Surgery Godfather
Chapter 825 - 739: The Ultimate Realm of Hand-Eye Separation

Chapter 825: Chapter 739: The Ultimate Realm of Hand-Eye Separation

After the hematoma was cleared, the bone at the base of the skull was roughened, along with roughening the surface of the bone of the posterior arch of the atlas. This facilitated the healing process with the implanted bone grafts.

Now it was Song Zimo and Xu Zhiliang’s turn to handle the atlantal bone graft. They trimmed the bone graft and filled the titanium mesh structure of the artificial atlas with it and crushed bones.

Yang Ping irrigated the surgical area under the microscope, achieved hemostasis again, and then implanted the internal fixator between the posterior cranial base and posterior arch of the atlas. By applying pressure above and below and implanting screws, the bone graft and crushed bones within the titanium mesh structure firmly supported the cranial base and atlas vertebra, serving as an auxiliary load-bearing column among the connecting columns of the cranial base and atlas. The construction was completed, and in the future, along with the anterior bone columns, they would become the support for the head. This once unsteady head was finally securely positioned on the spine.

"Call it a day!"

Yang Ping shifted his gaze away from the screen, and Song Zimo and Xu Zhiliang stepped forward to begin the final part of the procedure: closing the surgical incision.

"Actually, it’s nothing special. It’s just extending the range of endoscopic surgery. The anterior approach through the mouth is also completed under the scope. If the anterior approach can be done under the scope, why not the posterior? Theoretically, all surgeries can be completed under endoscopic guidance."

Seeing the surprised looks on everyone’s faces, Yang Ping quickly offered an explanation.

Before the surgery, Yang Ping had forgotten to inform everyone that the posterior approach was also planned to be done under the scope, and he certainly didn’t mention the use of two scopes to complete the procedure. Now, as he mentioned it so casually, the confusion on everyone’s faces couldn’t possibly dissipate in an instant.

"Sorry, I forgot to tell everyone before the surgery," Yang Ping apologized to the crowd.

But the apology didn’t do much good, as everyone still looked at Yang Ping with expectant and perplexed eyes, and even Song Zimo and Xu Zhiliang didn’t intend to immediately close the incision.

"Why are you all staring at me? Is there a problem?" Yang Ping sat down to rest.

"Professor, you have to give some explanation, right? You just used two screens to complete an unfamiliar cranial base-upper cervical spine surgery throughout the entire procedure under split endoscopic vision!" Song Zimo had to state it plainly.

No wonder these fellows were gazing at him so expectantly. Yang Ping suddenly realized that what might be a very common surgery for him—using two endoscopes almost reflexively—could be considered technical innovation, a sophisticated new procedure, to others.

Perhaps too engrossed in the work, he went through the entire procedure without explaining it. "I guess I’m a bit rough around the edges as a professor," Yang Ping thought to himself as he gathered his thoughts and said:

"For cranial base-upper cervical spine anterior approach surgeries through the mouth, using an endoscope for assistance makes the operation much easier and, under the endoscope’s view, provides a larger working space and a higher safety factor." Yang Ping was careful with his terminology, using ’endoscope’ when appropriate and ’laparoscope’ when needed, never mixing them up.

There is a difference between endoscopes and laparoscopes. An endoscope is used to enter the body through natural passages, such as gastroscope, colonoscope, and urological surgeries involving ureteroscopy and cystoscopy. These are all endoscopes.

Take the gastroscope, for instance. It enters the body through the mouth, then passes through the pharynx and esophagus before finally reaching the stomach. From the entrance to the entire pathway, these are all natural passages.

Laparoscopes, on the other hand, require creating an artificial hole in the body to serve as the entry point for the camera and instruments. For example, a laparoscope needs one or several small incisions on the abdomen to insert the camera and instruments, same with arthroscopy which requires puncturing a hole for entry.

"Most cranial base-upper cervical spine surgeries can be resolved through the anterior oral approach only. Therefore, everyone can train in endoscopic surgery through the mouth in the future, making cranial base-upper cervical spine anterior approach surgeries under endoscopic assistance a routine procedure."

"And completing posterior open surgery under the scope is not difficult either. Today’s use of two sets of endoscopic equipment to perform the surgery does indeed demand high coordination of hands, eyes, and brain. If you encounter various reasons leading to poor visual exposure and insufficient working space in future surgeries of this kind, you can try to complete the surgery under the scope. Of course, don’t imitate my use of two split screens. You should use a wide-angle camera, placed in the proper position, where a single camera and one set of equipment can get the job done. If you don’t use a wide-angle lens, you can also use two cameras and then integrate the images of the surgical area with a computer to display them on one screen. This all requires further designing of the equipment."

"Actually, open surgeries under a microscope have had precedents, such as the reattachment surgery for severed fingers in microsurgery. Using the traditional microscope, staring intently through the eyepiece, can cause significant eye fatigue. However, using a microscope equipped with a high-definition camera allows the surgical field to be transmitted to a screen. The operator doesn’t have to focus on the tiny field of view through the microscope and can just look at the screen, using hand-eye coordination techniques, which makes the entire procedure much more relaxed."

"Of course, to achieve this, one needs to be trained in hand-eye coordination, mastering the hand-eye coordination techniques."

"Professor, could you train us so that we too could perform microscopy-assisted surgeries at will, like you just did? Even better, all surgeries could potentially be performed endoscopically whenever necessary." August got excited.

He could imagine the scene: if he mastered this technique, someday, at a European spinal surgery conference, while demonstrating this microscopic operation, while others struggled with exposure, August could complete the surgery entirely under the microscope, whether it was via an anterior transoral approach or a standard posterior approach. What would that Englishman Milton think then? He would surely be astounded.

The damned old chap would probably dislocate his temporomandibular joint. I bet, August thought proudly.

Song Zimo and Xu Zhiliang were in the midst of closing the incision, while Yang Ping began to take off his surgical gown.

"If you’re interested, I can train you tomorrow in performing open surgery under the scope. Actually, like today’s surgery, if there were an appropriate surgical robot, with its assistance, the surgery would be even easier. It’s a pity that existing surgical robots are not capable of this kind of operation. Da Vinci’s robotic arms are very flexible and have the potential for such surgeries, but it lacks orthopedic surgical tools. Of course, at its current level, it’s not feasible for it to handle all orthopedic tools, so it’s limited to chest, abdominal, urological, and gynecological surgeries. The Tianji robot, though it can perform orthopedic surgeries, doesn’t have sufficiently flexible arms and can only carry out simple orthopedic procedures or certain steps in surgery, like pin placement. It doesn’t have the capability to conduct full operations autonomously and is only an assistant."

In Yang Ping’s mind, he envisioned a surgical robot with extremely flexible arms that could switch between arms of different thickness to suit various scenarios, and could also be fitted with various orthopedic power tools. That would be marvelous.

Sharp Medical was also researching surgical robots, but breakthroughs would take some time to materialize.

With such a robot, no matter what position the patient was in, the surgery would be effortless, and doctors wouldn’t be so passive.

The future of the surgical field is inevitably going to be dominated by surgical robots; they overcome all the shortcomings of surgeons and broaden both the operational space and visual field.

Song Zimo and Xu Zhiliang completed the closure of the surgical incision; Zhang Lin and Little Five, the two hook-pulling masters, could finally rest, their arms likely incredibly sore.

From the start of the hook placement to its removal, the two masters hadn’t moved a muscle throughout, fully living up to the title of hook-pulling wizards.

"When is your book going to be published? You have revised the manuscript many times, haven’t you?" Yang Ping asked Zhang Lin and Little Five.

Zhang Lin couldn’t help but sigh, "After all, it’s a world-class work. Insisting on a rigorous academic attitude, we have decided to revise it a few more times, striving for perfection."

Little Five was also very serious, "It’s a global pioneering monograph. There are some details that still need to be deliberated. For instance, whether to briefly mention or elaborate in detail about the training methods for the hook-pulling technique, we have not reached a consensus."

"If we elaborate, we will inevitably reveal some secret training methods, but to gloss over it would be against the scholarly conscience." Zhang Lin was filled with worry.

"It’s tough!" Little Five looked genuinely troubled.

With such solemn tones, neither of them seemed to be posturing—they truly cared for this monograph. It was their passion, their dream.

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