Surgery Godfather

Chapter 321: Chapter 0305: The Disappeared Intervertebral Disc

After completing the surgery, Director Gao felt less confused and a touch more enlightened.

He was aware that the insights gained from this experience surpassed any he could have obtained from attending a training course elsewhere. There weren’t many doctors across the country skilled in multi-ligament reconstruction of shoulder and knee joints. From now on, he, Gao Yuan, would be one of them.

While Yang Ping still had some spare time, Director Gao decided to seek more guidance from him in performing surgeries. Once Yang got busy, climbing this towering tree would become impossible.

“Director Gao, I still have several surgeries to perform on my end. I will take my leave now.” Yang Ping gave Director Gao a heads-up before making his exit.

Director Gao hastily transferred the task of wrapping up to his assistant. Hurriedly stripping off his one-time-use surgical gown, he followed Yang, adding, “I’ll see you off. I gained a lot today and now have a better understanding of the starting and ending points of these ligaments. There’s a bigger difference than I thought between reconstructing a single ligament and reconstructing several. Achieving balance truly requires advanced skills.”

“You already have a basic grasp of static balance. You still need to further hone your skills when it comes to dynamic balance. The data I gave you requires more attention. It shouldn’t be blindly followed. These data should be observed in relation to one another. The intricacy lies in why when a ligament’s start or end point changes just a little, it results in changes in every other aspect,” Yang Ping summed up his current learning progress.

“Thank you, Teacher Yang!” Director Gao expressed his gratitude for Yang Ping’s unreserved guidance.

His address of Teacher Yang came from the heart and was uttered spontaneously. Yang Ping paused in surprise before jokingly retorting, “Please, don’t call me like that. It makes me feel old. You can just call me Doctor Yang.”

“Fair enough, let me call you Doctor Yang. He who excels, teaches. If it weren’t for your hands-on teaching, I would’ve still been blindly groping around the subject of multi-ligament reconstruction. I would’ve still been a novice.” Director Gao wasn’t just flattering him. Maybe some doctors claimed they could perform multi-ligament reconstruction, but all they managed to do was implant tendons and formulated no actual postoperative functions. It was like taking a test, completing all the questions but scoring just twenty or thirty points.

Across the whole country, only about ten doctors were truly qualified in shoulder and knee multi-ligament reconstruction and scored an acceptable mark. Not more than a handful of doctors could manage decent scores. As for scoring as well as Yang Ping could, there was only one Yang Ping.

“I’ll go around the other operating rooms. Take care of yourself and don’t be shy. We are colleagues, call me whenever you need anything.” Yang Ping felt that Old Gao was highly motivated and was willing to teach him.

“Ok, I’ll show you out from here. Feel free to look around.” Director Gao waved.

Yang Ping noticed that one operating room for spinal surgery was not very bustling with people, so he decided to take a look.

Recently, he had participated in bone disease surgery training in the System Space; many of the cases were within the scope of spinal surgery, such as Lumbar Disc Herniation and Cervical Spondylosis among others.

The surgery here had not yet commenced. The patient was having an anesthesia administered and appeared in acute pain, his facial muscles contorted.

The patient’s X-rays, CTs, and MRIs were displayed on the light-box. Director Qin and Dr. Wen under him were reviewing the images, discussing crucial points about the surgery.

Dr. Wen was also a well-known figure in Sanbo Hospital, whose full name was Wen Zhong. Known as the elder master, he was professionally proficient and heedless of his appearance, often seen sporting disheveled hair, mumbling to himself as he walked. But he was undoubtedly intelligent and possessed diverse interests, well-versed in chess and calligraphy alike. Whenever the hospital held chess contests, he would have intense matches with Song Zimo. However, against such a talent, he would always narrowly miss the win. When a group of retired directors crowded around them, some were on the edge of their seats.

Yang Ping also squeezed in to have a look. It was a lumbar intervertebral disc herniation between the 1st and 2nd lumbar vertebrae, a free type. A piece of intervertebral disc had fallen into the spinal canal, roughly the size of half a thumb. The spinal canal was severely narrowed with the nerves under compression.

Dr. Wen turned around, saw Yang Ping, and promptly introduced the case. “The patient is a thirty-five-year-old male taxi driver. He was brought in as an emergency case. He’s in intense pain on the inner side of his left thigh. The pain is unbearable, he’s rolling around in his bed. We tried giving him morphine and infusing him with mannitol and glucocorticoids, but nothing worked. Emergency surgery is the only recourse.”

The so-called lumbar disc herniation isn’t diagnosed just because the x-ray shows lumbar disc protrusion. There have to be related symptoms, such as lower back pain or leg pain, to diagnose as lumbar disc herniation.

Sometimes, lumbar disc herniation can be highly painful. Yang Ping had seen a muscular man crying out in pain because of it. This is — lumbar pain is a minor illness, but hell when it strikes!

About 90%-95% of patients with this condition can be treated conservatively; only 5%-10% need surgery. The proportion requiring surgery is very small.

Which conditions demand surgery? For instance, if it leads to the weakening of defecation and urination; affects the sensation and muscle strength of the lower limbs; causes significant lower back and leg pain that remains ineffective after six months of standard conservative treatment, seriously affecting work and life; these need surgery.

At present, minimally invasive spinal surgeries have seen significant progress. Young people with simple lumbar disc herniation can undergo minimally invasive surgery and get the protruded intervertebral disc removed. Only in elderly patients with unstable spines does the consideration of major surgery arise. The pedicle screws are implanted in the lumbar spine, followed by bone grafting of the intervertebral spaces.

“We’re planning to perform percutaneous endoscopic lumbar discectomy, remove the dislodged intervertebral disc, and then scrape off some of the residual disc between L1/2.” Director Qin also noticed Yang Ping and shared his plan for the surgery.

Intervertebral discs are the round padding structures between the vertebrae, functioning as stress absorbers. The lumbar spine has five of them. Generally, lumbar disc herniation occurs at the segments L5/S1, L4/5, and L3/4.

Like this patient, the herniation of the intervertebral disc between L1/2 is quite rare. The spinal canal at this part still houses the spinal cord. Therefore, performing percutaneous endoscopic lumbar discectomy requires extreme caution.

The anesthesia took effect, and the patient was positioned. A prone position frame designed exclusively for spinal surgeries was used. The patient was laid prone on the frame. Dr. Wen took his team to scrub up, readying for sterilization and draping.

“What do you think? Any suggestions?” Director Qin sought Yang Ping’s opinion.

Director Qin felt that he could never resort to the flattering approach adopted by Gao Yuan to ask for guidance. But, a discussion with Yang Ping seemed feasible.

“Director Qin is the expert here. I am just here to take a few pointers.” Yang Ping stated humbly.

A surgery such as this posed no difficulty to an expert in spinal surgery, provided the location is accurately pinpointed, one can find the intervertebral disc once percutaneous endoscopic lumbar discectomy is performed. When the disc is removed using the nucleus pulposus forceps, and a part of the remaining intervertebral disc between L1/2 is cut away, the surgery would be deemed successful.

Yang Ping had planned to have lunch with Xiao Su at the cafeteria at noon. He didn’t have time to watch the surgery, so after a brief exchange with Director Qin, he left the operating room.

Returning from the surgical building, Luo Jin’s promotional film, after several revisions, was finally finalized, and began playing on loop in the lobbies of several large buildings in the hospital.

The artistic charm was extraordinary. Luo Jin working up a sweat, combined with music, captured the spirit of passion, perseverance, and tenacity very powerfully.

Following a series of shots, the last scene showed Luo Jin kicking a goal, followed by a few striking letters appearing against the backdrop: Letting You Move Forward—Sanbo Hospital Sports Medicine Center!

It was splendid. The purpose of any ad is to plant a concept in people’s brains, reinforce it constantly, and finally make people trust it.

Who directed this promotional film? They’ve certainly grasped the essence of advertising. After watching it, Yang Ping instantly felt a sense of trust in the Sports Medicine Center at Sanbo Hospital!

Many patients paused to watch the promotional film on the large screen. Some young people familiar with Luo Jin took out their mobile phones and started taking photos and recording videos.

Luo Jin had fallen several times in the face of painful illnesses, yet he always got back up, ever fiercer. He was a fine horse in the soccer field. Unlike other players, he came from a humble background, was an orphan, adopted by a sports teacher, and had faced hardship to get where he was now.

“Did they perform the surgery on Luo Jin?”

“Yeah, I heard that he can join the competition in June this year.”

“That’s amazing!”

“I thought he had surgery abroad.”

“Our Chinese doctors are not inferior to foreigners.”

As a group of young people discussed this, one of them had already sent the video he had just recorded to a friend. The friend had a ruptured anterior cruciate ligament and was weighing on which hospital to choose for surgery.

Dean Xia and his team were briskly walking through the lobby. He was inspecting the board hanging for the Sports Medicine Center. Upon seeing Yang Ping, Dean Xia took the initiative to say hello: “Xiao Yang!”

“Dean Xia!” Yang Ping reacted upon hearing his booming voice, as he had been engrossed in the promotional video.

Dean Xia glanced at the screen: “How about it, did they film it well?”

“Very well!” Yang Ping praised.

Dean Xia seemed quite proud: “Directed by a gifted Peking University student and with a true performance from one of the country’s top soccer stars, how could it not be successful? Xiao Yang, if you have any thoughts or difficulties at work or any situation at home that the hospital can help with, you can mention them. We are here to offer you logistical support.”

“Everything is great.” Yang Ping genuinely felt that Director Han and Dean Xia were good to him and they had provided everything he needed.

Dean Xia was very busy. After chatting with Yang Ping for a while, he hurriedly passed through the lobby and his group went into the elevator.

Yang arrived quite early when there were not many people in the dining hall. Xiao Su had already got the food and was waiting for him. They sat in a corner and chatted while eating.

While halfway through the meal, a phone call came. It was from Dr. Wen from the spine surgery department. He said that the patient he had just operated on did not have an intervertebral disc after positioning and checking with an endoscope. The disc disappeared? It was strange!

Was the positioning wrong? Did they operate on the wrong segment?

This patient had neither lumbosacralization nor sacralization, a normal spinal arrangement, without any variation, so the possibility of a wrong position was almost zero. These experienced doctors wouldn’t make such a basic mistake. It was unthinkable for both Director Qin and Dr. Wen.

But if he called at this time, it meant he was seeking help. If they said the intervertebral disc was gone, it was truly gone, otherwise, they would not have called so hastily.

In urgent situations like this, Yang Ping hung up the phone and stuffed all the food left in the plate into his mouth after a few quick bites.

“Spine surgery, Director Qin’s patient, during surgery, the herniated disc they planned to remove with the endoscope is somehow gone, they need me to take a look.” Yang Ping put down his chopsticks.

Xiao Su helped to collect the cutlery: “Should I come with you?”

She was also quite interested and really wanted to accompany Yang Ping to see how the disc had disappeared.

“I really like to accompany you on consultations and surgeries, but I feel embarrassed, I’m worried that other people might say I’m clinging to you.” Xiao Su said with a blush on her face.

“Come on, let’s go and take a look.” Yang Ping decided to take her along.

“Wait for me, I’ll clean the tableware.” Xiao Su said, taking the tray of tableware.