godfather of surgery

Chapter 859 The King

Professor Liang knew that Yang Ping originally had a background in trauma surgery. At that time, Sanbo Hospital established a trauma emergency center and followed the path of composite trauma surgery. The team led by Yang Ping was the absolute main force. He also knew that Sanbo Hospital and the University of Tokyo in Japan There was a social gathering, and Yang Ping's surgery on a special case shocked the audience.

This case is very special. There is a huge hemangioma in the patient's abdomen. The abdominal injury caused serious damage to the internal hemangioma. The hemangioma itself is a tortuous mass of blood vessels intertwined, and then connected to different blood vessels throughout the abdominal cavity. Once damaged, There is no way to stop the bleeding, and the only option is to remove the blood vessels entirely. To remove a huge hemangioma, all blood vessels related to the vascular flow must be cut off and ligated.

This is more difficult than any complex abdominal trauma surgery because hemangioma is unique, there are no identical cases, and its anatomy is unfamiliar to any doctor.

A huge hemangioma with hundreds of blood vessels at every turn was a hellish operation, but Yang Ping still performed the operation.

Song Yun, Kong Weiquan and other orthopedic surgeons were excited. Professor Yang was the real king of trauma surgery. No one could beat him in terms of surgical concept, surgical level, or surgical speed. It was unexpected that he could still see the professor performing such a trauma surgery today.

"Professor Yang also performs trauma surgery?" a doctor next to him asked Song Yun.

Song Yun couldn't restrain the admiration on his face: "You will see what it means to be a king in emergency trauma surgery later."

Orthopedic surgeons know that Yang Ping is the king of trauma surgery, but other doctors do not know that, such as neurosurgery, thoracic surgery, basic surgeons, etc. Doctors in these departments only know that Yang Ping has published 13 papers and have seen Yang Ping's cardiac surgery. and pancreatic surgery skills, but I didn’t know he was the king of trauma surgery.

When the orthopedic doctor said this, everyone was excited and wanted to see the level of king that Song Yun said.

Soon, Yang Ping came back with Qiu Nuo after brushing his hands. The two directors, Director Long and Director Wen, also came to help Yang Ping put on the surgical gown. This made the doctors around him envious.

These doctors usually get scolded by the two chief directors. Now the two chief directors are so kind to Yang Ping and personally help him put on the surgical gown. What else can you say about his status.

The most important thing in the operating room is his special equipment nurse. No boss in Xiehe would dare to be so awesome.

It's not that Yang Ping deliberately acted like a big star, he never thought about this at all. In Xiehe, Qiu Nuo was the one who paired up with Yang Ping the most, so Yang Ping brought her on stage without any other intention.

As Yang Ping's quasi-special equipment nurse at Xiehe, Qiu Nuo was very proud. Especially on such an occasion, it was such an honor to follow Yang Ping on stage.

Yang Ping put on the surgical gown and gloves, and Director Xu immediately gave up his position as the surgeon.

Director Xu no longer needs to think too much about Yang Ping's strength. He just used a few words of remote control command to help him solve several dangerous bleeding points. These bleeding points have not been solved by Director Xu for a long time.

All the doctors in the room immediately became nervous, especially the orthopedic surgeons. They immediately looked for the most suitable observation position. Yang Ping was the king in their hearts. The king came on stage and attracted everyone's attention.

Yang Ping raised his hands in front of his chest, his eyes were confident, his posture was upright, and his aura of king instantly enveloped the entire operating room.

"Thank you!"

He politely responded to Director Xu giving up his position as the surgeon, and then stood in the position of the surgeon without hesitation.

"Director Xu, please stand opposite me!"

Standing on the opposite side means acting as the first assistant. Yang Ping needs a high-level assistant to be able to display his own skills.

After quick adjustments, the positions of the surgical team were quickly adjusted. A young doctor was the chief surgeon, and a group of big shots were assistants to accompany him. This was something that all the doctors in the audience could not even dream of.

In a race against time, Yang Ping immediately operated:

"Remove the suction tubes of all suction devices and use the suction head to suction directly. Prepare five vascular forceps at a time and replenish them immediately after use; put a turning plate next to it -"

"Anesthesiologist! What are the patient's vital signs?"

"Tissue scissors! Suture needles and threads without damage, and anastomose the aorta!"

In just a few words, he told all the things to be done immediately and the things to be done next. Qiu Nuo and Yang Ping had played together many times, so they were familiar with Yang Ping's habits and could cooperate as much as possible.

In fact, it would be difficult for nurses to adapt to Xiehe Hospital, which would seriously affect the speed of surgery.

Yang Ping's idea was very clear and simple. He would first control a few large bleeding points, then seal as many bleeding points as possible, then pull out a few short steel bars, and finally deal with the two long steel bars.

Performing this major surgery is like fighting a war. You must have strategies and tactics to take the initiative on the operating table.

Relying on aortic occlusion is a temporary measure. Once the time is exceeded, the organ may suffer from ischemic necrosis, so even if the operation is successful, the patient's life cannot be saved.

Therefore, hemostasis and hemostasis must be completed first! It will always be the core technology of trauma surgery.

Yang Ping began to anastomose the aorta in the narrow space of the other hand. The aorta and inferior vena cava are currently the major sources of bleeding.

Yang Ping took the tissue scissors and cut off the aorta without hesitation, removing the bruised part in the middle. Because a small section had been bruised, you couldn't see it unless you looked carefully. Such a severely bruised blood vessel cannot be left at all, and it will definitely form a hemangioma in the future. It's like leaving a time bomb behind.

Anyway, for Yang Ping, repairing a blood vessel would take about the same amount of time as anastomosis, so he simply cut off and re-anastomized it in one step to avoid future troubles.

This sudden operation on the tip aorta shocked the doctors present. The cut had to be sutured, and there was not much time left for the occlusion. It was such a delicate operation at this time, and the space was so small that the anastomosis was not easy to perform.

Yang Ping started to anastomose the aorta without any thought at all. Because of the obstruction of the steel bars, the space left for the operation was too small, but this was not a problem. How could the level of the king be affected by a few steel bars.

Yang Ping's suturing movements are extremely small, and the entire movement is completed with the cooperation of fingers and wrists. The upper part of the wrist is very stable, without any compensation of movements.

There are even some subtle movements without even moving the wrist, and the instrument is controlled with just fingers.

Director Xu helped cut the thread, but even stretching out the scissors felt awkward, but Yang Ping could sew easily. This made Director Xu discover for the first time that suturing was also a technical job, and he could actually do it to this extent.

What was most unacceptable to Director Xu was that he found that his thread cutting could not keep up with Yang Ping's suturing speed. The instrument flashed and he couldn't see the specific movements of his hands at all. The suture and knotting had been completed, and he hurried to cut the thread. While suturing, Yang Ping looked upstream from time to time at the chest cavity: "Stop the bleeding first, no need to remove the lobes. I will help you later. Give me the vascular clamp."

The aorta is being sutured here, and there is still time to see what other operations are being done on the chest. Just when the thoracic surgeon and cardiac surgeon felt that Yang Ping was being nosy, Yang Ping actually asked for the vascular clamp in the cardiac surgeon's hand.

The cardiologist was intimidated by his aura, so he had no choice but to give it to him. Yang Ping moved the blood vessel clamp in and clamped a blood vessel.

"Get a few more vascular forceps! I'll help you stop the bleeding, and you can take a breath." Yang Ping ordered the cardiac and thoracic doctors, and then continued to suture the aorta.

The extracardiac and thoracic doctors looked confused. They stretched their hands so long that one of them was performing surgeries on both sides. But the forceps they used just now were really awesome. They clamped the blood vessels that were bleeding the most from the ruptured lung wounds. live.

In less than a minute, the aorta had been sutured, and then Yang Ping cut off the inferior vena cava and re-anastomized it, still so fast.

The doctors upstream who handled the chest were Director Deng from the Department of Cardiac Surgery and Director Rong from the Thoracic Department. The two directors confusedly asked the equipment nurse for a few vascular forceps in their hands.

Yang Ping saw their blood vessel forceps out of the corner of his eye. Taking advantage of Director Xu's free time to cut the thread, Yang Ping quickly took a pair of forceps from Director Deng's hand and put it in, clamping another blood vessel accurately.

Director Deng and Director Rong were dumbfounded. What should we do?

Before his mind could turn around, all the blood vessel clamps in his hands were drawn out.

"Give Director Deng a few more vascular clamps!" Yang Ping ordered the nurse.

Why did he urge the blood vessel clamp? Director Deng realized that Professor Yang had clamped so many blood vessels, so we intuitively ligated the blood vessels he clamped. Isn’t it good? So the two of them stopped being dazed and started ligating the blood vessels that Yang Ping had clamped.

Then a funny scene appeared. Yang Ping was very rhythmic. Every time Director Xu cut the thread, he would take a vascular clamp from Director Deng's hand and put it into the chest. Director Deng and Director Rong immediately started ligating the blood vessels.

Director Deng is also very conscious now. As soon as the blood vessel clamps are used up, he will immediately ask the nurse for a few and hold them in his hand while Yang Ping comes to draw them.

The doctors nearby were stunned when they saw this cooperation on the operating table. What kind of weird operation is this?

The inferior vena cava here has been anastomosed. After the two major bleeding cases were resolved, Yang Ping loosened the aortic clamp and checked the sealing degree of the anastomosis. He found that there was no problem.

Yang Ping began to eliminate the bleeding points on his side, and more bizarre operations began to appear.

Yang Ping held a pair of vascular forceps in his hand, put one into the abdominal cavity, and then another into the chest, repeating this boring action, while several directors worked desperately to ligate the blood vessels.

Every time a vascular forceps is put in, you can obviously see that the bleeding in that area slows down or stops. Just like this, batch after batch of vascular forceps are put in, some of which Yang Ping removes organs or tissues and puts them in, and some of them still Put it in from the gap between the steel bars.

A few more were put in from under the pancreas and liver, and the bleeding that was very troublesome just now stopped. After such an exaggerated operation, the thoracic and abdominal cavity areas now looked very clean.

After all, Director Xu is also the director of emergency surgery at Union Medical College, and he is one of the best in the country. He has been practicing medicine for 20 years and has never seen such an operation.

Director Deng and Director Rong upstream glanced at Yang Ping from time to time. He must have cut all the bleeding blood vessels. Why are they so familiar with the location?

When the doctors watching the battle saw this scene, their perceptions were refreshed over and over again, and they finally saw the level that Song Yun said was the king.

Now that the original bleeding point has been stopped, Yang Ping began to separate the two short steel bars. The scalpel cut along the steel bars and separated them, just like peeling off wrapping paper. Little by little, layer by layer, the steel bars were peeled off. All blood vessels will be ligated in advance, and there will be no bleeding at all.

All dangers around the steel bars were removed, and key parts were protected with hooks. Yang Ping easily pulled out the steel bars.

Director Xu, who has always been gentle, wanted to say what he thought was a bad word at this time - awesome Klass!

It seemed that other than this word, he could not think of any suitable words to pay tribute to the king in front of him.

No matter what it encounters, the scalpel cuts all the way through. It is invincible and unstoppable. Another steel bar passes through the liver, so what, the scalpel peels off the steel bar with force.

During the peeling process, in addition to hemostasis, debridement is also completed.

Two short steel bars were easily taken out.

Director Xu thought he was very fast in surgery, but in front of Yang Ping, he felt like he was just too fast. How did he develop such speed?

This kind of through steel bar cannot be pulled out directly and violently, for many reasons.

When steel bars penetrate the human body, they will cause damage to organs and tissues along the way, and will inevitably cause rupture of blood vessels. However, the specific extent of the injury is unknown. Originally, steel bars put a certain amount of pressure on surrounding tissues, and this pressure has a certain hemostatic effect. Once the steel bar is pulled out, the compression disappears instantly, and the blood vessels that were previously compressed immediately open up. There was no bleeding for a while and now it starts to bleed. The bleeding that was originally relatively small now suddenly increases.

At this time, all the damage and bleeding were concentrated in a long tunnel. The doctor could not stop the bleeding and could only hastily cut open the long tunnel.

There is also a method of filling the tunnel with gauze, which seems useful, but is actually useless because the so-called tunnel is not continuously closed and the anatomy in the middle is complicated, making it impossible to fill it all the way from the entrance.

Dirt, foreign matter, and devitalized tissue can accumulate in the tunnel, which are sources of infection.

Moreover, there is still a certain degree of adhesion between the steel bar and the surrounding tissue. Once pulled out, the force of tearing and friction will increase the damage and tear the adhering tissue into pieces, causing serious secondary damage.

Therefore, when dealing with this kind of steel bar, it is necessary to cut as much as possible and stop bleeding while incision. If it cannot be cut, it is also necessary to fully understand the anatomical relationship around the steel bar, understand the scope of damage, and try to separate the steel bar from the surrounding tissue. separate.

In short, the principle is to clearly identify where the steel bar is damaged, so that when the steel bar is pulled out, there will be no sudden bleeding or increased damage. It should also be convenient to clean foreign matter, contaminated tissue and inactivated tissue to avoid infection. It is best to pull out the steel bar. The surroundings are well protected when going out.

The two short ones were pulled out, and the remaining two long steel bars were the main enemies. Yang Ping took his time.

PS: I wish everyone a happy New Year, good health, a happy mood, and all the best! Thank you for your support over the past year and take a bow!

(End of this chapter)