Fear, for adults, there are too many things that can bring fear to them, such as riding in a small plane that is as bumpy as a tractor. A child's biggest fear is leaving his parents.
Bart was lying on the flatbed, antibiotics hanging from one hand. The surgery was so big that intravenous antibiotics were routinely administered one day before the surgery. The other hand was tightly grasping the corner of the hospital gown. Although he was covered with a quilt, his body was still clearly flexed and curled up. He tilted his head and looked pitifully at his parents who were far away with his big innocent eyes. I wanted to cry, but I looked at the two sisters in white coats next to me and didn't dare to cry.
The surgical trolley disappeared at the end of the corridor. Bart's mother didn't know what to do. Her hands were shaking and she didn't know where to put them. She kept crossing them and rubbing them, mumbling in her mouth.
Huaguo Hospital only needs to go to comprehensive level three. There is a pattern, there are three super departments, general surgery, respiratory department, and orthopedics, and many hospital leaders are from orthopedics. Then there are various high-end orthopedics, but the strange thing is that such a high-end place cannot even connect a little finger.
Zhang Fan was already waiting in the operating room. Bart was the patient in their group. Wang Yanan was originally supposed to be put on the operating table, but the girl was feeling a little uncomfortable these days, so Xue Fei was put on. I don't know what kind of deal he had made with Xu Xian in private.
Xu Xian happily entered the operating room, took a look at Director Gao, and then said to Zhang Fan: "Doctor Zhang, I will be the third assistant in this operation, is that okay? Teacher Xue has a little diarrhea."
Before Zhang Fan could speak, Lao Gao said, "He's itchy again. Why don't you think he's made any progress at all?" Zhou Chengfu left. Although he left quietly and silently, Lao Gao was still a little sad. .
Xue Fei and Zhou Chengfu were the disciples he brought out during the most difficult time. They were not his biological sons, but they were the two with the deepest affection. The scene of the three of them hugging each other for warmth was still vivid in my mind. But now, one leaves the master for his own future. And the other one is just out of tune.
Although Zhang Fan could be considered his disciple, he always felt that there was something missing about Zhang Fan. Perhaps what was lacking was the training process. Zhang Fan got up so quickly that he almost looked up before he even noticed. So when talking about Xue Fei, Lao Gao gritted his teeth.
Everyone knew what was wrong with Xue Fei, and Zhang Fan couldn't explain it even if he wanted to. Xue Fei was definitely not in the department at this time, and he might have been playing mahjong with his aunts.
"Xiao Xu, which major are you in?" Lao Wang asked happily and with a smile. He feels proud when Lao Gao's disciples fail to live up to expectations. Compared to Lao Gao, his disciples are much more powerful. Each of the several attendings is more powerful than the other, but they cannot be compared with Zhang Fan!
"Director Wang, I graduated from the Department of Spine Orthopedics." Xu Xian was already standing with Zhang Fan watching X-rays and MRI, but as soon as he heard Lao Wang's question, he quickly turned around to answer.
"Oh! Department of Spine and Orthopedics, which hospital assigned you to the Department of Orthopedics and Joints? Isn't this a waste? It's inappropriate. I have to ask."
After Xu Xian became a doctor, the orthopedics department was divided into three, so this happened. When Lao Wang said this, Xu Xian couldn't answer the question.
Xu Xian was down-to-earth and capable, so of course Lao Gao couldn't bear to part with him. He rolled his eyes at Lao Wang and said, "What's inappropriate? He is an orthopedic surgeon first."
"Take the patient number!" the head nurse's voice came over. The head nurse in the operating room helped the circulating nurse bring Bart in. "Kid, don't be afraid, it won't hurt at all. You'll be fine after you sleep." Then he gently touched Bart's little face, where the hair and goosebumps stood up.
Little Bart was lying on the bed, holding the head nurse's hand tightly with his non-injected hand. Even though the head nurse is usually very devilish, she really has an affinity for children.
"Sister! Don't leave!" After the head nurse arrived at the place, she was going to say a few words to Zhang Fan and the others. As a result, after coming out of the ward, Bart, who had been silent until now, spoke with a red face.
"Oh, haha, be good and obedient, sister, don't leave." The head nurse was really happy that such a pure and innocent child could call her sister. She was so happy that her heart blossomed.
Although Bart was as nervous and scared as a little lamb, the gentle words of comfort from the head nurse were the only thing he felt he could rely on in this strange and strange place.
He put his little hand into the quilt, and then took out something tremblingly, "For you, Bishi!" Bart took out a bone that seemed to be some kind of animal from somewhere, and it looked a little jade. It looked like It is Bart's favorite thing.
Bart's pure eyes were like clear springs. The young female head nurse, who had gone through countless hardships, suddenly felt a sore nose and burst into tears.
"Thank you! Sister, I don't want it."
"Sister, take it! Stone, bless you."
"Yeah! Take it, sister, take it! You will be my brother from now on." In a strange environment, although he didn't know what surgery was, he also knew that it was not a good thing.
Innocent, pitiful but with very sincere eyes, it directly impressed the head nurse who was the most influential person in the operating room. "Hey! What is missing makes it valuable. The sincerity in the children's world is so precious in the adult world." Lao Gao also felt a little deeply.
"Yes." Lao Wang nodded involuntarily. The head nurse took the wolf bone stone that Bart gave her, and held Bart's little hand with her other hand. She couldn't stop crying until Bart was slowly anesthetized and fell asleep!
"I'm going to wash my face. Zhang Fan must be careful!" the head nurse said to Zhang Fan specifically while standing in front of the operating room door.
"Don't worry!" Zhang Fan nodded. The circulating nurse helped Xu Xian disinfect, while Zhang Fan, Lao Gao, and Lao Wang brushed their hands. Lay out the sheets, cover the hole with towels, and everything is ready.
Zhang Fan put on gloves, took the scalpel handed over by the instrument nurse, and wiped the skin to be incised with an alcohol cotton ball. He turned around and looked at the clock hanging on the wall of the operating room, and said softly: "The operation begins."
Bart is lying on his stomach. There is a special operating bed for this position. Many people have gone to the large bathhouse to take a bath or have a massage. It's the kind of bed with a hole at the head of the bed so that your face can be put down.
Zhang Fan is the chief surgeon, Lao Wang is the first assistant, Lao Gao is the second assistant, and Xu Xian is the third assistant. The air pressure during the surgery performed by Zhang Fan was relatively low to begin with, and having Little Bart come for a while before the surgery made the atmosphere even more gloomy.
No one has the desire to speak. This may be the tragedy of adults! Simple things are luxuries that can no longer be obtained.
The scalpel opened an opening in the tender skin, and instantly a white line was opened on the skin, which is the dermis. Then the handle of the knife opens the subcutaneous tissue. Then change the electrosurgery and start to stop the bleeding.
Surgery, as long as it is a traumatic surgery, must be carried out layer by layer according to the physiological level, and the bleeding must be stopped layer by layer. Experts, especially surgeons who pay attention to details, look at their surgical operations as if they are art.
It was clean, neat, well-organized, and the anatomy was clear. There was almost no bleeding in the entire surgical field. And some doctors who are not very skilled do not know whether they are pursuing speed or do not understand anatomy. The layers were unclear, and the field of vision was full of bleeding. It really looked like a slaughterhouse.
Continue to extend inward to expose the spinous process, incise the supraspinal ligament, and then gently separate the incised ligament to both sides. "Periosteal stripper." After the bone was leaked, Zhang Fan said softly.
The surgical nurse accurately handed the periosteal stripper into Zhang Fan's hands. On the operating table, there's something special about passing things around. When passing sharp tools, such as knives and scissors, you should point the sharp edge towards yourself.
When it is passed to the opponent's hand, you must make a downward movement until the opponent makes a counterattack and then you can let go. Many nurses have to practice this detail many, many times. Is it simple? It's simple, but you must practice this movement into a subconscious movement and let your muscles have memory to be qualified.
This is not to be harsh, as there is nothing to be thankful for on the operating table. Some special equipment may only be one. If it falls to the ground during delivery, it will be an accident.
Zhang Fan used a periosteal stripper to stick closely to the spinous process, and pushed the thoracic paravertebral muscles from under the periosteum to the tip of the transverse process, and stopped when the lumbar spine was exposed outside the articular process.
"Gauze!" Lao Wang stared at Zhang Fan's movements intently. Not to mention other things, lumbar spine surgery causes a lot of bleeding. Humans have evolved very advanced. As long as the bones are surrounded, they will be accompanied by large blood vessels and important nerves.
The spine not only supports the body, but also protects the brain, so there are many large blood vessels. During the operation, large blood vessels can be avoided, but the small blood vessels branching off from the large blood vessels cannot avoid being destroyed.
When performing surgery, it is important to have both eyes and hands. When the surgeon gives an order, everyone else will act without thinking. For example, at this time, there were two bleeding places in the lumbar bypass.
Zhang Fan simply said: "Stop the bleeding." Which one to stop first, which one to stop last, how to stop the bleeding, whether to use gauze or electrocoagulation knife, these are all rules, these are all rules and regulations, this is all knowledge.
And both assistants and nurses must watch the surgeon's steps.
After Zhang Fan took the gauze handed over by Lao Wang, he began to compress it. During the operation, a lot of bleeding did not leak but seep out. When the muscles were separated from the bones, blood oozed out like sweating. At this time, the bleeding could not be stopped with electric knife or silk thread. This requires gauze compression to stop bleeding.
Moreover, the gauze used during surgery cannot be dry gauze. It must be soaked with physiological saline before it can be used. This is not a bandage. If Zhang Fan were handed a piece of dry gauze at this time, Zhang Fan could directly drive away the assistant and the equipment nurse. Because the tissue under the skin is so delicate, dry gauze acts like sandpaper.
"Retract it." Zhang Fan said to his assistant after stuffing gauze.
They are not novices, they have been prepared for a long time. As soon as Zhang Fan opened his mouth, Lao Gao and Xu Xian used retractors to pull the skin apart, exposing as much of the surgical field as possible.
Retractors are what surgical residents, especially general surgery residents, fear most. What does this thing look like? It is an L-shaped blunt alloy. It is very hard and ordinary people cannot deform it.
The orthopedics department is a little better, but the general surgery department is really miserable. The large retractor is probably the same size as the flexion of an adult's arm. During surgeries such as gastrectomy, the second and third assistants do one thing from beginning to end, pulling the stomach with steady force.
The surgical site is too deep. They couldn't see that during the four or five hours of surgery, they were just pulling on the patient. If the surgery was not good, the surgeon would not be happy. After one operation, my hands and arms could no longer move.
After the surgical field of view is opened, the critical period of the operation begins. This is the time when the skill of the surgeon is reflected. How to adjust, how much to adjust, this is too difficult.
In terms of imaging data, looking at the spine and looking at the spine with the body open are completely different things. From the image data, you still have an overall concept.
The surgery only opens the few areas that need to be adjusted, which are no more than a dozen centimeters in length at most. The anatomy is not clear, or the technique is not in place, and the bones to be adjusted cannot be found.
This is no joke, let alone the spine. Just a simple plate removal surgery after clavicle fracture surgery. Before the surgery, the clavicle and steel plate could be felt directly on the skin, as if they were just a little under the skin, and it seemed very simple.
But the reality is that when the surgical sheet is laid out, the drape is covered, and the scalpel is pulled, the subcutaneous tissue swells, then bleeds, and the muscles are stretched. All right! What about steel plates? Can't find it! This has happened to many doctors.
What Zhang Fan has to do now is to change this deformed whole or let it grow in the expected direction in the future.
Then you must first destroy its original connection. This is very dangerous because the spinal cord is in front of the spine. This position is fixed and does not change because the patient is lying on his stomach. For example, the skin on the back should normally be in front of the spine, right? In fact, the professional terminology on the operating table does not say this, but just the opposite.
Time has passed slowly for more than an hour, almost two hours. Zhang Fan and Lao Wang were sweating like beans. They couldn't even wipe it off during the tour, so they put towels directly on their foreheads.
The rongeur is the sharp-nose vise that everyone uses on a daily basis. Zhang Fan bit open the bone bit by bit, and then used a curette to remove all the bone fragments, cartilage, and soft tissue between the spine bit by bit.
Clean here must be clean. Because once a small bone fragment enters the spinal cord, the patient may suffer from postoperative inflammation, or suffer from lifelong lower back pain or numbness in the corresponding limbs.
Take care of this. Now comes the most dangerous step of the surgery. At this time, the position needs to be adjusted. Before adjusting the position, these abnormal bone fragments must be separated first.
How to separate them? Anyone who has eaten animal spines knows that the spinous processes of the spine are stacked together. To separate them at this time, they have to split them, yes, forcefully split them. At this time, it cannot be taken lightly or taken seriously.
If it is too light, it will not break apart, and it will cause more fragments of the bone. If it's heavy, the front is the spinal cord. "Ka! Ka!" Zhang Fan gritted his teeth and split the spinous process in two strokes.
Zhang Fan didn't realize how difficult it was, but Lao Gao and Lao Wang, the sound was like cutting on their hearts, and their hearts were hanging. If at this time, your hand slips or you exert too much force, the consequences will be unimaginable.
Xu Xian was also sweating, even though he graduated with a master's degree. But this kind of surgery is one of the most difficult in provincial hospitals.
