Surgical artist

Chapter 419 Advanced Concepts
Kyoto University of Medicine.

The thunderous applause almost toppled the roof of the auditorium.

Although this class is over, Zhao Peiru's simple teaching method and profound medical knowledge still deeply penetrated the hearts of these students.

In the first row of the auditorium, Zhan Kuo from the Affiliated Hospital of the University of Medical Sciences also applauded with everyone.

In his mind, the key word that Zhao Peiru raised before was always lingering.

"Layered Anatomy".

This keyword gave him inspiration somewhere.

He felt that this concept was very consistent with a recent difficult case in their hospital, but he couldn't grasp it.

This concept is very advanced, and it seems that it was first proposed by foreign countries, but so far, no one has been able to elaborate on it more specifically.

But just now, when Zhao Peiru used this concept to prove his improved technology, he could do it with confidence, as if he had a deep understanding of this advanced concept.

The only pity is that Zhao Peiru did not discuss this concept in depth in class.

"Dean Zhao should be going backstage now."

Zhan Kuo squeezed through the crowd, and wanted to go to the backstage to find Zhao Peiru, and have a good chat with him about the concept of "layered anatomy".

But at the backstage, Zhan Kuo looked around, but he never saw Zhao Peiru.

He grabbed an acquaintance, Zheng Guoxin, a staff member of the Medical University, and asked, "Xiao Zheng, where is Dean Zhao who was lecturing just now? Why can't you see anyone in a blink of an eye?"

"Director Zhan, you haven't left yet?" Zheng Guoxin said: "It should be summoned by the superiors. Dean Zhao has a high status, and many leaders have to queue up if they want to see him. This time Dean Zhao came to our medical university. Many leaders heard the news and turned it over."

Zhan Kuo nodded slightly.

To put it bluntly, top experts are scarce.In comparison, there are quite a few leaders in various departments and departments.

These leaders all want to take the opportunity to meet this new famous doctor in the field of pancreas who can be recognized by the three founders of Zou, Xu, and Peng. Whether it is public or private, they can form a good relationship.

"It seems that Dean Zhao Peiru won't be able to leave for a while."

Zhan Kuo could only give up his plan to see Zhao Peiru and leave first.

After a while.

Zhan Kuo returned to the Second Affiliated Hospital of Kyoto Medical University.

"Director Zhan."

"Director Zhan."

Everyone, greet respectfully.

After Zhan Kuo and the others nodded slightly, they went straight to the office and said, "Call Director Zhuo from Section [-] and Director Lian from Section [-]."

After a while, everyone gathered.

Zhan Kuo is the director of the first department of liver, gallbladder and pancreas, and the directors Zhuo and Lian he summoned are the directors of the third and fourth departments.These three subjects are more or less involved in the field of pancreas and pancreatic head.

"Continue to discuss the 12-bed case of Liu Jianming."

Liu Jianming's pancreatic head cancer with obstructive jaundice is the most complicated patient they have received in the past six months.

Been stumping them for a week.

Over the past week, they have been looking for and discussing a treatment plan. There have been more than a dozen consulting experts from various hospitals, but they have not been able to come up with a satisfactory treatment plan.

"Director Zhan." Director Sanke Zhuo said:
"The purpose of our operation on Liu Jianming is to remove the lymphatic and connective tissue between the inferior vena cava and the abdominal aorta. The hepatoduodenal ligament is boned and cleaned, the left side of the portal vein is separated from the pancreatic neck, and all the pancreatic hooks are removed. The soft tissue on the right side of the superior mesenteric artery and the mesduodenum were resected together, and the vessels invaded by the tumor were reconstructed..."

As soon as the purpose of this operation was mentioned, everyone's expressions became a little dignified.

In this operation, there are too many surgical purposes that need to be completed.The patient's condition is too serious.

Surgery is like repairing a broken car. If the damage is not serious, just a little repair will be fine.

The pancreatic head area of ​​this patient is like a broken car. There are too many repairs, and the cost of treatment is also rising.

Even Zhan Kuo was a little hesitant. Would it be better to do a transplant directly?
Transplant surgery is not that simple, not only need to match, but also consider the issue of rejection.The human body is not a real machine, and the original one is the best for people, but if it can be "repaired" and repaired, try not to replace it with others.

At this time, Director Lian of the fourth department said: "I don't care about the purpose of the operation. The worst thing is that the operation time will be longer. If it is really not possible, two operations will do."

He sighed, "The key difficulty is that once the operation starts, nerve invasion will constitute the main way of retroperitoneal infiltration, which will cause residual tumor tissue in the retroperitoneum."

"How to clear the nerve plexus and lymph nodes around the retroperitoneal vessels is the most troublesome point."

The experienced experts from various departments who were observing below also nodded with serious expressions.

This medical case really stumped the dozen or so experts.

The atmosphere was silent.

After a while, Zhan Kuo suddenly spoke.

"Didn't Director Deng say that he wanted to take advantage of Xie Miao, a sea market expert, to come to Beijing and ask his opinion? Has Director Deng gone?"

The "Director Deng" in Zhan Kuo's mouth is the chief director of the Second Affiliated Hospital of their Medical University.Xie Miao, an expert who planned to come to Beijing because of the "Liang Zhongyue incident", took the medical records to ask his opinion.

This expert Xie Miao can rank among the top five in the country in terms of diagnosis and treatment of such complicated pancreatic head cases, which is very good.

Director Zhuo of Sanke said: "Director Deng went yesterday, and expert Xie also gave us a proposal. Take a look."

Zhan Kuo took it over and looked at it again.Frowning slightly, Xie Miao's expert plan is similar to one of the several sets of plans they have researched by themselves.

However, I have to admit that the level of expert Xie Miao is still slightly higher, and there are a few improvements in the plan, which are indeed slightly better than theirs.Although it's not much better.

This is not to say that Expert Xie's level is not good, but in the face of this complex patient, it is quite difficult to think of these few improvement points.

Director Si Kelian said: "If in the end, I really can't think of another plan... In my opinion, let's use Expert Xie's set."

Most of the people in the room nodded slightly, agreeing to the proposal.

At this time, Zhan Kuo suddenly said:

"Have you heard of... the concept of layered dissection?"

Everyone was stunned.

Zhan Kuo continued: "Whether it is our plan or Expert Xie's plan, the main direction is to clean up around pancreatic tumors and large blood vessels."

"However, we all have a common problem in these operations, which is that the lymph nodes and nerve plexuses in the right side of the superior mesenteric artery, the retroperitoneum, and the abdominal aorta cannot be fully cleaned. This will result in a large amount of tumor-friendly lympho-fatty tissue Residual. Ultimately, it will cause the patient to relapse in the future."

Several other department directors also looked serious.

They have been unable to discuss a plan for a long time. In fact, they are worried about this.

Can't do surgery?

can do.

But two years after the treatment, the patient will come back to the hospital in nine out of ten cases. When the disease recurs, chemotherapy can only be used to treat it.They give the patient chemotherapy for another one to five years.

Ultimately, death.

Could it be that this is the fate of such complex and critically ill patients?

The directors of their departments have been reluctant to use the knife for a long time. This week, they have been racking their brains to find a way to ask experts...

Just want to change the fate of patients.

Not only will it change the fate of this patient, but it will also change the fate of more similar and complicated pancreatic head cancer patients in the future.

Zhan Kuo said: "Today, I heard a new idea, layered anatomy."

"The main purpose of layered dissection is to proceed from the shallow to the deep...the excision and cleaning are performed according to the procedure, so that the surgical steps are clear and the surgical field is clear. Especially when dissecting the inferior vena cava and abdominal aorta, change 'avoid blood vessel' to 'find' Vascular', the philosophy of the surgery itself changes."

Zhan Kuo gave several people the concept of layered anatomy that he heard from Zhao Peiru today.

The eyes of several department heads lit up when they heard this!
This new concept, explained by Director Zhan, may really be able to fully clean up those lymph nodes and nerve plexuses that could not be cleaned in their previous operations?To give the patient a clean, tumor-free body?Thoroughly eradicate the root of the disease buried deep in the body?

"Director Zhan, whose idea is this?"

"Surgical techniques under this concept should be completely different from our plans."

"This kind of concept is completely reinvented, very groundbreaking!"

The previous plans of theirs seem to have several sets, but in fact they are all different applications and extensions of the same ideological purpose.

And this new concept is completely different from their roots.

Zhan Kuo said: "Didn't I go to attend class in the morning..." He explained the situation.

Everyone suddenly realized that it was Dean Zhao Peiru.This man has become very famous recently, and now he puts forward such an advanced concept. It seems that his thinking is indeed very advanced.

"Unfortunately, this is just the prototype of the concept, it's too obvious."

"I guess, this is just a preliminary idea of ​​President Zhao Peiru, it has not yet formed, let alone applied."

It is a long process for an idea, from conception to actual use on the operating table, to be continuously improved, optimized, and finally matured.Even many ideas will be found to be "impractical" in the process, and thus be discarded.

Everyone discussed for a while, and finally decided.

Let the Second Affiliated Hospital of the University of Medical Sciences come forward to see if they can invite the dean Zhao Peiru to their hospital.

If you can invite me, then try to see if this new concept can be applied to this complex case.

If it doesn't work, then go back and continue to use the method of Haishi expert Xie Miao.

……

At this moment, Zhao Peiru is in the lounge of Hexie Hospital, packing his things and preparing to fly home.

When he came to Beijing this time, he performed surgery on Liang Zhongyue, gained great fame, and was also recognized by the three founders of the pancreas field.

He also went to Kyoto Medical University to give a live lecture, which was simultaneously recorded into a course video, which will be launched on the "Medical Education App" soon, and doctors all over the country will be able to watch his courses.

After coming to Kyoto, his reputation skyrocketed, and it was time to leave.

At this time, Zhao Peiru received a call.

Looking at the caller ID, it was Deng Changbing, a council member of the Medical Association.

Deng Changbing insisted on sending Zhao Peiru off and sent him to the airport himself.

When other experts left Beijing first, only the three founders enjoyed this kind of treatment of "the director personally sent him to the humanitarian airport". Now, Zhao Peiru is the fourth person to have this kind of treatment.

Soon, Deng Changbing's car came downstairs and picked up Zhao Peiru.

The leaders of Hexie Hospital, as the host, also showed up one after another to see Zhao Peiru off.

Just at this time, the vice president of Hexie Hospital answered the phone, and hurriedly said to Zhao Peiru who was about to get in the car:

"Dean Zhao, this is Dean Hong from the Second Affiliated Hospital of the University of Medical Sciences. They are coming over soon and asked if you could wait for them."

Deng Changbing looked at the time, "Why is this old Hong joining in the fun? If he is late, he will miss the boarding time."

He also thought that Dean Hong of the Second Affiliated Hospital was here to meet Zhao Peiru and make a good relationship.

At this moment, a car suddenly stopped in front of everyone. It was the car of the Second Affiliated Hospital of Medical University, and several people got out of the car in a hurry.

Dean Hong led the way, and behind him, Director Deng of the Department of Surgery and Director Zhan Kuo of the First Department of Hepatobiliary and Pancreatic Surgery were among them.

Dean Hong is a short, gray-haired man in his fifties. He got out of the car and quickly explained the situation.

Only then did Deng Changbing and the others understand that Dean Hong came here for a serious business.

"Dean Zhao, our director Zhan Kuo said that your concept of layered anatomy may be very suitable for treating this type of patients."

"Is your idea just a prototype at present, or is it mature enough to be applied clinically?"

Zhan Kuo also looked at Zhao Peiru, holding the medical record in his hand.

Zhao Peiru saw the medical record folder at a glance: "Let me look at the medical record."

Zhan Kuo quickly handed it to him.

At the scene, a group of people just waited quietly.

Deng Changbing still looked at his wrist from time to time, silently counting the boarding time.

Zhao Peiru read all the materials after only a few minutes.

He said: "The idea of ​​layered anatomy is mature enough that it can be directly applied to the clinic. This patient can be treated with the method of layered anatomy."

"Director Deng." He turned to look at Deng Changbing: "Please refund my ticket, it seems that I have to stay in the Second Affiliated Hospital of the University of Medical Sciences for two more days."

When he said this, it seemed to give Zhan Kuo, Dean Hong and others a reassurance!

Deng Changbing also smiled, he didn't want Zhao Peiru to leave so early.This kind of cutting-edge talent comparable to the level of the three founders will definitely be beneficial to this place if he stays in Kyoto for a few more days.

Zhao Peiru took Dean Hong's car and went directly to the Second Affiliated Hospital of the University of Medical Sciences.

In the car, Zhao Peiru looked at [Task [-]] in his mind.

【Task [-]: Apply advanced concepts in the field of pancreatic head cancer】.

Originally, he thought that this mission would have to go back to the southeast region and Jiangnan province.

Unexpectedly, I continued to complete it in Kyoto.

In his hands, he spread out the medical records.

In this medical record, the "layered anatomy" concept that needs to be used meets the requirements of the "advanced concept" of task two.

(End of this chapter)