Surgery Godfather

Chapter 350: Chapter 0333: Root of the Disease

The lightbox was very bright, Takahashi had looked for a long time but could not see the necrotic bone mentioned by Yang Ping.

Yang Ping had already indicated the area with a slight abnormality, but in Takahashi’s understanding, that was an impression made by a blood vessel, a typical vascular imprint. How could it be seen as necrotic bone? Necrotic bone and vascular impressions are two completely unrelated concepts and now they have become connected in the differential diagnosis.

Staring into the bright light for too long, Takahashi’s vision began to blur, his eyes began to sting, tears were squeezed out, and he had to divert his gaze temporarily. He looked away, his vision filled with flashes of light, even people were flickering in his sight.

“This advanced skill cannot be mastered in a short time. Even if Doctor Yang points out the male and female reproductive organs on a mosquito, we cannot distinguish them. We will study this in our spare time later,” Song Zimo said, temporarily putting away the film.

This surgery looks simple, but is actually quite difficult to perform.

The key is positioning. Without the navigation system, relying solely on the surgeon’s experience, a window needs to be opened at the lower end of the right tibia, and a large block of bone tissue has to be dug out to potentially remove the infected necrotic bone.

This type of infection in the necrotic bone must be fully excavated. Leaving even a bit behind is like leaving out an infection source, causing the infection to recur after a period, thus wasting all previous efforts.

Therefore, when excavating the necrotic bone, part of the normal bone tissue surrounding it also needs to be removed in order to guarantee thoroughness.

This surgery is like digging sweet potatoes. The sweet potato is buried deep in the ground. An open surgery is like digging a huge pit to finally excavate the sweet potato.

Minimally invasive surgery is like inserting a hollow bamboo tube into the soil and hammering it in. After reaching a certain depth, the tube is pulled out, filled with soil, and at this point, the sweet potato is inside the tube.

“Should we use the Tianji surgical robot and make a reservation with the operating room in advance?” Song Zimo thought that without navigation technology assistance, it would be difficult to perform minimally invasive surgery on such a tiny necrotic bone.

The Tianji surgical robot is equipped with a navigation device, and the accuracy of its navigation can reach 0.8 millimeters.

If the robot is used for the surgery, the child has to have a CT scan again, and the CT data needs to be imported into the robot’s navigation system. Intraoperative CT scans also have to be used for positioning, which would expose the child to a lot of radiation.

“I saw that the child has had a lot of X-rays and CT scans. No need for that again. Using robotic guidance would expose the child to more radiation. Let’s try to simplify this. We’ll do it in our operating room, I’ll perform the surgery.” Yang Ping looked at the large bag of images, hoping to reduce the child’s exposure to radiation as much as possible.

“We’ll schedule the surgery for today, urgent surgery, to be performed under local anesthesia. Discharge the child tomorrow and avoid vigorous activities for three months,” Yang Ping instructed Song Zimo. For him, this surgery was very simple.

“Is it really that simple?”

The child’s father thought he had heard wrong. In his impression, after the surgery, the child would recover at home for at least a month and would use crutches for three months. He was ready to take a long leave.

He had originally planned to take the child to see a doctor during the summer vacation, but recently, the child has been crying in pain every night. Especially in the past few nights, the intensity of the pain has been such that it hasn’t allowed the child to sleep. It didn’t seem to be pretend.

Left with no choice, the father took the child to the community health station for a consultation, where the doctors recommended that they go to Sanbo Hospital.

On reaching Sanbo Hospital, they didn’t see Doctor Yang’s office, so they randomly chose a doctor from Orthopedics. The doctor said that the child’s condition was a diagnostic problem and he suggested hospital treatment. The father requested for Doctor Yang to provide treatment, so the child was admitted to the Comprehensive Orthopedics ward.

Hearing the term “diagnostic problem”, the child’s parents were frightened. Would it be something serious?

But now, listening to Yang Ping who stated that the child could be discharged the day after the surgery, wouldn’t need crutches, and could immediately walk normally added to their surprise.

Originally, they thought the matter was extremely troublesome, but now it seemed even more straightforward than having a circumcision. Post-circumcision, one still had to grit their teeth and waddle like a duck for a few days.

Preoperative talk, signature, and various preoperative preparations were completed, and the surgery was scheduled for the subsequent operating table.

“No navigation? Is that feasible?” Xu Zhiliang asked.

Yet, Song Zimo was not doubtful: “You haven’t been here for long. Slowly, you will adapt. Doctor Yang is someone who continues to work miracles. He will help you to expand your imagination, continuously expand it.”

After rounds, apart from those on duty, they all went to the operating room. After performing several surgeries, it was time for the child’s operation. Song Zimo instructed Little Five to disinfect and set out the surgical drapes, and according to Yang Ping’s instructions, the local anesthesia was also prepared properly.

Takahashi borrowed a magnifying glass from a student and, bringing his face close to the magnifying glass and the lightbox, continued to examine the film. After a while, he rubbed his eyes and continued to look.

Yang Ping washed his hands and got dressed, spent a little more time considering the images, and determined the final positioning in his mind, he then began the operation.

He cut a vertical slit about 1 centimeter long on the inner skin at the lower end of the right tibia, went straight down to the periosteum and bone, then separated along the periosteum, used a hemostat to pull apart the small incision, revealing a small portion of the inner surface of the tibia.

He rested the drill against the bone surface, adjusted the direction, and then slowly drilled into it. When he reached a certain depth, he stopped, and pulled the drill out, bringing out the filled bone tissue.

He then irrigated the operating area, and used a dough-like substance mixed with vancomycin and calcium sulfate to fill in the small tunnel he had just excavated. The vancomycin slowly released in the locality, killing any remaining bacteria.

The tunnel was solidly closed. A small incision of 1 cm needed only one stitch, beginning with the periosteum, stitches placed layer by layer, covered with a small piece of sterile dressing, job done!

From stepping onto the stage to stitching the skin, it took one minute and twenty-two seconds. Takahashi had been timing it. That was it?

“Could you X-ray it please?” said Yang Ping as he took off his surgical gown and gloves.

The X-ray was a brief exposure, which involved much less radiation than the multiple or continuous exposures of navigated surgery.

After the X-ray, the previously imaged tunnel drilled by the reamer was just at the point where Yang Ping had said it would be, encapsulating that point perfectly, no more, no less.

Song Zimo pulled out the cylindrical bone tissue from the drill. The cylindrical bone tissue consisted mainly of cancellous bone, apart from a small amount of cortical bone at one end.

He then carefully cut the cylinder into thin, round slices. Cutting the cancellous bone was not difficult, indeed, he saw the lesion’s cross-section.

The cross-section looked like a sandwich. The center was a grain of necrotic bone surrounded by infected bone tissue, with a layer of normal bone tissue outside.

Looking at this cross-section, Song Zimo could fully confirm that the lesion had been completely removed. The accuracy of this positioning was even higher than that of a surgical robot.

“Do a CT scan after the surgery,” Yang Ping ordered.

A post-operative CT scan was inevitable. Evidence was needed to confirm that the lesion had been completely removed.

“Keep it as a specimen. Send it to pathology for examination. I’m going to pathology to check it under a microscope myself. Are any of you interested?” Song Zimo put several slices into a specimen bag for pathological examination.

“Wait a minute! Let me have a look.” Takahashi was still puzzling over how Yang Ping had managed to precisely locate the lesion without the aid of a navigation system.

Song Zimo had already handed the specimen bag to Zhou Can: “We will go to pathology later and take our time looking at it under the microscope. The ‘sandwich’ lesion has been precisely removed in one go.”

The child followed the doctor out of the operating room. Song Zimo told his parents that he could walk normally, avoid strenuous exercise for three months, be discharged and go back to school tomorrow, change medications every three days, and have stitches removed in 10 days.

“This is the lesion we dug out, with necrotic bone and infected bone tissue. Have a look.” Song Zimo showed a photo on his phone to the child’s father.

The child’s father didn’t understand, but he knew roughly that this was the root of the illness, and now the doctor had skillfully excavated it.

“Will it hurt a lot to remove the bone?” The child’s father asked worriedly.

“There are few nociceptive nerves in bone tissue, so it won’t feel too painful. If it does hurt, it’s the wound that hurts, and we will give a little painkiller tonight,” Song Zimo explained.

“Will the hole that has been dug be filled in later?”

“Generally, it will be filled with new bone tissue in about three months.”

“Now that the root has been removed, it won’t recur, will it?”

“Generally not, but no one can guarantee it 100%.”

“What should be noticed about the diet, anything to avoid? Or anything to supplement that will be beneficial to his bone growth? Can we make bone soup?”

“A normal diet is sufficient. If you like bone soup, you can make it for him. It doesn’t have any special benefits for this condition, but it doesn’t harm either.”

“Can I make soup with Chinese ginseng? It improves blood circulation and dissolves stasis!”

The child’s father was asking questions, many of which had already been thoroughly discussed preoperatively, but he brought them up again.

“Chinese ginseng is a Chinese medicine, don’t eat it casually. A normal diet is enough. Do you eat Chinese ginseng every day at home?” Zhang Lin, who was losing patience, interrupted.

“Could you share the photos with me?” The child’s father, embarrassed by Zhang Lin’s comment, changed the topic.

Song Zimo shared the photos with him. The father was quite active and immediately posted a moment with the photo: Finally dug out the root of my child’s disease, we can sleep peacefully tonight.

Then the trouble came. After the post in the moment, many people responded one after another, inquiring about which hospital it was and which doctor they had seen.

Source: Webn0vel.com, updated on Novg0.co