The Godfather of Surgery

This week, Yang Ping was very busy. He went to Xiehe University and was called to 301 for a general medical consultation.

The 10 establishment beds promised to Yang Ping by 301 have now been implemented, and Yang Ping has begun to carry out clinical and teaching activities in 301.

Yang Ping sorted out his innovations in surgery. Scoliosis innovations have significantly reduced the difficulty of surgery and improved the effectiveness and safety of surgery. Especially if the precise epiphyseal block technology is successful, scoliosis will be on the market. It can be performed safely in a Level 1 hospital and is as simple as doing vertebroplasty.

In terms of trauma orthopedics, Yang Ping integrated engineering theory into trauma first aid and established a systematic trauma first aid theory, which greatly improved the success rate of treating severe and complex trauma patients. This greatly improved the success rate of trauma first aid in Sanbo Hospital. Once this scientific first aid system and technology is popularized, it will greatly improve the success rate of first aid for severe and complex trauma.

The establishment of joint balance theory in sports medicine allows patients with multi-ligament injuries to obtain good results through surgery and restore the patient's movement ability to the maximum extent.

In joint surgery, the subject assigned to Su Nanchen and Robert is currently progressing smoothly. If successful, there will be a major breakthrough in cartilage damage and degenerative osteoarthritis.

The current K treatment experiments in bone tumors are still standing still. Even if they are standing still, they have opened the door to using the apoptosis mechanism to treat malignant tumors. Once successful, it can not only treat osteosarcoma, but also set off a revolution in the entire field of tumor treatment. A revolution.

In terms of neurosurgery, Yang Ping is studying the clinical anatomy of the brainstem to provide an anatomical basis for brainstem surgery.

Yang Ping felt that if he performed a beautiful operation, he would only be able to save a few more patients, and he would not make any contribution to medicine.

If the surgical method can be improved, the surgical effect can be improved, and the difficulty and risk of the surgery can be reduced, this will make a certain contribution to medicine, but it will still be very limited.

If we can study the mechanisms of some diseases and then innovate treatment concepts, such as the treatment of scoliosis, and update treatment concepts, this contribution is already very considerable.

If we can make a fundamental breakthrough in medicine and then set off progress in the entire field, this will be a truly huge contribution.

Yang Ping's space-guided gene theory is an innovation of this basic theory. This is the greatest contribution to medicine. Based on this, future doctors can use this theory to clone hearts, livers, kidneys, etc., and realize cloning of autologous organ transplants. era, solving many end-stage organ failure diseases. This is like the invention of steam engines, electricity and the Internet, bringing mankind into a new era.

How Yang Ping hopes that the system is an infinite system, but unfortunately this is just hope. The system is limited by points. He needs to accumulate points bit by bit, and then use the points to obtain various conditions for learning, surgery, and scientific research.

Because of the cooperation with the Municipal People's Hospital, Yang Ping personally came to guide the operation and met the legendary Director Zhuo Defeng. When Yang Ping came to the Municipal People's Hospital, Director Zhuo had already left the Municipal Hospital, so they had no intersection. They were only rumored by colleagues. I’ve heard Director Zhuo’s story.

Director Zhuo was young at the time, in his thirties, with good understanding and high standards. He was the highest-level orthopedics department in the Municipal People's Hospital. However, after President Xie started a competition for department directors, Wu Siwen took over as the original department director. After Wu Siwen took over, he will One by one, all the doctors in Corey were squeezed out.

Of course, he would not drive people away openly, but would deliberately disgust them so that these doctors would not be able to stay and resign.

This was the case with Director Zhuo. Wu Siwen stopped all his fourth-level surgeries and some third-level surgeries. Director Zhuo was the deputy chief physician at that time, but Wu Siwen lowered his status to that of an attending physician. Then he arranged for Director Zhuo to retract himself every day. During the operation, he often scolded Director Zhuo: You studied for a doctorate in vain and you can’t even retract. Our department doesn’t have idle people. If you don’t know how to retract, what can you do?

Director Zhuo still had a strong sense of professional ethics and did not get angry on the operating table because the operation was serious and sacred. When the operation was over, Director Zhuo remained silent.

When changing shifts in the ward the next morning, in front of all the doctors and nurses in the department, Dr. Zhuo, a doctor from Imperial Medical University, slapped his work badge on Wu Siwen's face: "I tell you today, I quit, and everyone in the world will know you." This director paid for it, but you think others don’t know, what else can you do besides flattering others, the surgery is like shit, even if you lift my shoes, I think you are too slow."

"You--you--you--" Wu Siwen didn't expect that Director Zhuo would dare to do this. This hit a painful spot, and he became so angry that he couldn't even speak. He almost burst a blood vessel in his brain.

I have a doctorate degree and am a deputy chief physician. I have all the skills, but I still end up dying at the hands of you bastards.

After taking off his work badge, Director Zhuo took off his white coat, folded it and handed it to the head nurse: "The white coat is sacred. I don't want to throw it away. Please help me return it to the hospital. Thank you to my colleagues for their care over the years."

I heard that the hospital that invited Director Zhuo lined up later, and many large tertiary-A hospitals came to me. However, Director Zhuo didn’t go anywhere, but went to a second-A hospital that was not considered a seventh- or eighth-tier hospital, because this second-A hospital had a close relationship with the city’s people. The hospital is on the same street, only a few kilometers away.

In this second-class second-class hospital, which was not popular, the director immediately handed over full authority to Director Zhuo to establish an independent orthopedics department, as if he had found a treasure. All resources were directed to Director Zhuo. This hospital originally did not have an orthopedics department, only the first department of surgery and the second department of surgery. Department, usually there are only a few orthopedic patients.

Director Zhuo started from scratch and worked in the Orthopedics Department of this hospital until it had 120 beds. Wu Siwen of the Municipal People's Hospital also did not rest and successfully worked in the Orthopedics Department of the Municipal People's Hospital from 120 beds to 60. Zhang, and the sixty is often not full, and the actual number of patients is only thirty-four.

There is not a single doctor with high professional titles in the Municipal People's Hospital, and even a rare master's degree is on the job. However, Director Zhuo's Department of Orthopedics has introduced several doctors and several masters, and the level of the entire doctor team is much higher than that of the Municipal People's Hospital.

These two hospitals are on the same street. The Municipal People's Hospital, which is a top three hospital, is being rubbed against the ground by a second-grade hospital. This is very abnormal in the industry.

Finally, both Wu Siwen and Dean Xie went in. Dean Chen took office and invited Director Zhuo to go to the Municipal People's Hospital. After all, this is a second-class hospital with a limited platform.

The conditions that Director Chen offered to Director Zhuo were to be the director and deputy director of the Department of Orthopedics, and the conditions that Director Zhuo offered were that if he wanted to go there, he would have no problem, and the Municipal People's Hospital would form a medical alliance with the second-class hospital where he was located.

For the sake of Director Zhuo, Director Chen agreed to this request and allowed the Municipal People's Hospital and this second-class hospital to form a medical consortium, with Director Zhuo serving as the department director of both parties.

Director Zhuo respects Yang Ping very much. He has just turned 40 and is in the prime of life. He is very willing to cooperate with Yang Ping. Moreover, he knows how high Yang Ping's level is and is very eager to follow Yang Ping. Learn how unhappy he is now with such an opportunity.

Under the introduction of Director Zhuo, Yang Ping learned in detail about the current situation of the Orthopedics Department of the Municipal People's Hospital.

Yang Ping took Director Zhuo to do a scoliosis machine, using Yang's osteotomy. Director Zhuo himself has had scoliosis, so it is very easy to learn. I will take him to do a few more machines and explain it. You can learn to be inseparable.

In addition to scoliosis surgery, Yang Ping also personally taught him how to perform spinal tumor surgery and cervical spine surgery. These surgeries are relatively difficult in orthopedics, especially Yang Ping’s new surgery. If he didn’t teach Director Zhuo face to face, let him It would take much longer to explore by yourself. Director Zhuo is very grateful to Yang Ping for his selfless help.

Just after the operation, Yang Ping was in the locker room preparing to change clothes and go back. He received a call from Dean Chen, saying that there was a difficulty in the thoracic surgery department in the operating room. He hoped Yang Ping could help. Dean Chen knew that Yang Ping was in the third hospital. Bo Hospital now has the authority to perform any kind of surgery, and he is an all-around surgical expert.

Thoracic surgery? It must be a heart surgery. If something went wrong on the operating table, life would be at stake. Yang Ping did not dare to delay and went to have a look accompanied by Director Zhuo.

Yang Ping was familiar with the operating room of the Municipal People's Hospital. Soon, they came to the operating room of the Thoracic Surgery Department. The director of the thoracic surgery department was Director Zhou Zhao, who was also the newly promoted department director of Director Chen. After Director Chen took office, he will All the previous department directors were removed and replaced by new young and promising PhD and master's students.

Director Zhou Zhao is about the same age as Director Zhuo. Because he has been staying in the hospital, he has not done any decent surgeries in recent years. However, he is the only doctor in thoracic surgery, and Director Chen is also the tallest among the shortest, so he was promoted to director. .

"Professor Yang!"

Director Zhou's forehead was wet, obviously from sweating.

"what's the situation?"

Yang Ping and Director Zhuo took a closer look.

Director Zhou stopped the operation and introduced Yang Ping's condition in person: "A fishbone was located in the sternum and penetrated from the esophagus into the aorta, forming an aortoesophageal fistula. It was clearly shown on the CT film, but it could not be found after the thoracotomy. Wherever the fish bone is, it’s gone.”

Director Zhou condensed the medical records and stated the most important information.

Yang Ping thought it was some kind of heart surgery, but it turned out to be fish bone removal. He immediately went to read the CT film in front of the reading lamp. Director Zhuo went to get the medical record folder and handed it to Yang Ping.

The fish bone enters the aorta, which is very dangerous and can easily cause massive bleeding. However, if the fish bone cannot be found during thoracotomy, it means that after such a major operation, the problem was not completely solved in the end. The patient and his family must not understand. This is really troublesome.

Sometimes, even if you look at a small fish bone, it is really difficult to do.

"Can the fistula on the aorta and esophagus be seen?" Yang Ping asked.

Director Zhou replied: "You can see the fistula. Should I repair the fistula on the esophagus and aorta first? Put the fish bones aside first."

Since it cannot be found, there is nothing we can do. We cannot let the patient lie on the operating table all the time.

Yang Ping saw from the CT film that there was indeed a fish bone, about two centimeters long, inserted diagonally into the esophagus and aorta. The CT picture was relatively clear, and the location was just behind the sternum.

Now that the fistula has been found, but the fishbone is missing, it means that the fishbone has been displaced. It is very common for fishbones and foreign bodies to be displaced. After CT, people have to move, breathe, etc., which will cause the displacement of fishbone.

It is not difficult to displace it in a local area. I am afraid that the fishbone will enter the aorta and then be displaced along with the blood circulation. This kind of displacement is far away and very difficult to locate.

There is an X-ray C-arm machine in the operating room. X-ray C-arm machines are generally used in orthopedics departments. They are commonly used in other departments, such as urology departments for urinary tract stone surgeries. X-ray C-arm machines are rarely used in thoracic surgery departments. He was brought in from the orthopedic surgery room to help temporarily. Even with the C-arm machine, he couldn't find where the fish bone was.

It’s not easy to go on stage at this time. Yang Ping looked through the medical records and found that the patient was 52 years old. He accidentally swallowed a fish bone at a dinner 10 days ago. At that time, he swallowed the fish bone together like a rice ball. After no foreign body sensation, he The patient thought he was fine, but 5 days later, he began to feel a dull pain in the back of his chest. The patient came to the Municipal People's Hospital, thinking it was angina pectoris, and did some cardiovascular examinations, but no evidence of myocardial ischemia or infarction was found.

The patient himself told the doctor that he had eaten a fish bone a few days ago. The doctor immediately thought that the fish bone was stuck in the esophagus, so he did an emergency chest CT and found a thin fish bone. It was not just stuck in the esophagus, but Puncturing the esophagus and entering the aorta behind it is equivalent to penetrating the aorta diagonally from the esophagus. This is very dangerous. Once the aorta is torn, massive bleeding will occur, which is life-threatening.

The doctor recommended that the patient be admitted to the hospital for emergency thoracotomy to remove the fish bone. This surgery must be performed through thoracotomy. It is difficult to perform with an esophagoscope and can easily aggravate the damage to the esophagus and aorta. In case of massive aortic bleeding when pulling out the fish bone, thoracotomy is required. It was too late, and the esophagus and aorta needed to be repaired, and there was no way to repair the aorta under esophagoscopy.

The patient and his family didn't quite understand that a fish bone required such a major operation as a thoracotomy, but after listening to the doctor's analysis, they reluctantly agreed. Now the patient is lying on the operating table, and the thorax has been opened, but the fish bone has not been found. What should I do?

While Director Zhou was anxious, Yang Ping had already decided to go on stage: "How about I go on stage to help you take a look?"

"Then trouble Professor Yang!"

Director Zhou burst into tears with gratitude. Professor Yang was a noble person invited by Dean Chen to help the People's Hospital improve its medical level. Improving medical level involves many aspects. Training talents and performing surgeries is one aspect, and helping to solve some problems is also another aspect.

A doctor immediately took Yang Ping to wash his hands, and Yang Ping washed his hands and came to the stage.

He carefully examined the fistula between the esophagus and the aorta, and combined with the fishbone images on the CT film, it was likely that the fishbone had entered the aorta and followed the blood circulation and traveled far away.

But Yang Ping still carefully explored the surrounding area, focusing on the location of the esophageal and aortic fistula, but could not find the fish bone.

"I'm afraid the blood circulation has gone too far after entering the aorta. We have to find it step by step according to the direction of blood flow." Yang Ping made a judgment.

Director Zhou immediately felt that his head was big. If so, where to find it? The aorta has many branches and fish bones can enter it. It can go to almost any organ.

Even if they find it with all their strength, it may leave again, and by then the blood vessels will be cut to pieces, and not even a hair will be found.

This is the first time Director Zhou has encountered such a battle with this fish bone.

When other doctors and nurses think about how much fish they have eaten over the years, they feel like they are surviving a disaster.