Surgery Godfather-Chapter 386 - 0365: Eighty Percent
Chapter 386 -0365: Eighty Percent
The three-month training period of Takahashi is almost over, and he hopes to extend his training time and continue to stay at the Sanbo Hospital.
There are still many cases that he needs to learn about. During his time with Yang Ping, he not only learned advanced surgical methods but also adopted a completely new way of thinking. His understanding of anatomy and surgery has reached a new level.
Takahashi feels that three months are far from enough. If he could stay, he would be willing to stay for one year, even three years–he’s willing to.
Unfortunately, it’s impossible for him to stay in China for that long. Tokyo University Affiliated Hospital still has a lot of work waiting for him.
Takahashi’s visa allows a maximum stay of 180 days, and he doesn’t want to waste a single day.
Therefore, he applied to Fujiwara Masao for an extension of three months. Fujiwara Masao replied: Takahashi can continue to study in China, but Miyuki must return to Japan on schedule after her term expires.
Miyuki’s arthroscopy skills have improved rapidly, and she can now engrave a twisted letter on an olive nucleus.
She is not bothered by Fujiwara Masao’s words. Although he is the director of the Orthopedics Department of Tokyo University, he is also her brother.
In fact, Miyuki has more time to stay than Takahashi. She is just a junior young doctor with no immediate responsibilities.
“You should listen to Teacher Fujiwara and return as soon as possible,” Takahashi didn’t want her to disobey Teacher Fujiwara.
Miyuki didn’t care at all: “Why should I listen to him? I have my own life!”
In fact, Miyuki understood that her brother only wanted her to return to Japan to meet Mitsui Tasuku. The two families were discussing their marriage arrangements. This was a major event—an alliance between the Fujiwara and Mitsui families.
Despite the fact that Mitsui Tasuku was also a high-achieving student at Tokyo University, with exceptional talents and looks, she didn’t care for him at all. She felt nothing for him.
“I also have a 180-day visa. I don’t want to call him anymore. You tell Mr. Fujiwara that I have decided to stay in China to continue studying,” Fujiwara Miyuki said firmly.
Takahashi sighed helplessly. This had become a matter for the Fujiwara siblings, something he couldn’t interfere with.
—
After the fifth round of surgery, the final round of regional competition was up next: anterior approach surgery for thoracolumbar fracture. Much like the hip fracture surgery, this surgery carries significant risk.
The surgical approach is a crucial part of the surgery, and the high-risk approach makes this surgery inherently risky.
One major hospital, after having a patient die on the operating table during anterior thoracic spine surgery, became excessively cautious. For quite some time, they prohibited anterior spine surgery.
Following the sixth round, Song Zimo still held onto his full score. His formidable ability and performance had attracted a lot of attention.
As the completion of the sixth round concluded the regional competition, the emblems of the qualified hospitals from each section were displayed on the homepage of the website.
The pictures of the chief surgeons from each team were also rotated on the website. Everyone was familiar with everyone else except for Yang Ping as he had never shown up in the regional match.
In the Western region, Li Ling from Huaxi Hospital, Professor Fu Shancheng’s student, advanced with a full score, while a team from Xi Jing Hospital missed the full score by only one point and advanced as the second place team. The third team to advance was also from Huaxi.
In the Northern region, Ouyang Siming, Xiao Yi, Lu Qing, and Song Yun, respectively representing the top three hospitals in the imperial capital – Jishuitan, 301, and Xiehe – all advanced with full scores.
In the Eastern region, Wen Rentao and Yue Zhengming advanced with full scores; Wang Kaisheng from Long March Hospital advanced as the second place team.
In the Central region, only Xiangya had a team that advanced with full scores, while Tongji Hospital was two points behind, and Xiangya’s brother hospital — Second Hospital was four points behind.
In the Southern region, Song Zimo and Su Nanchen advanced with full scores. Lin Hao lost one point during the anterior approach for thoracolumbar fracture surgery because his ligation of the intercostal artery was too hasty.
The number of teams that could advance from each region was three. Full scores were not limited by quota, and teams with tied scores could exceed the quota.
For instance, if there were more than three teams with full scores, all could advance and no chances would be left for other non-full-score teams.
If there were two full scores, the second place team would fill the last spot. If the second place was tied, all of them would advance together with that one remaining spot.
If there was only one full-score team, the other two spots would be filled by the second and the third-place teams. If the second place was tied and occupied all the spots, there would be no chance for the third-place team, and so on and so forth.
With a total of sixteen teams advancing to the national competition, there would be a two-week break and the teams would be randomly paired in the national competition.
The competition would follow a knockout system. Within a specified competition period, the teams would perform specified surgical operations. The overall points at the end would determine the winner. The team with the fewer points would be eliminated, while the team with more points would advance. If the teams had the same score, an extra competition round would be held.
The advancing teams would enter the second round of knockout, followed by the third round, until finally, the championship competition.
According to the current situation, the competition has exactly sixteen teams. The first round would narrow the competition down to the top eight, the second round would determine the top four, and the third round would decide the championship and the runner-up. The fourth round would be the championship competition.
In these high-level competitions, any slight deficiency in one aspect could leave a team lagging behind.
The young rising stars of the medical world were all eager and ready for the upcoming competition.
For the national competition, the first round of orthopedic surgery included arthroscopy and foraminoscopy. Doctors lacking comprehensive skills would find it difficult to go far in the competition.
Some hospitals with limited resources could not even find enough cases to participate in the competition, let alone compete.
So, in the end, the participating hospitals were all well-known top-ranking hospitals.
Knowing oneself and one’s opponent makes winning possible. After the regional competition ended, everyone started to analyze the competitors. Most were familiar, except for Sanbo Hospital which many knew little about.
Among those who attended the Trauma Orthopedics Academic Conference, many doctors, including Professors Fu Shancheng and Meng Heng, remembered the hospital.
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Lin Hao was extremely frustrated. He had originally thought of outperforming Sanbo Hospital, but ended up almost being outranked by Song Zimo.
He decided to be safe than sorry during the national competition. Even if he didn’t face Sanbo Hospital, he had to go farther than they did.
If he could face Sanbo Hospital in the first round of the competition, that would be even better. The reconstruction of multiple ligaments under an arthroscopy of the shoulder and knee were the highest-scoring surgeries in this round.
Lin Hao could rely on the world’s most advanced surgical techniques taught by his mentor Robert to score points and eliminate Sanbo Hospital in one fell swoop.
The two-week break, the random pairing results generated by computer, will be announced on the website before six o’clock on the second Friday afternoon.
—
In Director Han’s office, the flash drive containing Professor Feng’s medical imaging was inserted into the computer.
X-rays, CT and MRI of the cervical spine and skull, as well as enhanced images, appeared on the digital screen.
The chordoma is malignant and relatively rare in the upper cervical spine. It’s even rarer that it extends from the upper cervical spine into the skull.
The tumor originates from residual embryonic chord tissue and usually grows quite slowly.
Therefore, if the surgery is successful in removing it, the patient can have a certain survival period.
However, where the upper cervical cord connects to the medulla oblongata is the center for respiration and circulation, controlling a person’s heartbeat and breathing. If this area is damaged, the person’s breathing and heartbeat will stop instantly.
Director Han called Yang Ping to his office, but he didn’t yet reveal that the patient was his mentor, Professor Feng.
Yang Ping carefully analyzed the imaging and the 3D printed model.
Director Han imported the imaging data into a 3D printer and printed a model of the upper cervical spine, skull base, and tumor. The tumor grows intertwined, presenting in a dumbbell, antler, and complex twisted pattern.
Yang Ping observed for a long time. This case is indeed challenging, involving neurosurgery, orthopedics, and oncology.
You might as well say that this tumor should be a no-go area for surgery.
If you want to do this surgery, there are four difficult points. The first is exposure.
The usual exposure wouldn’t work; you would need to approach it from the rear, completely opening up the backside of the upper cervical spine and skull, and also be able to seal it up afterward.
Only then can the upper cervical cord and medulla oblongata be exposed. Afterwards, the medulla oblongata and upper cervical cord would need to be cut open, while protecting the life functions area and trying to remove the tumor as thoroughly as possible.
The other three points of difficulty require extremely precise surgical operations. This would be the ultimate test of surgical precision.
Robotic surgery could be very precise, but it’s not suitable for high-risk operations like this. Machines are the most reliable but also the least reliable.
Robots lack the touch of a human. If an error occurs, even the slightest one, it could be lethal.
The precision of this kind of surgery needs to be controlled to about 0.1mm. Even the sharpest metal scalpel could not achieve this level of precision, and a scalpel cannot cut tissue without causing compression. Regular scalpels inevitably cause compression when cutting.
Therefore, it is essential to use advanced laser knives for the operation.
Third, the boundary of the tumor needs dedication, the tumor is mixed with the medulla and upper cervical cord. No matter what method is used, it’s impossible to identify the tumor and the life function area that needs to be protected during surgery. It can only rely on the experience of the surgeon.
This case is rare to begin with, let alone the operations that have been carried out. Most of the case studies are failures. Where is the successful experience to draw from?
Finally, stopping the blood is a challenge too. The blood supply of this tumor is quite rich. If the bleeding is not thoroughly stopped, the hematoma will compress the respiratory and circulatory center, causing the patient’s breathing and heartbeat to cease.
Yang Ping was looking at the imaging and the 3D model, and Director Han was nervously fiddling with his cup on edge.
After a long time, Yang Ping finally spoke.
“Using the most advanced laser knife, the upper cervical spine and skull base are exposed from the rear, fully revealing the upper cervical cord and medulla oblongata, then performing surgery with a precision of 0.1 millimeters.”
Is the surgery feasible? Director Han finally heard Yang Ping’s answer and immediately asked, “What is the success rate for the surgery?”
“Not high!” Yang Ping’s reply was less confident than usual.
This was the first time Yang Ping didn’t sound confident in his response. Even with Lu Gang’s case, he was full of confidence, saying without hesitation: “Admit him.”
“How high do you think it is?” Old Han still wanted to ask.
“About eighty percent.”
Yang Ping made an approximate estimate. It couldn’t be helped, the surgery was too difficult. For this kind of forbidden surgery, how high could the success rate be?
“Eighty percent?”
Old Han thought he had misheard. The success rate of this kind of surgery, currently reported, has not exceeded one percent.
“Yes, nothing can be done, it’s too hard, a maximum of eighty percent!” Yang Ping was very troubled.
Only after confirming it was eighty percent did Old Han settle down.
“Where is the patient?” Yang Ping was very concerned. This case was very special.
Now, which case hasn’t been special or highly difficult in his hands?
“The patient is in Magic City Sixth Hospital. I don’t currently know their arrangement.”
Old Han finally had an idea in his heart.
