Fixed retractors have been around for a long time and are used in every department, but they are probably more common in orthopedic operating rooms than in other surgical departments.
The main reason may be that the surgical area of orthopedics is relatively fixed. Unlike general surgery and gynecology, which are performed in the abdominal cavity, the incision is limited due to the large area in the abdominal cavity. During the operation, the doctor needs to feel other organs to adjust the surgical area, which leads to the need to move the retractor around for coordination. It cannot be said that fixed retractors cannot be used in abdominal surgery, but generally doctors think that it is troublesome to adjust them.
The medical students who made the pinky promise are free human resources. They can obey orders flexibly and save time effectively.
Since orthopedics requires fixation and does not require much flexibility, using manpower may become a disadvantage at this time. In any case, Xie Wanying can save energy. On second thought, since orthopedics is a department with heavy physical work, the more labor-saving tools invented, the better.
The operation is about to enter the critical stage.
Dr. Liu followed the instructions of the chief surgeon, put the fixed retractor into the surgical field to expand it to a certain angle, adjusted the screws and tightened them. After a fixed retractor was placed above and below the incision, Xie Wanying could follow the teacher's instructions to pull out her own manual retractor, put on the suction device in her hand, and continue to assist the teacher in the work.
The surgical field in front of me was bloody. Unlike abdominal surgery, the exposed bones were the main part. This scene suddenly seemed more cruel, a bit like the feeling of a knife cutting into bones in a slaughterhouse. It was shocking. It was better not to associate it. If I think too much, the medical students who had just arrived would probably be unable to swallow their food again after seeing this.
The work of surgeons is hard to swallow, no matter which department they are in.
The surgeon on the table must control his thoughts and not think about the food on the table. He must change his thinking from the visual sense to the human body diagram, and consider ergonomics instead of things in the slaughterhouse. For surgeons, it is definitely necessary to practice more and more to develop this kind of thinking habit that does not affect eating.
...
...
The surgeon and his assistant both stopped and thought about it before preparing to repair the human bones.
The X-ray film is taken out and hung on the light board in the operating room. The doctor compares the current surgical screen with the imaging film to accurately verify the location of the diseased vertebra. There is no problem, and the surgeon shouts again: "Operate."
The instrument nurse handed over the electric knife.
Squeak, squeak, continue cutting, the sharp tip of the knife cuts off the small muscle ligaments around the bone, exposing the transverse process of the vertebra.
The pictures in the anatomy textbooks can depict bones very cleanly, but it is impossible to see clean bones in surgery. The bones of the human body are more like rusty iron blocks, which are covered with all kinds of things on all sides, and are definitely covered with blood and flesh. If you want to remove them cleanly, you have to use chemical agents when making specimens in the dissection room.
In order to distinguish the details of the bones in the bloody and fleshy mess, the doctor can only rely on experience and a pair of super good eyesight. After confirming that this is the right bone to be treated, the electrosurgical knife is replaced with a periosteal stripper to continue to clean up the soft tissue around the transverse process.
The transverse process connects the costal joints and ribs. If the entire diseased vertebra is to be removed, it is undoubtedly necessary to first break the connected ribs and flatten the broken rib stumps to avoid puncturing the pleura.
The transverse process was cut with a rongeur, and the ribs were cut with a rib shear. All were done with hard tools like vises used to repair machines.
Continue read on readnovelmtl.com
