Chapter 2404： 【2404】Tools and hands

Chapter 2404 [2404] Tools and Hands

The   xiphoid process is at the lower end of the sternum and is mostly cartilage.

For cartilage, you can use surgical scissors instead of a chainsaw. Doing anything can choose to break through from the easiest place to start, and finally bite the hard bone is a common strategy, and the same is true in the medical path. Removing the xiphoid process before sawing the sternum is equivalent to opening a breach. As with the previous point, the most important thing is to clean up the "stuff" that is attached to the bones.

To accompany the main knife, Yisuke, this time, without using the separation forceps, use the forceps to clamp the small baffle plate of the xiphoid process, and then clean up the "debris pile" behind the "baffle plate". For example, it is impossible to disassemble a robotic arm without cutting the surrounding wires connecting the robotic arm.

The electric knife held by the main knife squeaked and coagulated the exposed rectus abdominis after cutting the xiphoid process and raising it. The position here is close to the abdominal cavity, and great care must be taken to prevent excessive dissection. When the fluid placed in the pericardium of the thoracic cavity flows into the abdominal cavity, it will cause complications of the abdominal organs.

After    incision, a gap was exposed behind the xiphoid process. The main knife put down the electric knife, and extended a finger of the right hand to penetrate deep into the gap to the left rear of the sternum. This position is next to the pericardium, and the doctor's fingers gently and slowly push to open the pleura on the left and right sides of the mediastinum, doing blunt dissection.

If the child was younger, the doctor's fingers might be able to separate directly to the upper back of the sternum. If it is bigger, a finger cannot reach the upper end of the sternum. Like other engineering, in this case, only a tool can be used instead of a finger. Put it in and insert it forward along the direction of the finger. Doctors usually use long flat forceps against the sternum for blunt dissection.

Use tools instead, just like finger stabs, you need to determine where the stabs are and whether they have been stabbed. For this reason, after the long flat tweezers are inserted in this way, the end needs to be connected to confirm that the separated target orientation is correct.

To use an analogy, the human body is like a big cave with many caves hidden in a big mountain, intertwined and complex. A long flat tweezer is like a pole entering a hole in a cave in a large cave. You need to ensure that the rope appears at the designated hole, and you need to connect the end of the pole at the designated hole.

On the operating table, the main surgeon needs to free the other hand to the incision on the upper end of the sternum. Since the right hand is occupied, only the fingers of the left hand can be stretched out and inserted from the upper end to try to meet the length of the tissue separated from the bottom and upwards. Flat tweezers.

This separation path is next to the separation of the rear end of the sternum. The doctor's naked eye is hidden by the bone and is invisible, so it is called the mysterious cave. Sometimes it may be inserted for a long time, and the fingers of the left hand and the end of the long flat tweezers are not in contact, and it is unknown whether they are separated in place. If this is the case, the doctor can only withdraw the long flat forceps to the outside, measure the length just inserted and compare the length of the sternum, so as to determine whether the depth just inserted is in place.

You may find it strange. It stands to reason that the distance between the upper and lower ports of the sternum is not long, and it is said that it is invisible behind the bone, but if the distance is not long, you can rely on feeling to catch it. How can the two ends always fail to connect. Blunt dissection was mentioned earlier in general surgery, and blunt dissection is not an electric knife cut. To use another analogy, a doctor's fingers and tools are like tadpoles wandering in a cave looking for their mother. It is impossible for you to split the walls between the caves, and you must walk on the right path to meet them.

The best thing is to be able to touch it, and the little tadpole can find its mother.

(end of this chapter)