godfather of surgery

Chapter 648 Removal without leakage

Hearing that Professor Liang asked Yang Ping to perform the operation, the hearts of the young doctors were boiling.

They have long wanted to see the level of the Golden Knife Champion up close.

This is like an ordinary boxer seeing the world champion, hoping to witness the champion show off his glory and see how powerful he is.

This operation is expected to last up to [-] hours. Both the difficulty and the risk of the operation are very high, and it will definitely feast everyone's eyes.

Director Hu was taken aback when he heard Professor Liang's arrangement, but he immediately agreed that Director Hu had led a team to Sanbo Hospital and had the experience of performing surgery with Yang Ping. He knew Yang Ping's surgical level very well.

"Let Professor Yang perform this operation, do you have any objections?" Director Hu shouted loudly.

Knowingly ask!

"agree!"

Everyone shouted in unison, and the audience almost unanimously passed.

Especially the few doctors who are familiar with Yang Ping are very excited. They have experienced Yang Ping's scientific research ability before, and now they want to appreciate his surgical ability. They can't wait for the operation to start now.

The tumor involves three vertebrae, and the total vertebral resection of the three vertebrae is performed. Even in Xiehe, only Professor Liang and Director Hu can do the surgery. The other professors who lead the group are very reluctant to perform the surgery, let alone their young doctors.

It is estimated that such a young doctor performed total vertebral resection of three vertebrae, which is the only one in the country.

"Professor Yang, how do you arrange the time?" Professor Liang smiled, and just took advantage of this operation to let Yang Ping stand in harmony, which is convenient for future work, and it is also convenient for Professor Liang to help Yang Ping obtain some resources in the future.

Xiehe is different from Nandu Medical University. Nandu Medical University has only a few academicians in the entire system, while Xiehe has more than 20 academicians from the medical school to the hospital.

More than 20 academicians represent the strongest strength of Xiehe, but at the same time, they also said that it is not so easy for young people like Yang Ping, who is still a doctor in other hospitals, to win some resources.

For example, Yang Ping's stem cell project can not only easily obtain the cooperation of Nandu Medical University, but also occupy a leading position in the cooperation.

However, it is different in Xiehe. It is still unknown whether cooperation can be obtained. Professor Liang needs to work hard to win and lobby other big shots.

Of course, Yang Ping didn't care about this cooperation, it was just to repay Professor Liang's kindness.

Since Yang Ping said that he often performs this kind of operation, he is sure, but Professor Liang still asks an additional question out of caution.

"Are you sure?" Professor Liang asked Yang Ping in a low voice.

"Routine surgery, sure!" Yang Ping felt extremely relaxed.

Fortunately, Professor Liang is familiar with Yang Ping, otherwise the words just now would have killed him again.

This kind of top-level surgery, you can talk about routine surgery so easily.

But for Yang Ping, it is indeed a routine operation. Most of their general surgery operations are difficult and high-risk operations that others are unwilling to do.

"I'm short on time here, at most three days, and I have to go back to Sanbo Hospital on Monday afternoon. When can the surgery be arranged?" Yang Ping felt that the sooner the better.

"Director Hu, is it too late to arrange the operation tomorrow?" Professor Liang believes that if the operation is well prepared, it should be arranged early.

"No problem, I will tell the operating room to add another surgery. Tomorrow is an exchange meeting with the American Twin Cities Spine Center. The content of the surgery demonstration is spinal tumors. Because this surgery takes too long, I don't plan to include it in the demonstration. Operation."

The preoperative preparations for this operation have been very sufficient. Director Hu originally planned to include the demonstration operation at the exchange meeting, but because the operation time is expected to be as long as [-] hours, it is not suitable for demonstration, and the operation is too difficult. There was an uncontrolled accident, so this operation was removed from the demonstration operation list.

Professor Liang felt that Director Hu's arrangement made sense: "Then take over tomorrow's demonstration surgery and do it after the meeting? How about it?"

Yang Ping thinks that as long as the preparations for the operation are sufficient, it doesn't matter what time it is scheduled for tomorrow.

"Arrange it as you like, it's fine to arrange it as a demonstration operation." Yang Ping took it calmly.

Young people are fierce, this kind of operation is going to be demonstrated, [-] hours of operation, let it go, Director Hu shook his head.

"It's okay, it won't take that long, just a few hours, just for the Americans to learn."

There is nothing wrong with Yang Ping saying that. He really wants the Americans to learn this leak-free resection, and go back to the United States to promote it, so that he won't waste any more time.

Let Americans also learn to learn?
The boy is a little crazy!

Director Hu couldn't hold back what Yang Ping said.

"That's right, add surgery to let Americans learn." Professor Liang supported Yang Ping.

Director Hu immediately ordered Song Yun to make arrangements.

"Xiao Yang, what is the non-disclosure theory you just proposed?" Professor Liang was very interested.

"This is a concept I put forward for tumor surgery. Based on this concept, I have established a surgical system." Yang Ping thought that he could take this opportunity to promote his own technology.

Sharing good things with everyone can heal more patients.

Why does this guy have so many new things? It's like having a magical pocket on his body, and it's a treasure if he just takes it out.

If I hadn't just met this spinal tumor patient, who would have known what non-leak resection techniques he has.

Professor Liang looked at Yang Ping beside him, and felt very relieved. He thought carefully about the meaning of Yang Ping's leak-free resection.

Vertebral resection—en bloc resection, there are currently two schools of surgery in Japan and Europe and the United States.

Japan’s Tomita-based en bloc total spondylectomy technique: through the posterior median incision of the thoracolumbar spine, 360° stripping from the back to the front to expose the entire spine at the segment where the tumor is located, and then use a wire saw to cut the vertebrae on both sides. The intervertebral disc adjacent to the pedicle and the diseased vertebra is sawed off, so that the front vertebral body is completely separated from the rear attachment structure. Finally, the vertebra is divided into two parts, the vertebral body and the attachment, and the so-called "total spondylectomy" is completed.

The current whole vertebral resection in Europe and the United States is different from the Tomita operation in Japan. The method in Europe and the United States is to remove the normal bone tissue or soft tissue surrounding the tumor, try not to expose the tumor, and remove it together with the dura mater if necessary. , while the normal bone in the same segment of the spine not involved by the tumor does not necessarily emphasize en bloc resection.

Relatively speaking, European and American methods are better. The resected tumor is completely surrounded by normal tissue structures. Although this sometimes increases the resection range of normal tissues or structures around the tumor, it does reduce the surgical process to a certain extent. possibility of tumor contamination.

And what does Yang Ping's leak-free resection mean?
"Xiao Yang, can you explain it to me in detail? Be more specific, I don't understand your concept." Professor Liang is very modest.

Yang Ping briefly introduced his method to Professor Liang: "My method is different from that of Japan and Europe and the United States. The Japanese only emphasize the complete resection of the vertebrae and do not propose a method for complete resection of the tumor, while the methods of the Europeans and Americans emphasize the extent of the tumor. Complete resection, but did not mention how to completely remove the tumor, just generalized complete resection, and did not emphasize the complete resection of the vertebrae. In the end, it sounds good, but the effect is not good. I really encountered a case like Jing Yunsong. , most of the vertebrae are violated and there is nothing to do."

"My non-leak resection is not only a concept, but also a specific method. I have done in-depth research on these tumors, starting from their properties and growth methods, finding their boundaries, and starting from their invasion of the vertebral body. Find the way they invade the vertebral body, and find the method to break the circular structure of the vertebrae. Combining the two, the entire tumor and vertebrae can be resected. It is beautiful to say, and it is also beautiful to do. For example, the patient's 3rd lumbar vertebral body , the entire vertebra 360 is surrounded by tumors, neither the Japanese method nor the American method can do anything about it, but my method is fine. My method can remove the tumor from the bottom, leave a gap, and perform pedicle osteotomy .”

Professor Liang thought for a long time, and nodded approvingly: "It makes sense, you have created a third school of vertebral resection: the Chinese school! Just now everyone is getting together, and you tell everyone about your non-leakage resection technique, Work hard, the place to eat at night, Fengze Garden, Quanjude, Donglaishun, you can choose whatever you want."

"That's so embarrassing—actually, you don't need to be so polite—then it's settled! I'm a big meat eater." Yang Ping respectfully obeyed.

"Don't worry, Director Hu will pay for my treat tonight. It's not a problem if you can't finish the meal." Professor Liang smiled slightly.

"Go to the podium and talk to everyone, try to be as detailed as possible." Professor Liang encouraged Yang Ping.

Yang Ping stepped onto the stage, dozens of doctors in the audience applauded enthusiastically, and then waited for Yang Ping to start speaking. Yang Ping glanced at the audience, this is the elite of the elite, and his own method is powerful in curing diseases and saving lives in their hands. arms.

Song Yun helped to adjust the microphone, and Yang Ping didn't even have to introduce himself, and he went directly to the stage and it was dry:
"Vertebral resection---en bloc resection, there are currently two schools of surgery in Japan and Europe and the United States. Today I will teach you the third method. I named this technique called non-leakage resection, which is actually non-leakage resection. The upgraded version of the tumor technology just has a fancy name, for complex tumors of the spine, it is very difficult to perform real extra-tumor operations, so that the tumor cells do not leak out and the tumor is completely removed.”

"Because the vertebra is a ring structure, the spinal cord and cauda equina are nested in the middle of the ring, to cut off the entire vertebra, the ring structure must be broken, and the vertebrae must be released from the spinal cord or cauda equina. For complex tumors, the tumor has already wrapped and invaded the vertebral arch. The root, breaking the ring structure, and cutting off the pedicle often cannot avoid entering the tumor."

"But we know that there are natural barriers to tumor spread, such as the natural barriers of spinal tumors: anterior and posterior longitudinal ligaments, periosteum around the spinal canal, ligamentum flavum, lamina, spinous process periosteum, supraspinous and interspinous ligaments, cartilage endplates , annulus fibrosus, we need to be very familiar with these natural barriers and make good use of them during surgery.”

"Each vertebra represents a compartment surrounded by several barriers, which seem to facilitate surgical wide resection."

"However, the vertebra is a ring-shaped structure with the spinal cord in the middle. It is close to the important blood vessels and internal organs of the spine, and the complex anatomical relationship between the spine, spinal cord, important blood vessels, and internal organs hinders extensive surgical resection. For example, the front The repeatedly mentioned pedicle osteotomy is difficult to perform extratumoral operations, so we can change our thinking."

"Break the circular structure, not necessarily at the pedicle, where the bone quality is normal and not invaded by the tumor, we will break it there. For example, in this patient's waist 2, the pedicle is all violated. What should I do? Part of it is good, wouldn’t it be good to cut the bone from here, the diameter of the spinal cord is only 1.2 centimeters, we only need to have a 1.5 centimeter incision, and the ring can be untied.”

"Osteotomy can be done from the pedicle, but the surgical requirements are higher. The tumor should be separated first, and then the osteotomy should be performed. Those with poor operating skills should not try it lightly."

"How to resect the tumor without leakage, we must be very particular about the order of tumor resection. Before the operation, we must thoroughly study the tumor, where it starts, where it passes through, and where it ends. It's like wrestling. If you want to fall a person, first catch Which part to live on, which part to trip on, and finally destroy the center of gravity and throw people out."

"I just did some research on this patient. According to the principle of non-leakage resection, I divided the operation into 21 steps, and performed the operation according to the sequence of these 21 steps, and a complete resection can be achieved."

Yang Ping explained to the 3D image on the screen and told everyone how to cut it.

Everyone listened and thought, simulating the operation process in their hearts, especially Professor Liang and Director Hu, who have rich experience in surgery, and they can immediately understand the mystery of it as soon as they do the simulation in their hearts.

Indeed, it is much easier to cut it like this, and it can be completely removed.

"He updated the concept, and then innovated the technology under the new concept, instead of simply honing the technology repeatedly." After hearing this, Professor Hu Guolin felt that he had gained a lot.

"Yes, let him do the surgery tomorrow. Indeed, the sequence is very important to completely remove the tumor." Professor Liang appreciated Yang Ping's leak-free resection very much.

"Not only the order is important, but also the boundaries of the tumor, including natural boundaries, pseudomembranes, etc., are combined to form the isolation zone of the entire tumor. Around the isolation zone, the tumor is removed step by step."

"It's like demolishing a house. You can't demolish it blindly. If you have a method, you can demolish it first and then demolish it later. Since it is safe, you can demolish the house quickly."

"Tomorrow, this operation will be added to the demonstration operation, so that the Americans can experience non-leak resection. What is the name of the team leader?"

"Cheney!"

"Yes, doesn't he have eyeballs on the top of his head? Let Yang Ping help him reset the two eyeballs tomorrow."

"Twenty hours of surgery?"

"That's what you do. Xiao Yang shouldn't take so long to do it. Don't worry, even if it takes [-] hours, the Americans will not have any objections. They did a few cases of three full vertebrae last time, which seems to be very remarkable."

Professor Liang and Director Hu talked in low voices.

PS: Today is the day before the holiday, there are a lot of surgeries, so it will be revised first, and I wish you all a happy Mid-Autumn Festival!

(End of this chapter)