Surgery Godfather
Chapter 815 - 730: The Unbearable Separation in Life

Chapter 815: Chapter 730: The Unbearable Separation in Life

After the bleeding was successfully stopped, the boy had passed the first hurdle of Ghost Gate.

Next, he was to be transferred to the trauma ICU for continued treatment, and once his condition stabilized, he would undergo a second phase of surgery.

The content of the second surgery was extensive, not only stabilizing the head and neck but also operating on pelvic fractures and multiple fractures throughout the body.

"Get ready to transfer the bed, everyone take your positions!"

Song Zimo directed everyone to start moving the boy from the operating table to the transport gurney.

Due to weakened muscle strength, the boy had to rely on a ventilator to assist his breathing. A cannula inserted through a tracheotomy was connected to the ventilator, emitting rhythmic hissing sounds.

"1, 2, 3, lift!"

Following Song Zimo’s command, everyone worked together to successfully move the boy onto the gurney.

Normally, transferring a patient after routine surgery usually required only two or three people, but this time was different. To move the patient safely, seven experienced and strong doctors teamed up for the task.

Because the cervical spinal cord begins at the plane of the atlanto-occipital joint near the medullary respiratory center, any carelessness could potentially cause secondary spinal cord damage, and the outcome of such damage would be respiratory arrest.

"Is the blood oxygen dropping?" the anesthesiologist immediately alerted.

On the monitor screen, blood oxygen saturation had been dropping from 100%, down to 80%. Just one transfer had caused this critical fluctuation.

Everyone’s gaze turned to Yang Ping, hoping to receive some sort of rescue directive from him.

Yang Ping looked at the numbers on the guard screen for a moment before speaking, "No matter how cautious we are, it is impossible to ensure there is no rotation or translation of the cervical spine. Even the slightest movement can disrupt the already edematous cervical cord, affecting the respiratory center and causing a drop in blood oxygen. This is a transient fluctuation; let’s observe for a bit before we proceed."

The blood oxygen saturation maintained at 80% for less than 30 seconds before starting to rise again, climbing to above 95%. Everyone breathed a sigh of relief.

If the blood oxygen saturation had not risen but continued to fall, it would have indicated a fatal secondary injury to the cervical cord, and the boy likely would not have had a chance to survive. Fortunately, the blood oxygen saturation returned to normal, which was due to the good fixation of the scaffold and the professional cooperation of everyone during the transfer.

Yang Ping approached the transport gurney and touched the scaffold. Director Wei quickly followed, looking at Yang Ping worriedly, as the recent fluctuation of blood oxygen indicated the cervical spine was still unstable, hinting at some interference with the respiratory center.

Director Wei also extended his hand to touch the surface of the scaffold, determining if it was fitting properly, especially at the bends, and whether it was smooth, exploring along the edges of the scaffold to check if there were any gaps between it and the skin that were too wide.

After some examination, Director Wei said in confusion, "The fixation is very reliable; what’s going on?"

Yang Ping said indifferently, "The scaffold is practically perfect; it’s not an issue with the scaffold. Any external fixation is an elastic fixation and cannot be absolutely stable. Minor movements are fine as long as they are within a safe range. Don’t worry; now we can send him to the ICU. If there is another fluctuation in blood oxygen, we’ll stop, rest, stabilize, then continue the transfer."

Director Wei’s hanging heart was reassured. He had confidence in his own scaffold, having dedicated his life to this one task and believing he had achieved the pinnacle of perfection.

About fifteen minutes after the blood oxygen stabilized, the group began pushing the gurney to transport the boy to the trauma ICU.

---

Comprehensive Surgery Department doctor’s office.

It was already time to clock out, but doctors’ lives never really had a concept of "normal working hours."

Scattered empty lunch boxes were placed on the desktop; whether it was vegetables or rice, they had been completely devoured without a trace left behind.

Xiao Su and Tang Fei helped clean up the desktop, while Yang Ping, Song Zimo, Xu Zhiliang, August, Robert, and others discussed the case anew.

"The spinal cord shows edema but isn’t severed, which means it’s just a contusion. The limbs currently have a muscle strength of level one. As long as the surgery is timely, there is a great chance of recovery. Trauma-induced atlanto-occipital dislocation—I’ve performed similar surgeries, but only a few of them. There are not many reported cases of similar surgeries in Europe, and for this casualty, the atlas has comminuted fractures, which is a case I have never encountered before."

August was a top-notch spinal surgery expert. Experience was extremely important, and he wiped the corners of his mouth with a tissue as he spoke.

External trauma that leads to the disconnection of the joint between the head and the cervical spine causes the head and neck to lose their reliable bone and ligament connections, with only soft tissue maintaining the connection.

While such injuries were not uncommon, the cases doctors got to see were very rare.

Among cases of cervical spinal injuries resulting in death, about one-third are due to dislocations of the atlanto-occipital joint. Dislocations here are very unstable, and the vast majority of these patients either die on the spot from injuries or during transport due to further misplacement of the atlanto-occipital joint, which compresses or pulls on the spinal cord’s life center, causing respiratory arrest and death.

Hence, the cases that actually get to see a doctor are extremely rare, even on a global scale.

"The atlas vertebra, this term comes from the Titan Atlas in Greek mythology, who carries the Earth on his shoulders. Just as Atlas carries the Earth, the atlas vertebra carries the entire head. The joint formed between the atlas and the head—acondylar joint—is the only junction between the head and the cervical spine. Our large heads rely on this small joint to connect to the cervical spine and the torso—"

August pointed to the slowly rotating head and neck CT three-dimensional reconstruction image on the screen, eloquently explaining.

"Without Atlas, who would take up the burden of the Earth? Without the atlas, I don’t know how to accommodate this head?" August shrugged.

Robert said helplessly, "The separation of the atlanto-occipital joint is an unbearable separation in life!"

"We can only custom-make a prosthesis, with the prosthesis bearing the skull’s occipital portion at the top and connecting to the axis vertebra below, while also simulating the atlas—that is, to mold an artificial atlas, atlanto-occipital joint, and atlantoaxial joint," Song Zimo voiced his opinion.

This idea was bold, easy to speak of, but extremely difficult to execute.

"Isolated dislocations of the atlanto-occipital joint have a few cases, but for cases combined with comminuted fractures of the atlas, there is currently no precedent in the world to follow," August stated with disappointment.

"Logically, this case should not appear before us, but it has. We have to do something, right?" After a long silence, Xu Zhiliang joined in the discussion.

Yet Zhang Lin and Little Five remained silent, not because they did not want to take part in the discussion, but because it was too sophisticated for them; they had no means to intervene and could only learn as bystanders.

"If we use a custom-made prosthesis, the comminuted atlas needs to be removed. Completely resecting the atlas is a difficult task, with unpredictable bleeding occurring during surgery. What is even more challenging is that the surgery requires the patient to be in a prone position and then switched to a supine position midway. The change of position makes it very difficult to stabilize the head and cervical spine. It is impossible to use a support to fix it during surgery, and traditional cranial traction and various scaffolds are powerless," August added new worries.

Indeed, how to allow the patient to freely change positions without damaging the spinal cord during surgery was another significant challenge.

"Using the prosthesis for fixation is a good plan, but if an atlas prosthesis is used to complete the surgery, how can we achieve a stable, long-term fixation between the skull’s occipital part and the prosthesis, and between the prosthesis and the axis vertebra? Of course, we don’t have to think so far ahead. After all, as long as we can complete the surgery, no matter how stable it is, it would be a victory in medicine."

August had once participated in an academic exchange between Europe and the United States, where an American doctor tried to complete the surgery using this method, but ultimately, due to the loosening of the screws, the connection between the patient’s occipital part of the head and the cervical spine loosened, leading to respiratory failure.

"This method can be improved. The artificial atlas could use a titanium mesh-like structure. The mesh structure undertakes the mission of temporary fixation, while the mesh is filled with the patient’s own bone, such as rib or iliac bone, or the patient’s existing comminuted atlas, to allow the patient’s own bone to achieve bony fusion with the upper occipital part and the lower axis vertebra, thus killing two birds with one stone," Yang Ping suggested, leaning back in his chair.

Sometimes, when faced with a difficult problem, innovative thinking is necessary to find a solution.

Because they are challenging problems since existing knowledge doesn’t offer a solution, it requires you to use your imagination and propose a brand-new plan.

"A hollow cage-like structure filled with autologous bone, allowing the prosthesis to undertake both the temporary fixation and head-neck fusion tasks?" August said in surprise.

"Exactly!" Yang Ping affirmed.

"Aneurysmal Bone Cyst is currently only a radiological diagnosis; a pathology slice examination must be done during surgery to determine the nature of the atlas tumor. If it is malignant, we not only can’t use the atlas as donor bone; we also face more trouble," Xu Zhiliang brought up a new issue.

Yang Ping said approvingly, "Your thinking is very rigorous! Whether it’s an Aneurysmal Bone Cyst cannot be confirmed now; we must conduct a pathological examination during surgery. Regardless, our current surgical goal is only to achieve head-neck stabilization, survival is our only objective at the moment."

"An imaginative solution, what can I do?" Robert asked, mimicking the gesture of snapping his fingers.

After a brief thought, Yang Ping said, "You can do many things, but I’ve decided to entrust you with the most important, core task. I hope you are up to it."

Robert excitedly patted his chest, "Rest assured, trust me."

"From today on, you’ll join the trauma ICU nursing team. They need a member who is well-versed in orthopedics and physically robust, as turning the patient in nursing care is too crucial. The slightest carelessness could cause dislocation of the head and neck," Yang Ping said very seriously.

Robert’s eyebrows tightened, then relaxed in an instant, "Professor—I promise—to complete the task—may I make a request?"

"Please speak!" Yang Ping answered with ease.

"During the task, can my working meals be arranged for two?"

"No problem, not only will you have double portions, but we’ll also add a chicken leg!"

"This is a daunting and sacred mission, the most critical and core part of the entire treatment plan. There must be no mistakes. As a brother, I’d love to fight alongside you, but the situation won’t allow it. I’ll secretly cheer for you in my heart. Believe in yourself, you can do it, keep going," August encouraged his roommate.

"The nursing team also needs an expert in spinal surgery. If needed, I can push through the difficulty for you," Yang Ping gave August another assignment.

August stood up straight, swallowed, "Professor, I don’t want to cause you trouble."

"No worries! You’ve moved me, I’ll do my utmost to fight for it," Yang Ping said nonchalantly.

Search the lightnovelworld.cc website on Google to access chapters of novels early and in the highest quality.