Vol 3 Chapter 2256: System operating room in reality

In the classroom of the Pediatric Surgery at Didu Women's and Children's Hospital, a simulated operation was performed nervously and orderly.
This is a pair of conjoined babies, combined with the chest and abdomen. Although there are two hearts, they share a pericardium, and the hearts are also connected.
Separation surgery is quite difficult. The Women's and Children's Hospital and the Philadelphia Children's Hospital, the top children's surgery in the world, have entered a perioperative period after a series of preparations. As long as the simulated surgery is successful, the surgery can be started at any time.
Computer-aided design 3D printed models are exactly like real people.
Intraoperative navigation and customized two sets of external auxiliary devices all ensure that surgical simulation can be performed.
If the simulated surgery is successful, the pair of conjoined babies can undergo separation surgery at a younger age, effectively protecting their young heart's regenerative capacity.
This set of preliminary preparations is extremely expensive. Women and children's hospital is close to the world's advanced medical level at almost any cost, especially the application of 3D simulation printing and intraoperative navigation systems.
Intraoperative navigation is a preoperative evaluation mode that accurately matches the patient's preoperative or intraoperative image data with the patient's anatomy on the operating table and is reconstructed by computer.
During the operation, the surgical instruments are tracked and the positions of the surgical instruments are updated and displayed in the form of virtual probes on the patient's image in real time. This allows doctors to see the position of the surgical instruments relative to the patient's anatomy at a glance, making the surgical operation faster, more accurate, and safer.
Its applications are mainly intraoperative applications and simulated surgery before surgery.
Intraoperative navigation technology has existed for a long time, but because of its high price and insufficient computer-aided functions, the application of preoperative simulated surgery has not been fully spread in the clinic.
Zheng Ren knew this early, and it was the same as the experimental body in the system space. But the technology is immature, and there is no such thing as a big pig's hoof.
Today, doctors at the Women's and Children's Hospital are trying to carry out heart conjoined infant separation surgery in a "system operating room" built by heavy money.
The surgical model is a 3D printed artificial person exactly like a conjoined baby.
The operation was originally performed by the medical team of the Children's Hospital of Philadelphia. However, during the pre-operation simulation, the team at the 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%.
Siamese infants are carefully cared for in women's and children's hospitals, and their vital signs can withstand surgery, but over time, the symptoms of heart failure become more and more serious, and there is no way to delay it.
The hospital talked with the parents of the child many times, and finally reached a consensus-Siamese infants have already developed symptoms of heart failure, and there is still a first-line vitality for the operation. If there is no surgery, there is no first-line vitality.
Then try it.
As planned, this is the last simulated operation.
The CT and MRI three-dimensional positioning done yesterday, the images produced are bitmap, showing the situation inside the conjoined baby's body in three dimensions.
When the conjoined baby was born when he first came to Daedu Women's and Children's Hospital, the examination revealed that the pericardium was shared, 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 traffic. The apex of the heart is connected to the diaphragm. The two hearts have a small tubular connection with a diameter of 3 mm. The two hearts are mostly membrane-shaped.
There are many connected parts of the liver, but this is not the point.
The most difficult operation for conjoined infants is the brain connection, followed by the heart. The remaining organs are not very important.
However, the reason why the team of experts at the Children's Hospital of Philadelphia gave up was that as the conjoined babies grew, they found that their heart beats at different frequencies, and the operation could not be continued at all.
Tried a few simulated surgeries and no one could solve the problem.
Therefore, the Children's Hospital of Philadelphia announced that it had abandoned surgery.
Vice President Chen of Women's and Children's Hospital sat down and was ready to try a few more times. If the operation is abandoned at this time, the child will die within 1 month, and all previous efforts will be lost.
For the pair of conjoined babies, the women and children's hospital worked hard, only they knew.
Not to mention the top 3D printing simulation children, not to mention the introduction of surgical navigation systems, countless small details, are immersed in the hard work of medical staff.
Careful feeding is the first step.
In order to strengthen the constitution of conjoined babies, create conditions for surgery.
The two conjoined infants were at the age of 10 days at the hospital and weighed 393 kg. They belonged to Ⅱ ° malnutrition.
After admission, high-quality neonatal formula milk feeding, from 3mL each time, once every 3h, now increased to 60-90mL, once every 3h. And in the feeding process, pay attention to the inclination of the bottle, the size of the milk hole, and prevent choking, vomiting and even suffocation.
During the period, it was supplemented with intravenous nutrition-children's compound amino acids, fat milk, multivitamins, trace elements, and intravenously given the same type of plasma, human albumin, and calcium.
Every detail was left out, and the two babies' weights had increased to 78 kg before surgery.
This,
Just part of it.
In addition to feeding, basic care should be strengthened, and infections should be controlled and protected in isolation.
The air sterilizer of the ward is automatically sterilized at regular intervals. Pay attention to ventilation and keep the air fresh. The room temperature is 20 ℃ -24 ℃ and the relative humidity is 50% -60%.
The patient suffered severe diaper rash and impetigo in the armpit, groin, both lower extremities, and around the external when they were hospitalized. After being hospitalized, they were bathed with 005% Xinjieer water every day, and then more than one hundred red hip cream Wait until the affected area is applied 3-4 times a day.
And this is only part of the foundation.
Due to the relatively large range of conjoined children, there may be a large area of ​​skin deficiency after separation. In order to ensure that the incision skin is sufficient during the operation, and to avoid skin grafting as much as possible, the body bridge must be stretched and widened.
The body bridge is the "bridge" part shared by conjoined babies.
At the time of admission, the initial umbilical cord of the conjoined infant was 16 cm long. Body bridge with a width of 4cm and a circumference of 37. Because the body bridge tension is high, it is necessary to relax the chest and abdominal wall and expand the chest and abdominal cavity.
The pediatric director personally started and pressed the connected part of the conjoined baby 3 times a day for 15 minutes each time.
The old director is almost 60 years old. Every day, watching her use her four fingers to lay flat under the body bridge, with her thumbs on top, and press it rhythmically from light to heavy, Vice President Chen felt very hard.
When pressing, you should also observe the reaction and complexion of the conjoined body. After pressing, a rice bag with a length of 16cm, a diameter of 2cm, and a weight of 150g is pressed above the body bridge.
A cotton bag of the same shape is used to elevate the lower part, and a lateral traction method is used to place a small pillow between the two children during sleep at night, so that the two children can be pulled apart as much as possible in the lateral position to obtain the body bridge during surgery Ready to be satisfied.
With the joint efforts, the body bridge of the conjoined baby now has a circumference of 54cm, a length of 20cm, and a width of 7cm.
But everything is ready, but the operation cannot be completed.
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In the classroom of the Pediatric Surgery at Didu Women's and Children's Hospital, a simulated operation was performed nervously and orderly.
This is a pair of conjoined babies, combined with the chest and abdomen. Although there are two hearts, they share a pericardium, and the hearts are also connected.
Separation surgery is quite difficult. The Women's and Children's Hospital and the Philadelphia Children's Hospital, the top children's surgery in the world, have entered a perioperative period after a series of preparations. As long as the simulated surgery is successful, the surgery can be started at any time.
Computer-aided design 3D printed models are exactly like real people.
Intraoperative navigation and customized two sets of external auxiliary devices all ensure that surgical simulation can be performed.
If the simulated surgery is successful, the pair of conjoined babies can undergo separation surgery at a younger age, effectively protecting their young heart's regenerative capacity.
This set of preliminary preparations is extremely expensive. Women and children's hospital is close to the world's advanced medical level at almost any cost, especially the application of 3D simulation printing and intraoperative navigation systems.
Intraoperative navigation is a preoperative evaluation mode that accurately matches the patient's preoperative or intraoperative image data with the patient's anatomy on the operating table and is reconstructed by computer.
During the operation, the surgical instruments are tracked and the positions of the surgical instruments are updated and displayed in the form of virtual probes on the patient's image in real time. This allows doctors to see the position of the surgical instruments relative to the patient's anatomy at a glance, making the surgical operation faster, more accurate, and safer.
Its applications are mainly intraoperative applications and simulated surgery before surgery.
Intraoperative navigation technology has existed for a long time, but because of its high price and insufficient computer-aided functions, the application of preoperative simulated surgery has not been fully spread in the clinic.
Zheng Ren knew this early, and it was the same as the experimental body in the system space. But the technology is immature, and there is no such thing as a big pig's hoof.
Today, doctors at the Women's and Children's Hospital are trying to carry out heart conjoined infant separation surgery in a "system operating room" built by heavy money.
The surgical model is a 3D printed artificial person exactly like a conjoined baby.
The operation was originally performed by the medical team of the Children's Hospital of Philadelphia. However, during the pre-operation simulation, the team at the 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%.
Siamese infants are carefully cared for in women's and children's hospitals, and their vital signs can withstand surgery, but over time, the symptoms of heart failure become more and more serious, and there is no way to delay it.
The hospital talked with the parents of the child many times, and finally reached a consensus-Siamese infants have already developed symptoms of heart failure, and there is still a first-line vitality for the operation. If there is no surgery, there is no first-line vitality.
Then try it.
As planned, this is the last simulated operation.
The CT and MRI three-dimensional positioning done yesterday, the images produced are bitmap, showing the situation inside the conjoined baby's body in three dimensions.
When the conjoined baby was born when he first came to Daedu Women's and Children's Hospital, the examination revealed that the pericardium was shared, 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 traffic. The apex of the heart is connected to the diaphragm. The two hearts have a small tubular connection with a diameter of 3 mm. The two hearts are mostly membrane-shaped.
There are many connected parts of the liver, but this is not the point.
The most difficult operation for conjoined infants is the brain connection, followed by the heart. The remaining organs are not very important.
However, the reason why the team of experts at the Children's Hospital of Philadelphia gave up was that as the conjoined babies grew, they found that their heart beats at different frequencies, and the operation could not be continued at all.
Tried a few simulated surgeries and no one could solve the problem.
Therefore, the Children's Hospital of Philadelphia announced that it had abandoned surgery.
Vice President Chen of Women's and Children's Hospital sat down and was ready to try a few more times. If the operation is abandoned at this time, the child will die within 1 month, and all previous efforts will be lost.
For the pair of conjoined babies, the women and children's hospital worked hard, only they knew.
Not to mention the top 3D printing simulation children, not to mention the introduction of surgical navigation systems, countless small details, are immersed in the hard work of medical staff.
Careful feeding is the first step.
In order to strengthen the constitution of conjoined babies, create conditions for surgery.
The two conjoined infants were at the age of 10 days at the hospital and weighed 393 kg. They belonged to Ⅱ ° malnutrition.
After admission, high-quality neonatal formula milk feeding, from 3mL each time, once every 3h, now increased to 60-90mL, once every 3h. And in the feeding process, pay attention to the inclination of the bottle, the size of the milk hole, and prevent choking, vomiting and even suffocation.
During the period, it was supplemented with intravenous nutrition-children's compound amino acids, fat milk, multivitamins, trace elements, and intravenously given the same type of plasma, human albumin, and calcium.
Every detail was left out, and the two babies' weights had increased to 78 kg before surgery.
This,
Just part of it.
In addition to feeding, basic care should be strengthened, and infections should be controlled and protected in isolation.
The air sterilizer in the ward is automatically disinfected at regular intervals. Pay attention to ventilation and keep the air fresh. The room temperature is 20 ℃ -24 ℃ and the relative humidity is ~ EbookFREE.me. And around the and other parts have serious diaper rash and pustular rash, after bathing with 005% Xinjieer daily water after the hospital, apply the affected area with more than 100 gang red hip cream, etc., 3-4 times a day.
And this is only part of the foundation.
Due to the relatively large range of conjoined children, there may be a large area of ​​skin deficiency after separation. In order to ensure that the incision skin is sufficient during the operation, and to avoid skin grafting as much as possible, the body bridge must be stretched and widened.
The body bridge is the "bridge" part shared by conjoined babies.
At the time of admission, the initial umbilical cord of the conjoined infant was 16 cm long. Body bridge with a width of 4cm and a circumference of 37. Because the body bridge tension is high, it is necessary to relax the chest and abdominal wall and expand the chest and abdominal cavity.
The pediatric director personally started and pressed the connected part of the conjoined baby 3 times a day for 15 minutes each time.
The old director is almost 60 years old. Every day, watching her use her four fingers to lay flat under the body bridge, with her thumbs on top, and press it rhythmically from light to heavy, Vice President Chen felt very hard.
When pressing, you should also observe the reaction and complexion of the conjoined body. After pressing, a rice bag with a length of 16cm, a diameter of 2cm, and a weight of 150g is pressed above the body bridge.
A cotton bag of the same shape is used to elevate the lower part, and a lateral traction method is used to place a small pillow between the two children during sleep at night, so that the two children can be pulled apart as much as possible in the lateral position to obtain the body bridge during surgery Ready to be satisfied.
With the joint efforts, the body bridge of the conjoined baby now has a circumference of 54cm, a length of 20cm, and a width of 7cm.
But everything is ready, but the operation cannot be completed.
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