For those who gossip, the biggest news at the People’s Hospital is that Jiang Aiguo was fired.

But for people who like to engage in clinical practice and technology, the biggest news from the People's Hospital should be that Director Chen will start giving public classes and performing public surgeries again.

Moreover, this open surgery became more high-end and classy because professors from Fudan Zhongshan Hospital came to visit.

Fudan Zhongshan, this is a well-known brand in China. It was originally an unattainable existence for local hospitals at the level of Vietnam-China People's Hospital.

As a result, I heard that my dean could perform endoscopic surgery, so I came all the way here. It was said to be a visit, but in fact it was just to learn, because even the professors at Fudan University did not know how to perform this kind of endoscopic surgery.

This has made all the employees of the People's Hospital have a loud voice when they speak in the past few days.

So when Chen Qi was preparing for a public operation after lunch, the doctors sitting in the auditorium on the second floor of the People's Hospital watching the operation were no longer limited to the main hospital of the People's Hospital.

President Li of Haidong Medical University personally led the team, and a large number of doctors from five affiliated hospitals, as well as professors and associate professors responsible for teaching in the university came.

Of course, big names like President Li, Dean Wang of the First Affiliated Hospital, and Master Tutor Xu Jinxing of Chen Qi all went into the operating room to watch the operation with their own eyes. Other professors and directors could only watch the live broadcast in the auditorium.<

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Today's surgery was performed by Chen Qi, and the assistants were naturally Professor Zhang Weizhong and Lan Lijuan.

Yi Zewen, Dean Chen's best friend, took the initiative to act as a photographer.

In the operating room, the minor patients were still undergoing general anesthesia, while in the operating room office, Chen Qi was writing and drawing on paper, explaining his surgical ideas to everyone.

It must be explained, and this explanation is also broadcast live, otherwise others will not understand endoscopic surgery at all.

Different from traditional surgery, the endoscopic surgery Chen Qi is going to perform involves inserting a gastroscope through the mouth.

Gastroscopy is still a new thing in China, and non-gastroenterologists have never been exposed to it.

Moreover, domestic textbooks are still lagging behind and do not cover it. Young people are fine, but older doctors cannot understand at all what the anatomical parts of the TV screen are.

What you see is a small passage similar to the inside of the intestines, with pink or bright red fleshy things next to it.

Moreover, Chen Qi is going to practice a "tunnel drilling technique" today. The clinical technique of poem was not a new thing in his previous life. Almost any endoscopist could do it, but it's 1988 now.<

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So don’t say that doctors from other departments can’t understand it. I’m afraid doctors from the Department of Gastroenterology can’t understand it either.

Professor Zhang Weizhong sat next to Chen Qi, watching him draw diagrams and asking questions like a primary school student.

"Dean Chen, you are saying that we have never heard of your achalasia. Can you help explain it?"

At this time, Chen Qi’s voice sounded from the speakers in the auditorium:

"Okay, before the surgery, let me first talk about what achalasia is. Remember to take notes.

We know that the place where the tube is connected to the stomach is called the ventricle. The ventricle is usually closed, but when it goes in, it will open, so that things can enter the stomach through the tube.

If the bicardia cannot open normally when swallowing, that is to say, it cannot relax, it will cause difficulty in swallowing and a feeling of choking. Food and saliva will remain in the tube for a long time, and it will easily overflow when bending over or lying down, causing a reaction.

In severe cases, it feels like eating grass and ruminating, but of course it is not real rumination.

Some diseases cause chest pain. Due to poor blood flow, many patients will experience weight loss and weight loss. This is what we clinically call achalasia.

Of course, this disease needs to be identified, because esophageal tumors and even gastroesophageal reflux disease have similar symptoms, which requires our clinicians to do more endoscopy, barium meals, and esophageal pressure measurements.

This disease has been discovered in many foreign countries, and there is no such concept in China, but everyone should remember that in the future, achalasia will also be seen in our domestic gastroenterology department, and it was our Vietnam-China People's Hospital that first proposed this concept.
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Then I will develop a new technology to treat this achalasia, and then we will form an expert consensus, and then upgrade this consensus to clinical guidelines, which are also formulated by our Vietnam-China People's Hospital."

In the auditorium, the doctors from the People's Hospital burst into laughter, followed by a burst of warm applause.

Principal Li smiled and cursed at Lao Guo beside him:

"This guy is a master at stirring up the emotions of the masses. No wonder he was in charge of mass and women's work in the Fourth Hospital."

All the big guys in the operating room also laughed softly.

Because Professor Zhang Weizhong is not familiar with several big bosses, he acts as a curious baby and does a job of admiration:

"Then Director Chen, how did the achalasia you mentioned occur? What are the new surgical ideas?"

While Chen Qi was explaining, he was writing and drawing on the white paper. Yi Zewen pushed the camera lens forward, and this simple diagram appeared on the TV screen:

"The cause of achalasia is not very clear yet, and foreign experts have not studied it. Doesn't this give us a chance? If anyone can study it and publish it in a top international journal, I will directly give you a promotion and salary increase."<

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There was another chuckle in the venue. This is Chen Qi's new rule after becoming the dean. When a paper is published, there will be different rewards according to the level of the magazine.

If it is a foreign journal, especially the four major journals, then a direct reward of 5,000 yuan will be given, and the professional title will be upgraded to one level. This is very tempting, but of course it is also very difficult.

Chen Qi’s explanation continues:

"But one thing is clear, that is, it is the proper muscle part of the cardiac epicardium that ultimately determines whether the cardiac epicardium is closed or open, which can be called the cardiac sphincter or the subtubular sphincter.

It is this part of the muscle that cannot relax due to various reasons, resulting in the continuous closure of the epicardium and the inability to respond to the temptation of various delicious foods, resulting in difficulty in swallowing.

Therefore, if we treat achalasia, we can cut off this part of the muscle, which is equivalent to opening a dam for the barrier, so that the food can enter the stomach from the tube, thereby alleviating the symptoms of dysphagia."

With this explanation, not only Professor Zhang Weizhong understood, but everyone in the auditorium also understood the principle of treatment.

"In the past, when the subtubular sphincter was cut, a thoracotomy was required to saw off the ribs. It was very scary, and then a mediastinal surgery was performed. The side effects were severe, but the surgical effect was not very good. So today I will let you see what it is.

The power of endoscopic surgery."

At this time, the anesthesiologist ran over:

"Director Chen, the patient has completed general anesthesia and can undergo surgery at any time."

Chen Qi stood up: "Let's go to the operating room. Professor Zhang and Director Lan will follow me for preoperative disinfection."

The operation began, and everyone held their breath, whether in the operating room or in the auditorium.

Especially those surgeons who are unconvinced. They all want to see how the endoscope that can eliminate them can show its power?

Previous fundoplication surgery was only successful occasionally, and many surgeons were holding their breath and refused to accept it.

During the operation, Chen Qi successfully put the gastroscope tube through the esophagus, all the way down to the junction of the cardia and the esophagus, which is where the obstruction occurs.

At this time, Chen Qi’s voice sounded again in the stereo:

"Have you seen it? This is where the obstruction occurs. The fundamental reason is that the peripheral esophageal sphincter remains tight, causing the lower end of the esophagus to be tightened and closed, and the upper end of the esophagus to become thicker. So how to relieve the lower esophageal sphincter

Where is the machine's lock?"

All the doctors' minds were spinning rapidly, including famous doctors such as Professor Zhang Weizhong, President Li, and President Wang, and they couldn't figure it out.

After all, the gastroscope is now inside the esophagus, and the sphincter is outside the esophagus, separated by a layer of esophageal wall. How does your gastroscope deal with the muscles?

Make a hole in the esophagus?

This is obviously an invasive surgery, and it is not at all like the safe, convenient, non-invasive and effective endoscopic surgery principles mentioned before.

Moreover, the consequences of esophageal perforation are also very serious. If the perforation site is close to a large blood vessel, such as the aorta, it is a very dangerous behavior.

If complications such as mediastinal infection, thoracic infection, aortic infection or even rupture occur, the patient may die.

If the harm far outweighs the benefits, then this endoscopic surgery is of little significance.

There were all professional doctors present, and everyone wanted to see how this amazing dean would handle this difficult problem.

Contrary to everyone's expectations, Chen Qi did not stay too much at the esophageal cardia. After showing everyone the area of ​​obstruction and taking a few photos, the gastroscope went backwards and slowly began to be removed.

This move raised question marks one after another over everyone's heads.

What's going on? No surgery? Then why did you, Chen Qi, brag so much before?

This is a live broadcast, with so many big shots watching, it would be a serious accident.

Just when everyone thought Chen Qi was about to admit defeat and stop continuing the operation, Chen Qi suddenly stopped the gastroscope about 10cm away from the cardia and stopped moving.

"Professor Zhang, give me the electric knife."

Zhang Weizhong came back to his senses: "Oh okay, electric knife, electric knife..."

Lan Lijuan quietly handed Professor Zhang a tube with an electric knife on the front end. There was no way, Professor Zhang had never done endoscopic surgery and was not familiar with the equipment.

Moreover, the gastroscope tubes of each manufacturer are different. They are mixed in a big box, and it is impossible for an unskilled person to find them at a glance.

I saw Chen Qi taking the electrosurgical tube and inserting it into the empty slot along the gastroscope. You can clearly see the electrosurgical exposure on the screen. Then Chen Qi slowly cut the esophageal mucosa and made a small opening.
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When, when, when~~~~

There are more and more question marks above everyone's head. I can't understand why Dr. Chen made a small incision in the esophageal mucosa without penetrating the esophageal wall. The problem is that the gastroscope still cannot extend out of the esophagus.

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Can you retrieve things from afar?

Chen Qi took care of himself and gave the order: "Give me an injection and prepare the physiological saline."

Zhang·Curious Baby·Weizhong couldn't help but ask: "Dean Chen, why did you make such an incision? And why do you need saline?"

This is also a problem common to all doctors.

Chen Qi continued to explain to everyone while operating. After all, this is a public teaching surgery class, and the main purpose is to make people understand.
To be continued...