Famous Among Top Surgeons in the 90s

Do not assume that the professor's question implies that the hope to solve the problem lies in digestive endoscopy.

Doctors are generally very confident in their specialties because they have studied them the most.

In fact, many patients with anastomotic leaks in clinical practice seek help from internal medicine doctors themselves. Generally, surgeons are not interested in internal medicine solutions. Someone like Shao Jialiang must have been forced into a corner to resort to such measures.

Surgeons have many complaints about the method of blocking leaks with digestive endoscopy. For example, Professor Han Yongnian is now pointing out various flaws in endoscopic surgery: "How would you do it? Use biological protein glue to block it? The success rate isn't very high. Incomplete closures often occur. Use a titanium clip to clamp it shut? Internal medicine seems to have tried it once, didn't succeed? Implant a stent with an esophageal liner? This method isn't great, as leaks can continue to occur afterwards."

Endoscopic operation methods are quite limited; doctors operating almost feel like their hands are tied, which is frustrating to watch. The localized field of vision and narrow operating space make it extremely difficult for the operating doctor to use a needle to sew, so many auxiliary instruments have emerged. This includes the aforementioned titanium clip.

A titanium clip is a medical device composed of a titanium alloy or pure titanium clip and a clip tail. Because its metal part is titanium, it is collectively referred to as a titanium clip. There are actually various types of titanium clips, with each medical device company naming their titanium clip products differently, such as Clip, Hemostasis Clip, or Harmony Clip and so on. These product names and their respective uses are something a surgeon must understand. Doctors not only have to study human anatomy but must also be very familiar with medical instruments as they are tools that need to be used.

While the professor was discussing these points, Xie Wanying followed Senior Brother Yu for on-site learning. Having never been to a digestive endoscopy room or seen or experienced these endoscopic tools, they were foreign to her. Yu Xuexian seized the opportunity to give her a lecture on existing equipment at the hospital. Because if she is asked for her opinion later and doesn't know how digestive endoscopy operates or what instruments are available, it would be embarrassing for her.

Titanium clips, simply put, are clamps. The function of the clip head is to clamp onto "things," tissues, wound surfaces, and so on, while the clip tail provides a lever arm space during the clamping process, meaning the titanium clip has to be used in conjunction with a titanium clip applicator. A titanium clip applicator is like a garbage grabber; when opened and closed, the clip head can clamp onto "things." The difference is, the titanium clip can release the entire clip to remain inside the body to play a role in tissue suturing and fixation. If the clip tail is not long enough, the doctor cannot apply enough force to clamp it shut. If it's too hard to understand, try using a clip at home to clamp onto something; isn't it easier to pinch it closed if the clip tail is longer? If it's too short, you can't grip it steadily and apply force.

Thus, after endoscopic surgery, patients left with titanium clips can be seen with varying lengths of clip tails left within their lumens.

"Laparoscopic surgeries in surgery use titanium clips," Xie Wanying mentioned her experience seen during her surgery rotation.

"Didn't it look like there was no tail left?" Yu Xuexian asked her.

Don't assume that internal medicine doctors are clueless about everything. In reality, internal medicine often handles surgical follow-up tasks; internal medicine experts are well-versed in surgical tools. They just don't perform surgical tasks daily like surgeons, so they can't perform surgical maneuvers like a surgeon could. Skills can only be honed through practice.

"Yes."

This shows that there are many similarities and differences between surgery and internal medicine procedures. It requires hands-on practice to truly know where these differences lie and how significant they are.