When doctors have a simulated operating room
Chapter 220
The hip joint of the human body bears most of the weight.
The acetabulum is like a bowl, and the femoral head is like a ball.
When a person walks, the femoral head moves back and forth, just like a ball sliding back and forth in a bowl.
Artificial hip replacement is actually to replace the broken hip joint and femoral head with an artificial prosthesis.
So far, the choice of ceramic-to-ceramic hip joint is the most wear-resistant material with relatively small wear and long service life.
At first, it was metal, the least wear-resistant, most damaged, and short-lived material.
With the continuous development of technology, there are also acetabular made of ultra-high molecular polyethylene.
However, so far, ceramic-on-ceramic, that is, hard-on-hard hip prosthesis, is recognized by the industry as a material with long service life and low wear.
It is said that it takes about two hundred years to wear through the ceramic liner or ceramic femoral head.
Most patients, if they are young, basically choose ceramics with a longer life for replacement.
In the operating room.
The old lady had epidural anesthesia.
Lateral position.
After determining the incision position for the operation, disinfection began.
The entire abdomen plus the thigh to the knee were disinfected in a large area.
Spread the surgical towel, one layer, two layers, three layers.
Make a 20-centimeter incision on the front and outside of the right thigh.
The incision position varies from person to person, and the main purpose is to fully expose the joint and the prosthesis.
Skin, fat, fascia, muscle, periosteum...
Zhang Yi is the second assistant, so he handed the surgical instruments to Fang Jianyu on the side.
Or occasionally help lift a leg or something.
But he has always paid attention to Fang Jianyu's operation.
I have to say, this guy is really good.
From freeing the skin to exposing the hip joint, there is really no unnecessary movement.
Well, not bad~!
"Separate..."
Fang Jianyu was about to ask for a separation forceps, but Zhang Yi already knew what he needed next.
Looking at the separation forceps handed over, Fang Jianyu couldn't help but look at Zhang Yi a few more times.
This kid... is quite smart!
He knows what the surgeon needs, and he handed it over quite quickly.
Not bad, not bad, quite flexible, it seems that he is a very good intern.
After exposing the hip joint, separate the adhesions around the joint capsule.
Fully expose the front, top and bottom of the hip joint, including the position of the acetabulum.
Just when Fang Jianyu was about to remove the synovium around the joint capsule again, Zhang Yi took the initiative to hand over the free forceps.
Fang Jianyu was stunned.
This intern looks plain, but I didn't expect him to be an experienced orthopedic surgeon?
He was quite clear about what was needed in each step!
Then free it.
After cleaning the area around the entire right hip joint, the next step was for several people to lift the entire thigh together.
Then rotate it inward and then adduct it outward to dislocate the femoral head.
Before Fang Jianyu could speak, Zhang Yi walked aside and said to the other two assistants:
"Hold on here, and when you apply force later, first adduct it inward and then rotate it outward, so that the entire femoral head can be dislocated quickly."
Chen Fang and another assistant nodded repeatedly: "Okay."
Fang Jianyu was stunned again!
I am the main surgeon!
You agreed to him before I even opened my mouth? !
Are you so sure that what he said is right? !
But Fang Jianyu thought about it carefully, and it was really right...
Only in this way can the femoral head be dislocated quickly.
To put it bluntly, it is to rotate it outward first and then adduct it inward, and forcibly separate the entire femoral head and acetabulum.
For a moment, Fang Jianyu couldn't help but look at Zhang Yi twice more!
This guy's name is Zhang Yi, right?
You know what, he's pretty good, not only has a clear mind, but also agile movements.
He likes people who are quick and decisive to help him.
Fang Jianyu was thinking, he wanted to recruit Zhang Yi to Ruijin Hospital as his real assistant!
On the side, Han Dongliang's face, the pair of eyes above the mask looked at Fang Jianyu for a while, and then looked at Zhang Yi.
Haha~ He finally understood.
This Fang Jianyu might have taken a fancy to Zhang Yi!
Of course, this fancy is for the technology, not the person~
In the operating room, several people had their own thoughts.
"Come on, one, two, three lift!"
With Fang Jianyu's unified slogan, several people lifted their thighs.
External rotation!
'Click'!
Internal rotation!
'Click'!
After two clicks of the joint separating, the femoral head
It was pulled off the acetabulum like this.
Then the joint capsule and synovium remaining behind the hip were separated again.
After cleaning, the femoral head was removed with an acetabulum chisel.
The next second, the acetabulum chisel appeared in front of Fang Jianyu.
Fang Jianyu's eyes flashed with appreciation again.
The more he looked at Zhang Yi, the more he liked him.
It's a pity that such a smart guy stayed in Tianhe City Hospital as a doctor.
I guess the trainees here only make two thousand yuan a month? ?
Tsk tsk, I wonder if he is willing to be my assistant and go to Ruijin Hospital with me? ?
The salary must be higher than two thousand.
"Director Fang?"
Fang Jianyu was lost in thought, and Zhang Yi shook him, and he reacted.
"Oh? Haha, I'm fine, the operation continues."
Fang Jianyu realized that he was a little out of state, and immediately adjusted his state, and the operation continued.
Ding!
Ding!
Ding!
Buzz!
Buzz!
Buzz!
After a while, the sound of chiseling bones rang out in the operating room.
The dislocated femoral head was cut off, and the necrotic part was chiseled open to expand the medullary cavity in preparation for the placement of the prosthesis.
As soon as Fang Jianyu expanded the medullary cavity, Zhang Yi took the initiative to stuff gauze into the medullary cavity to stop the bleeding.
Fang Jianyu was getting more and more satisfied with Zhang Yi.
They didn't know each other, but they could cooperate so well!
He was simply the perfect choice to be his assistant! !
He hadn't found a satisfactory assistant in the Department of Orthopedics at Ruijin Hospital until now!
Thinking that Fang Jianyu really wanted to train Zhang Yi, he said while performing the operation:
"Zhang Yi, look here. When cleaning the acetabulum, you must be careful about the soft tissue around the hip joint. Don't hurt the sciatic nerve, femoral artery, femoral vein, etc.
You can do as I did. First, use the sharp teeth to hook the back of the bone outside the acetabulum rim, and then tilt it slightly outward like this to pull the surrounding soft tissue apart.
This can avoid slippage and fully expose the acetabulum.
Do you understand? Don't think I talk too much. I think you are quite good as a regular trainee.
I want to teach you some more experience so that you can grow faster."
Zhang Yi: ? ?
Chen Fang: ○o○? ?
Han Dongliang: ○o○? ?
Other assistants: ○o○? ?
Zhang Yi's inner OS: Big brother? Are you teaching me how to do things? ? ?
"Ahem...Okay Director Fang." Zhang Yi nodded politely.
Although Zhang Yi didn't need him to teach him, he shouldn't say it to his face to embarrass him.
Chen Fang and another assistant in the orthopedic surgery department couldn't help but shrug.
From the back, you can only see the shoulders of the two people shaking up and down.
Shrugging.
From time to time, a slight strange laugh came from his throat.
Fang Jianyu was puzzled.
Did he say something wrong? ?
Why did these two people react like this? ?
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