There is a new diagnosis, and it is Boss Zheng's diagnosis, which everyone attaches great importance to. In addition, the spine surgery department also required an MRI. In the shortest possible time, Director Mao was carried into the MRI room.
"Boss, how did you think of endometriosis?" Su Yun looked at the MRI images and confirmed that Zheng Ren was right.
Because of this, he was even more surprised and asked.
"Call Fu Gui'er and ask him to take Lao Liu for today's surgery." Zheng Ren suddenly remembered that he still had a lot of things to do, "Call Brother Yang again and tell him that there is something wrong with me. , patients with liver cancer undergoing interventional embolization will be treated later.”
"No one in the hospital knows that something is wrong, and the operation will definitely be postponed. Let me ask you, how did you diagnose endometriosis?" Su Yun asked again.
"It's not difficult. It's just to judge whether there is no coagulation or coagulation." After watching the MRI, Zheng Ren confirmed his idea and let out a sigh of relief.
"Use CT to judge? Are you lying?" Su Yun felt much more relaxed and said disdainfully.
"CT can only guess, MRI is required. But it is enough to provide a reason for guessing. Look at the reason I gave, how good it is." Zheng Ren said with a smile, then stood up, "Let's go to the surgery. "
"Seriously, how did you tell?"
"Three years ago, a similar case occurred in a prefecture-level hospital in the south. The patient's family made a fierce fuss and demanded compensation of 10 million yuan. In the end, the spine surgeon performed an operation and determined that it was endometriosis, and the matter was settled. "Zheng Rendao. (Note)
"Why don't I have any impression?" Su Yun was surprised.
"I didn't let it be reported. I saw the case report in a medium-sized journal a year ago. I just thought about it at the time. We were looking at the film in the CT room before, and something didn't look right, so we looked for similar case controls." Zheng Ren smiled.
"Is the operation safe?"
"Big." Zheng Ren said.
"Your confidence is really touching." Su Yun said expressionlessly.
"It's just a small piece of endometrium. Be careful not to break your gloves when peeling it off. Once it is broken, make a small incision and the endometrium will appear on your finger..."
"It's so disgusting. Stop talking about it." Su Yun was startled and stopped in his tracks.
When he thought that Director Mao's fingers would hurt and bleed during menstruation, Su Yun felt that his whole body was not well.
"What are you thinking about?"
"Boss, you said endometriosis is contagious, why doesn't it cause rejection?" Su Yun asked.
"..." This guy's brain circuit is really weird.
But what he said seems to be right. The organ transplant operation is not difficult. The difficulty lies in the rejection reaction after surgery.
There aren’t many cases of endometrium growing on other people, but they definitely do.
Zheng Ren was also stunned. This seemed to be a research direction in organ transplantation!
1.36 seconds later, Zheng Ren smiled and said, "Concentrate on the surgery. This is a spinal surgery."
"Are you good enough?"
"As your boss, you have to be perfect in every way."
"cut."
The two of them walked into the operating room as they talked.
"Have you ever seen thoracic spine surgery?" Zheng Ren asked.
"I saw it twice, what's wrong?"
"You'll know it after watching it once. That's what you said. Don't be unable to keep up when the stage is set." Zheng Ren said lightly.
"Boss, don't put too much pressure on me. I'm only the third assistant at most, and you're just the first assistant." Su Yun said scornfully.
Zheng Ren shook his head slightly.
Arriving in the operating room, Zheng Ren saw that Director Mao had lost consciousness and was lying on the operating table, while Director Xu was performing tracheal intubation.
A leading professor from the Department of Orthopedics was waiting aside. After the anesthesia was over, they were about to get into position.
Holding his arms and watching the film, Zheng Ren went to the system operating room and started surgical training.
Because the orthopedic surgeon used a master-level skill book to perform hip replacement surgery in Nanyang, Zheng Ren was not in a hurry.
Just thoracic spine surgery...
…
After 15′22″, preoperative preparation is completed.
The hair director is in a prone position to maintain the physiological forward curvature of the lumbar spine. The leading professor of the Department of Orthopedics personally performed the routine disinfection of the surgical area and laid out sterile towels.
After brushing hands, disinfecting, and getting dressed, Zheng Ren and Director Xu of the Spinal Surgery Department came to the operating table.
"Boss Zheng, come here." Director Xu said politely.
"Director Xu, I'm just here to help you," Zheng Ren said with a smile.
"You're welcome. Dr. Richard from Massachusetts General Hospital recommended you to become a tenured professor at Massachusetts General Hospital." Director Xu smiled, "I studied for a doctorate at Massachusetts General Hospital. Richard is older than me and can be regarded as my senior brother.”
This kind of indiscriminate identification of brothers is often seen in small hospitals.
But in 912, everyone relied on their status, and few people said that.
But that was with doctors in China. Director Xu was on a high level, and Dr. Richard didn't know that he was not.
Zheng Ren smiled, "I thought Dr. Richard was joking, but I didn't expect it to be true."
"I asked about it and said that your hip replacement surgery was very good, and it was Dr. Su who assigned you the surgery. Today, I am just helping you and learning from it."
The two of them had already put on their clothes. At Director Xu's insistence, Zheng Ren stood in the position of the surgeon.
"Dr. Su, I am standing in the position of the first assistant, but I am not trying to be the first assistant." Director Xu smiled and said, "You have to pay full attention."
Su Yun was startled for a moment and nodded.
"Microscope." Zheng Ren said in a deep voice before opening the skin.
An anesthesiologist assigned to Director Xu quickly put a microscope on Zheng Ren, and the operation officially began.
Reaching out his hand, the lancet gently patted his palm.
A longitudinal incision of about 6 cm was made centered on the 8th and 9th thoracic vertebrae.
Cut the skin, subcutaneous tissue, and deep fascia, start blunt dissection, free the erector spinae muscles along both sides of the spinous process, and clean the soft tissue on the 8th and 9th thoracic laminae and transverse processes.
Generally speaking, the erector spinae muscles need to be incised, but Zheng Ren used blunt dissection in order to reduce bleeding. The advantage of this is less bleeding, but there are also many disadvantages.
Remove the inferior articular processes on both sides of the 8th and 9th thoracic vertebrae, and expose the origins of the ribs on both sides.
The intercostal veins and nerves of the corresponding ribs are separated and ligated.
The surgery was performed cleanly, including the position of the articular process. Zheng Ren did not bite off all of it. It was enough to expose the surgical field.
The damage will be as small as possible and recovery will be quick after surgery.
"Pay attention to the pleura." Zheng Ren said after ligating the intercostal veins and nerves and protecting the intercostal arteries.
As soon as he stretched out his hand, the heavy rib pliers fell on his hand.
Zheng Ren used rib pliers to cut off the ribs about 3cm outside the costovertebral joint, and removed the ribs from the cutting point to the costovertebral joint.
Zheng Ren then bit off all the vertebral pedicles and superior articular processes on both sides of chest 8 and 9 to expose the spinal cord.
The reason for biting off the bone was that the bone stump continued to bleed and the surgical field was somewhat blurry.
Su Yun used a suction device to suck blood and dipped gauze in the blood. Less than 1 second after the surgical field is exposed, the surgical field will be re-covered with blood.
…
…
Note: This is the initial reason for finding endometriosis. Please forgive me for not saying which hospital it is from like when I first opened the book. When writing this case, I was terrified for a while. There is no point in being cautious. Being a doctor is all about saving your life.