Surgery Godfather
Chapter 725 - 646: Ceiling

Chapter 725: Chapter 646: Ceiling

There were a lot of people, and everyone was very eager to learn.

Professor Liang could always teach everyone a lot, so everyone liked to listen to his lectures.

Professor Liang’s achievements in the field of spinal surgery are outstanding, and he is not only a leader nationally but has also made world-class academic contributions, making Xiehe Hospital’s spinal surgery known worldwide.

Therefore, the high reputation of Xiehe Hospital has been built up by generations of hardworking people.

After Song Yun finished presenting the case and everyone had enough time to think, Professor Liang started speaking.

"Complete Vertebrectomy, also known as complete removal of the vertebral body, is a complex procedure, and currently there are only a dozen or so articles on it internationally, and even fewer hospitals can perform it."

"Due to the complexity of spinal anatomy, the proximity to the spinal nerves, major blood vessels, and vital organs, the difficulty and risk of surgical resection is extremely high. Previously, these cases were treated with subtotal resections, which lead to incomplete tumour removal and high recurrence rates. Recurrent tumours are difficult to manage and the treatment outcomes for these tumours are very poor."

"In the 1990s, Professor Tomita from Kanazawa University in Japan proposed the posterior approach total vertebrectomy, which is now the complete vertebral body removal surgery. With this technique, not only for this type of tumour, but also for all complex spinal tumours, the surgical outcomes have improved. With this case, I want to ask everyone, what is the specific procedure for vertebral body resection? Song Yun, can you tell me what you think?"

Professor Liang wanted to use this case as an opportunity to teach everyone about the high-risk, high difficulty vertebral body resection, so that they can fully understand the associated knowledge in the context of a real case.

Song Yun graduated from Xiehe’s eight-year program, excelling both in basic knowledge and learning ability. The admission score for Xiehe’s eight-year program is on par with that of Tsinghua University, but due to the smaller intake, it’s even more competitive than Tsinghua University.

This high-standard, stringent and demanding training develops exceptional talents who are the elite in their field.

Just think about Su Nanchen’s admission to Xiehe’s eight-year program with the top science score in the province.

Song Yun, calm and composed, answered in a clear and organized manner:

"Dr Tomita’s surgical approach is also the current mainstream approach, which involves performing the surgery from the posterior route, using a wire saw to split the vertebral body into two parts: the vertebral body and the processes, carefully isolating all structures around the vertebra."

"Given this patient’s specific situation, where the tumour invades the major blood vessels upfront and adheres to them, a simple posterior approach cannot solve the issue. A combined anterior approach is necessary to remove the tumour."

"The choice of the anterior approach should also take into account the growth pattern of the tumour. A lateral anterior approach cannot fully strip the aorta and inferior vena cava, so it is best to choose the anterolateral approach, which will facilitate the treatment of the aorta and inferior vena cava, while also protecting the internal and external iliac veins."

"The treatment of segmental arteries should be meticulous, and we must be very careful to prevent the nerves within the psoas major, that attaches to the vertebral body, from being injured during separation."

Song Yun briefly explained the surgical process and precautions, indicating that he has a very thorough understanding of the surgery to be able to summarize it in such a way.

"Very good! Not only have you read the relevant papers, but you also have some surgical experience and your understanding of the precautions is very accurate." Professor Liang praised.

While Professor Liang sets high standards, he is never stingy with his praise for students. He believes that criticism alone is not enough. Students should also receive timely praise and encouragement.

"So, when the vertebra in this operation needs to be cut from the pedicle, we need a special tool. Why is this tool special? What is special about it? Raise your hand to answer."

Professor Liang continued his questions, as this case had already been discussed, he wanted to check whether the young doctors had mastered it.

Many people in the meeting room raised their hands, everyone was very active, and the atmosphere was lively.

Professor Liang randomly pointed to a young doctor, who had a promising appearance and temperament, and answered with great confidence: "The complex structure of the vertebra necessitates the use of a special guide to get the saw wire under the pedicle root. Since the direction of the saw wire cannot follow the standard route as with long bones, a special redirector is also needed to change the direction of the saw wire, allowing it to go around the pedicle root and effectively cut it."

"It’s hard to buy these special tools on the market. Hospitals that can carry out this type of surgery either bring the tools back from abroad when they go to learn, or they adapt existing tools to accommodate this type of surgery."

"For this patient’s surgery, we need to redesign the tools. Looking at the 3D reconstruction of the spine and the tumor, normally the wire saw is inserted between the laminae, exits through the intervetebral foramen, and uses a redirector to cut the pedicle root. Now, there is an occupying lesion in the spinal canal and no gap to thread the wire saw. Forcing it may cause the tumour to disperse, leading to tumour haemorrhage. The tools need to be altered to accommodate this unique situation."

The reputation of Chinese hospitals is well deserved, with each medical professional being elite among the elites, and they all carry a certain quality: confidence and composure.

Yang Ping listened to their speeches quietly, pondering their unique insights and shortcomings.

"Very good! Every case should be treated as a classic. This is being responsible for the patient and ourselves. A case can teach us a lot. Who is responsible for the 3D printing?" Professor Liang spoke with confidence.

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