Surgery Godfather-Chapter 368 - 0349: Past Events

Chapter 368: Chapter 0349: Past Events

Before he left, Robert had only managed to carve a single legible letter into the olive stone.

With time pressing on, he couldn’t learn this advanced operation technique from Yang Ping, but he vowed they would meet again.

However, he made significant progress, under Yang Ping’s personal guidance, glimpsing the surgical methods for reconstructing the multiple ligaments of the shoulder and knee joints.

The day before he left China, Old Gao played host and invited Robert for a meal, gathering all the brothers from the Orthopedics Department. However, it was Takahashi who eventually paid the bill, outmaneuvering everyone with the speed of lightning.

Song Zimo occasionally managed to peel off two layers of grape skin completely, while Takahashi was still striving for the second layer. He and Xu Zhiliang both failed in their attempts, but he was faring better than Xu. Even though he created several holes, he could still separate the second layer, whereas Xu’s attempts resulted in several fragments.

Fujiwara Miyuki’s fruit-stone carving was progressing slowly, having difficulty carving a single letter properly. But the Japanese girl was working hard, taking every available opportunity to train in the afternoon. She wanted Dr. Yang to teach her personally, to show her how to master the control of the tools, how to transmit force to the tip of the tools but she was too shy to ask.

Zhang Lin and Little Five were still at the first layer in peeling grape skins. The prospect of advancing to the second layer, despite breaking a few holes, or shattering into large pieces, was unlikely in the short term.

However, they had made considerable progress with their hook holders, managing to hold a one-kilogram iron block for a half-hour, completely steady, and they were still improving.

Now, they were training with soap bubbles— using the hook to gently pull apart a basin full of large soap bubbles, with the intent not to burst any bubble.

This type of training was aimed at mastering the appropriate strength of the hook, to avoid damage to human tissue or organs. If they can handle soap bubbles with appropriate force, they would certainly avoid causing pressure damage during actual surgery.

Yang Ping had no intention of relaxing his strict requirements for them. Whenever he had time, he would supervise and guide them. Song Zimo, Takahashi, and Xu Zhiliang were very self-disciplined, while Zhang Lin, Little Five, and Liang Fatty were less consistent.

Liang Fatty’s cigarettes were also confiscated by Yang Ping. During training, Fatty would take Little Five for multiple breaks, all as an excuse to smoke, wasting a massive amount of time.

Yang Ping himself occasionally entered the system space for training. All the orthopedic surgeries had been unlocked, and Yang Ping had gone through training for all of them.

However, the pursuit of perfection never ends. Yang Ping, with his over half-a-million points, was consuming points from time to time, but there were also daily rewards being credited to his account.

So, without any major expenditures, his points were generally fluctuating around five hundred thousand, ensuring a strong purchasing power for the system mall.

Although the system space did not consume real time, nor physiological energy, the psychological experience was no different from reality.

The psychological tolerance for fatigue also had a limit, so even someone as resolute as Yang Ping had a limited time to stay in the space.

During this period of constantly entering and leaving, even Yang Ping himself did not know how much total time he had spent in the system space. The figure should be astonishing.

As for the Golden Knife Award, Yang Ping was confident, but he dared not take it lightly. To acquire the reward of the space lab, he must win the championship of the Golden Knife Award.

The Golden Knife Award was divided into regional competitions and national competitions.

The whole country was divided into five major competition areas: East, West, South, North and Central, each region held a three-month regional competition, with the top three teams in the scoring standings going onto the national competition. The national competition adopted an elimination system, where the competition continued until the final match.

Each hospital was allowed to send unlimited teams from each department, the team’s lead surgeon had to be at least an associate chief physician. A chief physician needed two external authority experts to sign a recommendation to take the role of lead surgeon.

Each step from diagnosis, surgery indication selection, pre-operative preparation, surgical operation, to post-operative treatment in the surgical case would be scored.

Key steps that had severe errors resulted in zero points. For instance, an incorrect diagnosis or incorrect surgical indication selection, regardless of how well the other steps are performed, would earn zero points.

The competition had a dedicated website, app and public account. Complete case data should be uploaded before surgery, and post-operative records should be updated and uploaded daily.

All surgeries were elective and conducted live, directly encrypted and archived on the website after the broadcast, with no option to modify or edit. If there were any fraudulent practices discovered, the participating hospital would be barred from participating in the Golden Knife Award for two consecutive cycles.

Some surgeries could be performed by the first assistant. All surgeries in the regional games could be performed by the first assistant. In the national games, the majority of surgeries must be performed by the lead surgeon, and lead surgeons must perform all surgeries in the finals.

In Yang Ping’s team, Song Zimo was the first assistant, and others included Zhang Lin Xiaowu, Liang Jing, Xiao Su, and Zhou Can.

Xu Zhiliang came later, he worked in the emergency department when they registered so he was not part of the team, but he could participate as a substitute replacement if any member beside the lead surgeon or first assistant was unable to perform for special reasons.

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The Golden Knife Award took place once every four years. Its purpose was to motivate young doctors to be persistent in the pursuit of technical perfection, so it was a platform for young people. Participants for the competition had to be forty-five years old or younger.

In this South China regional competition, the strongest contenders naturally came from Nandu Affiliated Hospital One, Fuer, and Provincial People’s Hospital. The Mary Hospital and Prince of Wales Hospital from Hong Kong also registered for the competition, which made the competition in the South China region extremely fierce.

—

Sanbo Hospital, Orthopedics Operating Room.

This was a teenage spinal scoliosis correction surgery, Professor Zhang’s patient. The patient traveled from Australia, with Professor Zhang sitting in a corner of the operating room.

“Begin!”

Director Han stood tall. After routine pre-surgery confirmation, he took out the scalpel, the back of the blade traced a mark on the patient’s back.

The patient was prone, lying on the spinal prone rack. Following the imprint on the skin, a long vertical incision was cut in the center of the patient’s back.

Attentive to Yang Ping’s height, Director Han made a point to stand on a footstool.

Undoubtedly, Director Han, who had been appointed the successor by the former chief of Mo Sixth, operated with unwavering precision and agility, exhibiting an impressive rhythm as he cut through the skin. Once an electric knife was in his hand, he meticulously stopped the blood flow, layer by layer, he went deeper.

“Everything has its own pace, including surgery. You must catch its rhythm: speed has its own rhythm, and so does slowness. Losing the rhythm can easily lead to chaos,” Director Han advised Yang Ping during a brief pause to change surgical instruments.

By this point, there was hardly anything technical left for Director Han to teach him. Instead, Director Han thought he should share some of his own introspective experiences.

Before the surgery, the child’s entire spine had been 3D printed to scale. Based on the 3D printed model, a pedicle screw positioning guide was also designed, making the entire procedure feel incredibly relaxed.

A few gauze pads were lightly stained with blood. Director Han carefully separated the layers of tissue on either side of the spinous process, revealing parts of the lamina and other spinal appendages.

Using the guide, he created an opening at the proposed point for the screw, using a probe to examine the four walls of the bone tunnel. Confirming there were no problems, the guide needles were inserted into the prepared bone tunnels one by one, passing through the pedicle and into the vertebral body. Once the last guide needle was inserted, a C-arm X-ray machine was used for fluoroscopy.

On the curved, deformed spine, the positions of the guide needles were exceptional. Each one was in the optimal position, direction, and length.

Scoliosis is a three-dimensional problem, correction is equally three-dimensional. The importance of 3D printing technology becomes evident at this stage, as it allows for a simulated surgery pre-operation. Whether it’s screw insertion or osteotomy correction, all the data can be mastered beforehand.

Director Han’s surgeries are always impressively fluid and robust. Regardless of its magnitude, he makes any surgical procedure seem straightforward and effortless.

The instruments in his hands seemed powerful, yet when he used them on the operating target, his touch was precise and just right.

Satisfied with the position of the guide needles, the widening of the holes followed, inserting the pedicle screws. Thanks to the preoperative 3D model, the length and diameter of each screw had already been determined. There was no need to measure, they could directly be put in place.

In the end, the crucial step was the osteotomy, which also had templates available. Having already rehearsed on the model, Director Han now carefully started the osteotomy, following the preoperative plan.

A somatosensory evoked potential monitor was used to constantly monitor the electrophysiological activities of the spinal cord, preventing overstretching and compression which could lead to severe consequences when correcting the spine.

Director Han executed the osteotomy at the preplanned locations in one swift action, before beginning the reshaping process.

The reshaping took place slowly and steady. With every small correction made, he glanced back at the monitor, which showed normal readings on the somatosensory evoked potential monitor.

Once the reshaping had reached a satisfactory level, Director Han stopped. This was the most dangerous and experience-demanding part of the surgery.

“Knowing when it’s enough is vital at this stage. Once the critical point is crossed, paralysis is inevitable,” he warned Yang Ping on the opposite side of the operating table.

Two metal rods were finally implanted, a crossbar was added, and then locked tight. The critical surgical steps were completed.

After another fluoroscopy, the results of the correction were very satisfactory. The somatosensory evoked potential monitor showed that the electrophysiological activities of the spinal cord were normal, indicating no injuries.

A mundane procedure with no dramatic ups and downs, that’s what characterized Director Han’s surgeries.

“Excellent doctors can turn dangers into safety, but achieving a higher level entails not exposing oneself to dangerous situations at all. Therefore, for a chief surgeon, a smooth, effective procedure is the best kind of surgery,” Director Han continued.

“In the final battle for the Golden Knife Award, all contenders are surgical geniuses and the judges are exceedingly harsh. Any minute flaw will be penalized.”

“I have complete confidence in you. But remember, we must never underestimate our opponents just like in a battlefield.”

Director Han personally handled the final stages; inserting the drain tube, closing the incision, and suturing the skin until the last stitch was done.

“I’m getting old. The stage is yours now.”

Director Han took off his gloves and went to chat and rest with Professor Zhang. There were several surgeries lined up and he didn’t want to waste time. He planned to complete the critical surgeries alongside Yang Ping all in one day.

“Second Brother Han, don’t lose the Golden Knife Award again this time,” Professor Zhang told Director Han who had just sat down.

Director Han didn’t respond, he just sat there, watching Yang Ping unfolding the sterile sheet on the operating table.

Years ago, Director Han and his senior fellow Hong Zhigang represented the Orthopedics department of Mo Sixth. Both of them led a team and made it to the finals. In the end, the championship showdown was between him and his senior.

Regrettably, Director Han withdrew from the competition just before the final match. His assistant ended up completing the final surgical procedure, leading to Hong Zhigang winning the national Golden Knife Award for Orthopedics.

This allowed the Golden Knife Award, after twelve years, to return to Shanghai. With the prior three championships going to hospitals in Beijing.