Chapter 2253 System Operating Room in Reality

In the demonstration classroom of the Pediatric Surgery Department of the Imperial Women's and Children's Hospital, a simulated operation was being carried out in an intense and orderly manner.

This is a pair of conjoined twins, with chest and abdomen united. Although they have two hearts, they share a pericardium, and the hearts are also connected together.

The separation operation is quite difficult. The Women and Children's Hospital has joined forces with the Children's Hospital of Philadelphia, the world's top children's surgery. After a series of preparations, it has entered the perioperative period. As long as the simulated operation is successful, the operation can be carried out at any time.

The 3D printed model of computer-aided design is exactly the same as the real person.

Intraoperative navigation and two sets of customized external auxiliary devices ensure that surgical simulation can be performed.

If the simulated operation is successful, the conjoined twins can be separated at a young age, effectively protecting the regeneration ability of their young hearts.

This set of preliminary preparations is extremely expensive. Women and Children's Hospital is close to the world's advanced medical level at almost all costs, especially the application of 3D simulation printing and intraoperative navigation system.

Intraoperative navigation is a preoperative evaluation mode that accurately corresponds to the patient's anatomical structure on the operating bed before or during the operation, and is reconstructed by a computer.

During the operation, the surgical instrument is tracked and the position of the surgical instrument is updated and displayed on the patient's image in the form of a virtual probe in real time, so that the doctor can see at a glance the position of the surgical instrument relative to the patient's anatomical structure, making the surgical operation faster, more accurate and safer.

Its application is mainly intraoperative application and preoperative simulated operation and so on.

Intraoperative navigation technology has existed for a long time, but because of its high price and insufficient computer-assisted functions, the application of preoperative simulation surgery has not been fully developed in clinic.

Zheng Ren knew this a long time ago, it is the same as the experimental subjects in the system space. But the technology is immature, and it's not as easy to use as a big pig's hoof.

Today, doctors at the Women's and Children's Hospital are trying to separate conjoined twins in the "systematic operating room" built with a lot of money.

The surgical model is a 3D printed humanoid that is exactly the same as the conjoined twins.

The operation was originally performed by the medical team of Children's Hospital of Philadelphia, but during the preoperative simulation operation, the team of Children's Hospital of Philadelphia found that the child's heart deformity was serious, and the success rate of the operation was less than 5%, so they directly rejected it.

Under the careful care of the conjoined twins at the Women's and Children's Hospital, the vital signs could withstand the operation, but as time went by, the symptoms of heart failure became more and more serious, and there was no way to delay it.

The hospital talked with the parents of the child many times, and finally reached a consensus that the conjoined twins had already shown symptoms of heart failure, and there was still a chance of survival after surgery, and there was no chance of survival without surgery.

Then try it.

According to plan, this is the last simulated operation.

The three-dimensional positioning of CT and MRI performed yesterday, the images produced are of bitmap nature, showing the situation in the body of conjoined twins three-dimensionally.

When the conjoined twins were born and first came to Daodidu Women and Children's Hospital, the examination found that they shared the pericardium, and two hearts were connected in the atrium. The large blood vessels at the bottom of the heart and the atrium are completely separated without communication. The apex of the heart is connected near the diaphragm. The two hearts have a small tubular connection with a diameter of 3 mm. Most of the two hearts are connected by membranous.

The liver has more connected parts, but that's not the point.

The most difficult operation for conjoined twins is the connection of the brain, followed by the heart. The rest of the organs are not very important.

However, the reason why the expert team of the Children's Hospital of Philadelphia gave up was that as the conjoined twins grew up, they found that their heart beats at different frequencies, and the operation could not proceed at all.

Tried several mock surgeries and no one could fix the problem.

Therefore, Children's Hospital of Philadelphia announced the abandonment of surgery.

Vice President Chen of the Women's and Children's Hospital was sitting in charge, ready to try a few more times. If the operation is given up at this time, the child will die within a month, and all previous efforts will be in vain.

For this pair of conjoined twins, only they themselves know how much painstaking efforts the Women and Children's Hospital has put into it.

Not to mention the top-level 3D printing simulated children, not to mention the introduction of the surgical navigation system, countless small details are immersed in the painstaking efforts of medical staff.

Careful feeding is the first step.

In order to enhance the physique of conjoined twins and create conditions for surgery.

The two conjoined twins were 10 days old when they were admitted to the hospital, with a total weight of 3.93 kg and belonged to II° malnutrition.

After admission, high-quality newborn formula milk was fed, from 3 mL each time, fed once every 3 hours, to 60-90 mL, fed once every 3 hours. And in the process of feeding, pay attention to the inclination of the bottle, the size of the milk hole, and pay attention to prevent choking and vomiting. Even suffocation occurs.

Intravenous nutrition was supplemented during the period—children's compound amino acid, fat emulsion, multivitamins, trace elements, and the same type of plasma, human serum albumin, calcium, etc. were given intravenously.

Every detail has not been missed, and the preoperative weight of the two babies has increased to 7.8 kg.

this,

just part of it.

In addition to feeding, it is necessary to strengthen basic care, control infection and place protective isolation in a single room.

The air disinfector in the ward is automatically disinfected at regular intervals every day, and attention should be paid to ventilation to keep the air fresh. The room temperature is 20°C-24°C, and the relative humidity is 50%-60%.

When the child was admitted to the hospital, he suffered from severe diaper rash and impetigo in the armpit, groin, lower limbs, and around the anus and genitalia. Buttock ointment, etc. apply to the affected area, 3-4 times a day.

And this is only part of the foundation.

Because the range of conjoined twins is relatively large, there may be a large range of skin deficiency after separation. In order to ensure enough skin for the incision and avoid skin grafting as much as possible, the body bridge must be lengthened and widened.

The body bridge is the "bridge" part shared by conjoined twins.

The conjoined twins had an initial anterior umbilical length of 16 cm on admission. A body bridge with a width of 4 cm and a circumference of 37 cm. Because the body-bridge tension is high, the chest and abdominal wall should be relaxed to expand the chest and abdominal cavity.

The director of pediatrics will personally press the connecting parts of conjoined twins 3 times a day for 15 minutes each time.

The old director is almost 60 years old. Every day, Vice President Chen finds it very hard to watch her put the four fingers of one hand together under the body bridge, put the thumb on the top, and press rhythmically from light to heavy.

When pressing, the reaction and complexion of the conjoined body should also be observed. After pressing, a rice bag with a length of 16 cm, a diameter of 2 cm, and a weight of 150 g was pressed on the body bridge.

Use a cotton bag of the same shape to raise the lower part. When sleeping at night, use the side lying stretching method, that is, put a small pillow between the two children, so that the two children can be stretched as far as possible when they are lying on the side, and try to reach the body bridge during the operation. Prepare to be satisfied.

With joint efforts, the body bridge circumference of the conjoined twins is now 54 cm, 20 cm long and 7 cm wide.

But everything was ready, but the operation could not be completed.

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