godfather of surgery

Chapter 167
In Cheng Liquan's office, Su Nanchen and Cheng Liquan stood in front of the reading light.

"Young Master Su, what should we do? I didn't look carefully at the time, so I fell into this pit." Boss Cheng's face flushed red.

Su Nanchen was very calm: "Don't worry, it stopped at the edge of the pit, and it hasn't fallen yet. It's not that you are not careful. Few people have experience in this kind of case. It's too special."

Boss Cheng slapped himself a little: "Young Master Su, it's all my fault for being impatient. If I listen to you and don't take this kind of patients for the time being, nothing will happen."

"It's useless to talk about it now! Wait for him to come over tomorrow, and we'll study together. The operation hasn't been done yet. What are you afraid of? Don't do it at all." Su Nanchen comforted him, complaining afterwards was useless.

Surgery is something that should not be forced, if it doesn't work, just admit it. If you don't admit it before the operation, you will swallow the bitter fruit after the operation. If you want to admit it, there is no chance.

When Su Nanchen came here last time, he was in a hurry, did not see the patient, and did not study the patient's imaging data. This time he came here specially and found that this patient was too special. The intercondylar fossa was severely deformed, filled with bone hyperplasia, and the posterior part of the tibial plateau was partially defective. The defect happened to be the original tibial insertion point of the posterior fork, and the patellofemoral joint was still underdeveloped, so a CT three-dimensional reconstruction of the knee joint was urgently performed.

Su Nanchen and Boss Cheng looked at the CT three-dimensional reconstruction in front of them, and frowned. Quadruple reconstruction is already extremely difficult, and with this special situation, the difficulty of the operation doubled.

In this operation, on the basis of quadruple reconstruction, intercondylar notch shaping is also required. This intercondylar notch is not easy to do. It is not enough to restore it, but the surgeon needs to design a shape of the intercondylar notch to meet the surgical needs. Otherwise, the operation will fail and cause bad consequences.

If it weren't for the doctors who are experienced in multi-ligament reconstruction of the knee joint, they wouldn't be aware of such bad consequences. Fortunately, Su Nanchen has experience in this area, otherwise he would have stepped on a thunderbolt.

"I checked later. The patient was seen at Yunjian. They said the schedule was too tight. In fact, it was not the case. They contacted Professor Ye. After seeing the patient's video data, Professor Ye thought it was too difficult, especially The intercondylar fossa can’t be formed, so they declined. They put this patient on me and deliberately harmed me, it’s too dirty." Cheng Liquan regretted it, his face was covered with sweat, this time Su Nanchen saved him If it weren't for Su Nanchen, he would not have known the serious consequences of the matter.

"Those people are vicious! They dug a hole for me to jump in. I almost jumped in, and the signboard was smashed with one operation." Cheng Liquan was a little scared.

"The operation is definitely not possible. The person I hired for you, no matter how powerful he is, can't complete this kind of operation, but I will pick him up tomorrow and study together. I have already made an appointment with him." Su Nanchen thinks this case is too complicated. In particular, Yang Ping must be invited over. Even if the operation is not performed, it is necessary to see the patient and study it.

"Listen to you, I will still pay your friend's fee according to the operation, and I will never make things difficult for you, Young Master Su." Boss Cheng wiped his sweat.

Su Nanchen didn't speak, and was still looking at the film on the film reading light. No matter how powerful Yang Ping's surgery was, it was impossible to complete this kind of surgery.

This intercondylar fossa can’t be done at all. If it is done routinely, it will definitely cause the instability of the patella joint and the use of the reconstructed posterior fork. This is the reason why Professor Ye dare not do it.

If you want to do it, you need to design a software, build a model, and use 3D simulation technology to reconstruct the intercondylar notch on the computer. Even so, the operator needs to have a strong spatial imagination ability to barely make a qualified intercondylar notch.
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Su Nanchen sent the patient's information to Yang Ping's mailbox. Yang Ping was playing ball and did not see Su Nanchen's message.

"Ding dong! Task: I'm just a fledgling, go to the outer hospital to perform a case of multiple ligament reconstruction of the knee joint. The surgery level has reached perfection, and the reward is 24 points. The task time limit: within [-] hours!"

When I was playing, the system issued a task. It was strange that I didn't release a single task for my five-link reconstruction. This quadruple reconstruction actually released a single task, and the reward points reached [-] points. Could it be that this quadruple is more difficult than the five-link?

Now the system is very good at picking tasks, and the reward points are also high. It is not too lazy to deal with not particularly difficult operations. High difficulty and high reward seem to be the current principle of the system.

After playing, Yang Ping took a quick look at the patient's information on his mobile phone during a break. Sure enough, this quadruple reconstruction was more difficult than the previous five-column reconstruction, a level higher.

When he was free in the evening, Yang Ping began to study this case in detail.

It is actually a hidden Wulian, which is more complicated than the one I made a few days ago. Why?Because on the basis of the quadruple, the intercondylar notch should be formed.

The five joints I made were quadruple joints plus habitual dislocation of the patellofemoral joint. This is based on the quadruple joints plus intercondylar notch formation. I had previously done an anterior cruciate ligament reconstruction with intercondylar notch formation.

However, the intercondylar notch is more difficult to form than the previous one. The previous patients only needed to be formed according to the mirror image of the uninjured intercondylar notch.

In this case, the entire intercondylar fossa was severely deformed, the posterior side of the tibial plateau was still partially defective, and the patellofemoral joint was underdeveloped. The quadruple injury plus these three factors made the situation worse.

The patellofemoral joint dysplasia indicates that the intercondylar fossa of this patient was abnormal before, but who knows what happened? The defect of the posterior tibial plateau indicates that when reconstructing the posterior fork, the posterior fork of the formed intercondylar fossa must be considered. The insertion point of the femur is not in the normal position, and this should be taken care of in shaping, so a very special intercondylar notch needs to be formed.

If according to the previous method, based on the normal intercondylar notch on the opposite side, the mirror image is used to perform intercondylar notch shaping, the operation will definitely fail, which will lead to loss of function of the reconstructed posterior fork and instability of the patellofemoral joint.

Originally, the patient can barely walk now, but it is likely that after the operation, the instability of the patellofemoral joint and frequent lateral dislocations make it difficult to walk. He can walk without the operation, but he cannot walk after the operation. Can the patient accept it?

In this operation, you need to conceive the shape of the intercondylar notch by yourself. There is no template for this shape, and several conditions must be met at the same time. It must provide the best tunnel entry point for the ligament without causing patellofemoral joint disorder and ligament damage. Impact, the difficulty is not recovery from the beginning to the end, but a reconstruction process, which is equivalent to designing an intercondylar notch with strict parameters. If there is a slight mistake, the operation will collapse.

It can only rely on the brain composition ability. The core of the super training plan is to cultivate the brain composition ability. This kind of composition is not a simple static composition, but a dynamic, connected and logical composition.

Yang Ping's brain composition ability is constantly improving. This time, he can easily construct static graphics, one-time forming, without making multiple supplements, but the construction of dynamic images is still very difficult, repeated many times, constantly correcting, supplementing, and strengthening. To make a picture.

The graphics change in my mind, sometimes I need to move, sometimes I need to switch, one after another intercondylar notch appears, and then the ligament is implanted according to the ideal position, no!Then continue to modify the intercondylar notch, re-implant the ligament, and repeat it many times. After several sets of ligament implantation, the best function and balance can be obtained; however, there is impact during flexion and extension, and continue to modify until the impact disappears completely; patellofemoral The joint instability reappeared, and I gritted my teeth and continued to modify, trial and error.When I finally solved this problem, my forehead was already full of sweat, my clothes were almost soaked, and my brain was consumed too much. Fortunately, I was able to find the most suitable shape of the intercondylar fossa through composition.

Yang Ping checked the final shape of the intercondylar fossa several times, and there was no problem, so he remembered it in his mind and prepared it for tomorrow's operation.

"This patient's intercondylar fossa needs to be formed, and it is extremely difficult to form. Come and have a look tomorrow!" Su Nanchen left a message.

"I've read the materials and it's really difficult, but it's not a big problem." Yang Ping replied.
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This guy, the problem with this kind of surgery is not too big. The surgery is really amazing, but he still didn't look at the video data carefully.

At 08:30 on Sunday morning, Su Nanchen arrived at Sanbo Hospital on time, and Yang Ping arrived at Liquan Hospital at about nine o'clock.

In order to show his importance, Boss Cheng stood at the entrance of the hospital. Su Nanchen brought Yang Ping into view. He took a look, no, how could someone who is better than Professor Ye be so young? Approximate age, isn't this only in the twenties?What is the concept of being in the twenties, at most a small indication, what kind of tricks did Su Nanchen play this time?
Boss Cheng thought about it for a second, Su Nanchen has always said what he says and does things, so there is no need to worry about this problem at all. The people he invited must be experts.It's a pity, if the patient is an ordinary quadruple reconstruction, it will be fine. Today, this operation has been done, filling the gap in Liquan Hospital, and marking that there is no technical gap between Liquan and Yunjian.But this patient--, the operation can't be done, what a pity!Boss Cheng sighed, feeling unwilling.

As a businessman, Boss Cheng was shrewd and tactful. He didn't show any thoughts on his face, not even his little side-by-side thoughts. He stretched out his hand from afar.

"Yang Ping of Sanbo, Dr. Yang!" Su Nanchen introduced.

"Hello, Dr. Yang, it's a pleasure to meet you, Cheng Liquan-" Boss Cheng was warm and friendly, making people feel like old friends at first sight. He immediately handed over his business card respectfully with both hands, and bowed slightly.

Yang Ping took the business card: "Boss Cheng, I have known you for a long time. In the medical circle, no one knows Boss Cheng's name."

Fame is there, but Yang Ping really knows Cheng Liquan's name for the first time.

The three chatted while walking. This sports medicine center is really good. The decoration is designed by a professional person. Even the slope of the stairs, the width of the steps, the height of the handrails, and the matching of colors are all very particular.

High-end is not only technology, but also an experience.

This person is in his twenties, but his demeanor, words and deeds are not frivolous and unstable at all. Instead, there is a strong sense of calmness and self-confidence everywhere. Chaoshan people are good at doing business, and businessmen are good at observing people and things. Boss Cheng Observing from the dark, this friend Su Nanchen is really a master in terms of temperament.

The beautiful nurse is leading the way. The slim nurse's uniform outlines the exquisite figure, and the professional smile makes people feel very comfortable. This hospital is run with great care.

Yang Ping has heard about these specialized hospitals, and is also somewhat prejudiced, but the one opened by Su Nanchen's friend should not be too wild.

From an intuitive point of view, this hospital is still very formal, and Boss Cheng kept introducing his hospital along the way.

"Sit in my office first and take a rest!" Boss Cheng said.

Yang Ping waved his hand: "No need, let's watch the film first, and see the patient later."

When everyone went to the doctor's office, the reading light was already covered with video films. Yang Ping walked to the light and carefully looked at the patient's film.

Everyone gathered around, two doctors and several graduate students were all trained by Boss Cheng, the mainstay of the hospital, now it is not optimistic for doctors and masters to find a job, especially in G city, it is difficult for better public hospitals to gain a foothold, some can only Secondly, go to some private hospitals, either large general private hospitals, very few, or such small and sophisticated specialized hospitals.

Yang Ping narrowed his eyes slightly, his sharp gaze swept over the film.

Boss Cheng held his breath, he still hoped that this operation could be done, although the hope was very slim, even though this was a surgery that Professor Ye gave up, even Professor Ye was unwilling to do it, who else in the country could do it?When it comes to this type of surgery, others are at most on the same level as Professor Ye.

Seeing that Yang Ping didn't speak, just staring at the film on the film reading light, Su Nanchen and Boss Cheng didn't want to speak, but just waited quietly. Originally, it was not good to call someone over for this kind of operation.

After reading it, Yang Ping said, "Let's go see the patient."

Boss Cheng asked the doctor to lead the way and took Yang Ping to the ward to see patients. The wards here are all suites and the decoration is very luxurious.

Yang Pingzai inquired about the medical history, carefully performed a physical examination on the patient, and had sufficient information, so he was confident.

Go back to the doctor's office.

"How is it?" Su Nanchen asked.

Boss Cheng waited eagerly for the result.

"Send the patient!" Yang Ping said lightly.

send patients?This can be done?
Su Nanchen wasn't sure, whether what he said was true or not, and this operation could be done, this guy is really crazy.

(End of this chapter)