Surgery Godfather
Chapter 727 - 647: Not in the Same Dimension

Chapter 727: Chapter 647: Not in the Same Dimension

Professor Liang carefully inquired about the patient’s medical history and personally examined him before feeling reassured.

This was his practice of many years. He would personally handle all the challenging cases in his department.

Before performing a surgery, he would always personally inquire about the patient’s history and carry out the physical examination.

He could not bring himself to start the surgery just based on an image, without having met the patient.

After the examination, Professor Liang put his percussion hammer back into the pocket of his white gown and said, "Mr. Jing, your surgery is quite a big project. We need to prepare thoroughly, so there’s no need to rush."

Jing Yunsong sat cross-legged on the hospital bed: "No rush, take your time to research. I tried the best hospitals in the whole of China and decided that coming here was the most reliable."

Professor Liang patted his shoulder, "Rest well. Once we schedule the surgery, we’ll notify you—it’s usually on Monday."

After meeting the patient, dozens of doctors regally moved from the ward to the doctor’s office.

The preoperative preparation had been very thorough. The 3D printed spinal implant was designed and could theoretically be printed and sent for sterilization today. The vascular surgery backup was also confirmed. Professor Hu Guolin was careful, striving for perfection.

Back in the doctor’s office, Professor Liang wondered:

"How do you plan to handle hemostasis? Removing three whole vertebrae will involve a lot of bleeding."

Professor Hu Guolin was undoubtedly well-prepared. He said confidently:

"We are preparing from three aspects. We have a tumor vascular angiography image for reference; we will ligate each supplying blood vessel of the tumor one by one; we will ask an interventionist to pre-embolize the main supplying blood vessels of the tumor before surgery; if necessary, we will temporarily and selectively block the aorta or the inferior vena cava during surgery."

Listening to Professor Hu’s words, Professor Liang nodded satisfactorily. Indeed, he had made sure nothing was left out in preparing for this surgery.

But Professor Liang felt that something was still lacking. After mentally reviewing the surgical procedure, he realized that when using a wire saw to cut off the vertebral arch base—the tumor had already enveloped the vertebral arch base—implanting the wire saw would inevitably damage the tumor, causing the tumor cells to leak out and create a risk of spreading.

Professor Hu had thought about this and decided to use a specially designed guide device for bone perforation, in order to guide the wire saw under the vertebral arch base. This was the best solution.

Professor Liang couldn’t think of a better method at the moment. Of course, if it was possible to peel off the tumor along with the periosteum from the vertebral arch base, and then implant the wire saw, that would be more perfect.

However, this operation only exists theoretically and is impossible to perform during surgery. Moreover, it is likely to be damaged during separation, increasing the risk of spread.

Professor Liang felt that Professor Hu’s treatment was already at its limit, so he turned to Yang Ping and asked, "What do you think about this case? Particularly about preventing tumor spread, do you have any good methods?"

Xiehe Hospital meticulously handled this case. Even if just few hospitals in the country could complete such a complicated surgery — simultaneous resection of three entire vertebrae and complicated chordomas.

The only area that could be improved was the step of severing the base of the vertebral arch. Using a special guide to get close to the bone would still puncture the tumor, leading to the risk of spread.

Yang Ping frankly said, "The surgery plan is very detailed and almost flawless. However, when it comes to implanting the wire saw, I think it would be best to first completely peel off the tumor at the vertebral arch base and intervertebral foramen, along with the pseudomembrane of the tumor and periosteum, even a bit of the bone cortex, and then implant the wire saw. This way, we can boldly cut off the vertebral arch base without worrying about the risk of tumor spread."

Professor Liang said to Song Yun, "Zoom in on the 3D reconstruction image."

After re-examining the images, Professor Liang furrowed his brows.

This method is the best as it can minimize the risk of tumor spread as much as possible. But the surgical difficulty is the highest, it’s impossible to implement, and the vertebral foramen, the pathway for nerve roots, might be injured if not careful, risking nerve damage.

Peeling the tumor in such a narrow and complex space with an intact pseudomembrane, along with the periosteum and a layer of sebaceous secretions, is an impossible task.

Professor Liang shook his head, "Theoretically, this is the best method, but it’s impossible in reality."

"Moreover, I think, the entire surgery should focus on the tumor, operate outside the pseudomembrane. Wherever bone is encountered, besides the vertebral arch base, other places can be ignored, and taken out together with the vertebra. In other places, the pseudomembrane should take along a few millimeters of normal tissue surrounding it. This way, the tumor will be most completely removed." Yang Ping pointed at the 3D image on the screen.

At this, Professor Liang glanced at Yang Ping, thinking Yang Ping might have not heard what he said.

Now this tumor is extremely complicated. Even operating on the vertebral arch base according to Yang’s approach is impossible, let alone removing the entire tumor according to this logic.

"The ideal is great, but the reality is hard. How can such precise operations be possible? It’d be fine if the surgical field was flat and wide, but here the anatomy is extremely complicated, especially the bone space is extremely narrow, full of dead corners."

Occasionally, Professor Liang made amusing remarks.

"The difficulty is high, but it can be done." Yang Ping confidently stated.

Among the dozens of doctors nearby, those who heard the conversation between Professor Liang and Yang Ping were all stunned.

This kind of operation isn’t something they hadn’t thought of, but something they dared not think about because it was simply impossible.

Could the level of the Golden Knife Award in the country achieve such a miraculous operation?

"Have you---used this method in spinal tumors before? What was the result?" Professor Liang now dared not readily question Yang Ping’s words.

After all, this young man couldn’t be treated ordinarily.

So, while interacting with him, one had to adjust their thinking to something a bit more imaginative. In other words, one had to open their mind, and not just a bit, but a lot, otherwise, he would easily end up baffling them.

Indeed, while everyone else discusses achievable things, his ideas tended to be incredibly challenging and seemingly impossible.

"I use it regularly, for spinal tumors, I generally adopt this method."

Yang Ping was telling the truth. Regardless of the complexity or obscurity of the spinal tumors, he always meticulously separates them along the pseudocapsule, taking with it a few millimeters of surrounding healthy tissue, without ever rupturing a tiny hole.

Even with the high-risk tumor at the base of the skull of Academician Feng Tiancheng, it was completely excised in this manner.

Used often?

Professor Liang was momentarily at a loss for words, as were the doctors present.

Young man, you have thoroughly baffled us.

Professor Liang was momentarily at a loss for words and managed to squeeze out a few words, "Often---used? The intervertebral foramen and the spinal pedicle are full of blind spots. How do you operate?"

"I use a laser knife to cut. However, you need to be extremely familiar with the anatomy of this area. Also, be very adept at distinguishing between the tumor, its pseudocapsule, and the normal tissue. Strong spatial location abilities are also necessary. Remember these images on the screen."Yang Ping liked this kind of straightforward interaction, where the conversation was purely academic, without the need to take into account the other person’s emotions.

"If the anatomical space is larger, we use navigation equipment, but in such narrow complex spaces, the equipment is useless. You can see it, but you can’t operate." Professor Hu Guolin seemed rather helpless.

"There’s no need for navigation!"

Yang Ping definitively stated.

This time, it was Professor Hu Guolin’s turn to be speechless.

"Have you performed many cases like this?"

The doctor who had just displayed a critical temperament asked.

"Every spinal tumor operation I perform follows this procedure," Yang Ping responded to him.

The critic was also left speechless and had nothing to say.

The atmosphere became somewhat awkward.

Professor Liang stroked his chin, his brow furrowed, signalling the others to temporarily hold their questions so that he could think things through.

Clearly, this young man was on a completely different plane from them. With a sigh, Professor Liang suggested, "Why don’t you teach us your method? If it’s convenient, it would be best if you could perform this surgery and demonstrate it to us."

Asking more questions was pointless. On one hand, Yang Ping regularly performed the surgery as a routine operation, while on the other hand, they had never been able to execute it and thought it impossible.

Discussing any further was meaningless. It would be better for Yang Ping to demonstrate his miraculous operation.

Professor Liang clearly trusted Yang Ping.

"I am willing!"

Yang Ping answered readily. Since Professor Liang trusted him so much, there was no point in hedging.