Since 1981 Health School

"ESD technique?"

Facing the Japanese doctor, you look at me, I look at you, there is a moment of blankness in the eyes, obviously no one has heard of this term.

As soon as Lan Lijuan heard it, she thought it was true. Now that it's time for Chen Qi to pretend to be slapped in the face, she knows that he won't 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 lightly, 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."

After Chen Qi finished speaking, he stood up, 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 suck 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 that you can’t think of even if you don’t talk about it, but it’s the same thing if you talk about it, it depends on whether you have thought of it or not.

At least so far, the EMR technique originally created by the University of Tokyo has been 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 and so on.

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 removed is still limited, and it is also difficult for the negative pressure to suck the lesion into the transparent cap to completely pick it up, which will also cause the risk of incomplete resection and local recurrence.

Therefore, 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 feeling, and at the same time, they are very curious about what amazing words this Dr. Chen from Huaguo has, or is it purely scaring people?

At this time, Chen Qi pointed to the anatomical structure diagram of the stomach and said.

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

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

Chen Qi smiled lightly, his crooked mouth was also a bit 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.

Therefore, 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 to himself that I only knew that in 1989 even Japan could only achieve 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 hadn't been invented by them, he cut off the beard decisively. 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 argument became more and more fierce. Obviously, some people were very unconvinced:

"No, I think this so-called ESD technique is a complete copy of our EMR technique."

"I feel the same way, 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 surgery? What if someone is bragging? After all, no one has seen this kind of surgery."

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

The director of the department, Sakuta Tsukasa, also felt that the two operations were very similar, so he decided to ask.

He stood up and bowed 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 are still not giving up.

Such a thought flashed in Chen Qi's 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 surgery is the ancestor of endoscopy and 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 was 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 very 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's the reason for your annoyance? That's the fact. We in Huaguo not only invented the ESD technique, but also invented the POEM technique. I'm not bragging, but there are witnesses.

WGO, Professor Grace, president of the World Society of Gastroenterology, and Professor 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 there were people who were dissatisfied before, now that Chen Qi brought out the Japanese father from the United States, the Japanese doctors looked at each other in dismay.

Americans certified?

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

Nimura Kaidou, as the equipment dealer, has a lot of information, and 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 not convinced, Ercun Haidou pretended to suggest kindly:

"Dr. Chen, there is an old saying in Huaguo, that is, seeing is believing and hearing is false. I wonder if you can do a few professor surgeries and demonstrate them to everyone. What is ESD surgery and what is POEM surgery?"

This is the purpose of Nimura Kaito.

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.

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

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

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

Chen Qi only uses Nipro's products for every operation, whether it is 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.

However, 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 make a move.

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

Now there is a small conflict between Chen Qi and the doctors of the University of Tokyo Medical Center, which falls right into Nimura Kaito's arms.

In this way, when Chen Qi performed the operation in front of the doctor in Tokyo, he would no longer be polite. He would definitely stare at him and would not put any water on him. 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 build an endoscopic treatment center in Huaguo, or even in the world, not just one operating room is enough, nor can one set of two endoscopic instruments be enough, which requires a large investment.

Humans and machines are indispensable.

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

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

They wanted him to advertise, he wanted their sponsorship, everyone had their own ghosts, and they hit it off.

"I think Mr. Nimura's suggestion 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, half angry and half unconvinced, so they all sneered.

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

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

"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. 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 plan 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 surgery model? I think gastroenterologists all over Japan will be very interested in gastroenteroscopy surgery."

The businessman definitely hopes 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 play 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 he would lose face for the country if he lost.

Professor Grace, the president of the WGO Society in the United States, personally traveled to Japan to add some authority and tension to this teaching operation.