The aorta and inferior vena cava separate all the way to the diaphragmatic fissure.

In addition to separating the main trunk, it is also necessary to separate their countless branches, which must also be separated to a sufficient length, otherwise the strong traction will tear the blood vessels and fill the patient's chest with blood in an instant.

There are too many branches, and each one has branches, and almost all the main branches have to be separated in this way.

This is a meticulous work, there is no way to get up quickly, Yang Ping's knife tip is parting those old sticks little by little.

This requires a lot of patience, not to be impatient, not to be discouraged, not to be slack.

In addition to the heart and large blood vessels, the chest cavity also contains the thymus, lungs, trachea, and bronchi.

Now that the problems of the heart and large blood vessels have been solved, the thymus gland does not need special treatment, and the rest is the problem of the lungs and trachea.

Under the blowing of the ventilator, the lungs shrank one by one, and the current state of the lungs is very good, and in the next spinal orthopedics, they will not be involved, and some adhesions are also easily handled by Yang Ping.

But the trachea and bronchi are not so rosy and must be properly separated, like the great blood vessels.

The trachea and bronchi are behind the heart and the great blood vessels, Yang Ping put in two rubber strips, bypassing the aorta and superior vena cava respectively, pulling them to the sides, and then clamping the two ends of the rubber strip with large curved forceps and handing them to the second and third assistants who are responsible for exposing them.

The retracted aorta and superior vena cava reveal a window, revealing the trachea and bronchi hiding behind.

If there was no separation of the aorta and superior vena cava, so that they could form independently, there would be no way to retract them now, and the trachea and bronchi would not be exposed.

The trachea is easier to reveal than the blood vessels because the annular fibrocartilage structure makes it easier to identify than the blood vessels and the surrounding adhesions.

To liberate the trachea and bronchi, the organ treatment of the chest cavity is not over, and the organs must be properly suspended and fixed in the human body, otherwise they will be stacked together because of gravity and movement.

Yang Ping has taken this into account, and when dealing with adhesions, some adhesions suitable for suspension are retained, but there are very few such adhesion bands.

In order for these organs to be well fixed, they have to be rebuilt at critical points, which seems simple but complicated to do.

If there is no suspension and fixation, it is very simple, when running, the intestines of five to eight meters long are either piled up together by gravity, or intertwined and knotted, but in fact we don't, let alone running, even if you turn a few heels, the internal organs and intestines are still fixed in their original positions.

This is because our internal organs have a special structure to fix it, and this fixed structure is some membranes, but the fixation should not be too dead, and the internal organs should be given a certain space to pulsate or peristalsis.

Several large blood vessels sent out by the heart, themselves extend in all directions, have a fixed effect, but this is far from enough, the main structure of the fixed heart is the pericardium, so after the pericardium is peeled off, it is enough to stop, instead of removing all the pericardium, so that the heart becomes a smooth egg.

The organs of the abdominal cavity are fixed to the body wall by the omentum, mesangium, and ligaments.

The intestine is surrounded and fixed by omentum and mesentery, and there are also many ligaments fixed by hepatobiliary, pancreatic and spleen.

Therefore, after separating the organs of the chest cavity, it is necessary to rearrange them and return them to their normal state, and the key part is to correct or rebuild their fixed structures, so that they can be in place and stick to their posts.

This is beyond the understanding and ability of the average surgeon, and few surgeries are considered so thoroughly, except for joint ligament reconstruction in sports medicine, few consider the reconstruction of ligaments in internal organs.

Most of the ligament structures have been isolated by Yang Ping, but they need to be lengthened because of contractures, very few need to be shortened due to laxity, and some ligaments need to be reconstructed.

Considering that it takes some time to reconstruct the ligament to heal, Zheng Baosheng will be restricted from moving in bed for two weeks, and will start to move on the ground after two weeks, and will not be able to play sports for three months.

Yang Ping began to perform surgery on these ligaments and mesangium, lengthening, shortening, or reconstruction, and the removed pericardial tissue came in handy at this time for waste utilization and became a material supplier for reconstruction.

Each ligament has been carefully treated, and the organs of the chest cavity have been treated, and now it looks as if they are still squeezed together as before, but this is only a superficial phenomenon, in fact, they have said goodbye to the previous adhesions.

It's just that due to the limited space, they have to still be crammed together.

If the spine suddenly returns to its normal curvature and the entire thoracic volume expands, these organs are immediately able to distribute in the ribcage in the correct position as close to a normal person.

Diaphragmatic tears, spaces connecting the chest and abdominal cavity, aorta, inferior vena cava, vagus nerve, and esophagus all enter the abdominal cavity through their respective spaces.

The diaphragm of the dome structure, now like a collapsed roof, loses its proper shape and is full of folds that, if not opened, will also receive traction tears once the spine is orthopedic and the volume of the ribcage is restored.

The diaphragm is like a folded lotus leaf, opening the folds and allowing it to gain the ability to open to fit the normal posture of the body in the future.

After the diaphragm is treated, the abdomen is opened, and the abdomen is also a median incision.

"Down there is the liver and pancreas?"

Professor Li was cautious, holding his breath even when he spoke.

Yang Ping nodded.

Crossing the diaphragm and entering the abdominal cavity is no longer an area of expertise for Professor Li.

"Let Dr. Song come?" Yang Ping felt that it would be more appropriate to let Song Zimo be an assistant in the next step.

In the training of compound trauma surgery, Song Zimo is already very proficient in the anatomy of the whole body, in terms of heart and large blood vessels, Song Zimo is far inferior to Professor Li Zehui, but in the anatomy of the abdominal cavity, he is definitely better than Professor Li, and it has nothing to do with fame.

Seeking truth from facts is the greatest conscience of doctors.

"After completing the treatment of the diaphragm, Dr. Song will be the first assistant, and I will be the second assistant."

Professor Li complied with the arrangement of the chief surgeon.

The organs of the abdominal cavity are much more optimistic than those of the thoracic cavity, and they are much less modified -

A group of orthopedic bigwigs, waiting to see scoliosis orthopedics, are now facing thoracic surgery, and they are also watching with relish.

Young people are so proficient in dissection, especially cardiac large vessel surgery, whether it is adhesion separation or suspension fixation, it is simply a miracle.

If he has such anatomical skills, any operation in his hands will be much easier than others.

Such a young talent, Professor Qin likes it more and more.

Even if it is not poached, Sanbo Hospital must be made into 301's medical center in the south.

With the support of leaders and their own efforts, this thing can be successful——

The surgery of abdominal organs, Yang Ping completed it quickly, almost all of them were adhesion separation, no fixation was required, and the original ligament position and length did not need to be corrected.

After the organs of the chest and abdomen are treated, the anterior surgery is completed.

The almost impossible operation was successfully completed by Yang Ping in such an orderly manner.

At this time, Professor Li was not only worshipping in his heart, but also worshipping.

If he hadn't seen it with his own eyes, he wouldn't have believed that someone could have done such an operation, or that someone could be so skilled in human anatomy.

"You rest for a while, I'll close my chest and abdomen." Professor Li has the attitude that Yizhu should have.

Yang Ping really needed to take a break, and he handed over the rest of the work to Professor Li and Song Zimo.

They began to flush the surgical area, then placed drains, from the inside out, with layered sutures, to close the thoracic cavity and abdominal cavity, drilled through the cleaved sternum, and secured with several pairs of wires.

Next, scoliosis orthopedics is done in the prone position.

Remove all sterile sheets, turn the patient over into a prone position, and re-sterilize the sheets.

There are norms for changing positions over the bed.

It takes several people to operate, how each person stands, what work he is responsible for, and the posture of his hands.

A head nurse in the operating room of Union Medical College Hospital has written a book called "Safe Surgical Position Atlas".

This should be the only monograph in China that systematically introduces how to position the surgical position.

In Europe and the United States, there are special positioners in the operating room, who specialize in helping patients position themselves so that doctors can operate comfortably.

Don't underestimate the patient's surgical position, a good position can make the operation more effective with half the effort. Poor or wrong positioning often makes surgery more difficult, sometimes making surgery impossible and causing complications.

This is the gap between a rough and fine technique.

If Zhang Lin and Xiao Wu can learn the "Surgical Hook" into a book, it will definitely fill the gap in China, and the pioneering work may also fill the gap in the world, because they will push the hook technology from rough to fine.

When the apple falls from the tree, when it is studied as a science, the results are immeasurable-

"Little Five, Zhang Lin, come on stage!"

Changing the position, Yang Ping took off the surgical gown and gloves, rested for a while, Song Zimo took them to disinfect the sheets first, cut them open, and beat the pedicle screws, and then Yang Ping went on stage for osteotomy and orthopedics.

"Okay!"

Zhang Lin dragged the urine bag and followed Song Zimo out to brush his hands.

Because he walked too fast, the urine bag dangled on his thighs.

Professor Li saw the urine bag hanging from Zhang Lin's trouser leg and immediately knew what was going on.

I remembered that when he was still a low-seniority resident, once, with a high-seniority resident, he drank a lot of beer, and when he encountered emergency surgery, Professor Li had no choice but to secretly hang a urine bag on stage, and Professor Li's role in the operation was the second assistant at that time.

The senior doctor who drank with him, but he didn't have this intelligence, and he couldn't hold his urine as a helper on the operating table, so he had to apply to the tutor: urination!

The tutor was very angry, and when Yizhu got off the stage to urinate, he said to Professor Li, "I remember you, and you will help you in the future." ”

A urine bag changed Professor Li's status in the heart of his mentor.

Anyone who can achieve things is a person who can be ruthless to himself.

This kid actually has the shadow of him back then.

The first is the latest.