The Godfather of Surgery

I have seen a lot of synovial chondromatosis of the knee joint, and so many are rare.

Xiao Wu took off the film, so as not to make the terrorists feel uncomfortable again, he admitted the patient to the hospital, and improved the preoperative examination and surgical arrangements.

Yang Ping continued to study the puncture of the patient in Huaqiao Building, and used the images constructed in his mind to simulate the puncture repeatedly to adjust the angle of the puncture, so as to be sure to hit a hit.

Song Zimo did not rest at noon, and stayed in the laboratory to practice arthroscopy. Tang Fei called him from the cafeteria for lunch. He finished it in the dining room of the department and continued to practice in the afternoon.

It is said that he used to practice in the trauma orthopedics department every night as long as there was no special event, and he practiced until after ten o'clock, sometimes until twelve o'clock.

The CT and MRI 3D reconstruction of the patient in Huaqiao Building has been completed. The thin-slice scan shows the reconstruction effect is very clear. Director Han compared Yang Ping's painting with the reconstructed image on the electronic film reader. There is almost no difference in the spatial structure. Yang Flat drawings are more expressive.

Director Han looked at the time, it was already 4:30, he put down what he was doing and took Yang Ping to the Overseas Chinese Building to attend the general consultation.

In the conference room of the Internal Medicine Department of the Overseas Chinese Building, several directors have already arrived, and so has Director Zhao of the Medical Department. Everyone gathered around the oval table and discussed Mr. Ning's condition privately in advance.

Director Kong greeted Director Han and Yang Ping to sit down. Every seat on the table is equipped with a high-definition tablet computer, which is the terminal of the mobile medical record system. The patient's medical record and auxiliary examination results can be accessed on the tablet computer. The screen of the tablet computer The resolution is much higher than the ordinary one, just to be able to see the details of the image clearly.

Director Kong's phone did not stop, and people came in one after another. All the major directors in the hospital and several professors from outside the hospital came. Director Zhuang of the Internal Medicine Department also came to help accompany the experts from the outer hospital.

This is from the Second Affiliated Hospital—

This is from the First Hospital—

This is from the cancer hospital—

Several directors came over and took their seats one by one. Director Kong and Director Zhuang were at ease and arranged properly without any slights or omissions. The brothers of the Overseas Chinese Building are also the characters on the scene.

The consultation naturally depends on the patient. Some people have already proposed to see the patient first. Director Kong takes someone to the ward to see the patient, and Director Zhuang helps to accompany the client.

Everyone uses this time to reminisce. These experts are usually familiar with the directors of relevant specialties of Sanbo Hospital. They often get together in meetings, and some of them are brothers and sisters.

I'm usually busy, and it's rare to meet each other. Except for academic conferences, it's this kind of general consultation to meet, chat a few words, and talk about each other's current situation.

Only Professor Su Qingyun from Attached One has not arrived yet. He is the main expert of this meeting. Although the patient is liver cancer, the problem to be solved now is caused by spinal metastases. Su Qingyun is the chairman of orthopedics in Nandu Province and an academician. The popular candidate is naturally the most important expert in this consultation. The meeting was postponed from three to five in order to wait for him.

Su Qingyun is still the dean of the First Attached. He is busy with business, and being able to take time to come here is already very saving face. Everyone privately discusses how sacred this patient is. When Professor Su is invited to appear in person, usually some outside hospitals have consultations. Even if he is invited, he will send students there. join.

There were still a few minutes before Professor Su showed up. Yang Ping had met Professor Su before. The Municipal People's Hospital once held an academic meeting, and Professor Su had been there. It was from a distance, not as close as it is now.

Professor Su has published more than a dozen articles in top international orthopaedic journals such as AJAM and JBJS. The impact factor is very high, so he is at the peak level in China and has a place in the world.

Some people raised their wrists to look at their watches, some looked at the door, and some whispered, but they all waited patiently.

Wait a moment to speak boldly, don't have stage fright, academic matters, one is one, the other is two, there is nothing to be humble. Director Han explained to Yang Ping in a low voice.

At five o'clock, Professor Su came in under the guidance of Director Kong, followed by a young doctor who looked like Professor Su.

As soon as Professor Su came in, he greeted everyone with a smile: Sorry! Everyone has been waiting for a long time!

In fact, he was not late, just came in on the hour, but the others came earlier.

Professor Su is in his fifties and does not look old at all. He wears glasses and a tunic suit with a white shirt inside. He has a refined temperament, and everyone shows his demeanor. His powerful aura comes from the precipitation of long-term academic high.

Everyone stepped forward to shake his hand. When shaking hands with Director Han, Professor Su stayed longer: Brother Han, long time no see.

Seeing Yang Ping beside Director Han, Professor Su asked, Who is this?

Doctor Yang, my student! Director Han introduced.

Yang Ping shook hands with Professor Su.

Young people have extraordinary temperament. Professor Han is famous for his poisonous vision. He hasn't recruited a doctor for many years.

This is Dr. Su! Director Han introduced the young man next to Professor Su.

Su Nanchen! The young man beside Professor Su shook hands with Yang Ping.

Yang Ping! Yang Ping could feel his confidence and calmness.

When Director Han was in Modu, he and Professor Su were both outstanding figures of the young generation of orthopedics, but Director Han had to start a new business from Modu to Sanbo in Nandu. Naturally, he couldn't compare with Prof. Su academically, but The foundation is still there.

The two cherished each other, exchanged a few simple words, and then took their seats.

That's Professor Su's son. He graduated from the Xiehe eight-year program with a young talent in orthopedics. After graduation, he studied at the Twin Cities Spine Center in Minnesota and the New York Special Surgery Hospital. He will be your strongest in the Southern Division of the Golden Knife Award. In the national competition area, he is a rare super-strength opponent, and he is also an all-round player. Director Han said beside Yang Ping's ear.

The tiger father has no dog son. This Dr. Su is not only a talented person, but also graduated from the Xiehe eight-year program. The difficulty of the Xiehe eight-year program is not worse than that of Tsinghua University. name.

Professor Su must have high hopes for his son. Otherwise, he would always take this kind of meeting with him. Taking him with him would allow him to see the world, participate in more exchanges, and even help him establish his reputation and contacts.

Everyone sat down, the consultation began, Director Zhao presided over, and the doctor in charge of the bed reported the medical records.

After reporting the medical records, Director Kong added: Dear experts and Professor Su, please take time out of your busy schedule for consultation today. The problem that this patient needs to solve at the moment is the severe pain in the chest, thank you all!

Let's see the patient first? Is it convenient? Professor Su suggested.

Director Kong took everyone to the ward to see the patient. Professor Su personally asked about the medical history and physical examination. Other professors also asked for the medical history and physical examination selectively according to their own needs.

After seeing the patients, everyone washes their hands and goes back to the conference room.

Director Xu of Sanbo Pain Department first spoke: This patient was admitted to the hospital the day before yesterday. From the time of admission to the present, we have been following up on the treatment of pain. According to the ladder principle of tumor analgesia, this patient has been using morphine for three months. In this hospitalization, morphine was used in extreme amounts, 30 mg/time, twice a day, but it could only resolve the pain in the liver area, and the pain in the front chest was still severe. The chest pain caused, according to the nerve location, the area of ​​the anterior chest pain is the innervation area of ​​the anterior branch of the thoracic 2 nerve. According to the CT and MRI images, the thoracic 2 nerve root is just invaded and compressed, so we think it is caused by the thoracic 2 nerve root, unfortunately , it is impossible to perform spinal anesthesia and analgesia here, and once it causes respiratory depression, the consequences will be serious, so we have encountered difficulties and need your help.”

Have you considered using an implantable analgesic pump, implanted into the spinal canal, using morphine as the main drug of the analgesic pump formula, and releasing it regularly, so that it can relieve pain without causing the plane anesthesia and affecting breathing . said the director of the pain department at Attached 2.

After the director of Attached No. 2 finished speaking, the director of the pain department of Attached 1 said: The implanted analgesic pump in the spinal canal is not realistic, and extreme amounts of morphine have been used to suppress pain in the liver area. This kind of radicular pain is based on our experience. , Morphine is almost ineffective. We have used it in the lower plane before. If the nerve root is healthy and there is no tumor invasion, it is effective. This kind of tumor tissue has already invaded and stretched. Morphine is ineffective, and anesthetics must be used to block the nerve. stagnant.

The director of the pain department in Attached 2 also had a different opinion: The nerve block is too difficult and almost impossible to do. Usually, when we block the nerve around the sheath, even if the sheath is punctured, there will be anesthesia leaking out. To block, it must be ensured that all the anesthetics are in the nerve sheath and cannot leak out, otherwise the plane will be anesthetized and breathing will be suppressed, and only a ventilator can be used to assist breathing.”

After a brief silence, the professor of the cancer hospital spoke: Whether to consider localized surgery, move in from the back, just excise the tumor tissue that compresses and invade the nerve root, relieve the compression, liberate the nerve root, and the pain will be eliminated naturally.

The family refuses the operation, even if it is limited! Director Kong explained.

Not willing to operate, but also to solve the problem, this is a problem for us. said the director of the orthopedics department attached to the second.

The Department of Orthopedics in Attached 2 ranks second in Nandu Province. A long time ago, Department of Orthopedics in Attached 1 and Attached 2 were evenly matched. Since Professor Su Qingyun became the Director of Department of Orthopedics, Department of Orthopedics in Attached 1 began to lead, from pressure to rejection.

The surgery that symbolizes the highest risk in orthopaedics, scoliosis correction, with an annual operation volume of more than 300, is in the first echelon in the country, while the second echelon has only nearly 100 operations and is in the second echelon.

For bone tumors, Attachment 1 has an independent and large-scale bone tumor ward, while Attachment 2 has no independent and large-scale bone tumor ward for the time being.

So naturally, Fu Er Orthopedics is willing to give up and regard Fu Yi as the big brother.

Spinal analgesia could not be used, nerve block was not feasible, and the family refused the operation.

Can't this discussion go on?

The discussion fell silent again.