Surgery Godfather
Chapter 822 - 736 Bone Tissue Can Also Be Made into Frozen Tissue Sections

Chapter 822: Chapter 736 Bone Tissue Can Also Be Made into Frozen Tissue Sections

After several twists and turns, Lu Jiangbei’s surgery finally began.

Even August had never seen a surgery like this, where the anterior and posterior procedures were completed in a seated position. He was very eager to see how the surgery would be performed.

Although Robert specialized in sports medicine, many things in orthopedics, and even in general surgery, are interconnected. He was also very interested in this surgery and wanted to know how the anterior and posterior approaches could be completed simultaneously while the patient sat.

Ivan was purely there for the excitement. His interest had always been in plastic surgery, and his purpose this time included bone contouring techniques, with an additional target now—skin culture technology.

After the morning handover, the surgery began.

Lu Jiangbei first laid in a supine position on the operating table, where he would be fitted with an external fixator to temporarily stabilize his head and cervical spine.

Standard hand-washing, disinfection, and draping were carried out.

The support scaffold used for the surgery was opened and placed on the operating table. Yang Ping had to fit this kind of scaffold. With its protection, his head, cervical spine, and body were firmly fixed to the operating table.

After securing everything properly, the motorized operating table was adjusted to resemble a lounge chair. The patient sat on the operating table with the buttocks as the pivot point. The slightly inclined backrest snug against the back, and then the area above the shoulders was left completely free for the surgery.

Although the fixed scaffold did interfere with the surgery, it was ultimately an open-frame structure, allowing a great deal of operational space.

The seated position was now ready, and the mouth was kept open with the help of a mouth gag.

Disinfection and draping were done once again.

The surgical light shone into the mouth, illuminating the back of the pharynx. Yang Ping took a look inside, then asked the patrolling nurse to turn off the surgical light.

He planned to use endoscopic assistance to complete the surgery, borrowing the ENT endoscopic system for this procedure.

August opened his eyes wide: Endoscopic-assisted transoral approach, using such a method for surgery, the professor always does what others cannot. Calling him a demigod was no exaggeration.

Under the open surgery approach, a very difficult operation seemed much easier with endoscopic assistance.

On the high-definition screen, the camera’s image was transmitted in real-time to the screen and then Yang Ping operated while watching the screen.

The back of the pharynx was incised, revealing the anterior aspect of the upper cervical spine. Then, bit by bit, it was separated. Going up, one could clearly see the base of the skull, and between the occipital bone and the atlas, as well as between the atlas and the axis, all the ligament structures were torn, displaying a horse-tail shaped tear. This was the result of some kind of stretching or twisting force that had torn all the ligaments.

Then, after all the ligaments had torn, the force came to an abrupt halt. That is, the violence stopped when the ligaments tore and did not spread or extend any further.

How fortunate he was that only the ligaments were torn by the violence, stopping right there without extending further. Just a little more unresolved force, and if it had continued, the atlanto-occipital and atlantoaxial joints under twisting or stretching forces would have inevitably damaged the spinal cord. That’s why most patients with such injuries die on the spot.

And for this boy, after the violence tore the ligaments, it stopped; he was like a car out of control heading towards a cliff that stopped at the edge due to the friction with the ground.

The images captured by the endoscope were very clear. August was amazed by the boy’s luck, while Robert was racking his brains finally came up with the phrase, "It’s like his ancestral grave is belching bluish smoke."

Everyone turned their heads to look at the startlingly articulate Robert. After three days, one must look at him with new eyes; his Chinese had reached such a level.

The astonishment wasn’t over yet; Robert added another line, "Belching smoke isn’t enough, probably need to spout flames, too."

Under the assistance of the endoscope, Yang Ping had fully exposed the upper section of the cervical vertebrae and the anterior half of the occipital region, the atlas was indeed shattered and beyond the possibility of fixation, so he meticulously removed the anterior arch of the atlas bit by bit.

After dealing with the fragmented bone and soft tissue on the anterior side and, for safety’s sake, temporarily discarding the whole bone mass of the atlas, the bone cyst on the atlas was located on the upper side block of the left atlas. Before the nature of the tumor was confirmed, Yang Ping could only treat it as a malignant tumor, operating with extreme caution to prevent the spread of tumor cells.

This is the tumor-free technology of oncological surgery, aimed at preventing intraoperative contamination of surrounding tissues by tumor cells, and preventing the cells from spreading like seeds.

A small piece of soft gauze was stuffed in and then spread out, encircling the targeted area of the surgery. Then a long-handle, pointed bone-biting forceps was inserted, the jaws of the forceps opened, and it nibbled away at the bone bit by bit. With each bite, the removed bone matter was taken out securely, without a single piece of debris scattering.

The procedure was steady, precise, nimble, and effortless; the fragmented bone was removed, followed by a larger piece of bone tissue.

"Bring up another person, set up a new instrument table, and open this piece of bone tissue. The cyst is inside. The bone tissue is to be sent for postoperative paraffin tissue section, and the cyst fluid and the scraped material from the cyst wall can be used for a frozen section. We’ll wait for the results from the section to decide whether to repurpose the atlas," Yang Ping said as he extracted the bone piece.

The patrolling nurse had already set up a sterile instrument table specially, and Yang Ping placed the bone-biting forceps and the bone piece together on the sterile table before changing his gloves.

Zhang Lin and Little Five began scrubbing their hands and stepped up to the operating table.

Soft tissues are suitable for frozen sections, which usually yield results within half an hour, hence intraoperative pathological examinations are done with frozen sections. However, paraffin sections take several days, so they are not suitable for intraoperative use, but for postoperative pathology.

For tumor surgery, intraoperative frozen sections can clarify the nature of the tumor. The surgical approaches for benign and malignant tumors are completely different, so surgeons often need to rely on the results of pathological examinations to make decisions about the next steps in the surgical plan.

"Ask Wen Ruzheng to look at it! Call him," Yang Ping ordered.

Wen Ruzheng, a doctor with a doctorate in the Pathology Department of Sanbo Hospital, was well-known in the hospital. He had once lost a bet to Yang Ping and ran around the hospital in only his underwear. Because of that streaking incident, Doctor Wen’s reputation had soared; everyone knew about him.

The quality of a frozen section can greatly test a doctor’s skill, so to reduce the possibility of any error, Yang Ping had specifically chosen Doctor Wen himself.

Doctor Wen’s professional skill was outstanding, and he had a keen interest in intricate details. After losing to Yang Ping, he became even more committed, and it was said he had recently been involved in some research.

Robert, who had already fully assimilated himself into the Comprehensive Surgery Department, took out his phone and called Doctor Wen as soon as Yang Ping finished speaking.

August watched this socially adept patient, who acted like a longstanding employee of Sanbo Hospital and even had the phone number of a pathology department doctor.

"Professor, Doctor Wen says he can also do a frozen section on bone tissue; just send it over without hesitation and he will get you results within half an hour," Robert reported after ending the call.

"He can perform a frozen section on bone tissue?" Xu Zhiliang wondered what kind of trick Wen Ruzheng was up to.

Song Zimo said, "He’s been secretive lately, always asking for bones in the operating room for his research; could it be that he’s studying frozen sections on bone tissue?"

"Yes, that’s what’s happening, and I’ve heard he’s been collecting samples of bone tumors during surgeries, not missing a single one."

Upon hearing that this guy could perform frozen sections on bone tissue, Yang Ping thought it would be great if it were true, as it would allow for a more accurate determination of the tumor’s nature during surgery. But he was worried that this young man might just be boasting.

"Ask him if he’s just boasting. This matter is crucial to human life; if he’s bluffing, it won’t just be a simple matter of streaking," Song Zimo instructed Robert to make the call, and he would speak.

"Old Wen, it’s me, Song Zimo!"

Once the call connected, Wen Ruzheng’s voice came through, "Has the specimen arrived yet? Damn, you doubt my skill? Song Zimo, let me tell you, I, Wen Ruzheng, am a gentleman who neither boasts nor lies, I..."