Surgery Godfather-Chapter 347 - 0330: The Mail of the United States

Chapter 347: Chapter 0330: The Mail of the United States

It is now just after five in the afternoon, which should be just after five in the morning according to American time.

This Robert from the United States seems to have a lot of energy, sending emails either at one in the morning or five in the morning. Doesn’t this man need to sleep?

Yang Ping opened the email: Dear Dr. Yang, sorry to trouble you again. I have used your surgical method and have completed a multi-ligament knee reconstruction. The result exceeded expectation. Now, among my patients, there is a special case, I have sent the case file to your email, see the attachment, if possible, please give your advice, greatly appreciated! Robert from New York.

Since the review process began, Yang Ping has communicated several times with Robert via email. Now that he is sending the case file, it seems that Old Robert is a real technician.

Yang Ping generally likes this type of person. The mobile phone screen is too small, and it is inconvenient to view imaging pictures. Yang Ping opened the email on the computer in the office, downloaded the files in the attachment, and then habitually scanned them for viruses.

The hospital’s information department has issued several notices on the internal network not to open emails casually, especially ones from overseas, and to conduct a routine antivirus scan before opening them to prevent ransomware infection.

Better safe than sorry. This email is from America, it’s better to scan it for viruses.

The computer is connected to a professional radiographic display, and the MRI images are very clear. This is a rare case of a five-year-old boy with knee injuries and multiple ligament ruptures.

Yang Ping has done many of these surgeries in system space, ranging from bizarre to common cases. This kind of case is considered relatively common in the system space but in reality, Yang Ping has not yet encountered it.

The difficulty of this case lies in that he has multiple ligament ruptures in the knee joint, and he is also a child in the growth and development stage. The reconstruction of multiple ligaments itself is difficult, let alone for a child, the difficulty is multiplied.

Children are not miniature adults. Children’s bodies are in the process of growth and development, each with its own characteristics, and children of different ages have different characteristics. Surgery for children cannot be regarded as a scaled-down version of adult surgery.

For a five-year-old child, the entire operation must not damage the epiphysis, otherwise, the knee joint and even the left lower limb will develop malformations.

The epiphyseal line of adults has long since closed, which is not an issue. When an adult undergoes this kind of surgery, neither the tibial nor femoral tunnels need to take the epiphysis into account. If the surgery for children is performed in the same way as adults, the tunnel will pass through the epiphysis.

Therefore, when performing this type of surgery on children, the starting and ending points of the ligament cannot be placed in the original anatomical position. They need to be moved to a special position to bypass the epiphysis.

In this way, once the starting and ending points of the ligament are changed, all anatomical data related to the normal ligament cannot be used. Under such special circumstances, simulating the normal function of the ligament is very challenging.

The tendon implanted during the operation, simulates the normal ligament function not only to achieve initial stability but also to account for his future growth and development trend.

After the tendon is implanted, it remains dead for a period of time, and it takes time to activate; after activation, for a long period of time, the growth rate of the ligament does not match the growth rate of the knee joint; after passing through this non-matching period, it enters a matching period, and the stability at this time is the ultimate stability.

The relationship between the growth of the ligament and the growth of the knee joint is not linear for a long time and is extremely complex.

If these are not taken into account, soon after the operation, the knee joint will return to an unstable state, requiring a second operation to adjust the tension of the ligament; after the adjustment, it is unknown when the stability gained from the operation will be lost again, requiring a third operation; endless operations until adulthood, and the surgical effect is still unsatisfactory; in this terrible process, the negative impact of instability on the growth and development of the knee joint has quietly occurred and is permanent.

This is also why Robert, a master of sports medicine, has not yet come up with a satisfactory surgical plan.

The market has relatively few medical devices and implants for children’s sports medicine. Only one American company makes these products—OrthoPediatricS, the only company in the world that focuses on pediatric orthopedic implants.

In China, devices for children’s sports medicine are a blank slate. For Yang Ping, the problem lies in the medical devices and consumables; technology is not an issue.

“Doctor Robert, congratulations on the success of your first surgery. I have studied the case material you sent. For this case, the surgery should be performed as soon as possible, the longer the delay, the more profound the damage to the growth and development of the knee joint. The surgery is very complicated, involving many factors, and many of these factors are related to growth and development and are in a dynamic state. However, there is no difficulty with the surgery. To successfully complete the surgery, it requires the assistance of the OrthoPediatricS company. However, their current products are not suitable for this patient. They need to use their flexible production line to design and manufacture a set of personalized devices and implants for the patient. Yang Ping from G City.”

Yang Ping replied to the email. He wasn’t sure if it was the influence of system space, or if he was too focused on medicine, but now he likes being straightforward to avoid wasting time.

Yang Ping turned off the film review screen, realizing that, when she had time, she should write a paper on the reconstruction of children’s shoulder and knee ligaments to spread related knowledge.

In reality, countless doctors might take decades to accumulate this knowledge, but Yang Ping could quickly gain experience in the system space, elevate experience into theory, and provide it for everyone – a wonderful thing indeed.

“My God, this is fantastic! Upon hearing this news, I spilled coffee everywhere: all over the floor, my desk, my computer keyboard, my clothes, and my pants. It wasn’t very hot, fortunately. OrthoPediatrics Inc., always stays in close contact with me, so producing dedicated instruments is not a problem. If possible, could we cross the Pacific and sit together, sipping coffee while discussing this case? If God would bestow a little more grace upon me, it would be even better if I could observe Doctor Yang’s surgery. Unfortunately, I saw on your hospital’s official website that Doctor Yang’s department requires international interns to have a level four proficiency in Chinese, a requirement I sadly can’t fulfil in the short term. However, could I visit Doctor Yang for academic exchange—even if for just one week? If that’s not possible, three days? If three days is not possible, even one day would do. Little Robert from New York, typing with one hand, and using the other one to clean up coffee on the desk.”

This American seemed to be waiting for emails and was treating emails like instant communication on WeChat. Just a few minutes after the email was sent, Robert replied.

“Regarding the academic exchange, I can’t give a definitive answer at this moment. I will ask the secretary of our department to contact you. Yang Ping from G City, China.”

Yang Ping called Zhang Lin to her office: “Zhang Lin, there’s a doctor from the United States, Doctor Robert from New York Specialty Surgery Hospital, who wants to come and learn about surgery. He said he temporarily can’t pass Chinese level four test. Can he visit our department as an academic exchange for a few days?”

“According to our department’s protocol, international interns must pass the Chinese level four. But for academic exchange, there is no language requirement. However, they can only observe and cannot participate in clinical work or perform surgery on the operating table,” Zhang Lin replied seriously, as he has been very diligent about this work.

Yang Ping gave Zhang Lin Robert’s email address: “Regarding the academic exchange, you can directly contact Robert and arrange it based on the regulations.”

Zhang Lin noted down the email address, feeling the weight of his responsibility. Little Gao has recently arrived, and now Little Robert is also planning to come.

“Doctor Yang, these foreigners are coming one after another. It’s quite a burden, you know? Allowing a loose management can lead to them not learning much, which would tarnish our reputation. But if I am too strict, I am afraid these foreigners would accuse me of being cold and oppressive,” Zhang Lin voiced his concerns.

Yang Ping smiled, getting a sense of Zhang Lin’s current state: “Just manage them as you should, focus on the work, not the people. As long as you follow the regulations, there will be no problem.”

“That’s reassuring. I’ll take care of Robert’s matter then.” Zhang Lin took on the responsibility.

In the future, there will be many doctors coming for internships and exchanges, and many of them are top-tier technical experts. It should be fine if they are respectful, but if they do not comply with the discipline, it is impossible without strict management regulations.

In the doctor’s office, some standardized training students were engaged in a lively conversation. When they saw Zhang Lin come in, they said, “Teacher Zhang, there’s some news.”

Zhang Lin was curious about the news amongst all this busyness.

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“Director Zhu and Wang Ge’s lawsuit is going to court for the second trial next Monday.” One of the training students showed Zhang Lin on his phone.

Not long ago, they had dinner together—Director Zhu was paying—so naturally, everyone started paying attention to Director Zhu’s affairs. Out of boredom, they searched online and found this news.

“Let me see.” Zhang Lin knew about it a few days ago but was too busy to share the news.