Nerve anastomosis?

That's great

This is exactly what Li Xiyang needs at the moment.

"Director Liu, the anastomosis of blood vessels and nerves can be handed over to me, and I am sure that it will be completed within four hours!"

"Four hours?"

Liu Qi glared and scolded, "Boy, this is not the time to joke!" ”

Although Liu Qi thinks that Li Xiyang has ideas and is a good seedling, it is a taboo for doctors to do things well and be ambitious.

Mo Kai just said that it would take more than ten hours, good guy, you directly shortened it by more than half.

Doctors should be down-to-earth and should not do anything at the cost of the patient's life or death.

"Director Liu, I'm serious, I didn't open it..."

Before Li Xiyang finished speaking, he was interrupted by Liu Qi waving his hand, "Don't say it anymore, I have already decided, or take conservative treatment and amputate the patient." ”

"As for the plan you just mentioned, it's really good, and I will apply to the above for clinical application after the operation, thanks to you!"

Li Xiyang still wanted to insist, but Liu Qi didn't plan to listen to it anymore.

At this time, Mo Kai, who had been silent, stared at Li Xiyang and said, "Are you really sure?" ”

Seeing Li Xiyang nodding, Mo Kai seemed to have made a great determination and said, "Director Liu, I agree to adopt Dr. Li's treatment plan. ”

"You..."

Liu Qi's brows furrowed, but he heard Mo Kai continue, "Something happened, I, Mo Kai, are fully responsible." ”

What?

For a moment, everyone turned their eyes to Mo Kai.

Xindao This kid shouldn't be Mo Kai's illegitimate son, right?

But it's not the right age!

Everyone really couldn't figure out how the man of the year in the emergency department in front of him could defend a newcomer like this.

Including Li Xiyang himself, he was stunned, "Doctor Mo, you..."

Mo Kai smiled handsomely, "I believe in my own vision." ”

Liu Qi's gaze went back and forth between the two...

Interesting.

I don't know if Zhang Zhenhua is here, he will be directly angry with the two of you.

But...

I like it!

Liu Qi beckoned to Li Xiyang, "What are you doing in a daze, come up!" ”

"Huh?"

"Oooh!"

Li Xiyang hurriedly stood on the operating table, and at this time, Mo Kai also gave up his position.

From this moment on, Liu Qi was in charge, and Li Xiyang was helping.

"Sucker!"

"K-wire ready!"

"Maintain the tongs, and reset the muscles and bones."

"Trombone plate ready."

"Screw No. 3 on the bone drill."

“……”

Liu Qi kept giving instructions, and Li Xiyang could always pick it up as quickly as possible.

This scene fell in the eyes of everyone, and it was only pleasing to the eye.

The two cooperate so tacitly, it is not like the first time they cooperated.

Under the mask, Liu Qi's old-fashioned and serious old face rarely showed a smile.

It would have taken at least three hours for the bones to reset, but this time it took only an hour and a half.

For a moment, Liu Qi suddenly felt that his surgical operation had improved again.

But he knows very well that this one of his own is too powerful.

Whether it is the use of K-wire or the separation of fascia, this little guy helps himself share most of the workload.

In fact, in the whole process just now, Li Xiyang looked more like the main knife.

The two attendant doctors looked at each other, and couldn't help but guess what Li Xiyang was about.

It can't be a high-tech person from the emergency department, right?

Mo Kai was shocked and excited, thinking that their emergency department had really picked up the treasure this time.

"Alright, it's up to you!"

All the bones were successfully reset, and Liu Qi officially withdrew from the main knife position.

Standing in the main knife position, Li Xiyang quickly picked up the intramedullary needle and suture.

This is the most critical part of the success of the operation, and Liu Qi wondered if he should remind him not to rush too much.

Try to be as steady as possible.

But in the next second...

Li Xiyang inserted the needle under the skin, holding the forceps and tying the knot...

The first superficial peroneal nerve is sutured!!

Liu Qi almost didn't pop out his eyes.

He has been in the first hospital for 30 years, and he has seen too many fast surgeons, but in the blink of an eye, he can stitch up a nerve...

Obediently,

What kind of monster is this kid!

Liu Qi hadn't recovered from the shock, and Li Xiyang had already completed the anastomosis of the three superficial peroneal nerves and the two deep peroneal nerves.

Mo Kai on the side has changed from shock at the beginning to obsession, "This is a counter-end anastomosis!" ”

"What?"

"He's actually doing a match-to-end anastomosis?!"

The two attendant doctors on the side glanced at each other, and their eyes were shocked.

There are three types of nerve anastomosis surgeries: contralateral anastomosis, endo-side anastomosis, and lateral anastomosis.

Contraend-to-end anastomosis, also called end-to-end anastomosis,

As the name suggests, the two sections of the nerve are directly butt and sutured.

This kind of stitching sounds simple, but it can be very difficult to practice.

First of all, he requires that there should be no defect in the nerve rupture surface, otherwise the contralateral anastomosis will cause excessive nerve tone, which will affect the normal mobility of the patient.

At the same time, compared with the end-to-side anastomosis, the contra-end anastomosis is more likely to injure neurons and the risk of surgery is greater.

Therefore, the most common suture methods in orthopedics are the latter two.

It is not that the end-to-end suture is bad, on the contrary, the advantages of the end-to-end anastomosis are extremely obvious, and it can restore the patient's mobility to the greatest extent, but this kind of suture has extremely high requirements for the operator's operation level.

Usually, the surgeon should first examine the broken end under the microscope, and if there is scar tissue and bone fragments around it, it should be removed before anastomosis.

The nerve should not be twisted during suturing, and the alignment of the two broken ends should be accurate to ensure that the nerve axon can grow forward along the anastomosis line.

It can be said that I don't have the skills of twenty or thirty years, and I don't dare to try it easily.

How dare this guy?

Wait a minute

Looking at the expressions of Director Liu and Dr. Mo, did he really do it?

The doctor on duty does not have the eyesight of the two bigwigs, in their eyes, they only feel that Li Xiyang is stitched quickly,

It's a bit ridiculously fast!

As if to answer the doubts of the two, Li Xiyang's hands kept moving, and his mouth said at the same time.

"The key to contralateral suturing is not to pass the needle directly through the nerve, but only to suture the nerve sheath, so that intraneural scarring does not affect the function of the nerve.

In addition, the nerve sheath is an extremely active source of connective tissue, and if there are too many sutures, the adventitia will inward form interfascicular connective tissue, which hinders axonal growth.

Therefore, when performing sheath sutures, only 1-2 stitches with noninvasive sutures are required.

If the nerve is too thin and the tunica vaginalis is not obvious, the connective tissue around the nerve can be sutured and fixed with tissue glue. ”

With just a few words, the two doctors on duty were stunned.

"Dr. Li, what if the nerve deficit is severe?"

"Isn't it possible to suture it with the opposite end?"

Unconsciously, the two of them have changed their name for Li Xiyang.

Li Xiyang raised his head and smiled, "Veins are the best material to protect the anastomosis of nerves." ”

"Veins?"

"Not bad!" While speaking, Li Xiyang used tweezers to take a section of intravenous line from the patient's wound.

While operating, he continued, "The venous line is cut open into sheets that can be used to wrap around the nerve sheath anastomosis. ”

"Of course, you can also put the venous segment over one end of the nerve, suture the tunica, and then move the venous sleeve to the anastomosis."

"The venous cannula can prevent granulation from growing into the nerve anastomosis, and at the same time play a role in fixing the severed end and protecting the nerve, which is the best material for nerve lengthening."

"However, it should be noted that the vein taken must be thicker than the nerve, so that there is a proper space between the vein and the nerve to prevent the nerve from swelling and compression..."

The voice fell, and Li Xiyang completed the operation in hand at the same time.

Looking at the time, it's only been three hours...

Everyone looked at the operating table in a daze,

Under the shadow of the light,

That man, a little tall...