Surgery Godfather

Chapter 123: Chapter 0120 Three-dimensional Reconstruction

The next day, at half past eight, the surgery commenced on time as the first operation conducted in the Department of Orthopedics.

Director Han also took the time to be present, to have a localized oversight of the workflow and address any loopholes.

The utilization of the multi-functional surgical suite proved to be quite an experience. High-definition LCD screens were fixed on adjustable overhead arms attached to the ceiling, allowing versatile angle adjustments.

Several screens were available for the primary surgeon, the assistant, and there was one connected to the operating room computer host, which allowed the patient’s clinical records and imaging data to be displayed anytime the doctors needed to reference them during the surgery.

Moreover, the screen connected to the host was covered with a transparent sterile isolation film. If the chief surgeon was dissatisfied with the lower-level controls, they could manipulate the screen to retrieve the desired data.

Positioning was achieved using surface ultrasound, and anesthesia was administered in the form of sciatic and femoral nerve blockade. Liang Fatty was quite adept at these procedures.

“How long will it last?” Liang Fatty asked.

This type of blockade used one-time medication, which couldn’t be replenished halfway through. If too much anesthesia was given, a patient may not be able to move their lower limbs even after the surgery; if too little was given, the patient would start feeling pain before the operation was complete. Therefore, the anesthesia dosage had to be calculated extremely accurately, accounting for body weight, age, and liver and kidney function. Additionally, familiarity with the chief surgeon’s operation speed was crucial.

“Half an hour!” Yang Ping answered.

“Is that enough?” Liang Fatty questioned.

A half-hour, less the time spent washing hands, sterilizing, clothes, and postoperative bandaging, only left slightly more than ten minutes for operating.

“It’s enough!” Yang Ping assured confidently.

Wash hands! Sterilize, redo hand sterilization, get dressed, cover with a disposable arthroscope sheet, connect various lines and tubes, drive out the blood, balloon the tourniquet, and Song Zimo’s assistant.

The scalpel penetrated the skin and the joint capsule, creating two 0.5 centimeter incisions on either side of the patellar eye. An exploration sheath was placed through the left incision to enter the knee joint and extend through the suprapatellar pouch. After the puncture spike was withdrawn, a lens was inserted and the surgery began.

A bright, circular view of the joint appeared on the overhead screen. After a thorough examination using the hook probe, it appeared as if the popliteal tendon foramen was normal.

The hook probe was inserted and a strip of synovial membrane was gently pulled out.

The basket forceps entered, severing the synovial strip, and the plasma knife was used to prevent bleeding and eliminate the less-than two-millimeter remnant. The whole process took just over ten minutes, followed by suction and withdrawal of instruments.

Long-acting local anesthesia was used to completely seal the two small incisions. The two 0.5-centimeter incisions were stitched up, stuffed with cotton pads, and compression bandage applied. Once the tourniquet was released, the patient’s right lower limb was able to move and sensation had returned.

The first surgery marked a striking collaboration amongst the entire team and the rhythm was very well controlled. The damage and stimulation caused to the human body by this surgery would not be more than skin abrasion caused by a fall.

The nerve blockade anesthesia was a type of local anesthesia. After surgery, the patient could immediately eat and even walk out of the operating room.

The patient moved her knee joint a little and it didn’t hurt or lock up anymore, she could feel the immediate effect.

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“You can be discharged tomorrow. Do not let the incision get wet before the stitches are removed. You will have to visit a nearby hospital or our hospital for regular dressings. The stitches will be removed in ten days.” Song Zimo was responsible for after-surgery education.

“Try it! Walk back by yourself?” Little Five supported her while Zhang Lin fetched her shoes.

“So soon? Let me try!” The patient put on her shoes and tried to step on the ground, but was unsure at first.

Yang Ping encouraged her: “It’s fine, take a few steps!”

She mustered her courage to take the first step, feeling good and steady. The second step and the third step were fine. She could really walk back home. There was no problem moving her knee joint, except for the slight restriction from the bandage, no pain or seize up.

Director Han got up, beyond the surgical proficiency of Yang Ping, his imagination.

The patient’s daughter waiting at the door of the operating room saw her mom walking out, chatting and laughing with the doctor, and thought the surgery was called off.

“What happened?”

“It’s done!”

Done? So fast. The patient moved her knee joint and deliberately walked a few steps, turning to show her daughter. It was indeed normal movement.

“Finally, it’s resolved. Where’s Yangyang? I need to pick him up.” The patient was delighted.

“Can she really be discharged tomorrow?” The patient’s daughter supported her, watching her legs closely.

Having undergone two surgeries, it was the third time that her problem was finally resolved. It was a good thing she didn’t rush the discharge.

The elder lady praised them all the way.

“Are you still single?” The elder lady asked — when she’s happy, she wants to play matchmaker.

“Getting married soon.” Zhang Lin interjected with the answer.

The elderly lady seemed a little disappointed.

“I have a friend whose knee joint is severely swollen. He can’t walk now. Can I ask him to come and see you?” The elderly lady was very pleased.

Her daughter was not pleased, complaining about her mother for poking into others’ business. Introducing doctors was a thankless task.

The elderly lady obviously didn’t care; she just wanted to lend a hand to her friend.

The first operation ended perfectly; everyone was delighted. It signified the official start of the comprehensive orthopedics Department.

Song Zimo began writing the surgical records. Zhang Lin recorded the course of the disease. The comprehensive Orthopedics Department had thirty beds in total. Zhang Lin and Little Five were in charge of 15 each, each of them guided two standardized training students, so the team had enough manpower to manage thirty beds.

Yang Ping began studying Mr. Ning’s condition again. The CT transverse sections had images of nerves, and the magnetic resonance images had images of nerves in three sections.

Three-dimensional reconstruction uses these sectional images to reconstruct a 3D image. This job was performed by the built-in software of the CT or magnetic resonance machine.

Yang Ping found his brain’s imaging ability had improved quickly and notably — in particular, his memory of details was extremely powerful, nearly reaching the point of photographic memory. This was the result of the system’s super training program.

He attempted to reconstruct a three-dimensional image of the patient using his brain.

Images appear, overlap, and combine in his mind. Both the details he focused on and those he did not were retained faithfully in their original appearance.

The three-dimensional spine, tumor, blood vessels, and nerves gradually took shape. This was not the work of a system but of his own brain processing, without reliance on any system.

To highlight, the nerves were marked in red, and their direction gradually became clear.

Creating this three-dimensional image was not easy and was quite strenuous. Some key details had to be repeatedly reinforced to achieve stable clarity. When one area was filled in, another was lacking. When one area became clear, another became blurry. The image only barely took shape after several augmentations.

Song Zimo was standing not far away, watching Yang Ping glare at the screen with focused eyes, like a thinker’s sculpture. He did not want to disturb Yang Ping, but wanted to see what he was so engrossed in.

Yang Ping pulled out a piece of paper and began to sketch on it. First were outlines, then lines, then a dimensionality rendering, and finally details.

The perfect application of surrealistic painting technique in medicine resulted in an image leaping out from the paper. Song Zimo approached, but Yang Ping was so engrossed that he did not notice.

“What is this? He actually made a reconstruction based on the CT and MRI images? Made a reconstruction using his brain? And then expressed the reconstruction through drawing?”

Is this even a human? Am I working with an ordinary person?

Director Han also came in, he saw the strange expression on Song Zimo’s face and the sculptural focus of Yang Ping, not knowing what had happened.

Upon closer inspection of the drawing and the images on the screen, he understood. Was this a reconstruction using the brain? And the reconstruction image was drawn out with a pencil?

How strong a brain’s visual construction capability would this require? No wonder it’s said that the content of a genius’s thoughts are images, while the content of an ordinary person’s thinking is simulated language vocalization.

Both of them were unwilling to disturb him. Putting down his pen, Yang Ping touched his forehead and found sweat. It seems that creating such an image is still very strenuous, and he needs to keep improving his drawing ability in the future.

“Oh, Director Han! “Yang Ping felt a presence behind him and turned around to see Director Han and Song Zimo.

“Song Zimo, how’s the patient after the operation?”

“No problem, very good!”

“Director Han, this is the picture I drew based on CT and MRI. This is the spine, this is the spinal cord and dura, this is the nerve root, this is the intervertebral foramen. The Th2 nerve root is invaded by the tumor and pushed aside by the tumor. And this tumor has a very rich vascular supply,” said Yang Ping, pointing to the picture he had drawn.

“The Oncology Department has performed embolization treatment for liver cancer. Now there are few blood vessels, even fewer than before the embolization,” Director Han said, Song Zimo pulled a chair for Director Han to sit on, and he himself also sat down.

“Are you still thinking about nerve root blocks?” Director Han knew his thoughts.

“Yes, it seems that apart from that, there is no other way?” Yang Ping seemed distressed.

“Is this the reconstruction image you drew?” Director Han asked.

“A sketch!” Yang Ping nodded slightly, answering succinctly.

This sketch can already compete with a real CT or MRI three-dimensional reconstruction, and the details are clearer. It’s right not to train him as a normal person.

“Do you have any good methods?” Director Han couldn’t help but ask curiously.

“Not yet!” The answer was very confident and precise.

Finding a method is not easy. It must be feasible in theory and practice. It must be safe and not cause side damage. This is why medicine progresses slower than other sciences.

Looking at his mobile phone, Director Han received a notification: a grand meeting consultation for the patient in the Overseas Chinese Building at five in the afternoon. In addition to the heads of each department of the hospital, orthopedic, tumor, and pain experts from Fuer will also participate.

The consultation was originally scheduled for three in the afternoon, but Professor Su Qingyun was not available. He could only arrive at five in the afternoon, so it had to be arranged for five in the afternoon. The family used many connections to invite Professor Su over.

Professor Su, Meng Heng in Beijing, Hong Zhigang in Shanghai, Fu Shancheng in the western regions, are all hot candidates for academicians.

“In the afternoon, you participate as well?” Director Han not only appreciated his talent but also his attitude towards medicine.

Yang Ping also wanted to join. He heard that Professor Su Qingyun was very distinguished, rigorous in his study, and advanced in his thinking. Whether in surgery or academic achievements, he was a top performer domestically and held a place internationally, a spiritual flag in the orthopedic academic field.

To be able to invite him was not a question of money, but of relationships. Perhaps Mr. Ning had a deep relationship with Professor Su.

To have the opportunity to discuss cases with him at close range, what a rare opportunity! Yang Ping thought.

The voice outside was familiar, the aunt who had undergone surgery today was talking.

She brought another aunt, and the family pushed her directly to the doctors’ office in a wheelchair.

“Doctor Yang, this is the friend I spoke of. Look, her knee is so swollen, she can’t move it at all, how long has it been?” The aunt was very enthusiastic.

The patient said, “It’s been swollen for several years, often suddenly getting stuck, then it can move after a while. But this time it’s been stuck for a month, completely immobile.”

“Have you seen a doctor?” Yang Ping asked.

“No!” The patient touched her left knee.

“You guys are busy, I have something else to do.” Director Han got up and left, while Yang Ping continued to see the patient. He inquired about her medical history in detail and performed a physical examination.

“This is likely synovial chondromatosis. There are lots of little objects like peanuts growing inside the joint. To confirm, we need to do some tests, get an X-ray, and do an MRI. Little Five, can you arrange this?” Yang Ping said after the examination.

Little Five explained to the patient’s family how to apply for a patient card, once the patient card was ready, they could come back up to get a check-up form.

Once the patient’s family understood, they pushed the patient to apply for the card.

They had no questions and trusted Yang Ping completely.

This is the power of reputation. Nothing is more persuasive than reputation.