Professor Wang was staring at the screen intently. Now the kidney transplantation is over and the liver transplantation is beginning. There is no intermission and the two operations are completely treated as one operation.
The first assistant was replaced by Director Li. Director Li specializes in liver transplantation, while Director Liu specializes in kidney transplantation. Liver-kidney transplantation is the surgery with the largest organ transplant expenditure at Sanbo Hospital.
Yang Ping's movements are extremely fast, and there are no repetitive or invalid movements at all.
Qin Xiaowei's abandoned liver was processed first. After laparotomy, Yang Ping quickly dissected out all the structures around the liver: dissected the first porta hepatis, freed the common bile duct, cut off the bile duct at the confluence of the left and right hepatic ducts, and freed the left and right hepatic arteries.
, cut and ligate them respectively close to the liver; free the main trunk of the portal vein to expose the left and right branches; free the subhepatic inferior vena cava; cut off the hepatic coronary ligament, left and right triangular ligaments, and falciform ligament to expose the second hepatic portal; separate the deep retrohepatic inferior vena cava.
noodle.
At this point, all connections between the liver and the surrounding ducts or parenchyma are severed, and the discarded liver is completely free and removed---
After Qin Xiaowei finished his work, the team did not dare to waste a second. They immediately moved to another operating room, changed gloves, and removed part of the liver from Li Jun.
The general steps are similar, the difference is that this time only a part of Li Jun's liver was removed instead of the entire liver.
Make a subcostal herringbone incision, go deep layer by layer, expose the liver, and use intraoperative color ultrasound to check the direction of the middle hepatic vein to determine the resection line; remove the gallbladder, and perform cystic duct angiography to check whether there are biliary malformations and the distribution of the biliary tree;
The first porta hepatis is dissected, and the bile duct, hepatic artery, and left branch of the portal vein are freed respectively; the second porta hepatis is dissected, and the combined trunk of the left hepatic and middle hepatic veins are freed; the liver parenchyma is separated along the pre-marked resection line; and the catheter is intubated.
Connect Professor Yao's machine; cut off the first and second hepatic hilum, remove the left half of the liver, and hand the removed liver to Professor Yao for weighing.
When performing partial liver transplantation, the transplanted liver must account for 1% of the body weight. After weighing, the quality of the removed liver meets the requirements.
Yang Ping closed all the duct stumps, performed cholangiography to check for biliary fistula, placed abdominal drainage, and closed the abdomen.
The team switched between the two operations, and Professor Yao came to Qin Xiaowei with a living liver.
Yang Ping began to transplant Li Jun's liver into Qin Xiaowei's body. The circulating nurse helped put down the head-mounted microscope on his head, and the anastomosis of blood vessels and bile ducts was completed under the microscope.
First, perform end-to-end continuous anastomosis between the donor hepatic vein and the recipient hepatic vein; then perform end-to-end anastomosis of the portal vein; end-to-end anastomosis of the hepatic artery; and end-to-end anastomosis of the bile duct.
Rinse the abdominal cavity, place a drainage tube, and close the abdomen.
Yang Ping completed all the steps by himself, and the entire surgical process was very clear and smooth. This kind of proficiency is the ultimate proficiency, which can only be obtained through countless surgeries.
Professor Wang took a deep breath, looked at Professor Pei next to him, and murmured: "He really knows how to do liver and kidney transplantation! He really knows how to do it! Without two thousand operations, he wouldn't be able to achieve this level."
"Yes, he is much more skilled than us. This is the real proficiency. How could he have never done an organ transplant? How could he not even have the qualifications? How could this be possible?" Professor Pei took the words and felt like a dream.
The surgery just now included processing the recipient's liver area, dissecting the donor's liver, connecting the machine, harvesting the liver, removing the recipient's liver, and transplanting the donor's liver. The whole process was well-paced, without any pause or confusion, especially when looking at Yang.
The anastomosis of blood vessels and bile ducts is really pleasing to the eye, as if you are watching some kind of stunt that has been passed down for thousands of years.
"Watching this kind of surgery is totally enjoyable!"
Professor Wang has never seen such a smooth operation, and his own surgical skills are far from reaching it.
People who engage in technology only believe in technology, and now he is really convinced. Regardless of whether Professor Yang has qualifications or not, the fact is that his surgery is absolutely top-notch.
About fifty minutes later, the liver transplant battle was over.
Including the 30 minutes for the kidney transplant, the total was more than 80 minutes. The operation was completed, which was 40 minutes shorter than the "bragging" two hours.
If Professor Wang had "terrible like this" in his vocabulary, he would definitely choose to use "terrible like this" to describe it now.
Not only Professor Wang and Professor Pei, but all the experts present were deeply confused.
Anyone who sees this kind of blitzkrieg would be confused.
We are all experts, but we have never seen this kind of surgery. This is not surgery, it is a stunt.
"How about it?"
Director Zhao, who had already returned to his seat, asked in a gentle tone, then reached for a peanut, peeled it open, and threw it into his mouth.
Asking knowingly!
Professor Wang took a sip of tea and replied: "Director Zhao, you are pretending to be a pig to eat the tiger. Professor Yang does not look like he has never done liver and kidney transplantation. Without the volume of 2,000 surgeries, he will never be able to do this level. How can you hide it?"
Deep enough.”
Professor Wang is the boss of the Imperial University Organ Transplantation Center, and Professor Pei is the boss of Renji Hospital Affiliated to the Medical College of Shanghai Jiaotong University. These two are the top organ transplant centers in the country.
Director Zhao said that Yang Ping had never had a liver or kidney transplant, which was impossible. It can be suspected that this was a malicious insult to the two bosses.
Isn’t it a joke that two big guys who are in top hospitals and have been performing liver and kidney transplants for 20 years are not as good as the doctor who did the liver and kidney transplant for the first time?
When Professor Wang and Professor Pei felt ashamed of themselves, they couldn't help but feel a little angry. Sanbo Hospital's behavior of pretending to be a pig and eating the tiger was unkind.
"Professor Yang has indeed not done any organ transplantation in our hospital, but he should have done a lot abroad. He often goes abroad for flying knife surgeries, and some countries have granted him special surgical licenses. Our hospital would like to help Professor Yang apply for organ transplantation qualifications.
"The two professors have also seen today's surgery. Does this level meet the standards?" Director Zhao went around in a circle and finally brought up the topic.
This is also a bit of a moral kidnapping. Foreigners can issue special surgery licenses under exceptions. Now, will you grant qualifications?
In fact, this qualification is not given by two big guys, but is issued by the Department of Health. If recommended by these two big guys, then it would be more justifiable to issue the qualification in an exceptional manner.
Professor Wang and Professor Pei were a little hesitant. According to the qualification process, Professor Yang must go to a designated place for training for one year and then take the assessment.
But in terms of actual level, this technology can train others. To be honest, it is also possible to train the experts here.
"Our General Surgery Department plans to give Professor Yang full surgical authority. All surgeries that can be approved by the hospital have been opened. The remaining surgeries are high-threshold surgeries, such as organ transplantation. However, there has been no authorization for it. Today's surgeries are still marginal.
Director Liu and Director Li’s qualifications serve as a protective umbrella, so we thought if we could trouble two great professors to jointly recommend and go through a special channel to award Yang Ping a qualification. If the two still have questions, they can investigate at will." Director Zhao died.
Stalking and beating.
Professor Wang waved his hand: "No need for inspection."
Professor Wang just watched the whole process of liver transplantation, and Professor Pei even watched the whole process of liver transplantation and kidney transplantation. With the level of surgery in front of you, what else is there to investigate?
This level of proficiency makes it impossible for you to even pretend, so there is no such thing as cheating.
However, it is recommended to grant special qualifications for liver and kidney transplantation, which requires careful consideration.
Sanbo Hospital can do such imaginative things, but the two bosses are very well-behaved people and don't dare to do this. In terms of clinical medicine, it is better to follow the steps.
---
After the operation, because there was not much blood loss, Qin Xiaowei and Li Jun's vital signs were very stable.
There were only a few pieces of hemostatic gauze thrown into the collection basin, with scattered traces of blood on them.
Yang Ping is very familiar with anatomy, so he avoids 100% of the blood vessels that can be avoided, and the small blood vessels that cannot be avoided are ligated or electrocoagulated in advance, so there is no bleeding at all and the surgical field is clean.
Director Liu and Director Li almost collapsed anyway. In order to keep up with the pace, they had to concentrate highly throughout the process, which consumed a lot of mental and physical energy.
When the operation just started, they were still a little worried. After all, they had never seen Yang Ping perform a liver and kidney transplant.
There are many legends about Yang Ping in Sanbo Hospital. Anyway, the more they are said, the more amazing they become. Some people even say that he performs black market surgeries in foreign countries. Others say that he is a famous black market swordsman and his ranking is quite high.
Director Liu and Director Li only heard about this kind of thing. If a person's ability is too outstanding, it will lead to unrealistic legends.
But for today's organ transplant operation, Director Liu can guarantee that if Yang Ping didn't have a dedicated organ transplant flying knife base abroad, he would have walked around three hospitals naked and upside down.
But this idea was immediately pushed back. Didn't Wen Ruzheng from the pathology department make a bet with him that he would run three laps of the hospital in his underwear?
No matter what, now that the operation is over, Director Liu and Director Li completely believe that Yang Ping is a god.
"Professor Yang, come to us more often to perform surgeries and guide us when you have time."
Director Liu said sincerely that he was now willing to bow before Yang Ping and follow Director Gao's path.
If Yang Ping had learned even half of the skills he had just learned, Director Liu felt that he could be alone in the world of organ transplantation.
Originally, Director Liu wanted to go to the United States to further his studies, but now he feels that he is a little far away from the near and far away. He went to the United States to study even though there is such a great figure in his own hospital.
"Yes --- Professor Yang --- come to us for more surgeries. Qualification issues don't matter. Just write our names and we will take care of you if you have anything. Don't worry." Director Li also fought for it.
Who doesn’t want to stand out, and the same goes for the medical field, who doesn’t want to become a respected and famous doctor.
"It's okay to make one occasionally, but too many are not enough. You must have qualifications." Yang Ping doesn't want to always play on the sidelines, which is dangerous and boring.
Yang Ping was about to take off his surgical gown, and Director Liu and Director Li rushed to help.
Professor Yao stood by the machine and had no intention of taking off his clothes and stepping off the stage. He looked like a wooden man with dull eyes.
Sometimes he looked at the patient lying on the operating table, sometimes at the pieces of gauze in the collection basin, and sometimes at the electronic clock on the wall panel. His whole mind was a bit confused and not normal.
In fact, Professor Yao was the one who was hit the hardest. His own technology and his own machines allowed others to create teaching cases.
The key is that the object of teaching includes yourself.
When a new technology emerges and becomes popular, the waves behind it will push the waves ahead, and gradually some people will improve it better and better.
But now the new technology has not been promoted and is still in our own hands. How come others are ahead of the curve?
Professor Yao just observed the surgery at close range. Yang Ping improved several details based on Professor Yao's original work, which is obviously better than Professor Yao's surgery.
The details of these improvements are precisely what Professor Yao has been pondering for many years but has not yet figured out.
Today I actually got all the answers here.
Is it true that I accidentally stole Professor Yang’s version? Professor Yang is the real owner?
No, this technology is indeed original and took ten years to develop.
There was no reference material at that time, so I was unique in the world.
Could it be that during the same period, Professor Yang also thought of ischemia-free transplantation technology and performed a large number of surgeries, but he did not publish an article.
This situation also exists, where two people independently develop the same technology without any communication or reference.
Finally, to determine who invents the new technology, just look at the paper and whoever publishes it first will be counted.
Professor Yao thought about it and felt that something was wrong. Didn't the General Surgery Department of Sanbo Hospital not yet carry out organ transplantation?
The more I think about it, the more confused my mind becomes, and even the basic logic is a little difficult to sort out.
Professor Yao was still confused. Yang Ping urged him to take off his surgical gown and then told him that there were still several areas for improvement in the machine. For example, the pipeline could be modified to make it more convenient, the circulation path could be improved, and various parameters could be optimized.
.
Professor Yao made a few ouch and untied his clothes several times without untiing them. He relied on Yang Ping's help to take off the surgical gown.
Forget about improving the details of the surgery, now you are more familiar with the machine than me and you help me improve it. These improvements have all been focused on the key points. They are all areas that I feel dissatisfied with, but I can't find an alternative.
I’ve never seen anyone bully the original creator like this!
Professor Yao felt like crying.
"Professor Yang, have you also studied this technology? Let me first state that the ischemia-free transplantation technology is really my original creation. I have not read any ready-made books or papers. I started from scratch, bit by bit.
Wow, it took ten years to achieve what we have today." Professor Yao explained pitifully to Yang Ping.
"I have never done research before. I only learned it after reading your papers and patent information. I am embarrassed to use your technology, so I took the time to do some research and found several areas that can be improved. I will give it to you.
How about the tuition fees?" Yang Ping joked with Professor Yao.
Professor Yao waved his hand: "I don't want to take it, I don't want to take it, as long as I am not suspected of infringing on you, it's fine. If you scare me, can I copy your surgery video?"
"Okay, you can copy it as you like. Do you have a disk? I'll have someone bring it to you." Yang Ping said cheerfully.
It's his skill in the first place, so copying surgery videos is nothing.
Professor Yao did not expect Yang Ping to be so forthcoming: "Yes, I have the disk and put it in the cabinet in the locker room. I will get a copy later."
Professor Yao plans to copy the surgery video and study it carefully.
This is an absolute teaching surgery!
Use Yang Ping's surgery videos to learn your own original techniques.