25-year-old Achen (pseudonym) has endured pain in his left wrist for 7 years. Due to limited wrist movement, his life was once unsustainable. Recently, he went to Zhongshan Orthopedic Hospital for examination, but unexpectedly found that the "scabola" of the bone in the core of his left wrist had been necrotic, and some of the bones had even been shattered and absorbed.
On the morning of October 13, Liu Bo, executive director of Zhongshan Orthopedic Hospital and chief physician of the hand surgery department of Beijing Jishuitan Hospital, used the first all-orthopedic surgical robot developed by the team of Academician Tian Wei of Beijing Jishuitan Hospital to help Achen complete the first internal fixation of an old sacrosse fracture bone graft in Guangdong Province jointly using robots and wrist arthroscopy.
Domestic surgical robots are "on the job"! Zhongshan Doctors use "black technology" to complete complex orthopedic surgery. South + Lu Ziheng took
" steel balls in bearing are broken"
"My wrist is already in unbearable pain, it is difficult to get up to support, and there is also a 'kick' sound when you turn it." Before the operation, Achen sat beside the bed and said that as a physical education teacher, his left wrist is very important to his daily life and teaching work.
In the past two years, he was worried for a while and went to three major hospitals in Zhengzhou for medical treatment. "The local hospital said that either the bones were worn off and the wrists would not hurt, but the movement was limited. Or the back of the hand to the wrist was cut and a large wound was opened for surgery." Achen thought to himself that the wrist joint was used extremely high, and more refined treatments must be used to retain the movement function of the wrist joint as much as possible.
For this, in 2020, Achen hung up the diagnosis number of Liu Bo, a hand surgeon at Beijing Jishuitan Hospital. However, due to the impact of the epidemic, it is particularly difficult to seek medical treatment in other places.
"We finally got a date and made an appointment to a bed in Beijing before, but the trip was cancelled due to the epidemic." Achen's father said, "Luckily, Dr. Liu Bo was stationed at Zhongshan Orthopedic Hospital for a year this time. He quickly arranged for Achen to undergo surgery here, and the hospitalization environment was also very good."
The bone injured by the young man Achen's left wrist is called "scabola". According to Liu Bo, this bone is particularly special. It is a "movement hub" at the wrist joint with a small size, complex structure and very irregular shape.
"You can imagine that this bone is like a small steel ball in a car bearing. The steel ball makes the bearing rotate smoothly, and the sailbones are the key to the flexible rotation inside the wrist joint." Liu Bo said that the young man injured this particularly special bone.
According to Liu Bo, there are more than 200 bones in the human body, and 3 of them have poor blood circulation, which are in hip , ankle and wrist joints. They are particularly prone to ischemia and necrosis after fractures, and "scaphoid bone" is one of them.
"6-7 years after the fracture of the 'snake bone', the wrist began to hurt. If you don't intervene, the wrist will be more and more severe in the next 10 years, and even develop to the complete wear of the entire joint." Liu Bo said that by then, it would be very difficult for the young man to drink water with his left hand. The wrist will be incapable of using his ability to use and wrist joints will become disabled. Therefore, surgery must be performed as soon as possible to help the "snake bone" heal.
For this reason, Liu Bo decided to use a total orthopedic surgical robot for surgery. "The 'snake bone' on the wrist is complex in shape and hidden, and the robot can perform three-dimensional guidance and positioning and minimally invasive and precise fixation more accurately." Liu Bo said, "In recent years, we have reported for the first time in the world that the precise wrist fracture minimally invasive fixation surgery was successfully completed with orthopedic robot assistance. In this operation, we jointly used robots and wrist arthroscopy to perform surgery. This surgery is not only the first case in Guangdong Province, but is at the leading level at home and abroad." At 8:30 am on the 13th, Achen was successfully pushed into the operating room.
The surgeon is undergoing surgery. South + Lu Ziheng shot
with the help of medical "black technology" to "repair" necrotic bones
13 at 9:10 am on the 013th, the operation began.
"Surgeon Doctor" Liu Bo pinched a slender instrument and gently penetrated the skin of the patient's left hand. Liu Bo said: "This is the thinnest and smallest arthroscope in the world. The camera at the end is only about 2 mm in diameter."
surgery site.South + Lu Ziheng took
arthroscopy through thin holes and penetrated into the patient's wrist joint, which was equivalent to placing a pair of "eyes" in it. The doctor will use these "eyes" to carry out detailed operations.
Internal image of the wrist joint appears on the large screen of the surgery. With the assistance of arthroscopy, only 2 smaller pinholes were left on the patient's hand, which was convenient for the doctor to operate. Under minimally invasive surgery, the patient's surgical wound becomes very small and the amount of bleeding becomes very small.
Through the arthroscopy, the medical team found that the patient's "scaphoid bone" had been seriously worn and many defects appeared. In order to protect the use function of the patient's left wrist, the medical team carried out "minimally invasive bone grafting" for the patient.
The surgeon is undergoing surgery. South + Lu Ziheng shoot
This is also a newer medical technology. The operation of "minimally invasive bone grafting" is not only very precise, but also requires high-quality and sophisticated equipment, but also tests the experience of the medical team very much.
"The patient's original bone quality was very poor. After polishing and removing necrotic bones, he found that there were more bone defects. So the amount of bone grafting this time was relatively large." Liu Bo said. In order to meet the needs of "minimally invasive bone grafting", medical staff took out part of the cancellous bone from the patient's hip position and placed it into the bones of the wrist defect to "repair" the wrist joint.
"And the cancellous bone of iliac is renewable, so you don't have to worry about taking it out and it will affect the patient, and it can help the patient better treat wrist injuries."
On the operating table, Liu Bo used a special bone graft to implant tiny bone granules through a funnel-shaped channel and into the defective bone. After more than an hour of "bone extraction" and "bone grafting", the patient's defective "scaphoid bone" was finally gradually repaired.
Orthopedic robot "on-job" operation is accurate and stable
"Minimally invasive bone grafting" is just the first step in the difficult task.
After "bone graft", the medical team must also fix the wrist joint with steel needles. Only by accurately fixing with steel needles can this necrotic "scaphoid bone" slowly heal in the later stage.
Domestic surgical robots are "on the job"! Zhongshan doctors use "black technology" to complete complex orthopedic surgery. South + Lu Ziheng shot
At that time, a medical "black technology" was about to debut. The medical team is nervously working with engineers to plan and virtually verify the application of surgical robot-assisted precision implantation steel needle fixation solutions.
In the past, traditional orthopedic surgery mainly relies on manual operations by doctors. Once they face extremely refined operations, it is easy to cause problems such as great trauma and low operation accuracy. However, the orthopedic surgery robot can accurately locate and the accuracy reaches submillimeter level, which can eliminate deviations caused by factors such as physiological shaking and fatigue of the arm during the doctor's bare hands, ensuring the accuracy and safety of the operation.
robot operation. Southern + Lu Ziheng shot
at 11:00 am. This robot assists and guides the doctor to complete the fixation of the steel needle. Compared with traditional surgery, this surgery has a small incision and a significant reduction in intraoperative bleeding.
"The step of fixing the steel nails is very important, which is related to the patient's later healing. The 'snake bone' is not only complex in shape and hidden position, but also has less than 10 mm in the narrowest place. We perform three-dimensional guiding positioning and minimally invasive precise fixing through the robot, which can improve the accuracy of setting the nails." Liu Bo explained that by inserting the fixed steel needle with the robot, it is not entirely relied on the robot to operate alone, but "human-machine" cooperated to complete this task together. First, rely on the doctor's rich clinical experience to carry out path planning and convey instructions to the robot. The robot is responsible for accurately implementing path planning. After the robot arm is in place, it provides a stable and accurate platform for doctors to place needles.
Domestic surgical robots are "on the job"! Zhongshan doctors use "black technology" to complete complex orthopedic surgery. South + Lu Ziheng shot
at 12:30 am. Liu Bo breathed a sigh of relief after walking out of the operation. He told reporters that although the operation is difficult, the entire operation process is very smooth and the operation is very successful.
[Record] Southern Daily reporter Zeng Yanchun Intern Deng Yetong Mo Yangyong
[Photographed] Lu Ziheng
[Correspondent] Zhao Wenjie Gao Xingshuai
[Author] Zeng Yanchun; Lu Ziheng
[Source] Southern Media Group Southern + Client
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