Surgery Godfather-Chapter 384 - 0363: Lad, That’s Strength

Chapter 384 -0363: Lad, That’s Strength

Due to the high difficulty and risk of the surgery, there are not many hospitals nationwide that can perform spinal scoliosis correction.

Among the few hospitals considered top-tier in this field nationally are Xiehe, 301, Nanjing Drum Tower, and Nandu Affiliated Hospital One.

Nanjing Drum Tower Hospital’s overall ranking nationally is not high, but its spinal scoliosis surgery is at the forefront, with more surgeries performed than the other top-tier hospitals, thanks to the efforts of Professor Qiu, who returned from studying in France.

Professor Qiu studied for eight years in France with the famous spinal correction master, Professor Contrel, learning advanced spinal correction surgery. Professor Contrel is one of the creators of the world-renowned CD correction technique.

After his studies, Professor Qiu gave up a generous offer in France to return to China and establish the spinal surgery department at Drum Tower Hospital, focusing on spinal scoliosis correction and narrowing the gap with developed countries.

The center for Spinal Scoliosis at Nandu Affiliated Hospital One is also top class. Under the hard work of Professor Su, it ranks alongside Xiehe, 301, and Drum Tower, creating a balanced situation.

In the second-tier hospitals that perform spinal scoliosis correction, there are the 304, 306, Beijing Chaoyang Hospital, and Beijing Children’s Hospital. The rest can only be relegated to third-tier or below.

Sanbo Hospital, which only performs a few dozens of surgeries a year, is considered third or fourth-tier. Yet for a new hospital established just ten years ago, this achievement is quite impressive.

Many emerging hospitals fade to obscurity after initial enthusiasm, losing staff, lacking patients, and struggling to survive.

There are examples everywhere. They invest billions and end up mainly owning a few beautiful buildings, a few nurses playing on their phones, plus a few online articles filled with grievances.

For a hospital like Sanbo to achieve this scale, especially in orthopedics, and to be able to subdivide its departments into spine, joint, sports medicine, and trauma orthopedics, is quite remarkable.

Lu Gang’s surgery is very challenging. Director Han has no doubts about Yang Ping’s capabilities, but as a doctor with decades of experience, seeing is believing.

Before Lu Gang’s surgery, Old Han wants Yang Ping to perform a standard spinal scoliosis correction surgery, so he can evaluate his skill level for this kind of surgery.

Even a genius needs an evaluation. It’s not a matter of distrust, but of a scientific attitude.

Spinal scoliosis correction surgery is the pinnacle of orthopedic surgery. Any mistake can lead to paralysis. So, no matter how much one trusts, there needs to be this evaluation process.

Just so happens there is a patient, a 19-year-old college freshman, who has suffered for ten years from untreated scoliosis. Her current thoracic scoliosis measured at Cobb’s 52 degrees and lumbar scoliosis at Cobb’s 64 degrees. After unsuccessful brace treatment, she sought surgical treatment and was referred to Professor Zhang.

She was admitted to the hospital before Lu Gang, and her pre-operative preparations have been completed.

Before the start of the surgery, Old Han and Professor Zhang were already seated nearby.

Old Han knows that Yang Ping is steady and experienced, and he would not agree to be the chief surgeon without being sure of success, so Old Han only needed to watch from below the stage.

During the spinal correction surgery, Yang Ping went back and forth, constantly entering and exiting the system space, having completed the devil’s training.

In the system space, there is no need to consume physical energy, eat, drink, sleep or excrete. As long as one can mentally endure loneliness and monotony, one can keep performing surgeries non-stop.

From being unskilled to being proficient, even if one surgery takes an average of three hours, one can do eight surgeries in a day, eighty in ten days, and eight hundred in a hundred days.

In the system space, Yang Ping can perform eight hundred surgeries in just over three months. In reality, this three months is just a moment.

Staying for three months each time is Yang Ping’s starting endurance level. With his incredible endurance, even if he does eight hundred surgeries each time, after ten times, it would be eight thousand; after twenty times, it would be sixteen thousand.

As long as the fire is hot enough, even a stone can be melted. That’s the devilish part about the system space.

Who can perform sixteen thousand surgeries in reality?

Even the hospital with the highest number of surgeries couldn’t reach this number with all surgeries throughout the entire department combined.

The points Yang Ping has accumulated has started a virtuous cycle, similar to when an investment enters a virtuous cycle and you hold a large amount of capital, profiting continuously, the more you spend, the more you have.

Previously, the five hundred thousand points rewarded from the main line task could buy a lot of surgery training. With this surgery training, he can perform higher and more difficult surgeries in reality, obtaining even more reward points.

Several surgeries on Yu Shuilian rewarded him a cumulative forty thousand points from the system.

According to the system’s characteristics, future main-line tasks only reward new modules, and surgeries in reality reward points. The more difficult, the more reward points.

Spinal correction surgeries have a training package starting from a thousand surgeries. Each training pack consumes about sixty thousand points. The points rewarded from Yu Shuilian’s surgeries can support about seven thousand trainings.

Moreover, there are also surgeries like those performed on her shoulders and knees, each of which rewards tens of thousands of points. Points continue to accumulate from various reward channels.

So, although Yang Ping has spent a lot of points on training during this period, his points are not decreasing, but increasing. Now, he still has more than eight hundred thousand points in his account.

As long as Yang Ping controls it well and maintains continuous profit from the points, he can get whatever he wants now.

“Should I use a thoracoscope and laparoscope to soften the thoracic vertebrae and lumbar vertebrae first?” Yang Ping seeks the opinions of Director Han and Professor Zhang.

This surgery plan is quite detailed, considering the use of endoscopy for anterior loosening. Director Han nods.

Song Zimo disinfects and prepares the table, Yang Ping scrubs in for surgery.

With the assistance of a thoracoscope and a laparoscope, the anterior loosening is completed quickly.

The surgery is progressing rapidly, which doesn’t seem like his first surgery. But in the eyes of Old Han, this is definitely Yang Ping’s first spinal correction surgery.

After the anterior loosening, the patient’s position is changed to prone, the area is disinfected again, and another scrubbing in for the surgery.

The incision is made rapidly, the bleeding is thoroughly controlled, and only a few dots of blood are seen on several pieces of gauze.

First the screws are placed, then bone is cut, and finally the deformity is corrected.

The steps of the surgery are clear. The major steps contain smaller ones, each progressing steadily, without redundant or repeated movements.

This shows that Yang Ping is not a newbie, or rather, his performance in this first surgery doesn’t resemble that of a newbie.

Old Han and Professor Zhang get up, walk over, and stare at the screen.

Making incisions, creating a path, detecting, and inserting guide wires, follow this sequence to complete one side, then the other, finish a vertebra, then move to the next.

Dozens of guide wires are implanted into the pedicles like this, and all are prospectively seen at once.

On the screen, dozens of guide wires are jumbled together, inserted from different points and in different directions.

Old Han and Professor Zhang check each guide wire on the screen of the C-arm machine, checking them multiple times.

The insertion point, direction, and depth of each guide wire are nearly perfect, with each one passing through the center of the pedicle at the optimal angle. None of them are unsatisfactory, not even the slightest acceptable deviation exists.

It may look chaotic, but each individual guide needle is in its optimum position, even a slight change would cause deviation.

After ensuring that the guide needles are properly positioned via fluoroscopy, they are removed one by one.

For each needle removed, a pedicle screw is implanted in its place, some adjustable, some not, until all guide needles are replaced with pedicle screws.

Another fluoroscopic examination shows that the screws are perfectly positioned without any doubt. The locations of the pedicle screws are all beautifully done.

“Ready for bone cutting!” Yang Ping reported the progress of the surgery and obtained permission.

“Proceed!” Director Han consented.

Bone cutting is a high-risk operation and one of the most technically-demanding steps of surgery.

Bone cutting requires several sections of the spine to be severed and reassembled. It is not as simple as just cutting, as it requires precise cuts to ensure successful reassembly.

The bone cutting process could potentially damage nerves, leading to paralysis. During the reassembly process, any misalignment could also result in nerve damage and paralysis.

In order to minimize nerve injury, neuro-electrophysiological monitoring and wake-up tests are often used during the surgery.

When cutting the bone, Yang Ping uses an ultrasonic bone knife, which is more precise and safer compared to traditional tools.

This tool is specific to hard surfaces—it only cuts through hard bone and does not affect the soft neural tissue.

The rhythm of the surgery is excellent. While cutting the bone, Yang Ping would glance at the neuro-electrophysiological monitor every time he makes a cut.

Fatty had adjusted the angle of the monitor to the best position so that Yang Ping could see the monitored waves at any time. If they stimulated or damaged the spinal cord or nerve roots, the wave amplitude would change, signaling a warning that the operation was dangerous.

Although Yang Ping had not employed the ultrasonic bone knife many times, the tool seemed incredibly obedient in his hands, as if it was born to serve him.

The bone cutting process was swift, causing Old Han and Professor Zhang’s heart rates to rise along with it.

As they listened to the noise created by the ultrasonic bone knife, they dared not speak, fearing that it would disrupt Yang Ping’s rhythm and lead to accidents.

“Bone cutting completed!”

Old Han and Professor Zhang were brought to reality. It was already done, and so fast.

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“Beginning the spinal correction!”

This step is the riskiest, where sometimes during the spinal correction, the patient could become paralyzed on the spot or a few days after the surgery due to the spine’s lack of tolerance for the correction.

Given paralysis would lead to disastrous consequences, every surgery is like walking on thin ice for the doctors.

In the system space operating room, Yang Ping had mastered a vast amount of data from more than ten thousand surgeries, such as to what extent deformations can be safely corrected—the data doesn’t lie.

He planned to organize the data when he got some time, summarize the patterns, and create a predictive model to guide scoliosis surgery so that operations could become more precise and standardized.

“Take it slow, Xiao Yang—”

Professor Zhang and Director Han both whispered their reminders simultaneously.

Yang Ping then took the tools and began to correct the spine.

During this process, Yang Ping wasn’t rushed. He would slightly adjust, then check for pulsation in the spinal cord and the monitor waves. Everything was normal, with no changes in the wave amplitude due to stimulation.

Bit by bit, step by step, at the right rhythm, the severed parts of the spine started to change spatially, and sequences were reconstructed.

The spine was corrected in three-dimensional space, followed by the implantation of a titanium rod, a gradual pedicle screw lock, and finally the insertion of a crossbeam for final locking.

The whole process took an hour. The pieces of tail gauze thrown into the collection basin were spread out by Zhou Can, dried, displaying a few faint bloodstains.

“Fluoroscopy!” Director Han commanded the standardized training student operating the C-arm.

“Should we also carry out a CT scan?” Yang Ping suggested.

This operating room was multifunctional, equipped with CT imaging equipment.

The CT scan was completed, and the three-dimensional reconstruction images slowly appeared.

Each screw was perfectly nestled in the bony tunnels of the pedicle, and the spine had fully restored its normal physiological curve, meaning that the bone cutting correction was carried to its very extent.

“Move your toes, yes, up, down, very good!”

Professor Zhang instructed the patient to wiggle his toes. Everything was normal.

Old Han was lost in the 3D images from the CT scan. There was nothing more to say about the operation.

This kid was born to perform surgeries—he truly was a surgical genius. This was not an exaggeration at all.

As soon as he started, it was like masterwork that takes a thousand years to perfect!

Old Han was used to it. His perspective had been altered several times, so what difference did one more time make?

If one must attribute it to something, it would be talent! Talent could explain everything.

A talent like him is rare to find, and Old Han felt extremely fortunate to have encountered him.

Yang Ping helped move the patient to the bed. Professor Zhang went over to Director Han, “The patient’s toe movement is very good!”

Considering it was his first time, how could he dare not to leave any leeway and precisely correct it to zero degrees?

Well, it’s simply his talent!

“Let him be the chief surgeon for Lu Gang’s surgery, right?” Director Han had no more doubts.

What else could Professor Zhang say: “The young man is really strong!”