They would have to constantly monitor the patient's urine specific gravity and adjust the contrast medium. The whole process was exhausting.
Hence, anyone who suggested it was already heads and shoulders above others.
This man would do it. Zheng Ren and Old Chief Physician Pan excused themselves from the ICU and went to prepare the interventional angiography system.
After the placenta abruption case, Old Chief Physician Pan had managed to source some of the materials suitable for interventional surgery.
This time, Zheng Ren would be better-equipped. He would have the right instruments and another doctor with him.
…
…
Zheng Ren prepared himself in the operating room.
Xie Yiren was here. She had taken the time to study interventional surgery as much as possible and was ready to assist Zheng Ren.
However, he would not allow her to. This was not coronary bypass surgery that would have the patient's heart stopped. There was no need for her to be exposed to radiation.
As for Su Yun, Zheng Ren simply did not care if he wanted to help or not.
Between an annoying, sharp-tongued pretty boy or an accommodating, delightful lady, Zheng Ren did not need to think twice about his pick. He was very straight, after all.
They required minimal machinery as it was simply an embolization surgery. In the world of interventional surgery, embolization was the easiest procedure to perform.
Fifteen minutes later, Zheng Ren heard the sound of the stretcher trolley approaching.
The preparations in the operating room were complete.
The patient was gently lifted onto the operating table. Care was taken as not to aggravate the patient's condition. Zheng Ren activated the system and gave control access to the operating room, then began to scrub in.
Interventional surgery had the risk of radiation exposure, but personnel entering the area had to wear heavy lead aprons as they worked. Operating with pounds of added weight was much more difficult than a normal surgery.
However, in certain cases, interventional surgery was the only viable option. If they did not proceed, it would mean standing aside and watching the patient bleed to death.
Zheng Ren went to the storage room and took out a lead apron. Suddenly, he remembered something.
When he had accomplished the solo mission, the System had rewarded him a silver c.h.e.s.t and a special lead apron that could turn radiation into energy.
The silver c.h.e.s.t did not entice him after three consecutive unboxings had given him nothing but skill books.
The special lead apron seemed prestigious. According to its description, it could absorb and transform radiation into energy for its wearer.
That would be very interesting.
Zheng Ren returned the lead apron in his hand and snuck a peek at Su Yun. The man was occupied with positioning the patient and other presurgical preparations. Zheng Ren hurried into the changing room and accessed the System, intending to put the special lead apron to good use.
Chapter 95 - 0095 介入医生的苦，你们不知道
1.0095 You Don't Know The Pain of An Interventional Surgeon
The special lead apron from the System was similar to the one in the hospital. The color and make allowed it to blend in with the other lead aprons on the clothes rack.
However, the System did not provide any explanation as to how the lead apron could transform radiation into energy. The getup only consisted of a vest with no apron skirt, headwear or goggles. Zheng Ren was mystified.
Whatever.
Zheng Ren had no time to investigate it further, so he put on the special lead apron alongside other normal gear. At the same time, the Chu sisters were starting general anesthesia.
General anesthesia was not necessary for interventional embolization surgery, but as the patient was in a state of hemorrhagic shock, seizures were a concern. If the guide wire broke in the patient's blood vessel… Now, that would make for an interesting day.
He washed his hands thoroughly and put on the sterile scrubs. The general anesthesia was complete and thus the surgery began.
"Do you have experience in interventional surgery?" Zheng Ren asked Su Yun.
Su Yun was already geared up and standing beside Zheng Ren like a shadow. Zheng Ren could only hope for such a handsome silhouette for himself but alas, life was unfair.
"Nope," Su Yun answered with a smirk. His eyes crinkled attractively.
Zheng Ren was speechless.
"I've seen you do it once, so I more or less know what to do," Su Yun said in earnest.
'Huh, do you think you're Saint Seiya? What doesn't kill you makes you stronger?' Zheng Ren thought.
Zheng Ren had nothing to say, but at least he had an assistant now. It would be much better than operating alone.
He would take Su Yun as an accompanying houseman.
The patient's blood pressure was at 60/40mmHg. Without saying another word, Zheng Ren opened the catheterization kit and took out his materials.
After disinfection, the first puncture attempt yielded blood.
It was a skill that Zheng Ren picked up after hours of intensive training in the System. He had also performed hundreds of catheterizations during the nitrite poisoning incident.
Su Yun's eyes brightened at this show of skill.
The first time he had witnessed Zheng Ren's skill at catheterization was during the placenta abruption case. He had dismissed it as a one-off stroke of luck. Now, this was the second time Zheng Ren managed to find the vessel at the first puncture. It could not be a coincidence.
Zheng Ren must have incredible skill to be successful on the first attempt, especially since the patient's blood pressure was so low.
Su Yun was quick to criticize but could recognize skill and talent.
"Guide wire." Zheng Ren held on to the vascular sheath and motioned with his other hand.
The wire was placed in his hand before he had even finished his sentence.
Zheng Ren was mildly impressed by the man. He had no experience in interventional surgery but knew what the next step was.
Su Yun was as quick as Xie Yiren when assisting in general surgery. This combination might work out.
Huh, he was quite the genius.
Thoughts were running through Zheng Ren's mind as he slowly inserted the guide wire into the vascular sheath within the femoral artery.
On the Xinglin Garden livestream, the bullet comments were flying.
[The surgeon just completed a spleen removal and liver trauma surgery. Now he's onto a pelvic fracture interventional embolization surgery? Which hospital does this stream belong to?]
[My mentor called up Xinglin Garden. They said the transmission originates from a teaching hospital in Montreal, Canada.]
[Oh? That's the hometown of Norman Bethune. Could it be that Old Mr. Bethune1 is starting a livestream to teach surgery?]
The origin of these mysterious livestreams was twisted into an unrecognizable mess.
Regardless of their identity, be they a foreigner or a Chinese citizen in a public or private hospital, the skills of the host surgeon or surgeons were indubitable.
For now, most people believed that it was a group of surgeons performing different types of surgeries. Hence, that it was a livestream from Canada was believable.
[Anyone who specializes in interventional surgery care to shed some light?]
[Yeah, I totally can't tell what's going on. I've seen a case like this in my hospital before. We didn't have an interventional suite. After getting informed consent from the family, they opened up the retroperitoneum and it was bad. Blood was everywhere. There was nothing we could do…]
[Thanks for the request! Pelvic fracture interventional embolization surgery mainly focuses on the internal and external iliac blood vessels. If the veins are damaged, the high pressure in the retroperitoneal space will stop the bleeding. It will be more complicated if the arteries are damaged, but simply put, the internal
iliac artery can be embolized without much consequences…]
An interventional surgeon from a third-tier city explained away in the chat.
He specialized in interventional radiology-assisted surgery, but found the field was only known for coronary bypass and stent surgeries.
He had watched the livestream of the placenta abruption surgery multiple times and concluded that his skill was on par with the widely popular surgeon on screen.
Maybe not the same level, but close enough.
His conclusion gave him a confidence boost and since then, he had looked forward to the next livestream.
The life of an interventional surgeon was lonely.
Even when he was in the hospital, 95% of the staff had little knowledge of interventional radiology-assisted surgery, let alone an average Joe.
Hence, he visited Xinglin Garden every day hoping to catch the opportunity to talk about his field. Now, he got to showcase his knowledge in front of a few thousand doctors.
[Why? Wouldn't embolization of the artery cause ischemia?]
[If you refer to an anatomy diagram, the internal iliac artery has multiple branches. The external iliac artery is another case, though, as total embolization will cut off the femoral artery. It can lead to the loss of function in the whole leg. Hence, the difficult part of this surgery is the treatment of the external iliac artery.]
[Okay, I think I understood that. How hard will this surgery be?]
[I've done around 20 surgeries; the average duration of one was four hours. You guys don't know the pain of an interventional surgeon.]
As the third-tier city doctor explained the basics on Xinglin Garden, the livestream had already changed to the inside view. The guide wire and guide catheter had been inserted with the utmost precision and the embolization coil followed suit to seal off the ruptured internal iliac artery.
[The surgery was faster than your explanation.]
[What a quick surgery. God damn.]
[I am envious but as I've said, the surgery's difficulty is not in the embolization of the internal iliac artery but the superselection of the external iliac artery.]
Onscreen, behind the flurry of comments, a guide wire began the process of superselection of the external iliac artery.
The wire was very soft and thin, hence leading it into a blood vessel that was not much thicker was very difficult.
It was akin to playing table tennis with a whip: incredibly complicated. The superselection of the blood vessel was ten times more difficult, however.
[Look, this is where the real surgery begins.]
The interventional surgeon started to explain himself. Interventional surgery was rare in the country. In third-tier cities, there would only be one hospital that had an interventional radiology department and possibly three to five specialists shared among them.
In second-tier cities, there could be two departments in total but no more.
Every year, there was a significant number of liver cancer patients rushed into the Vice City hepatology department for fifteen-minute interventional radiology treatment.
However, actual super selective chemoembolization for liver cancer would require more time. Fifteen minutes was likely just enough to take an image.
However, there was a high volume of patients and very few doctors, so some corners were cut.
The interventional surgeon who rarely got to speak finally had the opportunity to share his insights on Xinglin Garden. His eager words began to flow across the screen.
[The superselection has to go beyond the 2nd-grade artery, possibly even the 4th-grade artery to avoid issues. Hence, every pelvic fracture embolization surgery takes a long time to complete successfully.]
This interventional surgeon stared at his phone and typed out each character diligently. He was thrilled at this chance to educate other doctors.
They would finally learn about the advantages of interventional surgery. He was cheery even though he was not at the operating table.
However, he had the fortune of explaining the details of a pelvic fracture embolization surgery to a few thousand doctors, live. He was ecstatic.
His eyes were fixated intensely on the phone screen to the point of watering.
Behind the stream of comments… It seemed like the superselection of the deep circ.u.mflex iliac artery was already complete. The contrast agent was being administered.
No, it must be a trick. His eyes were probably deceived. The doctor shook his head and blinked a few times. He looked back at the livestream and saw, right behind his wall of text, the deep circ.u.mflex iliac artery had been selected and the leak located. The embolization step was happening right now.
God! That was ridiculously fast! Had it even taken three seconds? According to Wikipedia, Norman Bethune died in 1939, so the setting is likely in an alternate universe.
Chapter 96 - Bullseye
[Doesn't seem very difficult. I checked the time, five minutes per arterial branch.]
[That's because the surgeon is a superstar. The difficulty is set.]
[Could you perform an appendectomy in three minutes? I'm sure you can't even complete one in thirteen minutes.]
The trash-talking on Xinglin Garden was similar to that of any online forum.
In the interventional suite, the man next to Zheng Ren was blown away. Su Yun stared with his mouth agape at Zheng Ren as if he had just witnessed a miracle.
Su Yun had not been bragging when he said he could learn from observation alone.
After observing the placenta abruption case, Su Yun watched a few video clips of interventional surgery to obtain some level of understanding. He believed that he should improve his skills and become better than Zheng Ren.
Su Yun was anticipating a failed attempt at artery superselection, which would allow him to step in and save the day.
Who would have thought Zheng Ren could perform artery superselection at such speed and accuracy on the first try?
The diameter of the guide wire was 0.014 inches and one millimeter was equivalent to 0.03937 inch. It was around 0.3556 millimeters thick.
A 4th-grade blood vessel had an approximate diameter of 0.5 millimeters, which was very similar in thickness to the guide wire.
The manipulation of the thin and nimble guide wire into the blood vessel on the very first attempt… Su Yun belatedly realized he was absolutely outclassed.
Another person who shared the same thoughts with Su Yun was the interventional surgeon from the third-tier city hospital.
There was a minor difference between the doctor and Su Yun. Su Yun had talent and could pick up skills from just observing. On the other hand, the doctor had to sharpen his skills from assisting in countless surgeries. He had gone through dozens of pelvic fracture arterial embolizations.
No words could describe the hardship and struggle he faced.
Hence, if disappointment was all Su Yun felt, the doctor who witnessed Zheng Ren's surgery was totally baffled.
Superselective arterial embolization was an incredibly difficult procedure. To reach a 0.5 millimeter, 4th-grade blood vessel with a guide wire on the first try was a miracle!
He calmed down and for the first time, he wondered if he should go to this surgeon's hospital to learn more.
At this moment, he was just like the many doctors on Xinglin Garden who wanted to become the surgeon's pupil.
[I think that's the fourth 4th-grade blood vessel. I believe the bleeding has stopped.]
[Almost. Today I learned that complicated pelvic fractures could be treated like this. Our hospital has an interventional radiology department. I should ask them about this.]
Seeing how clueless these doctors were about interventional surgery, the specialized surgeon from the third-tier city started to type out a message.
[For orthopedics, before the removal of spinal neoplasm, one can use interventional methods to embolize the lumbar arteries. That way, the amount of blood loss can be reduced from 5000ml to approximately 1500ml.]
&
nbsp; The god-like surgeon probably had no time to explain his methods. Well, he would be the one to answer these doctors' questions.
A flame of motivation flickered in him as he continued introducing the various applications of interventional radiology to the doctors online.
[The surgery is almost ending. That's the last artery.]
[The selection was perfect, all that's left is the embolization. Once the image shows no leak, the catheter can be removed.]
[This perfect surgery took…]
The surgeon looked at the time and unconsciously sighed.
23 minutes and 15 seconds…
If it had been him, that procedure would have taken 4 hours. That was the difference between him and the surgeon in the livestream.
He could not even bring himself to challenge that time.
The anonymous surgeon in the Xinglin Garden livestream was like an indomitable mountain that one could only appreciate from afar.
In the operating theater, Zheng Ren switched off the angiography system. He gave a signal and Chu Yanran opened the sensor-activated lead door. With her were drugs needed for the patient.
The guide catheter and vascular sheath were retracted from the patient's body. Zheng Ren turned around to leave. "Maintain pressure, stop the bleed."
Su Yun was stunned. Was he being treated like an assistant now?
He tamped down his dissatisfaction. After all, Zheng Ren had just performed a perfect surgery. Su Yun was no match for him, so what else could he say?
He nodded and used the sterile gauze to press on the puncture site, still a bit dazed.
From Su Yun's observations, Zheng Ren's performance had improved by leaps and bounds since the last interventional surgery. Could it be that the instruments and materials were incompatible then?
Su Yun's mind settled on that as the reason.
Chu Yanzhi came into the room and saw Su Yun's faraway gaze. "Hey, have you woken from your drunken stupor now?"
The line cut his heart like a knife.
Yesterday… He drank too much. How embarrassing.
The Surgeon's Studio c1-799 Page 53
