The Surgeon's Studio c1-799
Page 135
Department Chief Kong had a satisfied smile as he watched Zheng Ren wrap up the surgery. "Boss Zheng's skill has improved since his visit to Imperial Capital. Youth these days grow up so fast. There seems to be no limit to their potential. Bravo!"
Director Xiao did a double take. Had he heard that right.
Boss… Did the department chief from Imperial Capital just call Zheng Ren 'boss'?
This was not a marketplace where the honorific could be thrown around recklessly. In the hospital, the honorific was reserved for people who had conducted nationally-acclaimed research and secured public funding for their work.
How had a chief resident in an emergency department earn the title, from an Imperial Capital department chief no less?
Could it be that his hospital had produced a legendary figure?
Director Xiao was deep in thought. On Xinglin Garden, the livestream was bombarded by numerous comments.
[Does anyone still remember the first interventional surgery, the one with the pelvic fracture and hemorrhage? Am I the only one who thinks the surgeon's skill has grown significantly since?]
[You're seeing things.]
[Doesn't seem like it. I,too, feel that the surgeon has improved. The person who stitched up the abdomen seems more skilled than my department chief, and the embolization was completed before the abdomen was even closed.]
Su Yun had similar thoughts.
He had initially planned to stitch up the abdomen, clean up, and then assist Zheng Ren with the interventional procedure, but Zheng Ren completed the surgery before he was done.
Su Yun had checked the cavity for active bleeds before rinsing and suction.
The procedure was clean and neat. He could not believe Zheng Ren had managed to perform the splenectomy blind with such accuracy and precision.
When Su Yun entered the operating room, Zheng Ren had already excised the spleen. The man's movements were getting faster and faster.
Su Yun could only sigh in defeat as he prepared to stitch up the abdomen.
When he next looked at Zheng Ren, the man was already pulling out the micro guide wire.
Was the artery embolization already done?
Chapter 280 - Two Heroes of Interventional Surgery (Part 4 of 4)
"Boss Zheng, is the surgery done?" Su Yun asked casually, trying to be affable.
Hopefully, he could make it less awkward.
"Yes, the four arterial branches have been embolized," Zheng Ren said. "Do you need help on that end?"
"No. I'm closing the abdomen up now. I thought you would get the uterine artery as well, you know, to cure the adenomyosis."
"No, this is an emergency surgery. The patient's injuries are severe and her body might not be able to handle another embolization. We don't want the uterine artery to be the last straw on the camel's back. She can come to us after she's recovered and we'll try it then."
"Understood." Su Yun found his explanation long-winded.
"You can be my scrub nurse. Yiren doesn't need to come in," Zheng Ren said.
"Chief Kong is here. Don't you wanna go greet him?" Through the leaded glass, Su Yun could see Department Chief Kong with a Caucasian man by his side.
Already? Su Yun smirked. He wondered how long he would take to reach, let alone surpass, or even conquer, Zheng Ren.
Even after moving the goalposts repeatedly, he still could not find a credible answer.
Zheng Ren turned to the control room and saw Department Chief Kong waving at him. He mumbled something to Su Yun and went to remove his surgical gown.
"Boss Zheng, I see your hands have gotten faster," Department Chief Kong said as a greeting when Zheng Ren entered the control room.
"Chief Kong, please don't exaggerate; also, just call me Little Zheng," Zheng Ren said with a smile. "What brings you here?"
"I heard that Professor Rudolph wanted to meet you, so I decided to tag along. There's something I'd like to discuss with you in person," Department Chief Kong said.
Professor Rudolph? Why did the name sound so familiar?
Zheng Ren was bad at facial recognition, but his memory was solid.
"Professor Rudolph Wagner?"
"Yes." Department Chief Kong stepped aside to let Professor Rudolph introduce himself. The professor offered his hand and spoke in heavily-accented Mandarin: "Nice to meet you, Zheng. My name is Rudolph Wagner from Heidelberg University in Germany."
Zheng Ren shook the hand obliviously.
"Chief Zheng, it's the second general surgery department. They're waiting on you," Chu Yanran reminded him.
"Oh? They're just starting now?" Zheng Ren asked.
"I'm not sure." His words worried Chu Yanran and she pursed her lips.
"We should hurry, then." Zheng Ren turned serious. "Chief Kong, my apologies, but I need to assist with a floating gallbladder case. I worry that too much time has been wasted."
"Go on. We'll talk once you're done." Department Chief Kong did not mind one bit. Zheng Ren's total disregard for the German professor as he excused himself was admirable. Before leaving to change, Zheng Ren exchanged a few words with Old Chief Physician Pan.
Most young doctors would fawn over a foreign professor. China's recent growth and development did not lessen the youths' worship of the West.
However, Zheng Ren did not pay much attention to Professor Rudolph, which pleased Department Chief Kong.
Su Yun was almost done with the stitching despite operating without any assistance.
"Send the patient to the ICU once it's done. Inform Chief Qian that the patient needs a ventilator," Zheng Ren instructed Chu Yanran.
"Yes, my lord," Chu Yanran whispered in a high-pitched voice.
Were it not for the presence of the hospital director, department chief and professor, Zheng Ren knew she would have shouted the words.
They filed out of the room and hurried to the operating room of the general surgery department.
The office director contacted the second general surgery department as they walked. The surgery had already begun.
As soon as the final stitch was done, the livestream on Xinglin Garden ended.
[These live surgeries are very enjoyable.]
[One must be incredibly skilled to be willing to do a live recording. I doubt even our department chiefs would ever reach this level of mastery. They probably wouldn't even match the surgeon's assistant.]
[The assistant did pretty well. Did anyone notice that the surgeon's embolization technique is similar to the one in the prostate interventional embolization video released a few days ago?]
[I did not catch it live but I saw the recording. Personally, I couldn't really understand the procedure.]
[The surgeon in that prostate procedure video is likely world-class.]
[I feel the surgeon today is comparable to that one.]
[I disagree. This Canadian surgeon's techniques are well-doc.u.mented, while the other surgeon used a never-seen-before method in the recording. I don't think they're comparable.]
[Two world-class surgeons on the same platform. Amazing! The whole community is filled with talent, whether in interventional or general surgery.]
Although the livestream had been over for a while, the doctors still chatted away.
The emergency hybrid surgery had featured the surgeon's extraordinary skill and techniques, earning much praise and admiration from the viewers.
If they ever encountered similar cases, they could replicate the surgeon's methods and save precious time.
Every additional minute in emergency rescue increased the patient's chances of survival.
…
…
A row of men in surgical gowns walked into the No. 2 operating room in the general surgery department.
An emergency surgery was ongoing.
Department Chief Sun's surgical cap was soaked through with sweat. He occasionally turned his head to the side so a nurse could wipe his forehead and prevent excess sweat from contaminating the surgical site.
In the operative view, the gallbladder was contorted like a fried dough twist.
As blood circulation had been cut off for some time, the gallbladder was showing initial signs of necrosis. Based on standard protocol, the deteriorating gallbladder had to be excised. Why else would they open up the abdomen?
The unfamiliar sight before him baffled Department Chief Sun.
His anxiety and nervousness drove his blood pressure over the edge as sweat seeped through his outfit.
Zheng Ren was the first to enter the operating room. "Chief Sun, allow me."
"Little Zheng, you're finally here. Have a look at this." Department Chief Sun welcomed Zheng Ren warmly, pride no longer of any concern.
Gallbladder torsion was difficult to diagnose but cholecystectomy was a straightforward procedure. Why had Department Chief Sun asked for him?
He gazed at the surgical site. The gallbladder was twisted to the point where the cystic duct, blood vessels and hepatic duct were all tangled in a mess.
A floating gallbladder? This one looked like it came from Tianjin 18th Street1. Tianjin 18th Street is famous for their fried dough twists.
Chapter 281 - Cooperation (Part 1 of 4)
"The knot is too tight and there's too little room for excision." Department Chief Sun prodded the necrotizing gallbladder with a hemostatic clamp.
"Do not untangle the knot. Necrosis has been going on for too long. If gangrenous tissue enters the hepatic duct, it'll be problematic," Zheng Ren said matter-of-factly.
"But…" Department Chief Sun glared in frustration at the twisted knot that held the cystic duct, blood vessels and hepatic duct.
There was no extra space at the base of the gallbladder to perform a resection and suture. If they forced it, the suture would likely unravel. Hence, they could not proceed with the cholecystectomy without untangling the knot.
"May I have a go?" Zheng Ren asked politely.
Department Chief Sun was elated to hear the offer and nodded.
That was why he had called the man here in the first place, after all.
This was a surgical consultation.
The practice of operating without the lead surgeon's approval was frowned upon. Such a move could soil the relationship between two professionals.
Once the green light had been given, Zheng Ren went to change and scrub in.
When he returned in a surgical gown, Department Chief Sun called out to him. "Little Zheng, come over here."
Zheng Ren hesitated for a moment before approaching.
The surgeon's position offered the best view of the surgical site. However, under certain special circ.u.mstances, the surgeon's view was obstructed and the assistant would help from their position.
Department Chief Sun stepped aside and Zheng Ren unabashedly stepped into the lead surgeon's spot, studying the gallbladder before him.
The chief had started off with a laparoscopic cholecystectomy but switched to a laparotomy when he noticed the atypicality.
However, the problem had remained unsolved even after he opened up the abdomen. This was the first time he had witnessed gallbladder torsion of this severity. It looked like a fried dough twist from 18th Street.
If they had started the surgery before necrosis had set in, the surgery would have been much easier. All he would have had to do was untangle the knotted organs.
Unfortunately, a few hours had been enough for the gallbladder to become gangrenous. It was saturated with fluids, which meant they could not untangle the knot; the slightest movement could tear apart the organ.
The consequences of that were dire.
No one spoke in the operating room, not from Director Xiao's presence, but the complexity of the patient's condition.
A lead surgeon would usually be in a bad mood upon encountering such a complicated case. Anyone attempting to joke in the operating room would be on the receiving end of a clamp missile.
Zheng Ren extended his hand and waited. Then, he realized his mistake and softly said, "Hemostatic clamp."
The tool was passed to him, but the force with which it was pressed into his palm discomfited him.
He started with blunt separation of the swelling surrounding the gallbladder. Department Chief Sun watched with trepidation, as the thin tissue walls were easily perforated.
Being too gentle would accomplish little.
Excessive strength would cause irreversible damage.
"Scissors," Zheng Ren said a few minutes later, his hand outstretched.
A pair of scissors was given to him.
Zheng Ren looked at them and placed them by the patient's t.h.i.g.h. "Blunt scissors."
The scrub nurse jolted and quickly handed him the requested tool.
Zheng Ren sighed internally. He strongly preferred his own scrub nurse.
However, asking for Xie Yiren would be too impudent, so it was best he put up with his lot.
"Move the retractor higher."
"Pull harder."
"Here. Hemostatic clamp. Careful with the pressure."
Zheng Ren constantly coached the assistant throughout the surgery. The time it took for the assistant to shift the retractors seemed longer than the actual surgery itself.
Director Xiao shook his head. Department Chief Sun and his assistant had utterly humiliated themselves in front of a foreign professor.
He would have a word with them after the surgery.
In the operating room, Zheng Ren gave out instructions in his monotonous voice to the assistant, who gritted his teeth.
A fiery anger burned in his c.h.e.s.t.
In his opinion, the way he had positioned the retractors was sufficient to provide the lead surgeon a suitable view into the surgical site. He believed Zheng Ren was nitpicking on purpose.
If the surgery went wrong, Zheng Ren could shift the blame, citing subpar assistance during the procedure. That would be 30% of the culpability off Zheng Ren's shoulders.
"Prep 3#0 atraumatic needle and suture. Smallest size." Then, Zheng Ren repeated his previous instruction, "Widen the smaller retractor. I need a better visual of the liver area."
The monster residing within the heart of the second general surgery department chief resident roared.
"Steady your hands. Hold on a little longer if you're tired."
The monster grew, almost breathing fire.
"I need a better view to perform blunt dissection of the Glisson's capsule."
"Steady the large retractor. Don't move."
Manning the retractors was a test of strength for a surgeon's assistant.
The second general surgery department chief resident could not predict Zheng Ren's next move, which was why he was always one step behind rather than ahead of the lead surgeon.
As Zheng Ren operated, more instructions were given to the assistant and the scrub nurse.
The atmosphere surrounding the operating table was uneasy and awkward.
The furious beast in the assistant's heart was beginning to rival Godzilla, but he held his temper. The thought of Zheng Ren blaming him for the surgery's failure made him persevere.
"Boss, shall I step in?" Su Yun called out from amongst the crowd.
"Has the patient been sent to the ICU?"
"Yes. She is stable. They're giving her a blood transfusion to mitigate any complications as she bled heavily from her fractures. We couldn't get fibrinogen, but I've told Chief Qian to reach out to others. Not sure if we'll find some," Su Yun explained.
"Chief Sun?" Zheng Ren said so softly that only the people next to him—Department Chief Sun and his assistant—could pick up the words.
The assistant understood what was being asked. The vein on his forehead bulged.
"Little Lei, go and take a break. Su Yun, you take over," Department Chief Sun ordered.
Su Yun went ahead to scrub in.
He came up to the operating table and flinched at the state of the patient's organs. "How are we doing this?"
"By splitting the liver," Zheng R
en answered.
The words fell like a bomb onto the heads of every doctor present.
A hepatectomy was usually part of the treatment of a liver cancer patient, when the tumor was between 3 to 5 cm. It was not a common surgery as it required specialization.
The liver was a fragile organ with an abundance of blood vessels. After the wedge resection, reattachment of the remaining tissues to stop the bleeding was a complicated procedure.
Once Su Yun was clear on the procedure, he turned to the nurse, smiled and requested several surgical tools which were then arranged beside the patient's lower body.
The operating room finally fell silent.
Su Yun matched each move made by Zheng Ren. Be it manipulating the retractors to give Zheng Ren a better view or assisting with the hepatectomy, Su Yun did everything without a word from Zheng Ren.
The surgery was smooth-sailing.
The effortless cooperation between Zheng Ren and Su Yun was a stark contrast to the previous arrangement.
It was a far cry from the second general surgery department chief resident.
A section of the liver was resected, followed by hemostasis. The cystic duct, hepatic duct and relevant blood vessels were cut before the gallbladder was removed. Another round of bleeding control later, the liver sections were reattached with its ducts and vessels.
The rage in the chief resident's heart immediately subsided as he watched the surgery.
Zheng Ren was in the right.
Their coordination put his own performance to shame; the chief resident slinked away, unable to show his face any longer.
Chapter 282 - Scientific Research (Part 2 of 4)
The rest of the surgery carried on without incident. Within 20 minutes, it was done.
The excised gallbladder was oddly-shaped and had an unnatural hue.
Zheng Ren chuckled. "Department Chief Sun, could you take this and show it to the family?"
"Excuse me, then." Department Chief Sun was glad to have not once offended Zheng Ren.
The fool Liu Tianxing was still at home, faking illness. He had wanted to press Zheng Ren down but had made the wrong choice. Zheng Ren's potential could not be smothered.