I don’t know about other industries, but as far as the medical field is concerned, the difficulty is to formulate a postoperative follow-up visit and expected big data, but the human body is too complex. Without a large-scale test base, the possibility of trying to figure it out is too slim. But this matter is too expensive, and there is no substantial economic benefit, so!
Moreover, the payback period in this industry is too long. You have to endure it when you are the youngest and most short of money. Most industries also need to endure, but the time for this industry to endure is a bit too long. Five years of undergraduate study, three years of transfer, and five years of hospitalization are still the smoothest. It is only when you are a doctor that you have a bit of a foundation. However, during this period of time, a lot of people have passed away.
Then a large number of medical students flooded into the civil service, and some medical students worked as pharmaceutical agents and other industries. No matter how much they hate or hate this industry, in the dead of night, they will definitely miss him in his white coat!
The sense of accomplishment between life and death is so beautiful! With every rescue, the adrenaline surges like a roller coaster. To snatch a person back alive from the hands of death. It's a really hearty feeling, and it's addictive.
"Director, prepare for bone grafting." Zhang Fan split the spinous process and turned to Lao Gao and said. For a small bone defect, osteoblasts will slowly fill it up. If it is such a large defect, it cannot be filled.
"Okay!" Lao Gao placed the automatic retractor. I went to the sterile table next to the instrument nurse and started preparing the allogeneic bone needed for bone grafting.
For bone grafting, the best bone quality is actually the patient's own bone, but Bart is too small and cannot be removed, so allogeneic bone can only be placed.
"Doctor Zhang, let me wipe the blood for you." Although Zhang Fan's chop was very accurate and gentle, a lot of blood still splashed on Zhang Fan's face and eyelids.
This kind of surgery is slightly better. If you do a knee replacement surgery, it will be all flesh and blood. Generally, when doing a knee replacement surgery, the surgeon must wear glasses like windproof glasses. Because the femur, the thickest bone in the human body, needs to be cut, when the cutting machine cuts, the bone marrow, blood, and a small amount of soft tissue will splash out directly with the cutting machine.
The circulatory nurse dipped the chlormethionate solution in and gently wiped off the blood on Zhang Fan's face, "Okay, Doctor Zhang."
"Yeah!" Zhang Fan said without even bothering to thank him. This kind of surgery would cause too much damage and he needed to hurry up.
How is this surgery performed? It is actually simple. It is to separate the deformed bone fragments that are connected up and down.
Then, adjust the position. Then place fixed alloy instruments from the upper and lower bone fragments. Then the deformed spine is slowly corrected through this alloy instrument.
"Vertebral hook." Zhang Fan said to the surgical nurse after cleaning up the bone fragments in the surgical area.
At this point in the operation, two hours have passed. Now is the time to place the titanium alloy instrument, and everything done at this time must be confirmed three times.
Because at this time, once the device is implanted, there is no way to modify it. If a mistake is made at this time, the operation will directly fail. There is nothing you can do to make up for it. The human spine is only such a big place. Once something goes wrong, trying to do it all over again is just a dream.
Up and down the spine, several curved spines, began to place corrective devices. What does it mean? In layman's terms, it's quite simple, such as a curved sapling.
To correct it, first drill a hole in a relatively straight place and put in a nut with a hole. This nut is the root hook. Then drill a nut with a hole in the middle, lower end and bottom of the sapling, or directly The only thing is to make a hole in the ground.
Then use an iron rod to pass through the hole on the upper end of the nut from the uppermost end until it reaches the ground, and then tighten the nut. In this way, as the sapling grows, the curvature becomes smaller and smaller, and finally becomes straight.
"Director Wang, help me support you." Zhang Fan took the vertebral hook and placed it on Bart's pedicle. The vertebral root hook is actually like a screw with a spiral, which is similar to the expansion screw commonly used in daily life, and there is a buckle connected to the top of the screw. A snap like a question mark.
The tool that holds this buckle is like a wine corkscrew, but this one is not for pulling out, but for drilling in. "Doctor Zhang, let's get started." After Lao Wang grabbed the nailer, he confirmed it for Zhang Fan.
"Okay, I'm starting." One, two, and three times. The thickness of the bone is different, and the number of turns is different. This is not wood or bricks. It cannot be turned casually. Once it is turned, the spinal cord is inside.
One lumbar vertebra, two lumbar vertebrae, three lumbar vertebrae, up to seven. An imported screw like this costs several thousand. Titanium alloy, because this metal is relatively stable in nature, it is not prone to electrolysis in the body and is not prone to infection.
Installing the screws is not a very laborious task, but just like that, Zhang Fan's sweat has soaked into the washcloth. If the surgical gown hadn't been extremely thick, it would have been soaked through.
The most laborious work has come. Orthopedic implant rod, the implant rod is a straight titanium alloy rod. The hardness is unknown, but this is probably the hardest metal Zhang Fan has ever seen.
Because the spine is inherently curved, now the implant rod must be corrected to a certain curvature, a specific curvature, a curvature that allows the spine to develop toward a normal physiological curvature. Why are there so many other female surgeons? Orthopedics is indeed very rare, because there are so many tasks in orthopedic surgery, not to mention women, even men with weak bodies and weak strength can't do it.
Orthotics are not fancy things, especially this kind of metal orthosis. They are very simple. They are three fixed circular iron pillars placed in a triangle shape on top of an iron lump.
"Dr. Zhang, I'll do the early correction, and you'll do the fine-tuning later. You've already had more than two hours of surgery." Xu Xian spoke.
"It's okay. I'll come!" On the operating table, Zhang Fan was too alone. At this time, let alone Xu Xian, even Lao Gao, Zhang Fan was worried.
"Don't worry about it. He doesn't trust anyone at this moment." Lao Wang understood Zhang Fan. Doctors are like this. They can only feel at ease if they do what they do.
Zhang Fan took a titanium alloy rod about ten centimeters long and put it into the orthosis. Xu Xian grasped the orthosis with his hands, and Zhang Fan held the two ends of the titanium alloy with a rongeur in his left hand and a rongeur in his right hand.
"Have you caught it yet?" Zhang Fan asked Xu Xian.
"alright."
"Hey!" As Zhang Fan made a dull sound from his nasal cavity, the titanium alloy rod began to bend visibly to the naked eye. It was really bent alive.
This kind of orthosis is extremely laborious. First, it needs to be corrected to a certain arc. Once the expected arc is not achieved the first time, it will be more laborious to fine-tune it later.
If you use too much force, it will be too bent, but if you use too little force, it will not move at all. And the number of times of correction should not be too many, because metal has a certain fatigue level. If you do repeated violent corrections, although it cannot be seen with the naked eye, in fact, the metal is no longer good. After it is installed, it will not take long before it breaks!
Therefore, one-time molding is best, which requires considerable familiarity with force control and understanding of this material. Zhang Fan suppressed his blush and bent the titanium alloy rod in one breath, and the bend was very beautiful, in line with the expected arc.
Zhang Fan held a slightly hot titanium alloy rod and made gestures on his lumbar spine. Although it felt appropriate to the naked eye, he still made gestures. At this time, those who directly put it on without any gestures would be sticks, but if it was really sticks, I guess this operation would not be possible.
Zhang Fan was making gestures, but Xu Xian was stunned. "This guy is not very strong. Why is he so strong? He is really a beast! Such a thick rod can be corrected in one go. It seems that I will have to go to the gym to lift irons in the future."
Lao Wang and Lao Gao were both used to it. They looked at Xu Xian a little stunned. Lao Wang smiled evilly and then asked: "Xiao Xu, do you have a partner?"
"Oh! We have a director."
"Look at Zhang Fan, he's so powerful!"
"Uh!" Xu Xian sweated. The operation went smoothly. Lao Wang couldn't help but want to talk. Zhang Fan was so annoying that he almost didn't talk during the operation. It was so difficult.
Zhang Fan glanced at Old Wang and said nothing. The old man was so bored. The head nurse is a little excited today, otherwise an old man paired with a young woman would be annoying to death.
"Zhang Fan, see if it fits." Lao Gao handed the repaired alien bone to Zhang Fan. Zhang Fan looked at it and said, "Just right." Normally, Zhang Fan would definitely praise him, but once he went into surgery, Zhang Fan seemed to have changed into a posture of not letting strangers in.
Zhang Fan took the allograft bone and gently shook it one screw after another. Although he installed it himself, this final check must be indispensable. If you forget this step, well, the surgery is the torture time.
It can take as little as a week or as long as a month, and I can probably dream about screws falling off every day.
"Add the implant rod and fix it." Zhang Fan said this, and several people involuntarily straightened their bodies. This is the most critical step in the operation. Zhang Fan gently inserted the orthopedic implant rod from the first fixing nut to the last nut. The correction was very successful, as if it was tailor-made for Bart.
Then gently and steadily turn the nut driver counterclockwise until the nut feels in place, and then tighten clockwise to prevent the nut from slipping. Tighten one by one, and finally use extra force to push the implant rod card into the top of the hook.
OK, the placement of the implant rod is completed. Is the operation completed? No, this is only half done. If you want to pull the deformed spine over, you must insert such instruments on both sides.
This is just like a curved small tree. Pulling on one side can pull the curvature over, but there is also a risk of breaking the small tree. The best thing is to put one on the opposite side to counteract the pulling force.
After installing the screws, Zhang Fan confirmed it again, and then said to Lao Wang: "Come on, Director Wang, let's change positions." On the operating table, especially for this kind of flat surgery, usually one assistant stands on the surgeon's side. opposite.
Now he has to do another side, so Zhang Fan has to change places with Lao Wang. When Lao Wang saw that Zhang Fan had already set the position, he originally wanted to say: Let me do it, but he looked at Zhang Fan's wolf-like eyes and did not speak.
After all, he was a director, but Zhang Fan refused when he opened his mouth. Isn't he ashamed? So without saying much, he started to change places with Zhang Fan.
For doctors themselves, this sterile area is actually defined as follows: below the neck, above the laces of the surgical gown is the sterile area, and from the hands to the shoulders is sterile. Once you have surgery, regardless of whether you are contaminated or not, the rest of the area is considered a contaminated area.
What does a surgical gown look like? It is actually made of a particularly thick fabric in the shape of a raincoat. When worn, it is reversed, that is, the buttoned side of the raincoat is on the doctor's back. However, there are no buttons on the surgical gown, it is all fixed with cloth tape.
Generally, it is recommended not to move around as much as possible during surgery. If it is necessary to change positions, it is not done at will. The two people must change positions back to back when they meet. Novice doctors are often scolded by operating room nurses for violating aseptic practices in the operating room.
Once the position is fixed, it is much faster to fix this side. Repeating the above steps, the operation was finally completed four hours later. Zhang Fan looked at the spine fixed by titanium alloy and smiled softly.
Because he seemed to have seen Bart grow up. As strong as a mountain, with a straight back!
"Rinse!" Xu Xian took over Lao Wang's place and helped Zhang Fan rinse. With the experience last time, Xu Xian no longer asked for sutures.
It's not necessary. I wanted to replace him, but this guy was so afraid that he would take the credit that he wouldn't even allow him to be stitched. He was stingy! Xu Xian glanced at Zhang Fan and cursed in his stomach.
Outside the operating room, Bart's mother and grandmother were silently chanting and looking forward to it, while Bart's father kept walking in the corridor. Check the time on your phone from time to time.
This feeling, especially for parents. Really, not ordinary anxiety. One moment, they are looking forward to the success of the operation and the child can come out jumping. The other moment, they are worried about the failure of the operation and what they should do. Their hearts seemed to be shrinking together, and they didn't dare to take a big breath. I am deeply afraid of affecting the doctors who perform surgeries in the operating room.
"Bart's family!" The head nurse felt much better at this time. After the operation, the family members must be informed. This is usually the job of the nurse, but today she rushed to do it.
"I am! I am!" Bart's father strode over.
"I'm Bart's mother! Doctor, I'm his mother." Bart's mother, who had been sitting on the stool for a long time, staggered over.
"Bart's surgery was completed. It was a success. He has been sent to the ICU now. You can visit him alone tomorrow morning at the specified time." After saying that, he added: "Don't worry! It's okay."
With just this sentence, Bart's parents' hearts dropped in mid-air. "Thank you! Thank you! Doctor, thank you!"
"I'm a nurse. You're welcome. Keep your voice down. There are others operating. Okay, let's go." The nurse entered the operating room. He returned to the operating room with light steps.
"Bart has finished the operation. Let's go back." The old grandmother with deaf ears dropped the rosary beads in her hand and looked at Bart's parents with trembling toothless lips. Bart's mother supported her mother-in-law and said One sentence.
"Done? Where's Bart? Why didn't he come out? Don't lie to me! Where is my grandson?" The old lady watched the nurse come out and then go in. Now her daughter-in-law said this again.
The anxious old lady shed turbid tears and grabbed Bart's mother to fight for her grandson.
"Mom, I really won't lie to you!"
