Dr. Wen spat out a series of nos, and Song Zimo couldn't interject.

Even Xu Zhiliang looked extremely impatient, he turned around and asked Robert to point his phone at him.

"You-you're -——-, just -—— a word-success--—— rate-—— not?"

Hearing this Xu language, Zhang Lin sweated on the back of his neck, Zhang Lin and Xu Zhiliang were a group of Xu Zhiliang's subordinate doctors, and they had to face this way of communication almost every day, every time they encountered this kind of stammering, Zhang Lin not only did not dare to refute, but also listened respectfully and seriously, and could not miss a word.

Wen Ruzheng's voice came from the phone: "Non-non-—— is very high, similar to ordinary frozen slices -—— Pu-Pu. ”

Damn, he actually dared to repeat himself, Xu Zhiliang was so angry that his teeth itched.

"Tell him that if anything goes wrong, he won't even be allowed to wear underpants this time." Yang Ping said towards his phone.

Wen Ruzheng's stammering voice inside immediately stopped, and after a while, he whispered, "Professor Yang is here?" ”

"In!" Yang Ping replied by himself.

"Hurry up and send the specimen down, don't worry, the technology is mature, I'm a gentleman, no-" Dr. Wen said in a serious tone.

Robert cut off his phone in time, and everyone in the operating room wanted to laugh, but in view of the respect for Xu Zhiliang, everyone couldn't help but laugh.

"Li Guodong, you personally send the specimen to the pathology department, don't come back immediately, wait until the results come back." Yang Ping named Li Guodong to be in charge of the specimen.

The bone pieces were put into a sterile specimen bag, Li Guodong wore gloves, carefully labeled the specimen bag, held it in his hand, walked out of the operating room, and rushed to the pathology department.

When the bone pieces were sent away, August suddenly discovered something, Yang Ping's bone rongeur went in, and it seemed to be easy, but he actually bit off the bone around the cyst, and finally completely removed the cyst and the bone wrapped around it.

How did he do it?

How is it possible to completely remove the cyst with a rongeur, and it is clear that there is no intraoperative imaging assistance, such as C-arm X-ray machine or CT scan monitoring.

If this is a malignant tumor, then this surgical procedure is undoubtedly a truly tumor-free technique, which can be called a complete resection.

August walked around the operating table a few times outside the yellow forbidden line, and then stopped near the instrument table, he was eager to see what was special about the long-handled thin ronget, and he even suspected that it might have a certain intelligent detection device on it.

Although separated by a certain distance, August still saw the bone forceps clearly, which was an ordinary long-handled and thin bone forceps, except that it was particularly suitable for microscopic operation, and there was nothing special to see.

How did Professor Yang remove the bone cyst in its entirety, without injuring the cyst wall and allowing the cyst fluid to flow out.

The seemingly uneventful operation, August racked his brains to figure out the reason behind it, but he couldn't figure it out.

Most of the anterior transoral surgery has been completed, and the remaining steps are to fill the artificial atlantospine with bone, and the artificial atlantoscope in the middle part of the internal fixator includes the anterior arch and the posterior arch and two lateral blocks, which try to simulate the mechanical structure of the normal atlas vertebrae.

The internal fixator spans the atlas and immobilizes the head and neck with the support of the headrest and pivot vertebrae, which is temporary, and eventually hopes that the filled bone can be healed together with the skull base and pivotal vertebrae, that is, the head and neck can be bony welded.

Bone welding, which is the "fusion" of spine surgery, is one of the basic goals of spine surgery.

The underlying logic of spine surgery is also the basic goal: decompression, stabilization, and orthopedics, and all surgeries will revolve around these three goals.

Removal of the hematoma, removal of the shattered atlas vertebrae, this is decompression, removal of existing or potential compression of the spinal cord.

The implantation of an internal fixator is to reshape the stability of the spine, which is temporary and ultimately relies on bone-to-bone healing to create permanent stability.

Orthopedics is to put the dislocated atlanto-occipital joint and atlantoaxial joint back into the correct position and maintain normal anatomical observation of the head and neck.

In the eyes of those young trainees and graduate students, the operation now seems to be flat and unexciting, but in August's eyes, he understands how difficult some surgeries are, especially when the cyst has just been removed completely, and the surgical skills required are very high.

Yang Ping stopped the operation and waited for Dr. Wen's frozen pathology results.

The current diagnosis of "bone cyst" is only an imaging diagnosis, and whether it is a "bone cyst" or another tumor needs to rely on pathological examination to determine the nature.

If the pathological examination is benign, the bone tissue of the atlas vertebrae, except for the cyst, can be used as a bone block for bone grafting; If the pathological examination is malignant, the bone tissue of the atlas spine must be abandoned, and Yang Ping needs to find another "supplier", such as removing part of the ribs or ilium.

"I've never heard that bone tissue can be frozen sectioned, can this guy do it?" Zhang Lin was a little skeptical.

Song Zimo believed in Dr. Wen very much: "This person's temper is a little strange and pedantic, but the level is not to be said, he must be sure of it." ”

"Bone tissue or calcified tissue to do pathological sections, first decalcification, and then deacidification, not to mention the next steps, it takes at least 24 hours to remove acid, and he will get results in half an hour?" Zhang Lin muttered.

"Without diamonds, he wouldn't dare to take this porcelain job." Robert took over.

August thought for a moment and said: "His washing and deacidification method should be a new method, and we are also trying to freeze sections of bone tissue, using 0.5% sodium hydroxide to deacidify, which can be completed in a few minutes, and I guess he should have mastered this method as well." ”

In oncology surgery in Europe and the United States, the surgeon is responsible for looking at the frozen pathological section during the operation, not the pathologist.

For example, August has spinal tumor surgery, after removing the tumor on the operating table, if you need to send frozen sections, the pathology room is near the operating room, and some are even next door, after the assistant does the frozen sections, August takes off the surgical gown, goes to the pathology room to see the frozen sections, and after confirming the pathological diagnosis, he washes his hands and dresses again and goes to the operating table to continue the operation.

In Europe and the United States, learning to read pathological sections is a basic skill that surgeons who perform tumor surgery must master.

Sure enough, in less than half an hour, the phone in the operating room rang, it was Dr. Wen's phone, his tone was serious and straight, less ridiculed before, Dr. Wen verbally reported the pathological results in detail, and then, the electronic report and paper report were also available immediately.

In order to make it convenient for Yang Ping, Dr. Wen took a picture of the pathological section and uploaded it to the computer, so that Yang Ping could also see the picture of the frozen section in the operating room.

On the high-definition electronic screen in the operating room, the picture of the frozen pathological section was called up, and Yang Ping approached to take a closer look, and the frozen section of the bone tissue was very clear, and the results were consistent with Dr. Wen's report.

This is a real bone cyst that is benign, not malignant.

Then the atlas bone can be wasted, so that there is no need to take ribs or iliac bones to graft bones, Zhang Lin and Xiao Wu began to deal with the removed part of the atlas vertebrae, large pieces of bone were trimmed into columns, and then embedded in the mesh internal fixation, and then the internal fixation was implanted between the base of the skull and the vertebral body, fixed with screws, and the bone inside was in close contact with the skull base bone and the pivotal vertebral body, like a pillar supported at the base of the skull and the front side of the cervical vertebrae, and this pillar is the main load-bearing column.

In this way, the anterior surgery is considered to be over.

Yang Ping started posterior surgery, because of the sitting position, the area above the shoulder is completely exposed on the operating table, and the posterior surgery does not need to change the position, which makes the operation easier and safer.

Surgery in the sitting position requires a lot of experience, and there will be many inconveniences for the doctor to operate in the sitting position.

The backrest was adjusted to close to ninety degrees, and posterior surgery began.

"In the seated position, it's very difficult to reveal the back road—"

August began to make trouble.

"Help connect a set of foraminoscopes and a set of arthroscopies!" Yang Ping instructed Zhou Can, the itinerant nurse in the audience.

"Or microscopic surgery? How is that possible? ”

August thought to himself, and he couldn't think of the use of foraminoscopy and arthroscopy in such open surgery.

(End of chapter)