Surgery Godfather
Chapter 1011 - 841 Trouble Helping Me Lead the Way

Chapter 1011: Chapter 841 Trouble Helping Me Lead the Way

If this surgery were to be broken down into steps, it would be divided into four major parts: the resection of the eight organs and the tumor as a whole---the ex-vivo resection of the tumor---the reconstruction of the blood vessels and some structures---the transplantation of an artificial blood vessel into the inferior vena cava and the autotransplantation of the six organs.

The patient’s vital signs remained stable, and Yang Ping began to speed up the surgery, trying to reduce the duration as much as possible.

The "Golden Team" was in place, Xu Zhiliang took Zhang Lin to harvest the great saphenous vein from the lower limb, while Yang Ping started with Song Zimo and Little Five on the various vascular reconstruction surgeries and some structural reconstructions.

Liang Fatty sat cross-legged, checking the data on the monitoring equipment from time to time, then making records and analyzing them mentally.

Director Shi stood beside the sterile table observing the surgery, Director Fang switched back and forth between the LCD screen and the sterile table, and other doctors gathered in front of the LCD screen. This screen, mounted on the wall, was far from the operating table, minimizing any disturbance to the surgical staff,

Xu Zhiliang harvested two very long segments of the great saphenous vein to use as material for vascular transplantation. He followed Yang Ping’s instructions, cutting the veins into various lengths, soaking them in saline before taking them out, and laying them out neatly on wet saline-soaked gauze for later use. The excised human tissue needed to be kept moist, otherwise it would dry out and die.

Director Shi was puzzled by Xu Zhiliang’s actions. Professor Yang’s team hadn’t calculated the quantity of blood vessels needed or measured their lengths, so how could they have prematurely cut all the veins into various lengths?

What if they were unsuitable? If unsuitable, those blood vessels would all go to waste.

Director Shi himself had also performed ex-vivo resections and autotransplants for pancreatic tumors. Although he had not racked up a large number of cases, he was still ranked at the forefront nationally, so his experience could be considered extensive.

It wasn’t just him; other experts too would only decide after tumor resection whether vascular transplantation was needed. If so, they would calculate the number, diameter, and length of vessels required, roughly estimate the data, and report it to an assistant, who would process the blood vessels accordingly. Never like this, where an assistant directly cut the blood vessels into dozens of pieces.

Could it be that Professor Yang had already considered these factors and made precise calculations before the surgery? It seemed impossible.

Director Shi, holding onto his question, couldn’t help asking Yang Ping, "Professor Yang, had you completed the measurements for the quantity and length of blood vessels through preoperative images?"

While performing the surgery, Yang Ping replied, "It’s like building a house; you need a blueprint beforehand, detailing what materials to use, their specifications, all planned in advance. Moreover, how much surplus material to prepare should also be included in the calculations. It’s the same engineering concept I was talking about. Our surgeries, especially such major surgeries, must be informed by engineering principles to be successful. Otherwise, it is easy to make a mess by overlooking certain aspects."

Director Shi learned something new today about the application of engineering principles in surgery; he pondered over the words of Yang Ping and found them incredibly meaningful. In the future, he too would apply these principles of engineering to his surgeries to make them more rigorous and precise.

Director Shi noted this core technique. Without the guidance of such engineering concepts, complex surgeries like this were very likely to fail.

The left kidney had been resected and did not need transplantation; the gallbladder was removed, with no transplantation involved; an artificial blood vessel was used to replace the inferior vena cava; Yang Ping had already transplanted the blood vessels for the remaining five organs, and now it was time to put them back into the body and get them properly positioned.

First, the transplantation of an artificial blood vessel into the inferior vena cava was completed to facilitate the subsequent surgeries.

After completing the transplantation of an artificial blood vessel into the inferior vena cava, the five organs were returned to their correct positions.

Once positioned, the suspensory ligaments and mesentery of the organs were first anastomosed to secure the organs within the body properly, preventing them from wandering and avoiding dangerous twists or herniations.

With the organs secured, Yang Ping began to anastomose their arteriovenous blood vessels, as well as any nerves that were necessary and possible to join.

First, vascular anastomosis was performed on the pancreas, followed by the reconstruction of the pancreatic duct, then the blood vessels of the liver were anastomosed, including the hepatic veins and the portal vein, and the biliary tract was reconstructed.

These two steps in the reconstruction of functional pathways were incredibly important; if not done well, they could easily lead to bile leaks and pancreatic fistulas, causing chemical peritonitis and infections, which could trigger severe complications.

Since the small intestine had been resected, the pancreatic duct needed to be connected to the jejunum. Yang Ping employed the Blumgart anastomosis, a modified technique for pancreatoenteric mucosal anastomosis, which required the surgeon to have a high level of skill with the fine details of duct anastomosis. For Yang Ping, who was proficient in anastomosing fine vessels, this was no challenge at all.

Reconstructing the liver’s biliary tract was also particularly tricky; in this patient, it was a biliary reconstruction near the hepatic portal that required forming the openings of several bile ducts before performing a Roux-en-Y biliary-intestinal anastomosis.

In these autotransplants of the various organs, those of the pancreas and liver were the most difficult due to the need for complex vascular and functional duct reconstruction.

Director Shi watched with keen interest, as every step represented the pinnacle of hepatobiliary surgery and pancreatic surgery. Now integrated into a single procedure, it was rare to see such complex reconstruction in typical circumstances.

"Professor Yang’s general surgery skills are extraordinarily high, aren’t they?" Director Shi mused, noticing that the gap between them was more than slight.

Especially the concept of applying engineering principles to major surgery; in terms of philosophy, he was already far ahead of Shi, who was still at the level of making a rough plan before the surgery and taking one step at a time during the procedure, without any of the detailed engineering concepts in mind.