Professor Guo said secretly in his heart.

Because now it is the most critical step, that is, to isolate the tumor close to the kidneys, sciatic nerve, iliac arteries and veins and other important organs and large blood vessels.

Once the blood vessels are pierced, the next step is to stop the bleeding!

Crazy to stop the bleeding!

Because sometimes blood vessels and nerves are attached to tumors?

Ruan Bin used a spinal rongeur to remove the lamina and spinous process of the sacrum at a posterior sacral foramen on the upper boundary of the tumor, so that the spinal canal was fully exposed.

Due to the embolization before the operation, he began to remove the sacral vertebrae with rongeurs!

Seeing Ruan Bin's action, everyone's breath suddenly froze!

"Are you going to have a total sacral resection?" Huang Weilin exclaimed! Because an incision to solve a total sacral resection was unthinkable in the past. Because of total posterior resection, it is necessary to amputate the sacroiliac joint from the back of the patient, but the problem is that all the blood vessels of the organs are in the front, and the slightest carelessness is a terrible hemorrhage. Therefore, no one dared to cut it from behind.

Now, is Ruan Bin going to challenge?

Even Professor Guo took a breath!

Is this young man so calm at this point? There is no nervousness on his face!

But this patient's tumor is so deep that Ruan Bin can only use this method to come up with and remove it completely!

In fact, the big reason why Ruan Bin is sure now is that after preoperative vascular embolism, there is not much bleeding from the wound, there is no dangerous bleeding, and there is not much bleeding even if the tumor is removed, so it is allowed to dissect the intrasacral structure in detail. In addition, the end of the dural sac ends at the level of sac 2, the superior nerve is located on both sides of the lower nerve, and the terminal line is located in the middle, which is easy to injure the dural sac and cauda equina nerve by bone knife or wire saw. This disadvantage can be avoided by rongeur excision.

Finally, in the sacral canal, if the tumor is higher than the sacral 3 foramen level, the sacral 3 is often compressed, displaced, or encapsulated within the tumor. However, sacral tumors are most likely not highly malignant, so it is allowed to cut the nerve sheath of the sacral 3 nerve, separate it from the tumor, and dissect it along the nerve root to the anterior sacral foramen, and enlarge the anterior sacral foramen with lamina rongeur to move the sacral 3 nerve above the osteotomy plane. If the sacral 4 and sacral 5 nerves are enclosed in the tumor and are not easily dissected, they can be removed together with the tumor.

Just when everyone was sweating for Ruan Bin, the scalpel in Ruan Bin's hand flew like an elf, and the entangled blood vessels, nerves, and so on were separated by him one by one.

There is no danger!

The separation was successful! Seeing that Professor Guo and the others almost thought that Ruan Bin was not from the earth!

In the next second, Ruan Bin cut the sacrum at the upper boundary of the tumor, and the tumor of more than ten centimeters was peeled off and removed step by step under the irradiation of a shadowless lamp. In the operating room at 24°C, Ruan Bin did not have the slightest bead of sweat on his forehead. On the contrary, Huang Weilin's assistant was sweating!

"Give me a rub. Huang Weilin said to the nurse beside him.

Finally, under the operation of Ruan Bin's hand of God, the tumor was successfully peeled off!

Ruan Bin used nail rods to fix the uncut ilium at both ends to form an arched structure like a church, and then used an allogeneic bone to resist the strength, which is equivalent to playing the role of a house beam. 4 rods, 10 nails, a heterogeneous bone, sawing, cutting, knocking, chiseling, twisting, Guo Wei's movements on his hands were smooth, and in just a few steps, half of the pelvis was cleanly rebuilt.

This one-handed operation made everyone stunned again!

Is it that simple to rebuild?

Why do they have to get half an hour at a time?

, people are more popular than people! No, I want to cry.

At this point, the posterior wall of the rectum bulged out of the wound after sacral resection, and he began to examine the lesion closely.

"What, how is it so fast?, is there any secret?" Huang Weilin couldn't help but ask.

This is also what another assistant wants to ask, and it is also what the dozen orthopedic surgeons outside who are watching the live broadcast of the operation want to see!

"If the tumor invades sacrum 2 and sacrum 1, the nerve roots should be dissected as much as possible, and sacral reconstruction should be done in addition to removing the tumor. For patients with total sacrohip resection, reconstruction can be achieved by transverse transplantation of allogeneic bone between the ilium on both sides or repair and fixation of the lumbar spine with metal rods and wires. If part of the sacral 1 vertebral body is still retained after the tumor is removed, a metal rod of appropriate length can be used, wait for the posterior superior iliac spines on both sides, and use steel wires to make ∽-shaped winding at both ends of the metal rod that exposes the outer wing of the iliac bone, fix the pelvis, and can also stand and walk after the operation, place the negative pressure suction tube in the wound through the gluteus maximus fibers, and suture the wound in layers and intermittently...... Ruan Bin saw that the operation was almost completed, and the movements in his hands slowed down, while explaining.

"Taught!"

"I benefited a lot from this surgery. "Although Professor Guo watched it through MR connection, he also benefited a lot!

Especially when he thought that he might be able to help, he didn't expect that Ruan Bin would have surgery during the whole process, and there was no mistake, so he didn't need to speak for guidance at all!

Even he had a lot of things in his heart that he wanted to ask Ruan Bin!

"This talent, if it were from our Jingjing University Hospital, it would be good. Professor Guo said secretly in his heart.

After the operation, Huang Weilin's attitude towards Ruan Bin changed from before.

He used to think that Zhang Chao was a little too boastful, but now after seeing Ruan Bin's real operation, he almost wanted to apprentice to Ruan Bin!

But when I thought of my age, I was twenty years older than the other party...... Forget it.

I can't afford to lose this person!

After all, have you ever seen a master so much younger than an apprentice?

Have you ever seen an orthopedic director studying as an attending physician in the emergency department?

Ahhh

"It's too difficult, it seems that there will be a lot of practice in the future, and I will take the opportunity to study here with him!" Huang Weilin thought in his heart.

......

"Director Huang, right, do you have his contact information, Dr. Ruan Bin?" asked Professor Guo with a smile. That's right, he wants to dig the foot of the wall!

"Uh...... He was in a hurry, and I didn't have time to ask. Huang Weilin was surprised, and secretly said in his heart, why did Professor Guo want Ruan Bin's phone?

"What? Isn't he your orthopedic doctor, how could a senior doctor of yours not have his phone?" Professor Guo said with some disbelief.

"Well, he's from the emergency department~" Huang Weilin said.

"What? The doctor in the emergency department ......" Now it was Professor Guo's turn to be stunned.

A doctor in the emergency department is at such a good level in orthopedics, why does Mao not come to orthopedics?

............

"Hahahaha! Lao Huang, Lao Huang, what's the matter, I just said that Ruan Bin is omnipotent, are you willing to lose the bet now?" After getting off work, Zhang Chao saw Huang Weilin and was very happy after knowing that the other party had lost the bet.

At the same time, he breathed a sigh of relief, Ruan Bin is really amazing!

Even Professor Guo is not too sure about the operation, he can do it!

And it worked!