Surgery Godfather
Chapter 880 - 778: This is How You Cut a Pineapple

Chapter 880: Chapter 778: This is How You Cut a Pineapple

Under the watchful eyes of the audience, Yang Ping began performing surgery on the pig, with Song Zimo and Xu Zhiliang serving as assistants. The Ultrasonography Department dispatched a doctor to operate the ultrasound machine, as the surgery needed to be conducted under the monitoring of esophageal echocardiography.

Traditional surgery requires opening the chest and using an electric saw to cut a long incision of at least 15 to 20 centimeters along the sternum, then prying open the chest cavity, cutting into the thick aorta, and entering the left ventricle through the aorta. The procedure of the surgery requires cardiac arrest and the use of extracorporeal circulation.

Yang Ping’s new technique did not require such drastic measures; it only necessitated making a small 5-centimeter incision between the ribs on the left side of the chest. Using this small opening to enter the chest cavity, a puncture was made at the heart apex to insert the electric rotary cutter.

In human bodies, surgery on other cavity structures can typically be done with an endoscope; however, this is not possible with the heart, which is full of blood. In the presence of blood, the endoscope sees nothing but red and cannot provide a clear visual field.

To ensure that the rotary cutter entering the left ventricle operated under "visible" conditions, it was necessary for the esophageal echocardiography to come into play. Its probe is inserted through the mouth and into the esophagus, from where it can observe the heart from behind.

Because it is closer to the heart and there is no bone obstruction compared to trans-thoracic ultrasound imaging, the image quality is clearer. From the chest wall, the heart is farther and obstructed by the ribs, naturally resulting in comparatively poorer image quality.

Inserting instruments through the heart apex leaves virtually no dead angles for the interventricular septum or the left ventricle, and having "free visuals" and "free operation" are extremely important for surgical operations.

The electric rotary cutter was now in position and started to operate, working similarly to the power shaving equipment used in arthroscopic surgery. It could be operated by a handle, which was very convenient.

The thickened interventricular septum was sucked onto the cutter head, and the rotary blade commenced resection. Professors such as Cao and department directors like Xin and Xiang, who specialized in cardiac surgery, were watching the surgery intently to learn. Meanwhile, many other students were gathered around, watching for the spectacle of the ten pigs and the bustling scene.

During resection, avoiding air bubbles and debris is critical. The cardiovascular system is a closed conduit system; debris or large amounts of air bubbles produced inside the heart can become emboli. These emboli can travel through the bloodstream, entering the aorta from the left ventricle and then into the systemic circulation, which is the larger circulation system.

The arterial blood vessels branch into finer vessels, eventually connecting to the capillaries and then to the veins.

Embolisms will travel with the flow of blood, and eventually, they will encounter an artery smaller than their own diameter. At this point, the embolism will block the vessel, causing ischemia in the region supplied by that blood vessel. These areas, deprived of blood, will soon become infarcted.

If the blockage occurs in a vital organ, it’s extremely dangerous, such as in the case of an acute cerebral infarction.

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Watching the images on the ultrasound monitoring screen, Department Director Xin stroked his chin, finding the surgery quite interesting.

No matter what conditions might arise postoperatively, at least for now, the interventricular septum was being thinned. This cutting method not only had good effects but was also very precise in the resection, and the surgical approach was minimally invasive.

What puzzled Department Director Xin—Yang Ping’s operation was incredibly skillful, and didn’t at all resemble someone performing a new technique and using new equipment for the first time.

Common sense dictated that the first time a new surgery was conducted, it should be done cautiously, slowly, step by step. However, Yang Ping was not the case; his operations were extremely adept.

Director Xin leaned in a bit closer and glanced at the electric rotary cutter in Yang Ping’s hand. How could this be a product of recent innovation? A mature instrument like this, from the initial thought to drawing the blueprints, then to multiple prototypes and improvements, would require three to four years to develop a mature product.

This new surgery must be the result of years of effort, certainly not a short-term achievement, Director Xin concluded.

Entering the left ventricle from the apex to resect the thickened interventricular septum is much more convenient than from the aorta. One is a roundabout flanking move; the other is a direct assault. If this were a battle, the former would achieve a surprise effect, but surgery is another matter entirely. A direct assault is much more straightforward than a roundabout flanking move.

Being straightforward means more freedom in terms of visibility and space. "Freedom of view" and "freedom of operation" are the foundation of surgical operations.

What a good method, the more Director Xin thought about it, the more brilliant he found it to be. He just didn’t know what the postoperative situation would be like or if there would be embolism caused by debris.

"Continuing to cut may cause a conduction block, but to demonstrate the effect of the rotary cutter, I’ll cut a bit more," Yang Ping gave the audience a heads-up in advance, especially to Professors Cao Zhenshan and Xin Weicong.

Since it was the first surgery, Yang Ping needed to demonstrate the immense power of the electric rotary cutter, so he cut out a whole 50g of myocardium from the interventricular septum and left ventricle, which would not be necessary in a typical surgery. Moreover, since the experimental pig’s heart was normal, not hypertrophied, cutting out so much myocardium indeed resulted in a conduction block in pig number one.

In order to gather more experimental data, Yang Ping did not give up on this experimental pig. He installed a permanent pacemaker to maintain the pig’s normal heart rhythm.

With the first surgery complete, following the regular surgery procedure, Yang Ping sutured the tiny puncture in the apex of the heart and then the 5 cm incision in the chest. Pig number one left the operating room with a respirator and entered a temporary observation room.

Pig number two has already been anesthetized by the seller’s team and moved to the operating table.

Some had already started chatting with Huang Jiahui down in the audience to understand the structure, principles, and operating method of the device, and Director Xin also took note of this young lady. After watching the surgery, he wanted to take a closer look at this rotary cutter as well.

Professor Xin moved a bit closer to the operating table, and he asked the instrumental nurse to show him the myocardium that was cut out as he wanted to see what the resected myocardium actually looked like.

Zhou Can gently grasped the myocardium with vascular clamps, lifting it for Professor Xin to see.

This piece of myocardium was intact and slightly curled. If the blade is sharp enough, theoretically, it should not produce any debris.

Professor Xin had been concerned about metal instruments interfering with the surface ultrasound of the esophagus, but now it seemed there was no issue. The ultrasound images showed no pseudo-images caused by metal, very clear indeed.

The surgery went quickly because of the improvements in the surgical technique and the innovation of the tools. It became relatively simple compared to open-heart surgery, and basically, there would not be any problems as long as one didn’t shave the myocardium too thin or puncture through it.

Later on, the pace quickened even more. The support team prepared another room as a prep area, sedating the pigs in advance. As soon as the surgery here was finished, the next pig was immediately brought over. With this almost assembly-line operation, the surgery was concluded in about five hours.

By the end, Professor Xin had forgotten his role as an "observer." With such a surgery, what was there to observe? He was now thinking about how to acquire a rotary cutter to try it out himself.

"How’s it going?"

Professor Cao asked Director Xin who was next to him, but when he turned his head, he realized his student had disappeared. Upon looking again, he saw that Director Xin was already asking Yang Ping for the rotary cutter, saying he also wanted to try the surgery.

It seemed that Sanbo Hospital was able to open a Comprehensive Surgery Department for this young man; his capabilities were truly impressive. Not just anyone had the strength to publish 13 CNS papers.

Thirteen papers, no less! Not to mention becoming an Outstanding Young Talent, he would soon be promoted to an academician, right? It was really baffling how young people nowadays could be so remarkable.

"How’s it going?"

Professor Zhang Zongshun asked Professor Cao.

At this moment, Professor Cao was engrossed with Huang Jiahui, listening to Jiahui explain the principles and methods of using the instruments.

The principle was very simple, akin to cutting the core of a pineapple, but utilizing such a simple principle to create such a precision-powered instrument required a lot of effort.

Everyone then went to see the pigs that had undergone surgery. The medication dosage controlled by Liang Fatty was very good; three pigs had already been extubated and were walking around in the temporary pigsty as if nothing had happened.

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Teng Shaokui was anxious; the girl in the bed next to his daughter had been admitted a day later, and her surgery was already done, while Xinmei’s surgery hadn’t even started.

Ah—how could they schedule surgery without the funds in place?

Even a fool understood that running away after surgery would mean someone had to foot the bill.

At this point, Teng Shaokui was extremely anxious, burning with impatience. Fortunately, he had finally gotten hold of Boss Li’s latest phone number. He found an opportunity to slip away and dialed Boss Li’s phone.

After a few rings, the call was answered, and the voice indeed belonged to Boss Li.

"Boss Li---I’m Da Kui, Da Kui!"

The person on the other end probably hadn’t expected Teng Shaokui to call him and took a long time to reply, "Oh, Da Kui, where are you now?"

"I’m still at my hometown, and what about you, still in Guizhou building the highway?"

"No, I’ve been in the provincial city for over a year now."

"The provincial city?"

Knowing that they were in the same city reignited Teng Shaokui’s hopes, and he was incredibly excited, out of sorts.

"I---am also in the provincial city now," Teng Shaokui said excitedly.

"You are too? Where?"

"Sanbo Hospital!"

"Sanbo Hospital? There aren’t any engineering projects over there, are there?"

"It’s a long story!"

"I’m busy right now; I’ll come to Sanbo Hospital to find you tonight. Wait for my call, you big brother, also in the provincial city." After laughing heartily, the person on the other end hung up the call.

Teng Shaokui didn’t dare to bring up borrowing money for the time being; after so many years without contact, asking to borrow money right away might scare the person off.

Although he had been so fixated on borrowing money from Boss Li and had finally made contact, Teng Shaokui was suddenly hesitant. Asking to borrow money was a very difficult task.

But without asking, who else could he turn to?

He had asked around among relatives and at most could gather twenty thousand yuan, which was still just a verbal promise.

As for his wife, there was no point. After laying out the situation, Zeng Cuiling immediately let loose a tirade of criticism.

Zeng Cuiling berated Teng Shaokui for lacking sense, wondering if he was out of his mind to spend one hundred thousand yuan on surgery. Xinmei was fine now; she would soon graduate from middle school and go out to work, she should earn her own money for treatment, or let her future husband or his family pay for it.

Teng Shaokui could only hang up the phone, feeling completely alone and helpless.

PS: The prototype of the new surgical technique in this case is the apex cardiomyotomy by Professor Wei Xiang, Director of the Cardiac Surgery Department at Tongji Hospital affiliated with Huazhong University of Science and Technology. This surgical technique and the corresponding instruments were completely independently innovated by Professor Wei, representing a world-leading technology. Many cardiovascular surgery experts from Europe and America, after observing Professor Wei’s surgery, also marveled—such surgery can actually be performed this way, far more advanced than their own methods. Salute to Professor Wei Xiang!