When the girl says this, the boy clearly has the upper hand, as if it is the case, even a normal healthy pig can be shorted like this.

The question of why the great doctor Fontan of the time did not experiment with pigs, but directly applied a completely new surgical method to patients, seems to be difficult to answer.

Since the girl is 12 years old, it seems that it is not an emergency life-saving operation, and there is absolutely time to prepare.

"Because Dr. Fontan is a genius, and it is not something for our minds to speculate, let's ask Professor Yang to answer this question."

"Me?"

Yang Ping didn't expect Song Zimogao to attack suddenly.

There was no time for Yang Ping to think about it, the audience burst into applause, Professor Yang is an absolute genius in the eyes of everyone, only geniuses understand geniuses, why didn't Dr. Fontan buy pigs to do animal experiments at that time?

Yang Ping stood up, and Song Zimo and everyone looked at him, waiting for his answer.

"Because he was so sure of his plan that he didn't feel the need to waste time on it, and in his eyes, every minute wasted was a danger to the little girl-——"

Song Zimo immediately applauded: "This kind of self-confidence is only possessed by a very small number of people, in fact, as long as you think about the behavior of these geniuses in the history of medicine, many of my questions have answers, okay, let's continue——"

Yang Ping sat down again, this kid is teasing me.

A Ph.D. student raised his hand: "I just mentioned the pressure difference, there is a pressure difference between the systemic circulation and the pulmonary circulation, that is, the pressure of the systemic circulation is stronger than the pressure of the pulmonary circulation, so as to ensure that the blood of the upper and lower vena cava reflux can flow to the pulmonary artery under this pressure gradient, so that the short connection can be successful, I would like to know, if -—— I just said that if there is high pressure in the pulmonary artery, resulting in this pressure difference does not exist, can this surgery still be done?" ”

Song Zimo answered this question:

"Very well, the situation you mentioned is a contraindication for Fontan, the foundation of Fontan's surgery is here, and the skin will be attached without hair. If there is high pressure in the pulmonary arteries, so that this pressure difference does not exist, and the blood cannot flow in the intended direction, the purpose of this surgery will not be achieved, but we can solve this difficulty, how to solve it? ”

Another graduate student raised his hand, it was a boy, and he wanted to regain the dignity he had just lost in front of the girls.

"Generally, the cause of this situation is pulmonary artery stenosis or pulmonary valve insufficiency, we will enlarge the pulmonary artery, or replace the valve, so that the pulmonary hypertension is relieved, the pressure gradient is formed, and this kind of surgery has a basis for existence, if pulmonary hypertension is caused by other reasons, we will solve these problems, if it cannot be solved, we can only give up this operation."

"Well said."

Song Zimo approved.

"Dr. Fontan's surgical approach began with the treatment of tricuspid atresia, but it can treat many types of congenital heart disease, giving a last hope to countless patients with congenital heart disease who have irreparable heart malformations and cannot wait for a heart transplant, but unfortunately, this method is only a palliative surgery and cannot cure the disease."

"The Fontan operation we just talked about was just a prototype, and later with the development, the Fontan surgery formed a system of surgical procedures, which is a combination of many surgeries, far more complex than the prototype, but these procedures follow Dr. Fontan's original principles: the heart is only responsible for systemic circulation, and the pulmonary circulation is completed by the inferior vena cava and pulmonary artery shorting; Oxygen-rich arterial blood and oxygen-poor venous blood cannot be mixed and must be separated. ”

"So how is the surgery done in this case? Follow the standard surgical procedure, in three steps! ”

Song Zimo wrote one, two, three on the electronic blackboard, and the Fontan surgery in this case was much more complicated than the founder's prototype surgery, and there were many more factors to consider.

During the lecture, Song Zimo observed that people came in one after another from the back door of the classroom, and because there were no seats, they stood in the last row casually.

Because everyone was facing the podium, no one would pay attention to the audience later, but Song Zimo, as a speaker, faced the entire demonstration room, and he clearly saw who came in behind.

Li Zehui, he just landed in the United States, saw this case from the WeChat group, and then he decided to buy a ticket to return to China, if it were not for the academic exchange visa that can travel back and forth to China many times, Li Zehui would never be so convenient.

And his brother is still stuck on a visa, and if his brother knows that there are still these cases, he will definitely cry and faint in the toilet.

Immediately afterwards, Song Zimo saw that Xia Shu led in Academician Wang, Professor Chen, and Director Xin, and they all returned to Sanbo Hospital, and they also heard about the discussion of this case in the Department of Comprehensive Surgery today, so they hurriedly came to Sanbo Hospital.

The case discussion in the department of general surgery unexpectedly turned into a meeting of top cardiac surgeons.

"In fact, there is an old-timer at our venue who has more say than me in the Fontan surgery to treat this case, he is the first doctor in my country to carry out the Fontan operation, and he is an authoritative expert in pediatric congenital heart disease in China." Song Zimo decided to invite Academician Wang to talk about Fontan surgery, and also let everyone have a glimpse of the academician's demeanor.

Academician Wang was actually standing behind, he heard that Song Zimo was talking about himself, and hurriedly waved his hand, a little embarrassed.

If you want to be rated as the most unscrupulous academician of the year, it must be Academician Wang, who does not regard himself as an academician at all, but just as an ordinary doctor to observe.

At this time, Yang Ping also looked behind and saw Academician Wang, and hurriedly called Xiao Wu over and asked him to arrange seats for the guests.

"I have invited Professor Wang from Fuwai Hospital in the Imperial Capital!"

Song Zimo applauded, then walked off the podium to shake hands with Academician Wang.

Everyone didn't react at all,, and academicians were caught in it to listen to the lecture, everyone's eyes followed Song Zimo's gaze, and saw an old professor shaking hands with Song Zimo.

Some people know each other, but most don't.

In fact, the circle of doctors is very small, even if the country's well-known experts, they are only limited to doctors in the same specialty, after all, we hold academic meetings together, often see experts on the podium, if few doctors participate in academic meetings, even if they are in the same specialty, they still do not know the big guys in the industry.

Academician Wang is approachable, he doesn't have an academician at all, he holds the microphone, like an ordinary teacher, walks up to the podium, and then Yang Ping stepped forward to shake hands with him.

"This is an academician?"

How can there be academicians sandwiched in it to listen to the lecture, the venue is excited, the comprehensive surgery is really incomprehensible, isn't it a case discussion in Corey, how can there be academicians to participate.

"Everyone, be quiet, let me say a few words, in fact, I just got off the plane, sorry, the plane was late, so I was late, I came here to participate in your case discussion, this case, is my patient."

Academician Wang pointed to the image on the electronic screen.

"Just now Dr. Song said that I am the first person to carry out Fontan surgery in China, this is true, not only Fontan surgery, I am the first to carry out many pediatric congenital heart disease surgeries, several editions of the guide in this area are my editor-in-chief, and now the editor-in-chief of the latest edition is Professor Chen Yueliang, we actually came to Sanbo Hospital a few days ago, and after returning to the imperial capital, I heard that you were going to discuss this case, and we flew back."

"There's a little more digression, let's get down to business."

"Why didn't this case be done outside our Fu, but put it in Sanbo Hospital to do it, many people have questions, in fact, it's very simple, let us do this operation, the success rate is not high, let Professor Yang do it, the success rate is much higher, it's that simple."

"All the doctors here, even if there are some interns, they are also quasi-doctors, and I don't want to tell you that there were two identical cases before, which were not saved in my hands, and the difficulty of this case is not only the Fontan operation itself, but also the more difficult is that there is a problem with the development of blood vessels, the lack of collagen fibers in the blood vessel wall, and the lack of elastic fibers, what is the reason, we have not yet found it, and it is speculated that it is related to the malformation of the heart, but in any case, it increases the difficulty of the operation, not a little more."

"The two cases of failure, one died on the operating table, opened the chest cavity, cut off the blood vessels and then failed to kiss when the anastomosis, accidentally hooked the blood vessel wall, finally the operation was completed, the cardiopulmonary bypass was removed, the heart began to stop bleeding after the rebeat, and it couldn't be stopped at all, why, here is a needle, where is it broken again, and finally watching the child leave, we can't do anything."

"You don't have this feeling when you're young, at our age, you've been a doctor for a long time, and you have this kind of memory, really, at that time it was really helpless, very helpless, very desperate, as a surgeon, a heart surgeon, you look at the blood coming everywhere, you can't stop it, what is the feeling."

"The second case, already 10 years later, we learned a lesson, the operation added artificial vascular assistance, this case did not have a problem on the operating table, but died in the intensive care unit on the third day after surgery, when we performed emergency rescue surgery, opened the chest, it was full of blood, blood spurted out, because the suture position of the large blood vessel and the artificial blood vessel was torn."

"Later, with the consent of the family, we did an autopsy to find the cause - the vascular anastomosis could not meet the requirements. This case would not have been possible without the emergence of a new basic theory, why? ”

"Because, if the operation is to be successful, your sutures must last for more than 5-7 days, but the reality is very difficult, basically impossible, do you know why?"

"Because this is like suturing on a soap bubble, but also to make the soap bubble not break, this brittle blood vessel once cut off and re-sutured, the requirements for suturing are difficult to do by manpower, this is like a very thin paper bag, when it is complete, he can lift water without leakage, and he can also lift very heavy water, because the stress is evenly distributed."

"When you cut the paper bag in half, you sew it together with a needle and thread, and then you go to lift the water so that it doesn't leak. Then let it lift a very heavy water, more difficult, why, the stress will be concentrated in the suture, especially where there is no suture position can not achieve uniform dispersion of stress, once there is a needle to carry too much stress, the paper bag will start to tear from here. ”

"I don't know what I'm saying, do you understand?"

Academician Wang stopped.

"Professor Wang, what do you mean, how can someone achieve a theoretically perfect suture, so that all the stresses of the anastomosis are evenly distributed on each stitch according to the theory, then the operation is likely to be successful?" One student asked.

"That's right! This student listened very carefully, and this is what he meant, although this does not guarantee 100% success of the operation, but it can guarantee the maximum probability of success. ”

"After five to seven days, why is it safe?"

Graduate students, trainees and interns didn't dare to speak just now, but when they saw someone taking the lead, everyone became active in their thinking and became bold in speaking.

"Think for yourselves, why is the problem so much diminished after the five- to seven-day danger period?"

A graduate student raised his hand.

"Because the anastomosis at the broken end of the vessel has healed and is no longer a weak point, the stress will not be concentrated there."

"That's what it means, the students of Sanbo Hospital are very bold in asking questions, we should learn like this, dare to ask questions, be good at asking questions, you don't even dare to ask questions, how can you progress? I really like the academic atmosphere, where you see so many young doctors, and students, discussing with each other. Our hospital is a bit rigid, the speakers are all senior doctors, and it is also according to the specialty, as long as I speak, everyone loses the ability to question, all say agree. ”

"I tell you, there is no authority in academics, you don't look at me as an academician, there are many things I don't understand, I don't recognize myself as an authority, there is no authority in academics, the Fontan operation just mentioned, Dr. Fontan, who invented it, was only in his thirties at the time, and he was also a junior doctor, and the authorities at that time said-—— You can't do this at all, you just do it behind closed doors, thinking nonsense."

"If there is an authority in academia, and it's over, Dr. Fontan will obey the authority, and the authority says no, that's no, and what surgery is left, then is there still the Fontan surgery we discussed today? The further step of scholarship begins with questioning the so-called authority. ”

"Every time I revise the thesis for the doctorate, after the correction, the doctor says - okay, teacher, I will revise it according to your guidance."

"I thought to myself, it's over, my students don't have the ability to question, this is a problem with my teaching, I want to revise your paper, why don't you even debate and refute, where is your opinion?"

"Just now I saw a few boys and girls arguing about the issue of pigs, the voice is very loud, but it is all academic debate, this is very good, academics have to argue, the more you argue, the clearer, don't be afraid of arguments, the right things are gradually recognized in the debate, and the incorrect things naturally die out in the debate."

Academician Wang stopped after speaking, Yang Ping was the first to applaud, Academician Wang is really simple, and there is really no academician at all.

Among the several academicians Yang Ping knows, Academician Wang is the most unassuming, and Academician Liang of Xiehe is the most upright, speaking and acting uprightly. His father-in-law, Academician Su, always feels noble, and he is personable at any time, how to say it, in a sentence that is not common, he has an aristocratic temperament.

To put it well, science must first have the ability to question, and science makes progress in questioning.

So science has no authority, and the existence of authority is an obstacle to progress.

"Infected by this atmosphere, I will say a little more, let me tell you about the three steps of Fontan surgery, I will try to be popular, I will finish, it is best for Professor Li Zehui to make a supplement, supplement some of the current cutting-edge research on Fontan surgery in the world, by the way, Professor Li Zehui is a top cardiac surgeon at Cleveland Clinic in the United States, and has made great achievements in congenital heart disease, coronary artery bypass, valve treatment, heart transplantation, etc."

"Wow!"

The audience turned their heads to look behind, the world bull was shyly waving to everyone, he was also standing behind, just listening to the lecture with everyone.

These young students are excited, and they are all big bulls, is this like a case discussion in the department?

PS: Wait for another chapter.,Today's "Editor-in-Chief Recommended" on the starting point client,I haven't recommended it for a long time.,This is a reward for the recent return to normal updates.,Thank you for your continued support.。 If you still have a monthly pass or a recommended ticket, help smash it. Thank you!

(End of chapter)