Chapter 1663： Prove by surgery
There is a new diagnosis, and it is the diagnosis of Zheng boss, which everyone pays more attention to. In addition, spine surgery also requires nuclear magnetics. In the shortest time, the hair is carried into the nuclear magnetic chamber.
"Boss, how did you think about endometriosis?" Su Yun looked at the image of nuclear magnetic, and determined that Zheng Ren was right.
Because of this, he was even more surprised, so he asked.
"You call the wealthy child, today's surgery, let him do it with the old willow." Zheng Ren suddenly remembered that there is still a bunch of things on his face, "Give another call to Yang Ge, saying that I have something to do with this. The patients with liver cancer interventional embolization are slightly later."
"Who does not know what happened in the hospital, surgery must be postponed. Ask you, how do you diagnose endometriosis?" Su Yun asked again.
"It's not difficult to judge the image of non-coagulation and coagulation." After watching the nuclear magnetic field, Zheng Ren determined his thoughts and took a breath.
"Just judge with ct? Are you cheating?" Su Yun relaxed a lot, disdainful.
"ct can only guess, it is necessary to nuclear magnetic. But it is enough to provide a reason for guessing. You see the reason I said, how full." Zheng Ren said with a smile, then stood up, "go, surgery." ”
"Really, how do you judge it?"
"Three years ago, a similar case occurred in a prefecture-level hospital in the south. The family members of the patient were very fierce and had to pay 10 million yuan. Finally, surgery in the spine surgery confirmed that it was endometriosis, and things would be gone. "Zheng Rendao. (Note)
"How come I don't have an impression." Su Yun was surprised.
"I didn't let the report, I was a case report I saw in the Chinese character magazine one year ago. At that time, I just thought about it. Before we watched the film in the ct room, how can we see how it is wrong? Look for a similar case control." Zheng Ren smiled.
"Is the surgery difficult?"
"Great." Zheng Rendao.
"Your confidence is really touching." Su Yun said with no expression.
"It's a small piece of endometrium. Don't break the gloves when you peel off. Once you break it, cut a small mouth and the endometrium will appear on your fingers..."
"What a disgusting thing, you can't say it." Su Yun stunned and stopped.
When I think of Mao's long menstrual period, my fingers hurt and bleeding, and Su Yun feels that the whole person is not good.
"What do you want?"
"Boss, you said that endometriosis can be transmitted, why is there no rejection?" Su Yun asked.
"..." The brain circuit of this goods is really wonderful.
However, he seems to be right, organ transplantation, surgery is not difficult, difficult to postoperative rejection.
There are not many cases of endometrial implants in other people, but absolutely there are.
Zheng Ren also stunned, this seems to be a research direction of organ transplantation!
After 136 seconds, Zheng Ren smiled and said: "Concentrated surgery, this is spinal surgery."
"Are you level enough?"
"As your boss, you must be perfect in every way."
"cut."
The two said as they walked into the operating room.
"Have you seen the operation of the thoracic vertebra?" Zheng Ren asked.
"I have seen it twice, what happened?"
"I have seen it once, this is what you said. When you have a match, don't keep up." Zheng Ren said faintly.
"Boss, you don't put too much pressure on me. I am at most a triple helper. You are a special helper." Su Yunyi said.
Zheng Ren shook his head slightly.
When he came to the operating room, Zheng Ren saw that Director Mao had lost consciousness and was lying on the operating table. Director Xu was doing endotracheal intubation.
A band professor in the orthopedics waited aside, and the anesthesia was over. They had to be in position.
Holding the film, Zheng Ren went to the system operating room and began surgery.
Because orthopedic surgery performed hip replacement during the Nanyang period, a master-level skill book was used, so Zheng Ren was not in a hurry.
It’s just thoracic surgery...
......
After 15'22", the preparation is completed before surgery.
The hair is in a prone position and maintains the lumbar anterior curvature. The professor of the orthopedic group took the initiative to get rid of the conventional surgical area and spread the sterile towel.
Brushing, disinfecting, and wearing clothes, Zheng Ren and Director Xu of the Spine Surgery came to the operating table.
"Zheng boss, you come." Director Xu is very gracious.
"Director Xu, I am giving you a handle." Zheng Ren smiled.
"You're welcome. Dr. Richard of Massachusetts General Hospital, he recommended you to be a tenured professor at the Massachusetts General Hospital." Director Xu smiled. "I am a doctor at the Massachusetts General Hospital. Richard is bigger than me, it is my brother."
This kind of misrepresentation of the brothers is often seen in small hospitals.
However, at 912, everyone was self-identified, and few people said so.
But that is the doctor with the domestic, Xu Director Pan is but "high branch", anyway, Dr. Richard does not know whether it is.
Zheng Ren smiled. "I thought Dr. Richard was joking. I didn't expect it to be true."
"I have inquired, saying that your hip replacement surgery is particularly good, and it is also the table that Dr. Su gives you. Today, I just take the handle and learn."
The two had already put on their clothes, and under the insistence of Director Xu, Zheng Ren stood at the position of the surgeon.
"Doctor Su, I am standing in a helping position, but I don't want to be a helper." Director Xu smiled: "You have to concentrate on it."
Su Yun stunned and nodded.
"Microscope." Zheng Ren said before he opened the skin.
An anesthesiologist who gave a contract to Director Xu quickly put a microscope on Zheng Ren, and the operation officially began.
Reaching out, the lancet is gently shot in the palm of your hand.
Take a longitudinal incision around the chest 8 and 9 vertebral bodies, about 6 cm.
Cut the skin, subcutaneous tissue, deep fascia, begin blunt dissection, free the erector spinae along both sides of the spinous process, and clean the soft tissue of the thoracic 8, 9 lamina and transverse process.
In general, the erector spinae are cut, but Zheng Ren uses a passive separation mode to reduce bleeding. The advantage of doing this is less bleeding, but the disadvantages are just as great.
The bilateral inferior articular processes of the vertebral bodies of the thoracic and vertebral bodies were removed, and the origin of the ribs on both sides was revealed outward.
The intercostal veins and nerves of the corresponding ribs are separated and ligated.
The cleanliness of the operation, including the position of the facet joints, Zheng Ren did not bite all, just exposing the field is enough.
The damage is as small as possible and the recovery is fast.
"Attention to the pleura." Ligation of the intercostal veins and nerves to protect the intercostal artery, Zheng Ren said.
A hand reaches heavy rib pliers fall on the hand.
Zheng Ren used rib pliers to cut the ribs about 3 times outside the rib joint and removed the ribs from the cut point to the rib joint.
Zheng Ren then bite the bilateral vertebral pedicles and superior articular processes of the chest 8 and 9 to reveal the spinal cord.
The reason for biting off the bones is that the bone stumps are bleeding, and the surgical field is somewhat blurred.
Su Yun uses a suction device to **** blood, while using a gauze to bleed. Less than a second after exposure to the field, the field will be re-covered by blood.
......
......
Note: This is the first reason to find endometriosis. It can't be the same as when you started the book. It is said which hospital is Barabala. When I wrote this case, I was afraid after a while. It is useless to be cautious. When you are a doctor, you have to be good.
vertex
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"Boss, how did you think about endometriosis?" Su Yun looked at the image of nuclear magnetic, and determined that Zheng Ren was right.
Because of this, he was even more surprised, so he asked.
"You call the wealthy child, today's surgery, let him do it with the old willow." Zheng Ren suddenly remembered that there is still a bunch of things on his face, "Give another call to Yang Ge, saying that I have something to do with this. The patients with liver cancer interventional embolization are slightly later."
"Who does not know what happened in the hospital, surgery must be postponed. Ask you, how do you diagnose endometriosis?" Su Yun asked again.
"It's not difficult to judge the image of non-coagulation and coagulation." After watching the nuclear magnetic field, Zheng Ren determined his thoughts and took a breath.
"Just judge with ct? Are you cheating?" Su Yun relaxed a lot, disdainful.
"ct can only guess, it is necessary to nuclear magnetic. But it is enough to provide a reason for guessing. You see the reason I said, how full." Zheng Ren said with a smile, then stood up, "go, surgery." ”
"Really, how do you judge it?"
"Three years ago, a similar case occurred in a prefecture-level hospital in the south. The family members of the patient were very fierce and had to pay 10 million yuan. Finally, surgery in the spine surgery confirmed that it was endometriosis, and things would be gone. "Zheng Rendao. (Note)
"How come I don't have an impression." Su Yun was surprised.
"I didn't let the report, I was a case report I saw in the Chinese character magazine one year ago. At that time, I just thought about it. Before we watched the film in the ct room, how can we see how it is wrong? Look for a similar case control." Zheng Ren smiled.
"Is the surgery difficult?"
"Great." Zheng Rendao.
"Your confidence is really touching." Su Yun said with no expression.
"It's a small piece of endometrium. Don't break the gloves when you peel off. Once you break it, cut a small mouth and the endometrium will appear on your fingers..."
"What a disgusting thing, you can't say it." Su Yun stunned and stopped.
When I think of Mao's long menstrual period, my fingers hurt and bleeding, and Su Yun feels that the whole person is not good.
"What do you want?"
"Boss, you said that endometriosis can be transmitted, why is there no rejection?" Su Yun asked.
"..." The brain circuit of this goods is really wonderful.
However, he seems to be right, organ transplantation, surgery is not difficult, difficult to postoperative rejection.
There are not many cases of endometrial implants in other people, but absolutely there are.
Zheng Ren also stunned, this seems to be a research direction of organ transplantation!
After 136 seconds, Zheng Ren smiled and said: "Concentrated surgery, this is spinal surgery."
"Are you level enough?"
"As your boss, you must be perfect in every way."
"cut."
The two said as they walked into the operating room.
"Have you seen the operation of the thoracic vertebra?" Zheng Ren asked.
"I have seen it twice, what happened?"
"I have seen it once, this is what you said. When you have a match, don't keep up." Zheng Ren said faintly.
"Boss, you don't put too much pressure on me. I am at most a triple helper. You are a special helper." Su Yunyi said.
Zheng Ren shook his head slightly.
When he came to the operating room, Zheng Ren saw that Director Mao had lost consciousness and was lying on the operating table. Director Xu was doing endotracheal intubation.
A band professor in the orthopedics waited aside, and the anesthesia was over. They had to be in position.
Holding the film, Zheng Ren went to the system operating room and began surgery.
Because orthopedic surgery performed hip replacement during the Nanyang period, a master-level skill book was used, so Zheng Ren was not in a hurry.
It’s just thoracic surgery...
......
After 15'22", the preparation is completed before surgery.
The hair is in a prone position and maintains the lumbar anterior curvature. The professor of the orthopedic group took the initiative to get rid of the conventional surgical area and spread the sterile towel.
Brushing, disinfecting, and wearing clothes, Zheng Ren and Director Xu of the Spine Surgery came to the operating table.
"Zheng boss, you come." Director Xu is very gracious.
"Director Xu, I am giving you a handle." Zheng Ren smiled.
"You're welcome. Dr. Richard of Massachusetts General Hospital, he recommended you to be a tenured professor at the Massachusetts General Hospital." Director Xu smiled. "I am a doctor at the Massachusetts General Hospital. Richard is bigger than me, it is my brother."
This kind of misrepresentation of the brothers is often seen in small hospitals.
However, at 912, everyone was self-identified, and few people said so.
But that is the doctor with the domestic, Xu Director Pan is but "high branch", anyway, Dr. Richard does not know whether it is.
Zheng Ren smiled. "I thought Dr. Richard was joking. I didn't expect it to be true."
"I have inquired, saying that your hip replacement surgery is particularly good, and it is also the table that Dr. Su gives you. Today, I just take the handle and learn."
The two had already put on their clothes, and under the insistence of Director Xu, Zheng Ren stood at the position of the surgeon.
"Doctor Su, I am standing in a helping position, but I don't want to be a helper." Director Xu smiled: "You have to concentrate on it."
Su Yun stunned and nodded.
"Microscope." Zheng Ren said before he opened the skin.
An anesthesiologist who gave a contract to Director Xu quickly put a microscope on Zheng Ren, and the operation officially began.
Reaching out, the lancet is gently shot in the palm of your hand.
Take a longitudinal incision around the chest 8 and 9 vertebral bodies, about 6 cm.
Cut the skin, subcutaneous tissue, deep fascia, begin blunt dissection, free the erector spinae along both sides of the spinous process, and clean the soft tissue of the thoracic 8, 9 lamina and transverse process.
In general, the erector spinae are cut, but Zheng Ren uses a passive separation mode to reduce bleeding. The advantage of doing this is less bleeding, but the disadvantages are just as great.
The bilateral inferior articular processes of the vertebral bodies of the thoracic and vertebral bodies were removed, and the origin of the ribs on both sides was revealed outward.
The intercostal veins and nerves of the corresponding ribs are separated and ligated.
The cleanliness of the operation, including the position of the facet joints, Zheng Ren did not bite all, just exposing the field is enough.
The damage is as small as possible and the recovery is fast.
"Attention to the pleura." Ligation of the intercostal veins and nerves to protect the intercostal artery, Zheng Ren said.
A hand reaches heavy rib pliers fall on the hand.
Zheng Ren used rib pliers to cut the ribs about 3 times outside the rib joint and removed the ribs from the cut point to the rib joint.
Zheng Ren then bite the bilateral vertebral pedicles and superior articular processes of the chest 8 and 9 to reveal the spinal cord.
The reason for biting off the bones is that the bone stumps are bleeding, and the surgical field is somewhat blurred.
Su Yun uses a suction device to **** blood, while using a gauze to bleed. Less than a second after exposure to the field, the field will be re-covered by blood.
......
......
Note: This is the first reason to find endometriosis. It can't be the same as when you started the book. It is said which hospital is Barabala. When I wrote this case, I was afraid after a while. It is useless to be cautious. When you are a doctor, you have to be good.
vertex
The fastest update, no pop-up window reading please collect ().
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