Surgery Godfather-Chapter 612 - 556: Straightening Artifact_2
Chapter 612: Chapter 556: Straightening Artifact_2
"Is this new technology reliable?" Guo Liu is still doubtful.
Cui Xubing gives a mysterious smile. Seeing no one nearby, he leans over and whispers to his wife, "Would they dare to accept the gift if the technology was unreliable?"
With his extensive experience, Old Cui knows that if someone dares to accept a gift, it means they are confident about the matter.
That makes sense!
Guo Liu nods her head.
The red envelope is like a reassurance pill, making Cui Xubing and his wife feel very secure.
Six-year-old Cui Shukai is laid on the spinal positioning frame.
For all orthopedic surgeries, the surgical bed and positioning frames are made from materials that allow X-ray penetration. Radiographic metal materials are infrequently used.
The 3D reconstructed image of Cui Shukai’s spine is displayed on the screen. It can be observed from various angles.
The operating room is in full swing, and Yang Ping has already started the operation.
A blue line emerges from the center of the pedicle root. Guided by the antenna, the robotic arm begins to align its position. The direction of the puncture needle matches the blue line on the image. The robot automatically calibrates and locks the direction of the robotic arm when there is no error.
The puncture needle slowly moves forward, just touching Cui Shukai’s skin when Yang Ping instructs it to stop.
Song Zimo uses a scalpel to make a small incision at the needle tip on the skin. Yang Ping manipulates the robotic arm, guiding the puncture needle to advance accurately along the pre-set path.
On the real-time fluoroscopic image, you can see the needle tip penetrate the skin and then reach the puncture point on the posterior part of the vertebra.
At this point, Song Zimo removes the puncture needle, and Yang Ping’s robotic arm backs off, moving away from the surgical site.
Song Zimo starts the manual procedures, inserting the cannula along the puncture needle step by step, from thinner to thicker gauges. When satisfied, he removes the puncture needle.
Xu Zhiliang has already fitted a drill bit onto the robotic arm.
The robotic arm once again aligns with the blue line. After calibration, it extends into the cannula and starts to rotate slowly, drilling as it advances. It stops after a while, and then continues to rotate forward.
Under fluoroscopy, you can watch the drill bit pass through the pedicle root into the vertebral body. The puncture point and direction are close to perfection.
When the drill bit enters about half of the vertebral body, it automatically stops under the control of the depth limit program.
Yang Ping rotates the 3D reconstruction image. The pedicle screw is in the only bony canal, surrounded by bone on all sides, perfectly centered.
At this point, part of the pedicle screw is left outside the skin, while the rest has entered the bone of the vertebra.
The robotic arm withdraws, while Song Zimo manually screws in a locking device. This device can prevent the pedicle screw from accidentally penetrating too deep, piercing the anterior part of the vertebral body, and damaging the anterior aorta and vena cava.
If there’s no locking device, even if the pedicle screw’s position is good now, it’s prone to penetrate deeper with the activity of the child, damaging the aorta and vena cava, putting the child’s life in danger.
This little locking device is an essential part of the surgical equipment’s safety guarantee.
The first percutaneous pedicle screw is successfully inserted.
All the vertebrae involved in the spinal deformity have pedicle screws inserted. As the vertebrae are deformed, all these screws sticking out of the skin are oriented in different directions, generally presenting a large ’C’ shape.
The next step is osteotomy, which is also the riskiest operation.
The osteotomy uses an ultrasonic bone cutter for minimally invasive incision osteotomy. The biggest advantage of the ultrasonic bone cutter is that it is hard but not soft.
It can cut through bone, but it will not damage surrounding nerves, blood vessels, and other soft tissues.
Song Zimo is responsible for cutting the skin open, holding the small opening apart, and allowing the robotic arm to perform the osteotomy.
Each deformed vertebra undergoes an osteotomy in different positions and directions. After the osteotomy is complete.
The remaining work can only be done manually--- the assembly of the external fixator.
This is a very delicate job.
"The professor initially wanted to use shape-memory alloy to make the external fixator. In this way, some low-age children would not need osteotomy for orthodontics. But that external fixator is too complex, and the orthodontic time is too long. Considering its practicality, he gave up the initial design. The current external fixator has lower material requirements and shorter orthodontic time. Although it requires osteotomy, both its safety and purpose of osteotomy are different from traditional surgery."
"By using osteotomy, the deformity correction is distributed to each vertebra, so the correction speed is very fast."
Song Zimo and Xu Zhiliang work together to install the external fixator. They recheck the scale markers on each knob and ask the circulating nurse to help record them.
Yang Ping’s initial design for the spinal external fixator was more perfect, but perfection is not necessarily the best.
When the product was designed at that time, no osteotomy was needed, and traction was applied to the soft tissue with the orthopaedic appliance.
But the required traction force is relatively large. Several parts of it need a special memory alloy. Huang Jiacai found the raw material for this alloy at a materials laboratory at Northwestern Polytechnical University. Unfortunately, the material meeting the requirements is not mass-produced and still an experimental product. Thus, the supply chain is not mature.
Moreover, although the external fixator is perfect and doesn’t require osteotomy, the orthodontic time is long--- often half a year or a year for a successful correction.
Later, Yang Ping opted for a workaround. He used the bone transplantation at the osteotomy site to achieve the orthopaedic purpose. Although the osteotomy is still required, both the method and purpose of this osteotomy are entirely different from traditional osteotomy.
The current spinal external fixator is indeed the most practical. It has low material requirements, and ordinary limb external fixator materials are entirely sufficient. Moreover, the orthodontic time is short, usually completed within three months.
Therefore, sometimes the most perfect technology, considering cost and efficiency, may not be the best.
After the installation of the external fixator is completed, the whole operation only results in a few tens of milliliters of blood loss. A surgery with the highest risk in spine surgery, ends so quickly.
Director Tan and Director Qin of Spine Surgery find it hard to believe that this magical device can straighten Cui Shukai’s severe spinal curvature in just three months.
If it can indeed achieve this, it’ll be a subversive technological innovation in spinal surgery.
"Old Xu, the Publicity Department wants to promote this technology. They want to give this spinal external fixator a catchy name for ease of publicity, what do you think it should be called?"
Song Zimo stitches the small incision while talking.
Xu Zhiliang snaps his fingers, helping to cut the thread: "Straightener!"
"Straightener?"
Song Zimo thinks for a moment, "Why does this name sound not like something from spinal surgery, but more like a name for a psychology department tool?"
"Right. When people hear ’Straightener,’ they won’t immediately think of straightening the spine, but of straightening other parts." Little Five also agrees with Song Zimo.
"Other parts? What other part needs straightening by you guys?"
The circulating nurse also joins the conversation, feeling that she doesn’t understand their chit-chat.
"Adults are talking, little girl, don’t interrupt. There are many parts that need us to straighten."
Song Zimo speaks to the puzzled circulating nurse.freewebnσvel.cѳm