Surgery Godfather
Chapter 508 - 464: Right to Speak

Chapter 508: Chapter 464: Right to Speak

As for whether monkeys will develop lumbar disc herniation, it’s indeed a valuable question.

Many doctors theorize that lumbar disc herniation is the toll humans pay for evolving from four-limbed crawling to bipedal walking.

The intervertebral disc, as an organ, hasn’t had time to adapt to the upright human body and is hurriedly pressed into service. As a result, it tends to prematurely wear out under heavy burden, particularly at lumbar regions such as L3/4, L4/5, L5/S1 where the stress is concentrated.

Although a monkey’s spinal column resembles that of a human, there are differences, as monkeys crawl on all fours. The intervertebral disc of a monkey doesn’t need to bear the burden of upright standing like that of a human. Theoretically, degeneration in monkeys would be much less than in humans.

If anatomical studies show that during a monkey’s lifetime, its lumbar discs rarely show the sort of degeneration or herniation seen in humans, this supposition could be supported by experimental data.

Little Five and Zhang Lin decided to uphold Newton’s apple spirit, and a research topic gradually formed during their discussion — comparing the differences between monkeys’ and humans’ intervertebral discs, and identifying the impact of human evolutionary factors on lumbar disc herniation.

This would require observing monkeys at different age groups, with a certain number of monkeys chosen for each age group. They then plan to use age as a clue to create an MRI image spectrum of the monkeys’ intervertebral discs from youth to old age.

Similarly, they would develop an MRI image spectrum of the intervertebral discs of humans of different ages, compare the two image groups and apply a series of statistical comparisons.

"If you thoroughly research this issue and clearly elucidate it theoretically, clarify it through biochemistry, anatomy, physiology, genetics, and other perspectives, you would be of Nobel Prize caliber. The simple question of why eating chili peppers causes anal pain led to two Nobel prizes in medicine with the discovery of TRPV1 (the ’chili pepper’ principle), TRPM8 (the ’minty cool’ principle), and PIEZO1 (the ’feeling of pressure from hugging’) channels." Xu Zhiliang wasn’t sure if he was encouraging or pouring cold water on their enthusiasm.

Zhang Lin generally feels that whatever Xu says is designed to belittle him. If researching why eating chili peppers causes anal pain can win a Nobel Prize, then analyzing the formation mechanism of farts should also be award-worthy, although he didn’t dare retort.

"Old Xu is genuinely praising you. The question of why eating chili peppers causes anal pain has really awarded two Nobel Prizes." Song Zimo stated calmly.

Yang Ping supports these two jesters’ speculation. He isn’t afraid of their absurdity, but rather if they become oblivious and have no desire to make progress.

Regardless of whether they chose to research chili peppers and anal pain, or monkeys and intervertebral discs, maintaining curiosity is always a good thing.

Yang Ping hopes the staff in his department would stay relaxed, optimistic, proactive, and independent instead of suppressed and rigid.

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The schedule is very tight. Now that they have Xu Zhiliang, the unit has ample staff, making shifts manageable. Previously, if the team had to travel to perform surgery, they would definitely be short-staffed left behind.

When they went to Malaysia’s Yingge Hospital for surgery, Yang Ping’s team drained their resources to the point where, out of necessity, Director Han had to personally be on duty with a group of standardized training students.

This embarrassing situation will not happen again now. With either Xu Zhiliang or Song Zimo left to run the department, Yang Ping can rest assured.

Thus, now they can pick up and leave for anywhere as they wish.

High-speed rail has made transportation in China very convenient. They departed at eight o’clock on Friday night and arrived in Guilin at eleven.

They spent a night in a Guilin laboratory to rest before the surgery promptly started at eight the next morning.

Perhaps Director He still remembers how much Yang Ping praised Guilin’s offal the first time he visited, so the main dish of the night was again offal, and even the morning’s porridge was made with offal.

Liang Fatty, guided by the new dietary balance idea, kept burping from the offal, but his gout didn’t recur.

Director He led everyone to begin work, fully supporting Yang Ping’s research. They tamed forty monkeys for the night, mingled sedatives in their food to keep them dozing off.

No food is allowed eight hours before surgery, and no water four hours before surgery.

The doctoral students from Xiehe Hospital were very dedicated. They removed all the body hair from the monkeys’ backs and pre-cleaned their skins. During the hair removal, they strictly followed the latest guidelines for preoperative grooming, using a combination of scissors and electric razors to minimize skin damage.

Each slight skin damage can be a settling point for bacteria, increasing the chance of postoperative infection. The latest preoperative guidelines prohibit the use of manual razors for hair removal and require scissors or electric razors to minimize the likelihood of skin damage.

At eight o’clock the next day, the first monkey was promptly fastened on a specially designed surgical table.

In the supine position, Liang Fatty carried out tracheal intubation for general anesthesia. The procedure for tracheal intubation for monkeys was not significantly different from humans and was similar to tracheal intubation for babies.

The anesthesia doses were calculated based on weight per kilogram, and the weight of each monkey had already been detailed in the medical records.

Each monkey was assigned a number, and each one had a medical record that included a variety of data, including preoperative examination results and the types and degrees of scoliosis.

After the anesthesia was completed, the monkey was placed in the prone position and still fastened by a specially designed rack.

In the operating room, numerous medical students were revolving through the laboratory.

Will the miraculous external spinal fixator devised by the youngest Golden Knife Award winner, who is highly valued by Professor Liang, turn out to be successful?

Song Zimo led Little Five in sterilising and draping. As this was an animal experiment, they aimed to simulate the most realistic human surgery as much as possible.

Even the preoperative verification was carefully completed to prevent a mix-up between monkeys and medical records, which might lead to false data.

Yang Ping was the chief surgeon, Song Zimo the first assistant, and Little Five the second. Percutaneous pedicle screws were implanted in the lumbar area, followed by the attachment of an external fixation frame.

The symmetrical incisions made during the procedure were so small, each only two to three millimeters across, that virtually no spinal structure was damaged.

The surgeries were executed almost as if on an assembly line. With each procedure lasting only ten minutes, the two operating rooms alternated. As one room conducted the surgery, the other put the monkeys under anesthesia. And as soon as one operation concluded, the theme moved to the other room. The switching of rooms greatly increased efficiency.

Once the monkeys awoke from the anesthesia, they were sent to the closed garden in the backyard for observation. Long ropes were used to bind them, limiting their movement. This was necessary for periodic rotation of screws.

The doctor in charge of the monkeys’ perioperative care had extensive experience. Having participated in many animal experiments, he had taught himself veterinary knowledge, including how to interpret monkeys’ lab results, how to read their electrocardiograms, how to analyze imaging findings for them. Monkey’s medical data differed from human’s, and he knew how to make sense of these data.

This doctor jokingly said that he planned to open a pet hospital after graduating, believing that he would make the best veterinarian.

His rich experience in performing heart, lung, liver, and kidney transplants on monkeys and operating on dogs’ brains and cats’ burns instilled great confidence in him. As for minor ailments, medicine simply cured them.

This wasn’t just empty talk. He had seriously considered and analyzed the idea, concluding that there was a wonderful future in becoming veterinarian.

This doctor, who had a babyface, was very familiar with Yang Ping. He said admiringly, "Dr. Yang, you are the only associate chief physician that has won the Golden Knife Award since its inception. Your surgeries are so good. How come you are so proficient at performing surgeries, even the new operative methods, as if you have practiced them for numerous times?"

Yang Ping could not tell him that he had an assisting tool on the side, which provided him with thousands of surgical cases. If he failed, he could retry without any worries.

"The more surgeries you do, the more proficient you become," Yang Ping replied.

As the old saying goes, practice makes perfect.

That is the reason.

As for the animal experiments of the spinal external fixation frame, I have conducted countless successful experiments in the system space.

The surgery was so simple, concluding within a day instead of the scheduled two.

On the "monkey hill" in the laboratory, forty monkeys were tethered by a long rope, with spinal external fixation frames fitted to their backs. They were curious, looking at each other’s metal frames and even reaching out to touch them.

If the external fixation frames could slowly correct their deformed spines, it would represent a significant innovation. This might mean no surgery for adolescents with spinal scoliosis, who could be corrected instead.

If this technique is developed further, adults’ deformations may also be minimally invasively corrected with external fixation frames. Ultimately, normal spinal form and function can be achieved. In contrast, traditional corrective surgery sacrifices much spinal mobility.

Although doubts have been raised. Even Professor Liang in Beijing wondered about controlling the power and direction of correction, maintaining the durability of power, generating drag-induced tissue regeneration under tension-stress, screw loosening of percutaneously implanted pedicle screws, and whether screw holes would get infected. All these questions are still up in the air.

Johnson & Johnson’s Swiss research institute did not believe that the external fixation frames could be applied to spinal correction. They thought the technological complexity was hard to achieve. Therefore, they had chosen to cooperate with Dr. Mitsui of Japan on spinal external orthopedic devices.

Yang Ping himself was very confident. After all, he was merely repeating a successful experiment of his own.

Song Zimo had no doubt about this either. Since their first meeting, Yang Ping had never failed to deliver on his promises.

Having worked all day, they could finally take a breather in the evening. There was no need to go back at night. The pace needn’t be so hectic.

They spent the night at the lab and would return to Sanbo Hospital early the next morning.

They had no time to appreciate the scenery of Guilin. They had come twice and both times had gone straight to the lab from the high-speed railway station. They didn’t have a clear picture of what Guilin looked like.

"This Asia-Pacific Orthopedic Forum in Japan is bound to be fervent. Professor Liang, Professor Qin, Professor Su, Professor Meng, and Professor Fu, all the big shots are going there. It is said that Fujiwara Masao is determined to win this time," Song Zimo brought up this topic on the way back.

Little Five reported, "Takahashi will be responsible for picking us up, and he and his students will accompany us throughout the trip."

"Additionally..." Little Five hesitated.

"What else?" Song Zimo asked, seeing him swallow his words.

"Takahashi mentioned that Fujiwara Miyuki insisted on participating in the welcoming ceremony." Little Five knew about Miyuki’s deep feelings for Yang Ping but felt embarrassed to mention it.

Yang Ping didn’t have the time to think about these things. All he was concerned about was not losing to Fujiwara Masao at the upcoming forum.

This forum was seen as a prelude and trendsetter for the upcoming Asia-Pacific Orthopedics Conference. Whoever had the final say between China and Japan would determine who would get more support.

In international academic organizations, the right to speak is critical.

Without this right, you can only follow others and conform to the standards they set.

This is why Professor Su, Professor Liang, and others are rallying power to clamor for the post of conference chair.

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