In the teaching room of the pediatric surgery department in the Imperial Capital Women and Children's Hospital, a simulated operation was performed nervously and orderly.

This is a pair of conjoined babies, with a chest and abdomen combined. Although they have two hearts, they share a pericardium, and the hearts are also connected together.

The separation surgery is quite difficult. The Women and Children's Hospital is jointly with the Philadelphia Children's Hospital, the world's top children's surgery. After a series of preparations, it has entered the perioperative period. As long as the simulation surgery is successful, the surgery can be performed at any time.

Computer-aided 3D printed model is exactly the same as a real person.

Intraoperative navigation and two customized external auxiliary devices ensure that surgical simulation can be performed.

If the simulation surgery is successful, this pair of conjoined babies can undergo isolation surgery at low months of age, effectively protecting their young heart regeneration ability.

This set of preliminary preparation costs very high. Women and children's hospitals are almost at all costs close to the world's advanced medical level, especially the application of 3D simulation printing and intraoperative navigation systems.

Intraoperative navigation is a preoperative evaluation mode that accurately corresponds the patient's preoperative or intraoperative imaging data with the patient's anatomy structure on the operating bed and is reconstructed through computers.

During the operation, track the surgical instruments and update the position of the surgical instruments in real time in the form of a virtual probe on the patient's image, so that doctors can see the position of the surgical instruments relative to the patient's anatomy at a glance, making surgical operations faster, more accurate and safer.

Its applications are mainly intraoperative applications and preoperative simulation surgery, etc.

Intraoperative navigation technology has existed for a long time, but because of its high price and insufficient computer-assisted functions, the application of preoperative simulation surgery has not been fully developed in clinical practice.

Zheng Ren knew this very early, and it was the same as the experimental subjects in the system space. However, the technology was immature and it was not as easy to use as a big pig's hooves.

Now, doctors at the Women and Children's Hospital are trying to carry out cardiac conjoined infant separation surgery in the "system operating room" built by a large amount of money.

The surgical model is a 3D printed simulated person who is exactly the same as a conjoined baby.

The operation was originally performed by the medical team of the Philadelphia Children's Hospital, but during the preoperative simulation surgery, the team of the Philadelphia Children's Hospital found that the child had a serious heart malformation and the success rate of the surgery was less than 5%, so he directly refused.

The conjoined baby is carefully cared for by the women and children's hospital, and his vital signs can withstand surgery, but as time goes by, the symptoms of heart failure become worse and worse, and there is no way to delay it.

The hospital talked with the children's parents many times, and finally reached a consensus that the conjoined infant has already developed symptoms of heart failure, and there is still a glimmer of life for surgery. If the surgery is not performed, there will be no glimmer of life.

Then give it a try.

As planned, this is the last simulated surgery.

The three-dimensional positioning of ct and mri made yesterday, and the images generated are bitmap properties, showing the situation in the conjoined baby's body in three-dimensional sense.

When the conjoined baby was born, he first came to the Daodidu Women and Children's Hospital. He found that he had a common pericardium and two hearts were connected to the atrium. The base of the heart was large, the atrium was completely separated and there was no traffic. The apex was connected to the diaphragm. The two hearts had a small tubular connection, with a diameter of 3mm. Most of the two hearts were membranously connected.

There are many parts connected to the liver, but this is not the point.

The most difficult thing in the surgery for conjoined babies is the connection between the brain, followed by the heart. The remaining other organs are not very important.

However, the reason why the expert team of Philadelphia Children's Hospital gave up was that as conjoined babies grew, they found that their hearts beat differently, and the operation could not be carried out at all.

I tried several simulation surgeries and no one could solve this problem.

Therefore, Philadelphia Children's Hospital announced that it would give up the surgery.

Vice President Chen of the Women and Children's Hospital is in charge and is preparing to try it a few more times. If the surgery is given up at this time, the child will die within one month, and all his previous efforts will be wasted.

Only they know how much effort the women and children's hospital has put into practice for this conjoined baby.

Not to mention the top 3D printing simulation of children, not to mention the introduction of surgical navigation systems, countless small details are immersed in the efforts of medical staff.

Careful feeding is the first step.

In order to enhance the physical constitution of conjoined babies, conditions are created for surgery.

The two-consecutive infant hospital was 10 days old and had a total weight of 3.93kg, which was 2° malnutrition.

After admission, high-quality newborn formula feeding will be increased from 3ml each time and once every 3h, and now it will be increased to 60-90ml, once every 3h. In addition, during the feeding process, you should pay attention to the inclination of the bottle and the size of the milk holes, and pay attention to prevent choking, vomiting, and even suffocation.

During this period, the supplementary intravenous nutritional children's compound amino acids, fatty milk, multiple vitamins, trace elements, and intravenously administered plasma, human albumin, calcium agents, etc.

No details were missed, and the weight of the two babies had increased to 7.8kg before the operation.

this,

Just part of it.

In addition to feeding, basic care should be strengthened, and infection should be controlled and protective isolation should be placed in single rooms.

The ward's air disinfection device is automatically disinfected regularly and pays attention to ventilation and keeps the air fresh, the room temperature is 20c-24c and the relative humidity is 50%-60%.

In the hospital, the children suffered from severe diaper rash and pustipes in the armpits, groin, lower limbs, and around the genitals outside the anus. After the hospital, they took a bath with 0.05% Xinjieer water and bathed in a daily manner, and applied the affected area with Baiduobanghong Buttock cream 3-4 times a day.

And this is only part of the foundation.

Because the conjoined children are relatively large in size, there may be a large-scale skin deficiency after separation. In order to ensure that the incision of the skin is sufficient during the operation, and skin grafting should be avoided as much as possible, the body bridge must be lengthened and widened.

The body bridge is the "bridge" part shared by the conjoined baby.

When admitted to the hospital, the umbilical umbilical part of the conjoined infant has a length of 16m, a width of 4m and a circumference of 37. Because the tension of the body bridge is high, the chest and abdominal wall should be relaxed and expanded.

The pediatric director personally takes action and press the connecting part of the conjoined infant three times a day for 15 minutes each time.

The old director is almost 60 years old. Every day, he looks at her putting her four fingers together and laying her thumbs above, pressing her rhythmically from light to heavy, and Vice President Chen feels it is so hard.

When pressing, you should also observe the reaction and complexion of the joint. After pressing, press a rice bag with a length of 16m, a diameter of 2m, and a weight of 150g above the body bridge.

The lower part is raised with a cotton bag of the same shape. When sleeping at night, use the side lying pulling method, that is, a small pillow is placed between the two children, so that the two children can pull as much as possible when they are lying on the side, so that the body bridge is ready to be satisfied during the operation.

With joint efforts, the circumference of the conjoined infant's body bridge is 54m, 20m long and 7m wide.

But everything is ready, but the operation cannot be completed.
Chapter completed!