godfather of surgery

Eating lobster is secondary, peeling lobster is the key point. Except for Lu Xiaobao, everyone has mastered the technique of peeling lobster with chopsticks, but the proficiency level is different.

Lu Xiaobao eats the most lobsters but has the worst skills. He pinches the head, removes the tail and peels the shell. Dr. Lu is always stuck on the shelling step. It seems that he still has to eat the lobster.

Because it had been agreed before eating that the whole process of peeling lobster could only be done with chopsticks and not with hands, so in the end everyone’s table was piled with shrimp shells, except for Lu Xiaobao who only had a few pitiful shrimp shells in front of him.

Treating guests by myself, in my "father-in-law's" shop, I like to eat lobster the most, but I just couldn't eat a few lobsters. I'm not as good as others, no wonder.

At the end, Yang Ping took a group photo with Lu Xiaobao's girlfriend and classmates. There was no way, they were all brothers, so this face had to be given. In fact, girls just like to post on Moments, and of course it's not just that.

In addition to visiting Yang Ping, they also had another purpose, which was to hold a social event. After all, there were both male and female students studying medicine, and there were also singles.

It's not that these girls can't find boyfriends, it's just that the hard conditions are stricter than being rated as a deputy.

For example, the academic qualifications require a doctorate, the school requires 985 or 211, and there are also requirements for the number of SCI papers and citation index. This is not a boyfriend, this is a professional title evaluation.

When these girls heard that their classmates had found Xie He's boyfriend, they immediately came out in droves. Doctors like Xie He stayed in the hospital almost 24 hours a day, so how could they have any girlfriends?

Ignore her, let’s create a group first, and then organize some social activities later. Lu Xiaobao’s girlfriend is not a vegetarian. She grew up eating lobster, which is obviously different. She is also a cadre of the First Medical Student Union, and has great mobility. Very strong. If they really get together in the future, Lu Xiaobao will be pinched.

Everyone did not dare to play too late at night, so they dispersed early and returned to the hospital. Yang Ping slept in the department for one night, and living in the department was more practical than outside.

Professor Liang was not at Union Hospital this time, but attending an important meeting. Yang Ping did not see the old man, but the old man talked with Yang Ping on the phone for a long time.

The next day, the operation started normally. Yang Ping not only had to perform his own operation, but also helped Director Wen of the Cardiac Surgery Department to anastomose blood vessels.

第一台手术是颈椎肿瘤的神经根减压术，关键步骤杨平亲自主刀，将对颈3/4、4/5、5/6、6/7双侧椎间孔的神经根进行肿瘤的切除，以消除肿瘤对神经根的压迫，从而缓解或消除患者的疼痛。

This surgery is actually very difficult. It is very difficult to remove tumors in these areas. During the removal process, the spinal cord and nerve roots can easily be injured, causing paralysis.

Vertebrae are irregular bones with relatively complex anatomical shapes, and the intervertebral foramina, which is composed of upper and lower vertebrae, is even more complex. It is a complete anatomical nook. After the nerve roots emerge from the spinal cord, they generally travel downward for a certain distance, and then turn left and right to exit from both sides. The intervertebral foramen go out and extend to the trunk and limbs. The nerves from the cervical spine mainly extend to the upper limbs and the upper part of the trunk. The nerves from the lumbar spine generally extend to the lower body and lower limbs of the trunk, each with its own fixed partition.

Once the nerve roots are damaged, it will cause sensory and motor disorders in their distribution areas. If the spinal cord is damaged, it will cause paraplegia below the spinal cord level.

This kind of surgery in the nook and cranny of anatomy is very delicate. Either a sharp knife or a more delicate laser knife is used. Every movement is dancing on the tip of the knife.

The operating room was full of people. Except for a few doctors who participated in the operation, the rest were all observing the operation. Doctors from other departments would come over to take a look and join in the fun when they had time. Yang Ping's department was special in Xiehe. The existence of the doctor was said to be miraculous, and they wanted to see this miraculous level of surgery.

Some of them had seen Yang Ping's surgery before, and they spread it everywhere with embarrassment, gradually turning Yang Ping into a legend of Xiehe Union. Some people had not seen it yet and were eager to see the highest level that existed in the legend.

Moreover, this department is full of young doctors under the age of 35, so doctors from other departments also want to know what tricks they can make.

The patients in the orthopedics department have been anesthetized. Song Yun led the junior doctors to start brushing their hands. In the operating room next door, Kong Weiquan led others to start preparations. It was a cervical spondylosis surgery. Kong Weiquan had no problem taking it down. Yang Ping just needs to check.

Director Wen of the cardiac surgery department has also started working, and the anesthesiologist has started administering anesthesia.

Yang Ping had a plan. The cervical spine tumor here was exposed by Song Yun first. It is estimated that the cervical spine exposure here and the thoracotomy of the cardiac surgery were about the same. The internal mammary artery was removed immediately after the thoracotomy there. After the internal mammary artery was removed, , Yang Ping helped to build the bridge. Of course, Yang Ping only assisted. If they could win it by themselves, then there would be no need for Yang Ping to come to power.

Because he had to go to the cardiac surgery operating room later, Yang Ping didn't wash his hands for the time being.

At the cardiac surgery department, the patient has been anesthetized and positioned, and the junior doctors have begun to disinfect and spread the sheets.

Director Zhang of Modu Children's Medical Center was invited by Director Wen to help and is now sitting in the operating room. This was something that had been discussed long ago and could not be shied away from, so Director Wen still invited Director Zhang.

Ordinary coronary artery bypass grafting is nothing to Director Wen. He is very skilled. However, this case is too young and the blood vessels are too thin. Director Wen really lacks relevant experience. For such a thin coronary artery bypass grafting, he is constantly troubled. The anastomosis of the jumping blood vessels is completely uncertain.

Dr. Chu, the junior doctor, was responsible for exposing the heart and coronary arteries, opening the chest, opening the subpericardium, exposing the heart, and dissecting the coronary arteries and their branches, all in one go.

The most common operation Dr. Chu usually performs is to open the chest to expose the heart. After the exposure is complete, he will hand it over to Director Wen to take the next steps.

"Brush your hands!"

The prelude was completed, and the big boss appeared on stage. Director Wen led Director Zhang to the stage.

They put on surgical gowns and gloves, and the circulating nurse helped put on the head-mounted microscope. The two directors stood on the operating table in full gear. Although they knew that the baby's heart would be very small, they were still a little surprised to see this moment.

The heart was smaller than a walnut, and the coronary arteries were pitifully thin, no thicker than a hair. Director Wen turned his head and asked the circulating nurse to help flip down the head-mounted microscope. He re-observed the coronary arteries and branches in the microscope field of view. , so thin! How to start? No, this is completely different from adults.

Director Zhang from Shanghai has anastomosed the coronary arteries of a 14-month-old child. Two bridges were built at that time. This was the first time he had seen such a 1-month-old baby. The blood vessels were really too thin. It was better than doing it himself. The 14-month-old is not a little bit younger, and it is a test of my microsurgery skills.

"Is this child born prematurely?" Director Zhang asked.

Director Wen said: "Yes!"

"The blood vessels are much thinner than expected. Don't rush, let's take our time!"

Before Director Zhang came, he also did targeted 1 mm vascular anastomosis training. However, training was training, and actual combat was still different. Director Zhang was under a lot of pressure.

"Get the internal mammary artery!"

Director Zhang began to remove the artery, which went smoothly. After taking it out, he handed it over to Dr. Chu for treatment. Dr. Chu cleaned some connective tissue around the internal mammary artery and then cut it into segments according to Director Zhang's requirements.

After everything was ready, he started to anastomose the blood vessels, but the blood vessels were too thin and were still hanging in the air. Director Zhang felt that his hands were obviously not moving properly and could not reach the state he had been in during the past few days of training.

When he was about to put in the needle, his heart skipped a beat, and he moved the needle again. He didn't dare to sew any more, because he might not have stopped the rhythm of his heart's beating.

Director Zhang evened his breathing and tried hard to find the rhythm of his heart beat. After trying at least a dozen times, Director Zhang managed to get a stitch, and he felt that the quality was not high.

Director Wen saw Director Zhang struggling, so he said:

"Professor Yang, please come over and take a look and help me!" Director Wen ordered the doctors in the audience.

A doctor immediately ran out after receiving the order and came to Yang Ping's operating room: "Professor Yang, Director Wen asked you to come over and help. The coronary arteries have been exposed and the blood vessels are very thin. They find it difficult." The exposure of the cervical spine here is similar. Yang Ping told Song Yun: "Put the automatic retractor in place, pad it with gauze, and then completely stop the bleeding. Then wait for me for a while. I will go over and take a look and then come back."

Yang Ping didn't wash his hands yet because he wanted to complete the child's coronary anastomosis before going on stage.

"Professor Yang?" Director Zhang didn't know who Professor Yang Director Wen was talking about.

Director Wen said: "We have a specially appointed professor in the Department of Orthopedics who is very good at anastomosis of blood vessels under the microscope. I discussed it with him before the operation. If the blood vessels are found to be too thin, I will ask him to help. We are older, so these Let young people try their hands at fine work."

"That's okay. Do you still have a specially appointed professor? From which hospital?" Director Zhang was very surprised. He just wanted to take a break and catch his breath.

"Yang Ping from Sanbo Hospital, the young man who published 13 CNS articles." Director Wen introduced the key points.

As soon as he heard about the 13 papers, Director Zhang immediately understood: "The young man you mentioned, is he in the operating room now?"

Before Director Wen could answer, Yang Ping had already come in with washed hands. The doctor who was leading the way helped him put on a surgical gown and put on a microscope.

"The blood vessels are quite thin, less than 1 millimeter. It's a bit difficult. We just performed surgery for a long time, and now we only have one needle." Director Wen introduced the progress of the operation.

"Has the internal mammary artery been harvested?"

"Get it!"

Yang Ping arranged the sterile gloves on his hands while walking towards the operating table. Director Wen moved aside to make way. Yang Ping looked into the chest, then turned to the doctor to help adjust the head-mounted microscope.

This blood vessel is indeed very thin, which makes it a bit difficult for the two directors. To do a good thing, I might as well help them perform the operation.

"How many? Bring the needle and thread, put a bent plate next to it, and put a pair of ophthalmic scissors in it." Yang Ping said, taking the needle holder from the nurse and starting to work.

"Two!" Director Wen said.

Director Wen thought Yang Ping had to do some research before taking action, but he didn't expect the young man to be so impatient and start taking action now.

This kind of surgery routine is videotaped, but there is no viewing screen here, so Director Wen and Director Zhang can only look into the chest cavity. Yang Ping sews stitches and cuts threads by himself. It is as easy as sewing skin, and there is nothing like that. It felt very cautious, and it was done very quickly, with dozens of stitches in just a few minutes, and the two bridges were built.

"That's it!"

As he said that, the blood vessel clamp had been loosened and the two bridged arteries had begun to pulsate. Yang Ping used a piece of gauze to gently press the blood vessel and its surroundings, and then released it. The blood flow was good and there was no sign of blood leakage. .

"I still have surgery over there, two directors, I'll go over first."

Yang Ping didn't say much, and immediately began to take off the surgical gown and gloves, preparing to re-do the surgery on his own hand.

I left quietly, taking away only a confused look!

Everyone watched Professor Yang hurried onto the stage and left hurriedly a few minutes later.

The two directors stood there numbly, not knowing what was going on. They looked inside for a few times at the same time, and then turned around at the same time to ask the doctor in the audience to turn the microscope back. When they looked inside carefully, they found that the blood vessels had already been removed. The anastomosis is good, neat and beautiful, and the coronary artery pulses well.

This is just for fun, the bridge is already built? Is it so easy to build a bridge? true or false?

The two directors looked at each other, then looked inside carefully again almost at the same time. They picked up the vascular forceps and gently lifted up the blood vessels to check. The sutures at the anastomosis were really neat. They had never seen more beautiful sutures than this.

Director Wen wanted to ask a few questions, but Yang Ping had already left and he had long since disappeared from the operating room.

I was just preparing to have a big fight, and now I'm going to end the operation so directly? Director Zhang asked uncertainly: "Call it over? Should we close our doors?"

The two directors were neatly dressed. It was impossible for them to just stand like this for a while and then do nothing. It was a record-breaking operation anyway. I don’t know if it was the youngest coronary artery bypass grafting in the world, but it was certain that it was done nationwide. There is no big doubt that it is the smallest and the smallest in Asia.

Several doctors nearby were also dumbfounded. They had never seen such a fast bypass. It was still the most difficult coronary artery bypass for a one-month-old baby. Even Professor Xu Yongzhong from Fuwai had the fastest record of 2 minutes and 30 for a single bridge. seconds, which is the highest ever recorded, and that's for adults.

Now for this one-month-old baby, it only takes about two or three minutes to complete the two bridges. He can still complete it by himself without the help of an assistant at all. This level is really illogical.

"Close the chest!" Director Wen gave the order and the operation continued.

What Professor Yang said for a few minutes yesterday, Director Wen didn't pay attention to. He just treated it as a young man's oral pleasure. He didn't expect it to be true. At this speed, no one could react.

Director Wen sewed and Director Zhang cut the threads. They flew all the way from the Magic City to the Imperial Capital. Today’s job is to tie knots and cut the threads.

"How about you sew and I cut the thread?"

Director Wen was really embarrassed, so he invited Director Zhang from Shanghai, but only the thread-cutting job was left. Why should he do something with high technical content? Skin sewing is more technical than thread-cutting.

Director Zhang said helplessly: "You can continue sewing——"

Is there a difference between leather sewing and thread cutting? It's not the same thing. Now Director Zhang is too embarrassed to take the 20,000 yuan for flying knives. He just waits and doesn't pay for it and treats it as voluntary labor. It's really embarrassing.

The two directors remained silent, burying their heads in closing the chest carefully. The entire operating room was also silent except for the whirring sound of the anesthesia machine.

"Anesthesiologist, how is the situation?"

Director Wen stitched the last stitch, and Director Zhang cut the last thread.

The anesthesiologist is having a hard time: "Resuscitation may take a long time."

The dosage of the medicine is a bit high. This operation was supposed to take several hours to prepare. Now you are finishing it so quickly without notifying me in advance. Who dares to only give half an hour of dosage for an operation that lasts several hours? It is a non-stop coronary artery bypass grafting. If the dose during the operation is not enough and the patient becomes agitated, which affects the surgical operation, it will be a big deal.

"Just wait!" Director Wen said helplessly.

Is there anything else I can do? I was sloppy today!