Surgeons perform surgery almost every day. How do you evaluate whether a surgeon does a good or bad job? Some people may say that older surgeons must do well, and surgeons with higher titles must do well. There is some truth to that. Then which surgeon with the same age and title does better? Which is better, the Chinese surgeon or the foreign surgeon? It is difficult to answer this question. I think there are three realms of surgery, which are suitable for all surgeons with different specialties, different years of experience and even different nationalities to compare and evaluate. The first realm is to complete the surgery (Just do it). Just do it means to be able to perform a surgery within one’s own specialty independently, without the guidance or assistance of a superior surgeon, and with only one or two interns as assistants. I think most senior surgeons are able to reach this level. This is because it is a minimum requirement. As the saying goes, practice makes perfect, and when the volume of surgery accumulates to a certain level, basically all of them can reach this level. The reason why we say that this level is the most elementary level is that there are people who are very familiar with a surgery, and there are people who sweat like rain; there are people who are clean and fresh, and there are people who are bloody and fleshy. So the difference in the quality of completing a surgery is very large. I remember an article describing a group of domestic elites visiting a foreign country to study. These elites were all fairly well-known surgeons in China, and there were many doctors who thought they could perform all the surgeries within their specialty very quickly and were often proud of it. They were stunned when they saw foreign doctors wearing magnifying glasses doing surgery without panic, so surgery could be done like this. Others do a surgery as if it were a work of art, meticulously sculpted, meticulously done. This is the difference. In comparison, sweating like rain, blood and flesh to complete a surgery, only can be considered to have completed the surgery, is the primary stage of the surgeon level, of course, some surgeons can only reach this level in their lifetime, this technology is not accumulated by the number alone can be improved. What is needed to improve from this level to the next level? This is the second level that I need to talk about. The second level is anatomic surgery. Anatomic surgery means that the surgeon follows the correct anatomical path during the surgery. You may say, “Every surgeon is doing surgery in this way. When I was in school, my teacher said that I must be familiar with anatomy in order to be good at surgery. This is true, but true anatomical surgery requires the surgeon to be firstly very familiar with the anatomy within the scope of the surgery and secondly to be able to reach the level of the anatomy teacher in terms of surgical technique. We have all taken anatomy classes, and when an anatomical specimen is brought out to the student, all the tissue hierarchy, all the arteries, veins, and nerves of all sizes are clearly shown to the student. An anatomical specimen of the neck may take an experienced anatomy teacher more than ten or even dozens of hours of work to complete. In contrast, it may take our surgeon only half an hour to do a thyroid gland. In other words, a surgeon’s level of surgical refinement is incomparable to that of an anatomy teacher. That is why anatomical surgery is very demanding. It is contradictory and unified to have both clear anatomy and fast speed. When the anatomy is familiar, the speed is naturally fast. The most fearful thing is that the anatomy is not familiar and fast, which is the first level of level I talked about earlier. Anatomical surgery contains two concepts, one is to be very familiar with the anatomy of the surgical area, and the other is to be very skillful in surgery. When you learn the anatomy well, you can close your eyes and imagine the anatomy of the pelvis, where are the blood vessels, where are the nerves, how the ureter travels, it is all clear, but when you get to the operating table it is not so clear. It is clear that there is a nerve and a blood vessel passing through the side of the bladder, but it is not possible for everyone to dissect this nerve and blood vessel very smoothly. It is a question of surgical technique. If you ignore it, take the plunge and sever the vessel, sever the nerve, and quickly remove the diseased bladder. That brings us back to the first level. What are the benefits of anatomical surgery? First of all, the damage is small, following the normal anatomical path, there is an anatomical gap between each organ, following this gap, then the chance of damaging the surrounding tissues is very small. For example, cutting the uterus will not damage the ureter, and cutting the prostate will not damage the rectum. Most people think that the damage is the skin incision damage, the small incision damage is small, in fact, the damage inside the incision is much greater than the damage that can be seen on the outside. The second is less bleeding, along the correct anatomical path to surgery, naturally avoid unnecessary damage to the blood vessels, bleeding naturally less, post-operative recovery will be faster. The most important advantage of anatomical surgery is good functional recovery. For example, in radical surgery for prostate cancer or bladder cancer, if nerve damage and damage to the external urethral sphincter can be avoided during surgery, the incidence of postoperative urinary incontinence is greatly reduced and the quality of life of patients after surgery is significantly improved. This is the reason why foreign experts like to wear magnifying glasses when doing pelvic surgery. The third realm is artful surgery (State of art). The highest level of any science or technology is the art level. This is the reason why the great scientists are fond of art. A surgeon who can reach the state of art is a true master, a higher level of sublimation for anatomical surgeons. What is the difference between these two? It stands to reason that being able to perform surgery as clearly and perfectly as an anatomy teacher should be the pinnacle of a surgeon, so what makes a master artist even more brilliant? That is, after knowing all the current surgical methods and techniques, creating newer surgical methods that can obtain better surgical results. To compare more simply, the anatomical surgeon is primarily a learner, gradually improving his or her surgical skills through study and experience, which also requires a certain amount of talent. Artistic level surgeons create, improve, and stand above all others at the forefront of academia, in addition to learning. Professor Patrick C. Walsh, a urologist at Hopkins Hospital, first introduced radical nerve-preserving prostate cancer surgery in the 1980s, allowing millions of prostate cancer patients to achieve normal sexual function after surgery. His great achievement is worthy of the title of master of his generation. Do we have such a master in China? There are too! Please take a look at Zhuangzi’s “The Butcher Takes the Cow” and you will see. “Butcher for Wen Hui Jun to untie the cattle, the hands of the touch, shoulders leaning, the foot of the foot, the knee of the p, like a to the Ran, playing the knife d Ran, nothing but the sound. Combined in the dance of the mulberry forest, is in the first meeting of the scriptures.” It means that when Butcher was killing the cattle, his footsteps stepped on the dance of “Sanglin”, and his rhythm and the beat of the music of “Jing Shou”. He said, “I’m good at the Tao, and I’ve advanced to the technical”, meaning that the level he reached was the “Tao”, which had long since transcended the so-called “technical”. Butcher’s realm is the realm of art, that is, the realm of our ancient “Tao”, which should be the ultimate goal pursued by all surgeons!