Surgery Godfather-Chapter 634 - 576: Dissecting a Strand of Hair

Yang Ping let them touch to feel the teratoma tumor through tactile sensation. However, his imagination was rather rich.

The pelvic tumor was shaped like a dumbbell with the sacral canal tumor, with one end larger and the other end smaller.

For a complete removal of the tumor, Yang Ping planned to divide the tumor into two parts, first remove the larger tumor in the pelvis. This way, without the obstruction of the large tumor, he could open the sacral canal in a wide space and slowly remove the small tumor inside.

One blood vessel after another was ligated and cut off, freeing it from these constraints.

Yang Ping ligated and cut off the connection between the tumor and the inside of the sacral canal, then removed the entire tumor from the pelvis and gave it to Xiao Su, who placed it on a special sterile table.

The structure of the sacrum was complex, with a sacral canal, sacral foramen, and nerves extending from both sides of the sacral foramen.

Yang Ping sorted out the anatomical structure here, distinguishing between normal tissue and teratoma tissue. If he cut wrongly and injured the nerves, it would cause neurological symptoms.

After sorting, Yang Ping marked the just cut connecting band of the tumor. All these tissues were the same as the tumor inside the sacral canal. It was unclear whether the tumor originally sprouted outside the sacrum or inside the sacral canal.

If the tumor was in the vertebral canal or sacral canal, the bony canal had to be opened, otherwise the tumor could not be exposed.

Yang Ping used an ultrasonic osteotome to open the sacrum from the front, shaping the cross-section of the cut bone into a trapezoid, this way the removed bone piece was larger on the outside and smaller on the inside.

It was cut like this so that the bone piece could be covered back later without sinking and pressing against the nerves in the sacral canal.

The anterior side of the sacrum was much thicker than the posterior side, so opening a window from the front made it easier to make this kind of well cover-like bone piece.

Moreover, opening a window from the front could reduce the occurrence of postoperative sacrococcygeal pain.

The whole bone piece looked curved and roughly square, with a trapezoidal cross-section, in total three such bone pieces were cut out.

The bone piece was lifted, revealing the tumor hidden in the sacral canal.

This way of exposure was completely different from textbooks.

Song Zimo and Xu Zhiliang witnessed the way Yang Ping entered the sacral canal, and memorized the whole process in their hearts. Next time, they could also use this method.

The advantages of this method were obvious, not only was it practical and aesthetic, but the bone piece could also be fixed back to its original position with a steel plate screw after surgery.

Moreover, each step of Yang Ping’s surgeries was clear, the anatomy was clear, it was naturally didactic.

Following Yang Ping for a long term made both their anatomical knowledge and surgical methods improve significantly, and they learned a lot that wasn’t in textbooks.

Zhang Lin and Little Five, they would occasionally check what’s happening inside while manipulating the retractor.

Most of the time, the retractor holders had no visual field, they couldn’t see what was happening inside, and naturally, they would feel sleepy after manipulated the retractor for a long time.

So one of the most basic qualities of a retractor holder was to not fall asleep.

Zhang Lin and Little Five were not ordinary retractor holders, they were the great ones, so naturally they wouldn’t fall asleep. In the near future, their book about retractor holding would be published.

"Little Five, the hospital basketball game is about to start, let’s draw lots after work this afternoon, you go, or I go?"

"You have bad luck, I’d better go."

"Brother, let me go, my luck has been great recently, I got an extra bottle whenever I bought Wong Lo Kat."

On such occasion, representing the most promising department and participating in the lottery in the image of a young talent, as the top of the tops, how could Zhang Lin miss this.

The basketball game had been prepared for a long time and was about to start.

In the preliminary round, the least wanted teams to bump into were the emergency department and the administrative department. Xiong Shihai from the emergency department was basically unmatched in the field due to his size.

The administrative department, with a group of deans, deputy deans, medical directors and other big shots, their skills were not good, especially Dean Xia, who was simply a foul king.

"Dean Xia is in every game, I will personally referee, I won’t let him off the hook!"

"Old Zhang!"

Professor Zhang stood behind, hands behind his back. Sometimes Director Han also helped out in the outpatient clinic, which gave Professor Zhang plenty of time.

If there was any special surgery, the old man would stroll in. For an eighty-year-old, if he didn’t visit the operating room for a few days, he would become quite anxious, like he was lost.

As long as he took a walk around, even if he did nothing, he would feel at ease.

Surgeons actually spend more time in surgery than at home, it becomes a habit.

"Old Zhang is awesome!"

While others call him Old Zhang, these rascals call him Zhang Old, and Professor Zhang didn’t take offense.

These brothers who often play online games together in private, are accustomed to calling him Zhang Old.

"Brother Fat, I heard that you’ve been in low spirits recently, what happened? Did the swan fly away?" Professor Zhang sidestepped and came over to Liang Fatty.

The intern quickly moved a stool for Old Zhang to sit on.

Fatty lowered his head, spluttering indecisively.

The shape of the sacrum is very irregular, and there are many outgrowth-like structures which make it difficult to completely remove the tumors; furthermore, these regions are full of blood vessels and nerves. ƒrēenovelkiss.com

This kind of surgery is as difficult as urban guerrilla warfare.

The foundation of surgery is actually anatomy, the more familiar you are with it, the easier it is to perform surgery.

The irregular teratoma in the sacral canal was completely removed by Yang Ping in the midst of laughter.

Two tumors, one large and one small, one spherical and the other irregularly shaped, were placed on the sterile table.

"Send them for frozen sectioning!"

A quick intraoperative frozen section can quickly provide a pathological diagnosis.

Doctors can wait for the pathological section report on the operating table; if benign, merely removing the tumor suffices; if malignant, you have to perform the surgery based on grading and staging, often expanding the surgery to a radical one; not just removing the tumor, but also cleaning up the surrounding lymph nodes.

In Europe and America, operating rooms are equipped with pathology rooms for surgeons’ use. The chief surgeon removes the tumor sample, takes off his surgical gown, goes to the pathology room to personally review the frozen section, confirms the nature of the tumor, determines grading and staging, then scrubs back in and continues the surgery.

However, in our country, surgeons don’t have this tradition of viewing pathological sections.

"Anyway, you have to cut it open, so why not take a look?"

Song Zimo took a keen interest in the structure of this teratoma.

Since it’s going to be sampled anyway, after cutting it open, different tissues can be sampled from multiple points, then sent separately to the pathology department.

The fleshball was laid on the sterile table, and Song Zimo and Xu Zhiliang, one holding the fleshball steady and the other performing the incision.

The swollen fleshball implied some internal pressure.

To prevent splashing fluid when it’s cut, Song Zimo asked everyone to keep their distance from the sterile table.

As the capsule was cut open, a pile of fat came bursting out, immediately followed by a thick, greasy liquid flowing out, mixed with a disarray of black stuff. Song Zimo took a bit of the fat for a specimen and then continued the dissection.

Those black and messy things turned out to be hair-like fibers; Song Zimo used a forceps to gently pull out a thick clump of hair that was over a meter long.

This sight was a bit horrifying - the idea of a bunch of hair growing in your stomach.

And it wasn’t just a little bit of hair, but large clumps, almost equal to the amount of hair snipped off a grown woman. No wonder the fleshball was so swollen. For a better diagnosis, Song Zimo sampled part of the hair too as a standard.

The tissue inside the fleshball was exceptionally complex, and to ensure a precise diagnosis, samples had to be taken from multiple points.

Apart from the bony tissue which could not be frozen sectioned, all other soft tissues could be.

Besides hair, there were also structures resembling teeth, one by one.

The spine-like structure seen on the imaging pictures was not actually a full spine, but well-aligned spine-like bone chunks.

There was also irregular muscle tissue around it, and they even found skin and nerve tissues.