The Godfather of Surgery

Dr. Zhou's operation is very standardized and skillful. The Chinese's hands are dexterous. Yang Ping's previous worries were a little unnecessary.

The supply blood vessels of the thoracic spinal cord, Dr. Zhou superselected one by one, carefully and patiently.

Yang Ping gave him navigation, when to stop, when to move forward, and when to push medicine, there was a certain delay from instruction to operation, but Dr. Zhou's ability to understand was very good, and his cooperation did not appear blunt.

Slow down, push, stop, push again, step over the bifurcation, go to the outside, yes, push two centimeters, stop - you can push the medicine. Every word of Yang Ping, Dr. Zhou can turn into his hands precise movements.

Dr. Yang has learned to intervene? Dr. Zhou was surprised, and the surgeon also knew how to intervene.

Yang Ping thought for a while: I am very familiar with the anatomy of this area, and I know the origin, direction and supply range of every blood vessel.

According to his navigation, Dr. Zhou completed the angiography of the first group of blood vessels safely and quickly. Dr. Yang is no longer familiar with anatomy, but superb.

The British's facial expressions are always so rich, surprise, doubt, admiration, all kinds of expressions on his face are very exaggerated by the expression muscles.

Milton took two steps toward the video screen, his cheeks bulged, his face flushed, as if he was holding his breath, and he opened his eyes as wide as possible, as if opening a little wider to get higher definition.

Auguste glanced at this old friend, not wanting to be left behind, and took two steps forward. As long as he was outside the yellow line on the ground, it met the requirements of hospital infection management.

The image on the screen is very similar to a Chinese ink painting. The black blood vessels are curved, from thick to thin, and the branches become thinner. The colors are also thick and light.

Dr. Zhou is now very used to following the navigation, and dare not speak any more. He stares at the screen with all his attention. The movements of his hands are extremely gentle and precise, and the blood vessels of the spinal cord are super-selected group by group.

Finally, the site of the arteriovenous fistula was found, and the contrast agent leaked out through the fistula and entered the vein, forming a clear communication between the arteriovenous.

Dural arteriovenous fistula! Milton exclaimed, as if holding his breath, just to shout this sentence.

Milton's voice was very soft, for fear of interfering with the operator's operation, but he had to shout this sentence to show that he showed no weakness in front of August, who glared at his old friend unfriendly.

How many cases is this in the world? August? Milton kept his eyes on the screen.

Don't disturb me, this is not the time for academic discussions, I also need to concentrate. August was very angry.

All doubts of Atsushi Kobayashi were swept away. The doctor who made up the numbers was actually a real top expert. His proficiency in anatomy exceeded Atsushi Kobayashi's understanding. Hard to beat him.

Fumiya Takahashi and Jiro Sasaki have personally dissected more than 100 general teachers. At that time, the University of Tokyo purchased hundreds of general teachers from Eastern Europe for a certain topic and used them for teaching. Takahashi and Sasaki were the main surgeons A hundred of them were dissected.

However, why is such a doctor not well-known in the world? He has never even seen his papers or attended international academic conferences.

Under the guidance of Yang Ping, Dr. Zhou saved a lot of time. The operation that was originally planned to take seven or eight hours is now estimated to be completed in three or four hours.

Another arteriovenous fistula was found. This patient has two arteriovenous fistulas. Yang Ping asked Dr. Zhou to relax a little: There are only two arteriovenous fistulas. You can also super-select the remaining groups and show them to them. Rest after finishing. In a few minutes, a few more mutated arteries are superselected.

Um!

Dr. Zhou seemed a little tired because of his high concentration. He thought that if Dr. Yang's guidance was given to each operation, no matter how difficult the operation could be successfully completed, if Dr. Yang performed interventional surgery, he would probably be at the top level in the world.

The remaining groups of blood vessels were super-selected, and there was no problem. Dr. Zhou took a break and began to super-select the mutated arteries.

The purpose of superselecting these variant arteries is to prove to everyone that these blood vessels are the main supply blood vessels of the spinal cord. Once damaged, it will cause ischemic necrosis of the spinal cord.

At the same time, use this DSA image to make a virtual reality 3D imaging to help everyone understand the position of this blood vessel in the approach and how to protect it.

These blood vessels are not found in normal anatomy knowledge, and they are curved and curved, and the difficulty of angiography is much greater than that of those groups of blood vessels. Those groups did not have Yang Ping's navigation. Dr. Zhou can complete it slowly by himself. These blood vessels, Without navigation, Dr. Zhou could not complete the operation.

Don't worry, slow down, these blood vessels have complex shapes and large curvatures, it is difficult to superselection, accidental injury, easy to cause bleeding or embolism, just like just now, listen to my navigation--

The guide wire in Dr. Zhou's hand did not dare to move, waiting for Yang Ping's navigation to start.

Move forward, continue, continue, and go forward about 0.5 centimeters, which is 5 millimeters! In order to prevent Dr. Zhou from mishearing, Yang Ping expressed it in two units.

Stop! Now cross the bifurcation, rotate the guide wire, stop! Advance 5mm, stop! The curvature is too large, each advance, do not exceed 5mm, stop after each push, think clearly before advancing.

Okay, go ahead, stop, push the contrast agent!

The dendritic ink painting spreads out, really, this is one of the main blood vessels of the spinal cord.

Doctor Zhou's palms were all sweaty, and it was a little sticky through the gloves. Looking at the image on the screen, he couldn't believe that he had succeeded in superselection of such a blood vessel.

Dr. Lin and Dr. Huang looked at the screen and did not speak.

Continue, the blood vessels are tortuous, and the operation progresses very slowly. Dr. Zhou's hands remain steady and careful. Every small movement condenses all his energy.

If you are not careful, the guide wire will puncture the blood vessel, causing bleeding, or damage the vascular endothelium, resulting in embolism. The consequences of each mistake are extremely serious.

Now, Dr. Zhou is like driving a car to open the winding mountain road at night, and the road is full of abyss.

Every time you move forward, you follow some kind of navigation, turning the steering wheel a few degrees to the left and a few degrees to the right.

Push a little further, stop, and finally cross a few forks, another super-selection success, push the contrast agent, and move on to the next one.

The second and third blood vessels were successfully angiographed, and the contrast agent image on the screen pulled a thick curved line along the blood vessels.

The three mutated arteries were successfully superselected, and Dr. Zhou's hanging heart gently put down, like putting down a priceless fragile antique.

What he feels now is that it was dawn, the car was on the top of the mountain, the driver looked down, the mountain road was along the cliff, and there was an abyss under the cliff, and he actually went up the mountain, I was afraid!

Dr. Zhou shuddered involuntarily, which might be a sign of fear.

Finally finished, everyone can breathe and talk.

The truth is revealed!

The diagnosis made by Chinese doctors with CT and MRI is correct. This patient is a dural arteriovenous fistula, and there are three variant spinal cord feeding arteries.

Can you do 3D reconstruction in virtual reality? It would be more intuitive to make 3D images of blood vessels in virtual reality, August suggested.

Our Central Hospital has it and can transmit data to it. Dr. Lin also felt it was necessary.

Yes, using virtual reality technology to reconstruct the spinal cord and blood vessels, it is more direct, I understand it all. Milton finally saw through the triple game.

It's a pity that DSA didn't understand it before, and it was a bit behind August. I'm afraid that he will not have enough confidence in front of August for a long time after that.

This DSA took nearly four hours, which is a relatively fast speed, and no time was wasted in the middle.

Now, it is not Yang Ping's own feeling, but in the eyes of others, he has become the man from the earth.

Such a complicated case seemed so easy in his hands, his confidence in analyzing the disease, and his proficient anatomy during DSA, as if everything was simple and clear in his heart.

Milton recalled Yang Ping's words: In fact, this case is very simple, not very complicated, and everyone has seen it less, so I am a little overwhelmed.

Dr. Yang was so calm, calm, and relaxed, while everyone was so confused, confused, and helpless. Even he had fully explained his condition, and no one understood except the old ghost August, and Milton felt ashamed.

Dr. Zhou pulled out the catheter and pressed the puncture site with sterile gauze to stop the bleeding. Dr. Lin was arranging for the doctor to collect pictures and transmit them to Singapore for virtual reality 3D imaging.

Yang Ping went to the locker room to take off the lead coat, August and Milton both caught up, rushing to help Yang Ping take off the lead coat.

Can you explain more clearly when you have time, how to accurately judge this type of vascular disease from CT and MRI? Milton pulled one side of the lead coat.

And hand-painted reconstruction of the image, how can it be done? Augusta sat on the other side of the lead coat.

The two pulled back and the lead coat took off. The two pulled each other a few times and hung up the lead coat together.

This is not something that can be explained clearly in a few words. Yang Ping said lightly.

If you don't have very proficient anatomical knowledge, you can't explain it clearly for the time being. When you summarize your experience and turn it into some knowledge that can be popularized and applied, then it will be easy to understand.

For example, multi-ligament reconstruction of the knee joint is an example. When a set of standard reconstruction procedures is summarized, everyone follows the procedures, so that the operation can be popularized.

Dr. Yang, I finally figured out that this case has three nested diagnosis and treatment traps, jumping out of one trap will inevitably lead to another trap? This forms a series of traps that are difficult to solve? Such a classic case should become the University of Cambridge Medicine. The teaching case of the academy. Milton realized with hindsight.

It should be the Charlotte Medical College! August showed no signs of weakness.

Two chapters will start tomorrow, I'm sorry, the evolution has been slow for two days, and I have worked very hard.