The Godfather of Surgery

When Yang Ping and Director Zhu were outside, they had already had a heated discussion.

Several international celebrities agree that this is because the blood supply of the spinal cord is damaged. If the blood supply of the spinal cord is damaged, it is impossible to restore the blood supply by surgery. Its natural development, and ultimately cannot escape paralysis.

Dural arterial fistulas lead to insufficient blood supply to the arteries and increased venous pressure, which in turn causes spinal cord edema, which are similar to the impaired blood supply to the spinal cord.

Moreover, judging that the blood supply of the spinal cord is damaged based on MRI and CT is not something that ordinary spine surgeons or radiologists can do. Only top spine surgeons have the ability to judge.

Therefore, this case in the middle of the bureau is considered a high-level bureau. Ordinary doctors have a way to enter the bureau, and senior doctors have a way to enter the bureau. This is the reason why many experts cannot solve the problem. Diseases are sometimes so wonderful.

Several big players finally broke the game with their wealth of knowledge, but they didn't know that they entered the game when they broke the game. They thought they had broken the game, but they actually entered a new game, and this new game was even more difficult to crack, because the entrants did not know it. So there is no chance of breaking the game.

We can try to perform DSA digital subtraction angiography on the main blood vessels of the spinal cord to look for damaged blood vessels, such as excessive ligation of the intercostal artery during surgery. We can try to repair it. At present, the spinal cord has not been necrotic and degenerated. Opportunity. August was more positive than Milton.

This is a huge and complex project. The scale and complexity are beyond your imagination. If it can be tried as a scientific research topic, there are many obstacles to clinical cases and immature ideas. Milton remained conservative.

If it is transported to our Shuntian Hospital, we have more advanced equipment than DSA to check the location and extent of vascular damage to assess whether it is suitable for surgical repair. If surgical repair is required, we have experience in this aspect in spine surgery. Kobayashi is very confident.

They really have a set of equipment more advanced than DSA, which was jointly developed by the University of Tokyo, its affiliated hospital, and Toshiba Corporation. Shuntian was fortunate to obtain an experimental machine.

In terms of inspection, our hospital also has better vascular inspection technology than DSA, computer X-ray dynamic simulation imaging technology, which can perfectly reconstruct the entire human blood vessel image. August did his part.

August is from the Harrahing Orthopedic Hospital in Munich, Germany. The spine surgery of this hospital is at the top level in the world. The Japanese say advanced in front of them, and he is a little unhappy.

This consultation invited several celebrities and a professor from the Twin Cities Spine Center in Minnesota, USA, which coincided with the Spine Surgery Symposium held by the hospital and declined the invitation to the consultation.

The arrogance of the British was shattered by the Germans and the Japanese. They each said that they have a set of more advanced inspection equipment, which should be in the experimental research stage and have not been widely popularized.

But Milton can't come up with such equipment, and cutting-edge equipment is almost monopolized by these guys. Now, most of the cutting-edge medical equipment in Milton's hospital comes from these two countries.

To detect the location and state of damaged blood vessels, it is not something that ordinary equipment can do, and more sophisticated imaging equipment and techniques are necessary.

Several doctors from other countries basically did not speak, and became the foil of several big names to make the scene grand.

Dr. Yang from China has not spoken yet. Let's listen to Dr. Yang's opinion. Dr. Lin took the opportunity to introduce Yang Ping.

Yang Ping was just looking at the images on the screen carefully when he suddenly heard Dr. Lin's introduction and immediately retracted his attention.

Everyone turned their attention, it was just a young doctor, maybe some insurance company was overcharging, just find a doctor to deal with it.

Moreover, during the discussion just now, I didn't see the doctor at all, and I don't know when he entered the venue.

I'm sorry, everyone, I still have at most half an hour to stay here. Milton is still a gentleman, reminding that the meeting will either end within half an hour, or he will leave early.

Yang Ping looked around, very calm, and said, Actually, this case is very simple, not very complicated, and everyone has seen it less often, so I am a little overwhelmed.

All meetings were spoken in English, and Yang Ping was no exception.

As soon as this statement came out, and it came out of Yang Ping's mouth, the kind of confidence and calmness that is unique to men from the earth, looking through time and space at a glance.

Let the experts in the audience be stunned at once, simple?

Such a complicated case was compressed into two easy words in his mouth - simple!

Milton, August, and Xiao Lin are all authorities in spine surgery. Someone actually said such a thing in front of him. Professor Milton shrugged as a silly joke; August rested his elbow on the table, Holding his chin in one hand, he listened carefully; Xiao Lin Du was a little disdainful, feeling that he was simply courting favor and forcibly seeking a sense of existence.

Please help to call up the patient's images, both CT and MRI are needed!

Dr. Lin immediately instructed the doctor in charge of computer operations to call up the patient's images.

Yang Ping walked to the screen directly opposite the oval table and pointed to the pictures on the screen: Slow down, just these few pictures, and MRI's, yes, keep these pictures.

After selecting the pictures, he pointed at the screen with an electronic pen: This is a typical case of a mid-game, a white game is a black game. You can't extricate yourself from a white game, and a patient can't be rescued from a black game.

In the middle of the game, I don't understand, I have never heard of such a case in medicine, everyone shook their heads and shrugged, looking helpless.

On the surface, in this case, the cyst compresses the spinal cord, and then intraspinal cystectomy is performed. The operation inadvertently damages the spinal cord blood supply. After the surgery, the neurological symptoms are temporarily relieved due to the cyst excision, and delayed due to the destruction of the spinal cord blood supply. The neurological symptoms are aggravated, everything is flawless, the entire diagnosis and treatment process can be included in textbooks, and no one will question it even after many years. Yang Ping paused.

Dr. Lin took the opportunity to deliver a bottle of mineral water, and Yang Ping took a sip.

Continue: But in fact, this is absolutely not the case. We cut open this case, and there is a rare case hidden in it-

Yang Ping's eloquence has also improved, and a case explanation is like telling a story.

This rare case is the dural arteriovenous fistula. You solved the white situation and found no black situation. The black situation continued to be evil and gradually aggravated, so the neurological symptoms in both lower extremities aggravated, and the white situation covered the black situation. The surgical injury to the blood supply of the spinal cord has become its scapegoat, blocking everyone's bright eyes, and everyone is unknowingly led into the trap by it, but they don't know it.

It's so exciting, God, are you sure you're talking seriously? August exclaimed, he had never heard such a strange opinion before, it was so new.

There is no basis! Dural arteriovenous fistula must be diagnosed with DSA or more advanced vascular imaging technology. CT and MRI cannot be diagnosed at all. This patient has no such examination. How do you diagnose it? Xiaolin Du sneered, the world There are currently no papers or monographs on the use of CT and MRI to diagnose dural arteriovenous fistulas.

Milton shook his head: No, no, no, there are less than 300 cases of dural arteriovenous fistula reported worldwide, CT and MRI are completely unable to diagnose, DSA needs to be done, and a comprehensive super-selective angiography of the spinal artery is required, even then there is still a diagnosis. The possibility of failure, I think your speech should be at least professional and prudent.

Whether right or wrong, we heard different voices, which is very important, the truth is in the hands of a few people most of the time, continue, I am very interested. The German old man hated the arrogance of the British.

Yes, the fistula cannot be seen directly from these pictures, but when you look at these MRI and CT pictures, there are several pictures that are very clear. This is a CT image of blood vessels. This is an image obtained by MRI using the vascular flow void effect. There is one thing in common, which I call the truncation effect: from a certain point as the boundary, there is discontinuous caliber dilation at the proximal end of the vein, while the artery does not have this phenomenon, which is the characteristic of arteriovenous fistula, suggesting that the There is a fistula connection between arteriovenous and arteriovenous communication, and there is congestion in the vein. This congestion causes the vein to expand, and the expansion loses its smooth transition. The venous congestion causes spinal cord edema. The two conditions are superimposed, leading to the diagnosis of a labyrinth. . Yang Ping pointed to a few pictures.

From the perspective of medical knowledge, everyone lacks this knowledge and cannot support or refute Yang Ping's words.

So, do a DSA for the patient and perform a super-selective angiography of the spinal cord blood vessels. Isn't this Dr. Yang's diagnosis confirmed? Auguste has always had a strong interest in this case.

The British are still conservative: Vascular superselective angiography takes a long time and may fail. Do you believe what he said?

We have more advanced technology than DSA to verify the diagnosis. Atsushi Kobayashi has been advising patients to transfer to Japan.

Actually, there is no problem with the diagnosis of this patient. It's just that everyone needs to make the diagnosis in a familiar way. You can do another DSA. This requires a doctor's super-skilled skills. There is a more critical problem - surgery, this The arteriovenous fistula is in a relatively hidden position, the treatment of blood vessels is very high, and the operation needs to be very delicate.

Yang Ping said truthfully that the treatment of this arteriovenous fistula can neither ligate the blood vessels nor do the fistula repair after separating the blood vessels like ordinary fistulas.

This doctor's words lack basic evidence to support, and only you can perform surgery. May I ask which hospital you are from? What kind of research? What research results have you obtained?

I'm Yang Ping from Sanbo Hospital in China. You will be able to see my paper soon. I have no intention of making a false statement. This operation is really difficult. It's catastrophic and irreversible, and I don't want to see that.

Yang Ping was very calm, he said everything he had to say, he stepped off the podium and took a sip of water.

Every patient, he will go all out to strive for the best results for the patient.

This patient is actually a triple game. Yang Ping only talked about the double game. Let them accept the double game first, and then explain the third game later. If you don’t fully understand some of the double game, he will talk about the third game. Bureau, too brain-burning.

Why did Yang Ping have to operate on his own, because when surgically treating arteriovenous fistulas, several arteries that blocked the access had to be ligated or coagulated.

However, these arteries are routinely regarded as useless arteries that can be ligated or coagulated in the surgical approach. In fact, these arteries are the main blood vessels of a certain segment of the spinal cord.

The mutation, the strange mutation, makes this case strange and startling!

If it wasn't for Yang Ping's powerful abilities in the system space, I'm afraid no one would be able to solve this triple situation. Like most incurable diseases in the world, there will never be a day of truth.

Everyone started whispering and discussing in low voices, not knowing exactly what to do next.

Dural arteriovenous fistula, less than 300 cases reported worldwide, a rare case! Fang Xiaoyun's case, from a real case of a friend, is very classic. Guo Jingyao's case was formed by combining two similar intractable diseases in reality. Hereby explain! Brother Wolf, sorry! Let me prepare for a few days, and the two shifts will only start on Monday. A book friend mentioned building a group. Let’s see if it is necessary to build a group? There are also book friends who mentioned the management of speech in the comment area. It doesn't matter, just let him go. If you like this book, you will naturally like it. If you don't like it, you can just detour. I don't have time to pay attention to the comments, and I want to give you more updates during the limited rest time!