Chapter 1663

There is a new diagnosis, and it is boss Zheng's diagnosis. Everyone pays more attention to it. In addition, spinal surgery also required MRI. In the shortest time, Director Mao was carried into the MRI room.

"Boss, how did you think of endometriosis?" Su Yun looked at the MRI image and determined that Zheng Ren was right.

That's why he was even more surprised, so he asked.

"You call Fuguier and ask him to take Lao Liu for today's operation." Zheng Ren suddenly remembered that there were a lot of things on his side, "call brother Yang again and say it's something on my side. Patients with liver cancer interventional embolization will be a little later."

"Everyone in the hospital doesn't know that something has happened, and the operation must be postponed. I ask you, how do you diagnose endometriosis?" Su Yun asked again.

"It's not difficult to judge the images of non coagulation and coagulation." After reading the NMR, Zheng Ren determined his idea and breathed a sigh.

"Judge by CT? Are you lying to ghosts?" Su Yun relaxed a lot and said with disdain.

"CT can only guess. It needs MRI. But it's enough to provide a reason for guessing. Look at the reason I said, how sufficient." Zheng Ren said with a smile, then stood up, "let's go and have an operation."

"Seriously, how did you judge?"

"Three years ago, a similar case occurred in a prefecture level hospital in the south. The patient's family members made a lot of trouble and wanted to compensate 10 million. Finally, spinal surgery was performed and it was determined that it was endometriosis, so the matter was over." Zheng Rendao. (note)

"I don't remember." Su Yun was surprised.

"I didn't let the report. I saw the case report in a Chinese Journal a year ago. At that time, I just thought about it casually. Before we watched the film in the CT room, we looked for similar case controls." Zheng Ren smiled.

"How big is the operation?"

"Big." Zheng Rendao.

"Your confidence is really moving." Su Yun said expressionless.

"It's just a small piece of endometrium. Be careful not to break your gloves when stripping. Once it's broken, cut a small hole, and the endometrium will appear on your finger..."

"It's really disgusting. Don't say it." Su Yun was stunned and stopped.

At the thought of Director Mao's menstrual period, his fingers hurt and he would bleed. Su Yun felt that he was not good as a whole.

"What do you think?"

"Boss, you said endometriosis can be infected. Why didn't there be rejection?" Su Yun asked.

"..." the brain circuit of this goods is really wonderful.

However, what he said seems to be right. Organ transplantation is not difficult. The difficulty lies in the postoperative rejection.

There are few cases of endometrial implantation in others, but there are definitely cases.

Zheng Ren was also stunned. This seems to be a research direction of organ transplantation!

1.36 seconds later, Zheng Ren smiled and said, "concentrate on the operation. This is spinal surgery."

"Are you good enough?"

"As your boss, you must be perfect in all aspects."

"Cut."

As they spoke, they walked into the operating room.

"Have you ever seen an operation on the thoracic spine?" Zheng Ren asked.

"I've seen it twice. What's the matter?"

"Once you've seen it, you'll see. That's what you said. Don't fail to keep up when you get on the stage later." Zheng Ren said lightly.

"Boss, don't put too much pressure on me. I'm just three help at most, and you're just one help." Su Yun despised.

Zheng Ren shook his head slightly.

When he came to the operating room, Zheng Ren saw that Director Mao had lost consciousness and lay on the operating table. Director Xu was doing endotracheal intubation.

A professor of orthopedics waited aside. When the anesthesia was over, they had to put themselves in position.

Holding his arm to watch the film, Zheng Ren went to the system operating room and began surgical training.

Because orthopedic surgery in Nanyang used a master level skill book for hip replacement, Zheng Ren was not in a hurry.

It's just thoracic surgery

……

After 15 ′ 22 ″, the preoperative preparation was completed.

The head of the hair is in a prone position to maintain the physiological anterior curvature of the lumbar spine. The professor of orthopedics took the lead in hand, disinfected the conventional operation area and paved sterile towels.

After washing hands, disinfecting and dressing, director Xu of Zheng Renhe spine surgery came to the operating table.

"Boss Zheng, you come." Director Xu is a guest.

"Director Xu, I just give you a hand." Zheng Ren smiled.

"You're welcome. Dr. Richard of Massachusetts General hospital recommended you to become a lifelong professor at Massachusetts General Hospital." Director Xu said with a smile, "I'm a doctor at Massachusetts General Hospital. Richard is a little older than me. He can be regarded as my senior brother."

This kind of random recognition of teachers and brothers is often seen in small hospitals.

But in 912, we all rely on our identity, and few people say so.

But it was with domestic doctors. Director Xu climbed a "high branch". Anyway, Dr. Richard didn't know whether it was not.

Zheng Ren smiled. "I thought Dr. Richard was joking. I didn't expect it to be true."

"I inquired and said that your hip replacement operation was very good. It's also the platform provided by Dr. Su for you. Today, I just give a hand and learn."

The two have put on their clothes. At the insistence of director Xu, Zheng Ren stands in the position of the performer.

"Dr. Su, I stand in the position of a help, but I don't want to be a help." Director Xu said with a smile, "you should concentrate."

Su Yun was stunned and nodded.

"Microscope." Zheng Ren said in a deep voice before opening the skin.

An anesthesiologist assigned to Director Xu quickly put a microscope on Zheng Ren, and the operation officially began.

Reach out and gently pat the lancet in the palm of your hand.

Take a longitudinal incision centered on the thoracic 8 and 9 vertebral bodies, about 6cm.

Cut open the skin, subcutaneous tissue and deep fascia, start blunt separation, free the erector spinalis muscle along both sides of the spinous process, and clean the soft tissue on the lamina of thoracic 8 and 9 vertebrae and transverse process.

Generally speaking, the erector spinalis muscle should be cut, but Zheng Ren used the blunt separation mode in order to reduce bleeding. The advantage of this is less bleeding, but there are also many disadvantages.

Remove the bilateral inferior articular processes of the thoracic 8 and 9 vertebral bodies, and expose the origin of the ribs on both sides outward.

The intercostal veins and nerves of the corresponding ribs were separated and ligated.

The operation was done cleanly, including the position of the articular process. Zheng Ren didn't bite off all of them, but it was enough to expose the operation field.

The injury is as small as possible and the postoperative recovery is also fast.

"Watch your pleura." After ligating the intercostal vein and nerve, protect the intercostal artery, Zheng Ren said.

As soon as he reached out, the heavy rib pliers fell on his hand.

Zheng Ren cut off the ribs about 3cm outside the costal vertebra joint with rib pliers, and removed the ribs from the cut-off point to the costal vertebra joint.

Then Zheng Ren bit off the pedicle and superior articular process on both sides of chest 8 and 9 to expose the spinal cord.

The reason for biting off the bone is that the bone stump is bleeding continuously, and the operation field is somewhat blurred.

Su Yun sucked blood with a suction device and dipped it in gauze. Less than 1 second after exposing the operation field, the operation field will be covered with blood again.

……

……

Note: This is the first reason to look for endometriosis. You can't say which hospital it is from barabarabara as you did when you first opened the book. Please forgive me. When writing this case, I was afraid for a while. It's no use being careful. Being a doctor is as good as life.