Chapter 341： Do your best
"Zheng Zong, I am the old week of orthopedics." There was a slightly bitter mother voice on the phone.
Is the doctor of the orthopedics Zhou, people are very good, is to talk a bit mother.
The recognition of this sound is too high, and Zheng Ren will hear it all at once.
"Zhou Ge, what happened?"
"Are you busy? Lumbar resection, patient intervention..." On the other side of the phone, the voice was hesitant. "Can the surgery be done in a while?"
Ok? Why are you so anxious?
"Now it's okay, is the patient fast enough to fast?" Zheng Ren does not care, said.
"Enough! Enough!" Dr. Zhou said quickly, "This operation is done by the professor of the Imperial Capital. The professor has something to face, or he will fly tomorrow morning, or he will need to say it three or five days later."
Dr. Zhou quickly explained that after all, it is now close to the time of work, looking for Zheng Ren to do surgery, it is to look at personal feelings.
"The patient is very painful. I have to use a lot of drugs to relieve pain every day. I am not thinking about it. The sooner I do, the less the patient can be sinned."
"Nothing, Zhou Ge, I have no emergency surgery on this side. If you are convenient, let the family sign it. You can send the patient directly." Zheng Ren said with a smile.
"Okay, okay." Dr. Zhou was busy with the promise, "I let my family go to find you."
After that, the phone was hung up.
Zheng Ren immediately began to write before the handwriting, because it is the first new surgery, Zheng Ren while pondering possible complications, while recording.
When the professor saw Zheng Ren start his work, he came over and asked: "Zheng, is it necessary to have surgery right away?"
"Yeah." Zheng Ren replied.
"The work on your side is really day and night." Seeing that I have to get off work, I have to go to surgery. As a rigid German, the professor must have an idea.
After work hours, it is private, and the professor really does not adapt to this kind of public and private life rhythm.
Where is life, it is simply a slave to the hospital.
But the professor is still not willing to leave, although he will not stop him if he wants to go.
At noon, the 64-row CT three-dimensional reconstruction opened a door for the professor and vaguely saw the new world.
As for the scenery of this world, you may see clues from this operation.
The professor only hesitated for a second and decided to stay.
Zheng Ren did not know the professor's rich inner drama. He explained the pre-operative corrections one by one. When the young women came, Zheng Ren was still pondering the various complications that might occur.
All that can be thought of is written down and explained to the patient's family.
The young woman does not care, in her words, this time is the family's heart, trouble doctors when the effort.
Moreover, she also did a good job in psychological construction. If she does not come to Taiwan, she will be less guilty.
She did not hesitate to sign the pre-operative report printed by Zheng Ren, and then went back to send the patient to the emergency room to prepare for surgery.
Zheng Ren called the operating room to prepare for surgery, and then did not call Su Yun, took the professor to the operating room.
Finally, I had arrived at Zheng Ren for a long time. Professor Rudolf kept asking questions about the three-dimensional reconstruction of 64-row CT.
Zheng Ren had no idea to answer the professor's question, and changed his head and changed his clothes. He occasionally talked with the professor.
What he thinks in his mind are all related to the embolization of the lumbar transverse artery surgery.
Still have to go to the system operating room to train, 10 or 20 surgical experience is enough.
Zheng Ren is now rich in money, and his first contact with the new technique is to think about ten times and twenty times.
As for how many hours each time, Zheng Ren did not think much.
If this is done before, it is absolutely not dare.
From simple to extravagant, Si is also rational.
In order to change clothes, Zheng Ren asked Professor Rudolph to prepare for the pre-operative, and he went to the small smoking room to ignite a purple cloud and enter the system space.
When the operation time of the surgery was purchased, the operating room of the system was raised and the experimental body appeared in front of Zheng Ren.
The lumbar artery, also known as the lumbar transverse artery, is divided into two anterior and posterior branches at the anterior aspect of the intervertebral foramen.
The anterior branch is ventral on the lower edge of the transverse process and the transverse ligament of the transverse process. The ventral transverse muscle is inserted between the transverse abdominis muscle and the intra-abdominal oblique muscle to supply the posterior abdominal wall tissue.
At the beginning of the anterior branch, a thin intervertebral foramen anterior branch is delivered to the spinal canal at the leading edge of the intervertebral foramen to support the area in front of the dura mater and behind the vertebral body.
In the same position, the posterior branch trunk sends out a nutrient branch into the lumbar plexus trunk.
Need to embolize, not only the trunk branch to the lower part of the nutrient branch into the lumbar plexus, but also the abnormal proliferation of the main vessels to support the blood vessels, tumor tissue abnormal proliferation of blood vessels.
This point has been determined at the time of noon 64-channel CT three-dimensional reconstruction.
Because the patient is in advanced stage of the tumor, the operation is also a palliative operation to improve the quality of life, so to avoid complications, try to embolize the vertebral body to support the blood vessels.
Simple destructive surgery is not as difficult. In the past, this type of surgery did not involve embolization of the lumbar transverse artery. The intraoperative blood loss should be 3000-5000 ml.
This is a daunting number.
However, if the lumbar transverse artery is inserted, the amount of bleeding can be controlled to 1500-2000 ml, which is acceptable.
Surgical training, the first surgery Zheng Ren did enough for nearly 3 hours.
Because Zheng Ren does not want to just sever the backbone of the posterior branch, in that case, although the surgery is relatively simple, it can also reach the level required by the professor of orthopedics.
However, the patient's intraoperative bleeding of about 1500 ml will still have a huge impact on the terminal patients.
To improve the quality of life in patients' survival, it is serious to try to get less blood.
Not only should the lumbar transverse artery or the left and right intercostal arteries be embolized, but the nearby small blood vessels should also be embolized as much as possible to ensure that the surgical bleeding is minimized.
In fact, Zheng Ren does not have to do this at all.
However, as a doctor, when you have a condition, you will always think about getting the patient to heal soon. And can not heal, try to improve the quality of life in life.
The spinal cord is very rich in blood vessels. In addition to the Adamchiviz artery, try to avoid it Others are also carefully angiographically found to have no effect on other organs or spinal cord, but simply donate blood to the tumor. .
The operation was very slow, and Zheng Ren gradually mastered some corresponding embolization techniques.
The level of involvement at the master level is not a joke.
Even so, ten surgical trainings were performed, and in the end, it was only possible to complete an embolization of the lumbar transverse artery every two hours.
To some extent, this kind of surgery has to meet Zheng Ren's requirements, which is even more difficult than prostate embolism.
After all, even if the proliferative capillaries of the prostate are ectopically embolized, it will not cause the patient to die.
Just like the patient who was done by Professor Rudolf Wagner, the upper bladder artery was embolized, and the patient only had symptoms such as urinary weakness, and the catheter was indwelled.
This time, it is the spinal cord that supplies the artery near the blood vessel.
If you are not careful, the patient will have paraplegia in the lower limbs and even sudden respiratory arrest, leading to death.
Is the doctor of the orthopedics Zhou, people are very good, is to talk a bit mother.
The recognition of this sound is too high, and Zheng Ren will hear it all at once.
"Zhou Ge, what happened?"
"Are you busy? Lumbar resection, patient intervention..." On the other side of the phone, the voice was hesitant. "Can the surgery be done in a while?"
Ok? Why are you so anxious?
"Now it's okay, is the patient fast enough to fast?" Zheng Ren does not care, said.
"Enough! Enough!" Dr. Zhou said quickly, "This operation is done by the professor of the Imperial Capital. The professor has something to face, or he will fly tomorrow morning, or he will need to say it three or five days later."
Dr. Zhou quickly explained that after all, it is now close to the time of work, looking for Zheng Ren to do surgery, it is to look at personal feelings.
"The patient is very painful. I have to use a lot of drugs to relieve pain every day. I am not thinking about it. The sooner I do, the less the patient can be sinned."
"Nothing, Zhou Ge, I have no emergency surgery on this side. If you are convenient, let the family sign it. You can send the patient directly." Zheng Ren said with a smile.
"Okay, okay." Dr. Zhou was busy with the promise, "I let my family go to find you."
After that, the phone was hung up.
Zheng Ren immediately began to write before the handwriting, because it is the first new surgery, Zheng Ren while pondering possible complications, while recording.
When the professor saw Zheng Ren start his work, he came over and asked: "Zheng, is it necessary to have surgery right away?"
"Yeah." Zheng Ren replied.
"The work on your side is really day and night." Seeing that I have to get off work, I have to go to surgery. As a rigid German, the professor must have an idea.
After work hours, it is private, and the professor really does not adapt to this kind of public and private life rhythm.
Where is life, it is simply a slave to the hospital.
But the professor is still not willing to leave, although he will not stop him if he wants to go.
At noon, the 64-row CT three-dimensional reconstruction opened a door for the professor and vaguely saw the new world.
As for the scenery of this world, you may see clues from this operation.
The professor only hesitated for a second and decided to stay.
Zheng Ren did not know the professor's rich inner drama. He explained the pre-operative corrections one by one. When the young women came, Zheng Ren was still pondering the various complications that might occur.
All that can be thought of is written down and explained to the patient's family.
The young woman does not care, in her words, this time is the family's heart, trouble doctors when the effort.
Moreover, she also did a good job in psychological construction. If she does not come to Taiwan, she will be less guilty.
She did not hesitate to sign the pre-operative report printed by Zheng Ren, and then went back to send the patient to the emergency room to prepare for surgery.
Zheng Ren called the operating room to prepare for surgery, and then did not call Su Yun, took the professor to the operating room.
Finally, I had arrived at Zheng Ren for a long time. Professor Rudolf kept asking questions about the three-dimensional reconstruction of 64-row CT.
Zheng Ren had no idea to answer the professor's question, and changed his head and changed his clothes. He occasionally talked with the professor.
What he thinks in his mind are all related to the embolization of the lumbar transverse artery surgery.
Still have to go to the system operating room to train, 10 or 20 surgical experience is enough.
Zheng Ren is now rich in money, and his first contact with the new technique is to think about ten times and twenty times.
As for how many hours each time, Zheng Ren did not think much.
If this is done before, it is absolutely not dare.
From simple to extravagant, Si is also rational.
In order to change clothes, Zheng Ren asked Professor Rudolph to prepare for the pre-operative, and he went to the small smoking room to ignite a purple cloud and enter the system space.
When the operation time of the surgery was purchased, the operating room of the system was raised and the experimental body appeared in front of Zheng Ren.
The lumbar artery, also known as the lumbar transverse artery, is divided into two anterior and posterior branches at the anterior aspect of the intervertebral foramen.
The anterior branch is ventral on the lower edge of the transverse process and the transverse ligament of the transverse process. The ventral transverse muscle is inserted between the transverse abdominis muscle and the intra-abdominal oblique muscle to supply the posterior abdominal wall tissue.
At the beginning of the anterior branch, a thin intervertebral foramen anterior branch is delivered to the spinal canal at the leading edge of the intervertebral foramen to support the area in front of the dura mater and behind the vertebral body.
In the same position, the posterior branch trunk sends out a nutrient branch into the lumbar plexus trunk.
Need to embolize, not only the trunk branch to the lower part of the nutrient branch into the lumbar plexus, but also the abnormal proliferation of the main vessels to support the blood vessels, tumor tissue abnormal proliferation of blood vessels.
This point has been determined at the time of noon 64-channel CT three-dimensional reconstruction.
Because the patient is in advanced stage of the tumor, the operation is also a palliative operation to improve the quality of life, so to avoid complications, try to embolize the vertebral body to support the blood vessels.
Simple destructive surgery is not as difficult. In the past, this type of surgery did not involve embolization of the lumbar transverse artery. The intraoperative blood loss should be 3000-5000 ml.
This is a daunting number.
However, if the lumbar transverse artery is inserted, the amount of bleeding can be controlled to 1500-2000 ml, which is acceptable.
Surgical training, the first surgery Zheng Ren did enough for nearly 3 hours.
Because Zheng Ren does not want to just sever the backbone of the posterior branch, in that case, although the surgery is relatively simple, it can also reach the level required by the professor of orthopedics.
However, the patient's intraoperative bleeding of about 1500 ml will still have a huge impact on the terminal patients.
To improve the quality of life in patients' survival, it is serious to try to get less blood.
Not only should the lumbar transverse artery or the left and right intercostal arteries be embolized, but the nearby small blood vessels should also be embolized as much as possible to ensure that the surgical bleeding is minimized.
In fact, Zheng Ren does not have to do this at all.
However, as a doctor, when you have a condition, you will always think about getting the patient to heal soon. And can not heal, try to improve the quality of life in life.
The spinal cord is very rich in blood vessels. In addition to the Adamchiviz artery, try to avoid it Others are also carefully angiographically found to have no effect on other organs or spinal cord, but simply donate blood to the tumor. .
The operation was very slow, and Zheng Ren gradually mastered some corresponding embolization techniques.
The level of involvement at the master level is not a joke.
Even so, ten surgical trainings were performed, and in the end, it was only possible to complete an embolization of the lumbar transverse artery every two hours.
To some extent, this kind of surgery has to meet Zheng Ren's requirements, which is even more difficult than prostate embolism.
After all, even if the proliferative capillaries of the prostate are ectopically embolized, it will not cause the patient to die.
Just like the patient who was done by Professor Rudolf Wagner, the upper bladder artery was embolized, and the patient only had symptoms such as urinary weakness, and the catheter was indwelled.
This time, it is the spinal cord that supplies the artery near the blood vessel.
If you are not careful, the patient will have paraplegia in the lower limbs and even sudden respiratory arrest, leading to death.
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