Surgery Godfather -
Chapter 931 - 805: Does This Look Like a Department Case Discussion? _2
Chapter 931: Chapter 805: Does This Look Like a Department Case Discussion? _2
At that moment, Yang Ping also looked back and saw Academician Wang, so he hurriedly called Little Five over to arrange seats for the guests.
"Please welcome Professor Wang from our Beijing, Fuwai Hospital!"
Song Zimo applauded and then walked down from the lectern to shake hands with Academician Wang.
Everyone was caught off guard. Holy crap, there was an academician among them sitting in on the lecture; everyone’s gaze followed Song Zimo’s gaze and saw an old professor shaking hands with Song Zimo.
Some recognized him, but most did not.
Actually, the circle of doctors is quite small; even nationally renowned experts are only known among doctors in the same field. After all, they attend academic conferences together and often see experts on the podium. If a doctor rarely attends academic conferences, even if they are in the same specialty, they wouldn’t recognize the industry giants.
Academician Wang was approachable; he didn’t put on any airs at all. Holding the microphone like an ordinary teacher, he walked up to the lectern and then Yang Ping came forward to shake his hand.
"This is an academician?"
How is there an academician mixed in listening to the lecture? The atmosphere in the venue was stirred up. General surgery really could be puzzling. It was just a case discussion within the department; why would an academician attend?
"Everyone, please be quiet for a moment. I’d like to say a few words. I just got off the plane, sorry, the flight was delayed, so I’m late. I specifically came over to join your case discussion; this case, in fact, is my patient," said the academician, pointing at the image on the electronic screen.
"Just now, Dr. Song said I was one of the earliest in the country to perform Fontan surgery, which is true. Not only Fontan surgery, but I also pioneered many surgeries for congenital heart disease. I’ve edited several editions of guidelines in this area; the latest edition is edited by Professor Chen Yueliang. In fact, we were at Sanbo Hospital a few days ago, and after we returned to Beijing, hearing that you were going to discuss this case, we flew back."
"I’ve talked quite a bit off-topic, let’s get back to the point."
"Many wonder why this case wasn’t done at our Fuwai but was moved to be done at Sanbo Hospital; the reason is simple. If we were to perform the surgery, the success rate wouldn’t be high; if Professor Yang did it, the success rate would be much higher. It’s that simple."
"Everyone here is a doctor, even though some are intern doctors, you are practically a doctor. Not to hide anything from you, I had two similar cases before that I couldn’t save. Apart from Fontan surgery itself, the difficult point of these cases is that there are issues with the development of blood vessels. The vessel walls lack collagen fibers, and there’s a deficiency in elastic fibers. What the exact cause is, we have yet to find out, but it’s suspected to be associated with cardiac malformation. But no matter what, it adds significant difficulty to the surgery, not just a little."
"The failed two cases: one died on the operating table; opening the thoracic cavity, when cutting off the blood vessels for anastomosis, it was impossible to suture; the blood vessel walls tore easily, and even though we finally completed the surgery, when we removed the extracorporeal circulation and the heart restarted beating and bleeding started, we simply couldn’t stop the bleeding. Why? Here a stitch, there another tore; finally, we helplessly watched the child pass away, powerless to do anything."
"You young people don’t have this kind of feeling. When you reach our age, having been doctors for so long, memories like this accumulate. Truly, at that time, you feel completely helpless, helpless, and hopeless. As a surgeon, as a cardiac surgeon, when you see blood spurting everywhere and you can’t stop it, what kind of feeling is that?"
"The second case, which occurred 10 years later, we learned from the past. During the surgery, we included an artificial blood vessel for support. There were no issues on the operating table for this case, but on the third day post-surgery, the patient died in the intensive care unit. At that time, we performed an emergency rescue surgery, opened the thoracic cavity, and it was full of blood, spurting because the major vascular and artificial blood vessel’s suture site had torn."
"Later, with the family’s consent, we performed an autopsy to find the cause—the vascular anastomosis did not meet the requirements. This case, without new fundamental theories emerging, would be impossible to operate, why?"
"Because, for the surgery to succeed, your suturing has to hold for at least 5—to 7 days. But in reality, it’s extremely difficult, virtually impossible. Do you know why?"
"Because suturing such fragile blood vessels is like suturing soap bubbles and expecting the soap bubbles not to burst. Once these brittle vessels are cut and re-sutured, the demands on suturing are beyond human capability. It’s like a very thin paper bag: when it’s whole, it can carry water without leaking, even very heavy water, because the stress is evenly distributed."
"When you cut the paper bag in half and you stitch it back together, then try to carry water without leaking, it’s very difficult. To carry very heavy water is even more difficult. Why? Because the stress concentrates at the sutures, especially since it’s impossible to evenly distribute the stress at the suture site. With too much stress carried by a single stitch, the paper bag starts to tear from that point."
"I wonder if everyone understands what I’m saying?" asked Academician Wang.
Academician Wang paused.
"Professor Wang, are you saying that if someone could achieve theoretically perfect suturing, distributing the stress evenly across every stitch at the anastomosis, then the surgery might be successful?" a student asked.
"Exactly! This student is paying very good attention. That’s exactly what I mean. Although this doesn’t guarantee a 100% successful surgery, it maximizes the probability of success," he affirmed.
"Why then, after five to seven days, is it considered safe?"
Graduate students, standardized training students, and intern students who initially dared not speak now became lively in their thinking, emboldened to voice their thoughts when someone else had taken the lead.
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