godfather of surgery

Chapter 808: Just hang up a sign?
Anastomizing blood vessels was his debut skill, so how could he fail at this?

Song Zimo took Xu Zhiliang and began to close his chest. Yang Ping calmly sat down to rest and chatted with Academician Wang and Professor Chen.

Li Zehui, Director He, and Xia Shu also moved as close as possible to this side. Although the operation had now entered the stage of closing the chest, as long as the surgical gown was not taken off, everyone did not dare to get too close and kept at least one meter apart.

Maybe if something unexpected happens, Yang Ping will be on stage to perform the surgery at any time.

Professor Yang has performed replantation of amputated fingers on infants before?No wonder the level of vascular anastomosis is so high. Academician Wang feels that Yang Ping is inscrutable.It feels like I know everything and can achieve a state of being able to do anything.

Li Zehui had just seen Yang Ping's skill in anastomosis of blood vessels and was amazed.

As a cardiac surgeon, there are absolutely no surgeons who perform finger replantation to anastomose as many blood vessels. Therefore, finger replantation is the most honed vascular anastomosis technique. However, unfortunately, it is impossible to perform finger amputation in the training experience of a cardiac surgeon. Replantation.

Director He was somewhat wary of Xia Shu's arrival. This doctor was an eight-year doctorate from Xiamen Union Medical College. He also completed clinical training outside Xiamen University of Finance and Economics. Now he has directly joined Sanbo General Surgery. He had to be wary of the reasons behind it.

Does the hospital leader have any arrangements?Director He had to think more.

It is the strategic policy of Sanbo Hospital to make department directors younger, more elite, and more doctorate. This Xia Shu originally worked in Fuwai. If he trains in general surgery for a few more years and then returns to thoracic surgery, will he be replaced? He Xiangjun had to think about his position.

Academician Wang did not expect that the baby's surgery would be so smooth, and he did not even need patching needles after the suturing.

After the operation, the baby was sent to the intensive care unit. Yang Ping decided to let him stay in the intensive care unit for 5 days to pass the critical period before transferring him to the general ward.

Of course, if the great blood vessels remain underdeveloped in the future and aortic dissection occurs again, that will be a thing for another time. At least the surgery is successful now.

Another patient, Song Hanhui, was a patient of Academician Wang’s Fontan surgery. He was still an infant at that time. Academician Wang performed the surgery and performed Fontan surgery on him. However, because Song Hanhui’s heart malformation was too serious, he only insisted on Fontan surgery. In 10 years, when Song Hanhui was now 11 years old, various serious complications had already occurred.

The only solution is radical cure, which is to correct the heart deformity.

This patient's heart malformation cannot be found in textbooks or literature. It has eight malformations. In theory, as long as the eight malformations are corrected, the patient can continue to live.

But the gap between theory and reality is sometimes huge.

Academician Wang also knew that it was theoretically possible, but in reality he was not able to do all the corrections, so he could only settle for the next best thing and use Fontan surgery for palliative care, hoping to delay the time and complete all the corrections within this period of time. Methods.

Now that I have reached retirement age, I still can’t do it, so I can’t help but feel regretful.

This time Professor Chen also brought Song Hanhui's case data, which was installed in a mobile hard drive.

After the operation, everyone moved to Yang Ping's office and took the time to discuss Song Hanhui's condition. The main theme of the doctor's work was to treat illnesses and save people, so he was thinking about and doing this from morning to night.

Academician Wang has retired, but this matter is still on his mind.
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Yang Ping's director's office is very spacious, not to express luxury, but because he often uses the office to discuss cases and must be able to accommodate a few more people.

Otherwise, sometimes when we need to discuss cases and go to the doctor's office, everyone has to work, which is too messy, and it is too troublesome to go to the classroom and conference room.

Connect the mobile hard disk and the case data is retrieved.

The case that makes Academician Wang regretful is indeed extraordinary. This heart with eight malformations can move for 11 years, which shows that Academician Wang's medical skills are very superb.

In this case, if it weren't for Academician Wang's surgery, he would not have lived to be 2 years old, and most people would not have lived to be 1 year old.

The first is dextrocardia, which is similar to the previous Mirror Man. The heart originally on the left grows on the right.

Followed by double outlet of the right ventricle, complete atrium-ventricular septal defect, severe subpulmonic stenosis, large vessel displacement, single atrium, severe atrioventricular valve insufficiency, separate hepatic vein opening in the right atrium - a total of eight cardiac malformations .

It is very difficult to treat any one of these eight deformities. When all eight deformities are put together, it can be imagined that the entire heart needs to be reconstructed.

Compared with him, Mai Zijing was just a dwarf.

In this case, Fontan surgery was the only option at the time, and Academician Wang was forced to have no choice.

It is very difficult to reconstruct the heart because it is a precise living pump, and every component must ensure its anatomical precision and functional perfection.

There are many aspects that need to be paid attention to during surgery, which are very detailed.

During the operation, you must be very careful and do not damage the conductive bundles on the heart, otherwise conduction block will occur after the operation.

The ventricular outflow tract must not be narrowed, the atrioventricular valves must not be insufficient, the pulmonary veins must not be obstructed, etc. These are all problems that must be avoided after surgery.

"How is it? Can it be done?" Academician Wang asked worriedly.

Yang Ping did not answer immediately, but half-squinted his eyes and tapped his fingers lightly on the desk.

After a while, he asked: "Are there no other contraindications?"

Professor Chen replied: "Nothing has been found yet."

"That can be done." Yang Ping said without hesitation.

We are all surgeons, so of course we need to ask if there are any contraindications to surgery. If there are absolute contraindications to surgery, it will be in vain no matter how high the level of surgery is.

The first thing to do is to do the surgery right, and the second is to do the surgery well!This principle cannot be violated.

For example, Fontan surgery, if the problem of pulmonary hypertension is not solved, no matter how beautiful the surgery is, the result will be zero, or even negative.

"Can it be done? Radical surgery?"

Academician Wang had just picked up the teacup. When Yang Ping said this, he put the teacup down again.

"There is no other way except radical surgery. All the original surgeries must be dismantled and then reconstructed one by one. The project is relatively large and complex and will take a long time." Yang Ping pointed to the images on the screen.

"This case is much more difficult than Maizijing. Everything needs to be reconstructed. The surgical design must be very delicate and interconnected, just like a precision aerospace engine. Each part must be precise and coordinate with other parts. "

Li Zehui also participated in the discussion. He recently visited Sanbo Hospital twice and saw two surgeries, which made him suddenly enlightened.

Some surgeries that were originally thought to be inoperable can actually be done here; some surgeries that were originally thought to be done that way can be done here.

Li Zehui's understanding and vision of cardiac surgery were opened up. "If there is a flaw in one link, everything may collapse, and every step will be like walking on thin ice."

Professor Chen is still very scared about this case.

Yang Ping's fingers tapped gently and rhythmically on the table, but it was just a movement and no sound was made: "Yes, eight deformities need to be corrected and all of them must be functional. It is very difficult, but this is the only way. Fontan surgery The diversion effect is now close to collapse, and reconstruction is the only way out.”

"The position of the great blood vessels is malformed, with the aorta deviating forward and the pulmonary artery posteriorly; the valve orifice is severely stenotic, only the thickness of a pencil lead, and is completely a small hole; the bivalvular malformation requires complete repair of the septum, and the single atrium requires reconstruction of the interatrial septum. Two atria are coming out, the interventricular septum needs to be repaired, and the connection between the left ventricle and the aorta needs to be rebuilt. They are too far apart now. Normally there are two groups of atrioventricular valves. Now they are one group. We need to separate the two groups. ——The mitral and tricuspid valves must neither be stenotic nor incompetent; the pulmonary veins, vena cava and hepatic veins must be separated above the atrium, the endocardial cushion defect must be repaired, and the aorta must be widened. The pulmonary valve needs to be formed, and the area below the pulmonary valve also needs to be widened—"

Yang Ping pointed at the image on the screen with the eraser end of the pencil and explained one part at a time.

Director He was sitting next to him, not daring to express his anger. Just listening to this string of nouns and verbs made his scalp numb. Now for Yang Ping to see these things come true, it would be harder than climbing to the sky.

"It seems that we need to make a good plan for the operation. Professor Yang, what kind of help do you need from us?" Academician Wang saw that Yang Ping was so confident and decided to give it a try.

"Xia Shu is here to take care of this patient. Our young doctors are inexperienced. In addition, it is best to transfer an experienced doctor from your cardiac surgery intensive care unit to lead the postoperative management." Yang Ping had no unnecessary words.

Sanbo Hospital does not have a dedicated cardiac surgery intensive care unit, but makes do with the coronary heart disease intensive care unit. This case is special and cannot be used improvised after surgery. There are too many indicators to observe and it is too complicated. It is necessary to arrange for a cardiac surgery intensive care unit. Doctors with intensive care unit experience.

"Yue Liang, go arrange the manpower immediately and fly over as quickly as possible." Academician Wang ordered Professor Chen.

"Is there anything else you need our assistance with?"

Academician Wang asked. He licked his dry lips and felt a little excited.

Yang Ping thought for a while and couldn't think of any other assistance he needed, so he said no more.

"I asked someone to make a digital model, and then used the digital model to simulate the preoperative pathological anatomy of the heart, the surgical process and the postoperative effects, which is more intuitive."

Yang Ping thought about it.

"The surgeries in our general surgery department started off like hell. I just browsed through other cases and there are almost no ordinary surgeries." Xia Shu sighed after seeing this case.

I just came to work in our general surgery department, and I felt very immersed in it.

Academician Wang also said: "This surgery is also hellish."

Yang Ping said in embarrassment: "There is nothing I can do. From the time I opened the Department of General Surgery until now, my life has been like hell every day. I'm used to it!"

Academician Wang had a look of astonishment on his face, and the young man said, "Life is hard!"

However, Academician Wang likes this kind of confident young man. He is not only confident, but also has the ability to be confident. Among the three surgeries recommended during this period, none of them were hellish.

The purpose of using digital technology to simulate the current heart, surgical process and postoperative heart is to allow everyone to intuitively understand the entire surgical process.

In the Digital Medicine Laboratory of Nandu Medical University, the new generation digital human project is progressing smoothly. In order to support the digital human project, Yang Ping plans to use scientific research funds to purchase a supercomputer for them.

At present, the construction of a piece of digital muscle has been completed. Professor He's team has also written a paper and submitted it to the journal Nature. Of course, Yang Ping's name is also in it, but he is not the first author.

Now it is a piece of cake for this team to create a three-dimensional animation of surgery.

"Professor Yang, how about we cooperate to build a cardiovascular surgery institute?" Academician Wang suggested.

With Yang Ping's surgical ability, combined with Fuwai's background, and the establishment of a cardiac surgery institute, Yang Ping's proposed use of dilators to treat left ventricular dysplasia can be a very successful topic. Get on the schedule quickly.

"Or, you can establish a research institute and our two research institutes can cooperate."

Academician Wang was worried that Yang Ping was unwilling to establish a cooperative research institute, so he changed the method. In fact, it was all cooperation, but the latter method highlighted the two independent teams.

General surgery itself is a listed surgical institute, and opening several specialist institutes is very simple. Just hang an extra sign at the door, one team, and multiple signs.

Yang Ping felt that Academician Wang's proposal was very good and agreed on the spot: "If there is an opportunity, we can cooperate and carry out research on cardiovascular diseases."

"You plan to establish a cardiovascular surgery institute? You need to start early. It requires strong support from hospital leaders and school leaders. It also needs approval from the provincial department and a lot of information and documents need to be prepared. We can assist you and you can refer to us for many things. "

Academician Wang was quite surprised that Yang Ping agreed so readily. It was difficult to establish a specialized research institute. Not only were there many conditions, but the process was also complicated.

Yang Ping said very relaxedly: "Don't bother me. I'll just find someone to write a sign and hang it on the door tomorrow."

Academician Wang was stunned. What does this mean? To build a research institute is to hang a sign at the gate?
Seeing the surprise on Academician Wang's face, Yang Ping explained with a smile: "My research institute is considered an internal research institute, so there is no need to go through any procedures or approvals. I will call our dean later and tell him. It can be put up tomorrow morning, and if it’s quick, I think it can be put up before get off work today.”

Is this too childish?

"Are you setting up an in-hospital research institute? Do you want us to help?"

Academician Wang did not say what he said later. At least one at the Nandu Medical University should be established, or at the municipal level. Of course, it would be better if it could be established at the provincial or national level.

"It doesn't have to be that complicated, as long as there is a brand and you can carry out research."

Yang Ping treated it calmly. He didn't need any level at all. As long as he had a brand, he could legally conduct scientific research and facilitate communication, keeping everything simple.

Academician Wang waited for Yang Ping, who was very indifferent.

Is this the way of a genius?It doesn't matter what level you are at, as long as it doesn't hinder your work.

But the resources obtained at different levels are different. Why not create a higher level?

Academician Wang also wanted to persuade him, but he didn't know that Yang Ping had already started calling Dean Xia and said that he wanted to put up a signboard of the Institute of Cardiac Surgery, which would facilitate patient identification and facilitate external communication, such as the current cooperation with Fuwai.

Dean Xia said: "Let me hang up a few brands for you, such as the Brain Research Institute, the Scoliosis Research Institute, the Sports Medicine Research Institute, and the Cancer Research Institute—"

Forget it!
The door must not be hung tightly, so Yang Ping quickly declined.

(End of this chapter)