Surgery Godfather
Chapter 1119 - 900: Fortunately, Listening to the Doctor

Chapter 1119: Chapter 900: Fortunately, Listening to the Doctor

PS: Haven’t changed; it’s messy. I’ll get back to it later. Thank you.

The little girl Xixi now exhibits left-sided limb paralysis, which indicates a blood vessel occlusion. A blood vessel occlusion means that if it persists beyond a certain time, the brain tissue supplied by this blood vessel will undergo infarction.

Emergency surgery aims to restore blood supply before the brain tissue infarcts, reversing the illness and averting lifelong disability. Thus, the left-sided limb paralysis would return to normal.

Once brain tissue infarction occurs, the condition is irreversible, resulting in permanent left-sided limb paralysis.

The core of surgery for Moyamoya disease is still the treatment of blood vessels, specifically intracranial vascular surgery, with vascular anastomosis being the most critical aspect.

Coronary artery bypass is also a vascular anastomosis, and organ transplantation involves vascular anastomosis, showing how vital the basic skill of vascular anastomosis is, evident in many cutting-edge surgeries.

Yang Ping tirelessly requires the department’s doctors to repeatedly train in basic skills to perfect them.

Even though Song Zimo and Xu Zhiliang are very skilled, he still requests that they regularly train in basic skills to achieve endless improvement.

Actually, any complex surgery is a combination of basic surgical skills.

For instance, the surgery for Moyamoya disease, after understanding its pathogenetic mechanism, involves a combination of basic techniques.

This little girl has ischemic symptoms due to blood vessel occlusion. To resolve the occlusion, one must either clear the vessel or create a new vessel to bypass the original occlusion, allowing blood to flow through. The former is impossible due to the congenital nature of Moyamoya vessels; hence, the latter is the only option.

Patching technique and vascular bypass surgery both aim to reestablish new blood flow; they differ only in method and process.

Zhang Lin and Little Five have already gone to the emergency department for a consultation, while Yang Ping is in his office contemplating the little girl’s surgery on his computer.

For consultations, unless they are particularly special, Zhang Lin and Little Five can handle them independently.

The surgical approaches for Moyamoya disease are divided into three types: vascular bridging, also known as direct vascular reconstruction, which is technically challenging and requires robust vascular anastomosis skills. It provides immediate effect but has a limited supply range when bypassing a single blood vessel.

The second method is the patching technique, where tissue with rich extracranial blood supply is applied to the brain. Over time, the blood vessels of this tissue gradually grow into the brain, establishing a rich collateral circulation over the brain surface with the necessary tissues. The effects start to show after 3-6 months as the patched tissue’s vessels spontaneously connect with the brain cortex’s vessels. This method is straightforward but slow to take effect, taking 3-6 months to show any result.

The third method combines the previous two, performing both types of surgery to complement each other and avoid the disadvantages of each while harnessing their advantages.

This two-year-old child, having particularly fine blood vessels, makes most doctors opt for the second method. However, as this little girl currently exhibits symptoms, it’s clearly inappropriate to use a method that takes 3 months or half a year to show results.

Yang Ping decides to use the third method, performing both vascular bypass and patching together.

The difficulty is considerable, but it provides the best outcome. For Yang Ping, there is no distinction between high or low difficulty in surgeries, only between superior and inferior outcomes.

This patient, for whom the bypass is not just one vessel, Yang Ping plans to bypass several vessels.

Emergency Department.

The emergency doctor has already performed the pre-operative checks on Xixi, ready to sign off and then send her to the operating room for emergency surgery.

Xixi’s father, Wang Chengpei, is extremely anxious, utterly bewildered, and it takes him a while to recover his senses.

Because recently at home, Xixi did not fall or sustain any injuries, she was watching a cartoon and suddenly couldn’t move her left limbs, and she burst into tears without understanding what was happening.

Her grandmother quickly came to console her and noticed Xixi couldn’t move one side of her body at all. Initially thinking it was a fracture from a fall, but clearly, there had been no fall, and the whole family witnessed her watching TV just fine until suddenly something was wrong, and she started crying.

If it were an elderly person, they would definitely think of a stroke, but how could a child have a stroke? So, their first thought was definitely an injury.

The family did not dare delay; since mom was still at work because of overtime, dad Wang Chengpei and the grandparents immediately carried Xixi to the hospital.

Fortunately, their home is close to the hospital, and they arrived quickly.

The emergency doctor was very experienced, asked a few questions, barely examined, and felt it was a brain vascular issue; however, to be certain, Professor Chen Jianliang from the Surgical Research Institute was called in.

Professor Chen, after examination, said, "This is definitely a brain vascular issue. It could be either cerebral hemorrhage or cerebral infarction. Why not perform emergency cerebral angiography?"

"Isn’t it a fracture or dislocation? How could a two-year-old have cerebral hemorrhage or cerebral infarction? Please let the orthopedic doctor have a look before proceeding," Xixi’s grandmother disagreed with doing any cerebral angiography, especially upon hearing that it involves injecting a contrast agent into the body, which made her even more apprehensive.

Professor Chen confidently said, "This is a problem with the brain vessels, likely a cerebral infarction. Don’t waste time. Go straight for the cerebral angiography. Once we confirm, treatment is a race against the clock, and any delay will result in lifelong hemiplegia."

Upon hearing this, Xixi’s father Wang Chengpei knew he couldn’t indulge the elderly’s whimsy. The doctors were professionals, so he instantly made up his mind, "Doctor, I’m the child’s father, we’ll listen to you. I’ll sign whatever needs to be signed, please proceed as you suggest, and let’s not waste any time."

The grandmother still attempted to intervene: "No, the child can’t withstand such torment. Let’s wait for Li Ni to arrive before deciding."

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