Surgery Godfather
Chapter 680 - 608: Escape from Underwater_2

Chapter 680: Chapter 608: Escape from Underwater_2

Music, Markus thought of August’s instructions.

The guzheng version of High Mountain Flowing Waters, which August had specifically brought from China, was loaded into the CD player. After a quick adjustment, he instructed the patrolling nurse to begin playing the music once the chief surgeon completed the preoperative verification.

The Harald Orthopedic Hospital in Munich has a history of over a hundred years and is one of the world’s leading orthopedic specialist hospitals.

At this moment, they were initiating the operation.

They had never thought that the little duke would be on the operating table so quickly.

August and Yang Ping, donned with sterile caps and masks, wearing blue scrub gowns, walked into the operating room. Yang Ping stood in front of the light box, performing the final film reading before the operation.

This was a habit. Regardless of how familiar he was with the case, Yang Ping always insisted on performing a final reading of the films in the operating room.

The operating room was very spacious. Several instrument tables were spread out in an L-shape, and even with numerous equipment and devices such as ECMO, navigation equipment, it didn’t appear crowded.

The tall and robust German nursetransitioned freely in the operating room.

August was by Yang Ping’s side, but the moment he faced someone else, he immediately regained his habitual majesty, issuing orders in the operating room. This was his territory, where he held absolute authority.

With patient positioning done correctly, everyone scrubbed in, disinfected, and covered the surgical area. The operation unfolded naturally.

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Surprisingly, they performed the operation in a lateral position, which everyone had not expected.

But upon further thought, it seemed that aside from the lateral position, there was no other suitable positioning because the little duke’s deformed body could not assume any position other than lateral.

The meeting room in the operating suite was filled with people. A dozen high-ranking doctors huddled at the front, shadows of anxiety clouding their minds, giving them a suffocating feeling.

A lateral position, severe body deformation, how would the surgery proceed?

As if the surgery had no space or time to unfold, this feeling filled them with unease, restlessness, and heaviness.

After the preoperative verification, the music of High Mountain Flowing Waters began, and Yang Ping started the surgery. He cut into the skin and fascia in the center of the patient’s lower back, then separated the muscles from both sides of the spine using an electric knife.

He was in no hurry. His first step was to perform posterior surgery, implanting the pedicle screws.

Although navigation assistance was available, implanting screws in this spiral spine was still a high-risk operation.

When everyone originally thought implanting screws in the lateral position would be extremely difficult, they saw Yang Ping sitting on a stool, facing the little duke’s lower back, Markus idle on the opposite side, and August assisting Yang Ping on the same side.

An automatic retractor was used for exposure of the surgical field.

Even the high-definition camera found it a bit challenging to see the lateral position surgery clearly.

However, Yang Ping kept repeating the steps: creating an opening, implanting the guide needle.

Tens of guide needles were implanted before everyone could react. Under the guidance device, their positioning was very good and then the same operations were repeated: creating an opening, screwing in the screws.

Within just a few minutes, tens of screws were successfully implanted.

This set of instruments was designed by Yang Ping and manufactured with the help of Markus.

Once the screws were in, Yang Ping connected them with a temporary external fixation frame, locking all the joints, then began the posterior osteotomy.

The ultrasonic bone cutter began to work amid noise. Osteotomy was usually a high-risk task, but it was surprisingly easy in Yang Ping’s hands.

The nature of the entire operation seemed to have changed, and the atmosphere on the scene went from highly tense to relaxed, because, watching him, everyone felt like they were performing a minor operation. It wasn’t as terrifying as they thought.

The primary steps of the posterior approach were complete.

Now, the anterior release began. The lateral position made switching between the front and back of the surgery effortless, with no need to change the patient’s position.

The surgery was so swift that the two instrument nurses found it difficult to keep up with the rhythm. Yang Ping and August moved to the other side.

They connected thoracoscopy, laparoscopy, and all kinds of circuitry and tubing. With the support of ECMO, Yang Ping instructed the anesthesiologist to alternatively collapse the lungs on both sides, making room for the operation.

When the thoracoscope was inserted into the chest cavity, the narrow space inside was filled with no visible workspace. Something filled the area around the lens, there was no visual operating space at all.

Yang Ping’s separating forceps pushed the tissue forward bit by bit until it reached the anterior side of the thoracic spine. Yang Ping handed the forceps to August. His job was to hold this forceps, block the surrounding tissue, and create a small gap to perform the surgery.

This gap was barely sufficient.

Watching the surgery on the screen, Professor Lloyd couldn’t help but feel numb in his scalp, because this kind of surgery was like a magician escaping underwater.

This magic trick involved immobilizing a person’s limbs, locking them in an iron cage, and then sinking the person and the cage underwater.

All watched with bated breath as the magician achieved an impossible escape, a sense of suffocation, desperation, and stimulation exactly like now.

This malformed chest, there was hardly any gap to manipulate the thoracoscope and tools in the chest cavity.

Yet Yang Ping boldly created a near-gap space with a pair of dissecting forceps, and another electric knife under magnifying view began to separate and loosen the soft tissue in front of the thoracic spine.

After loosening, a long endoscopic ultrasonic osteotome was extended into the sheath tube.

What was he doing?

Professors Lloyd, William, and Rambo all widened their eyes simultaneously. He was using the endoscopic ultrasonic osteotome to cut bones from the front.

Could it be? He used a temporary external fixator to stabilize the spine, cut the bone from the posterior approach, and cut the bone minimally invasively under endoscopic guidance from the anterior approach. After the bone was cut by the combined anterior and posterior approaches, the spine was corrected using the external fixator, and finally the rod-screw system was locked, the temporary external fixator was removed, and the surgery was completed!

Sure enough, the ultrasonic osteotome was used to cut the vertebrae from the front under thoracoscope.

As the ultrasonic osteotome vibrated, a wedge-shaped cut was made on the vertebrae, and then the excess bone was bitten off and removed.

The irritable Professor Lloyd slapped his thigh, this was genius! To use an external fixator in this way.

In this way, the bone could be cut corresponding to the spine’s stability without worrying about the interference of the spine’s own gravity on the cut, simplifying the entire surgery.

And he can actually use the thoracoscope in such a narrow space.

Even Constantin, a cardiac surgeon, might feel inferior.

What was next? Cut the ribs!

Yes, he guessed right, this surgery was really interesting, almost impossible, suffocating, yet it looked so relaxed.

One by one, the ribs were separated, cut off, and removed, then artificial ribs were inserted.

Twenty-four ribs in twelve pairs, except for a few centimeters left for securing the artificial ribs, all the rest were cut off and removed.

The procedure was delicate and clear, after each rib’s periosteum was opened, it was completely peeled off, revealing a shiny rib.

Artificial ribs were placed into the periosteum, and then sutured.

When replacing the titanium plate in the anterior chest area, August held the heart, because the patient was in a lateral position, there was nothing obstructing the heart, it could roll out of the chest cavity due to gravity.

After every few ribs were cutoff, a few artificial ribs were placed, until all twenty-four ribs were completely replaced.

Twenty-four artificial ribs, connected to the remaining ribs before and after, were then bridged to each other to form a sturdy artificial chest.

This was really daring? The patient’s life depended on ECMO, and he still dared to perform this kind of surgery.

All the big names watching the demonstration video were stunned. The Chinese professor had guts, but he had superb surgical skills to realize such daring plans.

Just that thoracoscopic soft tissue loosening and bone cutting, probably no one present could do it.

After the surgery on the thoracic spine and chest had finished, Yang Ping focused on the lumbar surgery, using laparoscopy, and just as with the thoracic spine, endoscopically relaxing and cutting the bone.

After the anterior and posterior combined bone sections were completed, and the chest had finished being replaced with the prosthesis, the surgery had reached this point with not much blood loss. Besides the inevitable blood loss from the cancellous bone during osteotomy, other bleeding was minimal.

Preparations complete, Yang Ping, along with August, returned to the lumbar and dorsal surgical area.

He carefully adjusted the external fixator, rearranged the severed vertebrae, and one hand watched the screen of the somatosensory evoked potential monitor while adjusting the external fixator with the other hand, being extremely careful.

Gradually, bit by bit, the spine was adjusted.

"Rod in!"

Yang Ping began to install the fixation rod, then locked it, and removed the temporary external fixator from the spine.

"Fluoroscopy!"

Navigation equipment can reconstruct a three-dimensional image of the spine, he was very satisfied.