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¡¾2404¡¿Tools and hands

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    The xiphoid process is at the lower end of the sternum and is made of cartilage in most people.

    For cartilage, you don¡¯t need an electric saw, you can use surgical scissors.  When doing something, you can choose to make breakthroughs from the easiest place and then attack the hard bones. This is a common strategy, and the same is true in the medical field.  Cutting off the xiphoid process in front of the sternum is equivalent to opening a breakthrough.  As with the previous focus, the most important thing is to clean up the "stuff" attached to the bones.

    The first assistant who will accompany the surgeon does not use separation pliers this time, but uses pliers to clamp the small baffle on the xiphoid process, and then cleans up the "pile of debris" behind the "baffle".  For example, if you want to dismantle a robotic arm, it is impossible to do it without cutting the surrounding wires connected to the robotic arm.

    The electric knife held by the surgeon was squeaking and coagulating to incise the exposed rectus abdominis muscle after the xiphoid process was lifted.  The location here is close to the abdominal cavity, so be very careful to prevent excessive dissection and prevent the fluid placed in the thoracic and pericardial cavity from flowing into the abdominal cavity and causing complications to the abdominal organs.

    After the incision, a gap was exposed behind the xiphoid process.  The surgeon put down the electric knife and stretched out a finger of his right hand to penetrate deeply from this gap to the left back of the sternum.  This position is next to the pericardium. The doctor's fingers gently and slowly push open the pleura on the left and right sides of the mediastinum, performing blunt dissection.

    If the child is younger, the doctor's fingers may be able to separate directly to the upper end of the back of the sternum.  If it is larger, one finger will not be able to reach the upper end of the sternum. Like other engineering projects, in this case the only way is to use tools instead of fingers. Put it in and insert it forward in the direction of the fingers.  Doctors usually use long flat forceps close to the sternum to perform blunt dissection.

    Using a tool instead is the same as poking with your fingers. You need to confirm where you poked and whether you poked through.  For this reason, after the long flat tweezers are inserted in this way, the ends need to be contacted to confirm that the target position of separation is correct.

    ??????????????????????????????????????????????????:  Long flat tweezers are like a pole entering an entrance of a large cave. You have to ensure that the rope appears at the designated hole and connects the end of the pole at the designated hole.

    This is reflected on the operating table. The surgeon needs to free his other hand to reach the incision at the upper end of the sternum. Since his right hand is occupied, he can only stretch out the fingers of his left hand and insert them from the upper end in an attempt to connect with the length of the upper part of the separated tissue below.  Flat tweezers.

    This separation path is located next to the back end of the sternum. The doctor's naked eye is blocked by the bones and cannot see it, so it is called the mysterious cave.  Sometimes it may take a long time, but the fingers of the left hand and the end of the long flat tweezers are not in contact, and I don't know whether the separation is in place.  If this happens, the doctor can only withdraw the long flat forceps outside, measure the length just inserted, and compare it with the length of the sternum to determine whether the depth just inserted is in place.

    You may find it strange that the distance between the upper and lower ports of the sternum is not long and cannot be seen behind the bones. However, if the distance is not long, you can completely rely on feeling to catch it. How come the two ends are always unable to catch it?  We have talked about blunt dissection in general surgery before. Blunt dissection is not hard cutting with electrosurgery.  To use another analogy, a doctor's fingers and tools are like a tadpole wandering around in a cave looking for its mother. It is impossible to split the wall between the caves for you. You must walk on the right path to touch it.

    It¡¯s best if you can touch it and the tadpoles can find their mother.

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