Chapter 129: Chapter 0126 Fifteen Degrees
Adjust it by fifteen degrees, to form a seventy-five-degree angle with the nerve root. If it’s too small, it will slide; if it’s toorge, the tube can’t be ced.
The angle calcted by Yang Ping is not a random estimate, but a precise angle derived from observing Su Nanchen’s simtion of the puncture.
The advanced training program of the system has improved Yang Ping’s ability to visualize, enhancing the precision of both his brain and hands. This isn’t just mechanical measurement, but also involves delicate, nuanced sensations.
A puncture made at a seventy-five-degree angle with a nerve root, which meant adjusting it fifteen degrees from vertical, how could it be so precise? Su Nanchen wondered.
The uracy of the navigation system could be as precise as a few tenths of a millimeter, but this was theoretical uracy. The reconstructed 3D image itself would have a certain distortion, and the reference points weren’t 100% urate either.
Just like the effective range of a sniper rifle being two thousand meters, it doesn’t mean that one can always hit the enemy within two thousand meters. There are too many factors affecting this.
“As long as it forms a seventy-five-degree angle with the nerve root, it will definitely seed.” Yang Ping once again reminded in a low voice, his tone certain.
Su Nanchen didn’t have much confidence in attaining such precision.
He attempted several times, but either the needle tip would slide off, or the tube could not be ced.
Professor Su also saw the problem. The percutaneous needle was rigid, and the guidewire was stic. If the direction was not optimal, it would be impossible to break through the adhesions, requiring a level of manual precision beyond human capabilities.
“No need to aim for perfection. Once the puncture is sessful, then ce the tube directly. Twenty-four hourster inject the drug. The micro-catheter and the surrounding nerve sheath would form a biological seal, and the chances of leakage are extremely low!” Professor Su urged Su Nanchen to end the surgery soon.
No need to stick to a hundred percent. Eighty percent is also a sess.
If the puncture is sessful, and the tube is ced directly, the micro-catheter is also left in the nerve root sheath, but the distance left is very short, which may cause drug leakage, as well as the potential for the micro-catheter toe out when the patient moves.
Although the probability is extremely low, the possibility still exists.
Su Nanchen didn’t want to give up, he wanted to fight for another twenty points, to reach a hundred percent.
Not for himself, but for the patients. If one hundred percent can be achieved, anything less is uneptable. That was his belief.
“Are you confident?” Su Nanchen asked Yang Ping.
Yang Ping nodded.
After a brief conversation and exchange of nces, they turned and switched ces back-to-back.
Su Nanchen let go, and Yang Ping took over the handle of the puncture needle protruding from the body.
The percutaneous needle has two parts, a thick one that is responsible for creating the tunnel in the bone tissue, and a thin one that enters through the sheath of the thick needle, responsible for puncturing the nerve root sheath. The micro-catheter, encased by the guidewire, finally passes through the hollow thin needle and enters the nerve root sheath.
Yang Ping held the handle, the thin needle in his hand spun around, trying to feel the sensation. The dynamic three-dimensional anatomical image in his mind appeared, perfecting the details bit by bit.
The needle in his hand was also present in his mind, the rtionship between it and the nerve root was even more realistic than with the navigation system.
He adjusted the direction of the thin needle, puncturing the nerve root sheath at a seventy-five-degree angle.
Su Nanchen passed the micro-catheter, which was threaded with a guidewire, into the hollow needle, five millimeters, one centimeter, three centimeters, smoothly entered without any bending.
This meant that the guidewire and micro-catheter had sessfully passed through the adhesion and entered the nerve sheath, prating up to three centimeters.
An air-filled balloon inside the bony tunnel of the pedicle secured the catheter.
The task that Su Nanchen failed toplete after several attempts was aplished by him in one attempt.
Professor Su nodded slightly, his appreciative gaze fell on Yang Ping, appreciating his talent.
The two switched positions again. Yang Ping handed the remaining actions back to Su Nanchen. Su Nanchen slowly withdrew the puncture needle, both thin and thick, and finally removed the guidewire. The puncture was aplished.
“Thank you!”
“I just helped you make the fifteen-degree adjustment.”
Both looked at each other andughed.
He had made a friend, Su Nanchen thought.
The catheter was fixed outside the skin and connected to the pain pump. Anesthetic was injected through the micro-catheter, entering the Thoracic 2 nerve sheath.
“How do you feel, Ning Tianxiong?” Dr. Su asked the patient.
The patient was under local anesthesia, so he couldmunicate clearly.
“No pain!” The patient, in the prone position, answered with difficulty.
“How’s your breathing, any difficulties?” Dr. Su asked again.
“Lying like this is a little strenuous.” Ning Tianxiong was very cooperative.
“Blood oxygen saturation, one hundred percent!” said the anesthetist who was helping monitor the situation.
There was no respiratory suppression, which indicated that the medicine didn’t leak. The catheter had prated three centimeters, so leakage would not ur.
“Lie on your back, observe for fifteen minutes, if there’s no respiratory suppression, then send the patient back to the ward.” Professor Su said to Su Nanchen.
Yang Ping and Su Nanchen helped the patient turn around to lie on his back. They observed for fifteen minutes and there was no respiratory suppression.
A highly difficult puncture was sessfully and perfectlypleted by two young people. The technique involved in this puncture is equivalent to a special forces decapitation operation in wartime, all of which required high skills.
It was already past seven o’clock, Director Han checked the time.
Director Zhao of the Medical Department ordered the internal restaurant to prepare meals. Because Professor Su was short on time, he had no ns to stay for dinner.
Now he had changed his mind and decided to stay for dinner.
“You have worked hard, stay and have dinner before leaving.” Director Han insisted.
“Okay!” Professor Su agreed cheerfully.
“Call Xiao Yang too!” Professor Su specifically requested.
Talented people respect and cherish other talents even more.
The other directors also decided to stay to apany Professor Su. After all, as the dean of the affiliated hospital, the chairman of orthopedics, and a future academician, whichever of his identities held significant weight in the medical circle. They couldn’t snub him, especially when they might need his help in the future.
The dinner was set in the restaurant within the cafeteria. Professor Su did not drink alcohol, and everyone else also refrained, some had to drive, and some still had surgeries to perform at night.
In addition to Director Han, there were also Director Tian, Director Tan, Director Qin of the Spine Surgery Department of Sanbo Hospital, Director Gao of the Sports Medicine Department, and Director Chang of the Joint Surgery Departmenting to apany him.
Both Dean Xia and Dean Sun came. As the dean of the affiliated hospital, he was a big shot in the medical world and could not be neglected. Moreover, Dean Xia and Professor Su were alumni and had once worked together, so they had a certain rapport.
Dean Xia and Director Han apanied Professor Su on either side, Su Nanchen asked Yang Ping to sit with him. The two of them had endless conversations about how the patient could be precisely punctured at a vertical adjustment of fifteen degrees and how this angle was calcted.
The dinner table was divided into two circles, Su Nanchen and Yang Ping in one, and everyone else in the other.
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Su Nanchen and Yang Ping were chatting in low voices, discussing entirely professional topics, and even added each other on WeChat. The others did not bother these two young individuals.
“Nanchen, your uncle is asking you something!” Professor Su reminded, and then Su Nanchen remembered that there were still Dean Xia and Director Han and others present.
“Nanchen,e to our house when you have time.” Dean Xia said.
Dean Xia and Professor Su were both graduates of Nandu Medical University and belong to the same ss. Dean Xia also was transferred from the affiliated hospital. When they were young, they lived in the old dormitory of Nandu Medical University. At that time, Su Nanchen was still in primary school.
Dean Xia’s daughter was about the same age as Su Nanchen, and they were ssmates in primary school. But Dean Xia’s daughter did not study medicine, she studiedw and works at the provincial judicial bureau.
“Okay, thank you, Uncle Xia.” Su Nanchen responded generously and then picked up the teapot, pouring tea for the seniors, and then raised his cup to toast everyone.
Dean Xia and Professor Su talked about the farm of the affiliated hospital. The two decided to find time to visit it. In the past, funds were tight, the affiliated hospital was given a piece ofnd in the suburbs to farm. Everyone took turns working thend during their free time, growing grains, fruits, and vegetables to supplement basic necessities.
Later, this piece ofnd was not sold. When it was passed to Professor Su, he built a modern farm on it. Every year, he would send some fruits and vegetables to the employees of the affiliated hospital as welfare.
Yang Ping felt that the dinner was quite rxed, and he gained a lot from it, especially by befriending Su Nanchen. Su Nanchen was knowledgeable but not arrogant, asking Yang Ping humbly about every detail of the case as if he wouldn’t rest until everything was clear. He showed none of the haughty habits often seen in privileged second-generation kids.
“Stay in touch when you have time!” Even after leaving, Su Nanchen sent a message over WeChat.
“Professor Su really appreciates you, Xiao Yang!” Director Han hummed a tune, looking very pleased.
After the dinner was over, the two went to the Overseas Chinese Building to see Mr. Ning. He was smiling andforting his daughter, “Rx, don’t be so upset, everyone’s life has toe to an end eventually, it’s just a matter of time. No one can escape it.”
Seeing Director Han and Yang Pinge in, he was very happy, “Thank you both, I’m not in pain anymore, and I have no problem breathing. I’m truly grateful.”
Pain can be a significant nuisance to people and is the most intolerable symptom for patients. The World Health Organization has listed pain as the fifth vital sign, following heart rate, respiration, blood pressure, and body temperature.
Eliminating pain has be a basic right for patients and an obligation and responsibility for medical staff.
“I feelfortable!” Mr. Ning leaned against the head of the bed, holding a “Visual Analogue Scale for Pain” in his hand. The muscles on his face were rxed, without any previous distortion.
“Thanks to you all! Thank you, Director Han, thank you, Dr. Yang! I’m really grateful!” Miss Ning stood up and bowed.
“Thank you, Professor Han! You’ve worked hard!” Mr. Ning shook hands with Director Han.
When shaking hands with Yang Ping, he said, “Dr. Yang and Dr. Su helped me with the puncture, and in the end, it seemed like there was a need for an angle correction, fifteen degrees. It was done by Dr. Yang.”
“I was conscious all along and kept listening,” Mr. Ning exined with a smile.
Because it was local anesthesia, he was lying on the operating table and heard the doctors’ conversation, so he was very clear about the surgical process.
“Thank you truly, for allowing me to sit here and talk with a smile,” Mr. Ning was in good spirits.
“Hmm, go back to rest early after eating, and don’t drink alcohol.”
Before dinner, Yang Ping had sent a WeChat message to Xiao Su.
Xiao Su had replied via WeChat, but he hadn’t checked it until now.