Since 1981 Health School Chapter 566

   "ESD technique?"

   The Japanese doctor who was facing me looked at me and I looked at you, with blank eyes. Obviously, everyone has never heard of this term.

  Lan Lijuan thought it was true when she heard it, and now that it was time for Chen Qi to pretend to be slapped in the face, she knew that he was not willing to suffer a little bit.

  The students in the master's class of endoscopy also became energetic all of a sudden, and wanted to hear how their tutors PK foreign doctors to win glory for the country.

   Sakuta asked a little strangely: "Excuse me, Dr. Chen, what is ESD?"

  Chen Qi smiled slightly, and said to the Japanese doctor who was giving a report:

   "Please adjust the previous slide to page 19, yes, this is it, thank you."

   Chen Qi stood up after speaking, walked to the front of the screen, and explained to the slide picture:

   "The EMR technique you invented is actually an improvement on the basis of gastroscopic biopsy technology, right?"

"right!"

"Your introduction of this EMR operation, the specific method is to inject normal saline into the mucosal layer, and then let polyps, early cancers protrude, and then ligate the surgical thread, or **** up the diseased tissue with negative pressure suction, and finally use electricity The knife removes the lesion, right?"

  The Japanese doctors nodded repeatedly.

  There are some principles, you can't think of them even if you don't talk about them.

  At least so far, the original EMR surgery by the University of Tokyo is very successful, has been recognized by the international mainstream medical community, and is widely used in the treatment of superficial gastrointestinal lesions.

   Such as gastrointestinal polyps, submucosal tumors, precancerous lesions, etc.

  Facing the picture on the slide, Chen Qi continued:

   "With all due respect, this operation has a very big disadvantage, that is, some flat lesions are difficult to ligate completely. Like this, after saline injection, the lesion still does not bulge, and you can't do it. How do you cut it?

  If the suction method is used, due to the limitation of the size of the transparent cap, the size of the lesion that can be resected is still limited, and it is also difficult for negative pressure to **** the lesion into the transparent cap to completely pick it up, which will also cause the risk of incomplete resection and local recurrence.

  So EMR is only applied to some early-stage cancers, which must be limited to the mucosa, have no metastasis, and are within 2cm in size, and can be resected en bloc, right? "

  Chen Qi asked such a few rhetorical questions, and the Japanese doctor immediately understood them.

  The Hua Guo doctor in front of me is not ignorant of endoscopy, on the contrary, he is very proficient, so everyone began to look serious.

  The Japanese doctors here have a bad premonition, and at the same time they are very curious about what amazing words this Dr. Chen from China has, or is it purely scaring people?

  Chen Qi said while pointing at the anatomical structure diagram of the stomach.

   "The full name of the ESD surgery I am talking about is endoscopic submucosal dissection, which translates to endoscopic submucosal dissection."

   At this time, a Japanese doctor asked in a low voice: "Resection? Stripping? Is there any difference between the two?"

  Chen Qi smiled lightly, his crooked mouth was similarly impolite.

"The difference between the two is quite big. EMR can be simply understood as excision of the mucosal layer, while ESD is repeated submucosal injection of adrenaline saline, separation, and the mucosal layer, submucosa and lower mucosa of the lesion. The muscular layer is completely separated.

  So ESD has a larger resection range than EMR, and the resection depth is deeper. The range can exceed two centimeters, and the depth can reach the submucosa. Thus, the lesion can be completely and completely resected. "

   With a bang, the Japanese doctors on the opposite side started talking.

  All the gastroenterologists present were able to perform EMR, so when Chen Qi mentioned the ESD operation, they immediately thought of the tricks and principles involved.

  Zhang Weizhong also whispered to him:

   "Dean Chen, why haven't I heard you mention this ESD technique?"

  Chen Qi thought that it was only I who knew that in 1989 even Japan had only achieved EMR surgery, so he had an idea to show off this new technique that was originally invented in 1995.

  In the original history, ESD was invented by Professor Fujita, a Japanese doctor at the University of Tokyo Medical Center.

  When Chen Qi realized that ESD had not been invented by them, he decisively cut off the beard. This can not only slap them in the face, but also become an original artist. How cool.

  The Japanese doctor on the opposite side discussed for a long time, and the debate became more and more fierce. Obviously, some people were very unconvinced:

   "No, I think this so-called ESD technique is completely plagiarized from our EMR technique."

   "I think so too, you see, the basic principle is the same, you need to inject saline and adrenal saline to separate the mucosa."

   "Director Saku, we can't give up Japan's precious endoscopy results."

   "First ask, what exactly is this ESD operation? What if someone is bragging? After all, no one has seen this kind of operation before."

  Japanese doctors are talking all over the place, and everyone agrees that their own intellectual property rights cannot be stolen by foreigners.

Director of the   Department, Sakuta Tsukasa also felt that the two operations were very similar, so he decided to ask for clarification.

  I saw him standing up and bowing slightly to Chen Qi:

"Chen Sang, my colleagues and I are very interested in the ESD technique you mentioned. Now I have two questions. One is whether the ESD technique you mentioned is improved from our EMR technique? The second is So, how many successful cases of the ESD procedure you mentioned?"

  The Japanese still don't give up.

  Chen Qi had such a thought in his mind.

   It is undeniable that the ESD technique is indeed an improvement on the EMR technique, and even the tunnel punching POEM technique that Chen Qi made before is also developed on the basis of ESD.

   But can Chen Qi say that?

   It is said that your EMR operation is the ancestor of endoscopy, and is the basis for the subsequent operations?

  If he said that, the little devil would definitely hold on to it, and then the whole world would yell that Chen Qi is a plagiarist, not an original creator.

  So you can't admit it even if you kill it, sophistry to the end.

"I can answer these two questions. First, to be honest, before I came to the University of Tokyo Medical Center, I didn't know that you had developed EMR surgery. This is the first time I heard of it today. I can assure you of this. .

As for the similarities between EMR and ESD, I can only say that it is a coincidence, but I also want to say that ESD is more widely used clinically, with better curative effect and cleaner resection , so it is a more advanced technique than EMR. "

"idiot!"

   Someone on the other side cursed softly, but it was particularly obvious in the silent conference room.

  Chen Qi doesn't know much Japanese, but he still understands these two words. Not only Chen Qi understands it, but even the 19 Huaguo doctors and students around him understand it, so everyone's face suddenly becomes serious.

  Chen Qi chuckled lightly:

  "Why Baga? What is the reason for your annoyance? The fact is that our Huaguo side not only invented ESD technology, but also invented POEM technology. This is not me bragging, but there are witnesses.

  WGO, Prof. Grace, president of the World Society of Gastroenterology, and Prof. Bradrick of the Sid-Sinai Medical Center in the United States also fully affirmed the advancement of ESD. In January, they came to China to see me perform these surgeries. "

   If some people were dissatisfied before, now Chen Qi brought out the Japanese father from the United States, which made Japanese doctors look at each other in dismay.

  Have all Americans been certified?

  Why haven't they heard anything? Haven't seen related papers published?

  As the equipment dealer, Nimura Kaidou has a lot of information, so he immediately stood up:

   "Everyone, Professor Grace is indeed going to visit Huaguo in January, and as far as I know, Dr. Chen should have performed a remarkable operation and solved a difficult problem for a rich man in the United States."

  Seeing that the Japanese doctor was still a little unbelievable, Ercun Haidou pretended to suggest kindly:

   "Dr. Chen, there is an old saying in Huaguo that the eyes are the truth, and the ears are the illusion. I wonder if you can do a few professor's operations and demonstrate them to everyone. What is ESD surgery and what is POEM surgery?"

  This is Nimura Kaito's goal.

  As the largest medical device manufacturer in Japan, Nipro's products are not limited to traditional surgical instruments, they also involve the production of endoscopes.

  There are more than ten manufacturers of endoscopes in the world, such as Olympus, Karl Stroz, Fuji, Pentax, Stryker, etc., all of which are strong competitors.

  Nippro has a strong comprehensive strength, but it does not have much advantage in the field of endoscopy.

  So how to find spokespersons, especially the technical masters who can lead new surgical methods, let them use Nipro's endoscopic instrument to play an advertising role, this is a problem that the company's senior management attaches great importance to.

  For example, Chen Qi in front of me, he had a great influence in plastic surgery and hand surgery.

  Chen Qi only uses Nipro's products for every operation, whether it's a clinical operation or a teaching operation, which makes Nipro's brand trusted by other plastic surgeons and hand surgeons, and the sales volume is steadily increasing.

  Now I heard that Chen Qi is going to practice endoscopic surgery, and Nipro also wants to promote its own endoscope, so Chen Qi is one of the best spokespersons they think.

   But Chen Qi has never done a public teaching operation in the world. No one has seen the level of endoscopic surgery except those American doctors.

what to do?

  The best way is to invite Chen Qi to visit and travel in Japan, and then find a way to get him to take action.

   In front of many colleagues, how is his endoscopic surgery level?

   Now Chen Qi had a small conflict with the doctors of the University of Tokyo Medical Center, which fell into Nimura Kaito's hands.

   In this way, Chen Qi is performing surgery in front of the doctor in Tokyo. He will not be polite anymore. He must be staring at him and will not put a little water. Let Japan's top gastroenterologist test Chen Qi's true level.

  When Chen Qi heard Nimura Kaidou's surgery suggestion, he didn't feel disgusted.

  He wants to establish an endoscopic treatment center in Huaguo, or even in the world. One operating room is not enough, and the required endoscopic instruments cannot be dispatched with one set or two, which requires a large investment.

  Man and machine are indispensable.

  Especially now he has to take care of 15 students, but now there is only one endoscopic operating room with only one set of advanced equipment. There are too many monks and too few porridge, which is obviously not enough.

  The hospital has no money, what should I do? Of course, it was sponsorship, and Nipro was his favorite.

  People want him to advertise, he wants sponsorship, everyone has their own ghosts, and they hit it off.

   "I think Mr. Nimura's proposal is very good. If necessary, I can do teaching surgery at any time, and I welcome my colleagues in Japan to give advice."

  The Japanese doctors became even more excited when they heard it. They were half angry and half unconvinced, so they all sneered.

  Seeing Chen Qi agreeing to make a move, Kaito Furumura felt a sense of joy in his heart, so he looked at Professor Sakuta Tsukasa, and wanted to ask him if he would agree?

  Professor Sakuta Tsukasa is noncommittal, he is not a young man who is easily impulsive, and what the sponsor's father means is what he means.

   "Then Chen Sang, what kind of patients do you need? We will fully cooperate."

  Not everyone is suitable for endoscopic surgery, Chen Qi must choose the patients himself, and Professor Sakuta Tsukasa will not set up troubles to deliberately embarrass Chen Qi.

  Chen Qi thought about it for a while. Due to the limitation of endoscopic tools, there are not many types of operations he can perform at present, so let's focus on what he is good at:

   "In this way, I am going to do a fundoplication, a POEM, and an ESD. In addition, if possible, early cancer is also possible, such as esophageal cancer and gastric cancer."

  Nimura Kaito suddenly interjected:

   "Dr. Chen, can we adopt an open teaching operation mode? I think gastroenterologists all over Japan will be very interested in gastroenteroscopy."

  Businessmen definitely hope that as many doctors as possible will watch this operation, and seize all opportunities for hype, so that the brand of Nipro can be valued by more doctors.

  Chen Qi is afraid of a bird, just a few small endoscopic operations, take it!

   "Okay, you can do whatever you want, I will follow the arrangement of Mr. Nimura and Professor Saku."

  Because it takes time to find suitable patients, but it is impossible for Chen Qi to stay in Japan for a long time, so the 4 public teaching surgeries were scheduled for 3 days later.

   And the name and degree of difficulty of the operation were announced at the same time.

  The news that Dr. Hua Guo at the University of Tokyo Medical Center was preparing to perform endoscopic teaching surgery spread quickly, causing quite a stir in the entire field of gastroenterology in Japan.

   Can't help being a sensation, there are two hype points in it.

  A doctor from a poor and backward country actually went to the most developed country in the world to teach the top doctors to do teaching surgery?

  Second, endoscopic surgery can perform so many tricks? Do you Hua people understand the new technique that the Japanese have not yet developed?

   Still the same example, when elementary school students teach calculus to college students, the sensational effect is not difficult to imagine.

  Under the sponsorship of Nipro, the University of Tokyo Medical Center and the Japanese Society of Gastroenterology jointly organized 300 gastroenterologists from major hospitals to Tokyo to observe the operation.

  The news that Chen Qi was doing something in Japan was also spread all over the world.

  The domestic medical community was quite worried. A Chinese doctor went to Japan to play a game. It was fine if he won, but it would embarrass the country if he lost.

  Professor Grace, the president of the WGO Society, who is far away in the United States, personally traveled to Japan, adding some authority and tension to this teaching operation.

Chapter end