Professor Tian's technique was smooth.
He cut open the skin and exposed the spinous process and lamina. The two vertebrae of the diseased vertebra were fully exposed.
To better expose the incision, the sacrospinalis muscle should be cut horizontally at the level of the diseased vertebra and retracted distally and proximally.
Under normal circumstances, there should be at least 200ml of blood loss.
This was because the periosteum had to be removed during the process of exposing the spinous process and lamina.
However, today's surgery was surprisingly smooth.
The blood loss was less than 50ml and the entire surgical field looked exceptionally clean.
Professor Tian was very satisfied with his technique. It seemed like his technique was smooth today and the blood loss might be less than 3000ml.
The next step would be a large amount of blood loss. Professor Tian's hands were much gentler and he slowed down seriously. Every operation was carefully identified to prevent accidental bleeding.
The forceps began to bite off the spinous process and lamina with tumor infiltration.
"Crack ~" A piece of broken bone was bitten off by the forceps.
Due to the tumor infiltration, the lamina was not as hard and the sound was like leather.
Although it was not hard enough, the abnormal proliferation of blood vessels from the tumor allowed the lamina to have sufficient blood supply, causing the sudden increase in blood loss.
The large amount of blood loss started from this moment.
A piece of lamina was bitten off by the forceps and Professor Tian habitually covered it with a piece of dry gauze.
Strange …
In an instant, Professor Tian realized that the dry gauze was only soaked in blood after a full ten seconds.
Professor Tian was very skilled. Although he was not at the level of Legend, he was an orthopedic professor who was close to the level of Grandmaster.
He had a deep understanding of vertebral resection surgery.
It could be explained if the previous bleeding was due to his high level of separation.
However, it was impossible for there to be a small amount of blood loss after the forceps had bitten off the lamina.
Normally, the surgery would be carried out in a pool of blood from this step onwards.
Even an aspirator would not be able to suck it clean.
The poor vision would lead to more blood loss and the vicious cycle would continue.
On the other side, fresh frozen red blood cells were hung up and waiting for Professor Tian's order to be transfused into the patient's body.
Strange, could it be a rare tumor? Insufficient blood supply?
That could not be it. Professor Tian could not understand the situation in front of him.
Even if the blood supply of the tumor was insufficient, the blood supply of the vertebral body was quite abundant. No matter what, it would not take ten seconds for the blood to soak through a piece of dry gauze.
"Professor Tian?" Doctor Zhou saw that Professor Tian was in a daze and did not know what was going on, so he called out softly.
Professor Tian woke up from his endless guesses. He focused and continued the surgery.
He continued to bite off the vertebral lamina to expose the nerve roots.
The tumor invaded the spinal canal. During the operation, the dura gradually bulged outwards without pulsation. The epidural fat often disappeared, and the dural sac was compressed, displaced, or deformed.
Professor Tian did not continue to cover the vertebral lamina with dry gauze. He wanted to see how much blood there was.
Sure enough, the amount of blood loss was very small, only a few dozen milliliters.
It was a problem with interventional surgery!
Professor Tian quickly deduced the truth. However, he could not accept this truth.
As a specialist and professor in spine surgery in Imperial Capital, he often cooperated with interventional surgeons to complete vertebral resection surgeries.
But had he ever encountered such a small amount of blood loss?
No, not even once.
With the cooperation of the Department of Interventional Medicine, they could indeed reduce the bleeding to a certain extent. It had something to do with the surgeon's technique, but it did not have much to do with it.
It was just a lumbar artery embolization, how difficult could it be?
If he could not find an interventional surgeon, Professor Tian could perform the lumbar artery embolization surgery with a lead apron.
However, whether it was the interventional surgeon or himself, they could only reduce the blood loss from five thousand milliliters to two thousand or three thousand milliliters.
No matter how small it was, Professor Tian had never encountered it before.
Sea City was such a small place, how could there be a better doctor than in Imperial Capital?
Impossible, completely impossible.
Professor Tian's hands did not stop moving as he thought about these things.
He had performed this kind of surgery many times. Although he could not perform it with his eyes closed, at least he did not have to repeatedly recall the local anatomy like the first time.
He used nerve stripping to find the nerve roots on both sides of the dural sac and protect them.
Then, Professor Tian started to dissect the tumor tissue, dural sac, and lateral nerve roots. He then removed the superior and inferior articular processes, pedicle, and tumor tissue.
Generally speaking, this was the role of lumbar artery embolization before laminectomy.
Without interventional embolization, there would be threatening bleeding.
What was threatening bleeding?
An invisible blood vessel would bleed profusely and the entire surgical field would be dark red. Not even the bleeding vessel could be found, let alone a laminectomy.
No threatening bleeding, that was good.
But … how was this not threatening bleeding? There wasn't even bleeding, okay?!
It would be bullshit to say that there was no bleeding at all.
However, Doctor Zhou was holding an aspirator without a condom and easily sucked all the blood out. The surgical field was so well exposed that Professor Tian was a little flustered.
This was not the laminectomy that he was familiar with …
Did he make a mistake?
He stopped and recalled the entire surgery process. There was no problem!
He looked at the surgical field again. The anatomical structure was so clear that it could be used as a textbook diagram. There was no problem either.
What the f * ck was going on?
There was actually a problem even though the surgery was too smooth.
Professor Tian was a little anxious. He had never seen such a surgical field ever since he came into contact with laminectomy.
If he was in Imperial Capital, Professor Tian would have looked for a few colleagues or even his own teacher to observe the surgery to see if there were any mistakes.
However, this was Sea City.
He had to bite the bullet and do it.
The exposure and removal of the lumbar transverse process was smooth. There was still very little bleeding. The lumbar transverse process usually bled about 500 ml and it took 30 minutes.
This was Professor Tian's experience.
However, the amount of blood lost in this damned surgery was only 30 to 50 milliliters. It only took 15 minutes to complete this step.
Professor Tian then started to expose the anterior lateral side of the vertebral body. The vertebral body that was invaded by the tumor was moderately swollen, but the boundary between the tumor and the surrounding tissue was clear. The surrounding tissue could be removed with a gentle dissection.
Normally, this step would still result in 200 to 300 ml of bleeding. Time consuming …
However, it was still smooth. The bleeding was only one-tenth of the usual. Looking at the aspirator tube in Doctor Zhou's hands, it would be good if there was only 20 to 30 ml of bleeding.
After dissecting the lesion vertebral body to the anterior longitudinal ligament, Professor Tian asked Doctor Zhou to use the Hohman retractor to retract the surrounding tissue. The anterior lateral approach to the vertebral body appeared in front of them.
The surgery … was too smooth. It was so smooth that it made people feel dizzy and fearful.
Was this a laminectomy?
No way, how could there be so little bleeding? How could the surgery be so smooth?
What … what the f * ck!
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