godfather of surgery

The news of Yang Ping's coming to the United States has been informed by Robert.

Woodhead and Griffin are official members of the WeChat group and naturally know the news.

Li Zehui and Massimo, who were applying to join the WeChat group, also received notification from Robert. They immediately put down their work and rushed to Mayo Clinic in Rochester, Minnesota.
Woodhead was at the Twin Cities Spine Surgery Center in Minnesota, the closest to Mayo, and he was the first to get to Mayo.

The next person who rushed over was Griffin. His working hospital is the Anderson Cancer Center in Houston, Texas. This surgical oncologist is good at surgical operations on various tumors and is also familiar with tumor intervention, chemotherapy, immunotherapy, Biological therapy and radiotherapy, etc.

Griffin, who has always been silent in the group, actually speaks Chinese very fluently. He has passed the Chinese Level [-] test. This guy who only does things but doesn't speak, didn't expect to improve so quickly, and Woodhead felt that he was not as good as him.

Li Zehui from the Cleveland Medical Center in Ohio and Massimo from the Johns Hopkins Hospital in Baltimore, Maryland, did not lag behind full members and arrived at Mayo in time.

The surgery was scheduled for the next day, so there was plenty of time. After lunch, everyone had tea with friends in the hotel and held a small internal academic salon to discuss some difficult cases.

Everyone had a great time chatting and had in-depth discussions on some cutting-edge medical technologies. Of course, they most wanted to listen to Yang Ping's opinions, as Yang Ping was everyone's mentor.

At the same time, Li Zehui and Massimo took the opportunity to formally submit Chinese applications for membership. Robert, on behalf of the organization, conducted interviews and inspections for Li Zehui and Massimo. If the applications and interviews were passed, the two would undergo a three-month inspection period. During the inspection period, their performance Good, the WeChat group will then vote to decide whether to accept it as a formal member.
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The next day, the operation started as scheduled.

WeChat members also stayed at Mayo Clinic to observe surgeries. Before they obtained the training qualifications, it was difficult for them to have the opportunity to watch Yang Ping's surgeries up close, so they cherished the opportunity.

It can be said that they cherish the opportunity to observe and practice more than any other doctors.

So very early on, under the guidance of a dedicated person arranged by Johannesson, I took a good seat in the operating room demonstration classroom.

Although Mayo's overall strength is the best in the United States, its strength in many individual specialties is not as good as other top hospitals.

For example, in terms of tumor research and diagnosis and treatment, Anderson Cancer Center is number one in the United States; as for cardiology, Cleveland Medical Center has long held the top spot; needless to say, Johns Hopkins has the same overall strength as Mayo.

The Johns Hopkins Hospital has created many firsts in medical history, including the first heart bypass surgery, the first orthopedic surgery for neonatal tetralogy of Fallot, the first complete gender reassignment surgery, and more.

In clinical medicine, many common operations today, such as cardiopulmonary resuscitation, kidney dialysis, and the use of sterile rubber gloves in surgical procedures, all started at Hopkins Hospital.

People came in one after another, and soon the room was packed.

A Mayo neurosurgeon was curious when he noticed a few strangers sitting in a classroom.

The white-haired doctor and the muscular doctor sat down next to these people. The muscular doctor couldn't help but ask where these people came from, because it was definitely not Mayo.

The social cow shook hands with these people one by one.

"Hello, Griffin, MD Anderson Cancer Center."

"Woodhead, the spine of the Twin Cities."

"Massimo, Johns Hopkins."

"Li Zehui, Cleveland Medical Center."

None of these people are ordinary people. They are just neurosurgeons. Why don't I know them? It's impossible.

The muscular man from Sheniu had to inquire again, and the answer he got was that they were not neurosurgeons at all, but specialists in oncology, spine, interventional and cardiac.

"Are you interested in this surgery?" the muscular doctor asked curiously.

Griffin didn't bother to answer this boring question. At the same time, he had no interest in chatting with the muscular man. Griffin now felt that he was not the same level of doctor as the muscular man. After all, he would soon join the mysterious world. Top Medical Club.

Woodhead nodded: "The Chinese doctor who performed the surgery is our mentor, so we sit here and learn."

Their mentor?
The muscular man was completely unable to turn around. These powerful figures in different majors all regarded Yang Ping as their mentor and claimed to be Yang Ping's students.

Anyone else would not be able to turn around for a while.

At this time, the muscular man's curiosity immediately turned into an inexplicable awe.

"who are they?"

the white-haired doctor asked the muscular man.

The muscular man's tone was a little unconfident: "They are all students of Chinese doctors."
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The operation officially begins and the entire operation will be performed under a microscope.

This is not just talk, but actually removing an eyeball and entering through the eye socket.

The approach to the surgery is a bit strange. The first step is to make a small incision outside the outer canthus of the eye, and then open a small window in the bone wall.

Then, the separation and removal of the eyeball began. A sharp scalpel incised the conjunctiva in a circular motion along the corneal limbus, and then separated the conjunctiva and subconjunctival tissue downward until below the equator.The eyeball and eye socket are connected by blood vessels, nerves and muscles. Nerves are structures that must be preserved, while blood vessels and muscles can be cut off.

Because blood vessels can be anastomosed after being cut, and the same goes for muscles.

But the nerve is different. Once the nerve is severed, it cannot be restored by repairing the severed end after anastomosis.

Once the nerve is severed, the distal nerve is immediately destroyed. The nerve fibers inside will eventually dissolve and disappear, leaving only an empty tube. The proximal nerve sprouts like a vine, growing into the distal end and remaining along the old nerve. The lower tubes continue to move forward, and eventually reach the terminal end, which is the part innervated by the nerve.

There is a problem here. During the growth process of these nerves, some will grow wrongly, and some will be lazy. They will stop growing when they reach a certain distance. Therefore, the number of nerves that eventually reach their destination will definitely decrease. If the distance required to grow is If it is too far, it is likely that all the nerve fibers will not grow through in the end.

Therefore, trauma orthopedic surgeons are not afraid of blood vessels being cut off. As long as the blood vessels are cut off and the bleeding is stopped in time, there will be no sequelae after the blood vessels are anastomosed during surgery.

They are most afraid of nerve rupture. If the nerve is ruptured relatively high, that is, far away from the end, serious disability will definitely be left after the operation.

There is a nerve in the wrist called the median nerve. It is about in the middle of the wrist and its location is relatively superficial. Many patients who have had their pulse cut, due to lack of professional knowledge, do not cut the radial artery but cut the median nerve, leaving some parts of their hand behind after the operation. My disability is too late to regret.

Eyeball transplantation is currently in the experimental stage, and there are only a few clinical cases. The effect is not satisfactory. The reason for the poor effect is that after the nerves are connected, the number of transplanted eyes is not enough, making it difficult to obtain vision.

The operation continues, and the four rectus muscles are separated, and a thin silk thread is used to suture the rectus eye muscle in the figure of 8. Then the rectus muscle is cut, and about 0.5mm of the tendon stump of the medial rectus muscle is retained, and a silk thread is sutured for pulling. eyeball.

Then start to separate the optic nerve from the inside and above, and continue to separate the optic nerve deeper to obtain a sufficient length. Use the silk thread sutured at the stump of the medial rectus muscle as a traction line to gently move the eyeball to see how far it can be moved.

The last and most difficult step is to separate the branches of the ophthalmic artery one by one, and protect them from damage, and then follow them to find their distribution trunk-the ophthalmic artery, and cut off the ophthalmic artery here. And mark it with a small, non-damaging line.

This step of operation requires the cooperation of the eye socket and the window outside the eye socket to complete the separation and cutting of blood vessels.

Mayo's ophthalmologists have been watching the operation on the stage. They are also unfamiliar with this kind of surgery, but they have just observed Yang Ping's way of handling the ophthalmic artery. The ophthalmologists have to admit that this Chinese doctor is a world-class ophthalmologist. .

Chinese doctors are more familiar with eye anatomy than any ophthalmologist at Mayo Clinic, and not a drop of blood was produced during the entire operation.Moreover, the level of operation under the microscope is extremely high. The entire operation is performed under the microscope, and both upper limbs are completely suspended without relying on the support of the operating table.

"Use ice gauze to protect your eyeballs!"

Yang Ping ordered his assistant. At this time, the assistant was not Johannessen, but an ophthalmologist.

The ophthalmologist carefully wrapped the eyeball with sterile ice-cold saline gauze.

Yang Ping discovered that every piece of Mayo gauze has a QR code. You can scan the QR code to trace the source of the gauze. Americans still have a way of managing it.

In the demonstration classroom at this time.

The live video has always been about the operation in the surgical field. There is a small video with a larger viewfinder in the upper right corner of the high-definition screen, and the entire upper limbs of the surgeon and assistant can be seen.

During the entire microscopic operation, both upper limbs of the surgeon are suspended in the air?

How can the speed of suspended operation be so fast?

Every doctor is impressed by this kind of suspended operation. The level of operation under the microscope is the lifelong pursuit of any neurosurgeon. It can be said that without a certain ability to operate under the microscope, it is impossible to become a neurosurgeon.

If another doctor is asked to do it, both elbows must be supported on the operating table to ensure the stability of the hands and prevent jitter during the operation under the microscope.

Suspended operation is possible for a short time, but it is difficult to maintain for a long time.

Moreover, when operating in the air, the movements are generally relatively slow and cannot be done quickly and flexibly.

But Yang Ping is currently operating in the air, and the next surgery will still be in the air.

This is not because Yang Ping deliberately showed off his skills. For him, the micromanipulation in the air is very stable, so why bother to rest his elbows on the operating table?

"All the operations he just performed were suspended?" the white-haired doctor was surprised.

The muscular man disagreed: "The current operations are rough operations and have little impact. The fine operations that will enter the skull later will not allow the arms to be suspended for a long time."

"The separation of the ophthalmic artery and the optic nerve just now is considered a delicate operation, right? Especially the separation of the ophthalmic artery and its branches?" The white-haired doctor just saw it very clearly.

Members of the WeChat group sat together, whispering in Chinese about the surgery.

"Professor is getting better and better, and the operation with his hands in the air is so stable."

"Yeah, support will only slow him down and make him feel less flexible."