The Godfather of Surgery

In the conference room of the Sixth Hospital of the Magic City, intense case discussions are taking place.

Hong Zhigang presided over the meeting, with orthopedics, neurosurgery, oncology surgery, and medical oncology as the mainstays, and other departments such as cardiovascular medicine and respiratory medicine were also present.

Dean Chen of Magic Six and Director Peng of the Medical Department attended the meeting as nonvoting delegates.

Among the many experts, there are several experts who came from the United States for consultation.

The case in question is Academician Feng Tiancheng. Professor Feng is a domestic orthopaedic leader. Whether it is the Magic Six Hospital or Hong Zhigang himself, he will do whatever it takes to treat his disease.

Hong Zhigang invited Professor Johannesson from the Neurosurgery Department of the Mayo Clinic, Professor Griffin from the Anderson Cancer Center, and Professor Woodhead from the Twin Cities Spine Center from the United States.

To treat Professor Feng's illness, this team is undoubtedly the dream team of today's world.

Professor Feng's upper spinal cord and medulla oblongata tumors have invaded the respiratory and circulatory centers, causing slowing of breathing and heartbeat.

Once due to respiratory depression and arrhythmia, blood oxygen saturation could not rise, acid-base and electrolyte imbalance, and was sent to ICU for rescue.

After rescue, after a period of time, the ventilator assisted breathing and improved, and he was extubated and taken off the line a week ago.

At present, under the condition of oxygen inhalation, the blood oxygen saturation is maintained above 95%, and the acid-base and electrolyte balance has been corrected, but the heart rate and respiratory rate have been very slow and have not returned to normal. The heart rate is maintained at 50 beats/min, and the breath is 16 times. /Minute.

If the heart rate drops again, I am afraid that a pacemaker will be implanted, and if breathing is suppressed again, tracheal intubation and ventilator assistance will be required again.

The tumor is rich in blood supply and originates from the upper cervical spinal cord. It grows aggressively through the skull base and enters the medulla oblongata. The tumor has been mixed with the parenchymal tissue of the respiratory and circulatory center. During the resection, the respiratory and circulatory center will definitely be damaged.

This is equivalent to peeling the yolk from an egg, provided that the white is not damaged. However, the yolk and white of this egg have been mixed together and penetrated into each other. Who can completely peel the yolk without damaging the white?

Respiration and heartbeat began to slow down, and within a few months, it gradually tended to stop. If it hit the bottom line of life again or caused a foramen magnum hernia, the patient would die at any time—

Professor Johannesson from Mayo Clinic Neurosurgery spoke in American English.

He expressed regret that he couldn't help, that Mayo Clinic's neurosurgery ranks first in the United States, and Johannesson is the best neurosurgeon in the world.

Professor Griffin of the Anderson Cancer Center, bald, obese, with sparse golden hair curled around his head, loosened his tie: Such a chordoma, until there is no pathological examination, we will call it for the time being For chordoma, the current success rate of surgery is less than 1%. In other words, the success rate is close to zero. There are very few successful cases where the tumor is not obviously mixed with the respiratory and circulatory center. In Professor Feng's case, even using laser surgery Knives can't avoid injury, no one can challenge this kind of surgery, which is currently a forbidden area for surgery.

Woodhead of the Twin Cities Spine Center is taller and taller, and he looks energetic. He points to the anatomical model on the screen and explains:

Exposure is also a problem. Neurosurgery's craniotomy of the occipital bone is connected to the posterior exposure of the cervical spine, the medulla oblongata is exposed through the opening of the occipital bone, and the upper cervical spinal cord is exposed at the posterior side of the upper cervical vertebra. Then the upper cervical spinal cord and the medulla oblongata are cut open, or they are not removed. , excision is damage, the gangster and the hostage are mixed together, so that we can't shoot.

Hong, I suggest to give up the operation, maintain the status quo, and let nature take its course. Moreover, the patient is old, and after a rescue operation, the current state cannot withstand the blow of the operation. Besides, the success rate of this operation is negligible, so the operation is meaningless. Can hasten death--

Professor Johanneson spread his hands, saying that everyone tried their best, and there was nothing they could do.

Dean Chen turned his eyes to Hong Zhigang. Hong Zhigang turned over the medical records in his hand and was very unwilling. Is there really no way?

He knew that there was no need for someone who was almost 80 years old to fight for this hopeless operation, but he didn't want to watch the teacher leave like this, he had to do something.

These top leaders in the world are helpless, which means that they can only watch the teacher leave. It is foreseeable that if the tumor is not removed, or persist for two or three months, or misfortune will happen tomorrow.

At this time, Hong Zhigang's heart was burning and he was suffering. The teacher was so kind to him, but he couldn't do anything about it.

Although my teacher is almost 80 years old, from other physiological indicators, if it weren't for this tumor, it would not be a problem to live for a few more years.

Hong, when you sent me the patient information, I used virtual reality technology to perform surgical simulations, but none of them have been successful. All of them failed due to the arrest of breathing and heartbeat. Professor Johanneson spoke again.

The virtual reality he mentioned is currently the most advanced technology in the world, which can simulate the anatomy and physiology of organs.

Then using virtual haptic technology, surgeons can operate on virtual organs, incising a certain part, it will bleed and hurt an important part, it simulates physiological interference, which is closer to real surgery.

This is the magic weapon of Professor Johanneson. When facing extremely high-risk operations, he will use this system to simulate.

However, no matter how realistic it is, this technology cannot simulate a truly complex human body. It can only do simple simulations of physiology and anatomy. If the simulated operation fails, it will be even less successful on the human body.

Professor Hong? Wen Rentao next to him saw Hong Zhigang's strangeness.

A tear dripped from the corner of Hong Zhigang's eyes slowly, he quickly took out a tissue and wiped it: It's okay, let's think of a way, there's no way we can do it.

How many difficult operations, in his hands, saved the danger and finally succeeded.

The atmosphere of the whole venue fell into dullness. Today's meeting is mainly to listen to the opinions of American experts. The experts of this hospital have discussed it many times.

It is recommended to use radiation for palliative treatment, which may prolong survival. If necessary, I can help arrange, recommend the EDGE non-invasive surgery system, and I can help contact the Henry Ford Hospital Cancer Center. Professor Griffin broke the dullness.

EDGE non-invasive surgery system, the world's most advanced tumor radiation therapy equipment.

Thank you, everyone. Your opinions are very valuable. Let's think about it again. Hong Zhigang stood up and bowed to everyone.

Several colleagues flew over the Pacific Ocean to come to the consultation and offered help, but unfortunately, the condition was too serious. The doctor was a human being, not a god.

The consultation meeting ended, and several American professors were led to visit the hospital.

There is a call from the ICU, Mr. Feng wants to see you. Wen Rentao whispered to Hong Zhigang.

Well, I'll come over, you are with everyone, have the MRI results of the 16-bed come out? Hong Zhigang asked.

Come out. Wen Rentao knew the patients in the department well.

Hong Zhigang entrusted Wen Rentao with the task of accompanying the American professor. He was very satisfied with the student's technical strength and communication skills.

Hong Zhigang rushed to the ICU in a hurry. Although the teacher was conscious, the heartbeat and breathing rate were still relatively slow. This is the interference of the tumor on the respiratory and circulation center. I don’t know where this lifeline is. Once the lifeline is crossed, the teacher will leave.

Hong Zhigang put on an isolation gown, hat and mask, put on shoe covers, and entered the ICU.

Seeing Hong Zhigang coming, Professor Feng stretched out his hand, his voice still sober: Zhigang!

Teacher, I'm here. I just attended the consultation. Professor Johannesson of Neurosurgery at Mayo Clinic, Griffin of Anderson Cancer Center, and Woodhead of Twin Cities Spine Center discussed the surgical plan together. They are in this regard. With rich experience, the success rate of the operation is very high. Hong Zhigang helped the teacher arrange the oxygen catheter and held the teacher's hand.

Professor Feng smiled slightly: Zhigang, you have your heart. As doctors, we must seek truth from facts. According to the current reports, the success rate of the operation is less than 1%. I have a complicated upper neck. Medullary and medulla oblongata tumor, there is no precedent in our hospital, you don't have to hesitate, arrange an operation for me, you will be the chief surgeon, if it fails, I will conduct an anatomical study after the operation, thoroughly understand the pathological characteristics of this tumor and the operation method, and we will The surgical level of complex tumors of the upper cervical spine and skull base has been improved to a higher level, and the progress of medicine is full of risks and ups and downs. Even without this disease, how many years can I live?

Teacher, rest well. The EDGE non-invasive surgery system of Henry Ford Hospital Cancer Center is also more suitable for your situation. I am contacting. Hong Zhigang comforted the teacher.

EDGE is radiation therapy in the final analysis, and the accuracy is only 0.2 mm, which cannot guarantee that the breathing and circulation center will not be damaged. If the laser knife is used for surgery, the odds of success are higher. The current laser knife accuracy has reached 0.1 mm or even lower, and there is a silver lining. Professor Feng is now clear-headed.

Did the MRI of the 16-bed come out? Professor Feng suddenly remembered the purpose of calling Hong Zhigang here.

Out!

Show me.

Professor Feng coughed a few times and tried to get up, but Hong Zhigang immediately held him down: Teacher, don't move, I'll show it to you.

Hong Zhigang waved his hand through the glass door, and the ICU doctor immediately came in. Hong Zhigang said, Please bring a tablet over here.

The doctor brought a tablet computer, and Hong Zhigang entered the hospital system, called up the patient's MRI, and then rocked the teacher's bed slightly higher.

I'm not used to seeing this, Professor Feng complained. He was used to watching film on the reading light, but now he lives in the ICU ward and can only do it.

This is likely to be a solid hemangioblastoma. Be careful when removing it. These blood vessels are very thick. The blood vessels are ligated while removing. This is the blood supply danger zone of the thoracic spinal cord. Pay attention to protect the blood supply of the thoracic spinal cord, especially this root. The blood vessels must be very careful and do not damage them, once the damage is done, the spinal cord will be ischemia and cause paralysis after the operation, please remember!

It's arranged, Rentao is the main surgeon. Hong Zhigang helped the teacher press his legs and do ankle pumping exercises. Lying in bed for a long time could easily cause venous thrombosis in the lower extremities.

Rentao is a good boy, but after all, a young man lacks in experience. You have to come to the stage to help him. This kind of operation is easy to fall into a trap. You must not be paralyzed. Professor Feng explained Hong Zhigang carefully.

He is stable. This tumor needs a microscope. He is more stable under the microscope than me, but don't worry, I will take the stage. Hong Zhigang laughed.

Professor Feng put down the tablet and rested half-lying, which can reduce the load on the heart.

When you're well, I'll take you to our countryside to rest for a month. Now in the small river, it's time to fish. Hong Zhigang chatted with the teacher while watching the monitor screen.

Oh, I'm afraid I won't be able to go. Go ahead and do your work, I'll sleep for a while.

Professor Feng narrowed his eyes.

The writing has been slow recently, because the more you go to the back, the more complicated the case is. The plot laying should be advanced slowly, interlocking, and the transition will be natural, paving the way for the next several climaxes and accumulation. The description of the case should be explained in simple terms, maintain a high professional standard, and be understood by everyone without being boring. Recently, many friends who have given rewards have opened a single chapter to thank them when they have time, and there is also an update from the leader who has given a reward. After writing these chapters, I will add more updates.