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Chapter 347: The Melon That Leads To The Vine
“Chief Zheng, you’re amazing,” the gynecology chief resident said from behind. She had gotten a glimpse of the necrotic organ and saw that it was not attached to the surrounding tissues of the patient’s reproductive system.
She was not a sore loser. The medical field was different from others.
If they had proceeded based on her diagnosis, it would be troublesome.
The surgeon would have to quickly leave the table to inform the family.
A reasonable family would understand and the gynecology surgeon would have to seek a general surgeon to resume the surgery as they would have to change the surgical method.
If the family was unreasonable, then congratulations!
If the unreasonable family had some power or was up the social ladder, then you would have hit the jackpot!
Therefore, the gynecology chief resident was grateful if nothing else. Compet.i.tiveness was not an issue here.
“I’m alright.” With a clamp and his hand, he carefully separated the accessory spleen from the surrounding organs. He did not want to risk tearing any unseen connections and damage the other organs.
“It’s an accessory spleen?” the gynecology chief resident asked.
“We’ll know more later. We have to finish up here first.” Zheng Ren focused on identifying the connections within the site. The artery supplying blood to the accessory spleen was twisted, leading to organ necrosis. He would want to avoid puncturing the organ as there would have been pus buildup within.
Zheng Ren worked with caution, always keeping in mind that the ma.s.s could be cancer.
“Could you check if the pathologist is here?” Zheng Ren asked the chief resident.
“Sure.”
[Whoa! That’s an accessory spleen!]
The Xinglin Garden livestream was lively.
[Is the accessory spleen so deep within?]
[I’ve never seen one in real life but it looks like one.]
[We’ll see. Maybe it’s a malignant tumor.]
While the surgeon in the video had demonstrated countless successful high-difficulty surgeries, the doctors on Xinglin Garden still approached the livestream with their own individualistic thinking. They did not blindly accept the diagnosis given in the livestream.
Supremacy?
Even the mighty made mistakes.
Independent thinking was essential for a doctor.
Hence, the doctors in the audience maintained a respectful disbelief toward the published diagnosis, but no one doubted the surgeon’s skills.
Every surgery thus far had been accurate and precise.
The audience believed the surgeon on camera was from an internationally-acclaimed medical facility in Canada.
There were no other major organs attached to the accessory spleen. Zheng Ren carefully wrapped the spleen with a wet gauze, then palpated his way up the feeder artery.
His motions were gentle and cautious. He felt his way up the abdominal structures that he was familiar with, avoiding pressure on the other organs.
Once he had a clearer picture of what was going on, he prepared for ligation and removal.
[How detailed.]
[Is he following the vine to the melon?]
[More like the melon to the vine, then uprooting the whole plant.]
[Judging from this, the probability of a malignant tumor is low.]
[Agreed, but let’s see how the surgery ends. To be honest, in my ten years in general surgery, I’ve never seen an abnormally long pedicle on an accessory spleen.]
[It does look oddly long.]
The mood in the livestream was not as rowdy as before.
This surgery was rather mild and did not showcase any spectacular skills.
Tracking the artery up to the source and removing the accessory spleen were simple procedures that were not flashy.
The only highlight was the accessory spleen’s odd location.
[The surgeon seems to be operating solo again.]
[Oh yeah. However, this procedure seems to be doable without a.s.sistance. It’s just ligating and removing the accessory spleen. There’s no point in having two surgeons.]
[Probably not. In previous streams, the surgeon performed surgeries of higher caliber without any help.]
At this moment, Yang Lei hurriedly entered the operating room.
Noticing the surgery was halfway through, he quickly scrubbed in.
With Yang Lei’s help, it was easier to maneuver upstream.
Xie Yiren stood near to the patient’s lower body and could only pull the retractor in a single direction. In order to follow the feeder artery, he needed someone at the upper body.
Yang Lei got in position and held the retractor. He observed the scene before asking, “Chief Zheng, is this an accessory spleen?”
It was not his first time seeing an accessory spleen, but this one was odd.
“Yes, it is.” The blunt scissors and curved forceps made slow but steady progress upward. He was separating the attachments to the feeder artery all the way to the main trunk.
A call came from the gynecology chief resident. “The pathologist is here.”
“Okay. The sample will be out in five minutes,” Zheng Ren replied confidently.
Yang Lei felt like a small ant in Zheng Ren’s presence.
He had rushed over to the hospital only to find out that the surgery was nearing its end.
Frustrated, he looked at Zheng Ren.
The emergency chief resident was wholly-focused on the operating table, his eyes unblinking.
Yang Lei signed in his heart. How did his appendectomy partner from a few months ago become such a powerhouse?
Clank! The sound of metal on metal echoed. The appendix retractor he held made contact with the forceps.
The retractor in Yang Lei’s hand trembled slightly. He lowered his head and cleared his mind.
If something similar had happened with Department Chief Liu, a surgical tool would be striking his head at this moment and he would be barred from surgery for at least a month minimum.
Yang Lei gathered his thoughts and followed Zheng Ren’s hands. He retracted a part of the tissue to expand the surgical site.
The feeder artery was long and the minor tissues attached were not heavy. They spotted the torsion at the duodenum.
Zheng Ren did not intend to untangle the knot. Doing so would restore the blood flow through the accessory spleen and allow the acc.u.mulated pus to enter the circulatory system.
[Look! That’s the twist.]
[What a long artery. From the looks of it, the twist happened not too long ago. It can only be an accessory spleen. Their diagnosis is incredibly accurate.]
[Yeah, but a histology is needed to confirm this.]
Soon, the surgeon reached the hilum of the spleen.
The feeder artery originated from the hilum.
Zheng Ren reached out and a pair of hemostatic forceps was placed into his hand.
As the incision was short, the retractor was needed to gain access to the target site. Once the retractor was in place, Yang Lei was under to observe the surgery from his angle.
The gynecology chief resident was bent at an angle to watch Zheng Ren’s maneuvering.
“Chief Zheng, there’s insufficient exposure. Maybe you should widen the incision?” No matter which angle she observed from, it was impossible to see the spleen.
“It’s alright,” Zheng Ren said with a smile.
Zheng Ren was confident he could remove the organ as long as he could reach it. The first System training on appendectomy taught him that.
Another surgeon would not be able to perform such a feat.
No surgeon would have the opportunity to practice a procedure numerous times on simulation mannequins.
The gynecology chief resident was silent. She did not understand why Zheng Ren refused to widen the incision. Without visual inspection, how could he ascertain what was going on inside?
Just as she was doubting him, Zheng Ren had a hemostatic clamp in his hand.
He asked for a scalpel then got to work. A length of artery was pulled out from the abdominal cavity.
As the separation was clean, he was able to retrieve the elongated vessel along with the necrotized accessory spleen. The organ was then tossed into the surgical tray.
“Send it for frozen section biopsy.”
[The real surgery is starting. Is the surgeon not worried something might go wrong?]
[You must be new here.]
[It must be. If one has watched The Night of Appendectomies, one would not be surprised by the surgeon’s actions.]
[To be frank, I disagree with the surgeon’s methods to this date. Although he is very capable, it is best to err on the side of caution.]
The circulating nurse studied the operating table. Seeing that there were no other instruments needed, she put her gloves on and bagged the surgical and its contents. It was to be sent to the pathology lab.
Zheng Ren reached for a long-handle needle holder with sutures.
He performed the st.i.tching within the small, confined s.p.a.ce. The gynecology chief resident and Yang Lei watched him in astonishment.
Their view of the surgical site was obstructed. All they saw was Zheng Ren’s hands moving about.
Chu Yanzhi adjusted the surgical lamp to deliver a direct light beam from behind Zheng Ren. The light illuminated the surgical site to give him a better view of the insides.
Suture, knot, snip.
Zheng Ren took the warm saline gauze and covered the surgical site.
The surgery had come to a pause as they waited for the pathology results.
If all was well, Zheng Ren would perform a rinse and some st.i.tching to close up the abdomen.
If the results showed malignancy, the cleanup afterward would be unimaginable.
“Chief Zheng, are you sure the st.i.tching will hold?” the gynecology chief resident asked worriedly.
Her concerns were viable as the angle and s.p.a.ce Zheng Ren operated in was extremely small.
“No worries,” Zheng Ren replied in an easygoing tone. He gave her a confident smile.
“Signs of malignancy?” Yang Lei asked.
“I don’t think so. The surface was smooth and there were minimal attachments to the surrounding tissues. If it was a malignant ma.s.s attached to the spleen hilum, metastasis would have occurred,” Zheng Ren said.
Although Zheng Ren was sure it was not a malignant tumor, he had to follow the standard operating procedure and wait for the frozen section biopsy results.
There was a one in a million chance the System was wrong.
[This half-blind surgery is going well.]
[Guys, how do you think the surgery is being filmed? Where is the camera?]
[We were able to look into the surgical site. It’s probably on the surgical lamp?]
[I don’t think it’s on the surgical lights. If so, there must be multiple cameras. Just now when the lamp moved, we only saw the lighting change but there was no sign of people in the operating room.]
Messages started to fill the screen as they waited for the pathology report.
This was a break in the livestream, allowing the audience to interact with each other. Other times, the surgery carried on without pause.
Whether it was in the operating room or the surgery livestream, the 40 minutes pa.s.sed with laughter and banter.
A call came from the pathology lab, negative for cancer.
The abdomen was st.i.tched back up and the surgery came to an end.
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