godfather of surgery

Chapter 639 Teaching Surgery
Professor Wang was engrossed in staring at the screen. Now that the kidney transplantation is over and the liver transplantation is starting, there is no intermission. The two operations are completely treated as one operation.

The first assistant was replaced by Director Li. Director Li's specialty is liver transplantation, while Director Liu is in kidney transplantation. Liver and kidney transplantation is the most expensive operation in Sanbo Hospital.

Yang Ping's movements are extremely fast, and there is no repetitive or invalid movement at all.

First deal with Qin Xiaowei's discarded liver. After laparotomy, Yang Ping quickly dissected the entire liver surrounding structure: dissecting the first hepatic hilum, freeing the common bile duct, cutting off the bile duct at the confluence of the left and right hepatic ducts; freeing the left and right hepatic arteries , cut off and ligate them close to the liver; free the main trunk of the portal vein to expose the left and right branches; free the subhepatic inferior vena cava; cut off the hepatic coronary ligament, left and right triangular ligament, and falciform ligament to expose the second hepatic porta; separate the retrohepatic inferior vena cava deep noodle.

At this point, the liver is completely cut off from the surrounding pipelines or parenchyma, and the discarded liver is completely dissociated, taken out——
After Qin Xiaowei finished his work here, the team didn't dare to delay for a second, and immediately transferred to another operating room, changed gloves, and took part of the liver from Li Jun.

The general steps are similar, the difference is that this time only a part of Li Jun's liver is taken out instead of the whole liver.

A herringbone incision was made under the costal margin, and the liver was exposed layer by layer. The direction of the middle hepatic vein was checked with intraoperative color Doppler ultrasound to determine the resection line. Dissect the first porta hepatis, free the left branch of the bile duct, hepatic artery and portal vein; dissect the second porta hepatis, free the joint of the left hepatic vein and the middle hepatic vein; separate the liver parenchyma along the pre-marked resection line; intubate Connect to Professor Yao's machine; cut off the first and second hepatic hilums, cut out the left hemi-liver, and hand over the cut liver to Professor Yao for weighing.

When performing partial liver transplantation, the transplanted liver should account for 1% of the body weight. After weighing, the quality of the harvested liver meets the requirements.

Yang Ping closed all the stumps of the pipeline, performed cholangiography to check whether there was biliary fistula, placed abdominal drainage, and closed the abdomen.

The team switched between the two operations, and Professor Yao came to Qin Xiaowei's side with a living liver.

Yang Ping began to transplant Li Jun's liver into Qin Xiaowei's body. The roving nurse helped put down the head-mounted microscope on his head, and the anastomosis of blood vessels and biliary tract was completed under the microscope.

First, end-to-end continuous anastomosis of the donor hepatic vein and recipient hepatic vein; then, end-to-end anastomosis of the portal vein; end-to-end anastomosis of the hepatic artery; end-to-end anastomosis of the bile duct.

The abdominal cavity was flushed, a drainage tube was placed, and the abdomen was closed.

Yang Ping completed all the steps by himself, and the connection of the whole operation process was very clear and smooth. This kind of proficiency is the ultimate proficiency, which can only be obtained through countless surgical exercises.

Professor Wang took a deep breath, looked at Professor Pei next to him, and murmured, "He really knows how to do liver and kidney transplants! Really! There are no [-] operations, and he can't practice this level."

"Yes, he is much more proficient than us. This is the real proficiency. How could he not have done organ transplantation, how could he not even have the qualifications, how could it be possible?" Professor Pei took the words, feeling like a dream.

The operation just now, dealing with the recipient's liver area, dissecting the donor's liver, connecting the machine, taking the liver, resecting the recipient's liver, and transplanting the donor's liver, the whole process has a clear rhythm, without the slightest pause or disorder, especially watching Yang The anastomosis of blood vessels and bile ducts is really pleasing to the eye, just like watching some kind of stunt passed down by a thousand-year-old.

"Watching this kind of operation is completely enjoyable!"

Professor Wang has never seen such a smooth operation, and his own operation level is far from reaching it.

People who work in technology are only obsessed with technology, and now he is really convinced, no matter whether Professor Yang is qualified or not, the fact is that his surgery is absolutely superb.

In about five to ten minutes, the liver transplantation also ended the battle.

Including three 10-minute kidney transplants, the total was more than 80 minutes. The operation was over, which was four 10 minutes shorter than the two hours of "bragging".

If Professor Wang had "so horrible" in his vocabulary, he would definitely choose to use "so scary" to describe it now.

Not only Professor Wang and Professor Pei, but all the experts in the audience were deeply in a daze.

This kind of blitzkrieg would be confusing to anyone who saw it.

Everyone is an expert, but they have never seen this kind of operation. This is not an operation, it is a stunt.

"How about it?"

Director Zhao, who had already returned to his seat, asked in a gentle tone, then reached out to peel a peanut and threw it into his mouth.

Knowingly ask!

Professor Wang took a sip of tea and replied: "Director Zhao, you are pretending to be pigs and eating tigers. Professor Yang doesn't look like he has never done liver and kidney transplants. He doesn't have [-] cases of operations. He will definitely not be able to do this level. deep enough."

Professor Wang is the leader of the Organ Transplant Center of Imperial University, and Professor Pei is the leader of Renji Hospital Affiliated to Jiaotong University School of Medicine in Shanghai. These two are the top organ transplant centers in the country.

Director Zhao said that Yang Ping had never done a liver and kidney transplant, which is impossible. It can be suspected that this kind of remark was a malicious insult to the two big brothers.

The two bosses live in a top hospital and have carried out liver and kidney transplantation for 20 years. Isn't it a joke that they are not as good as the doctor who performed liver and kidney transplantation for the first time?
When Professor Wang and Professor Pei were ashamed of themselves, they couldn't help but feel a little angry. Sanbo Hospital's behavior of pretending to be a pig and eating a tiger is not kind.

"Professor Yang has never done organ transplantation in our hospital, but he should have done a lot abroad. He often goes abroad for flying knife surgery, and some countries have issued him special surgery licenses. Our hospital wants to help Professor Yang apply for organ transplantation qualifications. , The two professors also saw today's operation, does it meet the level?" Director Zhao went around and finally brought up the topic.

This is a bit of a moral kidnapping. Foreigners can issue special surgery licenses. Now, do you give them qualifications?

In fact, this qualification is not given by two big bosses, but issued by the Department of Health. If these two big bosses recommend it, it will be more justifiable to award the qualification exceptionally.

Professor Wang and Professor Pei were a little hesitant. According to the qualification process, Professor Yang must go to a designated place for training for one year before being assessed.

But in terms of real level, this kind of technology can train others. To be honest, it is also possible to train the experts sitting here.

"Our General Surgery Department intends to grant full surgical authority to Professor Yang. The surgeries that the hospital can approve are already open, and the rest are high-threshold surgeries, such as organ transplants, which have not been authorized for a long time. Today's surgeries are still on the sidelines. The qualifications of Director Liu and Director Li acted as a protective umbrella, so we thought, can we bother the two great professors to recommend jointly, go through a special channel, and give Yang Ping a qualification. If the two still have questions, they can investigate casually.” Stalker.

Professor Wang waved his hand: "There is no need to investigate."

Just now Professor Wang watched the whole liver transplant, and Professor Pei even watched the whole liver transplant and kidney transplant.

This kind of proficiency makes it impossible for you to pretend, so there is no fake.

However, it is recommended to issue qualifications for liver and kidney transplantation as an exception, which requires careful consideration.

Sanbo Hospital can do such unrestrained things. The two bosses are well-behaved people, and they don't dare to do it. It's better to follow the steps in clinical medicine.
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At the end of the operation, Qin Xiaowei and Li Jun's vital signs were very stable because there was not much bleeding.

There were only a few pieces of hemostatic gauze thrown in the collection basin, with scattered traces of blood on them.

Yang Ping's anatomy is too familiar, so the blood vessels that can be avoided are [-]% avoided, and the small blood vessels that cannot be avoided are ligated or electrocoagulated in advance, so there is no bleeding at all, and the operative field is clean.

Director Liu and Director Li almost collapsed anyway. In order to keep up with the rhythm, they had to concentrate on the whole process, exhausting their mental and physical energy.

At the beginning of the operation, they were still a little worried. After all, they had never seen Yang Ping perform a liver and kidney transplant.

There are many legends about Yang Ping in Sanbo Hospital. Anyway, the more people talk about it, the more mysterious it is. Some even say that he is doing black market surgery in foreign countries, and some people say that he is a famous black market knife, and his ranking is quite high.

Director Liu and Director Li just listened to this kind of thing, and unrealistic legends would arise if people's abilities were too outstanding.

But for today's organ transplant operation, Director Liu dared to guarantee that if Yang Ping didn't have a special organ transplant flying knife base abroad, he would walk around the third hospital three times naked on his head.

But this idea was immediately pushed back. Wen Ruzheng from the pathology department just made a bet with him to run around the hospital three times in his underwear?
Anyway, now that the operation is over, Director Liu and Director Li completely believe that Yang Ping is a god.

"Professor Yang, come to us for more operations when you have time in the future, and guide us."

Director Liu said convincingly that he is now willing to bow before Yang Ping and follow the path of Director Gao.

Just now, if Yang Ping has learned half of his skills, Director Liu feels that he can stand alone in the field of organ transplantation.

Originally, Director Liu wanted to go to the United States for further studies, but now he feels that he is a bit far away, and even though his hospital has such a big god, he still went to the United States to study.

"That's right—Professor Yang—come to us more often for surgery, qualifications are not a problem, write our names, we will take care of things, don't worry." Director Li also fought together.

Who doesn't want to be famous, and the medical field is the same, who doesn't want to be a respected doctor.

"It's okay to make one occasionally, but it's not good if there are too many, and you must have qualifications." Yang Ping doesn't want to always play side-by-side, it's dangerous and boring.

Yang Ping was about to take off his surgical gown, and Director Liu and Director Li rushed to help.

Professor Yao stood by the machine, not about to take off his clothes and step off the stage, looking like a wooden man with dull eyes.

Sometimes I look at the patient lying on the operating table, sometimes I look at the pieces of gauze in the collection basin, and sometimes I look at the electronic clock on the wall panel. My thinking is a bit confused and not normal.

In fact, it was Professor Yao who was hit the hardest. His own technology and his own machine allowed others to make teaching cases.

The key is that the object of teaching includes yourself.

Unexpectedly, a new technology emerges, and after it is popularized, the waves behind the Yangtze River will push the waves ahead, and gradually someone will improve it better and better.

But now the new technology has not been promoted, and it is still in our own hands, so why are people leading the way?

Just now, Professor Yao observed the operation up close, and Yang Ping improved several details on the basis of Professor Yao's original technique, which is obviously better than Professor Yao's technique.

The details of these improvements are precisely what Professor Yao has been pondering for many years and has not figured out.

All the answers are here today.

Is it true that I accidentally stole Professor Yang's version?Professor Yang is the real master?

No, this technology is indeed original, and it took ten years to complete it.

At that time, there were no materials for reference, and I created it myself in the world.

Could it be that during the same period, Professor Yang also thought of the non-ischemic transplantation technique and carried out a large number of operations, but he did not publish any articles.

This situation also exists. Two people independently developed the same technology without any communication and reference.

In the end, to determine who invented the new technology, it depends on the paper, and whoever publishes it first will count as it.

After much deliberation, Professor Yao felt that something was wrong. Didn't the General Surgery Department of Sanbo Hospital not carry out organ transplantation yet?

The more I think about it, the more confused my mind becomes, and even the basic logic is a bit difficult to sort out.

Professor Yao was still in a daze, Yang Ping urged him to take off his surgical gown, and then told him that the machine still needs to be improved, such as the pipeline can be changed to be more convenient, the circulation path can be improved, and various parameters can be optimized .

Professor Yao said a few times, unbuttoned the clothes several times, and did not take off the surgical gown with the help of Yang Ping.

It’s fine to improve the details of the operation. Now you are more familiar with the machine than I am, and you help me improve it. These improvements have all been changed to the key points. I feel dissatisfied, but I can’t find an alternative.

I have never seen such a bullying creator!

Professor Yao wanted to cry in his heart.

"Professor Yang, have you also studied this technology? Let me declare first that the non-ischemic transplantation technology is really my original creation. I have not read any ready-made books or papers. I started from a blank, bit by bit. Damn, it took ten years to achieve today's achievement." Professor Yao affirmed to Yang Ping pitifully.

"I haven't researched it before, I only learned it after reading your papers and patent materials. I'm embarrassed to use your technology, so I took the time to research and found several areas that can be improved. Let me give it to you. How about the tuition fee?" Yang Ping joked with Professor Yao.

Professor Yao waved his hand: "Don't dare to do it, don't dare to do it, as long as I'm not suspected of infringing on your rights, it's fine, just scare me, can I copy your surgery video?"

"Okay, you can copy whatever you want, do you have a disk? I'll send someone to send you a disk." Yang Ping said straightforwardly.

It was originally his technology, so copying the operation video was nothing.

Professor Yao didn't expect Yang Ping to be so forthright: "Yes, I have the disk. It's in the locker in the locker room. I'll copy it later."

Professor Yao intends to copy the operation video back to study and study hard.

This is absolutely teaching surgery!
Use Yang Ping's surgery videos to learn your own original techniques.

Why does Professor Yao feel weird.

(End of this chapter)