The Godfather of Surgery

In fact, the case discussion started at two o'clock, and the case of the Sports Medicine Center was discussed at about three o'clock.

This patient with Achilles tendon laxity has won the Olympic gold medal in the women's 5000 meters, and is still in the golden age of sports, so Attachment 1 pays special attention.

If the operation of this patient is done, the sports medicine specialty of Affiliated One will likely enter the top of the industry pyramid like spine surgery.

After seeing the patient, Su Nanchen took Yang Ping to the conference room on the twentieth floor, where the weekly orthopaedic case discussions were held.

In the second row of the conference room, there were two vacant seats, and Su Nanchen took Yang Ping to sit down.

Sure enough, it was a big scene. In the first row were the directors of various specialties of the Orthopedic Center. They were all doctoral tutors, experts who received special government allowances, and several of them were well-known national figures.

For example, Professor Zou, the director of the Spine Center, is a national leader in scoliosis correction. He used to follow Professor Su. After Professor Su became the dean, he paid less attention to clinical work and focused on scientific research and administrative work. The Spine Center Most of the surgeries were handed over to Professor Zou. The first editor-in-chief of Scoliosis Surgery was Professor Su, and the second editor-in-chief was him.

Professor Huang, director of the Orthopaedic Trauma Center, is also a well-known professor in the country, and one of the main translators of Principles of Internal Fixation for AO Fractures.

Professor Guan Sheng of the Sports Medicine Center, a proud student of the sports medicine boss of the Third Academy of the Imperial Capital, was recruited by Su Qingyun, and he has made sports medicine prosperous in a few years.

Generally, doctors who sit in this venue will definitely feel a sense of shock and oppression. But Yang Ping didn't, he was very calm, after all, he was a person who had been tempered in the system space.

He sat calmly, and Su Nanchen observed secretly, this calmness, this calmness, is definitely not something ordinary people can have, and I admire it even more.

The hierarchical system of doctors is vividly reflected here. Even if there are vacancies in the first row, no unqualified person will sit on it.

In the second row are the professors who lead the group, all of whom are chief physicians or deputy chief physicians; the third row is the other deputy chief physicians, and the fourth row is the outstanding among the younger generation.

Starting from the fifth row, you can sit freely, but you still spontaneously divide into camps. For example, doctors and attending physicians are in the front, masters and resident doctors are in the back, and those with advanced studies and regular training are in the back. No one is stupid. Squeeze in front.

Sitting in the second row is Chen Ge, a professor of sports medicine. This guy is also a character. He usually likes to compare with Su Nanchen. He is Guan Sheng's doctorate. Competitive, but kept being pressed by Su Nanchen.

He saw Su Nanchen leading a stranger in, and glanced sideways.

Chen Ge knew that Su Nanchen had invited a doctor from an outside hospital to come over for consultation.

I thought he was some kind of professor, but looking at this face, he was only in his twenties, a young doctor who came to Fuyi for a consultation.

Su Qingyun looked back and saw that Yang Ping was already sitting with Su Nanchen. Seeing his appearance, he was as steady as Mount Tai, and he secretly admired it.

The case discussion was very intense, and everyone was red-faced. Although the voice was loud, the speaker was never noisy or made personal attacks. Instead, it was a well-founded, purely academic debate, and academic issues were resolved in an academic way.

Everyone has the right to speak, and do not bear any consequences for speaking! Doctors have grades, and speeches are not graded. This is the rule set by Su Qingyun. The free academic atmosphere is also one of the magic weapons for the rapid development of Fuyi Orthopedics.

Usually, the general case discussions are discussed within each department. The cases discussed at the orthopaedic center level are either difficult, high-risk, or some new surgical procedures, or patients in important positions with certain social influence.

Yang Ping also listened to it. One of them had scoliosis, almost folded in half, his nose was about to touch his toes, and he was about to undergo orthopedic surgery to straighten his spine.

Finally, it was the turn of the sports medicine center. There were two cases discussed by the sports medicine center, one with unstable knee joint, and one with loose Achilles tendon.

This knee is unstable, a professional football player, a well-known star, and his knee dislocates, causing all the anterior cruciate ligament, posterior cruciate ligament, posterolateral structure, and posteromedial structure to be ruptured, all of which need to be reconstructed, and the four structures that need to be reconstructed, including There are several structures to be reconstructed for the posteromedial and posterolateral structures, which are like nesting dolls, and the complexity can be imagined.

The operation is very complicated. The reconstruction of this case is the top operation for knee sports injuries. There are only six hospitals in the country that can perform this operation, and there are only a handful of doctors who can do it.

Most of sports medicine surgeries are not life-saving, the goal is directly to the function, the most exquisite surgical quality is not to solve the problem of whether or not, but to solve the problem of quality. Just like plastic surgery, the goal is directly to the appearance, and the results are clear at a glance.

What do you think of this case? Su Nanchen whispered.

There are too many structures to be reconstructed. We must grasp the static balance, dynamic balance, near-term balance, and long-term balance. Yang Ping also lowered his voice.

If you do it, will it be a split operation or a single operation? Su Nanchen wanted to find out what he said.

One time! Only in this way can a real balance be achieved. Yang Ping replied without hesitation.

Once? Balance, this kind of difficulty is very big, and Su Nanchen is ashamed.

The second case is a female long-distance runner with slack Achilles tendon. Dr. He came to the stage to report the medical record, and the attending doctor helped and added at any time. The image data was marked with a prominent date and displayed on a huge high-definition screen.

This patient is a professional athlete, and the problem of the Achilles tendon is related to sports performance and future career. We plan to shorten the Achilles tendon, so we use the classic surgery to cut the Achilles tendon in a Z-shape or transversely, and then do a shortening suture. This solves the problem of laxity, but leads to a new problem, the Achilles tendon is cut and re-stapled, there will be some scars, even if they are small, they will still exist, and a small amount of scar healing will reduce the strength and endurance of the Achilles tendon. The patient has been to the UK See a doctor, the treatment plan given is the same, so please discuss it with everyone to see if there is a better plan?

After the report of the medical records was completed, Su Nanchen, as a professor leading the group, pointed out the purpose of the discussion.

As for suturing the Achilles tendon, any orthopaedic resident can skillfully suture it. How much we shorten is the core of the problem. Too much will cause the Achilles tendon to be tense; if it is too little, the Achilles tendon will still be loose. The operation is performed under a microscope, the Achilles tendon is quickly cut with a sharp knife, and the suture is as neat as possible to reduce scar healing. Chen Ge spoke very positively.

Then how to judge how much to shorten? asked Guan Sheng, director of the Sports Medicine Center.

Chen Ge said proudly: For every millimeter shortened, how much does the tension of the tendon increase? I am doing animal experiments, and the data is being sorted out.

Chimpanzees crawl on four legs, while humans walk upright, and the thickness of the Achilles tendon fibers of orangutans is different from that of humans. It is difficult to apply animal experimental data to humans. Another professor of sports medicine objected.

Why do animal experiments have to be carried out, can't we directly look for reliable data from the healthy side? A postdoctoral fellow in the station put forward his own opinion.

During the operation, the skin of the unaffected side was directly incised, the Achilles tendon was exposed, and the tension in the same posture was measured, and then this data was applied to the affected side and shortened in steps until the tension matched the data on the unaffected side! the postdoctoral fellow continued to explain.

He was nestled in the fourth row, with a disheveled look, the button of his white lab coat was all buttoned off, a bottle of milk was in his hand, and the straw had been chewed.

Drinking milk and eating is allowed as long as you don’t make too much noise. Because of the case discussion in the afternoon, many doctors may have just performed surgery and did not eat Chinese food.

The tension adjustment that everyone is talking about is static, and the patient's running is dynamic. We must analyze the patient's movement state. After all, the patient's Achilles tendon and triceps have relatively slipped. Is it still in accordance with the previous standard? To determine the tension? This data must be obtained from the dynamic. Su Nanchen also expressed his opinion.

The discussions were fierce and continued. The voices of expressing opinions came one after another and came from different directions. All the contestants were true talents and practical learning. Not a single phone rang.

Everyone's speech was very active, and the opinions were actually relatively unified. The surgical method for Achilles tendon shortening is the difficulty in how much the shortened distance is. This data must be accurate, otherwise the operation will fail, and even the patient's athletic performance is not as good as before the operation. Everyone. Many methods have just been proposed, such as animal experiments, healthy side reference, and movement state analysis, then our next step is to figure out the exact length of shortening, Professor Su, look, can you?

Professor Su got up and said: Everyone's opinions are very good, and they put forward their own unique opinions, which shows that everyone is thinking seriously. This is what academic discussions should be like, free and equal dialogue! Today, for this patient, we are honored to invite Sanbo. Consult with Dr. Yang Ping from the hospital. Dr. Yang has unique experience in sports medicine. Let's see if Dr. Yang has any good opinions?

Professor Su applauded, and everyone else followed suit. Everyone knows about Sanbo Hospital. Everyone knows about several major hospitals in one city.

But what is the origin of Dr. Yang Ping, I don't know! Never heard of it! Was actually invited to Fuyi for a consultation?

Su Nanchen got up: Dr. Yang, please!

On such occasions, stage fright would have chilled Su Nanchen's enthusiasm and let down the high expectations of others.

Yang Ping was calm as always, got up, and greeted everyone.

Xiao Yang, come to the podium and talk about your views. Professor Su encouraged.

Who is he? Where did he come from! Everyone looked around, hoping that someone would recognize him and give him a reply.

A few people who just followed him to check the room said: Dr. Su's classmate, this guy is really awesome!

One of them is very sincere. He has already taken out his notebook and is ready to take notes: Brother, take notes seriously. I just went to him to see this patient in the room. He talked about a paragraph. After listening, I suspect that I am a fake doctor.

The person who asked the question also took out the notebook he was carrying and took out a pen.

Su Shao is a student studying in the United States?

Nine percent of the time!

Yang Ping was unusually calm, walked to the podium, and bowed slightly to everyone.