The human anatomy is very complex, with various potential gaps, and the abscess is far from being visible to the naked eye, and the magnetic resonance shows that there are several places nearby, and it is difficult to achieve all-round observation with the naked eye during the operation.

Choledoscope, soft mirror! Now it is going to be put to use, usually this is the instrument used in general surgery to remove bile duct stones, and now Yang Ping uses it to observe the true extent of the abscess.

With magnetic resonance images as guidance, the scope of the abscess is already well known in the mind, and the soft scope is inserted, up and down, left and right, to explore the entire range of the abscess, and then guide the suction device to suction.

This device has never been used in previous surgeries, but Xiao Su knows that this step is going to be used, and he also knows that Yang Ping is going to use it now, Yang Ping habitually stretched out his hand, and the lens was actually delivered to his hand in a timely manner, and various wire tubes had been connected in advance, Xiao Su asked Zhou Can to turn on the display screen as well.

Rinsing and suction, Yang Ping held the lens in his left hand and operated the suction device with his right hand, flushing and suction in various directions without dead angles, and attracted almost 3,000 milliliters, removing 2,000 milliliters of rinsed saline, and 1,000 milliliters of pus.

"Can a choledoscope still be used like this?" Song Zimo wants to try it next time.

Yang Ping said while doing it: "The soft lens can change the direction of the lens, which is suitable for all-round exploration, and then you can also use a thin soft lens, which is used for intrahepatic bile duct stone removal, to explore the range of pus in the spinal canal, and completely remove it. ”

The entire vertebral body of the 9th thoracic vertebra was invaded by an abscess and had collapsed, and the bone fragment moved backward and invaded the spinal canal.

Only the 9th thoracic vertebra can be removed, Yang Ping finished dealing with the blood vessels around the vertebral body, and reminded the anesthesiologist: "Prepare to remove the vertebral body, pay attention to blood pressure." ”

The vertebral body is a layer of cortical bone that surrounds the cancellous bone, and the cancellous bone is rich in blood circulation, so when the vertebral body is removed, there is much more bleeding than other steps.

At this point in the operation, the suction device that attracts blood is still relatively clean for the time being, there is not much blood to suction, and the suction device used to remove the cheese has been changed several times, and the suction head has been changed several times, and the cheese that has been sucked out has been more than 2,000 milliliters.

The bone knife chiseled off the vertebral arches on both sides, cleared the upper and lower intervertebral discs, and then took out the vertebral body completely.

This step, generally with a bird's beak biting forceps, bite off the vertebral body one by one, such a step operation, it is inevitable to have a lot of blood, now Yang Ping directly and completely take out the vertebral body, there is no bleeding at all.

The section of the pedicle is blocked with bone wax, and the spinal canal is exposed, exposing the touched spinal cord, which is a tofu residue-like substance, mixed with dead bone, compressing the spinal cord.

It is no wonder that the patient developed neurological symptoms, muscle weakness and sensory impairment in both lower limbs, and if surgery was not performed, the muscle strength slowly continued to deteriorate, and finally became grade zero, and both lower limbs were completely paralyzed.

Curettes and nerve stripping ions are used together to remove the tofu residue-like substance, leaving a part for bacterial culture and pathological examination, which is a necessary step.

Yang Ping is still not at ease by going up and down the spinal canal space to remove the compressive substances, after all, the spinal canal is like a narrow tunnel, and it is difficult for the naked eye to completely discover the true scope of these pathological substances.

The choledoscope, which is going to be used again, gently extends into the spinal canal, almost sticks to the spinal canal wall, and explores up and down, according to the magnetic resonance prompts, there are still some areas that are not visible to the naked eye, there is an abscess, although there is no compression, but it will become an obstacle to healing.

Reach in and peel the ions, under the guidance of the soft mirror, easily remove these residual substances, rinse and suction, remove again, repeat several times, and finally remove it.

"Microscopic instruments!"

Xiao Su was ready, it knew that Yang Ping would not let go of this step, would not let go of the exploration of the anterior spinal artery, and Yang Ping would not lose any of the points he deserved when he did the operation.

Exploring the anterior spinal artery, Yang Ping carefully exposed the anterior spinal artery, and the microscopic forceps gently clamped it, feeling the tension of the blood vessel wall.

No, the feeling under the tweezers is very hard, not what a normal pipe structure should be, there should be an embolism.

"What? Embolized? Song Zimo looked at the movement of the microscopic tweezers in Yang Ping's hand.

"Embolism!" Yang Ping is sure.

If the embolus is not lifted, the spinal cord will be ischemic and necrotic and degenerate, and the postoperative paraplegia will not recover, and it will continue to worsen.

"What should I do?" Song Zimo asked heartily.

Fortunately, Yang Ping carried out exploration, otherwise the sensation and muscle strength of both lower limbs could not be recovered after surgery, or gradually worsened, and it would be too late to explore at that time.

"The embolization should not be long, if it is too late to open the blood vessels now." Yang Ping judged from the hardness of the blood vessels under the forceps.

A surgery, a perfect result, is the result of countless perfect details.

"Cut the blood vessels, remove the blood clots, and then anastomoses the blood vessels?" Song Zimo guessed.

Yang Ping nodded: "Prepare the microscopic instruments for anastomosis of blood vessels!" ”

A careful investigation changed the fate of this patient, otherwise, she would probably spend the rest of her life in a wheelchair.

In spinal tuberculosis surgery, there is no step to explore the anterior spinal artery because most spine surgeons do not have the thinking and experience of microsurgery.

Yang Ping decisively cut the anterior spinal artery and used tweezers to gently drive out the blood clot, which was like a tiny earthworm and placed on the saline gauze in Xiao Su's palm.

"Take pictures!"

Yang Ping instructed that Zhou Can was temporarily fine offstage and helped to take pictures, which were to leave complete information for the operation and accumulate original data for future scientific research.

According to the process of microsurgical small vessel anastomosis, heparin saline flushes the vascular pipe, trims the adventitia of the blood vessel, does not damage the vascular anastomosis needle, anastomoses the blood vessels, and checks whether the blood vessels leak blood and whether the pulsation is good.

After observing for two minutes, Yang Ping was relieved: "Okay, let's take the iliac bone for intervertebral bone grafting." ”

Song Zimo began to take the iliac bone, and it was very skillful to take the ilium, which had to obtain a satisfactory volume without affecting the appearance and function of the donor area.

"I got married on New Year's Day, my brothers must come over to be lively, I have already sent Director Han's invitation, and I have asked the head nurse to help send the invitation, and I will submit it in person later." Xiao Wu said coldly.

"So fast?" The fat man arrived surprised, brother, he was the fastest.

"If you don't hold a banquet again, you will have to hold a banquet with your baby." Zhang Lin said lightly.

"What? You're going to be a dad, aren't you just one step faster? "The fat man didn't expect that he didn't have a girlfriend yet, and this kid was going to be a father.

"Father-in-law and mother-in-law are urging me tightly, and I don't dare to disobey." Xiao Wu said helplessly.

"Won't you quit your career as a doctor and become a charter clerk after you get married?" Zhang Lin teased him.

Xiao Wu's parents-in-law are local people in G City, who went back and forth to Hong Kong and the mainland to resell electrical appliances in the 80s, made a fortune, and then invested in real estate, and made a lot of money.

The old couple only has such a daughter, and they are very cautious about their daughter's lifelong events, after seeing the little five, the old couple likes it very much, the young man is handsome, eloquent, and flexible, graduate school, doctor, education and career are good.

Now that Xiaoqing is pregnant, the old couple is happy, they want to be grandparents and grandmothers, and they urge the two to get married every day, so that they don't have to worry about anything, and the two old men will handle it.

"Fifth brother, do you have a sister-in-law? Sister-in-law can do it too! "Fat people don't feel like they're a little behind.

"Don't say it sooner!" Xiao Wu said while pulling the hook.

The fat man was pleasantly surprised: "What, that's it?" ”

"Earlier, I persuaded them to have another one, but now I'm afraid it won't work." Xiao Wu said with a smile.

Between talking and laughing, Xiao Wu and Zhang Lin's reels did not move, and the operation area was well exposed.

Song Zimo's iliac bone is taken, square and very beautiful.

Yang Ping used a propgetor to prop open the upper and lower vertebral bodies, and the implantation of the iliac bone was fast, just right.