Professor Tian's technique is very smooth.

The skin was incised, and the spinous process and lamina were exposed, and the two vertebral bodies above and below the diseased vertebral body were fully exposed.

In order to better expose the incision, the sacrospinous muscles on both sides should be cut transversely from the level of the affected vertebrae and retracted distal and proximal, respectively.

In general, there should be at least 200ml of bleeding at this time.

Because in the process of exposing the spinous process and lamina, a certain periosteum has to be processed, resulting in hemorrhage.

But today's surgery went unexpectedly well.

The amount of bleeding is less than 50ml, and the entire surgical field looks exceptionally clean.

Professor Tian is very satisfied with his technique, and it seems that today's hand style is very smooth, and the surgical bleeding may be less than 3000ml.

The next step was about to start bleeding profusely, and Professor Tian's hand was much softer, and he slowed down very seriously. All procedures are carefully identified to avoid accidental bleeding.

The rongeur begins to bite off the spinous processes and lamina with tumor infiltration.

"Gaba~", a piece of broken bone was bitten off by bone rongs.

Because of tumor infiltration, the bone plate is not so hard, and the sound is like a decay.

Although the stiffness is insufficient, the amount of bleeding increases dramatically because there are abnormal blood vessels in the tumor, which causes the bone plate to have sufficient blood supply.

Heavy bleeding, that's from now on.

A piece of vertebral plate was bitten off by the rongeur, and Professor Tian habitually covered it with a piece of dry gauze.

Odd......

In an instant, Professor Tian found that it had taken a full ten seconds for the dry gauze to be soaked with blood.

Professor Tian has a very high level, although he has not reached the level of a master, but he is also a professor of orthopedics at the level of a senior master, almost at the level of a grandmaster.

He has a deep understanding of vertebral body removal surgery.

If there was less bleeding before, it was because of the high level of self-separation, which can be explained.

However, if the rongeur bites off the vertebral plate, it is unlikely that the amount of bleeding will be particularly small in this step.

Generally speaking, from this step, the surgery is performed in a pool of blood.

The kind that can't be sucked clean by the suction device.

Blurred vision can lead to more bleeding, and so on.

On that side, fresh frozen red blood cells were already hung, waiting for Professor Tian's order, ready to be transfused into the patient's body at any time.

Strange, is it a rare tumor? The blood supply is not abundant?

No, Professor Tian was a little incomprehensible to the situation in front of him.

Even if the blood supply to the tumor is not abundant, the blood supply to the vertebral body is quite abundant. It would never have taken ten seconds for the bleeding to soak through a piece of dry gauze.

"Teacher Tian?" Seeing that Professor Tian was stunned and didn't know what was going on, Dr. Zhou called out softly.

Professor Tian came to his senses from the infinite speculation, condensed, and continued the operation.

Continue to bite off the lamina, exposing the nerve roots.

The tumor invades the spinal canal, and the dura gradually bulges outward without pulsation during the operation, and the epidural fat often disappears, and the dural sac is compressed, displaced or deformed.

Professor Tian did not continue to cover the vertebral plate that was bitten by the rongeurs, and he wanted to see how much bleeding there was.

Sure enough, the amount of bleeding was extremely small, only a few tens of milliliters.

It's a problem with interventional surgery!

Professor Tian quickly judged the truth of the matter. However, he could not accept this truth.

In the imperial capital, as an expert and professor in spine surgery, I often cooperate with interventional doctors to complete vertebral body extraction.

But have you ever encountered such a small amount of bleeding?

No, not once.

With the cooperation of the interventional department, it can indeed reduce a certain amount of bleeding. It has something to do with the artist's technique, but it doesn't have much to do with it.

What's so hard about just embolizing a transverse lumbar artery?

Unable to find an interventional doctor, Professor Tian himself was able to perform surgery to embolize the transverse lumbar artery in a lead suit.

However, whether it was the interventional doctor or his own embolization of the transverse lumbar artery, the amount of bleeding could only be reduced from 5,000 ml to 2,000 or 3,000 ml.

No matter how little, Professor Tian has really encountered it.

Haicheng is such a small place, there are doctors who are stronger than the imperial capital?

Impossible, completely impossible.

Professor Tian had these things in his mind, but he didn't pause at hand.

This kind of surgery is done too much, not to mention that it can be done with the eyes closed, at least it is not necessary to repeatedly recall the local anatomy like the first time.

Nerve stripping ions are used to locate nerve roots on both sides of the dural sac and protect them.

Subsequently, Professor Tian began to peel off the tumor tissue, the dural sac and the lateral side of the nerve root, and removed the superior and inferior articular processes and pedicles one by one, together with the tumor tissue seen.

Generally speaking, before laminectomy, the transverse lumbar artery is embolized.

There is no interventional embolization, at which point threatening bleeding occurs.

What is threatened bleeding?

An invisible blood vessel, whirring blood, the whole surgical field was red, and even the bleeding blood vessels could not be found, let alone vertebral body extraction.

No threatening bleeding, fine.

But...... There is no threatening bleeding here, and even bleeding is not good!

To insist that there is no bleeding at all is.

But Dr. Zhou held an undomed suction device in his hand, and he easily cleaned up the bleeding, and the surgical field was exposed very well, so good that Professor Tian was a little panicked.

This is not the vertebral body extraction that I am familiar with......

Did you do something wrong?

He stopped and recounted the whole procedure without any problems!

Looking at the field again, the anatomy is clear and can be used as a textbook map, and there is no problem.

What the hell.

The operation went so smoothly that there was a problem.

Professor Tian was a little apprehensive in his heart, since he came into contact with vertebral body extraction, he had never seen such a surgery.

If he was in the imperial capital, Professor Tian would have the heart to find a few colleagues, and even find his own teachers to watch the stage to see if he had any mistakes.

But this is Sea City.

Let's do it.

Exposure and removal of the transverse process of the lumbar vertebrae, very smoothly, bleeding ...... It is still very rare, the lumbar transverse process here, the bleeding will generally be about 500 ml, and it will take 30 minutes.

This is Professor Tian's experience.

But in this hellish operation, the amount of bleeding was only 30-50 ml, and it took 15 minutes to complete this step.

Subsequently, Professor Tian began to expose the anterolateral surface of the vertebral bones, and the vertebral body invaded by the tumor was moderately enlarged, but its margins were clearly demarcated from the surrounding tissues. Gentle peeling pushes the surrounding tissue away for peeling.

Normally, this step will still have 200-300 ml of bleeding, which is time-consuming......

However, it is still very smooth here, the amount of bleeding is only one-tenth of the usual, looking at the suction device pipe in Dr. Zhou's hand, it is estimated that there is 20-30 ml of bleeding.

After dissecting the diseased vertebral body to the anterior longitudinal ligament, Professor Tian asked Dr. Zhou to use a Hohman retractor to retract the surrounding tissues, and the lateral anterior approach of the vertebral body appeared in front of him.

Surgery...... It's so smooth, it's so smooth that it's trance-like and terrifying.

Is this vertebral body extraction?

No, how could there be so little bleeding? How could the surgery go so smoothly?

True...... What the hell!