It is very important to accurately identify the tumor tissue during surgery, otherwise even if all organs and tumors are taken out, it will be impossible to distinguish which ones are tumors, which ones are normal, and which ones are mixed tissues.

Of course, Yang Ping, with his rich anatomical experience, can make judgments through naked eye recognition and finger touch, and if you add CT enhanced scans and PET-CT scans to memorize the images in your mind, and then apply these pictures to the solid tissues, the judgment is basically inseparable.

But not every doctor is Yang Ping, and in Yang Ping's view, if only he can do this operation, it is his failure.

Any surgical method is only a good surgical method if the method is improved, the difficulty of the operation is reduced, and the operation can be popularized, otherwise relying on one doctor to die of exhaustion can only do so many surgeries.

The five-year survival rate for pancreatic cancer is less than 8%, and 90% of patients die one year after surgery.

In order to increase this rate and achieve a good survival rate, Yang Ping can only rely on his superb surgical skills to achieve complete excision as much as possible, and there is no other way.

The same thing can be done very advanced, or it can be done very simply, this is a matter of technical level.

For example, to build a house, primitive people built a house with trees and thatch, and now a high-rise building with hundreds of floors is also a house, which is a problem of the level of construction technology.

It's the same with surgery, it's also pancreatic cancer surgery, and rough excision is also surgery.

Like Yang Ping, who takes surgery from strategy to tactics, and is meticulous in every detail, it is also surgery.

Extracorporeal excision is a strategy in the whole surgical plan, and under the strategy, there must be tactics, and every battle.

The film brought by Nie Shun'e is CT enhancement, which is actually enough to make a diagnosis, and CT enhancement is the best examination of the pancreas, which can be used for localization and qualitative, differential diagnosis and staging.

But in order to further understand the condition, Yang Ping still gave her PEC-CT, at this time, it is not a matter of saving money, but trying to pursue the best effect is the king, otherwise there is no point in saving money, it is better not to spend money, PEC-CT can evaluate the metastasis and systemic condition of the tumor.

Judging from the PEC-CT scan, it is still metastasizing to the abdomen and not to the brain, lungs and other organs, indicating that if the surgery can be achieved to a certain level, there is still hope.

There are only a few ways to metastasize tumors - direct invasion, hematogenous metastasis, lymphatic metastasis, implantation metastasis, tumor cells are like seeds, where they spread, they take root and sprout, and soon a bunch of tumor cells will be formed.

It is difficult to eradicate the root of the weed, this is the big trouble of malignant tumors, and if anyone can remove the roots, it is to find a cure for the tumor.

Although Yang Ping can't eradicate the roots, he tries to cut the grass as much as possible.

In order to achieve the identification of tumor tissue during surgery, Yang Ping is ready to use indole green for fluorescent staining, after this special staining of tumor tissue is not special to the naked eye, but under the special laparoscope or glasses, the tumor tissue can emit green fluorescence, which is clearly different from normal tissue.

Methods are very important, good methods make the job easier and easier, relying on the power mode to achieve the goal is sometimes a helpless choice.

Indocyanine green needs to be injected into the blood vessels before surgery, and Nie Shun'e's liver function is acceptable, so indocyanine green is generally injected 3 days before surgery, indocyanine green circulates in the blood, and finally binds to tumor cells, while normal cells do not bind to it.

While thinking, Yang Ping used hand drawings to improve his surgical plan, and strive to make every detail possible to simulate in his mind.

In the doctor's office, Song Zimo was collecting everyone's surgical plans, and after collecting them, including his own, they were put on the desk together, waiting for Yang Ping's examination.

Yang Ping came out of the director's office and came to the doctor's office, where everyone sat in the doctor's office and waited.

Song Zimo pulled a chair and Yang Ping sat down.

The table was full of surgical plans, and Yang Ping looked at them one by one, and the design of the surgical plan could best exercise a person's ability.

Well, Yang Ping looked through it slowly, Song Zimo was as good as ever, he always did things perfectly, this person was born a perfectionist, there was no way.

Xu Zhiliang was born a top student and wanted to study everything thoroughly, so the surgical plan of these two people was the most satisfactory to Yang Ping.

Xia Shu is a newcomer, a doctor of cardiac surgery, and his skills in hepatobiliary and pancreatic surgery are still much weaker, but the weakness is only relative to Song Zimo and Xu Zhiliang, these two have been by Professor Yang's side for a long time, and even the teaching materials are internal special, which is beyond anyone's ability, and just one anatomical knowledge can dominate the world.

Li Guodong is good, he is very smart, and he is also motivated, and he has begun to show his strength as a scholar, although he is not experienced enough, but the surgical plan is decent.

Zhang Lin Xiaowu has also worked very hard and can write a very detailed plan, which is worthy of recognition, it seems that Mr. Zhang and Mr. Wu's ideal is not only to be a hook man.

Dr. Li Min is a college student, and his low education is not necessarily low ability, but low education means that there is a certain gap in the education he receives, and he needs to continue to catch up, so his plan, even if it is much worse than Zhang Lin Xiaowu, but Yang Ping doesn't care about this, he is a special case, and Yang Ping has another training plan.

Regardless of whether Li Min is a piece of jade or a stone, Yang Ping can carve him into a work of art, which is definitely possible.

After Yang Ping finished reading these surgical plans, everyone was sitting on their knots, waiting for his corrections and comments. Song Zimo was the most confident, and he felt that the professor should praise him. However, Xu Zhiliang did not fall behind, feeling that in addition to his eloquence, he was no worse than Song Zimo, and Dr. Li Min was a little unconfident and uneasy.

But Yang Ping didn't make any judgments on the spot, but dropped a sentence: "Put these here for me, and after this operation is done, everyone will write a new copy and hand it to me." ”

That's it? Some people are disappointed, some people feel that they have escaped.

Song Zimo originally thought that he could be praised by the professor, but Xu Zhiliang wanted to verify whether he was tied with Song Zimo, because he was unwilling to lose to Song Zimo many times.

But the professor's words made all the thoughts of the two come to naught, okay, after the operation, they will be divided into high and low.

Zhang Lin Xiaowu escaped, otherwise their surgical plan would definitely be criticized, and it was actually very uncomfortable to always hang on the tail of the train, but they had long been used to it and accepted the status quo.

Rather for the phoenix tail, not for the head of the chicken, do not compare horizontally, but to compare vertically, today's self is better than yesterday's self, this is the philosophy of life of the two brothers.

The surgery still has to wait for a few days, in addition to the need to inject indocyanine green a few days in advance, it is also necessary to approve the surgery in advance.

For such a major operation, it is necessary to remove organs, and it is certain that a kidney will be removed, and other organs such as the pancreas are not certain, and maybe they may be removed during the operation, so this major, potentially disabling, and destructive operation needs to be signed and filed with the medical department of the hospital.

At this time, Director Zhao of the Medical Department and Director Zhou of the Science and Education Department were discussing important matters together, Li Guodong found Director Zhao with the application form, and Director Zhao saw that it was Yang Ping's list, and immediately signed it after a little look.

Since Professor Yang's debut, it seems that he has not been able to perform surgery, which is not Director Zhao's personal acquaintance, but the consensus of Sanbo Hospital.

"Is Professor Yang in the office now?" Director Zhao asked by the way.

Li Guodong nodded: "It's still there just now." ”

Sometimes the doctor can't really say where he is, sometimes he goes to the outpatient clinic, sometimes he goes to the emergency room, sometimes he goes to the operating room, and the surgeon has a hard time finding someone anyway.

Director Zhao picked up the phone, dialed Yang Ping's mobile phone directly, confirmed that he was still in the office, and he pulled Director Zhao to discuss things with Yang Ping.

During this time, both the medical department and the science and education department were very busy, and Director Zhou of the science and education department is really sad now, since Yang Ping's 13 papers broke out, the application for further study on the table of the science and education department is piled up.

These applications are available in hospitals all over the country and abroad, and in addition to doctors applying for further training, there are also researchers from several of the world's top medical laboratories applying for academic exchanges.

The Institute of Surgery is such a big place, how can it accommodate so many people, what to do, Director Zhou panicked, so he had to come to his brother Director Zhao for help.

Director Zhou is a little hypochondriasis, and when he sees foreigners studying abroad, he always wants to get some special treatment, but after being severely criticized by Dean Xia and Director Han, the hypochondria did not attack for a while, but it is difficult to cure the hypochondriasis.

This time, he was more cautious, afraid that he would invisibly have symptoms of hypochondriasis, so he came to Director Zhao to help him come up with ideas, Director Zhao said: The tide is rising, and with the increasing number of trainees, the original training system of the Institute of Surgery is no longer suitable.

The two directors came to the Institute of Surgery together, and Director Zhou told Yang Ping about the matter, but Yang Ping actually didn't have any good ways to deal with it.

The general principle is to choose the best, since the best are selected, there must be elimination, so in what way, Yang Ping remembered, the college entrance examination is actually quite fair, although there are a lot of criticisms of the college entrance examination, but it is definitely the fairest selection, as long as no one can bypass the college entrance examination, then it is very difficult to make small moves.

Yang Ping said: "Let's take the exam, let's get the test papers here, buy me a safe, the test papers are sealed and locked in my safe before the exam, and when the exam starts, I will send the test papers, refer to the college entrance examination, and strictly enforce the examination system." ”

"Do you want an interview?" Director Zhou asked.

Director Zhao waved his hand: "There should have been an interview, but what?" Interviews are easy to taste like - forget it, if you really want to be strict, you only need a written test. ”

"That's it, our comprehensive research institute will ask questions, the science and education department will organize the exam, the medical department will be responsible for invigilating the exam, and the camera will monitor the whole process without dead angles during the exam, and the three of us will send people to stare at the camera, and face the live broadcast of the whole hospital, and the exam video will be permanently archived." Yang Ping felt that this matter was very simple.

The three of them agreed with this method, and Director Zhou of the Science and Education Department suddenly straightened his chest, remembering that the examination he organized made those foreigners come to participate in it, and he raised his eyebrows in his heart.

It turned out that it felt so good to straighten the waist, but the invigilator was handed over to Lao Zhao, and the invigilator felt better.

"Can we exchange it, no, you organize the exam, and we proctored it?" Director Zhou wants to exchange jobs with Director Zhao.

Director Zhao glared at him: "The management of further education is the business of your science and education department, we are just assisting, so it is decided, you organize the exam, and we are responsible for invigilating." ”

How can such a good errand be handed over to you, think about that scene, at home and abroad, doctors from various top hospitals bowed their heads and answered the questions hard, and walked through the examination room with their heads up, what kind of aura is that, what is the taste of that, let your old Zhou come to nod and hunch, can I have the momentum of my old Zhao?

Today, Yang Ping was very busy, sending Director Zhao and Director Zhou away, and Dean Xia called again, saying that Bao Yulou's son had ruptured multiple ligaments in his knee joint, and Yang Ping had been ignoring him because of the conflict with Yang Ping.

Later, Bao Yulou took his wife and son to write an apology letter to the hospital, and took the initiative to publish the apology letter on the hospital's official website.

Dean Xia was immediately unhappy: "Do you mean that Professor Yang is embarrassing you?" ”

Bao Yulou immediately felt that he had said the wrong thing: "Misunderstanding, misunderstanding - I mean, we know that the operation is very difficult and risky, and we ask Professor Yang to help us try it, and we are willing to take the risk." ”

"Alright then, I'll just ask Professor Yang."

Dean Xia then turned around and called Yang Ping.

"Professor Yang, if you say yes, I will convince them, and if you say no, I will directly refuse them." Dean Xia was simply sharp.

"Let them come."

It's not a deep hatred, since he sincerely repents, Yang Ping is willing to give him a chance.

To tell the truth, this kind of knee injury wants to recover athletic ability, if you still want to play football, only Yang Ping in the world can do it before, and now Su Nanchen, Gao Yuan, and Robert can also operate on it, but in the end, Yang Ping is the original and a mentor, Bao Yulou doesn't want his son to be disabled in the future, so he tried his best to ask Yang Ping to help.

Dean Xia saw that Yang Ping had agreed, so he replied to Bao Yulou: "Since you are so positive, we Professor Yang will try our best." ”

A person like Dean Xia, in the position of the dean, it is definitely not possible to be everything, he must be round on the outside and square on the inside, and be comfortable in various relationships, otherwise this dean will not be able to be the dean.

So many leaders called to intercede before, but Dean Xia just said: "Hey! Our small hospital, the level is not good, the doctor is timid, and he can't do such a complicated operation, so let's let him go to the imperial capital magic capital! ”

Even if you know that this is a reason, but the other party can't help it, medical things, especially surgery, people themselves say that they can't do it, you have to ask someone to come to power, who dares to be responsible.

Now that Yang Ping is relieved, Dean Xia can say: "Although the operation is very difficult and the risk is very high, since you are so active, we doctors can only try our best." ”

Dean Xia was originally very tough, who was afraid of receiving the award in the Great Hall of the People, since he had Yang Ping, he was even more tough, and sometimes he was so hard that he even felt that he was the best dean in the country.