2254 The system operating room in reality
At the capital Women’s and Children’s Hospital, in the children’s surgery department’s demonstration room, a surgery simulation was being conducted in an orderly and tense manner.
This was a pair of conjoined twins. Their chests and abdomens were combined. Although there were two hearts, they shared the same pericardium, and the hearts were also connected.
Separation surgery was very difficult. Women’s and Children’s Hospital and Philadelphia Children’s Hospital, which was the world’s top children’s surgery hospital, had joined forces. After a series of preparations, they had already entered the perioperative period. As long as the simulation surgery was successful, the surgery could be carried out at any time.
It was a 3D printed computer-assisted design model that looked exactly like a real person.
Intraoperative navigation and two sets of customized external assistance devices ensured that surgery simulation could be performed.
If the simulation surgery was successful, the conjoined twins could be separated at a young age to effectively protect the young heart’s ability to regenerate.
This set of early preparations cost a lot. The women’s and children’s hospitals were almost close to the world’s advanced medical standards at all costs, especially the application of 3D simulation printing and intraoperative navigation system.
Intraoperative navigation was a preoperative assessment mode that was reconstructed by the computer after the preoperative or intraoperative imaging data was accurately matched with the patient’s anatomical structure on the operating table.
During the surgery, the surgical instruments would be tracked and the position of the surgical instruments would be updated and displayed in real time on the patient’s image in the form of a virtual probe, so that the doctor could see the position of the surgical instruments relative to the patient’s anatomical structure at a glance, making the surgery faster, more accurate, and safer.
Its application was mainly during surgery and the simulation of surgery before surgery.
Intraoperative navigation technology had existed for a long time, but due to its high price and the lack of computer assistance, the application of preoperative simulation surgery was not fully implemented in clinical medicine.
Zheng Ren had known about this a long time ago, just like the experimentals in the system space. However, the technology was not mature, and it was not as good as the big pig trotters.
Nowadays, doctors in women’s and children’s hospitals were trying to carry out the separation of the conjoined twins in the “system operating theater” that was built with a lot of money.
The surgical model, on the other hand, was a 3D printed human simulation that was exactly the same as the Siamese twins.
The surgery was supposed to be performed by the medical team from Philadelphia Children’s Hospital. However, during the pre-operation simulation, the team from Philadelphia Children’s Hospital found that the child’s heart deformity was serious, and the surgery success rate was less than 5%, so they directly rejected it.
Under the meticulous care of the Women’s and Children’s Hospital, the conjoined twins ‘vital signs could withstand the surgery. However, as time passed, the symptoms of heart failure became more and more serious, and there was no way to delay it.
The hospital had talked to the child’s parents many times, and in the end, they came to a consensus that the conjoined twins had symptoms of heart failure. There was still a chance of survival if they underwent surgery, but if they didn ‘t, there was no chance of survival.
Let’s give it a try then.
According to the plan, this would be the last simulated surgery.
The three-dimensional positioning done with CT and MRI yesterday produced a map-like image that showed the situation in Siamese twins ‘bodies in three-dimensional terms.
When the conjoined twins arrived at the Dao imperial capital Women’s Hospital, they found out that the two hearts were connected to each other in the atrium. The large blood vessels at the bottom of the heart and the atrium were completely separated without any communication. The tip of the heart was connected near the diaphragm. The two hearts were connected by a small tubular connection with a diameter of 3 mm. Most of the two hearts were connected by membranes.
There were more parts that were connected to the liver, but that was not the main point.
The most difficult part of surgery for conjoined twins was connecting the brains together, followed by the heart. The other organs were not very important.
However, the reason why the specialist team at Philadelphia Children’s Hospital gave up was that as the conjoined twins grew, they found that their heart rates were different, and the surgery could not be carried out.
He had tried a few simulated surgeries, but no one could solve this problem.
Therefore, Philadelphia Children’s Hospital announced that they would give up on the surgery.
Vice Director Chen of the Women’s and Children’s Hospital was in charge, and he was ready to try a few more times. If she gave up on the operation now, the child would die within a month, and all her previous efforts would be in vain.
Only the Women’s and Children’s Hospital knew how much effort they had put into this pair of conjoined twins.
Forget about the top-notch 3D printing simulation for children, forget about the introduction of the surgery navigation system, the countless small details were all the blood, sweat, and tears of the medical staff.
Carefully feeding him was the first step.
It was to strengthen the physical constitution of Siamese twins and create the conditions for the surgery.
The two conjoined twins were 10 days old and weighed 3.93 kg in total. They were suffering from malnourishment.
After admission, high-quality newborn formula milk was fed. From 3 mL every time, once every three hours, it had increased to 60 – 90 mL, once every three hours. During the feeding process, he had to pay attention to the tilt of the bottle, the size of the milk hole, and to prevent coughing and vomiting. Even suffocation occurred.
During this period, he was supplemented with intravenous nutrition, which included aminographus compound, fat milk, a variety of vitamins, trace elements, as well as isotramic blood plasma, human blood protein, and calcium agents.
He did not miss any details. The weight of the two babies had increased to 7.8 kg before the operation.
This …
It was only a portion.
In addition to feeding, basic care must be strengthened, infection control must be controlled, and a single room of protective isolation must be placed.
The air disinfectant in the ward would automatically disinfect at a fixed time every day, and pay attention to ventilation to keep the air fresh. The room temperature was 20°C to 24°C, and the relative humidity was 50% to 60%.
When the patient was admitted to the human hospital, he would suffer from serious rashes and empyesis in his armpits, groin, lower limbs, and around the anus and external genitalia. After he was admitted to the human hospital, he would take a bath with 0.05% new Jeller Aqua every day and apply baiduo gang red butt cream to the affected areas three to four times a day.
And this was only a part of the foundation.
Due to the relatively large area of connection between the conjoined twins, there may be a large area of skin deficiency after separation. In order to ensure that there was enough skin for the incision during the surgery and to avoid skin implantation as much as possible, the body bridge must be lengthened and widened.
The body bridge was the “bridge” part that was shared by the conjoined twins.
When they were admitted, the conjoined twins ‘initial navel was 16 cm long. It had a bridge that was 4 cm wide and 37 cm in diameter. Due to the high tension of the body bridge, the thoracic and abdominal walls had to be relaxed to expand the thoracic and abdominal cavity.
The Department Director of Pediatrics would personally press on the connecting part of the conjoined twins three times a day for 15 minutes each time.
The old director was almost 60 years old. Every day, he watched her rhythmically compress her body with four fingers placed under the bridge and her thumb above, from light to heavy. Even Vice Director Chen felt that it was very hard on her.
During the compression, the conjoined twins ‘reactions and facial expressions had to be observed. After the compression, a 16-cm long, 2-cm in diameter, and 150-g heavy rice bag was pressed above the bridge.
The lower part of the child’s body should be padded with a similarly-shaped cotton bag. During night sleep, a small pillow should be placed between the two children using the lateral pulling method so that the two children would be separated as much as possible in the lateral position. This would ensure that the body bridge preparation was satisfactory during the surgery.
With their joint efforts, the body bridge diameter of conjoined twins had now reached 54 cm, 20 cm in length, and 7 cm in width.
However, even though everything was ready, the surgery could not be completed.
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[Book pushing: “national project”. One is about the historical changes in the National engineering industry, and the other is about the career of a group of construction fanatics.]
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