With 3 lumbar vertebrae, Yang Ping began to demonstrate the technique of separating tumors from the pedicle and foramina.

Isolation also begins at the spinous process, as cristae tumors rarely invade the spinous process.

Starting from normal tissues, they are separated in a scientific order, which is the principle of non-leakage excision.

As the separation progressed, from the spinous process to the lamina, the pedicle and the vicinity of the intervertebral foramen were separated with a layer of bone cortex. Easy separation of the bone cortex, and only a laser to the knife can do this, ordinary scalpels can not do, ordinary instruments to separate the bone cortex, can only use a sharp bone knife.

In addition to the bony cortex, near the dural sac and nerve roots, the separation of the dural crest and the adventitia of the nerve, these unrelated layers of tissue are treated as pseudomembranes of the tumor, and the entire layer is lifted without damage.

Yang Ping adjusted the speed of the operation several times to adapt to the speed of the instrument nurse Qiu Ruo and the assistant Song Yun.

Surgery is a team effort, and it is easy to cause some problems.

Qiu Ruo could understand that this young professor had slowed down several times, but he was accommodating himself, and he was very moved.

How can there be a chief surgeon who accommodates the instrument nurse for surgery, but now it is like this, obviously the chief surgeon is accommodating her, she is like a favored princess, her heart is very sweet, and at the same time she is more focused, hoping to try to be as fast as possible.

After the cortex is lifted, the laser knife can easily complete the osteotomy in a very large part of the vertebral arch.

Both pedicles are separated in this wonderful way.

"This is because the periosteum is violated, but the bone cortex is fine, with soft tissue as the pseudomembrane, we have no way to start, so we can only use this extreme technique, this method is called subosseous separation, when there is no laser knife, the sharp small bone knife can also complete the separation, but it is very difficult, with a laser knife to separate, it will be much easier."

Yang Ping explained to Song Yun while doing the operation.

Subosseous separation, Song Yun heard of this separation method for the first time, but now this vertebrae, if you don't use subosseous isolation, there will definitely be tumor cell leakage.

Once separated from the bone, the problem is solved, and it is indeed a wonderful idea.

"The surgical method is very important, just like racing without restricting transportation, no matter how good you run, you can't run a car."

Yang Ping used an analogy to illustrate: if there is no concept and method of subosseous separation, and the habitual thinking that soft tissues are pseudomembranes are still stayed, the tumors of waist 3 will definitely rupture and leak.

L3 successfully amputated the pedicles on both sides to complete the opening of the loop.

Total vertebral resection, no matter what method is used, must open the ring, like a closed iron ring on a column, which cannot be taken out from the top and bottom of the column, either breaking the column or breaking the iron ring.

Obviously, the patient's spinal cord and nerves cannot be broken, so only the rings of the vertebrae can be opened.

The extent of invasion of lumbar 4 tumors is much less, the pedicle is not invaded, and the pedicles on both sides can be truncated using conventional separation methods.

In this way, the isolation of the posterior tumor and the opening of the loop of the three vertebrae were completed, which took about an hour, which was slowed down to take care of the assistant and the nurse.

In fact, the quality of doctors and nurses in Xiehe is very high, absolutely world-class, but Yang Ping is too strong!

"Would you like to take a break?"

Of course, Yang Ping wants to complete the operation in one go, but I don't know what everyone thinks, if you really can't keep up, it's better to take a break.

"It's okay, you can continue!"

The first to respond was Qiu Ruo, and when she rested, she was even more reluctant to go, and she had already received special care from Professor Yang.

"Professor Yang, do you want to add an instrument nurse!" Nurse Xin now offers to do so.

After graduating from Peking Union Medical College, Nurse Xin has been working at Peking Union Medical College, and I have never seen any kind of professor, but I have never seen a professor like Yang Ping.

The operation is ridiculously fast, and it is done so well, such a hand of kung fu can really be described as a stunt!

"No need, Nurse Qiu cooperated very well, the first time she cooperated so well, it was rare, Concord is Concord."

Yang Ping gave enough face to the instrument nurse today and enough face for Concord.

He is an outlier, and he can't ask others to be heterogeneous, but Yang Ping is still self-aware.

Hearing this, Qiu Ruo's heart warmed and he was very grateful.

---

Cheney's eyes never took off the screen, and he focused on watching every detail of the operation.

With three vertebral bodies, posterior surgery took only an hour.

I usually have a much rougher posterior separation than this, this kind of tumor, without five hours, can never complete the separation of the posterior road, and now the main knife of Concord only takes one hour to complete the separation.

So fast, what about the quality?

As long as you are a serious expert, you will definitely be able to see the quality of this god-level surgery.

Cheney's self-esteem was badly hit, no, badly crushed.

The bottle of mineral water was in Cheney's hand, pinched and kneaded, and there was no longer a normal place.

He had many questions in his heart to ask Director Hu, but Director Hu kept staring at the screen, his eyes did not take his eyes off, and Cheney did not dare to speak.

"Where's the bathroom?"

Cheney's bladder was a little nervous, and he couldn't hold it back, so he asked Director Hu.

"Concentrate on it! If there is any problem, I will mention it after the operation! Director Hu replied again.

“Yes，Isee!”

Cheney sat up straight, it should be okay to endure it any longer, the bladder has the ability to reabsorb, wait and see.

Professor Lu Donglai is a surgical oncology student, and after seeing this level of surgery, he finally understood why Professor Liang was so bloody about Yang Ping.

When it comes to picking people, Liang Lao's vision is the first in Xiehe, and no one dares to say second.

Zhang Chunquan, who was unremarkable at the time, was caught by him and poured a lot of effort into it, although this kid is now in the United States, but his ability is definitely the world's top, the stem cell project of the Massachusetts Institute of Technology Whitehead Laboratory in the United States, Zhang Chunquan accounts for the number one credit, and I heard that there will be Nobel funds in the future.

"Elder Liang, your student's surgical level is a bit exaggerated, I said that Elder Liang, how can you lose your eyes when you fancy the talent, so I Lu Donglai didn't blink when he signed it." Professor Lu said it as if it were true.

Professor Liang didn't buy his account as the director of the medical department: "Of course you don't blink your eyes, because you signed with your eyes closed under my coercion and temptation, and you didn't sleep well for three days after signing, right?" Can you get a good night's sleep tonight? ”

Professor Lu's ridicule of Professor Liang was that his face did not change and his heart did not beat: "After signing at that time, I really didn't sleep well for a few days, I was excited!" ”

The skin is thicker than the city wall, and Concord is only Lu Donglai.

Now the credit for the introduction of Yang Ping, Professor Liang is the first, and Lu Donglai is the second.

After a while, maybe Lu Donglai will be the first and Professor Liang will be the second.

---

After the posterior surgery is completed, the posterior surgical area should be temporarily closed, gauze should be filled in a special position, the incision should be temporarily closed with leather nails, and then a sterile medical film should be pasted.

Turn the patient over and turn it into a supine position, re-sterilize the sheets, and perform anterior surgery.

Because the tumors of Lumbar 2 and Lumbar 3 invaded the abdominal cavity anteriorly, adhered to the abdominal aorta and inferior vena cava, and the walls of the large blood vessels had been degenerated, Yang Ping thought that if he ignored them, the risk of aortic dissection in the future would be extremely high, so he asked Song Yun to ask for the support of vascular surgery and implant artificial blood vessels to take precautions.

If it was in Sanbo Hospital, Yang Ping would not need to ask for a vascular surgeon at all, and insert artificial blood vessels by himself, and do the full set by himself.

In Sanbo Hospital, he has the authority to perform general surgery, and it is estimated that he is the only surgeon in the country who can have such special treatment.

But not in Xiehe, his authority is only within the scope of the --- orthopedics of the old bank, separating the aorta from the abdominal cavity or playing the side ball, if Director Hu comes to do it, this step also requires the coordination of basic surgery and vascular surgery.

If it is an emergency life-saving situation, Yang Ping will make an exception, now is not the time to save lives urgently, and can only act in accordance with medical regulations.

Yang Ping has always believed that doctors should be rational, not emotional.

Director Zuo Ruiting of the Department of Vascular Surgery of Union Medical College came to support with two assistants, and the Department of Vascular Surgery of Peking Union Medical College receives many emergency surgeries such as aortic dissection every year, so Director Zuo basically does not have the concept of Saturdays and Sundays.

In his own words, Wangfujing Pedestrian Street is near Xiehe, and he can see the lively scene from the window, and he rarely goes to visit, sometimes just looking through the window.

Called by the Department of Orthopedics to cooperate, Director Zuo had no complaints, and took the assistant to just look at a few image pictures: "This patient is to be inserted into an artificial blood vessel in advance, otherwise ninety percent may have aortic dissection and tear after surgery, not long ago we had such an operation, after the abdominal tumor, the tumor was adhesion with the aorta, three months after the operation of the outer hospital, the aortic dissection was formed, and more than 20 centimeters were torn from top to bottom, but fortunately, it was sent in time and saved." ”

Director Zuo has rich experience and has rescued many patients with aortic dissection, and snatched people from Lord Yama in three days.

"Brush your hands!"

Director Zuo is a bold person, and when he gave an order, he took two assistants to brush his hands on stage.

Surgeon, just do this one.

---

Yang Ping withdrew for the time being, and hid his hands in the handguards on his chest to rest.

"Professor Yang---"

Taking advantage of Director Zuo's time to wash his hands and the operation was paused, Qiu Ruo shouted in a low voice.

Yang Ping turned his head when he heard Qiu Ruo's voice, and the instrument nurse was smiling at himself: "Thank you!" ”

"You're welcome!"

"You --- look at the equipment I prepared, right? Wait a minute, you're going to use it. ”

Yang Ping took a look, that's right, it's these instruments.

In fact, Qiu Ruo is really an excellent instrument nurse, worthy of being a graduate student of Xiehe, but it is still a little worse than Xiao Su at home.

"That's right, it's these instruments, stabilize your speed, don't rush."

"Well, thank you!"

I didn't expect this big professor to respond to herself and chat with herself, she thought that Yang Ping would only deal with a few words.

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Chapter 654 - Yes, I see!