Chapter 1087: Chapter 885: Between Two Points, The Line Segnt is the Shortest._3 Chapter 1087: Chapter 885: Between Two Points, The Line Segnt is the Shortest._3 “Professor Yang, could you please take another look for us and see if the cyst on the liver needs surgical treatnt?” Nong Zhiwen seized the opportunity to ask all his questions.
Liver cyst?
Yang Ping had just reviewed the dical records, and indeed, there was a cyst on the liver, but such cysts generally don’t pose a major issue, so he hadn’t focused on it.
“Did you bring the imaging films?” Yang Ping asked.
“Yes, I brought them all!”
Nong Zhiwen imdiately took out a large, thick bag; inside were many films, all the imaging studies his father had undergone over the past few years.
Nong Zhiwen didn’t understand all these films; he simply put them all together, and each ti they visited a doctor, he would bring them along for the doctor to review.
“No problem, I’ll take a look through them slowly.”
Yang Ping asked Nong Zhiwen to place the films near the light box. Then, he went through all the images one by one on the light box, sorting them according to the type and date of examination. So of the films had dissolved and beco blurry due to age.
It took Yang Ping about fifteen minutes to organize these films. After he had sorted them out, he started to review them in chronological order.
The liver had not only been examined with surface ultrasound but also with CT and enhanced CT, and there were also whole-body PET-CT images of this area.
Starting with the first image that showed the liver, there was a mass, which at the ti was noted as a space-occupying lesion, considered to be a cyst undergoing organization. A series of subsequent images of the liver showed that the mass remained unchanged.
Although he couldn’t be 100% certain, the imaging basically confird that it was a cyst, and an organized one at that, which did not require surgical treatnt. It only needed a follow-up surface ultrasound every six months to a year.
Yang Ping conveyed his opinion to Nong Zhiwen.
“No need for surgery? But what if it turns out to be a malignant tumor?” Nong Zhiwen was very frank.
Yang Ping communicated with patients in a straightforward manner too, as this could save unnecessary ti.
“The likelihood that it’s a malignant tumor is extrely slim, virtually zero!”
Yang Ping’s answer was very confident.
“I understand what you’re saying, Professor Yang; if we wanted to be proactive, would surgery be necessary?”
Nong Zhiwen wanted to understand further.
Yang Ping’s opinion was very clear, “This liver cyst has no indications for surgery. Surgery is a tool for us doctors to treat diseases; it is a double-edged sword, and we cannot use it indiscriminately. So diseases must be operated on, so may or may not require surgery, and so do not need surgery at all. From a dical standpoint, your father’s liver cyst doesn’t require surgical intervention.”
This statent vastly contradicted Director Qian’s advice; not only did Director Qian recomnd surgery, but he also suggested robot-assisted surgery, which he said could more accurately and completely remove the tumor, resulting in the best postoperative outco and peace of mind. Conventional surgery could not remove the tumor as precisely and completely, potentially leaving remnants of the mass behind. As he put it, if it was sothing bad, any remnants would cause significant trouble; not eradicating the problem thoroughly could lead it to return with the spring breeze.
Both sides made sense; what should he do? Nong Zhiwen was very confused now.
The opinion from Sanbo Hospital was very clear without any ambiguity. Nong Zhiwen felt intuitively that Professor Yang was very confident, different from the average doctor.
The opinion from Director Qian also seed logical. What if it really was sothing bad? What then? If the illness was delayed over this hundred thousand yuan, it would be too late for regrets. As Director Qian said, his father was only in his fifties.
Every patient has an instinctual desire to live, accompanied by fear, longing, and fantasy, and all sorts of swindlers thrive by preying on these patient psychologies.
“Why don’t you think it over and avoid further hassle? You can inquire around about our hospital and Professor Yang’s reputation,” Director Fang advised Nong Zhiwen.
Nong Zhiwen also left Sanbo Hospital with a big bag of docunts, full of doubts in his mind. His trip was very worthwhile, as it allowed him to hear different opinions.
After Nong Zhiwen left, Director Fang turned to Yang Ping for advice, “Is there any good thod for this surgery?”
In Director Fang’s mind, Yang Ping could do anything.
Yang Ping had been thinking about this issue just now. How could he solve the problem of recurrent laryngeal nerve repair? His recent contemplation had yielded so clues:
“We can directly dissect the distal end of the recurrent laryngeal nerve from below the brachiocephalic trunk and trace it back to the vagus nerve, then anastomose it with the nerve at the larynx behind the carotid artery.”
After hearing this, Director Fang was a bit confused; he didn’t quite understand what he had heard.
While drawing, Yang Ping explained to him, “Actually, the principle is very simple. It’s about bypassing, to solve the issue of distance. The start of the nerve is A, point B is where the nerve crosses below the subclavian artery, and the endpoint of the nerve is C. Normally, the path starts at A, goes around to point B at the subclavian artery, and finally to point C at the throat. The segnt between A, B, and C often needs segntal resection due to tumor invasion, which results in a defect. If the defect is too long, traditional thods involve using another nerve for bridging or nerve transposition, like bridging wires, or drawing an additional wire from another room.”
“Such thods are not feasible for this patient; the distance for bridging is too far. If we were to draw a wire from another room, the wires in other rooms are also scarce, and it’s challenging to find a suitable one right now.”
“What should we do?”
“We will directly reroute the existing wire without going around point B and instead connect it directly to point C, to complete the connection between points A and C. I have asured the distance, and based on the growth and recovery rate of nerves, the patient should see significant recovery in about six months if we use this thod.”
As Yang Ping spoke, he drew a diagram on the A4 paper, illustrating the anatomy of the neck.
To express anatomy and surgery, drawings are the best thod; verbal descriptions can seem pale and weak.
“Between two points, the straight line is the shortest!”
With the aid of Yang Ping’s drawing, Director Fang instantly understood the content of Yang Ping’s earlier explanation. When it had just been described verbally, Director Fang had been sowhat confused; now, he completely understood.
“Brilliant! To put it precisely, it’s the shortest distance between two points in the form of a line segnt!” Yang Ping complinted.
Holy shit, isn’t this a primary school math problem? And he’s praising for it. Does Professor Yang see as a primary school level?
However, applying this simple mathematical axiom here, it surprisingly beca effective, leading to the developnt of a new surgical technique to solve the problem.
“Do you know how to draw anatomy diagrams?” Yang Ping asked Director Fang, who was still looking at the drawing.
Director Fang shook his head.
“This won’t do; you must learn to draw.”
Drawing is a basic skill for doctors at the Surgical Research Institute, and Doctor Li Min, as a grassroots doctor, has already mastered dical illustration.
Director Fang’s face flushed with embarrassnt, “I can learn, I will learn right away, and I can pick it up quickly.”
“Hmm, you use three months to learn dical illustration, including system anatomy, local anatomy, cross-sectional anatomy, and surgical approach anatomy—the four main blocks. No problems with that, right?”
Yang Ping believed if Director Fang truly wanted to improve, he must systematically learn.
“I guarantee I will accomplish it!”
Director Fang was extrely excited in his heart. Was this a formal induction?
PS: Regarding the new technique for recurrent laryngeal nerve repair in this chapter: The technique is the masterpiece of Professor Ji Qinghai and Professor Wang Yulong from the Departnt of Head and Neck Surgery, Fudan University’s affiliated Cancer Hospital. The paper was published in “Head & Neck,” and the technique is at an international leading level, improving the global academic standing of head and neck surgery in China. Respect to the two professors!
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