Chapter 2059: Chapter 1781: This Is What True Mentorship Looks Like (Part 2)

Song Yun paused: "We plan to use Professor Yang’s osteotomy, combined with screw rotational correction."

Yang Ping shook his head: "Hmm."

In the third ward, there was a man in his forties.

This man was very strong, the muscles on his arms bulging through the hospital gown, but he lay in bed, afraid to move. When Song Yun was introduced, he stared at the ceiling, his eyes somewhat hollow.

"A huge osteosarcoma in the pelvic area, involving the right sacroiliac joint and part of the acetabulum. Neoadjuvant chemotherapy has been performed, the tumor has shrunk somewhat, but is still progressing. A pelvic rotational osteotomy in combination with tumor excision is being planned."

Yang Ping took the scans, his brows slightly furrowed.

Pelvic tumors are one of the recognized "forbidden zones" in orthopedics. The anatomic structure is complex, surrounded by major vascular structures, nerve plexus, and vital organs, with an extremely high risk of bleeding and many postoperative complications. Very few hospitals nationwide can perform complete excision.

Song Yun continued to report: "The Intervention Department has been requested to perform preoperative embolization, and the estimated intraoperative blood loss is 2000-3000 milliliters. Blood preparations are ready, and autologous blood transfusion is planned during the surgery."

Yang Ping said nothing, walked to the bedside, and began the physical examination. He asked the patient to try lifting his leg, the right leg could only lift a little, while the left leg could lift to 45 degrees. He pressed the patient’s lower right abdomen, causing the patient to gasp in pain.

After the examination, he returned to the scans and looked at them for a long time.

"This tumor involves the sacroiliac joint and part of the acetabulum. If done conventionally, a hemipelvectomy would make it difficult for the patient to walk afterward, and would result in significant functional loss." He pointed at the scans, and said to the young doctors behind him, "Look here, the demarcation between the tumor and normal bone. If we can cut here, rotate the entire right ilium down, cleanly remove the tumor, then rotate the healthy portion back and fuse it with the sacrum, the pelvic ring can be preserved and walking will be much better."

The young doctors stared at the scans, someone asked softly: "What about the acetabulum?"

Yang Ping said: "The part of the acetabulum invaded by the tumor is to be cut away, and the remaining portion can be reconstructed. It can be done with a 3D printed prosthesis, or with autologous bone transplant. The key is that the plane of rotational osteotomy must be precise, to cleanly cut while preserving blood supply."

He turned to Song Yun: "For this case, have you coordinated with the 3D printing center?"

Song Yun nodded: "Coordinated, the prosthesis is being designed."

Yang Ping said: "In the design, pay attention to several points: first, the osteotomy plane must maintain a sufficient safe distance from the tumor boundary; second, the rotated bone block must have sufficient blood supply and must not necrotize; third, the angle of the reconstructed acetabulum must be appropriate and not affect joint function."

He spoke slowly, each word seemingly etched into the young doctors’ minds.

The patient suddenly spoke, his voice hoarse: "Doctor, will I be able to walk?"

Yang Ping looked at him and said, "Yes, but this road is long, you need to be patient."

The patient looked at him, tears suddenly streaming down, but he did not cry out loud, only bit his lip and nodded.

...

Finished checking the ward, it was almost eleven o’clock.

The next are three surgeries.

The first is the pelvic tumor.

The atmosphere in the operating room was more tense than usual. The anesthesiologist repeatedly confirmed blood pressure, heart rate, and blood loss. The instrumental nurse neatly prepared hemostatic materials. Song Yun stood in the chief surgeon position, took a deep breath, and then began.

Incision, exposure, vascular separation, finding the tumor boundary... at each step, Yang Ping was watching from the side, occasionally saying a word or two: "Pull lighter." "Separate that vessel another two millimeters." "Osteotomy plane, shift outward one more degree."

Four hours later, the tumor was completely excised. The right ilium with part of the acetabulum was rotated down, and fixed in a new position. The 3D printed prosthesis perfectly filled the defect. Blood loss was controlled at 2200 milliliters, better than expected.

Yang Ping said: "Well done."

The second case was the upper cervical tumor.

Song Yun was the chief surgeon, Yang Ping was his first assistant, the surgery took a full five hours.

First exposing the bilateral vertebral arteries, freeing them from the normal area towards the tumor direction bit by bit. The tumor tightly encased the arteries like an octopus, and any carelessness could lead to massive bleeding. Song Yun’s hands were as steady as a machine, cutting millimeter by millimeter.

Then opening the vertebral canal, handling the tumor’s relationship with the dura mater. The tumor had pressed the dura mater inward, and careful dissection was required not to injure the medulla and cervical cord below.

Finally, the excision of the tumor body. The most difficult part was where the tumor adhered most tightly to the vertebral arteries. Song Yun used the microsurgical scissor to gradually cut through, each snip was like walking a tightrope.

During those five hours, hardly anyone spoke in the operating room. Only the ticking of the monitor and occasional commands: "Suction!" "Gauze!" "Pull a bit more!"

When the tumor was completely excised, everyone breathed a sigh of relief. Blood loss was 800 milliliters, both vertebral arteries were intact.

After the surgery, it was already past eight o’clock at night.

Yang Ping took off his gloves, washed his hands, Song Yun chased after him, said: "Professor, Director Liang is waiting for you in the office."

Yang Ping looked at his watch: "It’s so late..." 𝗳𝐫𝚎𝗲𝚠𝚎𝗯𝕟𝐨𝘃𝚎𝗹.𝗰𝗼𝗺

Song Yun said: "He said he must see you."

Yang Ping nodded, followed him to the old building.

Director Liang’s office was at the end of the old building, the door still hung with an enamel sign from the 1980s: "Director’s Office." Yang Ping knocked on the door, a hoarse voice came from inside: "Come in."

Pushed the door open, Director Liang coughed a few times, stood up: "Professor Yang is here, sit, sit, sit."

Yang Ping walked over and sat across from him: "Professor Liang! How are you feeling?"

"Not bad, not bad." Director Liang waved his hand, "Getting old, the components are not working, but the brain is still functional."

He looked at Yang Ping, suddenly smiled: "I heard that today’s cervical tumor, Song Yun was the chief surgeon?"

Yang Ping nodded.

Director Liang was silent for a while, then said: "What do you think of Song Yun?"

Yang Ping thought for a moment: "Progressed greatly."

"Compared to before?"

"The difference is like night and day."

Director Liang laughed, a bit comforted.

At nine o’clock at night, Yang Ping prepared to return to Nandu.

Song Yun accompanied him to the parking lot. The two walked in the corridor of the old building, their footsteps one behind the other. The old building’s lights were somewhat dim, the enamel signs on the walls reflecting an old light.

Almost to the entrance, Song Yun suddenly said: "Professor, I want to tell you something."

Yang Ping stopped and looked at him.

Song Yun lowered his head, said: "...Thank you."

Yang Ping said nothing.

Song Yun raised his head, his eyes a bit red: "When I lost to you for the Golden Knife Award back then, I was very unwilling. I felt I was not inferior to you, just unlucky. Later, Director Liang scolded me, and woke me up."

He paused, continued: "He asked me to learn from you, it was only after studying for some time that I understood what truly excellent surgeons are. When you operate, every cut is exactly where it should be, no more, no less, not skewed nor tilted. I vividly remember watching you perform the first upper cervical tumor surgery, standing by watching, sometimes hardly daring to breathe."

Yang Ping looked at him: "Aren’t you doing very well now?"

Song Yun thought for a moment, said: "If it weren’t for you guiding me hand by hand, I wouldn’t have progressed so quickly."

Yang Ping had walked to the car, his assistant opened the door. Before starting the engine, he rolled down the window, said to Song Yun: "See you next Wednesday."

Song Yun suddenly came to his senses, shouted: "See you next Wednesday!"

The car slowly drove out the hospital gate. Song Yun stood still, watched the car disappear into the night for a long time, without moving.

Security guard Old Zhang walked over and handed over a cigarette: "Director Song, Professor Yang left?"

Song Yun took the cigarette, nodded.

Old Zhang said: "Professor Yang is really nice."

Song Yun looked at the cigarette in his hand and suddenly smiled.

Yes, really nice.