

After making preoperative preparations and assessments, Xie Ke visited Zhong Liangquan, talked with him as usual, explained what would happen during the operation, and then mobilized him to cooperate as much as possible.Zhong Liangquan was also a frequent visitor to the operating table, but the previous doctors were not as meticulous and patient as Xie Ke, so even if he didn't understand something, he still pretended to be very serious.

Xie Ke went to the operating room earlier, and after brushing his hands, he saw Feng Daqiang in the anesthesia room checking various equipment.

Feng Daqiang winked at him when he saw no one was around.

"Hey, how about the play hard to get that I taught you last time, is it useful?"

When Xie Ke heard this, he wrinkled a bitter face and said, "It failed."

"How could it be!" Feng Daqiang exclaimed in disbelief, "Unless he doesn't care about you, it's impossible."

Xie Ke: "I couldn't bear it, so I surrendered."

"..." Feng Daqiang was speechless, but he immediately said cheerfully: "Haha, me too. The target is too capable, and all plans are useless."

The two then chatted for a while, Zhong Liangquan, Zhu Ming and Wang Lei also came in.

Zhong Liangquan was pushed in after taking the muscle relaxant. He was obviously still a little nervous.However, Zhu Ming and Feng Daqiang, two seemingly reliable and experienced people, were full of praise for Xie Ke, so Zhong Liangquan relaxed a little.

Feng Daqiang used rapid intravenous induction to anesthetize him while chatting with him, so Zhong Liangquan soon lost consciousness.

Because this operation takes a long time, general anesthesia is still required.Although regional block anesthesia has advantages in postoperative analgesia, improvement of peripheral perfusion, and reduction of the risk of thrombosis, it can only be used in minor operations.

No matter how powerful Xie Ke is, that is to say, he is faster than others, and it is impossible to freeze time.

Zhong Liangquan's operation site this time is the fixation of the occipital neck and neck 1 and neck 2.

他曾经被拿掉的是c1c2之间的椎间盘和c4c5之间的椎间盘。c4和c5之间的问题不大，所以谢克不准备去动那个地方。主要问题出在上颈段。

Thankfully, the approach for this fusion surgery is a posterior approach, that is, a vertical midline incision at the back of the neck.

Relatively speaking, patients undergoing anterior cervical spine surgery are placed supine, which is simple for anesthesia management, but difficult for the surgeon.Because the anterior approach involves complex anatomy, multiple layers of tissue, and a relatively small operative field, which is also adjacent to important organs, blood vessels and nerves, which can easily injure the supralarynx, recurrent laryngeal nerve, and spinal cord.Intraoperative operations are also likely to stimulate the carotid sinus and carotid body, thereby causing changes in blood pressure and heart rate.

The posterior approach is relatively easy anatomically, but its difficulty lies in the complex position.After anesthesia, the patient needs to switch from supine to prone.This alone requires the cooperation of many people, especially the anesthesiologist and the chief surgeon.

Therefore, the workload of surgeons is very large. In addition to fine work, strength is also very important.Those genius doctors on TV generally have a good body.Xie Ke is not tall, but he is not short either. He belongs to the middle class, but he usually pays great attention to exercise, and he has developed muscles that cannot be seen.

After Zhong Liang was completely induced by anesthesia, several doctors waited for his circulation to stabilize and the anesthesia reached a certain depth before turning him over.

Because the tube has been intubated, the neck cannot be twisted a little during the turning process.

The last surgery on Guan Yao also required turning over, but Guan Yao is a baby whose body is only as long as the forearm, so it is much more convenient.

Zhong Liangquan is a big and thick guy.Xie Ke and the others gently and slowly kept the head, neck and spine rotating at the same level to prevent the body from twisting or forming an angle, otherwise it may cause cardiac arrest.

After turning over, everyone let out a sigh of relief. Before the formal operation began, they already felt a little sweaty from the heat.

Feng Daqiang checked the condition of the airway, and then signaled ok.

Xie Ke asked the nurse to fix all the bell beams with high and low beds and shelves, and tie up the places that should be tied.Especially for the head, Xie Ke made the head and neck form a slope, while exposing the surgical area behind the neck as much as possible, let Zhong Liangquan lie on his stomach so that it should not be too flat, and put a cushion under his chest.

Although the pathogenesis of ischemic optic neuropathy is not well understood, reducing stress may help.In order to prevent this from happening, in addition to maintaining sufficient blood volume and avoiding excessive fluctuations in blood pressure during the operation, Xie Ke also made efforts in the posture—making the plane of the head higher than the heart, and wearing Zhongliang Quan goggles.

After everything was done, the anesthetist and nurses relaxed a bit, but the surgeons became nervous.

It's time to start!

Xie Ke's fingers have already started to move around, but through the latex gloves, it is useless for him to rub, and this kind of habit is not very good in the operating room. Although it has been sterilized, Xie Ke's requirements for himself are specification!

Therefore, except for the extraordinary talent shown by his fingers when he became a scalpel last time, generally he would not use them during surgery.He only blurred out his fingers, and gestured at the place where he was about to cut, so that when he cut the knife, he would be extremely precise.

When Xie Ke drew the line on Zhong Liangquan's neck, he virtualized his fingertips by the way, and the fingertips became the shape of a blade, extending along the pen tip, as if cutting into the skin.

Xie Ke knew the thickness of Zhong Liangquan's subcutaneous tissue when he saw it himself.He held the scalpel handed over by the nurse with a grip, tightly pinched the notch on the handle with his thumb and index finger, relaxed his arm muscles, moved his right shoulder forward, and stroked down.

It was not the first time for Zhu Ming and Wang Lei to see his knife skills, so they were not surprised or worried at all by his wide-opening and closing movements. Instead, they watched with admiration.The two agreed that if they wanted to learn, they probably wouldn't be able to learn like this in this life, so they could only watch it.

After all, even Cai Tianqiao can't do this kind of ability at present, and Xie Ke is the only one.

Xie Ke made a long incision, extending from 2 cm above the occipital prominence to the skin of the c5 spinous process.

After the skin was cut, everyone looked at the incision, even Feng Daqiang looked at the incision.Sure enough, it was so perfect that it just cut through the skin and fat, without hurting any ligaments and muscles, and there was no need to make up the knife at all.Because of this, there was very little bleeding.

Xie Ke didn't use any equipment, but directly used a free movement to separate the nuchal ligament and neck muscles along the midline, and retracted them to both sides with the retractor.Xie Ke didn't know how to choose it, and he didn't look or think much, let alone touch it, so he used an electric knife to peel off the spinous process along the subperiosteum around the c2 spinous process.

Xie Ke's movements are simple and effective, so there is minimal damage to the muscles and minimal bleeding.

He used a sharp bone rasp to expose the occipital scale caudally to the occipital prominence, and the posterior tubercle of the atlas, located deep within the midline region, could be touched with fingertips.

Now, the spinous process starting from the second cervical vertebra, as well as the important muscles and blood vessels are displayed in front of everyone.

At this time, only 2 minutes had passed!