Chapter 609 Teamwork, Bone Grafting Success
In the operating room of the Traditional Chinese Medicine Orthopedics Department, upon learning that Li Quan was going to try to perform a thoracic vertebra replacement surgery on the patient, the top surgical doctors volunteered to complete this unprecedented and difficult surgery with Li Quan.
Jin Leiming from the General Surgery Department, Director Yin from the Neurosurgery Department, and even Professor Tang from the Internal Medicine Department all came with a shameless face, saying that they were here to help.
Actually I want to see it for myself.
The progress of human medical technology is all due to some bold doctors who dare to try new treatment methods.
Dare to challenge some methods that have never been used before.
Bone replacement is actually not uncommon.
Even many cosmetic surgery hospitals dare to perform this operation.
For example, rhinoplasty involves taking a small piece of your own bone or allogeneic bone and implanting it.
The ultimate goal is to make the nose straighter and better looking.
There is also surgery to replant severed limbs, which is actually equivalent to bone replacement.
"Director Li, are you really going to try this operation that has never been done before?" Jin Leiming's expression was very serious.
As a senior general surgeon, Jin Leiming has extensive surgical experience and profound knowledge in all aspects of surgery.
He always felt that although Li Quan's idea was feasible to a certain extent, it was extremely risky.
The key is that no one has ever performed a similar operation.
"I'm serious." Li Quan said with a firm tone.
"Whether this operation will be successful depends on whether our medical teams can work together. We will open the skull and take out the bones, and open the chest and take out the bones at the same time. For the sake of safety, my idea is this: Director Yin of the neurosurgery department will be responsible for opening the skull and taking out the skull. As for which part of the skull to take out, how big the area is, and how thick it is, I have already given you the data."
After Li Quan finished speaking, he looked at Director Yin.
"Director Yin, do you have any questions?"
"In order to ensure the success of this operation, I have brought the entire elite team of neurosurgery. My team and I will definitely go all out." Director Yin is already quite old, but it was because Li Quan used acupuncture to treat brainstem hemorrhage that made him and Director Chen famous.
Family members know their own business.
In fact, he and Director Chen have no outstanding medical achievements.
It's kind of bland and standard.
This time, Li Quan gave him an opportunity to write a medical legend. He was so excited that he tried his best to perform the operation.
"I feel much more relieved after hearing what Director Yin said!" Li Quan nodded and turned to look at Jin Leiming next to him. "Director Jin, you will be responsible for opening the chest of the patient with your team and creating conditions for me to take the bone. In order to prevent accidents, I have specially invited the chief physician and head nurse of the Department of Critical Care Medicine to come."
You must be fully prepared for this kind of surgery.
If the patient stops breathing or his heart stops beating during the operation, emergency treatment is necessary.
Artificial lung membrane can save the life of sick children at the critical moment.
“I have no problem with my team.”
Jin Leiming is also full of passion.
"Anesthesia can be started now. The patient's vital signs monitoring is now entirely in your hands." Li Quan said to the anesthesiologist .
"Please rest assured, Dean. I will be extra careful."
The anesthesiologist nodded solemnly.
People who work in anesthesia are generally ruthless and don't talk much.
"Hey, Dean Li, you can't be partial to one and look down on us old people! You have to arrange something for me, right? Even if it's just to help you with the surgery, or hand you a scalpel or tweezers, that will be fine!"
Professor Tang was unhappy.
"Let professional instrument nurses do things like handing over scalpels. Professor Tang is the mainstay of the internal medicine department of Huier Hospital. After the operation is completed, we will definitely need strong internal medicine support. Are you still afraid that you will have nothing to do by then?"
Li Quan couldn't help but feel a little funny.
Professor Tang is so cute.
"Well, that's more like it! Actually, I can also perform the surgery." Professor Tang wanted to participate more.
Li Quan did not agree this time.
After all, Professor Tang is a professional internist. As for surgical operations, although Professor Tang has a good foundation, he certainly cannot compare with a professional surgeon like Jin Leiming.
When it comes to interventional surgery in internal medicine, Professor Tang may be very professional.
However, Li Quan didn't dare to let him perform such a major surgery as thoracotomy.
"The patient's head has been shaved and skin preparation is complete!"
Director Yin and Jin Leiming reported at the same time.
"Anesthesia has reached the ideal state. The patient's heart rate, blood pressure, respiration, and pulse data are stable. The operation can begin." The anesthesiologists cooperated very well at the critical moment.
"Let's get started!"
Li Quan gave the order.
The atmosphere in the operating room was extremely tense. The palms of the attending physicians who came with their teachers to watch and learn were full of sweat.
As for the resident level, only a few particularly outstanding ones have the opportunity to be taken into the operating room by their teachers for observation.
…
About thirty minutes later, the patient's craniotomy was completed, and Director Yin was carefully removing the bone. Jin Leiming's team's thoracotomy was also completed, and the thoracic vertebrae could be seen.
It’s just that the growth of bone spurs is very tricky.
It grows on the inner side.
This also made it extremely difficult for Li Quan to remove the bones.
In the operating room, apart from the buzzing sound of the monitor, the only sound is the electric saw, which makes people's scalps tingle.
Li Quan carefully operated the electric saw to remove a small piece of the patient's severely diseased thoracic vertebra.
It can be clearly felt that this thoracic vertebra has developed osteoporosis.
This also reduced the difficulty of Li Quan's bone removal.
The heart and lungs nearby were temporarily protected with gauze .
Even so, Li Quan still walked on thin ice.
Even the slightest shake of the hands, or the use of too much force, may harm the heart and lungs of the sick child.
Normally, even using an electric saw to perform amputation on a patient would involve great risks.
You can imagine how high the risk is at this moment.
The nurse kept wiping the sweat from Li Quan's forehead.
Sweat contains salt and various bacteria, so it must not be allowed to drip into the patient's wound.
Otherwise, it is easy to cause infection.
It took Li Quan nearly an hour to successfully saw off the small piece of diseased thoracic vertebrae.
When he was done, he checked again to make sure that no part was missed.
All that's left is intact bone tissue.
After successful bone harvesting, the most important thing is bone transplantation.
In orthopedic surgery, the most common method for joining broken bones is to use titanium alloy rivets, metal plates, or locks to fix them.
Li Quan, a master of traditional Chinese orthopedics, does not need to use those things.
Just like when a truly skilled carpenter builds furniture, he never uses nails, but instead uses mortise and tenon joints.
"Grind down the bone spurs on this bone, and I will implant it into the missing part of the skull later." Li Quan said to Director Yin.
"OK!"
After Director Yin took it, he started working immediately.
Li Quan took the skull removed by Director Yin's team and examined it. The bone removal was very professional.
I actually compared the size and it’s just right.
Modern medical high-tech instruments do provide strong support for doctors to perform some extremely difficult operations with high precision.
From this operation, we can see that the era of doctors working alone is long gone.
The more complex and difficult the surgery is, the more it requires the close cooperation of one or even multiple medical teams.
The most critical person in these medical teams is Li Quan.
He is the marshal, and he commands and dispatches everything, and even needs to go into battle personally.
It looks like just taking a piece of bone, but it actually tests everyone's professional level.
First, Li Quan needed to estimate in advance how big a piece of skull would be needed. To be accurate to the millimeter level, and to be able to make such an accurate estimate based on the patient's photos before opening the chest, this is definitely not something that an ordinary chief physician can do.
Secondly, when Li Quan removes bones, he must ensure that the missing area after removal is consistent with his estimate.
This is a real test of Li Quan's skills.
Furthermore, the skull taken by Director Yin's team must be exactly the size estimated by Li Quan, which also requires very high skills.
It can be said that any mistake made by either Li Quan or Director Yin’s team would result in an imperfect operation.
The skull was too big to fit in and needed to be polished temporarily, which was very time-consuming.
The patient had both a thoracotomy and a craniotomy. This was not a child's game, he could die at any minute.
"Bring me the ointment I prepared!"
Li Quan said to the nurse.
When it comes to doing this kind of thing, Li Quan actually likes Hu Yue'er the most.
Because he has been working with Hu Yue'er for a long time, Li Quan doesn't need to say much when he wants something, Hu Yue'er will deliver the things to him in advance.
However, Hu Yue'er accompanied Sophie all night yesterday, and Li Quan felt sorry for her and gave her a day off so that she could go home and have a good rest.
"Open it and hold it for me." Li Quan continued to direct the nurse.
After opening the bottle cap, the smell of Chinese herbal medicine filled the operating room.
The smell is very light though.
This ointment looks a bit like gelatin and a bit like jelly.
It is not as black as chicken shit as the Black Jade Paste.
Li Quan had actually used this ointment once during the competition at Jiang's Orthopedic Hospital.
Its function is to glue the broken bones together and promote rapid healing of the broken bone ends.
In terms of efficacy, it is certainly not as good as the Black Jade Ointment, but it can be applied directly to the broken bone ends. And it has a strong adhesive property.
In fact, every medicine has its own uses.
There should be no panacea in this world.
Those medicines that claim to cure all diseases are basically scams or health drugs.
Li Quan brushed the ointment evenly on the skull.
Then he applied ointment again on the cut where the thoracic vertebrae were missing.
Next, carefully assemble.
It fits perfectly in the missing part, neither too big nor too small, and the gap is closed with only a thin line left.
"Okay, it's done. Check the gauze and instruments, and prepare to seal the chest." At this point, Li Quan finally breathed a sigh of relief.
From the formation of this idea in my mind to its implementation, it went more smoothly than I imagined.
It may also be related to the patient's age.
Thirteen or fourteen years old is the golden age for surgery.
Patients in this age group have good physical fitness and strong vitality, and both complications during surgery and postoperative recovery are very good.
"Has the bone spur on that thoracic vertebra been smoothed out?" Li Quan asked.
"Yes, it has all been ground down. There are more than twenty bone spurs, and the osteoporosis of this bone is very serious." Director Yin has been practicing medicine for many years, but this is the first time he has seen a bone that is so badly damaged.
"The skull is fixed, so there shouldn't be any problems after the implant. If it doesn't work, we can consider using medication to help the bone reach a more normal level."
Li Quan had already made a plan.
In fact, there is nothing wrong with the bone becoming like this.
The key is that it is in a moving part, which causes constant friction and stimulation, and eventually causes bone spurs to grow.
Moreover, the bone spur was located right inside the chest cavity and pierced into the lungs, posing a life-threatening risk.
If you implant it into your head, bone spurs shouldn't grow anymore.
After taking over the severely diseased thoracic vertebra, Li Quan compared it with the missing part of the skull and found that it was smaller.
There is nothing we can do about this.
In order to ensure that the skull fits perfectly into the missing part of the thoracic vertebrae, it was locked in place.
When taking bones, a larger area of skull bone should be taken, and a smaller area of thoracic vertebrae bone should be taken.
Because when an electric saw cuts bones, there will definitely be some damage.
Just like a ten-centimeter piece of wood, after being cut in the middle with an electric saw, the total length of the wood may only be nine centimeters left.
The lost centimeter turned into sawdust.
After Li Quan applied ointment on it, he implanted it into the missing part of the skull.
Only two sides can be aligned, and the remaining two sides have large and obvious gaps. There is no way to do this, and we can only wait until the patient's bones grow and the gaps are slowly healed.
This will take some time.
Normally, it takes about a month for bones to form callus.
It will probably take more than half a year, or even longer, for it to fully heal.
Bone growth is actually very slow.
It is not like muscles and skin, which can be fully grown in just a few days.
“Sew it up!”
After Li Quan installed the thoracic vertebra, he said to Director Yin.
…
After more than fifty minutes, the patient's head had been sutured.
Next, wake up from anesthesia and continue to monitor the patient's vital signs.
Heart rate, breathing, pulse, etc. are all normal.
At this time, Li Quan could finally let out a long breath, and his heart, which had been hanging in the air, finally settled down.
The operation involved multiple medical teams and was innovative in nature.
The significance is very important.
Next , you need to wait patiently.
Observe the patient's subsequent recovery.
Li Quan has great confidence in the patient's prognosis.
Should be able to return to normal state.
At that time, you can consider writing an international-level orthopedic medical paper.
"Okay, thank you for your hard work! Send the patient to the intensive care unit first and observe him closely for a week. If there is no obvious abnormality, he can be transferred to a general ward for recovery. Be sure to explain to the patient and his family that the skull will not heal in a short period of time, so it is best to wear a protective half helmet."
Li Quan did not use any alloy rivets or steel plates, saving a lot of money for the patient's family.
I guess there will be a lot left out of the 200,000.
Of course, what we have to pray for now is that the patient can recover smoothly after the operation without any rejection, complications, infection, etc.
Li Quan walked out of the operating room and found several missed calls on his mobile phone.
It was Officer Han calling.
I don’t know what it is, I have to go back and ask.
It is probably related to the criminals who kidnapped Sophie.
