Surgery Godfather
Chapter 934 - 806: Innovation Starts with Boldness and Absurdity_2

Chapter 934: Chapter 806: Innovation Starts with Boldness and Absurdity_2

After Academician Wang finished speaking, everyone fell silent, momentarily at a loss for questions.

Not wanting to let the atmosphere cool down, Yang Ping said at this time, "Let’s brainstorm, everyone. Think of anything, no matter how absurd or outlandish. For instance, this case involves underdevelopment of the left ventricle, right? What if we could implant an expander in the left ventricle and gradually enlarge it to normal size? We could initially perform a Fontan Surgery as a temporary measure while implanting the expander in the left ventricle. Once the left ventricle has expanded, we could remove the Fontan Surgery and reposition the blood vessels to their correct places."

Academician Wang was immediately taken aback by Yang Ping’s idea. Indeed, it was a notion that could be described as "bold and preposterous" and something that nobody had yet considered.

It had always been assumed that since the left ventricle was underdeveloped and small, it was unusable. Other than a heart transplant, the only option was Fontan Surgery, which is merely a palliative procedure that enables the deficient heart to function normally.

No one had ever thought of a way to restore a developmentally impaired left ventricle to normal.

Exactly! Could we create an expander to implant in the left ventricle and gradually enlarge it? Everyone was immediately energized by the topic thrown out by Yang Ping.

Such truly genius thinking! The minds of geniuses are indeed distinct. Both Li Zehui and Professor Chen were astounded by this flight of fancy.

A student began to speak:

"The left ventricle is naturally small, and artificially enlarging it might thin the myocardial wall, leading to weak contractions or even a rupture, right?"

Seeing that such a viewpoint did not provoke laughter, many others grew bolder.

"Exactly, just as during skin expansion, the more you expand the expander, the thinner the skin becomes, turning it into something like a pancake. If you want to increase the area, the thickness will decrease."

Students are inherently active thinkers with rich imaginations. As their confidence grew, so did their boldness, and they dared to speak up, regardless of the feasibility of their ideas.

"Children are still growing, and so is the heart; it’s not stretching something unchangeable. According to the Ilizarov Principle, tissue subjected to tension grows faster," said Li Guodong excitedly.

"Wouldn’t such a large expander placed in the left ventricle cause thrombosis?" a female student asked.

"We just mentioned that this case had already given up on using the left ventricle because it’s too small to be functional. We could completely seal off the space between the left ventricle and left atrium, hence no blood in the left ventricle and thus no risk of thrombosis with the expander. Once the left ventricle develops, we can remove the expander, and reopen the sealed partition between the left atrium and ventricle," another male student quickly responded.

Yang Ping was very pleased internally; he relished this kind of atmosphere where everyone dared to speak up. How wonderful it was.

Academician Wang too was surprised; these young minds’ ideas were incredibly bold and innovative.

If we were to implant an expander in the underdeveloped left ventricle, how would we implement the expansion? Normally, when we do skin expansion, there’s a water bag implanted inside the skin expander with a tube leading out that is periodically filled with water to achieve gradual expansion. How would this work for the heart?" asked Li Guodong.

"Right, how could the expansion be achieved?"

The young doctors scratched their heads. Indeed, how could the expansion be implemented? Surely we can’t have a tube coming out of the heart like we do with skin.

The idea was preposterous, but medical advances often begin by turning seemingly preposterous ideas into reality.

"Could we lead a small tube out through the blood vessels, similar to creating a fistula for dialysis, and inject water when needed, then seal it off afterward?"

"The blood vessel won’t work, if there’s a tube in the vessel, it would quickly form a thrombus, blocking the entire blood vessel. Besides, since the left ventricle is no longer part of the circulation, we can’t guide it into the vessel," said Song Zimo, joining the discussion.

"The left ventricle is out of the circulation; that makes things easier. Considering neurosurgery’s ventricular drainage, let’s fix a tube to the left ventricle directly, design a path leading out of it," he added.

"It can’t exit through the thorax; the thorax is under negative pressure. Even if buried under the skin, if the tunnel leaks air, when the skin is cut later, air would follow the tube, through the gap between the tube and tunnel, into the thorax, causing a pneumothorax," Professor Chen also became excited.

"Considering a ventricular shunt, after leading the drainage tube from the left ventricle, it could be passed through the diaphragmatic hiatus into the abdominal cavity, then led out of the abdominal cavity to under the skin, and buried near the skin fold by the belly button. When needed, it could be cut open to inject water, and sewn shut when not needed, safe and convenient," she continued.

The discussion reached this point, and Academician Wang realized that the plan to implant an expander had begun to take shape: how to implant it, where the tubes would run, how the expansion would work, all had specific implementation plans.

This comprehensive surgery department would indeed be a gathering place for geniuses in the future. Just now, Dr. Song’s reference to a ventricular shunt had suddenly opened up new possibilities.

"After the left ventricle is expanded—the biggest issue is—the interval between the left ventricle and the left atrium—that is, the mitral valve—how to restore it—I think that’s the biggest—problem!" Xu Zhiliang spoke up.

This guy actually used his manner of speech to pause at sensible points, although he spoke slowly, he somehow made it easy for everyone to understand clearly.

Is reopening the mitral valve a difficulty?

Song Zimo thought for a bit and said, "It’s not difficult; the valve is present and there’s a basis for suturing. We could perform a mitral valve replacement surgery."

"There’s another issue—we know—we use Ilizarov theory for—bone elongation—the limit in bone lengthening is the nerve—the nerve can only stretch to a certain extent—beyond that, it becomes unusable—during the expansion process—could there be a conduction block—that is, the cardiac conduction bundle might become unusable due to the stretching."

The discussion grew deeper, and Academician Wang sat down and listened attentively.

"This possibility could either exist or not; we could accumulate some data through animal experiments, then gradually collect data in clinical practice, and progressively optimize. It’s certain that, if this possibility exists, there must be a critical threshold between becoming unusable and remaining normal."

"I think this idea is really good; we could make it a research project, it holds great potential. Whether it succeeds or fails in the future, at least it explores a new path," Academician Wang got excited; he was increasingly convinced by this proposal.

Although it was preposterous and seemed impractical, many innovations start with ideas that are bold and preposterous, and many such innovations have made their way amidst absurdity and impracticality.

PS: Two Chapters, over eight thousand words, consider it a mini explosion! Thanks everyone, show some encouragement, smash some votes! Thank you!!!

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