Professor Tian’s technique is very smooth.

The skin is incised to expose the spinous process and lamina. The upper and lower vertebrae of the lesions are fully exposed.

To better reveal the incision, the sacrospinalis muscles on both sides should be cut off from the level of the diseased vertebrae and pulled away and proximal to the distant and proximal respectively.

Generally speaking, at this time there should be at least 200ml of bleeding.

Because during the exposure of spinous processes and laminar plates, a certain periosteum must be processed, resulting in bleeding.

But today's surgery went unexpectedly.

The bleeding volume is less than 50ml, and the entire field looks particularly clean.

Professor Tian is very satisfied with his technique. It seems that the hand wind is smooth today, and the surgical bleeding may be less than 3,000ml.

The next step is to start bleeding a lot. Professor Tian’s hand became much softer and slowed down very seriously. All operations were carefully identified to avoid accidental bleeding.

The bone biting forceps begin to bite off the spinous processes and laminar plates that are infiltrated with tumors.

With a "Gaba~", a piece of broken bone was bitten by the biting pincers.

Due to tumor infiltration, the bone plates are not that hard and the sound is like a failure.

Although the hardness is not enough, due to abnormal tumor proliferation, the bone plate has sufficient blood supply, causing the bleeding to suddenly increase.

A lot of bleeding starts from now on.

A piece of lamina was bitten off by the biting forceps, and Professor Tian habitually covered it with a piece of dry gauze.

strangeness……

In an instant, Professor Tian found that it took ten seconds before the dry gauze was soaked in blood.

Professor Tian has a very high level. Although he has not reached the level of a master, he is also a senior orthopedic professor at the level of master.

He has a deep understanding of vertebral removal surgery.

If you say that the bleeding was less before, it was because of your high separation level, which could be explained.

However, if the bone bite forceps bite the lamina, it is impossible for this step to cause a particularly small amount of bleeding.

Generally speaking, from this step, surgery is required in a pool of blood.

The kind that can't even absorb cleanly.

Unclear vision will lead to more bleeding, and such a vicious cycle continues.

On that side, fresh frozen red blood cells were already hung up, waiting for Professor Tian’s orders and ready to be input into the patient’s body at any time.

Strange, is it a rare tumor? Is the blood supply not abundant?

No, Professor Tian is a little confused about the situation in front of him.

Even if the tumor blood supply is not abundant, the blood supply of the vertebrae is quite abundant. No matter how long it takes, the bleeding will not soak a piece of dry gauze.

"Teacher Tian?" Dr. Zhou saw that Professor Tian was stunned and didn't know what was going on, so he shouted softly.

Professor Tian woke up from infinite guesses, concentrated and continued the operation.

Continue to bite the lamina and expose the nerve roots.

The tumor invades the spinal canal. During the operation, the dural gradually bloats outward without pulsation. The epidural fat often disappears, and is compressed and displaced or deformed in the dural sac.

Professor Tian did not continue to cover the laminar plate with dry gauze because the bone bite was bitten by the bone-biting forceps. He wanted to see how much bleeding was.

Sure enough, the amount of bleeding was very small, only a few dozen milliliters.

It's an interventional surgery problem!

Professor Tian quickly judged the truth. However, he could not accept the truth.

In the imperial capital, as an expert and professor in spinal surgery, I often cooperate with interventional physicians to complete vertebral resection.

But have you ever encountered such a small amount of bleeding?

No, not once.

With interventional department cooperation, it can indeed reduce certain bleeding. It has something to do with the surgeon's techniques, but it has nothing to do with it.

What's the difficulty of just embolizing a transverse lumbar artery?

The interventional physician was not found, and Professor Tian could perform surgery to embolize the transverse lumbar artery even with his lead coat.

However, whether it was an interventionist or he had an embolization of the transverse lumbar artery himself, he could only reduce the bleeding volume from 5,000 ml to 2,000,3,000 ml.

No matter how few, Professor Tian has never encountered it before.

In such a small place as Haicheng, is there any doctor who is stronger than the imperial capital?

Impossible, completely impossible.

Professor Tian was thinking about these things in his mind, but his hands didn't stop.

This kind of surgery is done too much, and you can do it without closing your eyes. At least you don’t have to repeatedly recall local anatomy like when you first did it.

Use nerve extensors to find nerve roots on both sides of the dural sac and protect them.

Then, Professor Tian began to peel off the tumor tissue, the dural sac and the lateral side of the nerve root, and eliminated the upper and lower articular processes and pedicles together with the tumor tissue seen.

Generally speaking, the effect of embolizing the transverse lumbar artery before laminectomy is here.

Without interventional embolism, threatening bleeding will occur at this time.

What is threatening bleeding?

Some of the invisible tiny blood vessels were bleeding, and the entire field was red, and even the bleeding blood vessels could not be found, let alone vertebral removal surgery.

No threatening bleeding, it's good.

But... there is no threatening bleeding, and it is not even good for bleeding!

If you insist that there is no bleeding at all, that is nonsense.

But Dr. Zhou held a suction device without a condom and easily sucked the bleeding cleanly. The art field was exposed very well, which made Professor Tian feel a little panicked.

This is not the vertebral removal procedure I am familiar with...

Did you do something wrong?

He stopped and recalled the entire operation without any problems!

Let’s look at the art field. If the anatomy is clear, it can be used as a textbook map, and there is no problem.

It's really a terrible sight.

The operation went too smoothly and there were problems.

Professor Tian was a little nervous. He had never seen such a field of surgery since he came into contact with vertebral removal.

If he was in the imperial capital, Professor Tian would have been interested in finding a few colleagues, or even his teacher to watch the platform to see if he made any mistakes.

But this is Haicheng.

Do it with your teeth.

The lumbar transverse process is exposed and removed, and it is very smooth, and bleeding... is still very rare. Here, the lumbar transverse process usually has bleeding of about 500 ml, which takes 30 minutes.

This is Professor Tian’s experience.

But this hell operation only had 30-50 ml of bleeding. It took 15 minutes to complete this step.

Then Professor Tian began to expose the anterior and lateral side of the vertebral bone. The vertebral body invaded by the tumor showed moderate expansion, but its edges were clear from the surrounding tissue. Gently peeling off the surrounding tissue can push apart and peel it off.

Normally, this step will still have 200-300 ml of bleeding, which will take time...

But it was still very smooth here, with only one-tenth of the usual bleeding. Looking at the suction tube in Dr. Zhou's hand, it was estimated that 20-30 ml of bleeding would be good.

Before dissecting the lesion vertebrae to the anterior longitudinal ligament, Professor Tian asked Dr. Zhou to use Hohman hook to pull open the surrounding tissue, and the lateral frontal approach of the vertebrae appeared in front of him.

The operation... was so smooth that it made people dazed and frightened.

Is this a vertebrae removal surgery?

No, why is there so little bleeding? How can the surgery be so smooth?
Chapter completed!