The Surgeon's Studio c1-799

by Black Ursa Prime

  …

  …

  Zheng Ren's movement was swift as he had performed more than a hundred similar cases in the System last time.

  Zheng Ren believed that there were many surgeons who had performed more appendectomies than him in this country, but using a colonoscope to resect an inflamed appendix? He was undoubtedly the most trained surgeon in this field.

  More surgical training resulted in proficiency. There would be solutions to mistakes encountered which meant that the chances of unforeseen events would decrease tremendously.

  The colon and appendix appeared on the screen.

  He then used an injector with a mixed solution—indigo carmine, epinephrine, and normal saline—to improve the delineation of the appendix.

  Zheng Ren started incising the mucosal layer with the instrument.

  His hand movements and manipulation of the instrument had to be performed in reverse, just like an inverted image in a mirror. That was the difference between this surgery and open surgery.

  The blood vessels were clearly visible after one mucosal layer was incised with a needle knife. After that, a pair of forceps was used to initiate the blunt dissection of the submucosal layer.

  This was a delicate surgical task as performing the blunt dissection of the submucosal layer through the colonoscope was much more difficult than under direct vision.

  The anesthesiologist beside Zheng Ren was captivated by the swift movement on the screen.

  She had worked in the operating theater for many years, so it was natural that she knew its difficulty even though she had not performed it personally.

  Blunt dissection was preferred by most high-skilled surgeons due to advantages such as decreased trauma and less bleeding from the dissected edge. However, if something went wrong with the procedure—from uncontrolled strength or a lack of anatomical knowledge—and an iatrogenic intestinal perforation arose, excreta in the intestines would flow right into the peritoneal cavity.

  This medical error would lead to a severe peritonitis, which was treatable if the patient was lucky. Otherwise, they would have to receive treatment under observation in the ICU for approximately ten days. If luck was not on their side and the condition was complicated with septic shock, they risked losing their life.

  Thus, the surgeon's skill and overall qualities were the most important factors in performing a blunt dissection.

  However, blunt dissection was usually performed using fingers or a pair of hemostatic forceps under direct vision.

  Zheng Ren's method was to manipulate the colonoscope and a pair of forceps through the instrument port outside the body. One could only imagine the extreme difficulty of such a delicate task.

  'Please don't make any mistakes,' the anesthesiologist prayed in her heart and fought the urge to remind Zheng Ren of it. He was manipulating the instruments with undivided attention and the patient's assistant was on the scene as well. If he was distracted for even one second and perforated the intestine…

  Fortunately, what she was afraid of did not come to pass. Zheng Ren manipulated the colonoscope and forceps dexterously while dissecting the mucosal layers as if with his own b.a.r.e hands. Whenever a blood vessel was encountered, he would use the hook knife to cut it directly instead of rupturing it, causing it to bleed before using the knife to achieve a hemostatic effect.

  There was a huge difference between these two methods, and the anesthesiologist, who was highly experienced, admired Zheng Ren for his superb standards.

  Soon, the submucosal layer was exposed.

  Zheng Ren replaced the forceps with a transparent cap to push the connective tissues away from the submucosal layer and dissected the layer further with the endoscopic electric knife.

  After the dissection was complete, the intestinal wall was then incised and the colonoscope entered the peritoneal cavity.

  The mesoappendix was divided, the appendix well skeletonized, and the appendiceal artery ligated.

  After that, Zheng Ren replaced the instrument again and inserted the endoclip purchased from the System into the instrument port.

  The inflamed appendix was in a severe edematous state due to failed conservative treatment for three days and was on the verge of perforation. Any unnecessary increase in strength would cause it to burst and the surgery would end in failure.

  The anesthesiologist involuntarily held her breath upon seeing this as though her heavy breathing would cause the edematous appendix to rupture.

  Holding the inflamed appendix with a pair of forceps and placing the endoclip at the base of the organ, Zheng Ren resected it and clipped the mucosal surfaces together.

  The endoclip with the resected appendix was removed and the intestines were irrigated. After ensuring that there were no obvious bleeding spots and the mucosal surfaces were tightly sealed, the colonoscope was then removed.

  "The surgery is complete. You can administer drugs now," said Zheng Ren.

  "Huh?" The anesthesiologist was taken by surprise. That was true. The surgery was basically complete after the appendix was resected.

  However, something seemed wrong. She had expected the surgery to go on for five hours, but how long had it been?

  She glanced at the time on her cell phone—merely nine minutes had passed.

  "Chief… Chief Zheng, is it really over? You don't need to recheck the surgical site?" the anesthesiologist started stuttering.

  "Recheck? I've done that." Zheng Ren took off his surgical gloves, folded both arms across his c.h.e.s.t, and sat on a stool against the wall.

  "Er…" The anesthesiologist was left speechless. Staring at Zheng Ren's confident expression, she really wanted to pinch his ear and roar, 'Can't you just check it again? Don't you know that the hospital management places a high value on this surgery?!'

  However, she fought the urge to do so in the end.

  She had already calculated the required dosage of reversal agents to let the patient regain consciousness, but had not expected to perform the injection so soon.

  According to its precalculated value, a reversal agent was intravenously injected to reverse the effects of muscle relaxant, and a mixture of atropine and neostigmine in a 1:1 ratio was injected afterward.

  Slight movement was noted in the patient two minutes later.

  The anesthesiologist glanced at the patient's vital signs on the electrocardiogram and yelled into her ear, "Zhou Jinxi, Zhou Jinxi!"

  "Huh?" Zhou Jinxi mumbled through her nose.

  "The patient is awake. Come and transfer the patient," the anesthesiologist announced to Zheng Ren after confirming the patient's status one last time.

  "Doctor Zheng, I'm sorry to bother you." Zhou Jinxi's assistant stood in front of Zheng Ren and bowed apologetically.

  Apology? He must be exhausted. Otherwise, why would he hear traces of apology when the assistant expressed her gratitude? However, the inside of her surgical gown became clearly visible when she bowed and allowed gravity to pull her gown downward.

  'Those are rather small…' The thought flashed past Zheng Ren's mind.

  "Please leave first. We've arranged nurses to escort Miss Zhou back to her sick room," said the assistant softly but firmly.

  Oh, so that was what all this was about. Zheng Ren smiled after realizing that the assistant preferred not to expose Zhou Jinxi's private parts to a man.

  Well, it was understandable as she had the potential to be very popular in the future. Some day, if someone spread today's incident onto the internet, tut-tut… That would be troublesome.

  Zheng Ren nodded in response and left the operating theater.

  He had no idea that the entirety Xinglin Garden had entered a half-paralyzed state because of this surgery.

  A live broadcast room could accommodate one thousand viewers at most. The moment Zheng Ren resected the appendix and clipped the mucosal surfaces with the endoclip, thousands of comments flooded the entire screen which exceeded the threshold of the technical bandwidth. As a result, the livestream
crashed and one thousand viewers were disconnected at the same time.

  The hornet's nest was immediately stirred up.

  When viewers reconnected to Xinglin Garden and realized that the livestream had turned off after the surgery was complete, they started expressing their dissatisfaction by turning the forums upside down.

  Numerous phone calls began bombarding the CEO of Xinglin Garden as well.

  How could a professional website be established without financial investment from a few moguls?

  It was beneficial to be acquainted with more of them as the website grew further.

  However, that was also the reason why the CEO had to feel their wrath today.

  There were various types of senior experts supporting the website. Some of them were cultivated, some were easily irritable, but all of them shared a similar quality—they were intellectual individuals.

  That the CEO had to feel their wrath was an exaggeration, but the fact that they had expressed their dissatisfaction and disappointment was more than enough to drench the CEO of Xinglin Garden in cold sweat.

  Hence, a group of skillful technicians started improving the website and gave Xinglin Garden a system upgrade. Who actually caused so many professors to be unhappy at the same time? What happened in the livestream that actually crashed the entire live broadcast room? These questions had piqued the CEO's curiosity.

  Their answers, though, were completely beyond his imagination.

  Chapter 36 - Acute… Acute Myocardial Infarction!

  Zheng Ren had no idea that the largest medical expert website in the country had crashed due to the surgery he had just performed.

  He left the endoscopy unit operating theater in good spirits.

  Cen Meng, who was not allowed to enter the conference room due to lower rank, was standing in the corridor, obviously anxious and irritated.

  He was startled when Zheng Ren exited the endoscopy unit.

  In his imagination, Zheng Ren had been struggling and could not possibly have finished the surgery so soon as this was the first time anyone used such an advanced, unfamiliar surgical technique in Sea City General Hospital.

  He had assumed that he knew Zheng Ren well and was aware of the limited surgical choices he could perform with his low standards, but that had not been the case recently.

  Something must have gone wrong in the surgery. There was no other explanation for it!

  That realization made Cen Meng's heart jump.

  His gloomy mood brightened up instantly as he approached Zheng Ren with a warm smile on his face.

  "Chief Zheng, do you lack any surgical instrument or require an assistant? I wanted to slot in a doctor from the endoscopic unit for you but the patient's side disagreed with my suggestion." Cen Meng tried to express his "kindness" and hope at the same time.

  How he wished that Zheng Ren had messed up the surgery.

  "The surgery is finished, so here I am," replied Zheng Ren with a smile.

  "Fi… Finished?" Cen Meng was dumbstruck.

  Even though Cen Meng had more or less expected this result, he was still devastated that Zheng Ren had so quickly completed a surgery that he had not seen or even heard of.

  Zheng Ren walked past Cen Meng, whose expression was blank and eyes as dull as stones, and gave him a gentle tap on his shoulder before going into the conference room. "What else could it have been?"

  Zhou Jinxi's agent, who still had a phone in her hands, gave Zheng Ren an astonished look when he entered the room.

  "Doctor Zheng, how was the surgery?" asked the agent carefully, fearing the worst from Zheng Ren.

  "Everything went well. The resected appendix is in the operating theater. You can take a look at it before sending it to the pathology lab." Zheng Ren walked toward Old Chief Physician Pan, met his gaze briefly, and sat down.

  The director and deputy director of the hospital concealed their amazement well. Meanwhile, the chief of the medical administration division started instructing medical staff to transfer Zhou Jinxi back to the ward and gave Zheng Ren a penetrating stare before leaving the room.

  Old Chief Physician Pan asked Zheng Ren softly while everyone went to check on the patient, "How was the surgery?"

  "Good. There won't be any problem at all," answered Zheng Ren clearly as he understood what Old Chief Physician Pan had in mind.

  A sly smile formed on Old Chief Physician Pan's honest face. "Take some rest. After this is over, I'll take everything we deserve."

  Zheng Ren nodded in response.

  "I appreciate your hard work," said Old Chief Physician Pan before he stood up and left the room.

  Hard work? It was just a nine-minute surgery.

  Ding dong! A bell rang in Zheng Ren's ears and the System's robotic female voice emerged at the same time.

  [Sudden Mission: The Soldier Dies For His Comrades accomplished. 30 skill points and 300 experience points obtained.]

  Well, that was stingy… He had purchased an instrument for 3200 experience points for a reward of only 300 points.

  [Time used: 1:12:36. Extra 13644 experience points obtained.]

  Zheng Ren was startled by the new reward as he grumbled internally. Calculating it was not required as it was obviously the unused time to completion from that allocated by the System.

  One second for one experience point; that was awesome!

  The exhilarated Zheng Ren felt that there was a bright future ahead of him.

  Suddenly, he recalled that the endoclip he had purchased in the System's Shop was still in the operating theater.

  His hair stood on end instantly.

  He took off like a scalded cat; that treasure cost him 3200 experience points! There was no way he would throw his item away even though more than ten thousand experience points had emerged out of nowhere and went into his experience pool.

  The stretcher trolley was wheeled out of the operating theater. Zhou Jinxi had awakened from the general anesthesia and her vital signs were stable. Meanwhile, her agent was staring at the resected appendix in the kidney dish in Old Chief Physician Pan's hands.

  Although none of them knew about the surgical process, Old Chief Physician Pan was able to explain how the appendix was edematous, where the sign of perforation in the appendix was, what would have happened if surgical treatment was not performed in time, and so on.

  Chief Surgeon Liu from the first general surgery department and Chief Surgeon Sun from the second general surgery department were standing at one side with dark expressions. Chief Surgeon Liu's complexion was chalk-white, as if his cadaver-like face had been smeared with hydrated lime powder.

  The terrified agent was listening to Old Chief Physician Pan's explanation while mumbling about how lucky she was to have had the surgery done on time.

  The stretcher trolley had already left the endoscopic unit when Old Chief Physician Pan finished explaining the patient's condition. The whole corridor was quiet with only a few people still lingering in the area.

  The agent walked toward Zheng Ren with a polite smile, bowed slightly, shook his hand enthusiastically and asked, "Doctor Zheng, when do you think Little Zhou will recover?"

  "She can get out of bed tonight and walk with care in two days. There shouldn't be any delay to her recovery and she can attend the contest in three days, but her diet needs to be taken care of. Liquid meals only for the next few days and no high-intensity exercises allowed."

  The final three days later would not be affected!

  This was precisely what the agent wanted to hear from Zheng Ren. Dark gray clouds drifted away instantly and allowed the sunlight to fill her world with joy.

  She took out a business card and handed it to Zheng Ren. "Doctor Zheng, your surgery skill is unparalleled. This is my name card. Give me a phone call when you visit Sorcery Capital in the future. Don't consider yourself as an outsider."

  "That's kind of you." Zheng Ren accepted the business card and put it away.

  Her fingernails were too red and her lipstick too se
ductive. Those were definitely not Zheng Ren's preference.

  There were only four people—Zheng Ren, Old Chief Physician Pan and the two chief surgeons of the general surgery department—left in the empty hallway after the agent took her leave.

  Old Chief Physician Pan grinned victoriously but made no attempt at being a gracious winner.

  He stood in front of Chief Surgeon Liu and pointed his index finger. "The emergency department will handle every emergency general surgical case in the future. They are no longer under your responsibility."

  Total dominion with no room for bargain.

  It was a notice, not a discussion.

  The chief surgeons lowered their heads, unwilling to meet Old Chief Physician Pan's vile attitude.

  However, that was just the beginning…

  Another finger was extended as Old Chief Physician Pan said slowly, "Since the general surgery department doesn't need to handle emergency surgical cases anymore, I'll apply for reallocation of medical staff from the general surgery department to the emergency department to solve the overstaffing issue."

  A fundamental solution! It was ruthless!

  Old Chief Physician Pan's demand threatened the core of the general surgery department.

  The chief surgeons raised their heads instantly and Chief Surgeon Sun pleaded, "Old Chief Physician Pan, I didn't offend you. Please allow some discussion on this matter."

  Chief Surgeon Liu stared at Old Chief Physician Pan with trembling hands. He knew that retreat was not an option because there was an abyss right behind him.

  "I disagree," Chief Surgeon Liu rejected his request directly.

  "You disagree?" Old Chief Physician Pan raised his eyebrows and radiated a murderous aura. "Have you no sense of shame?"

  Have…

  You…

  No sense of shame…

  Simple, rough, and direct.

  "You want to hold on to resources when you can't perform surgery well? Let me ask you this: have you no sense of shame?!"

  "..."

  The chief surgeons of the general surgery department were shocked. Were they getting scolded? How many years had it been since anyone scolded them?

  "You tried to put a spoke in my wheel by sending every patient with acute appendicitis from the surrounding rural areas to us. Fine, I won't deny them because we can perform appendectomies well and aren't afraid of your tricks. However, you want to take up resources when you can't even do your job properly? You're ruining Sea City General Hospital's reputation!" reprimanded Old Chief Physician Pan coldly.