Surgeons dressed as poor people in the Republic of China

Ye Yibai glanced at Robert, "Are you coming?"

Robert nodded, "I'm here, why, you're not welcome."

Ye Yibai nodded, "Okay, here you go, take it." He handed the double-toothed hook to Robert.

Robert's straight waist immediately bent down. There is no director in the operating room, only doctors. Ye Yibai understands this truth, and Robert also understands this. In the state of being rotated and pulled away, the child's larynx is fragile and cannot be as hard as the skin tissue.

"Knife."

"Doctor Ye, let me wipe off your sweat." Laura said.

Ye Yibai took the scalpel handed over by Susan, straightened up and tilted his head slightly, "Are you adjusted?"

Laura stepped forward to help Ye Yibai wipe his forehead, "It's adjusted."

"That's good."

The scalpel cleanly cut off the pharyngeal constrictor muscle at the edge of the right thyroid cartilage, separated the paraglottic space, and exposed the cricoarytenoid posterior muscle on the right side to all the white coats.

"The atrophy of this muscle is a bit obvious." Robert looked at the exposed cricoarytenoid muscle, frowning slightly.

Ye Yibai continued to retrogradely separate the left recurrent laryngeal nerve from the back of the right cricothyroid joint. After a while, he followed the recurrent laryngeal nerve and saw the tiny nerve tip tumor. The moment he saw the nerve tip tumor, Ye Yibai's The brow is also frowned, the shape of this nerve terminal tumor is actually crescent-shaped, and most of it has been embedded in the recurrent laryngeal nerve.

X-ray films can only take flat and flat images, which will result in one-sided images. For example, the meniscus, half moon, circle, and ellipse are all circles when taken from a certain direction, and such images will be accurate. Doctors are misleading.

"The section where the nerve tip tumor is embedded is definitely not going to be preserved. The trouble is the second half. The recurrent laryngeal nerve in the second half has obviously shrunk and shrunk, so even if the end-to-end anastomosis is managed, the effect may not be good." Robert frowned.

Taylor and the two interns immediately poked their heads over to carefully observe the situation in the surgical field. Even without a surgical magnifying glass, they could see that the second half of the white nerve was obviously a little thinner than the first half.

Everyone unconsciously looked at the surgeon who performed the operation.

Ye Yibai sighed softly, "That's right, if it shrinks like this, it won't get better after barely anastomosis, change the operation plan, anastomosis with the main branch of the cervical loop, the operation time may need to be extended appropriately, please persevere. "

The operating room in 1933 was not as good as that of later generations. The constant temperature environment was always around 25 degrees Celsius. It’s better to put a few pieces of ice in the room to keep it cool. Doctors in the operating room wear a lot of clothes. In order not to affect the operation, they can’t fan the fan. After this large-scale operation, the doctor is not only a test of skills, but also a test of physical strength. .

"Doctor Ye, we're fine. There's a saying in Huaguo that God puts a heavy responsibility on a person, and it will torture him mentally and physically. We doctors are charged with curing diseases and saving lives. It's so hot that it's nothing to worry about." Female intern Seriously speaking a combination of Cantonese and Shanghainese, which is not authentic, expressing his determination very seriously.

Although the words were not very clear, but the heart was conveyed.

"The little girl is right. We have been wearing white coats for so many years, and our state of mind cannot be inferior to that of other little girls." Robert kept bending over to pull his throat, and laughed when he heard this.

Then there was a burst of echoes and chuckles in the operating room, as if the summer heat had dissipated a lot.

Laura wiped Ye Yibai's sweat. After entering the second half of the operation, the frequency of wiping sweat increased significantly, and the back of the clothes inside the surgical gown was completely soaked.

Gently pull up the recurrent laryngeal nerve with a thin thread, remove the part where the nerve tip tumor is embedded, and place a white, thin, round tubular object on the treatment tray with forceps.

The tweezers collided with the treatment plate, making a crisp but not pleasant sound.

"Knife, No. 10 blade."

"Pull away a little bit."

"Vocal cord paralysis caused by recurrent laryngeal nerve injury is mostly due to surgical sequelae. It is rare to have a nerve tip tumor like this. Generally, there are no more than three ways to deal with this situation."

Ye Yibai saw that the two interns wrote down what they had or didn't have in the notebook, so he opened his mouth to help them sum up the key points.

Taylor and Henry's eyes lit up, and Robert's ears quietly pricked up. The repair and anastomosis of the recurrent laryngeal nerve itself is a new procedure, but according to Dr. Ye, it seems that it has already formed a system.

Vocal cord paralysis - recurrent laryngeal nerve damage - three ways to deal with it?Such a complete logical chain can almost be directly entered into textbooks.

"Like this kind of nerve tip tumor, if the tumor is small in size and regular in shape, and does not compress the nerve to cause nerve atrophy, the growth part of the tumor can be completely removed, and then end-to-end anastomosis can be performed. Like this kind of recurrent laryngeal nerve, part of the atrophy or other reasons If the end-to-end anastomosis is not applicable, as we do now, find the adduction and abduction branches of the recurrent laryngeal nerve, and anastomose the main branch of the cervical loop with the adduction finger of the recurrent laryngeal nerve.

There is another situation, which is generally used for recurrent laryngeal nerve injury caused by surgery. If the patient has a history of neck surgery, you can first open the neck along the original incision to see if it is caused by surgical sutures or scars. Vocal cord paralysis caused by increased pressure in the larynx. "

Ye Yibai had freed Ken's right cervical loop nerve while talking, "Line."

The cervical loop nerve was lifted slightly with a thin black thread, cut distally, and drawn to the right recurrent laryngeal nerve.

"Needle holder."

The nerve anastomosis is a test of skill, at this time Ye Yibai also stopped talking, and began to concentrate on the nerve anastomosis.So the white coats in the operating room once again saw the suture like art.

In Ye Yibai's hands, the needle holder and the extremely thin thread are as flexible as his fingers, oh no, more flexible than fingers, after all, it is impossible for fingers to penetrate into a nerve with a diameter of only one or two millimeters, and then return to it. so neatly.

Watching Ye Yibai's movements, Robert wondered whether he could complete the operation. He estimated that he should be able to complete the operation if he understood the operation process, but he wanted to be like Ye Yibai. It is almost impossible to align the two ends of the nerve so evenly.

Taylor and the two interns couldn't wait to put their eyes into the operating field. They didn't have a surgical magnifying glass, so what they could see was that Dr. Ye's hands kept moving, and then the thread passed in and out, and then the two nerves were connected together.

Their brains are very confident and tell them that they will, isn't it just two tubes sewn together, the brain thinks they will work, and then the interns look at their hands... well, the hands tell them, they will only remember notes.

"Scissors."

With the sound of "click", the anastomosis of the main branch of the cervical loop recurrent laryngeal nerve was officially completed.

Ye Yibai let out a long sigh of relief, "How much bleeding?" He turned to look at Susan.

Susan quickly lowered her head to look at the amount of blood collected, "15 milliliters."

Ye Yibai nodded and raised his hand at the same time, "I'll leave it to you, no problem."

"No problem!" The two interns answered quickly, and then attracted the suspicious eyes of the rest of the white coats.

The two interns blushed and lowered their heads.

After watching the operation process, Robert naturally handed over the finishing work to Taylor. Taylor was quite happy. He took the surgical magnifying glass carefully, carefully observed the results of Ye Yibai's nerve anastomosis, and then began to suture .

The two interns even watched the suture with relish. Of course, their brains knew how to do it, but they thought that if it was just skin suturing, they could still try it.

"Doctor Ye, why did you think of the anastomosis of the recurrent laryngeal nerve and the cervical loop nerve?" After the operation was officially completed and waiting for Ken to pass the anesthesia, the female intern Ella stuck to Ye Yibai's side directly.

"If you compare a person to a city, then the blood vessels are the roads and the nerves are the wires. Before you ask this question, you should first ask yourself what the purpose of our operation is, and work backwards from the purpose. To achieve For this purpose, what do you need to do. For example, if I want to transmit a signal, where is the original transmission of the signal, for example, its original path is 1234, but one of the 3 is broken, so skip 3 and go directly to 124, okay? The same is true for nerve anastomosis, our goal is to repair the problem of vocal cord paralysis, then directly anastomosis of the recurrent laryngeal nerve and the cervical loop nerve is enough to transmit the signal."

Ye Yibai's explanation is very vivid, even Robert and others can understand something from it, "In the final analysis, it is the basic skills. To figure out the function of every blood vessel and nerve in the human body, anatomy is the foundation of everything." Robert Exclaimed.

And Ella kept recording in her hand while staring at Ye Yibai with sparkling eyes, the admiration in her eyes was not concealed at all.

"Doctor Ye..."

"Doctor Ye..."

The little girl chattered around Ye Yibai, making Robert shake his head, "Ye really has someone."

"Does Doctor Ye have a date?" Taylor asked in surprise.

"Yes, the relationship between the two is not bad." Thinking of the people he met at the door of the operating room, Robert said with certainty.

A very light cough sounded, and Henry checked Ken's basic data immediately, "Heartbeat, pulse, and breathing are all normal."

"Ken, Ken, are you awake? Can you hear me?"

Ken slowly opened his eyes.

Then only Henry's scream sounded, "Oh, God, why are you crying? Is it the pain after the analgesic? It shouldn't be..."

Ken shook his head vigorously, but the tears couldn't be stopped. Although it was light, he heard the cough...

He can cough up...