The Surgeon's Studio c1-799

by Black Ursa Prime

  However, they had not expected it to take so long to occur.

  After his short explanation, he handed everything over to Chang Yue. It was now her turn to give a pre-surgery briefing, especially regarding the possibility of necrosis due to ectopic embolization which would require the complete removal of the patient's kidney.

  While the briefing was being carried out, Zheng Ren and Su Yun changed into the proper attire in the surgery room.

  After that, Zheng Ren prepared to gather all the tools he would require for the surgery.

  At that moment, he heard Su Yun's voice go, "All instruments have been prepared. Chief Zheng, you may begin surgery immediately."

  "Huh?"

  Chapter 105 - A Flawless Junior Doctor

  "Hmm?"

  "As an inexperienced junior doctor, one has to perform everything flawlessly," Su Yun said, gently running his fingers across his bangs before putting on his sterile face shield. "I have informed the others in the groupchat, they should be ready for the surgery right now."

  "How did you do it?" Zheng Ren was speechless.

  "Are you asking me how I knew which tools and machines they would require for this surgery?" The hair that was moments ago covering his forehead was now neatly tucked behind his face shield. However, out of habit, Su Yun began to toy with it again. "I had made a table, which now hangs outside the interventional operating theater, listing which apparatus and machine each procedure requires. Basically, different as they may be, each procedure has their similarities. Hence, all I had to do was make some minor adjustments. Chief Zheng, will you be using the gelatin sponge for embolization or the spring-loaded one?"

  Since surgical nurses were unfamiliar with interventional embolization, it was about time a leading nurse was assigned to the interventional embolization control room.

  Good lord… this was the first time in Zheng Ren's life he felt this way.

  It was not at the level of joy, but rather relief.

  "The gelatin sponge, then."

  "Hey, is anyone in now?" Su Yun yelled.

  The patient was not yet in the surgical theater and the hallways were empty. A shouted response echoed down the empty hallway.

  "What do you need?" Based on the voice, it was most likely Chu Yanzhi.

  "The gelatin sponge."

  "Alright."

  Zheng Ren was suddenly overwhelmed with a feeling of powerlessness.

  What kind of situation was this? There was absolutely no need for him to prepare anything for this surgery. Was that not a luxury solely enjoyed by instructing professors?

  "The patient is currently in transit, current blood pressure at 60/40 mmhG. Stay here and watch for the patient, then let me know what kind of machines are to be used. I will be heading out to scrub now," Su Yun said softly after making a phone call.

  There were hints of flirtatious intent in that gentle voice.

  The feeling was… oddly peculiar.

  The patient arrived swiftly and the blood bag in his pressure transfusion set was almost empty.

  After the transfer was made, Zheng Ren placed the patient onto the surgical bed with the help of the urologist. Su Yun had already changed into his lead apron and sterile surgical gown and was disinfecting his gloves.

  Zheng Ren also changed; he put on his special lead vest, then got himself scrubbed thoroughly before putting on his surgical gown.

  As he stood in front of the operating table, he realized that disinfection and the placement of sterile surgical sheets had already been done. Su Yun was holding the introducer sheath and to his surprise, even artery cannulation, the very first step, was complete.

  Zheng Ren sighed as he lamented how fast everything was being performed.

  This brat was truly incredible; could someone with such impressive photographic memory truly exist in the world? Zheng Ren was unsure, since even he required continuous practice and revision with his System. It was only through constant exercise that he could improve his skills.

  This man however, mastered everything with a single glance.

  In the live broadcast room of Xinglin Garden, several hundred doctors were already sending messages of support within the first minute of the livestream.

  During the day, there were fewer people online, with viewer counts rising at around 8 or 9 in the evening.

  With a daily schedule of routine room inspections, surgeries and writing patient reports, anyone caught watching livestreams on their phones would be scolded into oblivion by their superiors.

  [Hmm? Finally, I've been waiting for another interventional embolization.]

  [We'll see what it is. Tsk, it looks like postoperative hemorrhaging after kidney removal.]

  [None of you understand my pain in the urology department. Removing a segment of a kidney is and will always be marginally more difficult than spleen restoration surgery. A spleen can be removed at a whim, but the kidney cannot. Tears are streaming down my face now. I'll come back in ten minutes after I'm done crying about it.]

  Several bold comments flooded the screen as the viewers were currently unfocused, and the host surgeon could be seen positioning the micro guide wire. The stream picked up as superselective catheterization began.

  [Why do I feel like the standards of the surgical assistants have been greatly improved?]

  [Good god! There is no limit to his skill, is there? I'm so envious right now.]

  [You are unworthy of being a surgeon if your observation skills are so poor.

  [Can't you see there's another pair of hands at the bottom right corner of the stream? The surgeon has found themselves an assistant.]

  [Why would this surgeon even need to go through the trouble of finding an assistant? A single call would attract at least a few thousand people.]

  [However, with an assistant now, the rate of surgery is marginally faster. It's almost as if they are flying.]

  The stream view shifted to the patient, displaying a view of his blood vessels and the micro guide wire within them.

  The wire arrived at the edge of the aorta branch. As the viewers watched, the micro guide wire advanced once more and swiftly reached the renal artery.

  It then entered the renal artery, allowing for radiography to begin.

  The wound at the edge of the kidney was clearly visible. Under the contrast medium, it looked like a cloud of lethal fireworks exploding out of the kidney.

  Superselective catheterization continued as it entered the renal artery through to its branching vessels.

  [Partial nephrectomy can only be performed in top-of-the-line hospitals in huge cities. If any backwater hospital performed this procedure, the moment the kidney began to bleed, they would resort to removing the entire organ to minimize injury.]

  [Come on now, the modern era of medicine is different and combines several fields. Private hospitals are only capable of performing minor surgeries. Their focus lies mainly on ophthalmology and anorectalogy. Any post-surgery side effects would be referred to general hospitals.]

  [You're going off topic; minor hospitals are not capable of performing these procedures and our hospitals do not have an interventional embolization department.]

  [Report: our hospital had a pelvic fracture patient yesterday with some inflammation in the peritoneum leading to hemorrhagic shock, hence my immediate suggestion of performing interventional embolization. The patient has since been transferred to a hospital that performs this procedure, and according to what I was told, the surgery was completed and the patient is now fine and still alive.]

  [Pfft… that person sure is lucky. Had this happened a month prior, that patient would've died in your hospital.]

  As the stream viewers were conversing with each other, the gelatin sponge was swiftly embolized in a single attempt. The entire swift, smooth action was visible on-air. After three whole minutes, another radiograph was taken and the lethal, morbidly beautiful firework of blood had disappeared completely.

  The entire duration of the surgery, including the three-m
inute wait, was five minutes and twelve seconds.

  Thus, the stream ended. However, the doctors were speaking to each other in the comments.

  [If our urology department wanted to perform a partial nephrectomy, someone has to master interventional embolization.]

  [Stop joking now, alright, it's bold of you to assume anyone would be brave enough to perform this procedure even if they had mastered it. Without a radiography license, if any unfortunate accidents were to occur, you might as well say goodbye to your medical license. If you're brave enough to perform such a risky procedure, the patient's family would also be bold enough to cause a scene. Let me tell you, young man, if you want to solve such an issue, you'll have to have at least one million yuan lying around.]

  [There's way too few radiographers out there, and fewer still would have clinical knowledge. What should we do about this?]

  [What should you do? Tuberculosis was a terminal illness a hundred and fifty years ago. Time will solve everything.]

  [I really, really want to study under you now, which hospital do you work in, my lord?]

  [I believe there is a rumor that this signal was broadcast from Montreal General Hospital]

  [...]

  …

  The surgery had been completed extremely quickly. Zheng Ren felt a wave of relief wash over him.

  Having an assistant felt amazing!

  Although Su Yun was still rough at the edges, having him was still better than performing the entire procedure alone.

  As the surgery concluded, they removed their gloves, recorded the surgery and began editing the video recording of the procedure in order to hand it over to the patient's family.

  The urologist had literally wheeled the stretcher out of the operating theater moments ago and had just managed to reassure the family for a few minutes.

  The moment he returned, the surgery was complete.

  Assistant Director Chen grabbed Zheng Ren's arm as the latter edited the video of the procedure. He said, "Chief Zheng, you're wasting your talent in our hospital."

  "It's fine," Zheng Ren replied, chuckling.

  "Your standards in specialized fields notwithstanding, your skill at interventional embolization alone would easily net you an annual salary of over a few hundred thousand yuan, even after tax deductions. You'd only make four thousand yuan a month in our hospital."

  "I'm not a lead surgeon yet, I'm just a chief resident. It's actually three thousand eight hundred yuan," Zheng Ren corrected.

  That was the gross total inclusive of tax, which was dwarfed by the sum of a few hundred thousand yuan after tax.

  "You're joking, Assistant Director Chen," Zheng Ren said as he edited the video, "Who would want a lead surgeon to write a patient's report after performing a surgery, right?"

  "Yes, you have a point. Just take care of the patient's report first; the assistant chief surgeon will take over after that. Haih, what would we do if a similar patient were to be in our hospital?"

  The single statement by Assistant Director Chen instantly silenced the entire room.

  It was an impossible debacle to solve.

  Chapter 106 - Crossed Hands Maneuver

  Shenzhen City, a city open to all.

  The phrase, "everyone is welcome to Shenzhen City", was deeply ingrained in the hearts of all of its people. Following the construction of the Hong Kong-Zhuhai-Macau Bridge, Shenzhen City received another boost to its already rapid development.

  People of all creeds and origins swarmed into Shenzhen City from all over the country, and to sustain this influx, hospitals with multiple specialties were established. In addition, there was a massive influx of medical professionals into the city due to the shockingly high wages on offer.

  …

  …

  Shenzhen Economic Development Zone People's Hospital was a large, newly-constructed Class Three Grade A general hospital. Its bright, spacious corridors coupled with clean wards were eye candy.

  However, what attracted visitors most was the presence of metaphorical demons of the medical field from Mainland China, which the People's Hospital had hired for a king's ransom.

  One of them was Wu Haishi, a retired senior consultant in interventional radiology, who had been re-employed in the People's Hospital.

  The elderly man, who was already sixty-four years old, was one of the first few people in China to study interventional radiology and was an eminent authority in the domain.

  He had a smaller workload due to fewer consultations in the newly established People's Hospital and the standardization of various treatment programs, which were still in progress.

  Old Wu adhered to the style of the older generation—being down to earth and hardworking. Even in Shenzhen City, without fail, he insisted on exchanging views and theoretical knowledge with his fellow colleagues every day.

  After the morning ward round, Old Wu sat in his office, put on his spectacles with presbyopia lenses and began preparing materials for his next lecture. He also added footage of digital subtraction angiography so that junior doctors could better understand the process and potential difficulties of surgery.

  "Knock-knock-knock!" Someone was at the door.

  "Please come in."

  "Master," greeted a man in his thirties who entered and stood in place ceremoniously.

  He was Mu Tao, a thirty-eight-year-old closed-door student1 of Old Wu. He had taken a successive undergraduate-graduate program before furthering his studies as a doctoral student under Old Wu's guidance. When Old Wu had been re-employed to Shenzhen Economic Development Zone People's Hospital, he had followed suit and moved to the rapidly changing city.

  Despite his advancing age, Old Wu's hearing was flawless. Still reviewing his materials, he nodded. "Yes?"

  "Recently, there has been an anonymous account in Xinglin Garden that broadcasts its surgery live. Its host surgeon has just finished a renal artery embolization for post-partial nephrectomy hemorrhaging today, and I thought it was very interesting…"

  "Oh? Let me see it. Footage for this type of surgery is quite rare." Old Wu immediately raised his gaze and pushed his spectacles up, interested.

  Mu Tao quickly took out his phone and transmitted the video to an LCD television in Old Wu's office via Bluetooth.

  In the video, the host surgeon was performing a femoral artery cannulation.

  His maneuvering was proficient and effective, and every step was done accurately without haste. In a blink of an eye, the introducer sheath successfully entered the femoral artery.

  In Old Wu's opinion, it was only to be expected for the host surgeon to be adept at artery cannulation, which was why he had no criticism to give the beautiful maneuver.

  When the micro-guidewire was in place, the imaging system was activated and the operative field was adjusted upward.

  "Eh?" mumbled Old Wu this time.

  Mu Tao quickly paused the video, perking his ears attentively.

  He had followed Old Wu for more than a decade. Without the need for words, he knew Old Wu had discovered something.

  That "something" was most likely related to the host surgeon's precision in blind manipulation of the micro-guidewire. In the video, the micro-guidewire made contact perfectly at the end of the renal artery, which saved a lot of time for subsequent superselective catheterization.

  "The crossed-hands maneuver?" said Old Wu as he pointed at the host surgeon's hands on the screen.

  Mu Ta froze for a moment. From his perspective, the host surgeon's surgery had multiple highlights, but the pair of hands that would soon disappear from the screen had definitely not been one of them.

  What the hell was the crossed-hands maneuver?

  Old Wu stood up with a smile, walked to the large screen and pointed at the host surgeon's crossed hands wrapped in sterile gloves. "This is an operative habit only used by the older generations who first learned interventional radiology.

  "Look, the left hand is securing the guidewire on the right and the right hand is inserti
ng the catheter on the left.

  "Here, you can clearly see the assistant's hands, but the host surgeon still habitually uses the crossed-hands maneuver to perform the surgery. Do you know why?"

  Mu Tao was perplexed after hearing Old Wu's question.

  Were he honest with himself, he considered the maneuver flawed or at least unnecessary as it largely made the assistant's role obsolete during the surgery.

  "I don't know," answered Mu Tao truthfully.

  "When it all began, the few surgeons who were interested in interventional radiology had difficulty hiring assistants. Therefore, they had to set the guidewire and insert the catheter all by themselves, and thus developed the crossed-hands maneuver where their more nimble right hand would manipulate the catheter while their left secured the guidewire.

  "However, you youngsters don't have to learn that technique now."

  Old Wu felt a little emotional and nostalgic. He missed the old days, where he would perform surgery patiently and meticulously under a large amount of radiation.

  Now, every procedure—contrast agent injection, superselective catheterization and insertion of absorbable gelatin sponge—was done smoothly and successfully without pause.

  Following the embolization, the host surgeon waited for a few moments before performing another imaging test to ensure the complete absence of the previously massive hemorrhage from the renal artery. With that, the surgery video ended.

  "That was good," said Old Wu softly.

  "Their maneuvering was very fast.

  "Every act of superselective catheterization was successful, meaning the host surgeon is incredibly precise. Let me try to guess who they could be." Old Wu sat in his chair, closed his eyes and began meditating.

  Mu Tao waited patiently without a sound.

  A few minutes later, Old Wu shook his head and said, "Those who used the crossed-hands maneuver have basically retired from the clinical field. Even when invited to attend surgeries, they will guide the surgeon rather than perform it personally. This host surgeon is meticulous, with stable hands and superb eyesight, so I suppose they are a young man."