The Godfather of Surgery

Yang Ping took Xiao Su to the operating room. The two just came out of the men's and women's locker rooms and met Nurse Jiang.

Xiao Su said hello immediately, and Head Nurse Jiang smiled: "Xiao Su, have you returned to her parents' house? Didn't you feel wronged over there?"

Xiao Su smiled and said, "No, the head nurse has worked hard. I'll come over with Dr. Yang to see the operation."

Head Nurse Jiang looked dignified: "Dr. Yang, you can't bully our Nurse Su, or we won't be able to spare you."

Yang Ping just laughed, the head nurse was very busy: "Go, there are too many emergency operations today, I have to quickly deploy staff and go back to the office for a meeting."

Saying goodbye to the head nurse, Yang Ping took Xiao Su to the operating room of spine surgery. Director Qin and Dr. Wen were analyzing the reason. Such a large piece of free intervertebral disc would disappear if you didn't see it, which was a bit scary.

"Doctor Yang!" When Dr. Wen saw Yang Ping come in, he immediately saw hope.

Dr. Wen's understanding of Yang Ping has been relatively deep since Yang Ping performed surgery on Professor Zhang. At that time, he also participated in Yang Ping's small lectures and participated in discussions.

Director Qin looked at the screen of the G-arm and studied the pictures of perspective positioning: "Start from the first one, slow down, I haven't seen it clearly yet. You can flip whatever you want to flip through."

Director Qin was a little angry, and his tone was not very good. This kind of minimally invasive surgery usually has an explanation with the patient before the operation. In case of special circumstances, it may be converted to open surgery.

But the intervertebral disc disappeared inexplicably. Even if the operation was performed, the intervertebral disc was not found. In the end, a switch operation was performed. The patient's problem was not solved. After the operation, the patient still rolled on the floor in pain. I can't even hang on my face.

Director Qin walked back and forth between the reading light and the screen of the G-arm machine. Looking at it, CT and MRI clearly showed that the intervertebral disc with half the size of the thumb rested there, and the positioning was completely correct. Didn't see a single bit.

"Oh, Xiao Yang, let's take a look together." Director Qin saw Yang Ping standing beside him.

Ask Yang Ping to come over. This is Dr. Wen's suggestion. If there is a difficult problem in the operation of the trauma and orthopedics department, it is not a new thing to ask Yang Ping to discuss.

However, spine surgery is the first time. Although they are all orthopaedic departments, the contents of the specialties are completely different. The threshold for surgeons in spine surgery is higher than that in trauma orthopaedics.

General simple operations are not qualified to be performed by senior surgeons; slightly difficult operations must be performed by the deputy chief doctor. After all, the operation involves the spinal cord and nerve roots. If there is a mishap, it will be either paralysis or disability.

Yang Ping is a young man who has just been promoted to the main department. According to common sense, he will never have the opportunity to perform spine surgery. Therefore, Director Qin has some ideas. It is reasonable that he is not as modest as Director Gao.

Since Dr. Wen brought it up on the operating table, Director Qin disagreed. In case of an accident, he would be stubborn, so he still agreed to invite Yang Ping over.

"Eating now? I'm sorry to disturb your meal." Dr. Wen saw Xiao Su also following, and it was time to eat.

Yang Ping didn't care: "It's okay, I just received your call after eating."

After analyzing the images, Director Qin said helplessly, "Stop the operation, push it down and do an MRI again to see where the intervertebral disc is."

Like the C-arm machine, the G-arm machine is actually a mobile X-ray machine. The difference is that the C-arm machine can only form an image of one surface at a time, while the G-arm machine can form two images of the front side at a time.

The intervertebral disc is not visible under the X-ray, so under the fluoroscopy of the G-arm machine, the intervertebral disc cannot be seen at all, only the vertebrae can be seen. The positioning is to determine the ordinal number of the segment of the intervertebral disc herniation before the operation by magnetic resonance and CT, and then enter the segment of this ordinal number under the G-arm fluoroscopy.

Everything went according to this procedure, and no mistakes were found. The mistakes that may be made in ordinary times have been checked repeatedly by everyone, and these mistakes have not appeared.

"Xiao Yang, it's hard work, why don't you push it down for an MRI, let's go down and have a look?" Director Qin has already withdrawn the equipment, Dr. Wen sutured the small incision at the back of the patient's waist, the dressing covered the incision, and lifted the sterile sheet. open.

This type of surgery is usually done under local anesthesia, but the pain symptoms of this patient were too obvious, and it was impossible to keep the patient in pain during the operation, so combined spinal-epidural anesthesia was chosen, and the lower body was anesthetized.

The patient was awake. Director Qin personally explained to him the special situation encountered during the operation. The patient was fine and understood. They solved the problem for him, and no one deliberately played tricks.

Before Yang Ping had time to read the video, everyone moved quickly. The patient had already been transferred to the flat car, and he was going to the imaging department for an MRI.

Although it is a bit embarrassing and a bit shameful to deal with it in this way, but for the safety and effect of the patient's surgery, Director Qin can only put aside his face temporarily.

The flat cart was pushed towards the MRI room of the imaging department, and everyone followed silently, not daring to speak. After all, it was the director who fell over.

After several times of tossing and turning, when he arrived at the MRI room, Director Meng was very generous and waited in the operating room in person. A machine was also vacated ahead of time, and the patient pushed in. The doctors and nurses were busy checking contraindications, checking whether they were carrying magnetic metals, and whether they were loaded. The patient is placed on the platform, and the patient is placed on the platform.

"Old Qin, what's the matter? The intraoperative exploration and preoperative imaging are not the right way?" Director Meng asked Director Qin to sit down, knowing that he had encountered a problem, otherwise the operation would not have been completed halfway, and the patient would be pushed down for an MRI.

Director Qin looked unlucky: "The positioning is accurate, there is no problem at all. The intervertebral foramen mirror enters the spinal canal, but the free intervertebral disc cannot be seen."

"Is there such a thing?" Director Meng hesitated.

The technician and nurse were positioning the patient. The other doctors were waiting outside. Only Yang Ping and Dr. Wen followed, and Xiao Su followed behind Yang Ping. When Director Meng saw Yang Ping coming, he was very polite and immediately pulled the chair in person: "Yang Doctor, sit down!"

Director Meng is familiar with Yang Ping, especially Yang Ping can see the dural arteriovenous fistula from the patient's MRI. He is full of admiration. If there is any difficult case, he likes to call Yang Ping over to study together.

Almost ready, Director Meng looked into the examination room through the thick glass wall. The technician and nurse had already come out, and the door of the examination room was closed.

"Intervertebral foramen mirror has been done for about ten years. There should be 2,000 cases. I have never encountered such a situation." Director Qin was still immersed in helplessness.

During the conversation, the technician skillfully adjusted the parameters on the operating platform, pressed the switch, the platform moved, and the patient was slowly sent into the black hole.

The strong magnetic field makes the hydrogen ions spin in the human body neatly oriented in the same direction, the magnetic field is withdrawn, and the orientation of the hydrogen ions returns to a free and chaotic state.

In this way, the length of recovery time is different, and the difference is generated. The difference is the basis of the image, and only the difference can be used to compose the picture.

Just like a pencil, the difference in the density of lines is used to compose the picture, and the X-ray film is composed of the difference in the amount of radiation absorbed by objects of different densities. There is no difference, just a piece of white or black.

Several doctors in the imaging department were already wandering outside the door. Since Director Meng was inside, it was difficult to get in. Everyone came to see Yang Ping. Once a person became a bully, there would be many legends. It has become a myth, giving everyone a sense of height and distance from him.

Let's not talk about the awesome things before, just talk about the most recent one, on the sixth day of the first lunar month, I heard that Yang Ping was invited by a wealthy Malaysian businessman to a consultation for surgery.

It is also rumored that Yang Ping pressed the outstanding experts from Yingde and Japan to the ground and rubbed them on the ground. The fee for this cross-border consultation was in the millions, and the younger brother who followed him received 100,000 to 200,000. Zhang Lin recently bought a car, and he knew that the number was close to ten.

Things piled up one by one, and Yang Ping gradually became a myth in the hearts of these people and became a legend. Some people even wondered whether there would be an imaging doctor in the future of comprehensive orthopedics. If he was lucky enough to join, he would follow him. Pick up meat to eat.

Didn't that Fatty Liang from the anesthesiology department also follow Yang Ping? The stewardess on the plane, who the hell spread this word, the fat man is looking for big mouths everywhere. Whenever this happens, Zhang Lin immediately persuades him: calm down, calm down, there is no privacy for famous people.

The speed of light-speed magnetic resonance imaging is very fast, and the image is slowly taking shape. Director Meng stopped chatting. Director Qin leaned over to see that the lumbar intervertebral disc herniated. To these old birds, you can see at a glance, what segment, how much protruding, eyes closed. can't be wrong.

That piece is still there, so obvious. Judging from the low signal, it is undoubtedly the nucleus pulposus of the prolapse of the intervertebral disc. It is still in its original position without any change. It is located in the spinal canal, behind the lumbar 1 vertebral body, and the foramen mirror The approach was right against the intervertebral disc, and there was no mispositioning either in sagittal or cross-section.

"That's right, the intervertebral disc is here!" Director Meng pointed to the picture.

Director Qin flipped through the picture several times, and it was true, it was good, it was a hell, did the mirror stray into other tissues, just separated from the intervertebral disc? As long as the intervertebral disc is still there, there is a way to explore it carefully.

"Send to the operating room, re-sterilize the sheets, and continue the operation." Director Qin has a bottom line.

Although there is a lot of tossing, but the operation is like this, or you don't take the stage. Once you take the stage, if you encounter an unexpected situation, even if you are in trouble, you have to do it under the trouble. It is better to have trouble on stage than to have trouble stepping down.

"Director Meng, sorry, let's go on to the surgery." Director Qin said goodbye.

Director Meng got up to say goodbye: "You're welcome, I'll contact you if you need to."

"Xiao Yang, it's been hard work, why don't you go back with us?" Director Qin left a way back, fearing that if there were any more problems, at least there was someone who could help.

The patient was pushed to the operating room again, and the body was put in a position. The G-arm machine was used to re-fluoroscopy to confirm that the segments were correct, and the sheets were re-sterilized.

There was no problem with the original approach, the small incision was removed from the suture, and the entry was still made through the original entrance, the mirror was inserted, the water rushed in, and the vision was clear.

The dural sac and nerve roots are clear. After ten years of this kind of operation, how can I misunderstand? The lens has not strayed into other tissue spaces. It is clearly in the spinal canal. Where is the intervertebral disc?

"Are you kidding me? Is that the MRI just now?" Director Qin wanted to confirm.

The doctor under the stage carefully checked the date: "Yes, it was just taken, and I just hung it up."

What the hell, Director Qin scolded swear words in his heart. Today, this is a bit nonsense with Dou, and the little confidence he just gained was deflated and shriveled!

Director Qin sorted out his thoughts, what is the problem? Where did it come from?

"Turn on the screen, call up the previous MRI and the one just taken, zoom in!"

This operating room is a multi-functional operating room with a large screen. The main surgeon can operate the control panel and call up the required medical records through the sterile membrane. It is just that Director Qin is used to watching films on the reading light and does not use this high-tech .

Through the sterile membrane, Dr. Wen opened the screen, called up the images, found a few typical ones, opened them, and arranged them side by side. There was nothing wrong. Whether it was the previous film or the current film, the intervertebral disc was still in its original position.

But he obviously didn't get the wrong segment, and the camera was in the spinal canal, so why didn't he see the nucleus pulposus tissue of the intervertebral disc? No matter how you adjust it, you can't see it.

"Damn it!" Director Qin was stunned again, sweat dripping from the forehead of the old fritters.