It is very important to accurately identify tumor tissues during surgery. Otherwise, even if all the organs and tumors are taken out, it will not be possible to distinguish which ones are tumors, which ones are normal, and which ones are mixed tissues.
Of course, with his rich anatomy experience, Yang Ping can make judgments through naked eye recognition and finger touch. If coupled with CT enhanced scanning, the images of PET-CT scans are memorized in his mind, and then he can apply these pictures to
In terms of physical organization, the judgment is basically the same.
But not every doctor is Yang Ping. In Yang Ping's view, if only he can perform this operation, it will be his failure.
For any surgical procedure, only by improving the method, reducing the difficulty of the operation, and making the operation more popular is the best surgical method. Otherwise, one doctor will be exhausted and can only perform so many operations.
The five-year survival rate of pancreatic cancer is less than 8%, and 90% of patients die one year after surgery.
To increase this ratio and obtain a good survival period, Yang Ping can only rely on his superb surgical skills to achieve complete resection as much as possible. There is no other way.
The same thing can be done very advanced or very simply. This is a matter of technical level.
For example, when building a house, primitive people used trees and thatch to build a house. Nowadays, high-rise buildings with hundreds of floors are also houses. This is a matter of the level of construction technology.
The same goes for surgery. It is also surgery for pancreatic cancer, and rough removal is also surgery.
People like Yang Ping who carry out operations from strategy to tactics and are meticulous in every detail are also operations.
Extracorporeal resection is a strategy in the entire surgical plan, and under the strategy, there are also tactics and every battle.
The film Nie Shun'e brought was a contrast-enhanced CT, which is actually enough to make a diagnosis. Enhanced CT is the best examination of the pancreas and can be used for localization, differential diagnosis and staging.
However, in order to further understand the condition, Yang Ping still performed PEC-CT on her. At this time, it was not a matter of whether to save money, but to pursue the best results as much as possible. Otherwise, there is no point in saving money, and it is better not to spend any money.
Qian, PEC-CT can evaluate tumor metastasis and systemic conditions.
Judging from the PEC-CT, it is still metastasized in the abdomen and has not metastasized to the brain, lungs and other organs. This shows that if the surgery can be performed to a certain level, there is still hope. This is how to treat diseases. It can be done to the extent that it can be achieved.
To what extent.
There are only a few ways of tumor metastasis - direct infiltration, hematogenous metastasis, lymphatic metastasis, and seeding metastasis. Tumor cells are like seeds. Wherever they are spread, they will take root and sprout, and soon a bunch of tumor cells will emerge.
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It is difficult to eradicate the disease by cutting the grass. This is the big problem with malignant tumors. If anyone can eradicate the disease, it is to find a cure for the tumor.
Although Yang Ping could not remove the root, he tried to cut the weeds as much as possible.
In order to identify tumor tissue during the operation, Yang Ping plans to use indocyanine green for fluorescent staining. The tumor tissue after this special staining is nothing special to the naked eye, but under a special laparoscope or glasses, the tumor tissue can be
It emits green fluorescence, which is clearly different from normal tissue.
Methods are very important. Good methods make work easier. Relying on powerful modes to achieve goals is sometimes a helpless choice.
Indocyanine green needs to be injected into the blood vessels before surgery. Nie Shun'e's liver function is acceptable, so indocyanine green is usually injected 3 days before surgery. Indocyanine green circulates in the blood and finally combines with tumor cells, while normal
Cells will not bind to it.
While thinking, Yang Ping perfected his surgical plan with hand drawings, striving to simulate every detail in his mind.
In the doctor's office, Song Zimo was collecting everyone's surgery plans. After collecting them, including his own, they were placed on the desk, waiting for Yang Ping's examination.
Yang Ping came out of the director's office and came to the doctor's office. Everyone was sitting in the doctor's office waiting.
Song Zimo pulled up a chair and Yang Ping sat down.
The table was full of surgical plans. Yang Ping looked at them one by one. The design of the surgical plans can best train a person's abilities.
Well, Yang Ping looked through it slowly. Song Zimo was as excellent as ever and always did things perfectly. This person was born to be a perfectionist and there was nothing he could do about it.
Xu Zhiliang was a born academic and wanted to study everything thoroughly, so the surgery plan of these two people satisfied Yang Ping the most.
Xia Shu is new here, a PhD in cardiac surgery, and his skills in hepatobiliary and pancreatic surgery are still much weaker, but his weakness is only compared to that of Song Zimo and Xu Zhiliang. These two people have been with Professor Yang for a long time, giving advice, and even the textbooks are in-house special
This is something that no one outside can do. Just a knowledge of anatomy can dominate the world.
Li Guodong is good, he is very smart, and he is also motivated. He has already shown his ability as a top student. Although he is not experienced enough, he did a decent job planning the surgery.
Zhang Lin Xiaowu has also worked very hard and was able to write a very detailed plan, which deserves recognition. It seems that Teacher Zhang and Teacher Wu's ideals are not just to be a hook puller.
Dr. Li Min is a junior college student. Low education does not necessarily mean low ability, but low education means there is a certain gap in the education he received, and he needs to continue to catch up. Therefore, his plan is still far behind Zhang Lin Xiaowu, but Yang
Ping doesn't care about this, he is a special case, and Yang Ping has another training plan.
Regardless of whether Li Min is a piece of jade or a stone, Yang Ping can carve him into a work of art, which he can definitely do.
After Yang Ping read these surgical plans, everyone sat at attention, waiting for his corrections and comments. Song Zimo was the most confident, and he felt that the professor should praise him. But Xu Zhiliang was not far behind. He felt that except for his eloquence, he was no worse than Song Zimo. Li
Doctor Min was a little unsure and uneasy.
However, Yang Ping did not make any judgment on the spot, but said: "Leave these to me. After the operation is completed, everyone will write a new copy and give it to me."
This chapter is not over yet, please click on the next page to continue reading the exciting content! That’s it? Some people are disappointed, and some people feel that they have escaped.
Song Zimo originally thought he could get praise from the professor, but Xu Zhiliang wanted to verify whether he was tied with Song Zimo, because he was unwilling to lose to Song Zimo many times.
But the professor's words made all their thoughts go to waste. Well, let's decide who is better after the surgery.
Zhang Lin Xiaowu escaped, otherwise their surgery plan would have been criticized. It would be uncomfortable to always be hanging on the tail of the train, but they have long been used to it and accepted the status quo.
I would rather be a phoenix's tail than a chicken's head. Don't compare horizontally, but compare vertically. Today's self is better than yesterday's self. This is the life philosophy of the two brothers.
You still have to wait a few days for the surgery. In addition to the need to inject indocyanine green a few days in advance, you also need to get approval for the surgery in advance.
Such a major operation requires the removal of organs. It is certain that one kidney will be removed. It is not certain that other organs such as the pancreas may be removed during the operation. Therefore, such a major, potentially disabling, and extremely destructive operation is not possible.
You need to apply to the hospital medical office for signature and filing.
At this time, Director Zhao from the Medical Department and Director Zhou from the Science and Education Department were discussing important matters together. Li Guodong came to Director Zhao with the application form. Director Zhao saw that it was Yang Ping's order and signed it immediately after looking at it.
Since Professor Yang’s debut, it seems that he has never been unable to perform surgery. This is not Director Zhao’s personal understanding, but the consensus of Sanbo Hospital.
"Is Professor Yang in the office now?" Director Zhao asked by the way.
Li Guodong nodded: "I was there just now."
Sometimes the doctor is not sure where he is. Sometimes he goes to the outpatient clinic, sometimes he goes to the emergency room, sometimes he goes to the operating room. Anyway, it is difficult to find a surgeon.
Director Zhao picked up the phone and dialed Yang Ping's mobile phone directly to confirm that he was still in the office. He took Director Zhao and went to Yang Ping to discuss the matter.
Both the Medical Department and the Science and Education Department are very busy during this period. Director Zhou of the Science and Education Department is really worried. Ever since Yang Ping's 13 papers were exposed, applications for further study have piled up on the desk of the Science and Education Department.
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These application forms are available in hospitals all over the country and abroad. In addition to doctors applying for further training, there are actually several researchers from the world's top medical laboratories applying for academic exchanges.
The Institute of Surgery is such a big place, how could it possibly accommodate so many people? What should I do? Director Zhou panicked and had to come to his brother, Director Zhao, for help.
Director Zhou has a bit of rickets. When he sees foreigners coming to study, he always wants to get some special treatment. However, after being severely criticized by Dean Xia and Director Han, the rickets have not occurred for a while, but the rickets will take a long time.
It is difficult to cure.
This time he was more cautious, fearing that he might develop symptoms of rickets invisibly, so he came to Director Zhao for help. Director Zhao said: "A rising tide lifts all boats. With more and more people training, the original training system of the Institute of Surgery can no longer be used."
suitable.
The two directors came to the Institute of Surgery together, and Director Zhou told Yang Ping the matter. Yang Ping actually had no good solution to the matter.
The general principle is to select the best. Since there must be elimination, what method should be used? Yang Ping thought about it. The college entrance examination is actually quite fair. Although there are many criticisms of the college entrance examination, it is definitely the fairest selection. As long as anyone can
If you can't avoid the college entrance examination, it will be very difficult to make small moves.
Yang Ping said: "Let's take the exam. Let's issue the test papers here. Buy me a safe. The test papers will be sealed in my safe before the exam starts. When the exam starts, we will distribute the test papers. Refer to the college entrance examination and have a strict exam system."
"Should there be an interview?" Director Zhou asked.
Director Zhao waved his hand: "We should have set up interviews, but what? Interviews can easily become sour--forget it, if we really want to be strict, we only need a written test."
"Just like this, our Institute of Comprehensive Studies will set the questions, the Department of Science and Education will organize the exam, and the Medical Office will be in charge of invigilating the exam. During the exam, the camera will monitor the whole process. We will send people from the three families to watch the camera, and it will be broadcast live for the whole hospital, and the exam video will be permanently archived.
"Yang Ping thinks this matter is very simple.
The three of them all agreed with this method. Director Zhou from the Science and Education Department suddenly felt his chest straighten out. He felt proud when he thought of the exams he organized and those foreigners came to participate in them. He also passed the exams when he went abroad to study.
Only through examination and selection can you have a chance.
It turns out that it feels so good to straighten my back, but the job of invigilating the exam is left to Lao Zhao. Obviously, it feels better to invigilate the exam.
"Can we make an exchange? You will organize the exam and we will invigilate it?" Director Zhou wanted to change jobs with Director Zhao.
Director Zhao glared at him: "Additional education management is the responsibility of your Science and Education Department. We are just assisting. That's it. You organize the exams and we are responsible for invigilating them."
How could such a good job be entrusted to you? Think about that scene. Doctors from various top hospitals at home and abroad lowered their heads to answer questions and walked through the examination room with their heads held high. What aura and feeling it felt.
, making you, Old Zhou Lai, nod and bow down, can you be as powerful as me, Old Zhao?
Yang Ping was very busy today. He sent Director Zhao and Director Zhou away. Dean Xia called again and told him about Bao Yulou's son. He had suffered multiple ligament ruptures in his knee joint before. Yang Ping had been ignoring him because of a conflict with Yang Ping.
Later, Bao Yulou took his wife and son to write an apology letter to the hospital, and took the initiative to publish the apology letter on the hospital's official website. Bao Yulou also donated money to the hospital to set up an emergency relief fund. Now after so long, Bao Yulou dared to carefully ask Xia Yuan
Chief: Can you trouble Professor Yang to do the surgery for his son?
Dean Xia immediately became unhappy: "Do you mean that our Professor Yang will embarrass you?"
Bao Yulou immediately felt that he had said something wrong: "Misunderstanding, misunderstanding - I mean, we know that the operation is very difficult and risky, and we ask Professor Yang to try it for us. We are willing to bear the risk."
"Okay then, I'll ask Professor Yang."
Dean Xia then called Yang Ping back.
"Professor Yang, if you say yes, I will convince them. If you say no, I will reject them directly." Dean Xia said simply.
"Let them come."
It's not a deep grudge. Since he sincerely repented, Yang Ping was willing to give him a chance.
To be honest, if you want to restore your sports ability after this kind of knee joint injury, if you still want to play football, only Yang Ping in the world could do it in the past. Now Su Nanchen, Gao Yuan, and Robert can also perform the surgery, but after all, Yang Ping is the original creator and mentor.
, Bao Yulou didn’t want his son to be disabled in the future, so he tried his best to ask Yang Ping to take action.
Seeing that Yang Ping had agreed, Dean Xia replied to Bao Yulou: "Since you are so active, we, Professor Yang, will try our best."
For a person like Dean Xia, in the position of dean, it is definitely not possible to be tough on everything. He must be round on the outside and square on the inside, and be able to handle various relationships with ease, otherwise he will not be able to be the dean.
When so many leaders called to plead for mercy, President Xia just said: "Hey! Our small hospital is not good enough and the doctors are timid and cannot perform such complicated surgeries. Let him go to the Imperial Capital!"
Even if you know that this is a nonsense reason, there is nothing the other party can do about it. Medical matters, especially surgeries, cannot be done by others themselves. If you insist on having someone come on stage, who dares to take responsibility?
Now that Yang Ping has relented, Dean Xia can say: "Although the operation is difficult and risky, since you are so active, we doctors can only try our best."
Dean Xia was always very tough. He had received an award in the Great Hall of the People, so who could he be afraid of? But since he got Yang Ping, he has become even more tough. Sometimes he is so tough that he even thinks that he is the best dean in the country.
