The silence was short-lived, and the discussion continued, tense and intense.

Engaged in academics, there are not so many curves, everyone sometimes quarrels, slaps the table, and everyone is red-faced, and no one is convinced.

With Professor Su in charge of this meeting, naturally there will not be such an explosive situation, but arguments are indispensable.

"Director Han, what do you think?" Director Zhao asked.

Director Han is straight, like a general holding a pre-war meeting: "The best way is to perform a nerve root block, but to avoid anesthetic leakage, it is necessary to perform nerve root sheath puncture and catheterization, which is very difficult, but it is still feasible." ”

The problem was pulled to the nerve root block, the director of the cancer hospital slid the tablet with one finger, supported the palm of the hand on his cheek, and looked at it for a moment: "This nerve root block is really too difficult, I see that the blood vessels of the tumor tissue are very rich, and the patient's coagulation function is not very good. It is easy to wear it by mistake and cause bleeding. ”

"Well, that's true, this kind of piercing is like a sniper, it has to be hit with one shot, there can be no mistakes, and one mistake can have serious consequences." Director Yu of the Department of Orthopaedics of Appendix 2 agreed with the opinion of the Cancer Hospital.

The plan has eyebrows - nerve root block, it seems that no one can come up with any other plan except this, but the difficulties are also in front of them, and they are not small difficulties.

Everyone looked at Professor Su and handed over the problem to Professor Su.

Professor Su held the tablet with his left hand, propped his right elbow on the table, took off his glasses, looked up and said, "Everyone has explained in detail, it seems that nerve root block is the only option, and everyone has no objection." The difficulty lies in the difficulty of puncture, which is indeed very large, but it is not impossible, and we need to use CT and MRI 3D reconstruction to find a way to choose a correct puncture approach. With the help of computer-aided navigation technology during the operation, puncture can be realized! ”

Puncture is difficult, but achievable, this is Professor Su's conclusion.

"What if it fails? Salvage measures? Director Yu of Appendix 2 has a different opinion.

Professor Su, take a piece of lens cloth, wipe the glasses and said: "This problem is very good, there are risks in any medical operation, in the face of risks, we must try our best to prevent it, and there must be backup rescue measures, if once the puncture fails, into the tumor, causing bleeding, we will give up the puncture, and place a drainage tube in the puncture path, which can bring negative pressure to draw out the blood and avoid the formation of hematoma and compression of the spinal cord." ”

Professor Su has an active mind and careful thinking, and the selection of solutions, risk control, and rescue methods for the worst outcome in a short period of time have all been arranged, which Director Yu admires in his heart.

This puncture, far from being as simple as imagined, how to achieve it, can see a person's thinking ability and the accumulation of knowledge and experience in ordinary times.

Just like a sniper rifle to shoot a shot, it is not as simple as pulling the trigger, every time you pull the trigger, it is the result of a thousand tempers.

"Do you have any other comments?" Director Zhao asked questions as the moderator.

Director Han smiled and said, "Two young men, do you have any opinions?" Also speak a few words, don't say a word. ”

Originally, on this occasion, it was inconvenient for Professor Su Nanchen to speak, so it would be good to observe. Now that Director Han took the initiative to let the young people exercise, Professor Su said to Su Nanchen beside him: "What good ideas do you have for such a precious opportunity given by your seniors?" ”

Su Nanchen was confident, but not arrogant, and said calmly: "Thank you Professor Han for giving the juniors the opportunity to speak!" This puncture is indeed like a sniper, the enemy is still hiding in the bunker, the puncture must avoid both tumors and bone tissue, and the choice of puncture path is very limited. If conditions permit, 3D printing technology can be used to print out the reconstructed spine, tumor, and neurovascular, and use a one-to-one accurate printing model for puncture approach design, simulate puncture, and even temporarily design positioning instruments, so that if navigation equipment is used during the operation, the success rate of puncture will be greatly improved. ”

This young man has a really good mind, he is able to combine cutting-edge 3D printing technology and puncture, and according to him, the success coefficient can indeed be multiplied.

Several directors were impressed by Su Nanchen, even without Su Qingyun's help, he could make achievements in medicine.

Professor Su put back on his glasses: "Xiao Yang, what do you think?" ”

Professor Su has a good memory, Director Han only introduced it once, and he remembered the name, whether it is to love young people or return the favor, he should name them and let them speak.

Director Han encouraged: "Professor Su has named him, let's say a few words." ”

"Xiao Yang, tell me what you think?" Director Zhao also encouraged.

Yang Ping also said calmly: "Thank you, Professor Su, thank you!" I think that the puncture does not need to avoid the bone tissue, directly from the bone tissue, from the pedicle, the bone tissue is the safest, as long as the puncture needle is in the bone tissue, there will be no risk of damaging the blood vessels, you don't need to know where the reef is, just know where there is no reef. ”

The pedicle is the bony duct that connects the anterior and posterior parts of the vertebrae, with hard cortical bone on the outside and loose cancellous bone on the inside.

It's a novel and unconventional idea.

"Since the enemy is hiding in the bunker, which is a dead end of our trajectory, we will accurately calculate the enemy's position in the bunker, shoot at the bunker wall, penetrate the wall, and then let the bullet pass through the hole in the wall and snipe the enemy, thank you." Yang Ping finished speaking.

Professor Su looked at the three-dimensional reconstruction image on the tablet again, this idea is really imaginative, the entire puncture path is in the bone tissue, and the last step is to penetrate the bone tissue, so that the possibility of accidental penetration is not reduced, but completely solved, the possibility of accidental injury is almost none, and the rest is the problem of how to hit the enemy.

Pedicle puncture, which is a basic technique for any spine surgeon, is a pedicle nail every day, and the probability of failure is extremely low. However, conventional pedicle access is not possible, it needs to be tilted, and the ultimate goal is intravertebral, not intravertebral.

Professor Su was very interested: "Xiao Yang, your idea is very imaginative and very feasible. ”

"Transbone and pedicle puncture, if combined with Dr. Su's 3D printing to simulate puncture, the success rate is very high, and there is no problem with feasibility." Director Han synthesized the opinions of the two people.

The director of the cancer hospital laughed: "It's still young people who have imagination, one has moved out 3D printing, and the other has proposed sniping on the wall, which is interesting, it seems that we are old." ”

Director Yu joked: "I saw that you were like this for a while, drank two bottles of water, and didn't mean to go to the bathroom at all, where is the old, I really don't see it." ”

Everyone laughed, which was a relaxation of the tense discussion.

"The puncture path is clear, the method to improve the success rate of puncture is also available, and the rest is action, do you have any other opinions?" Professor Su asked.

At this point, the question is very clear.

"Transbone puncture, there is no possibility of accidentally injuring the tumor, and the possibility of bleeding is also minimized, but bleeding cannot be completely avoided, the puncture path is all cancellous bone, and it will also bleed, and finally the puncture needle is not into the vertebral body, but inclined to break through the bone tissue and enter the spinal canal, and the blood may flow along the puncture pipe to the spinal canal, forming a hematoma compression, the possibility is very small, but it is still possible, and there needs to be a coping plan." Director Yu found a loophole in the plan.

"This kind of bleeding is different from blood vessel rupture bleeding, it is bleeding from the bone surface, use a local catheter with a balloon, calculate the distance, the balloon is coated with bone wax, the balloon is partially placed in the bone tunnel, and the catheter is inflated and compressed to stop bleeding." Professor Su immediately said that there was little thinking, and the countermeasures that he came up with on the spot showed how extensive his knowledge was.

"Wonderful!" Director Yu blurted out.

Unexpected remedies are also available, and the program is very complete.

"Professors, do you have any questions?" Director Zhao asked.

Everyone shook their heads and drank water.

Director Zhao finally concluded: "Then set the plan: thoracic 2 nerve root block, transbone puncture catheterization, preoperative 3D printing simulation puncture, intraoperative computer navigation assistance!" ”

"Professor Su, look, is this okay?" Director Zhao asked Professor Su for his opinion, and he was only the administrative host, and he still made the decision professionally.

"Yes, just use this wall sniper plan!" Professor Su has the final word.