Surgery Godfather
Chapter 1122 - 901 I Can Also Perform This Surgery_2

Chapter 1122: Chapter 901 I Can Also Perform This Surgery_2

The bridging blood vessels were generally harvested directly from the scalp, and Yang Ping’s movements were quick as he selected several arteries of appropriate diameter and length for standby.

After harvesting the bridging vessels, Yang Ping proceeded to isolate the superficial temporal artery.

The superficial temporal artery is the terminal branch of the external carotid artery, emerging between the lateral face’s temporomandibular joint and the ear, then ascending to the scalp.

If the surgery is to be meticulous, it is best to use intraoperative surface ultrasound to locate the superficial temporal artery, seek its course, and then mark it.

The superficial temporal artery is then isolated based on the marking.

Yang Ping was extremely familiar with human anatomy, so he didn’t need surface ultrasound for localization, thus saving more surgical time, but this was limited only to him.

So as not to mislead other doctors, whenever he performed such personal shortcuts, he would remind everyone, "When you perform this surgery, you must use surface ultrasound for locating the superficial temporal artery. You must not imitate my omission."

Xia Shu hadn’t been at the hospital long and was still unfamiliar with some things, but he was very earnest and liked to get to the bottom of things he didn’t understand, so he curiously asked, "Why can’t we do it this way? Isn’t it pretty good? Skipping a step saves surgical time, especially in emergencies, it’s both fast and effective."

"Your skills aren’t flawless yet. If you skip the surface ultrasound localization, it’s easy to damage the vessel during the harvest, and if you want to achieve quality in surgery, you must locate the superficial temporal artery. This allows you to grasp its exact course, maximally protecting the vessel during harvest and preventing injury," Professor Chen responded to Xia Shu.

So, it was a matter of surgical expertise. Xia Shu finally understood.

After isolating the superficial temporal artery, Yang Ping, based on his mental image of its course in the scalp and the preoperative images, along with the anatomical features of a two-year-old child’s head, selected an appropriate site for the vascular anastomosis within the center of the cranial bone window that he was ready to carve out.

The surgical incision was designed to be about 0.5 cm on either side of the anastomosis point, making the incision about 1 cm in total.

This was using a minimally invasive approach. In adults, the anastomosis is usually only about 2-2.5 cm apart, with an incision around 5 cm, much smaller compared to traditional surgical incisions.

"This isn’t the conventional method?" Professor Chen asked.

"Minimally invasive!" Yang Ping said as he worked.

The primary condition for this minimally invasive method was precise judgment of the anastomosis point, which must be the closest location between the superficial temporal artery and the middle cerebral artery.

To find this optimal spot, one typically relies on CTA-based navigation, but Yang Ping could locate it precisely just using the images.

After making the incision, Yang Ping opened a bone window about 0.5 cm in diameter at the center of the anastomosis point, entered the skull through the bone window, and then opened the dura mater.

The patrolling nurse immediately brought over the microscope, and under it, Yang Ping looked for the appropriate recipient artery to isolate.

He cut through the temporal muscle and then opened a 1 cm diameter window, opened the dura mater, and freed less than 1 cm of the recipient vessel, temporarily clamping it shut with the finest microvascular clamp.

"Pay attention to this step, everyone. Don’t allow the vessel to twist. Once it twists, it can easily lead to vessel blockage," Yang Ping warned everyone.

"Attention everyone, critical technique!" Zhang Lin reminded everyone.

Li Min immediately pulled out a small notebook, and almost simultaneously, several other doctors also pulled out their notebooks, indicating a similar routine among them.

Carefully, Yang Ping used micro forceps to cut open the recipient artery and performed an end-to-side anastomosis between it and the superficial temporal artery. After the anastomosis, he injected indocyanine green and then confirmed under the microscope that blood flow was unobstructed.

Indocyanine green is a fluorescent imaging agent, and right now, the microscope Yang Ping was using had a fluorescent imaging feature.

Thus, under the microscope, the blood flow within the vessels could be observed through fluorescence.

"You absolutely can’t skip this step, no matter how confident you are. Look, even I didn’t skip it," Yang Ping once again reminded everyone of the critical step.

After completing the bridging of the superficial temporal artery with the middle cerebral artery through a single vessel anastomosis, Yang Ping did not feel reassured and went on to bridge anastomose two more vessels.

At this point, the first step of the surgery was completed.

The second step involved applying the temporal muscle and flipping the dura mater, which seemed much simpler in this part of the surgery.

The blood supply of the temporal muscle and the dura mater was rich, and by attaching it to the surface of the brain tissue, which was secreting a special substance due to cortical ischemia, the stimulus from this special substance would cause the growth of new vessels from the temporal muscle or dura mater towards the cortex, improving the blood supply to the ischemic brain tissue.

The once malformed blood vessels were replaced by newly formed ones.

The entire surgery took only half an hour to complete and appeared to be straightforward.

Watching from the sidelines, Li Min felt that he could perform the surgery too, as it seemed quite simple.

In reality, that was an illusion. No matter which surgery was performed by Yang Ping, it always looked incredibly simple, so simple that even an intern would be eager to try.

——

Xixi’s mother finally rushed to the hospital and anxiously asked Xixi’s father outside the operating room, "How is Xixi doing now?"

"She’s undergoing emergency surgery," Xixi’s father replied.

"Does it have to be surgery? What’s the matter? There isn’t anything serious, is there?" Xixi’s mother was very worried.

"She just went in; don’t worry, Professor Yang is the chief surgeon, there will definitely be no problems," Xixi’s father reassured her.

"What about my parents? Did they not come together?"

"They came, but I guess they’re downstairs arguing right now. Mom won’t allow the doctors to perform any examinations on Xixi, claiming it’s harmful to her health, let alone surgery. The doctors said it was urgent, so I took the decision into my own hands. While still in the emergency ward, dad pulled mom outside, and I guess they’re still arguing now."

"We definitely can’t listen to them; you’re right to act this way. It’s okay for trivial matters, but for something this serious, we can’t let them make a fuss. Don’t worry about them, I know my own parents." Li Ni didn’t blame her husband and thought he had done the right thing.

But her daughter was still in surgery, and he was indeed worried.

While the couple was speaking, the operating room door opened. Had the doctor not called the family at that moment to say the surgery was over, Xixi’s parents would have definitely suspected a problem with the operation.

The whole process of the surgery, from beginning to end, lasted less than an hour.

——

After the surgery, Xixi was taken back to the ward. Back at the doctor’s office, Yang Ping explained the situation of the surgery to Wang ChengPei and his wife, telling them that the surgery was very successful, that Xixi could drink water and eat six hours after surgery, and that she could be discharged in a few days. He advised them to ensure she drank more water to keep her blood from being too concentrated.

Wang ChengPei thought, it was a good thing his former colleague, Guo Peihua, had advised him. Since his own mishap, Guo Peihua had had a major realization and no longer stayed up late or worked overtime. He sold his old house and bought a new one near Sanbo Hospital, and even quit his old job to find another locally.

Once, while dining with Guo Peihua, Wang ChengPei mentioned an issue with his EKG from a physical exam. Speaking from experience, Guo warned him not to take it lightly, as once something went wrong, it would be serious—Guo had, after all, survived a brush with death at Ghost Gate.

Thinking it over, Wang ChengPei got a bit scared and immediately discussed it with his wife, who was rather supportive of whatever he did. So, they sold their house and bought a new one near Sanbo Hospital. Shortly after moving in, their daughter had this incident.

The couple stayed by their daughter’s bedside, and by that time, the old man and the old lady had stopped arguing and found their way to the ward.

"I said it was bad luck to move houses, didn’t I? You didn’t listen to me, and look, something happened, didn’t it?" the mother-in-law prattled on.

Being the son-in-law, he definitely wouldn’t argue on matters of principle.

But his daughter was a different matter; Li Ni was not afraid of her mother.

"The doctor said it’s congenital, she was born with it, what does moving have to do with it? It just hadn’t been discovered before. If we weren’t now close to the hospital, who knows what would have happened."

"If the doctor says so, then so it is? Can’t you use your brains? Nowadays doctors just want to make money, they’re just scaring you, haven’t you seen the news?" her mother-in-law argued confidently.

"Those are rare occurrences. Every industry has its bad apples. Haven’t you also seen news about bank deposits just disappearing? Have your bank deposits disappeared? Have you ever embezzled a customer’s deposit?"

Li Ni countered her mother, who had worked in a bank before retiring.

Her mother, at a loss for words from Li Ni’s rebuttal, knew that her son-in-law usually indulged her mother, but she did not tolerate it and always stood by her husband’s side, supporting him.

"What are you saying?"

"I’m just making a comparison. Don’t treat every rare incident you hear in the news as if they’re the norm."