Dr. Shenwai founded the tertiary hospital, which is the top three neurosurgery departments together with Tiantan Hospital and Xuanwu Hospital
Located near the scenic Xiangshan Park, Sanbo Brain Hospital of Capital Medical University is a well-known private hospital with outstanding advantages in the direction of neurosurgery. It is said that the origin of the name of the hospital is related to the fact that its founder was 3 medical doctors. One winter morning, the "medical community" came to the foot of Xiangshan Mountain and visited one of the three doctors, Professor Luan Guoming, the founder of Sanbo Brain Hospital, and asked him to tell his story.
Built a family in 10 years
hospital
When asked about the origin of the name of the hospital, Luan Guoming replied with a smile: "At first, we had the idea of starting a hospital, named 'Sanbo', which is indeed related to our 3 doctors. Professor Yu Chunjiang, Professor Shi Xiangen and I am the second batch of doctors of Academician Wang Zhongzhong, and the first batch of doctors to do neurosurgery. We enrolled in the same year in 1989 and graduated together three years later. In 1994, we first had the idea of co-founding a private neurology hospital. ”
In 1994, Luan Guoming also studied at the University of California, Los Angeles (UCLA) Medical Center, and he found that some of the best hospitals in the United States were private medical institutions, such as the Mayo Clinic and the Cleveland Clinic. He discussed with his friends whether he could also run such a modern neurosurgical hospital in China.
After 10 years of long planning and planning, Sanbo Brain Hospital was finally born in 2004, but at this time, "Sanbo" had a deeper meaning - Bo medicine, bo education, bo research, "this is also our academy motto, adhering to the concept of academician Wang Zhongzhong, that is, to do a good job in teaching and scientific research on the basis of being proficient in medical treatment." "In 2010, as a private hospital, Sanbo Brain Hospital was absorbed into the Capital Medical University system and became the eleventh clinical medical school of Capital Medical University and the third department of the College of Neurosurgery, which also means that the strength of the hospital has been recognized.
Looking for functional neurosurgery,
At the age of 37, he became the director
After graduating from undergraduate, Luan Guoming chose neurosurgery, and when he was studying for a doctorate, he came to Beijing Tiantan Hospital to study vascular diseases under Academician Wang Zhongzhong. After completing his Ph.D., he went to UCLA Medical Center for further studies, where he was exposed to newer concepts and more advanced surgical techniques. "The functional neurosurgery at UCLA Medical Center is strong and the level of stereotactic surgery for epilepsy is high."
It was during that time that Luan Guoming deeply studied and understood the subspecialty of functional neurosurgery. Functional neurosurgery may be a relatively unfamiliar term to many people, and he explained to the author the relationship between neurosurgery and functional neurosurgery:
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Neurosurgery is a discipline developed from the 1880s on the basis of the maturity of anesthesiology, aseptics and localization techniques, including brain tumors, cerebrovascular diseases, infectious diseases, spinal cord diseases, etc., which generally have structural abnormalities. Functional neurosurgery developed late as a branch of the gods, and its disease is peculiar in that although it also occurs in the nervous system, it is often difficult to find structural abnormalities, which are only manifested when the disease occurs. Pain, Parkinson's, epilepsy, psychosis, etc. are all functional neurosurgery.
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Luan Guoming believes that Enshi has made great contributions to the development of neurosurgery. In his view, Mr. Wang not only participated in the creation of China's neurosurgery, but also promoted the popularization of advanced concepts. In the reform era, many old comrades had very conservative concepts, and Teacher Wang boldly reused new people who had returned from studying abroad. Because Luan Guoming has laid a solid foundation in this field, coupled with the guidance of his mentor, he finally chose this profession as a lifelong struggle. "I was 37 years old when I became the director of functional neurosurgery."
Luan Guoming believes that functional neurosurgery has a unique charm than general neurosurgery. Nervous system tumors, traumatic hematomas and other diseases, its lesions and injuries at a glance, surgical resection can solve most of the problems; but instead of epilepsy, pain, lesions are often invisible, can not be touched, how to treat it through surgical means?
"For such diseases, it is generally through intervention in brain function, the use of electrophysiological monitoring to find abnormalities, but also need to damage and remove targets or lesions." In the process of electrophysiological monitoring of the brain, not only diseases can be found, but also the functions of different parts of the brain can be discovered, so it is called functional neurosurgery. ”
He further explains: "A Parkinson's patient has a constant tremor in his hand, and you put a wire and an electrode on the target, and his tremor may stop immediately. A chronic pain patient, the pain even wants to jump off the building, want to hit the wall, but you through functional neurosurgical means to find his lesions, targeted treatment, he suddenly no longer pain. While the patient's pain is greatly reduced, we also gain a great sense of accomplishment. ”
Of course, functional neurosurgery is also very demanding for practitioners. Luan Guoming believes that in order to do this line, it is first necessary to have a very solid foundation in neurosurgery and overall major surgical techniques, and to be very familiar with tumor surgery, vascular surgery, trauma surgery, etc. In addition, strong learning and research ability, especially the ability to study and summarize the advanced functions of the brain, is also essential.
Minimally invasive, neuromodulated and AI, the trend of the times
In recent years, neurosurgery has been moving in the direction of minimally invasive, and functional neurosurgery is no exception. Since small trauma can solve big problems, will traditional craniotomy lose its meaning and will be replaced?
For this issue, Luan Guoming shared his views. He believes that the choice of any treatment should be based on the perspective of patient benefit. Whether it is minimally invasive surgery or craniotomy, there are corresponding indications and existential significance, and the premise of the choice must be to bring greater benefits and better prognosis to patients.
For patients with very complex conditions and huge lesion areas, surgery is performed through only a small hole, and the damage on the outside is very small, but the internal damage may be very large, and it may not be able to be removed cleanly, which is more than worth the loss. Therefore, there is no need to pursue minimally invasively too much. But diseases that can really be treated through a small hole naturally do not have to go to craniotomy.
The concept of minimally invasiveness is the most typical and accurate embodiment in functional neurosurgery. "Functional neurosurgery is based on precise localization of treatments such as excision damage, electrical stimulation or medications. Our current technology can already do it, with robots for positioning, the error is as small as 0.03mm. "This precision is amazing to all of us doctors, not only to remove lesions, but also to protect brain function and increase patient benefits."
In addition to being minimally invasive, neural regulation is also one of the future development trends. In 2010, Luan Guoming established the Neuromodulation Committee of the Chinese Medical Doctor Association and held the first academic conference. Over the past 11 years, neuromodulation therapy has also made continuous progress.
Luan Guoming introduced that neural regulation is a type of treatment that uses physical (electronic), chemical (drug) and other means to contact nerves and thus have an impact on nerve function. "As the simplest example, the main method of treating Parkinson's tremor earlier was to destroy the lesion, but as the disease progresses, the efficacy gradually deteriorates, and the tremor worsens. Since 1998, we have changed to electrical stimulation therapy, the effect is very good, if the symptoms worsen, but also in vitro adjustment of stimulation parameters, maintain a good effect, patients benefit a lot. ”
At that time, the first case of electrical stimulation treatment in China was carried out by Luan Guoming in tiantan hospital, but at that time, he did not understand the term "neuromodulation". In the process of going abroad to participate in the study, Luan Guoming gradually accepted this concept and realized that in fact, the scope of neuromodulation treatment is extremely wide.
Neuromodulation involves a variety of fields and is not only effective for neurological disorders. For example, giving a diabetic foot patient a spinal cord stimulation can improve his blood circulation and gangrene; neuromodulation is particularly closely related to functional neurosurgical diseases, for depression, epilepsy, chronic pain patients, give electrical stimulation therapy, and then pump the drug into the target, can have excellent therapeutic effect, the damage is also very small.
It can be said that in various specialties, neuromodulation has its significance and value. In the future, this treatment is bound to play a greater role in different fields, and even become the mainstream treatment method for brain functional diseases. Luan Guoming also proposed the term "neural network disease", including psychosis, epilepsy, pain, movement disorder diseases, etc., and neural regulation has a significant improvement effect on such diseases.
Through the continuous publicity of the Neuromodulation Committee of the Chinese Medical Doctor Association for 11 years, the clinical understanding of neuromodulation has been deepening, and many departments have carried out neuromodulation treatment. There are further subdivisions under the Neuromodulation Committee, including the Faculty of Motion Disorder Diseases, Epilepsy, Psychiatry, Robotic Exercise, etc., and the Youth Committee has been established, which will promote relevant new technologies at academic conferences every year. Transcranial magnetic stimulation, direct current stimulation, light stimulation and other applications in different fields will bring good news to more patients.
Not long ago, Luan Guoming completed a book on neurosurgical robotics (Figure 1). This is also a comprehensive introduction to the application of robot technology in neurosurgery at home and abroad, helping the application of robot technology in neurosurgery.
Figure 1 Professor Luan Guoming's latest works
With the deepening of the study of "brain-like", people have found that robots can be applied to various fields, and the use of robots to do surgery has gradually become a reality. Artificial intelligence (AI) can summarize the experience of a large number of experts, and its accuracy and judgment rate are difficult for the human brain to match. But it cannot replace the human brain, after all, even advanced AI is inseparable from human design. Nevertheless, AI can still bring great convenience to clinicians, such as the combination of AI technology and medical treatment, which can be used for imaging diagnosis and various surgeries, improving the accuracy of diagnosis and operation, and saving doctors' physical strength.
In the field of functional neurosurgery, the application of AI is more common. For example, the use of robots to implant electrodes into the head lesion, the error is very low, all kinds of blood vessels can be avoided, the operation can be completed in a few seconds, and the bleeding rate damage rate is extremely low. Looking at the Da Vinci robot, the doctor saw the intraoperative situation through 3D glasses, and I did not need to go to the surgical scene in person, and I had already broken the truth of the condition on the simulation machine, as if it was unmanned.
Luan Guoming believes that the application of AI to clinical medicine can not only improve the diagnosis rate and treatment accuracy, but more importantly, the collection of big data, which is conducive to more accurate diagnosis and treatment.
Reluctant to retire, inseparable from the operating table
In the nearly 20 years of working in Sanbo Brain Hospital, Luan Guoming needs to undertake hospital management, clinical, scientific research, teaching and other aspects of work, but he has always adhered to the clinical frontline and has never left the operating table. He has great enthusiasm for his work: "People's energy and vitality are limited, I am a doctor, I will not leave my post." As for the management work, there are more professional departments and personnel to help me share the burden. ”
The 62-year-old has also planned to retire, gradually slowing down from a certain time, seeing less disease and learning more new knowledge, but all plans do not include leaving the clinic. Treating the sick and saving people is the biggest focus of his life.
In addition to clinical work, Luan Guoming will divide more and more time into academic research work. "I have created academic organizations such as the Beijing Key Laboratory of Clinical Medical Research on Epilepsy, the Epilepsy Institute of the Beijing Academy of Major Brain Diseases, and the China Branch of the World Neuromodulation Society, and have participated in a large number of domestic and international related work. I now spend almost half my time doing research. ”
It is understood that Professor Luan Guoming has participated in the completion of the national "Eighth Five-Year Plan" and "Ninth Five-Year Plan" research projects and nearly 30 national, municipal and ministerial scientific research projects; published more than 100 articles in many magazines at home and abroad, nearly 50 SCI articles, more than 20 books edited and edited; and won nearly 10 national, municipal and ministerial scientific and technological achievement awards. On December 21, 2021, Brain, an international authoritative journal of neuroscience and neurology, published the latest clinical research results of Professor Luan Guoming and Director Guan Yuguang online: "Clinical characteristics and surgical treatment effects of epilepsy caused by cerebral surface hemangioma disease", which believes that this is a single-center clinical report on the largest sample size of the disease at home and abroad, which has important guidance and reference value for further understanding and surgical treatment of this rare disease.
Luan Guoming laughed and said that his eyes are not as good as when he was young, and his reading speed and memory are no better than they were then. But his surgeon's hands were still steady and strong, and his physical strength was good, and it was not a problem to stand for two hours. "As long as I'm still breathing, I can see a doctor and serve my patients, which is my purpose as a doctor."
Expert Profiles
Luan Guoming
Chief Physician Professor Doctoral Supervisor
President of the 11th Clinical Medical College of Capital Medical University (Sanbo Brain Hospital).
Director of the Epilepsy Institute of beijing Institute of Major Brain Diseases
In his more than 30 years of neurosurgery, Professor Luan Guoming has successfully performed 9,700 cases of neurosurgery, including more than 6,200 epilepsy surgeries alone. His surgical method of "bipolar electrocoagulation fever burning brain superficial cortex treatment of refractory epilepsy in the functional area" was praised by the "Health Newspaper" and other media as "Luan's surgery", and won the approval of the then president of the World Neurosurgery Department at the 2002 Sydney World Congress of Functional Neurosurgery. At present, this method is widely used in clinical practice at home and abroad. In May 2012, its laboratory was approved by the Beijing Municipal Science and Technology Commission as the "Beijing Key Laboratory of Clinical Medical Research on Epilepsy". Professor Luan Guoming is also a pioneering expert in the application of deep brain microelectrode stimulation (DBS) in the treatment of Parkinson's disease (PD) in the mainland, in 1998 in the Temple of Heaven Hospital to carry out the first (Chinese) PD patient DBS surgery, in 2012 took the lead in carrying out ROSA stereotactic EEG localization, the application of the equipment to carry out advanced stereotactic intracranial electrode surgery, minimally invasive accurate localization of epilepsy lesions. In the same year, DBS treatment was pioneered in the new field of chorea and achieved good results. In May 2017, he won the World Neuromodulation Important Contribution Award. He also serves as the chairman of the Neuromodulation Professional Committee of the Chinese Medical Doctor Association, the vice president of the Chinese Anti-Epileptic Association, and the member of the Surgical Treatment Committee of the International Anti-Epilepsy Alliance (ILAE) and other academic organizations. In addition, Professor Luan Guoming also has deep knowledge in the treatment of common diseases of functional neurosurgery, such as trigeminal neuralgia, facial muscle spasm, refractory pain, cerebral palsy and brainstem hypertension, and brain functional area tumors.
Source: Medical Neurology Channel
Editor-in-charge: Wang Hang
Proofreader: Zang Hengjia
Plate making: Xue Jiao