I Spent Those Years In the Operating Room Fighting Monsters
Chapter 30: Let's try again!
The popliteal fossa is a very dangerous area. Even orthopedic surgeons who are most familiar with the anatomy of the popliteal fossa do not want to touch this area easily.
The popliteal fossa contains a lot of adipose tissue. In the adipose tissue, there are a lot of blood vessels and nerves, and there are various branches of blood vessels and nerves, including the popliteal artery, the popliteal vein, the popliteal nerve and its branch pretibial blood vessels. Nerve groups and their sub-branches.
Lu Cheng still clearly remembered that when he was in the joint surgery department, the director of joint surgery wanted to go into the popliteal fossa. The deputy director almost shouted the boss in a pleading tone. In the end, the director of joint surgery didn't have much trouble.
But now Professor Zhou Xuanqing has made this decision without hesitation.
The patient was so scared that he almost ran away from the operating room when he was awakened. However, when Professor Zhou told him that if he did not undergo vascular embolization, he would have to amputate his limbs to stabilize him, but he couldn't sleep at all.
A pair of red eyes looked at Zhou Xuanqing, and said, "Professor Zhou, you must help me. I still have a wife and children. If I can't move anymore, what can they do? The children are still young..."
Zhou Xuanqing can only comfort: "I will do my best."
Zhou Xuanqing is a professor of orthopedics. Although he has high attainments in orthopedics, he is facing the problem of vascular surgery specialists at the moment, and he can only do his best.
This kind of sudden arterial embolism during the operation is the most feared by orthopedic surgeons. Fortunately, this patient did not wear a tourniquet at the beginning, otherwise, it would be impossible for any of them to discover the embolism!
Zhou Xuanqing glanced at Lu Cheng, re-washed his hands and put on clothes, re-washed and disinfected the patients' hands, and laid towels. After completing these steps, he did not hesitate to make another arc-shaped incision behind the popliteal cavity.
Then he drove in in an orderly manner, carefully peeling it off layer by layer, not daring to make any movements.
The talking on the operating table stopped, and everyone's breathing seemed a little serious and heavy!
Less than ten minutes later, two people wearing green surgical gowns walked in. The headed person came in and immediately asked, "Teacher Zang, what's the situation now?"
is the director of vascular surgery Tan Yuanwu. Following him is the chief resident and chief resident of vascular surgery, who is in charge of emergency operations related to vascular surgery.
But I heard on the phone that today’s operation was to invite a professor from the Second Xiangya Hospital to perform the operation. There was an arterial embolism during the operation, so he didn’t dare to do it personally, so he called Director Tan directly again.
When Director Tan heard the call, he immediately pushed over the meal he had originally had, and hurried over, obviously also paying great attention to this emergency. If this matter is not dealt with properly, then the Changshi First People's Hospital will be embarrassed.
In the future, when professors from the Second Xiangya Hospital are invited to perform operations below, they may hesitate. After all, there are precedents of being ‘pitted’ even though everyone knows that this was not intentional.
Tan Yuanwu used to follow Zang Xun when he was doing an internship in orthopedics, so he always called teacher Zang Xun, and Zang Xun had always encountered vascular surgery matters, so he was the first time to look for him.
Now that he has become the director of the ward, he does not dare to neglect. After all, many orthopedic problems in their department are directly approached by the director Zang.
Zang Xun said: "Arterial embolism occurred during the operation. Before the operation, the pulsation of the dorsal foot artery was still good. Just after cutting the front skin, the dorsal foot artery could not be felt. We used needles during the operation. After a while, there is no blood oozing from the plane below the tibial plateau."
"So the preoperative color Doppler ultrasound results are useless."
"Director Zhou Xuanqing sutured the previous wound again and immediately transferred it to the popliteal fossa. Now the popliteal artery and the anterior tibial artery have been separated, and the posterior tibial artery has not been detected because it is hidden deep."
"Now you can take over at any time!"
Zang Xun spoke quickly, but Tan Yuanwu already knew the probabilities. He hurriedly told the traveling nurse: "You guys go down and get the vascular surgery bag, and then bring my special equipment bag!"
"Tong Sheng, you and I go to wash our hands and go on stage right away. Pay attention to the specific location of the embolization. There is no arteriography before the operation. The situation of this patient is very complicated."
Tongsheng certainly understands that this is an unexpected situation during the operation. The preoperative arterial color Doppler ultrasound is okay. The dorsal artery of the foot before the operation is open. It is suddenly embolized, so where is the embolization?
In this situation, it is definitely not possible to drag the patient out of the operating room to have an arteriography again. This has to test their skill and level.
Tan Yuanwu and Tong Sheng immediately went on stage and took over the operation.
Zang Xun immediately called Zhou Xuanqing and Tu Chaoran to leave the stage to rest temporarily, and at the same time he also stepped off the stage. After saying hard and sorry to Tan Yuanwu, he hurriedly followed Zhou Xuanqing and explained the work. .
Zhou Xuanqing was a little unhappy, but he also knew that this incident could not be Zang Xun or anyone deliberately doing it.
Zhou Xuanqing said: "Old Zang, what are you talking about? In such an emergency, our doctor is not a god, let alone a fortune teller. We will count a hexagram before the operation. Surgery."
"This time, I hope that the vascular surgery can remove the embolus smoothly, otherwise it will be troublesome. It is difficult for you to explain to the patient."
It is difficult to explain this kind of emergency to satisfy the patient and family members. They will definitely ask why you don’t do a systematic assessment before the operation?
Even if they have done Zang Xun, the patient will still say, "Why does it happen after you have assessed the safety?"
So, it should be Zang Xun who can't sit still.
On the operating table, although Tan Yuanwu and Tong Sheng took over the operation, Liu Kaihua and Lu Cheng were still following the stage to help.
The two people cut open the popliteal artery quickly, and then started to remove the embolus with a special embolization device from the popliteal artery up and down.
Towards the femoral artery, it is open, without emboli!
Towards the anterior tibial artery, the embolus was still not removed.
Towards the posterior tibial artery, the embolus was not taken out!
Tan Yuanwu and Tong Sheng looked a little uncomfortable, and then they continued to extend down, but still did not take out the embolus.
Tan Yuanwu finally spread his hands out and whispered in Liu Kaihua's ear: "Director Liu, UU reading www.uukanshu.com, we have done our best."
"Can't take it out, the embolus may be closer below."
"This patient may eventually have to be amputated."
Liu Kaihua did not dare to speak loudly because he knew that the patient was under continuous epidural anesthesia, not general anesthesia.
Liu Kaihua's face turned pale immediately, and he wished it was just a joke, even if the joke was a bit big.
Liu Kaihua can only say: "Thank you, Director Tan, Doctor Tong, for your hard work."
"Oh!" Tan Yuanwu sighed, and then he was about to close the wound.
And at this moment, Lu Cheng suddenly said, "Teacher Tan, the blood flow under the tibial plateau of this patient is not smooth. Is it possible that this embolus is located at the intersection of the posterior tibial artery and the peroneal artery?"
"When you just took it, it happened to be squeezed to the side of the peroneal artery, so you didn't pull it out?"
Although this was the fact that Lu Cheng saw, he could not say that. He could only rely on his knowledge of anatomy to give an answer that was closest to the facts.
After listening to Lu Cheng's words, Liu Kaihua immediately said: "This is a new doctor in our department. He just came here and doesn't understand the rules! Director Tan, please be considerate."
After he finished speaking, he immediately glared at Lu Cheng.
Lu Cheng, this is questioning the ability of vascular surgery, and guiding other departments to perform operations is a taboo for communication between departments!
It was Liu Kaihua's look that moved Tan Yuanwu a bit. At this time, Liu Kaihua was still saving face for them. On the operating table, although this was an orthopedic operation, they did not take out the embolus. It was also because of their lack of ability to help.
Tan Yuanwu said inwardly: "Director Liu, it's okay, let's try again!"
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