Chapter 264 The sexy operation begins! (Please subscribe!)

Zhou Cheng carefully separated a section of the blood vessel and saw that the shape of the blood vessel was already in a state of severed segments.

Thinking back to the general picture he saw on the ppt before, Zhou Cheng really used his hometown dialect to describe it in his heart.

One leg was numb and torn.

Zhou Cheng had some pain in his head and the operation was temporarily interrupted.

Opposite Zhou Cheng, Li Xuande did not blame Zhou Cheng, but said with a deep heart: "The condition of the blood vessels is very worrying. Maybe our previous estimate of the wound was conservative. The previous blood oozing was not from the muscles.

There is leakage in the blood vessel segment, but this kind of blood vessel segment."

The condition of the blood vessels was not caused by Zhou Cheng's operation. On the contrary, it was very difficult for Zhou Cheng to be able to find the blood vessel segments from the muscle tissue so quickly.

(Note: A little popular science experiment, you can buy pork in every household. There are nourishing blood vessels in the pork muscles...)

"Xiao Zhou, do you want to go out and discuss amputation directly with the family?" Li Xuande quickly calmed down.

They worked hard, and they did their best. From ten o'clock to three o'clock in the morning, five hours were used for debridement, carefully peeling out all the debris inside one by one, and connecting the soft tissue bed.

Well, we also asked a vascular surgeon to suture the larger blood vessels.

But sometimes, hard work may not necessarily lead to very satisfactory results. Learning to face all disasters honestly and letting yourself go is also a kind of salvation for yourself.

When your manpower is limited, there is no need to worry about everything. Even if such a thing falls on you, it will still be the same. When you make things difficult for others, you may not be happy, but others will definitely be miserable.

Zhou Cheng knew that this was not Li Xuande's original intention. If he didn't want to do it for this college student, he would have amputated his leg long ago. However, since he has worked hard to reach this point and everyone has stayed up late for so long, he still needs to work harder.

He raised his head and said, "Professor Li, let's take a look at the specific situation inside. I've only just begun. It's just that you have to work hard for a while."

Li Xuande smiled and didn't care: "It's time to get through it anyway."

At this point, everyone understood what the other person meant and tried their best to make the final struggle.

Then, Li Xuande saw that after Zhou Cheng put the tiny forceps inside again, he took out another blood vessel segment. It was still bloody inside, and the blood vessel wall was broken and rotten.

However, Zhou Cheng did not give up and continued to take out such blood vessel segment tissue from other places.

This crushed soft tissue is really shocking. The blood vessel segments inside are all crushed like this, which is a bit too scary.

Even after Zhou Cheng took out the vascular tissue from three muscles, it was still the same.

Li Xuande felt that it was better to look at it first and not to make things more difficult for Zhou Cheng: "Xiao Zhou, please stop the operation. I will go and talk to the family. This leg cannot be saved. If it is saved, it may be useless."

Recognizing the limitations of modern medicine and knowing how much human power is when manpower is limited is an essential basic skill of modern medicine.

Li Xuande felt that it was better to let Zhou Cheng go. With such an organizational structure, not to mention how to rebuild the blood supply was a difficult problem. Even if it was rebuilt, it would still be a useless leg and could not function.

Zhou Cheng's ability and strength have reached a limit, but this limit cannot reverse the consequences of the current trauma. This is a living and cruel reality.

Li Xuande is the supreme controller of this operation, and he has absolute decision-making power.

This time, it was Zhou Cheng who reached out to stop Li Xuande, who was about to step down, and said, "Professor Li, wait and see, there may not be anything we can do."

Zhou Cheng's mind was spinning rapidly, and then he asked: "Professor Li? Has this patient discussed the possibility of making an incision on the healthy side of the limb before the operation?"

Li Xuande's movement to step down was stagnant, and he asked slightly confused: "Xiao Zhou, what do you want to do?"

As the Chief Director of Orthopedics and the Director of Trauma Surgery at Renji Hospital affiliated to Jiaotong University in Shanghai, it is his goal to bring up the strength of Renji Hospital’s Department of Orthopedics. However, at the same time, Li Xuande has the responsibility and courage that a Chief Director should have.

Not lacking.

He did not personally interview the family members, but he could instruct someone to do so, but he had to know Zhou Cheng's specific ideas first.

"The unaffected limb has rich blood circulation. Even if I remove several arteries, I can still provide blood supply by rebuilding collateral circulation."

"The nutrient arteries we take out can be used as a vascular bed between the muscles on the affected side to provide arterial use. It will not affect the condition of the patient's healthy side and is the best substitute for the nutrient arteries." During the operation,

Don't say too much, but express your meaning appropriately.

Therefore, Zhou Cheng only told half of the story and left the other half in vain.

But what kind of person was Professor Li Xuande? He immediately understood what Zhou Cheng meant. Blood vessel transplantation was a nutrient artery transplantation. Likewise, it was an intramuscular vascular reconstruction.

Vascular arterial transplantation is a combination of blood vessel suturing and cutting, and it is also a variant, and reconstruction surgery is still the same. However, most of the surgeries performed by vascular surgery are on large blood vessels, and there is no time to take into account small arteries.

Such an operation is not difficult in principle, but it is extremely difficult to find such a small artery. Finding the complete anatomical structure requires a lot of patience, and the transplantation process is even more unimaginable.

Such a difficult technique is something people can imagine, but is it possible for people to complete it?

It is theoretically possible to build a tall building that reaches directly into space, lay tiles on the Great Wall, and fill the sea with sand, but the amount of work is huge and requires very detailed micro-operations.

When Zhou Cheng was speaking, the hand of the chief resident standing directly opposite Zhou Cheng shook. He was really frightened by Zhou Cheng's thoughts.

His eyes were a little bulging, and he sniffed inexplicably, and then he immediately came back to his senses, tightened his hands, and looked carefully at the surgical field, for fear that his unnecessary activities just now would cause irreversible damage.

Fortunately, Li Xuande was a battle-hardened man and had seen a lot of things in the world, so he turned to look at the chief resident and asked, "Xiao Fu, have you discussed this before?"

The name of the chief resident is Fu Qiangxue. His Adam's apple rolled up and down twice as he swallowed: "I didn't talk about it specifically, but I told my family that we can't rule out taking bone from the unaffected side for bone grafting."

And tendon harvesting for tendon transplantation."

"If necessary, I can go out and talk again."

This is an operation method that Fu Qiangxue could not even imagine. How could he predict things so well?

The operation Zhou Cheng is proposing now is an impossible surgical technique within theory and outside of operation. Is he a god? Can he predict it.

"Then you go out and talk later!"

"Xiao Zhou, let's make a muscle first to test the possibility and operability. Which one is more suitable to take first?" Li Xuande immediately made a decision.

He is a professor-level doctor. When this patient was brought in, he had no immediate family members and his condition was urgent. Therefore, the chief on duty gave the order to operate immediately. When encountering difficult operations, he has a certain degree of authority to perform operations first and then perform operations.

of.

Otherwise, what should we do if the patient's family members fail to arrive? Naturally, if we don't go out to talk at this time, we still don't want to give too many expectations to the patient's family members, lest they be even more disappointed and have violent mood swings.

Zhou Cheng understood what Professor Li Xuande meant. If you can do this kind of thing, do it. Don't do it.

Since you have such an idea, let's try it first. If it can be established, then go and talk to the family members. If not, just ampute the leg from the thigh and cut it off to save your life!

Zhou Cheng said without hesitation: "Professor Li, otherwise, the impact force of this patient should be from the front, so the vasa vasorum in the biceps femoris muscle at the back may be relatively intact."

"Let's take one of the inner strips and rebuild it to test it out."

The feasibility of the experimental operation of removing the affected side first was below the amputation range and would not cause unnecessary wounds to the patient. Naturally, Zhou Cheng would not embarrass Li Xuande.

"This is the best." Li Xuande took a deep breath.

If the leg is not saved and the healthy side is cut, it is not easy to explain to the patient's family. Although it can be explained that it is an effort to save the limb, it can be avoided and should be avoided as much as possible.

The patient's injury was destructive, and the quadriceps muscle was almost to pieces. This was after being rested, so the biceps femoris muscle behind the femur was naturally exposed.

It was cut by the fractured fragment of the femur and has not been sutured yet. Because the blood vessels in the upper segment are clamped, there is not much blood leakage, but there is also a small amount of blood leaking out of the collateral circulation.

After Zhou Cheng found one of the branches of the biceps femoris muscle, he was not in a hurry to get the blood vessel. Instead, he carefully sorted out and recalled the anatomy, especially the groundbreaking anatomical theory, and then took a deep breath.

tone.

Said: "Give me the sharp knife, please."

Zhou Cheng entered the state, concentrated on it, and no longer paid special attention to the names. He had to put all his energy on his hands and the arrangement of the surgery.

No one cared that there was no title in Zhou Cheng's instructions. Professor Li Xuande personally handed the handle of the sharp knife to Zhou Cheng's hand. Zhou Cheng held it, and then carefully moved it from the broken end position, so that the tips of the knife faced upward.

He needs to find the completed nutrient artery first, and the nutrient artery is very thin and can easily be injured with the tip of the knife pointing downward. At this time, controlling every variable factor will increase the success rate, although one operation is not much.

However, if accumulated, the improvement obtained will be very considerable.

It didn't take Zhou Cheng too long, about a minute, to find the trophoblast artery. Professor Li Xuande knew that there was such a trophoblast artery, but when he usually looked for it, he always found it based on the shape of the artery, from large arteries to small arteries.

I found it this way.

Like Zhou Cheng, he has never challenged the method of directly picking out the muscles.

Therefore, I was quite shocked. I felt that if the surgery reached a sophisticated level, it would be possible to achieve such a surprising and numb scalp.

It definitely couldn't be cut with one knife. After Zhou Cheng carefully exposed the vasa vasorum, which was slightly smaller than the diameter of wool, he did not dare to clamp it directly with a vascular forceps. Instead, he cut a sterile glove and used it to cover it.

Then it was handed over to the chief resident.

Fu Qiangxue carefully pinched both ends of the rubber band, not daring to exert force at all. He was afraid that if he was not careful with this fragile blood vessel, even its mother would be overthrown...

Blood vessels are actually very fragile.

Zhou Cheng then used a sharp knife to carefully follow the alignment of the blood vessels and continued to walk inside. This is not called a direction, but a alignment.

The anatomy of vasa vasorum is not as clear as that of large blood vessels. Small branch-like blood vessels that are almost invisible to the naked eye are crawling around the lumen of blood vessels and can be easily broken.

However, Zhou Cheng's sword would always carefully avoid them.

No one dared to speak. Even Professor Li Xuande's eyes were extremely focused at this moment. He secretly held his breath. One was worried about Zhou Cheng, and the other was secretly wondering why Zhou Cheng did this?

He continued to explore, and after reaching a certain length, the hole Zhou Cheng made was about six centimeters long.

This time, Zhou Cheng chose to clamp the proximal blood vessel. Then, Zhou Cheng did not cut it off with a sharp knife, but chose to continue to slowly peel off the branches of the vasa vasa layer.

When Zhou Cheng performed this operation, even Li Xuande, who had just watched Zhou Cheng perform the operation on the nourishing artery, still felt his scalp numb.

If dancing on a sharp knife is an art, then the process of Zhou Cheng using a sharp knife to find the branches that nourish the arteries is also an art.

They all seemed a little nervous, unbelievable, and worried about Zhou Cheng's operation.

But Zhou Cheng's hand was like a stone fixed in the air, very stable, without shaking up and down, and just followed the shape of the branches very carefully.

After about two centimeters, Zhou Cheng cut off the branches with a sharp knife.

Well, such a small blood vessel can be cut off directly without affecting it at all. You can cut it off at will, and there is no need to perform any operations to stop bleeding.

One, two, everyone gradually got used to it...

You know it in your mind, but your hands are ready to move and ask you what on earth you are thinking about.

After a full ten minutes passed, Zhou Chengcai carefully opened up such a nourishing artery and came out. The branches were all there, and the shape was relatively complete.

Then, Zhou Chenggong moved the "blood vessel he found somewhere" to the previous muscle bed. Just when Professor Li Xuande was about to ask what Zhou Cheng should do next.

Surprisingly, he saw that Zhou Cheng had used tweezers with extremely small tips to bring a silk thread over for some reason. After sending it over, Zhou Cheng used a tiny needle to sew a stitch into the blood vessel. It only went through without tying a knot.
To be continued...