Surgery Godfather
Chapter 726 - 646: Ceiling_2

Chapter 726: Chapter 646: Ceiling_2

"Me!" A young doctor raised his hand.

The doctor immediately went to the computer and projected the model of the 3D artificial spine onto the screen.

Due to the significance of 3D printing technology, almost every doctor in Xiehe Orthopedics is proficient in this technology, which they take as a fundamental skill to train.

The 3D printed artificial spinal prosthesis was projected onto the screen, rotating 360 degrees.

"This is the 3D artificial spinal prosthesis we designed to replace the three vertebrae that will be removed during the surgery. To effectively reconstruct the vertebrae, we tailor-designed it according to the patient’s anatomical structure and biomechanical characteristics. This is the top and bottom of the prosthesis, perfectly fitting the connection surfaces of the normal vertebrae above and below. These are the purposely designed screw implantation holes, which can connect the artificial vertebrae with the posterior rod system, forming a unique truss structure. The truss structure combined with the porous design of the titanium alloy we used endows the artificial vertebrae with sufficient biomechanical strength. After the surgery, the patient can get out of bed and start rehabilitation training as soon as possible, achieving a life and work like a normal person."

Yang Ping thought the design of this artificial vertebra was excellent, in complete accordance with biological and biomechanical requirements. The designer must have undergone related systematic training.

Having combed through it all, the preparation for the whole surgery seems thorough and without any omission.

"I have a question!"

A young doctor raised his hand to ask a question from the crowd where there were no seats.

Because there were so many people, some had seats while many young doctors were standing.

"Go ahead!"

Professor Hu Guolin asked him to stand out.

A doctor in his early thirties stated aloud, "The preparation for the surgery that was just mentioned is all based on the assumption that everything goes smoothly. But what if it doesn’t? What if in extreme situations the aorta or inferior vena cava ruptures while being peeled off? Specifically, what if large-scale tearing happens?"

This doctor walked up to the podium with his chest held out and continued confidently:

"Look here, the tumor adheres to large blood vessels for up to 10 centimeters. In this situation, the aorta and inferior vena cava are very likely to tear. Even if they don’t and the tumor and large blood vessels are successfully separated, can these large blood vessels still function? Is there a safety risk like an aortic dissection, a ticking time bomb? I saw an article mentioning a case about an abdominal tumor specialty. The tumor was adhered to the abdominal large blood vessels, and the doctor successfully separated the tumor and the large blood vessels. The surgical process went smoothly, but the patient suddenly died on the fifth day after the surgery. Autopsies later determined the cause of death to be an aortic aneurysm. The aorta was invaded by the tumor; the vessel wall had changed, providing groundwork for the onset of an aortic aneurysm. The patient developed an aortic aneurysm after the surgery; a large-scale aortic tear led to the patient’s shock due to internal bleeding and death. Have we considered how to act in the worst-case scenario? Rely on blood transfusion?"

This young doctor spoke critically, his tone sharp as if questioning his colleagues, questioning Professor Liang and Director Hu in the front row.

Yang Ping noticed that the Xiehe’s doctors, almost none of them stooped or hunched, all holding their heads high and chests out, standing straight.

Even at his age, Professor Liang, whether sitting, standing, or walking, holds his head high and his chest out, looking alert and energetic.

"Very Good!"

Professor Liang applauded the questioner, and everyone followed suit with applause.

"What do I always tell you as doctors to be like?"

Everyone replied together: "Do your best and prepare for the worst!"

"Correct! We strive towards the best goals, but we also prepare for the worst. Who can answer this doctor’s question?" Professor Liang was very satisfied with the doctor’s question.

People in academia must have a spirit of inquiry and not follow others blindly, lacking the ability of independent thinking.

Director Hu stood up: "Let me answer. We have already considered this situation and have even measured the vascular wall on the imaging pictures. Indeed, there is a high risk involved with the vessel wall. For this, we have an artificial blood vessel prepared and have invited vascular surgeons for assistance. We will check the vascular condition during the surgery and, if necessary, preemptively implant the artificial blood vessel to prevent the worst-case scenario that this doctor mentioned."

The questioner was very satisfied, as the director’s considerations were indeed thorough.

"Are you satisfied with my answer? You must have left the case discussion early because this issue was mentioned last." There was no accusation from Director Hu, but he politely informed the questioner.

Indeed, the doctor, who was part of the medical team on duty, had temporarily left for an emergency surgery.

Yang Ping sat in the first row, with the screen displaying the enhanced three-dimensional reconstruction of the tumor. Seeing the extent of the tumor’s invasion, filling up the spinal canal, invading the spinal cord and nerve roots, adhered to the anterior side and the inferior vena cava, the difficulty of removal was indeed very high. Especially since the wall of the vena cava is thin, a slight mistake during the separation process would cause the wall to rupture.

The tumor, intertwined with the spinal cord nerves inside the spinal canal, could easily damage nerves. The surgery was undeniably world-class.

Preemptively implanting an artificial blood vessel was a very clever move that minimized the risk of rupture during and after surgery.

There was another issue, not fatal, but poorly handled it could easily lead to the spread of the tumor. The tumors on vertebrae L2 and L3 had already invaded the pedicles on both sides. In this case, using a wire saw to saw off the pedicles would inevitably damage the tumor body, causing the tumor cells to spread.

To reduce the chances of spreading, meticulous operation was the only solution.

If the vertebra is not bisected but instead removed as a whole piece, this problem could be avoided.

However, with no precedent in the world for this kind of complete vertebra excision, the complexity was overwhelming and it was virtually impossible to achieve.

Yang Ping was contemplating this issue in his mind, striving to perfectly handle each step.

"Does anyone have any other questions?"

Director Hu asked everyone as the discussion couldn’t go on indefinitely. It would never end even if it went on for days and nights.

"Just now, it was mentioned that the tumor and pedicles are intertwined, how can we insert the wire saw without damaging the tumor body and reducing the spread of the tumor?" A doctor was also contemplating this issue and raised it.

"To remove the vertebra, it must be bisected. It’s impossible to remove it as a whole. Thus, this problem can’t be avoided. We can only peel the tumor off the pedicles, insert the saw after peeling, and improve our tools by adding a protective cover during insertion, which will minimize the risk of spreading," Director Hu introduced the solution.

The person raising the question nodded in satisfaction. This was already the best method; taking out the entire vertebra at once was simply not feasible.

"Any other questions? We’re short on time; further questions can be discussed privately."

When nobody raised their hand, Director Hu said to Professor Liang, "Shall we go see the patient?"

Professor Liang nodded and said to Yang Ping, "Let’s go see the patient together."

Professor Liang didn’t give Yang Ping a chance to speak. After all, it was Yang Ping’s first time at Xiehe. Professor Liang didn’t treat him as a student but as a fellow professor, as the conference was of an educational nature.

Together with Song Yun, everyone arrived at the ward. Jing Yunsong, a chubby man with a notably swollen abdomen, was chatting with his fellow ward mates. Seeing the professors coming to make rounds, he immediately returned to his bed.

Upon such visits, most patients are usually baffled and unclear about the situation, but Jing Yunsong was very relaxed, likely due to his experiences at various hospitals.

"Professor Liang, it’s nice to finally meet you," Jing Yunsong recognized Professor Liang.

Prior to his arrival at Xiehe, Jing Yunsong had scoured the profiles of all orthopedic doctors on the hospital’s website.

"We’re preparing to perform surgery on you. The operation is quite complex and carries a high risk, so we wanted to come and see you again," Professor Liang kindly said.

Jing Yunsong chuckled, "If it’s not complex or challenging, I wouldn’t have come to Xiehe. I’ve heard that when other hospitals encounter difficult cases, they usually suggest transferring to a higher-level hospital. But Xiehe doesn’t have that kind of talk because it is the highest-level hospital in all of China. If you won’t perform the surgery, then my only option is to travel the world."

It was rare to encounter patients who remained so relaxed, regardless of whether the ease was genuine or feigned, the fact that he could confront it with optimism was a good thing.

"Professor Liang, I heard Xiehe performs the most surgeries of this kind in all of China. That’s why I came. Whether it’s possible or not, now that I’m here, there’s no other place for me to go. There’s a saying, ’the King of Hell wants a soul at the third watch, but Xiehe can hold him off until the fifth watch.’ I find the saying amusing," the patient was quite humorous.

It is very rare for a tumor patient to be so optimistic.