The Godfather of Surgery

On Saturday, at nine in the morning, the meeting started on time.

The large conference room of the Sanbo Hotel was full, and the front row was also full of guests.

As of 9 o'clock, the number of delegates has exceeded 2,000. For this kind of hospital-only study, if 1,000 people come, it will be very successful. Now there are more than 2,000 registered doctors.

The large conference room of the Sanbo Hotel can accommodate up to 1,000 people, and it can only be done with temporary addition of stools.

According to the plan, in addition to the main venue, six sub-venues have been opened. The sub-venues can use the big screen to watch the speeches of the guests, and the question-and-answer session with the guests can be completed by using the video call function.

The mobile company cooperated with Sanbo Hospital and used 5G technology to help Sanbo build a video system for the entire venue. They also took this opportunity to promote 5G.

After Director Tan delivered the opening speech, he introduced the guests.

He began to show everyone the current situation of the microtrauma orthopaedic department of Sanbo Hospital, especially the case of five-stage replantation as a signboard for publicity.

For this operation, the video data is complete and most convincing, and the operation patient Xiao Guoqiang took the initiative to apply and stand on the podium to demonstrate the function of the limbs.

Director Tan's speech is in English, and all the other guests will use English. It is positioned as an international conference, and it is impossible to speak without English.

The team led by Tang Fei is responsible for the on-site translation. She attends a Chinese-English bilingual school in elementary and middle school, so she is very good at speaking and listening in English. She is a doctor, so her translation is not worse than a professional translation. would be more accurate.

Translation, in order to allow the participating doctors to understand, because most doctors do not have the ability to listen and speak English, even if they passed CET 4 and CET 6, they are all dumb English, they can do the questions, but they really listen Say no.

Qiangzi was a little nervous in the backstage of the conference room, and his girlfriend comforted him: It's alright, relax, follow the doctor's instructions, and show it to them, just treat Director Han and Dr. Yang in front of them.

Dr. Che, who was in charge of Qiangzi's rehabilitation, instructed the movements that needed to be demonstrated again and again, and Qiangzi followed carefully.

This five-stage replantation was very sensational at the time. Almost all orthopaedic trauma surgeons across the country knew that they were amazed at the superb technology of Sanbo Hospital, but at the same time they had no hope for the function of the replanted limb.

Everyone felt that Sanbo Hospital performed this operation entirely to gain attention. Maybe after a period of time, the limbs would not function and become burdensome and the limbs would be amputated.

Whether it has function or not, and whether there is an amputation in the end, everyone wants to know the result, and many doctors come here.

Director Tan originally planned to shoot a video to show the postoperative functions, but after knowing the situation, Qiangzi took the initiative to request and demonstrate in person at the venue.

The blood supply of the replanted limb was completely fine, the muscles and tendons had healed, and the most challenging part was repairing the nerves.

According to the EMG test, the nerve has grown to the wrist, which is in line with the average growth progress of one millimeter a day.

Nerve rupture is different from the repair of other tissues. Other tissues are healed, but nerves are different. Once the nerve is ruptured, the distal segment will be completely abolished, the nerve fibers will disintegrate, and finally an empty shell is left.

Nerve repair Nerves close to the end of the fracture grow into the pipe left at the far end, and have to grow to the end of the limb in order to have good function.

The higher the position where the nerve is cut off, that is, the farther it is from the terminal, the less likely it will grow. Those tubes are large tubes and small tubes. There are many nerve fibers that cannot find the tube. Without the tube, it will not grow. It's like a train can't move without a track.

The nerves of the limbs are divided into motor nerves and sensory nerves. The two have different functions. One is responsible for muscle movement and the other is responsible for skin sensation. When many nerves grow at the broken end, they will drill the wrong tube, and the motor nerve will drill into the sensory nerve. The tube, the tube through which the sensory nerve drills into the motor nerve, is drilled wrong, and it won't work if it grows.

In this way, many factors lead to the recovery of peripheral nerves, especially the recovery of high nerve injury, the effect is very poor, it is a worldwide problem.

The hadron's nerves reach the wrist, and the muscles of the forearm gain innervation.

The dorsal extension and flexion of the wrist joint are very good, and the flexion and extension of the five fingers are also very good, but the adducting and abduction of each finger on the opposite palm of the thumb is not enough, because these movements are driven by the muscles of the hand, and the nerves are still not yet. It didn't grow over, and it didn't connect with the muscles of the hand.

Judging from the current growth trend, the last five centimeters should have grown in the past.

Hadron demonstrated holding dumbbells for elbow and wrist resistance activities, and five-finger ball gripping.

If you wait another two months, it is estimated that you can easily write and use chopsticks. At present, the inner muscles of the hand have not been innervated, and without the cooperation of the thumb to the palm, it is difficult to hold the pen and chopsticks.

The five-stage replantation, which took half a year to achieve such an effect, has been very successful.

——

Yoko's judgment on the traffic conditions in City G was very accurate. About 8:30, she sent Fujiwara Miyuki and Takahashi Fumiya to Sanbo Hospital on time.

Fujiwara Miyuki and Takahashi Fumiya naturally became the focus of the meeting.

Fujiwara Miyuki is the champion of the Victoria's Secret Show, and the only doctor in the world; and Takahashi Fumiya, as a doctor at the Affiliated Hospital of the University of Tokyo, became famous very early, and is often active in various large international conferences. figure.

For example, at the annual meeting of trauma surgery in North America, he was invited as a guest and sat in the first row. In Asia, it is estimated that only his teacher Masao Fujiwara and him can have this status.

After listening to Director Tan's introduction, Takahashi touched his chin and the five-segment replantation of the upper limbs. It is impossible to have good functions. Takahashi Fumiya has a clear judgment on this.

This is just a gimmick at the meeting. There is really nothing to take out. Only the severed limbs that are good at are replanted. As for the function, wait and see.

From the beginning to the end, Takahashi was reluctant to participate in this small meeting. He was very resistant. Behind every seemingly sincere etiquette, arrogance and prejudice were hidden.

He didn't even take the initiative to talk to the Korean doctor next to him. When they asked a question or two, he responded bluntly, hoping that the meeting would end soon. He was here to complete the homework for the teacher.

The operation video of the severed limb replantation is very shocking, and the speed and rhythm of the operation are unbelievable, but Takahashi believes that the video is suspected of editing, so just take a look.

As a great figure in trauma surgery, he is very clear about the difficulty of this five-stage replantation.

If the nerve can grow smoothly, it needs to cross five fractures, which requires very superb nerve suturing technology, which is feasible in theory, but no one can do it in practice.

If you can't do it yourself, who else can?

Takahashi decided to check the patient's function in person if he had the opportunity, but he didn't know if he would be given the opportunity.

I had no interest in the meeting at first, but when I thought about it, I suddenly had a strong interest, just like the audience insisted on debunking the tricks of the magician.

The theme of Takahashi's speech today is the application of infrared monitoring equipment in trauma surgery, especially the use of hemoglobin fluorescence imaging technology, combined with excellent computer algorithms, can make trauma patients become transparent people on the operating table.

With this technology, they can now stand alone in the world, making it almost impossible to make mistakes in hemostasis on the operating table.

Fujiwara-sensei's next goal is to overcome the repair of peripheral nerve damage. He also uses infrared technology and a nerve fiber-clearing agent to make motor nerves appear red under infrared light, and sensory nerves appear blue, and then use these images with the camera system. Integration is performed, and finally the image of the captured nerve fibers on the screen is separated into clear blue and red.

In this way, blue to blue and red to red, the nerve anastomosis will not be mismatched, and the effect of nerve recovery will be multiplied.

There are two factors for poor nerve recovery: first, the loss of nerve fibers caused by the wrong growth of the nerve; second, the degeneration of the target organ caused by the slow growth of the nerve.

At present, the Affiliated Hospital of the University of Tokyo has solved the first factor, and the second problem is in an experimental state. Although it is immature, it will soon be able to break through. If the two problems are solved, they will overcome a world problem.

The second problem is that the speed of nerve growth is too slow. The motor nerves innervate the muscles. Sometimes, the nerves grow by chance, but the muscles are degenerated and fibrotic because they have not been innervated for a long time. The muscles are no longer muscles and become Fibrous tissue, even if it waits for innervation, cannot complete the function of contraction.

To break through the second problem, either speed up the growth of the nerves, or keep the muscles in a normal state for a long time and not be fibrotic.

Takahashi is now working on the subject, so that the nerve grows faster and binds to its target organ as quickly as possible.

Participating in this kind of meeting is boring, like a college student listening to elementary school students' class, Takahashi really wanted to stretch.

He sneaked a glance at Fujiwara Miyuki, she was listening to the speech very seriously, and Takahashi thought this young lady was ridiculous.

The worst thing is, today or tomorrow, there will be a demonstration of trauma emergency surgery on the same stage.

So boring, like watching a football match.

The matchup between the Brazilian team and the Chinese team, a crushing, no suspense matchup, will make people very boring.

Taoqiao-kun, please be serious, the teacher asked you to come to the meeting, not a vacation.

Miyuki reminded Takahashi beside her.

Because he actually dozed off, clasped his hands on his chest, and narrowed his eyes slightly.

At this time, Director Tan wants to invite out the patient hadron and personally come out to demonstrate the function of the limbs.

The magic started, and Takahashi cheered up.

He unscrewed the cap of the mineral water bottle and took a sip.

I almost choked on the water because of my absent-mindedness.