Because it is a large project and the technical difficulty is large, the time for this operation will be very long.

The Iris Clinic is still Zhou Qiao's main surgeon, Murphy's first assistant, Stephanie second assistant, and Elena and Ava. The anesthesia team at the community hospital did not make an appointment with Nancy this time, but replaced Caroline.

Although the level is slightly lower, Caroline is also a senior anesthesiologist for many years, so it should not be a problem.

Nancy has accumulated many years of leave, and this time she has a new white boyfriend, so she and her boyfriend went on vacation to Europe.

Nancy doesn't want to be too moisturized now, that little boyfriend is said to be only eighteen years old, from France, typical romantic little fresh meat.

However, this is someone's private life, and in addition to envy, everyone is not good at interfering too much.

The most envious may be Park so-joo.

Park so-joo and Nancy are about the same age, but Nancy has often changed boyfriends since the divorce, and Park so-joo has been widowed. The main reason is that she is conservative, and the other is that she doesn't want Yun'er to be unhappy.

Then after meeting Zhou Qiao's type, she couldn't look down on other men. But it's impossible to talk to Zhou Qiao, so you can only feel sorry for yourself.

In addition to being a little lonely, Park so-joo feels that her life is very good now. So I don't want to toss around anymore. In case you meet someone who is unladylike, it is you who suffers.

Before Zhou Qiao's five-person group entered the operating room, they all fasted and fasted water like patients.

Of course, unlike the patient's request, doctors and nurses do not eat or drink too much just to avoid frequent toilet trips during surgery. Therefore, patients cannot drink even a sip of water, but medical staff can drink less and eat less.

In addition, during the intense surgical process and high-intensity work, doctors and nurses will also have a "stress response", and the urge to urinate and defecate will be less than usual. With Zhou Qiao's experience, seven or eight hours can be "suffocated".

I can't hold it back, in the case of a "substitute", you can leave for a while, and there is a bathroom in the operating room.

Besides, according to your own situation, the ability to hold urine, you can also wear diapers.

"I'll be waiting for you here, wearing the stars and the moon, and riding the wind...... Walking all the way through the high and low, the green silk has turned white in the morning and twilight......"

After the anesthesia was completed, the multi-party check was completed, and the song "Waiting for You to Return", touching the heart and full of healing melody, Zhou Qiao began artificial total hip replacement.

The operation is divided into two major links, compared with the spinal osteotomy and orthopedic spine in the back, total hip arthroplasty is relatively simple, because this is not an emergency, so Zhou Qiao first easy and then difficult, do this one first.

Do the simple ones first, and you can also get yourself into the state as soon as possible. The kind of state that devotes himself wholeheartedly to it and has always been at the peak of the supergod.

If it is an emergency life-saving, it is necessary to do the most difficult thing first, and then save your life. This is on a case-by-case basis.

Total hip arthroplasty is arguably one of the most successful and reliable surgeries in the field of orthopedics, and every year I don't know how many patients suffering from hip pain undergo this surgery to achieve satisfactory results and usher in a new life.

Moreover, with the development of science and technology, the clinical application of polymer materials and high-tech 3D printing technology, the performance of the prosthesis is getting better and better, and the curative effect is naturally more significant.

The Moore posterolateral approach is exposed, and the press-fit is ......

Zhou Qiao did not use screws, because the use of screws was limited to situations where initial stability could not be achieved with press-fit technology. Zhou Qiao's perfect surgical skills are easy to get and don't need screws.

Clean the acetabulum and start filing the acetabular with an acetabular file that is about 8 mm smaller than the acetabular prosthesis......

In fact, most of orthopedic surgery is manual work, and compared with the delicate and subtle surgery of neurosurgery, it requires a higher physical strength of the surgeon.

But Zhou Qiao doesn't have to worry, he has undergone three transformations of genetic medicine, and the various attributes of his body have already evolved into a "freak", although he is not as invincible as Marvel heroes, but it is not comparable to ordinary strong men.

Let's just say that the black scorpion under Luo Ya, if he came to compete with Zhou Qiao now, without using firearms, purely hand-to-hand combat, Zhou Qiao might be able to abuse him. If Zhou Qiao learns a little more fighting skills, it will be even stronger.

Of course, this refers to a contest, not a life-and-death fight, a real life-and-death fight, Zhou Qiao does not have that ruthlessness. He's a doctor, he's a Sven, not a humanoid fighting machine.

If he really wants to fight to the death, he can only go to hypnosis, instantly control people's spirits, and kill people invisibly. But this skill is too perverted, and he easily does not dare to reveal it, just as a means to save his life at a critical moment.

In the vertical horizontal plane, the file is polished until the medial wall of the acetabulum is exposed, and then along the direction of the acetabulum, the file is gradually increased with an angle of 35°-40° abduction and 15°-30° forward.

The acetabular file is in close contact with the anterior and posterior walls of the acetabulum, as well as the top and outer edge of the acetabulum, and the file is smoothed to the horseshoe socket, showing a "blush sign".

……

Trial repositioning, intraoperative testing, fitting of the prosthesis, closure of the incision.

Then, on the other hip, do the same as before......

Among them, there are several surgical difficulties, such as how to determine the position of the molar cup in the surgical field, how to check and measure the anterior angle, how to determine the "safe position" of the acetabular prosthesis, what kind of manipulation and force can ensure that the direction of the file is consistent with the axis of the femoral neck in the proximal medullary cavity, how to check the length of the lower limbs, compare the distance between the small trochanter and the scichial tangent, etc.

The process is quite complicated, there are a lot of small skills in it, and there are many aspects that Zhou Qiao is still innovating, so the orthopedic surgeons who observed in the monitoring room couldn't help but marvel again and again.

"I have long heard that Dr. Zhou is omnipotent, and I didn't believe that he could be proficient in our orthopedic skills, and I never imagined that this means, this technology...... Tsk, bow and worship! ”

"Yes, it deserves to be the god of Zhou."

"I suggest that we apply to Dean House, and let Dr. Zhou also come to our orthopedic department for guidance."

"That's going to cost money, I don't know if there's a budget for this year, and other departments are going to compete for this opportunity."

……

This operation took a long time, more than two hours passed, and it was able to complete the first major part, artificial total hip replacement.

Ava selected many songs, some in English, some in Chinese, some in Little Day and some in Korean.

Suddenly, an adapted version of "Mrs. Luxury" lifted Zhou Qiao's spirits, this "Mrs. Luxury" has the same melody at first hearing, but the specific lyrics are completely different.

"The cliffs on both sides of Loushan Pass, the yellow flowers on the banks of the Songpan River are in full bloom, the rivers and mountains are full of sores, and the scorched earth is dangerous with blood and tears......"

"Wumeng Mountain is connected to the mountains outside the mountain, the moonlight sprinkles on the Xiangshui Beach, and the future is uncertain and paranoid......"

Murphy, Stephanie, and Elena saw Zhou Qiao's strange expression, there seemed to be tears in their eyes, and their hearts suddenly burst out, thinking that the operation was going to fail, but they thought too much.

Zhou Qiao quickly abandoned distracting thoughts and entered the super-god state again, listening to this song, the operation seemed to be done more smoothly.

The second stage of surgery, i.e., spinal osteotomy and orthopedics, is the most important part.

At this stage of surgery, there is a great risk, that is, there is a risk of nerve damage!

Compared with no osteotomy, osteotomy has an additional step, that is, the bone around the nerve is crushed and removed with a special tool. During the operation, there may be a certain contact with the nerve, and damage and excessive pulling of the nerve will cause sequelae, and the most serious consequence is paralysis.

If the surgery is not successful, it may not be as good as before.

Before the operation, little Engelly could barely walk "without seeing the sky", but if the operation failed, she may be completely paralyzed. That situation is even worse.

If you're an orthopedic surgeon, it may feel tricky and stressful. However, Zhou Qiao's neurosurgery on the brain is a ceiling, and the nerves on the spine are not a problem?

It's time for Dr. Chow to show off his exquisite skills!

The truly horizontal steps made the orthopedic surgeons of the community hospital in the observation room worship again, all kinds of amazements!

The stiff and deformed bones of the spine are amputated and re-docked......

During the docking process, the two bones fit perfectly.

In addition, although Zhou Qiao has self-confidence and does not hurt nerves, in order to reassure the observers and see the effect, Zhou Qiao did not take it lightly and save trouble, and still used measures such as neural monitoring and arousal tests.

Normally, the nerve will have a current amplitude on the display, and if the doctor accidentally touches the nerve during surgery, the amplitude on the monitor will produce a stimulation signal, prompting the doctor to avoid this position.

Zhou Qiao made a move, but he didn't trigger this abnormal signal once.

The doctors who watched didn't know how to express their admiration.

In addition, every time Zhou Qiao completes a step, he will take the initiative to send out an electrical signal.

For example, if electrical signals are transmitted from the head to the muscles of the spine, if the pathway is smooth, the nerves are not damaged.

Continuous neuromonitoring is a very practical technique to escort in spine surgery.

Sometimes, a brief awakening of the patient is performed during the operation to check the nerve conduction, which requires the cooperation of the anesthesiologist, and then the surgeon adjusts the details of the surgery according to the patient's condition.

Zhou Qiao uses a posterior median incision, because little Engelly is bent forward nearly 90 degrees, so it is more convenient to approach from the posterior median, including the upper and lower 5 vertebrae.

The upper and lower vertebral plates are exposed first, then move to the middle and finally reveal the dislocation space, and the soft tissue of the dislocation space is carefully removed......

Dislocated vertebrae dislocated anteriorly...... Reveals transverse processes on both sides......

In terms of spinal deformity and orthopedics, there is an international grading system, called "Schwab Spinal Deformity Orthopedic Grading System", which was proposed by Schwab in 2014 and is a spinal deformity orthopedic grading system based on anatomical surgical approach, with the purpose of facilitating academic exchanges and standardizing research results.

The classification system is divided into 6 types of osteotomy methods, the first grade is SPO, the second grade is Ponte, the third grade is PSO, the fourth grade is BDBO, the fifth grade is VCR, and the sixth grade is VCRS.

The further back on, the more difficult and risky the surgery becomes.

Zhou Qiao used the most difficult sixth-level osteotomy, that is, VCRS, which can be seen from the English abbreviation, and the sixth-level VCRS is actually composed of multiple fifth-level VCRs.

You don't need level six, it's not good, it's based on little Engelly's condition.

A single VCR can be corrected up to 50 degrees, and multiple VCRs can correct 90 degrees and above, of course, it depends on the doctor's technique!

The same type of surgery, performed by doctors of different levels, the quality of the surgery is naturally very different. Some of them are very rough and have many sequelae and complications, but some doctors make it like restoring a work of art, without flaws and perfectly.

Dr. Zhou is the top of this kind of top stream!

For more than six hours, Zhou Qiao's team has been busy in the operating room, without going to the toilet, I went, the orthopedic surgeons who observed in the monitoring room actually had no intention of urinating throughout the whole process, and stayed here after work to study tirelessly, and refused to leave with hunger and rumbling.

In fact, Dr. Zhou's skills are almost Tao, and the opportunity is quite rare.

The director of the orthopedic department of the community hospital also came over to take a look, because it was too abnormal to leave after work. As a result, he couldn't help but exclaim: "If we had a national surgery competition in orthopedics, Dr. Zhou would undoubtedly be the absolute champion." ”

(End of chapter)