Surgery Godfather
Chapter 734 - 654 Yes, I see!

Chapter 734: Chapter 654 Yes, I see!

At the L3 vertebra, Yang Ping started to demonstrate the technique to separate the tumor from the pedicle and intervertebral foramen.

The separation still starts from the spinous process, as spinal tumors seldom invade here.

Starting from the normal tissue and separating in a scientific order is the principle of no-leak resection.

With the progress of separation, from the spinous process to the lamina, when separating the area near the pedicle and intervertebral foramen, even a layer of bone cortex is separated. Only a laser knife can easily separate the bone cortex. Ordinary scalpel cannot do this, to separate the bone cortex with ordinary instruments, a sharp osteotome is the only option.

Not only the bone cortex, but also the dura mater and outer membrane of nerves are carried with the separation near the dural sac and nerve roots, these irrelevant tissue layers are all treated as the pseudocapsule of the tumor, and the whole layer is opened without damage in this way.

Yang Ping has adjusted his surgical speed several times to match the pace of Qiu Ruo, the scrub nurse, and his assistant Song Yun.

Surgery is a team effort, and rash advances can cause problems.

Qiu Ruo understood that the young professor slowed down several times to accommodate her, and she was very touched.

Where are there any surgical operations where the main surgeon accommodates the scrub nurse? But now it is like this, it is clear that the main surgeon is accommodating her. She feels like a pampered princess, feeling very sweet in her heart. She is also more focused, hoping to be as quick as possible.

After the cortex was lifted, the laser knife easily completed the osteotomy at the lamina portion.

This fantastic method was used to separate both sides of the pedicle.

"This is because the periosteum is invaded, but the cortex is still ok. We can’t start with a soft tissue as a pseudocapsule, so we can only use this extreme method, which is called subcortical separation. When there is no laser knife, a sharp osteotome can also complete the separation, but it is difficult. Using a laser knife to separate is much easier."

While performing the surgery, Yang Ping was explaining it to Song Yun.

Subcortical separation, Song Yun heard of this separation method for the first time, but now for this vertebra, if subcortical separation is not used, tumor cells will definitely leak.

Once subcortical separation is adopted, the problem is easily solved. It is indeed a creative idea.

"The method of surgery is very important, it’s like racing without limiting the means of transportation, no matter how good you are at running, you can’t outrun a race car."

Yang Ping used an analogy to explain: If there is no concept and method for subcortical separation, and we still linger on the habitual thinking of using soft tissue as a pseudocapsule, now the tumor of L3 will definitely rupture and leak.

The two sides of the pedicle of L3 were successfully severed and the round was completed.

No matter what method is used for total vertebrae excision, a round must be opened. It’s like a closed iron ring on a pillar, either breaking the pillar or breaking the iron ring to take it out.

Obviously we can’t break the patient’s spinal cord and nerves, so we can only break the ring of the vertebra.

The range of invasion of the L4 tumor is much less, the pedicle is not invaded, and the conventional separation method can be used to cut off the pedicle on both sides.

In this way, the separation of the tumor from the posterior approach and the steps to open the circles of the three vertebrae from the posterior approach are all completed. This step took about an hour, and this was to accommodate the assistants and nurses by slowing down the pace.

Actually, the doctors and nurses of Xiehe are of very high quality, absolutely first class in the world. It’s just that Yang Ping is too strong!

"Does anyone want to rest for a while?"

Of course, Yang Ping wants to complete the surgery in one go, but he wonders about the views of others. If they can’t keep up, it would be better to rest for a while.

"No problem, we can continue!"

The one who responded first was Qiu Ruo. If she rested, she would feel even sorrier, as she had already received special care from Professor Yang.

"Professor Yang, do you need an additional scrub nurse?" Head Nurse Xin took the initiative to make the request.

Head Nurse Xin graduated from Xiehe Medical University and has been working at Xiehe ever since. She had met all kinds of professors, but never had she met someone like Yang Ping.

The surgery was performed at a stupendous speed, and he did an exceptionally good job. This kind of surgical skill can really be described as a unique skill!

"No need, Nurse Qiu is cooperating well. It’s rare to have such good cooperation the first time. Xiehe really lives up to its reputation."

Yang Ping gave a lot of face to the scrub nurse and Xiehe today.

He was an anomaly and couldn’t demand others to be an anomaly too. Yang Ping still had self-awareness.

Listening to this, Qiu Ruo felt warm in her heart and was very grateful.

---

Chene’s eyes never left the screen, he was concentrating on every detail of the surgery.

Three vertebrae, the posterior approach only took an hour.

His usual posterior separation is much rougher than this, this kind of tumor takes at least five hours to complete a posterior separation, but now, the chief surgeon of Xiehe completed the separation in an hour.

With such a fast speed, how about the quality?

Any serious expert would be able to see the godlike quality of this surgery.

Chene’s self-esteem was seriously hit, no, it was seriously crushed.

The mineral water bottle in Chene’s hand was squeezed and kneaded, there was no normal place left.

He had many questions to ask Director Hu, but Director Hu kept staring at the screen, his eyes never moved, so Chene didn’t dare to speak.

"Where’s the restroom?"

Chene’s bladder was getting uncomfortably full. He couldn’t hold it in any longer and asked Director Hu.

"Focus on what you’re seeing! If you have a question, ask after the operation!" Director Hu responded in the same fashion.

"Yes, I see!"

Chene sat up straight again, trying to endure it a bit longer. The bladder could reabsorb some urine, he would wait a bit longer and see.

Professor Lu Donglai, originally from the Oncology Surgery Department, finally understood why Professor Liang valued Yang Ping so much after witnessing this level of surgery.

When it came to spotting talent, no one would dare dispute that Old Liang had the best eye for it in Xiehe Hospital.

Zhang Chunquan, who had once been an average student, was chosen by him. Although he had now moved to the United States, his abilities were definitely world-class. Zhang Chunquan was the leading contributor to the stem cell project at the Massachusetts Institute of Technology’s Whitehead Lab, and rumor had it he might even be in contention for a Nobel patent in the future.

"Old Liang, your student’s surgical skills are a bit exaggerated. I always say, people you have an eye on can’t be wrong. That’s why I, Lu Donglai, didn’t hesitate to sign the contract." Professor Lu made it sound as if it were true.

Professor Liang didn’t fall for his flattering words: "Of course you didn’t hesitate because you signed blindly under my coercion. And you couldn’t sleep well for three days after signing, could you? Can you sleep soundly tonight?"

Professor Lu responded to Professor Liang’s ridicule calmly: "After signing, I indeed didn’t sleep well for a few days, I was too excited!"

Thicker-skinned than a city wall, only Lu Donglai could be this in Xiehe Hospital.

Currently, in the matter of recruiting Yang Ping, Professor Liang deserved most of the credit, followed closely by Lu Donglai.

In a while, it could very well be Lu Donglai who takes first place and Professor Liang settles in second.

---

Following the completion of the posterior surgery, temporary closure of the posterior surgical site was needed. Special gauze was stuffed into precise sites, the incisions were temporarily closed with skin staples, and then covered with sterile medical film.

The patient was then turned over to assume a supine position. Their body was re-disinfected, fitted with a fresh set of sheets, and prepared for anterior surgery.

The tumor at L2 and L3 extended forward into the abdominal cavity, adhering to the abdominal aorta and inferior vena cava. The wall of the large blood vessels was already denatured. After examining it, Yang Ping feared neglecting it could lead to a high risk of aortic dissection in the future. So, he had Song Yun call for vascular surgery support to preemptively insert an artificial blood vessel.

If it was Sanbo Hospital, Yang Ping wouldn’t need to call for vascular surgery support at all. He would insert the artificial blood vessel by himself.

At Sanbo Hospital, he had complete surgical privileges, a special treatment likely unrivaled by any other surgeon in the country.

But it wasn’t the same at Xiehe Hospital. His privileges were limited to his home field—orthopedics. Even separating the aorta from the abdominal cavity was pushing the boundaries. If Director Hu were operating, this step would also need the cooperation of general and vascular surgery.

If it was an emergency life-saving situation, Yang Ping would make an exception. But it wasn’t an emergency moment now, and he had to follow medical protocols.

Yang Ping always believed that doctors should be rational, not emotional.

Director Zuo Ruiting from Xiehe Hospital’s Vascular Surgery Department came over with two assistants to provide support. He usually had to treat many emergency surgeries involving aortic dissection, so he basically didn’t have the concept of weekends.

As he often said, he’d look at the bustling scene of Wangfujing Pedestrian Street near Xiehe Hospital from his window; he seldom went there to stroll around, and sometimes, he’d just peek at it through his window.

Briefly looking at the imaging pictures, Director Zuo and his assistants were more than willing to collaborate with Orthopedics: "The patient is going to need an artificial blood vessel. Otherwise, there’s a high chance of developing aortic dissection and tear post-surgery. We’d had a similar case not long ago. The patient had abdominal tumors that adhered to the aorta. Three months post-surgery from an outside hospital, the patient developed an aortic dissection; it tore down more than twenty centimeters from top to bottom. Fortunately, the patient was brought here in time and we saved them."

Director Zuo was very experienced, having saved many patients with aortic dissection. He often snatched people back from the brink of death.

"Scrub in!"

Director Zuo was a hearty person; with one command, he and his two assistants went to scrub in for the surgery.

Just as all surgeons did, he relished the operations.

---

Yang Ping temporarily stepped aside, tucking his hands inside the chest pocket of his gown to rest.

"Professor Yang---"

While Director Zuo was scrubbing in and the operation was temporarily paused, Qiu Ruo called to him quietly.

Yang Ping turned to look at Qiu Ruo when he heard the nurse’s voice. She was smiling at him: "Thank you!"

"You’re welcome!"

"You---are these instruments I’ve prepared correct? The ones you’ll need shortly."

Yang Ping took a look. Yes, these were indeed the instruments.

In fact, Qiu Ruo was an excellent instrument nurse, worthy of being a graduate student at Xiehe Hospital, but she still wasn’t quite at the level of Xiao Su from his home hospital.

"Yes, these are the right instruments. Keep your pace steady, no need to rush."

"Okay, thank you!"

She didn’t expect this well-known professor would actually respond to her and chat with her for a bit. She thought Professor Yang would only respond with a perfunctory ’hmm’.

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