godfather of surgery

Chapter 1125 Gauze's Problem

The operation is not only destructive but also very risky, but Yang Ping has no other choice now. To reduce Sisi's risk, he must perform the operation, take the initiative to intervene, and take the initiative into his own hands.

Head surgery requires shaving the head bald. Now Sisi's head has been shaved bald by the nurse. When he was on the operating table, he began to feel frequent nausea and vomiting. This was caused by high intracranial pressure, which meant that the disease was progressing rapidly. Yang Ping's judgment was correct. If he hesitated for a moment, it might really cause trouble.

According to traditional practices, there will be a series of problems after decompressive craniectomy. For example, the defect formed after the removal of the craniectomy can only be filled with a titanium alloy mesh. If the enlarged brain tissue cannot be reduced to normal size, these protruding brain tissues will eventually not be able to be reduced and can only be removed, which will cause some sequelae.

However, Yang Ping had done an analysis before the operation. He could use an improved method to avoid the use of titanium mesh and use the original skull bone flap to cover the gap. This is the "lifting-the-lid" bone flap procedure he had previously improved. The bone block was taken away like lifting a lid, and the lid could be put back on during the second stage of surgery. This seemingly easy improved procedure actually requires a certain level of technical content, otherwise it would not have relied on traditional titanium mesh gap filling technology for such a long time.

As for the brain tissue that cannot be restored and has to be removed, Yang Ping has also analyzed it carefully. In this case, the swollen brain tissue can recover and shrink back because the remains of the dead tumor cells will eventually be absorbed and eliminated. Although the space originally occupied by the tumor cells will be occupied by body fluids, some special methods can be used at that time to promote the absorption of these body fluids.

It seems that even if the treatment is effective and the tumor cells die, a bunch of new problems will be left to deal with. This is why the success rate of new drug trials is extremely low. In clinical trials, many problems that have never been encountered or thought of before will be encountered. Each of these problems is difficult to solve. If they can be solved, the trial will be successful. If the problems are not solved, the experiment is doomed to fail. In most cases, these problems are difficult to solve. Sometimes it takes several years, more than ten years, or even decades to solve a problem.

Non-doctor researchers in the laboratory also sit in the operating room's demonstration room to observe surgeries. Although they do not need to participate in clinical work and only conduct research in the laboratory, they can master some clinical knowledge, which is of great help to scientific research.

Professor Zhang Zhiwei from Nandu Medical University led a team to Sanbo Hospital to observe the operation. Their task in the project was to select the most suitable virus and provide a plan for virus modification, which was implemented by the genetic laboratory of Nandu Medical University. In the past, when they were limited to studying viruses in their own field, they never thought that viruses could be used in this way, and they never thought that such clinical problems would arise in the experiment.

Even though Yang Ping was extremely skilled in the operation, he did not omit necessary steps. Firstly, necessary steps are a guarantee of safety. Secondly, if necessary steps were omitted, it would inevitably set a wrong example and mislead his learners. Once this misleading information spreads, the consequences will be disastrous.

Before the operation, Yang Ping drew lines on Sisi's head to mark how to make the incision, how to perform the bone cut, and the shape and area of ​​the bone flap, so as to achieve the best match with the internal fixation device that would be implanted later.

Sisi was in the prone position under general anesthesia, with her head fixed with a special fixator. Yang Ping began to cut the scalp, clamping a hemostatic clip every time he cut a little. The scalp has a rich blood supply. If the hemostatic clip is not delivered in time, it will bleed a lot. For example, skin avulsions in other parts of the body generally do not bleed too much as long as the large blood vessels are not damaged, and shock will not be caused by skin avulsions. However, scalp avulsions are different from ordinary skin avulsions. Even if the large blood vessels are not damaged, the bleeding rate caused by extensive oozing of the scalp is alarming. If the bleeding is not stopped in time, it can cause shock and death.

When cutting the scalp, no matter how fast the surgeon is, he cannot keep the scalp incision clean and free of bleeding. But Yang Ping did it. He cut the scalp and placed the scalp clip steadily and accurately before the blood seeped out.

After the entire incision was completed, the incision was surprisingly clean and no bleeding was seen. The gauze that the assistant held in his hand to apply pressure to stop bleeding was almost unused.

Clean. The first intuitive feeling that Yang Ping's surgery gives people is that it is clean, very clean. No bleeding can be seen from beginning to end. Only Yang Ping can achieve such thorough cleanliness.

Sometimes when Song Zimo and Xu Zhiliang encountered difficulties during surgery, after Yang Ping came on stage, the surgery would become clean as they went on, as if Yang Ping was not helping to solve the problem, but cleaning up. Not only Song Zimo and Yang Ping noticed this problem, but all the doctors who were saved by Yang Ping were aware of this problem. Every time a bloody operation was handed over to Professor Yang, when he returned it to the surgeon, the surgical area would be clean and pleasing to the eye. Of course, this cleanliness could not last long, and after the surgeon took over again, the bloody and messy area would soon return to normal, as if bloody and messy was the norm.

The scalp was opened and then turned over in a flap shape, and the vascular clamps were neatly arranged along the scalp. The neatness seemed to be achieved not by human effort but by some kind of sophisticated machine.

"Professor, you can save a lot of gauze for the hospital every year. I have been holding the gauze in my hand since the start of the operation and have not changed it yet." Song Zimo did not feel that he was flattering, and the people around him did not feel that way either.

I don't know why, but if you praise others, it will be more or less considered as flattery. However, if you praise Professor Yang, even if it is really flattery, people will not feel that it is flattery at all.

"I haven't calculated it yet. Why don't you set up a project and write a paper?" Yang Ping kept moving his hands and chatted with his assistants from time to time.

"The relationship between the frequency of gauze use and the amount of surgical bleeding? Is this topic okay?" Zhang Lin knew how to seize opportunities. The bits and pieces of knowledge that the big guys chatted about were just idle talk to others, but to Dr. Zhang and Xiao Wu, they were important information.

It is said that the driver of a wealthy man in Hong Kong used the information he heard overheard to guide his investments, and became a small wealthy man when he retired.

Zhang Lin and Xiao Wu understood this principle. They were very self-aware. They did not have the IQ of top students like Song Zimo and Xu Zhiliang, so they could not accomplish anything earth-shattering. They only wanted to pick up some of the tricks leaked by the big guys and find a foothold in the medical field, and they would be satisfied.

"This is too superficial. It should be the correlation between gauze consumption and postoperative complications? I have recently done statistics. The more hemostatic gauze is used, the greater the possibility of surgical complications, and vice versa." Xiaowu and Zhang Lin are a good pair of partners. They will come together for good and bad things. They unite their two ordinary heads and try to barely keep up with the pace of those academic masters.

"Mr. Song, you look down on this kind of topic, so why don't you give it to us?" Zhang Lin asked flatteringly.

Song Zimo was stunned. He was just joking. Are these two funny guys really going to use this topic as a research topic to write a paper? Is this true?

"We can't do the big ones, so we can only pick up small ones. Ordinary small topics are too ordinary and easy to repeat, so we can only take a different approach." Xiaowu said.

"Are you not going to study the hook?" Yang Ping asked. "Of course I can't. The hook is our unique skill. In our spare time, we should also study other topics to enrich our academic achievements." Zhang Lin is very confident in his research results on the hook, which can be called the best in the world.

Not only did they write the world's first monograph on retractors, but they also obtained a large number of patents related to retractors. The number of patents they own is also the highest among doctors in the world. They have worked silently in the retractor niche field and have become the well-deserved number one in the world.

"If you continue to do this, the manufacturers of surgical gauze will have to go bankrupt." There were still a few faint bloodstains on the gauze in Song Zimo's hand, which was far from meeting the requirements for replacement.

"Now you know why many medical devices are made into disposable consumables, right? This is not necessary. The technology can completely make them available for multiple uses, but this is not economically possible. How can we sell them if we don't consume them? How can we make money if we don't sell them? How can we research and develop without making money? How can we make progress without research and development?" Tang Shun, who was standing nearby watching the operation, also joined the conversation.

"If every doctor was like the professor and only used a few pieces of gauze in a major operation, either the price of gauze would go up or the gauze factory would go bankrupt. There would be no third possibility." Tang Shun is a compound talent with a relatively high financial quotient.

Since Yang Ping handed over the laboratory to him, he has used his ability to make money to the extreme, raising a large amount of funds through the laboratory's new technology. He is also very courageous in setting the prices of some projects. For example, some top stem cell projects range from millions of dollars to tens of millions of dollars per treatment. At first, everyone thought he was a joke, but later it was proved that the people who laughed at him were the joke.

"Dr. Tang, how is the rejuvenation project you launched going?" Xiao Wu asked, "My father-in-law asked me to find out about it. He is very interested. Can you give me a discount when the time comes?"

"This project is selling like hot cakes now, and the reservation queue has been lined up until next year. What about your father-in-law? How can he get a discount for his own people? It's free right now. Why don't you take the time to bring him here to experience it?" Dr. Tang is a very sensible person. He knows the difference between inside and outside. He makes money from outsiders, so he doesn't use the idea of ​​making money on his own people.

Xiaowu's father-in-law is a typical local "landlord" in the provincial capital of Nandu. He owns several office buildings in the prosperous area of ​​the city and collects rent. Including other office buildings that are not in the core business district, there are more than a dozen of them. The couple has only one precious daughter, Xiaoqing. In order to follow Xiaowu to Sanbo Hospital, Xiaoqing threatened to commit suicide by cutting her wrists. The old couple was so scared that they immediately urged Xiaowu to get married quickly.

There was no other way. Under such high pressure, Xiaowu had to get married. In fact, doctors are quite popular. Many elderly people like to choose doctors as their sons-in-law. This landlord father-in-law is no exception. Especially when they later learned that their son-in-law had made outstanding achievements in the field of surgery and published the world's first monograph on retractors, the old couple were very happy.

"Xiao Wu, I heard that your father-in-law wears big shorts, flip-flops, and carries a big snakeskin bag and a scale to collect rent, and he collects money by weight?" Fatty Liang was wearing cropped pants and crossed his legs.

"You believe the old jokes. Can you carry a snakeskin bag? Nowadays, everyone has a company with dozens of financial staff. Do they still need to carry a snakeskin bag to collect rent?"

"You mean he has dozens of financial staff in his company just to help collect rent?"

"It seems that his company has no other business except collecting rent. He doesn't know how to do other business. He said that he was not educated and couldn't do anything else. At that time, he only knew how to deal with real estate. He was also very conservative. He didn't have the courage or the spirit to take out loans or expand. All the real estate bosses of his time were expanding nationwide. He is still at this scale now, managing more than a dozen office buildings and collecting rent."

"He said that he could only do this kind of small business in his lifetime and he didn't have the ability to do big business."

"Why doesn't your father-in-law give your wife a younger sister?" Fatty Liang said with regret.

Zhou Can, who was working as an instrument nurse on the stage, immediately glared at Liang Pangzi, who immediately explained, "If your wife had a sister, what would our Xu Zhiliang have a chance?"

"Old Xu is married and has children."

"Oh, I mean Xia Shu!"

"The head nurse will come to you with a kitchen knife immediately."

Fatty Liang was speechless, made frequent slips of the tongue, and no longer dared to say a single word.

The bone flap has been opened, the operation has been done inside the skull, and the brain stem has been dissected. How could the operation be so quick? We just chatted for a while.

The second characteristic of the professor's surgery is its fluency. It is not only fast, but also smooth and seamless, without any unnecessary or ineffective movements.

Generally, during craniotomy to decompress the bone flap, the bone flap is removed and discarded. Why is it discarded? Because when removing it, it is either bitten off in small pieces, instead of removing it as a whole piece. What is there to use it with?
Either after an entire bone flap is removed, the edge of the bone flap will be damaged during the removal, so when it is put back, the lid will be smaller than the hole and will not be able to cover it at all; even if there is no damage, the lid will sink into the hole when put on.

Yang Ping's improved procedure can cover the skull with the original skull cap. First, he removes the bone flap in one piece. When cutting the bone flap, he uses a thin electric saw and tries to be as delicate as possible to reduce the loss of the edge. Secondly, the method he uses is quite special. He uses a bone flap that is small inside and large outside. The skull is divided into two layers, the inner plate and the outer plate. The outline of the first layer of the outer plate of the bone flap is larger than the outline of the second layer. In this way, the edges of the skull hole left are exactly the opposite, with a large hole on the outer layer and a small hole on the inner layer.

This is just like the manhole cover on the street. The skull bone flap can be used as a lid to cover it. It fits perfectly without sinking into the manhole. Even if the edges are a little worn, it doesn't matter.