Doctor of Healing
Page 276
But Director Sui didn't speak, nor did he stop him.Deng Chaohong wanted to hit him hard, so he would do it himself.
"Who is this? Your new leading professor?" Seeing that Director Sui was silent, Director Shi continued to ask.
"Dr. Xiaoji got the first place in the country in the doctor's qualification examination, full marks." Director Sui said.
"..." Shi Shuo was startled, it turned out to be this one!
Over the past 20 years, there has finally been a full-score examination paper for the doctor's qualification examination. This matter has been widely circulated. I didn't expect that in the Second Affiliated Hospital, with the assistance of teachers, I can perform level 4 surgery.
No wonder he was so proficient in using the tourniquet just now, and he turned out to be the winner of the full test paper.
Jixiang made an incision on the skin, blunt dissection, and hemostasis. Then, he inserted arthroscope and instruments respectively to explore the suprapatellar bursa, medial and lateral recesses, lateral space, and intercondylar fossa. No obvious damage was found on the cartilage surfaces of the patella and femoral condyles. .
The technique is sophisticated, neither fast nor slow, and has the style of a veteran artist.
Shi Shuo looked more and more surprised.
It is not difficult to operate an arthroscope. It may be as detailed and appropriate as Ji Xiang. It is absolutely impossible to do it without hundreds of operations.
Immediately, Director Sui saw Ji Xiang's inspection and saw the stump of the anterior cruciate ligament. Although it was not completely broken, the torn part was severely damaged, and a small part had been absorbed.
The continuity of the posterior cruciate ligament exists, and Ji Xiang used a probe to detect its good elasticity.
After doing this, Shi Shuo didn't see anything unusual, but the young surgeon's technique was very stable and accurate.
Is it an elite level magician?Director Shi evaluated in his heart.
But at the next step, Director Shi was stunned.
Chapter 391 Intraoperative Contrast
For normal anterior cruciate ligament injury surgery, it is necessary to use bite forceps to bite off the stump of the anterior cruciate ligament, and then explore the inner and outer menisci to see if there is any obvious damage.
After the exploration, take the lower medial longitudinal incision of the left knee, separate it to the upper edge of the goose foot, incise longitudinally, separate and expose layer by layer, free the semitendon and gracilis muscle, and free 2 cm to the proximal end, and remove the tibial attachment Remove it, use the key remover to sneak to the proximal end to resect the full length, and weave and suture the two ends with No. 1 absorbable suture.
That is, the autologous tendon is "grafted" into the patient's joint cavity to act as the anterior cruciate ligament.
This is a very mature surgery in orthopedics, and it is now commonly used internationally and domestically, so there is no doubt about it.
But the young surgeon in front of him actually started washing, cleaning the joint cavity and preparing to suture!
Will he have arthroscopic surgery?
Director Shi Shuoshi was amused, "Director Sui, your surgery is really a different approach."
Director Sui also frowned.
"Professor Deng, what is the surgery?" Director Sui asked in a deep voice.
"Director, the USC sports medical team specially designed ligament surgery for athletes." Deng Chaohong was a little guilty and focused on looking in the mirror. He already felt Director Sui's eyes fell on his back like a knife.
For a moment, Deng Chaohong wanted to give up.
It's not difficult to cut the tendon of the sartorius muscle, and it's not like I can't do it myself.
But the last patient with rotator cuff injury appeared in Deng Chaohong's mind.
If the operation is performed by oneself, although the patient will recover, recovery is not the same as recovery.
The operation performed by Ji Xiang, the patient has recovered his motor function and is actively preparing for the National Games.
If I do it myself, I am afraid that the patient has already retired.
Postoperative results vary widely.
And talking with Ji Xiang last night, Deng Chaohong thinks what Ji Xiang said is feasible.Although it's a little troublesome, hybrid surgery is going to be done.
He bit the bullet and assisted Ji Xiang in the operation, ignoring Director Sui's murderous gaze.
"The sports medicine major at the University of Southern California is number one in the world." Shi Shuo laughed angrily. "Today, I learned a lot and saw how the world's first-class surgeries are performed."
There was sharp irony in his words, which made Director Sui a little embarrassed.
"Professor Deng, can I come to study in a few days? Learn the world's top new techniques." Professor Fan jokingly asked.
Deng Chaohong's hands trembled a little, and the words and emotions of these people behind him brought him tremendous pressure.
"Pa~" The hemostatic forceps hit Deng Chaohong's radial styloid process.
"Concentrate on it." Ji Xiang said lightly, "Leave this to you first, and I will do the imaging."
"!!!"
"!!!"
"!!!"
Countless exclamation marks floated on the heads of the two directors and Professor Fan.
Contrast?
What the hell is that?
Under normal circumstances, ligament surgery requires MRI. This young doctor should not be hysterical.
Director Sui immediately thought of Deng Chaohong's bloated body, damn it!He cursed secretly, Deng Chaohong was performing the surgery while wearing a lead suit!
"Old Shi, are you looking inside or outside?" Director Sui asked.
Orthopedics are often exposed to radiation, so they don't have the same fear of interventional surgery as other doctors.
Moreover, Director Sui noticed that Jixiang had laid out weird sterile sheets before, and it turned out that he was going to have an interventional operation early in the morning, so the weird way was laid.
"Professor Ma, thank you for your hard work." Ji Xiang bowed slightly, wearing a sterile gown, three meters away from Professor Ma in the corner.
Professor Ma was a little helpless, he knew very well that the purpose of his visit was to give Ji Xiang a reason to undergo surgery—commonly known as taking the blame.
But Ji Xiang's surgery was at least 2 grades better than his own, which is why Professor Ma agreed to him.
Professor Ma is curious, he wants to see what is the relationship between ACL repair surgery and interventional surgery.
If it was someone else, even Director Zhao would sneer at what Professor Ma said.
But Jixiang said it could be done, but he just wrote the "ghostly obsessed" letter.Although Ji Xiang is only Gui Peisheng, the story of pointing his nose and scolding Boss Qin at the annual meeting in the past few months has spread throughout the world.
Shi Shuo also had a dewy face. He frowned and thought about the ACL repair operation again.
Not only the surgery at home, but also the lectures of other people who participated in the society were counted together. No one proposed the idea of doing hybrid surgery.
There are only a few differences - direct suture has been basically eliminated, which muscle tendon is used for repair.As for the ligaments that use high-value consumables, they are too expensive and hard, and the effect is relatively average.
The attention of orthopedic experts is on consumables manufacturers. To achieve further curative effect, better ligaments are needed.
"Old Shi? Where are you looking?" Director Sui asked.
"It's here." Shi Shuo said in a deep voice, "I'm going to get dressed."
Soon, three people walked in wearing lead clothes.
There are seldom so many people involved in interventional surgery, and Professor Ma also felt a little strange.
Jixiang started puncture, placed arterial sheath, and then super-selected.
Professor Ma's mind couldn't keep up with the neat technique, so he didn't have time to get distracted, so he could concentrate on doing his job as an assistant.
Soon, Ji Xiangchao selected a branch from the middle knee arterioligament and began to create contrast agents.
"Dr. Xiaoji, I have never done this blood vessel before." Professor Ma said.
"The blood supply vessels of the anterior cruciate ligament are some small blood vessels from the middle knee arterial ligament branch and the infrapatellar fat pad. Take an angiogram to see." Ji Xiang said, "Whether the postoperative recovery is good or not depends mainly on whether the blood supply can be re-established. "
"Tsk tsk." Professor Ma could understand what Ji Xiang meant, but he couldn't think about the next operation at all.
Ligaments have a blood supply, but the blood vessels are very thin, similar to capillaries.
An ACL repair surgery turned into a hybrid surgery, everyone is curious.
The high-pressure injector injects the contrast agent, and Ji Xiang sees the blood flow clearly, then said, "Professor Ma, thank you, the tube has been withdrawn, please."
Professor Ma was very impressed.
Although it was just an ordinary angiography, Jixiang did it extremely finely, super-selecting the middle knee artery and ligament branch.
At this level, there is no one else, at least no one in the Second Affiliated Hospital is better than Ji Xiang.
"What's the point?" Shi Shuo asked.
"That's right, do a radiography, can you still anastomose the capillaries?" Professor Fan also asked.
Ji Xiang turned his head, glanced at the two of them, and narrowed his eyes slightly.
If you are not wearing a mask, it should be a smile, a kind smile.
"Xiaoji, what should we do next?" Director Sui didn't sneer or ridicule, but asked full of doubts.
"When you see the feeding vessels of the anterior cruciate ligament, just avoid it during suturing, and the postoperative vascular reconstruction will be very fast." Ji Xiang replied.
Chapter 392 This Child Has Nothing to Do in the Future
"6-0 gut." Ji Xiang stretched out his hand.
Tang Yan made some adjustments, quickly threaded the needle holder with 6-0 gut and slapped it in Ji Xiang's hand.
"What are you going to do?" Shi Shuo asked suspiciously.
"Sew up, just avoid the capillaries. The smaller the damage, the better the postoperative recovery." Ji Xiang replied.
"What are you thinking about?" Director Shi Shuoshi scolded, and he lowered his voice and said in Director Sui's ear, "I thought it was some advanced technique, but I didn't expect it to be an old technique that has been abandoned for many years and proved to be unfeasible. surgery."
Director Sui was also a little embarrassed.
Directly suturing the incompletely ruptured anterior cruciate ligament has indeed been abandoned for a long time.
Generally, autologous tendons are used to replace ligaments, or ligaments are replaced by high-value consumables.Both options have their own benefits, and it makes sense to choose either.
But Ji Xiang's kind is a bit nonsense.
Shi Shuo almost didn't laugh, thinking that the young doctor who was number one in the country would show some supernatural means.
He turned a simple operation into a complicated hybrid operation, but in the end he showed his timidity and started to suture directly.
"What's his name?" Shi Shuo asked Director Sui.
"Ji Xiang."
"Good name." Shi Shuo praised, "Dr. Ji Xiang, you have never had a tendon taken before."
"Huh?" Just as Ji Xiang was about to sew, he looked at the screen directly opposite him, ready to use his foresight.
At this time, Shi Shuo came up to "whisper" with himself.There were no questions in the words, only ridicule.
Do you need to ridicule yourself?
Ji Xiang looked back at Shi Shuo, his eyes were clear, but he didn't squint, but looked down at Shi Shuo from a high position.
Director Shi was stunned, and the moment Ji Xiang's eyes fell, he seemed to feel that he had returned to his youth, and he was stared at by the old director with stern eyes when he made a mistake.
His eyes were full of regrets that he hated him for indisputable and the emotions of "this child will have nothing to do in the future".
The fat on Director Shi Shuoshi's face trembled, and he almost threw the fat onto the mask.
The deepest fear engraved in his heart was awakened, and he fell silent at a loss.
Ji Xiang didn't say anything excessive, and he didn't use the skill of [Superior Doctor's Gaze], he just "looked" at the talkative Director Shi Shuoshi.
With the improvement of technology level, Jixiang himself did not realize that his every move has the style of a superior doctor.
Go back and start sewing.
A 6-0 catgut is threaded through one end of the ruptured ligament and out the other.
Location……
In the eyes of Director Sui, Shi Shuo, and Professor Fan, the position Ji Xiang chose can be described as horrible.
Skewed, twisted.
The conventional anastomotic tendon can be sutured with a "8" suture or other suture methods. Of course, the position should be selected in the middle, so that the tendon can be evenly stressed and avoid postoperative rupture.
But Ji Xiang didn't seem to know how to perform surgery. The angle of the suture in his hand was perverted, which looked particularly unpleasant.
"It's okay to sew like this?" Professor Fan was almost not annoyed, he didn't see Ji Xiang's "look" at his director just now, and said helplessly.
"Professor Fan, in order to avoid opening capillaries, we can only sew like this." Deng Chaohong said suddenly.
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