godfather of surgery
Chapter 851 A professor should look like a professor
When the anesthesiologist said this, Director Zhang quickly returned the pen.
Professor Yang is indeed interesting. This way of holding the knife is very innovative. The key is that it is very easy to use. Director Zhang had never had any idea about the posture of holding the knife before. Surgeons have been holding it this way for a hundred or two hundred years, and neither have they. Who feels wrong.
In fact, some medical things are just like this. They have always been done according to tradition. Why exactly they are done this way is not clear at the moment. Anyway, it is passed down like this from the older generation.
One day, someone suddenly made an innovation, and everyone suddenly discovered that it could be like this.
The tumors in the spinal canal and epidural have been completely removed, and even the tumors in the intervertebral foramen have been cleaned up. There is no longer any pressure on the nerve roots. A bunch of tumor tissue is thrown into a metal basin and is ready to be sent to the pathology department. check.
A few liberated nerves lie quietly in the spinal canal, freely protruding from the intervertebral foramen, and then rush to their own world. The numerous scars on the "body" reveal the humiliating years of oppression, and they once used pain as a form of resistance. Now, oppression is gone, which means resistance is gone too. Presumably the patient will be able to sleep peacefully and live a pain-free life within a certain period of time.
"Professor! This patient shouldn't be in pain anymore, right?" Song Yun asked.
Yang Ping returned the equipment in his hand to the steering wheel: "I will answer you after tonight."
Song Yun was startled. This answer was a bit cunning. When did the professor become so cold and humorous?
"Close the mouth. The old rule is to use interrupted sutures for each layer." Yang Ping gave up the position of the surgeon and left the rest of the finishing work to Song Yun. As a professor, he should look like a professor.
Most doctors prefer continuous sutures for tissues within the skin. In one word - fast!
However, if one stitch is loosened in the continuous suture, the entire layer will also become loose. Even the current barbed thread cannot solve this problem.
Intermittent suturing is time-consuming, but each loose stitch is one stitch. Each stitch is independent and does not interfere with each other. It is safer than continuous suturing.
There is absolutely nothing wrong with using this saying in medical treatment.
Song Yun and a doctor began to close the incision. Seeing that the surgical area was clean and there was almost no bleeding, Song Yun didn't even want to put in a drainage tube, but he put one in according to the procedure.
"Professor Yang, the way I hold the knife is a bit special, do you have anything to say?"
Director Zhang was quite curious and asked as he helped Yang Ping take off his surgical gown.
"Fancy knife holding! It's called flower knife for short!" Yang Ping replied.
Fancy holding the knife, flower knife, it has such an evil name, but it does sound nice and has a strong character.
"Can you teach me a lesson? I think it's very practical?" Director Zhang didn't care about his face, and only those who were able were teachers. Not only did this young man have two brushes, he was obviously a wholesaler of brushes.
Which one Director Zhang thinks is practical, all doctors think is practical. When Director Zhang asked, the other doctors immediately turned around.
Since someone was asking for advice, Yang Ping was unequivocal. The anesthesiologist next to him handed over his pen: "Use this to demonstrate?"
Demonstration is demonstration. Yang Ping took over the pen and used the pen instead of the knife. The pen was performing acrobatics in his hand. The pen tip could change almost 360 degrees without any dead angle.
The anesthetist was the closest, and he was dizzy. He was a master of pen-twisting when he was in middle school, but he had never become like this. Moreover, Yang Ping was not a pen-twist at all, because the pen was always firmly in his hand, and it was just the cooperation of a few fingers. , allowing the pen tip to show different angles. At each angle, the pen barrel is firmly controlled in the hand.
What a flower!
Director Zhang finally knew why it was called a flower knife, and he planned to go back and think about it carefully.
Professor Hu Guolin, deputy director of the Department of Orthopedics at Union Medical College, took time to come over to see, firstly, his concern for Yang Ping, and secondly, to see if he could learn anything new. He mainly wanted to see the second surgery. The second surgery was scoliosis surgery. The patient had congenital myelomelia and the surgery was extremely risky. Doctors would generally refuse surgery in such cases.
However, the biggest advantage of Yang Ping's Yang's osteotomy is to reduce the risk of postoperative paraplegia. Its principle is to use multiple scientific osteotomies to disperse the deformation of the spinal cord. The reason for paraplegia after spinal orthopedic surgery is that the spinal cord appears after the correction. Deformation, causing squeezing or pulling, thereby damaging the spinal cord.
As soon as he entered the operating room, Hu Guolin met Yang Ping teaching him the skill of cutting flowers. He thought he was doing acrobatics during the intermission in the operating room. Why was Professor Yang so leisurely today?
If it were anyone else, Director Hu would definitely criticize him seriously. What kind of place is the operating room? It is a sacred and serious place. What kind of entertainment program is there? The operation is not over yet.
But he was Yang Ping, so Director Hu had to smile: "Professor Yang, are you doing acrobatics?"
"It's not acrobatics, it's a new way to hold the scalpel - fancy knife holding! Professor Yang is now teaching on-site." Director Zhang explained on the side.
The anesthesiologist also nodded in agreement: "I am also learning from it."
How do you, an anesthesiologist, learn how to hold a scalpel? Director Hu Guolin took a closer look and found that he was really teaching how to hold a scalpel. The scalpel could still be held like this. He wanted to see it, but the teaching ended there.
Song Yun completed the closure of the surgical incision, and the first cervical spine tumor surgery was completed.
The operating room needs to be cleaned and disinfected midway, so everyone moves to the operating room next door. Kong Weiquan is performing minimally invasive endoscopic cervical disc herniation fusion surgery through the anterior cervical approach, which is the cutting-edge technology of minimally invasive spine surgery. He has done many cases under Yang Ping's step-by-step guidance, and now Kong Weiquan is starting to do it himself.
Young doctors master minimally invasive surgery very quickly, not to mention that Yang Ping has already trained them in endoscopic operations.
Hu Guolin marveled at the rapid progress of this group of young doctors and had to admire Professor Liang's vision. If Professor Liang had not withstood pressure from all sides to establish such a department, how would these young doctors have such a good opportunity.
These young doctors, with the attitude of great professors, calmly perform the most cutting-edge surgeries.
The cleaning and disinfection of Song Yun's operating room has been completed. The second surgery was a scoliosis correction surgery. The patient's spine was bent forward and bent to 90 degrees. The condition was much milder than the folding surgery performed by Yang Ping before. However, because of the The reason for congenital myelocele is that the surgery is not easy at all, and the probability of paraplegia after surgery is no less than that of folded people.
But with the help of Yang's osteotomy, the risk will be minimized, so it is not difficult. For the second operation, Yang Ping only planned to stand on the operating table and let Song Yun perform the surgery. Among this group of young doctors, Song Yun was the best in both theory and surgery. Under Yang Ping's guidance, he is now He is very skilled in performing scoliosis correction surgery. If you want to compare with doctors across the country, he must be on the front line.
Song Yunlai will perform this surgery?
Director Hu Guolin was so frightened that he broke out in a cold sweat. Even if he performed the surgery himself, he was still trembling and unsure, so he asked Song Yun to perform the surgery. Although he was also the deputy chief physician, his qualifications were still relatively low.
"Professor Yang, aren't you going to perform this surgery yourself?" Director Hu Guolin asked indirectly.
Yang Pingfeng said calmly: "It's okay, they can do it, I'll do the soy sauce on the stage."
A professor should act like a professor. Do you still have to do this surgery yourself? Director Hu couldn't say anything. This was Professor Yang's territory, and of course Professor Yang had the final say.
The department established by Union Medical College for Yang Ping is an independent ward of the Department of Orthopedics and belongs to the Department of Orthopedics in terms of affiliation. However, it has complete independence in all aspects. Medical activities are not restricted by the Department of Orthopedics or other departments. This is a privilege given by Professor Liang. .
Even Professor Hu Guolin, who is the deputy director of the Department of Orthopedics, now observes the surgery as a brother in the department rather than instructing the surgery.
Scoliosis correction is Song Yun's main specialty, so he is very familiar with it. If we follow the routine of martial arts novels, Song Yun is the true successor of Yang's osteotomy, and he is currently the first true successor in the north.
Generally speaking, for adolescent idiopathic scoliosis of 40 to 60 degrees, if it can be detected early, it can be corrected through relatively simple and safe surgery, and the treatment effect is also the best at this time. Because the scoliosis is not very serious at this time and the spine is relatively soft. Therefore, the surgery only requires implanting titanium alloy screws and placing correction rods in key parts of the spine. Screws and rods can be used to correct deformities more easily. Such surgery is less risky, simple and safe.
But in more severe cases of scoliosis, this simple surgery is not enough, and spinal osteotomy and orthopedic surgery are needed. Special surgical tools are needed to cut off the stiff and deformed spinal bones and then rejoin them to complete the correction. This is the cutting-edge technology of spine surgery - spinal osteotomy and correction.
The biggest risk of spinal osteotomy and correction is damage to the spinal cord and nerve roots.
Compared with surgery without osteotomy, osteotomy surgery has one more surgical step, which requires cutting off the stiff and deformed spinal bones and then rejoining them. During the docking process, the two bones may have docking problems. Once they are misaligned, they will Damage to the spinal cord and nerve roots in the spinal canal. Sometimes even if there is no dislocation, because the degree of spinal correction is too great, the spinal cord and nerve roots inside cannot withstand the accompanying deformation, and will be squeezed or stretched. This squeeze or stretch can cause spinal cord and nerve damage. Root damage. The more severe the scoliosis, the higher the risk.
On the other hand, osteotomy requires the removal of some excess bone and the use of special tools to crush and remove the bone around the nerve. The operation around the nerve root is also dangerous. The instrument may come into contact with the nerve, thereby damaging the nerve.
In order to reduce risks, Yang Ping analyzed previous osteotomy and orthopedic procedures and then improved them.
Any improvement in surgery must achieve certain goals - improving effectiveness, increasing safety and ease of operation. One of the three must be present, otherwise the improvement will be meaningless.
Yang Ping's improved osteotomy method can significantly disperse the deformation of the spinal cord and nerve roots during correction, thereby greatly reducing the possibility of spinal cord and nerve root damage. So far, most of the scoliosis cases performed by Yang Ping are extremely severe, but There was not a single complication of spinal cord or nerve root injury.
Yang Ping’s original minimally invasive spinal external fixator to treat scoliosis has a higher technical content. It cleverly uses Ilizarov’s theory to correct the spine, which not only ensures the stability of the spine during the correction, but also completes the correction process. The technical requirements are very high.
Although Director Hu was horrified, the operation went very smoothly and nothing happened. The evoked potential detector showed no disturbance during the whole process. The advantages of Yang's osteotomy were fully demonstrated in this operation.
Director Zhang is an expert in children's heart surgery, and now he enjoys watching orthopedic surgeries. He came all the way from Shanghai to Xiehe, and the only job left for him was to tie knots and cut threads, but fortunately, the trip was worthwhile, at least Witnessed the unique skills of flower knife.
As for the "labor fee" of 20,000 yuan, Director Zhang has already planned not to take any of it, and the air ticket money he rebates will be used as tuition for observing the surgery.
The third operation was performed on a patient with parasitic infection in the lumbar spinal canal. On the operating table, a live tapeworm with a length of more than 30 centimeters was actually removed. A lot of tapeworm secretions and body segments were also removed, which truly eliminated the parasite. After diagnosis of infection, the tapeworm was sent to the pathology department for pathological examination.
In the two operating rooms, Yang Ping took turns guiding the operations.
I didn't get off work until ten o'clock in the evening after the operation. However, it was normal for me to do it at night at Peking Union Medical College Surgery. It would be abnormal if I got off work early in the afternoon.
Yang Ping still rested in the department at night. Song Yun and Kong Weiquan all slept in the department anyway, so everyone could still chat.
In the evening, Qiu Nuo also cooked some dumplings and delivered them to everyone.
Even Song Yun found it strange that the beautiful woman in the operating room was so nice to the men from the orthopedics department. She treated the guests to dinner and made late-night snacks herself. How could such a nice thing happen in normal times?
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Pan Doudou has been living in the general surgery department. She can only rely on parenteral nutrition now. Apart from organ transplantation, there is no other option. She is also willing to accept an organ transplant. She has been suffering from so many years of illness. As long as the pain can be solved, She was completely willing to accept the organ transplant plan. In fact, she did not go to a hospital. Apart from symptomatic treatment such as enemas and laxatives, there was no other method.
Now that the Internet is developed, you can get a general idea by searching a lot of information. After she knew that she had this disease, she also checked the information. At this stage, there is no other way.
Because she has to wait for a suitable donor, she has been waiting in the hospital, hoping to wait. If she can't wait, she has not thought about what to do in the future. If she is not hospitalized, will she go to the hospital or clinic every day to get several bottles of nutritional injections? ?
Director Fang has been actively helping her contact suitable donors, but donors are not easy to wait for. There are only a few people willing to donate organs, and they have to be matched with the right type.
However, the donors Pan Doudou needs are pancreas, small intestine and stomach. There are relatively few patients who need these organs, so it is relatively easier to wait for them.
Pan Doudou was lucky. Not long after, news came from the City's Second People's Hospital that the family of a young man who was brain-dead in a car accident agreed to donate his organs, and based on the information, Pan Doudou was a good match.
After contacting the other hospital, Director Fang quickly prepared to arrange the surgery.
But what should Professor Yang do in the Imperial Capital these days? Director Fang was so anxious that his mouth was filled with smoke.
Director Fang has never performed this kind of surgery before and needs Yang Ping's guidance. However, it is now midnight and Professor Yang is still in the imperial capital and has not returned.
This kind of surgery cannot wait. It can be done whenever organ surgery is available. The doctor has no control over the time.
PS: I have been very busy these days, and I have posted less today. The draft has not been revised yet, so I will send it out first and revise it when I have time tomorrow. thank you all!
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