Famous Among Top Surgeons in the 90s-Chapter 1934: The Critical Phase
The fixed retractor has long been available, present in every department, though perhaps seen more frequently in the orthopedic operating room than in other surgical disciplines.
The main reason might be that the surgical area in orthopedics is relatively fixed. Unlike general surgery or gynecology, which are located within the abdominal cavity where the large range of the cavity limits the incision size, doctors need to explore other organs to adjust the surgical area, causing the retractor to be moved back and forth accordingly. This is not to say that fixed retractors cannot be used in abdominal surgeries at all, but generally, doctors find it more of a hassle to adjust them back and forth.
The medical students serving as retractors are invaluable free human resources, flexible and responsive to commands, effectively saving time.
In orthopedics, where stability rather than flexibility is required, relying on human resources might become a disadvantage. No matter what, Xie Wanying could save her strength. On another note, orthopedics is a physically demanding field, so inventing labor-saving tools is always welcome and beneficial.
The surgery is about to enter the critical phase.
Doctor Liu, following the Chief Surgeon’s instructions, placed the fixed retractor into the surgical field, expanded it to a certain angle, and tightened the screw. After placing a fixed retractor on both the upper and lower parts of the incision, Xie Wanying was instructed by her teacher to withdraw the manual retractor and hold a suction device instead, continuing to assist her teacher.
The current surgical field was as bloody as it gets. Unlike abdominal surgeries, where mainly bones were exposed, the imagery was suddenly more brutal, resembling the feeling of seeing bones after a blow in a slaughterhouse—truly shocking. It’s best not to think about it; newcomers might find it hard to eat after seeing this.
The work of a surgeon, regardless of the department, makes eating difficult to stomach.
Surgeons must control their thoughts, avoid thinking about food at the dining table, and transform the imagery in their minds into anatomical blueprints, focusing on human ergonomics rather than slaughterhouse scenes. Cultivating this mindset, which doesn’t affect dining, certainly comes from extensive practice and work for surgeons.
Both the Chief Surgeon and assistant paused, reflected, and were ready to proceed with repairing the human bones.
The X-ray film was taken out again and hung on the lamp board in the operating room. The doctor compared the current surgical view with the imaging films, precisely verifying the exact location of the diseased vertebra. With no issues detected, the Chief Surgeon called out, "Knife."
The instrument nurse handed over the Electrosurgical Unit.
Szzzz, continue cutting, the sharp tip of the blade severed the small muscles and ligaments around the bone, exposing the transverse process of the vertebra.
In the anatomy textbooks, bones can be depicted as clean, but in surgery, it’s impossible to see clean bones. Human bones in reality are more like rusted iron blocks covered all around by various tissues, definitely with blood and flesh. To cleanly remove everything would require chemical agents used during specimen preparation in an anatomy lab.
Doctors can only rely on experience and excellent eyesight to distinguish the details of bones amid the bloody mess. Once more, confirming the bone in question, the Electrosurgical Unit was replaced with a periosteal elevator, continuing to clear away the soft tissues around the transverse process.
The transverse process connects to rib joints and ribs. If the whole diseased vertebra needs to be removed, undoubtedly, the connecting rib must be severed first, and the ends of the severed rib must be smoothed to prevent piercing the pleura.
Use a Bone Nibbler for the transverse process, and rib cutters for the ribs. All heavy-duty tools akin to machine repair pliers are brought into play.
