Dr. Zhou's operation is very standardized and skilled, and the hands of the Chinese are dexterous, and Yang Ping's previous worries are a bit superfluous.

Dr. Zhou over-selected the blood vessels of the thoracic spinal cord one by one, carefully and patiently.

Yang Ping gave him navigation, when to stop, when to move forward, when to push the medicine, from instructions to operation, there was a certain lag, but Dr. Zhou's understanding ability was very good, and the cooperation did not appear stiff.

"Slow down, push, stop, push again, cross the fork, go outside, yes, advance two centimeters, stop --- you can push the medicine." Every word of Yang Ping, Dr. Zhou can be turned into precise movements in his hands.

"Dr. Yang has learned to intervene?" Dr. Chow was surprised that the surgeon also knew how to intervene.

Yang Ping thought for a moment: "I am very familiar with the anatomy of this area, and I know the origin, direction and supply range of each blood vessel. ”

Dr. Zhou followed his navigation and completed the first set of vascular imaging safely and quickly, and Dr. Yang was no longer familiar with the anatomy, but was fascinated.

The British man's facial expressions are always so rich, surprised, confused, adoring, and all kinds of expressions are very exaggerated on his face.

Milton took two steps forward to the image screen, his cheeks bulging, his face flushed, as if holding his breath, and he opened his eyes as wide as he could, as if they were open a little wider to achieve greater clarity.

August glanced at this old friend, not to be outdone, and also took two steps forward, as long as he was outside the yellow line on the ground, he met the requirements of hospital infection management.

The image on the screen is very similar to a Chinese ink painting, the black blood vessels are curved and curved, from thick to thin, the more branches are thinner, and the colors are also thick and light.

Dr. Zhou is now very accustomed to following the navigation, he didn't dare to speak anymore, he looked at the screen intently, the movements of his hands were extremely gentle and precise, and the blood vessels of the spinal cord were superselected in groups.

Finally, the site of the arteriovenous fistula was found, and the contrast agent leaked out through the fistula and into the vein, creating a clear communication between the arteriovenous and vein.

"Dural arteriovenous fistula!" Milton exclaimed, as if holding his breath, just to shout out the words.

Milton's voice was soft, for fear of interfering with the sorcerer's operations, but he had to shout this to show that he was not showing weakness in front of August, who glared at his old friend unkindly.

"How many cases are there in the world? August? Milton's eyes never took his eyes off the screen.

"Don't bother me, this is not the time for academic discussions, I need to concentrate as well." August was angry.

All of Kobayashi's suspicions were swept away, and the doctor was a true top expert, and his proficiency in anatomy was beyond Kobayashi's knowledge, and Fumiya Takahashi and Jiro Sasaki at the University of Tokyo Hospital, known for their trauma surgery, could hardly beat him.

Fumiya Takahashi and Jiro Sasaki personally dissected more than 100 "general teachers", and at that time, the University of Tokyo purchased hundreds of "general teachers" from Eastern Europe for a certain topic and used them for teaching, and Takahashi and Sasaki dissected a full 100 of them.

However, how can such a doctor not be internationally famous, and he has never even seen the papers he wrote, nor have he ever seen him attend international academic conferences.

Under Yang Ping's guidance, Dr. Zhou saved about time, and the operation, which was originally planned to be seven or eight hours, is now estimated to be completed in three or four hours.

Another arteriovenous fistula was found, this patient had two arteriovenous fistulas, Yang Ping asked Dr. Zhou to relax a little: "There are only two arteriovenous fistulas, and the remaining groups, you can also overselect them to show them, finish resting for a few minutes, and then overselect a few mutated arteries." ”

"Hmm!"

Dr. Zhou was a little tired because of his high concentration, and he thought that if every operation was under the guidance of Dr. Yang, I am afraid that even the most difficult surgery could be successfully completed, and if Dr. Yang did interventional surgery, it was estimated that it would be the best in the world.

After the remaining groups of blood vessels were overselected, there was no problem, and Dr. Zhou took a break and began to overselect the mutated arteries.

The purpose of these mutated arteries is to confirm to everyone that these blood vessels are the main feeding blood vessels of the spinal cord, and once damaged, they will cause spinal cord avascular necrosis.

At the same time, the DSA image image is used to make a virtual reality 3D imaging to help everyone understand the location of this blood vessel in the approach and how to protect it.

These blood vessels are not in the normal anatomical knowledge, and they are crooked, and the difficulty of imaging is much greater than that of those groups of blood vessels, and those groups can be completed slowly by themselves without Yang Ping's navigation, and these blood vessels, without navigation, Dr. Zhou cannot complete the operation.

"Don't be in a hurry, slow down a little, these blood vessels are complex, the curvature is large, it is difficult to over-select, accidentally damaged, easy to form bleeding or embolism, just like just now, listen to my navigation ---"

The instructor in Dr. Zhou's hand did not dare to move, waiting for Yang Ping's navigation to begin.

"Push forward, go on, go on, about 0.5 centimeters further, that's 5 millimeters!" In order to prevent Dr. Zhou from mishearing, Yang Ping expressed it in two units.

"Stop! Now to cross the fork, rotate the guidewire, and stop! I push forward 5 mm and stop! The curvature is too big, each time you advance, don't exceed 5 mm, stop every push further, and think clearly before you are advancing. ”

"Okay, go on, stop, push the contrast medium!"

The dendritic ink paintings spread out, really, this is one of the main blood vessels that supply blood to the spinal cord.

Dr. Zhou's palms were full of sweat, and he was a little slimy through his gloves, looking at the images on the screen, he couldn't believe that he had succeeded in overselecting this blood vessel.

Dr. Lim and Dr. Huang looked at the screen and did not speak.

Continuing to bend the blood vessels, the operation progressed very slowly, Dr. Zhou's hands remained steady, carefully, every small movement, condensed all the energy.

If you are not careful, the guidewire can puncture the blood vessel, causing bleeding, or damaging the endothelium of the blood vessel, leading to embolization, and the consequences of each mistake are extremely serious.

Now, Dr. Chow is like driving a car on a mountain road at night, with an abyss on the side of the road.

Every time I go forward, I follow some kind of navigation, and the steering wheel hits a few degrees to the left and a few degrees to the right.

Push a little further, stop, finally cross a few forks, and once the overselection is successful, push the contrast agent, and then move on to the next one.

The second and third blood vessels were successfully imgraphed, and the contrast agent image on the screen pulled a curved and thick line along the blood vessels.

The three mutated arteries were successfully overselected, and Dr. Zhou's hanging heart was gently put down, as if he had let go of a priceless fragile antique.

His feeling now is that it is dawn, the car is on the top of the mountain, the driver looks down, the mountain road is along the cliff, and under the cliff is an abyss, he actually went up the mountain, and he is afraid!

Dr. Zhou involuntarily shivered, which may be a sign of fear.

It's finally done, and everyone can take a big breath and talk.

Truth!

The Chinese doctor's diagnosis based on CT and MRI was correct, and the patient was a dural arteriovenous fistula with three variant spinal cord feeding arteries.

"You can do virtual reality 3D reconstruction, no, it's more intuitive to do a virtual reality three-dimensional vascular image." August suggested.

"We have the central hospital and can transfer data to the past." Dr. Lim also felt the need.

"Yes, reconstructing the spinal cord and blood vessels with virtual reality is more straightforward, I get it all." Milton finally saw through the trifecta.

It's a pity that it wasn't DSA who understood it before, and he was a cut behind Auguste, and I'm afraid that he would be lacking in confidence in front of Auguste for a long time after that.

This DSA took nearly four hours, which is considered a relatively fast speed, and there was no waste of time halfway.

Now, it is not Yang Ping's own feelings, but in the eyes of others, he has become the "man from the earth".

Such a complex case seemed so easy in his hands, the confidence when analyzing the condition, and the proficiency in anatomy when doing DSA, as if everything was simple and clear in his heart.

Milton recalled Yang Ping's words: "Actually, this case is very simple, not very complicated, and everyone has seen it relatively rarely, so it is a little overwhelming. ”

Dr. Yang was so calm, calm, and relaxed, while everyone was so confused, confused, and helpless, that he had already told his condition in full, except for Auguste, the old ghost, no one understood, and Milton was embarrassed.

Dr. Chow pulled out the catheter and pressed the sterile gauze to stop the bleeding at the puncture site, while Dr. Lim arranged for the doctor to collect pictures and transmit them to Singapore for virtual reality 3D imaging.

Yang Ping went to the locker room to prepare to take off his lead clothes, and August and Milton both caught up and rushed to help Yang Ping take off his lead clothes.

"Can you explain more clearly, how to accurately judge this type of vascular disease from CT and MRI?" Milton grabbed the side of the lead coat.

"And how can you do a hand-drawn reconstruction of the image?" Auguste pulled on the other side of the lead coat.

The two pulled back, took off the lead clothes, pulled each other a few times, and hung the shelves where the lead clothes were put together.

"It's not something that can be said in a few words." Yang Ping said lightly.

If you don't have extremely proficient anatomical knowledge, you can't explain it clearly for the time being, and when you summarize your experience in the future and turn it into some knowledge that can be popularized and applied, it will be easy to understand at that time.

For example, knee multi-ligament reconstruction is an example, when a set of standard procedures for reconstruction is summarized, everyone follows the procedure, so that surgery can be popularized.

"Dr. Yang, I finally figured out that this case is that there are three nested diagnosis and treatment traps, and if you jump out of one trap, you will fall into another trap? This creates a chain of traps that are difficult to unravel? Such a classic case should become a teaching case for the University of Cambridge School of Medicine. Milton realized it later.

"It's supposed to be Charité Medical School!" August showed no signs of weakness.