There was a vast difference between a 1% and 50% chance of survival.
Even if the patient had a 50% survival rate, there was the other 50% of death. This was an incredibly high-risk surgery.
He picked up the phone immediately to contact the chief of the medical administrative division and the executive deputy director who was the head of clinical operations.
He filled them in on the current situation and emphasized the surgical method's novelty.
A few hours later, the hospital contacted the family members and acquired their consent.
Like that, a "new" surgical method began in Class Two Grade A Hospital in Horqin Right Middle Banner of Inner Mongolia.
The interventional doctor was so excited, his hands were shaking.
Nevertheless, he quickly calmed himself and operated the micro-guide wire with simple instruments, superselection, radiography, and embolization.
He completed the series of procedures in a single sitting without any hesitation.
The surgery from the broadcasting room had been replaying in his mind countless times.
All of the procedures were "branded" into his mind.
The only thing that disappointed him was that the recording function in the live surgery broadcasting room was canceled. Otherwise, he could have replayed the recording to his colleagues in general surgery, allowing them to better understand the subsequent surgical process and thus minimizing its risks.
He was not prepared beforehand and did not think to pre-recorde the surgery. The next time, he needed to record the live surgery broadcast.
Even though he regretted it, he still had to proceed with the surgery.
Of course, there was one more thing—the embolization surgery took 1 hour and 6 minutes, which was much longer than the surgeon from the broadcasting room.
Nonetheless, the interventional doctor was not affected by it. It was normal to have a gap between him and the world's top professor, right?
It would be weird if they had the same level of skill.
After completing the embolization, the general surgeon went to the operating table.
He performed a laparotomy, searched for the intestines, and covered them with gauze soaked in warm saline.
The surgery proceeded with much difficulty under constant instructions from the interventional doctor.
Half an hour later, the intestines showed defined boundaries after changing the warm saline gauze several times.
The necrotic intestine was around 40cm. They removed the necrotic parts and stitched them back together. After ensuring that there was no more bleeding, they closed up the stomach too.
The patient's vitals were stable and the surgery was a success.
Even the chief of general surgery who completed the surgery was a bit surprised. He had encountered more than a hundred cases like this over the past few decades as a doctor.
Most patients died quickly, even those with family members who strongly pushed for surgery. There was almost…no one who managed to survive at the operating table, much less recover.
However, the chief of general surgery was quite certain that this patient would be able to survive if there were no serious postoperative complications in the ICU!
This…
He heard from the interventional doctor that the Xinglin Garden broadcasting room would have a live surgery broadcast at irregular times, presumably performed by a top surgeon from the Montreal Medical Center in Canada.
He did not know about Xinglin Garden. There were not many users on this kind of professional website. Most of them gravitated toward first-tier cities such as Imperial Capital, Sorcery Capital, and Shenzhen.
If the remaining users were averaged across the country, it would be lucky if there were one person per city to follow Xinglin Garden all year round.
A thought struck him; he would ask one of his residents to download the app for him after he got out of the operating theatre. He also wanted to watch world-class surgeries.
There were times that a simple thought could decide the fate of someone's life.
Canada was the homeland of Dwight L. Moody. To be able to organize live surgery broadcasts regularly, how great did their medical skills have to be?
The patient was transferred to the ICU. The interventional doctor was still drenched in sweat.
Even though he was physically exhausted, he was still riding on an adrenaline high.
The surgery succeeded! This meant that the surgery he observed in the Xinglin Garden broadcasting room was replicable!
This also meant that more patients could receive such treatment!
The interventional doctor was touched. The broadcasting room's merits really held no bounds. At the very least, the patient who had just received surgery just now would have died if not for the broadcasting room.
…
Zheng Ren was unaware of what was happening in Horqin. He probably did not know where Horqin was.
His afternoon was filled with reading and texting Xie Yiren.
Sometime past 3 o'clock in the afternoon, his office phone rang.
He answered the call, it was from the orthopedic department.
Chapter 341 - Go All Out
A feminine voice could be heard from the other end of the phone call. "Chief Zheng, I'm Old Zhou from ortho."
Dr. Zhou in orthopedic was a good man but spoke in a feminine manner.
His voice was too distinct, so Zheng Ren was able to recognize him immediately.
"Brother Zhou, what is it?"
"Are you busy? There's this interventional surgery on a patient who needs vertebral column resection surgery…" The voice over the phone hesitated, "Can you perform the surgery later?"
Hmm? Why was he in such a hurry?
"I have some free time. Has the patient finished fasting?" Zheng Ren asked nonchalantly.
"Yes! Yes!" Dr. Zhou replied instantly. "We actually invited a professor from the Imperial Capital to perform this surgery, but the professor had an emergency and could only fly in tomorrow morning or he would need to delay the surgery for another 3 to 5 days." Dr. Zhou explained hurriedly.
It was almost time to leave work. Zheng Ren's agreement to do this surgery would depend on his personal ties with him.
"The patient is in a lot of pain, requiring plenty of pain meds to suppress the pain. I'm thinking that if we could do the surgery earlier, the patient wouldn't have to suffer as much."
"No worries, Brother Zhou. I don't have any emergency surgeries here at the moment. If it's convenient, you can ask the family members to sign the consent and just send the patient over to me," Zheng Ren said while chuckling.
"Oh, okay," Dr. Zhou hastily agreed. "I'll refer you to the family members now."
He hung up right after.
Zheng Ren immediately started writing the pre-operative briefing. Since this was the first time they would be attempting this new method, Zheng Ren was figuring out the possible complications that could arise and noted them down.
The professor saw Zheng Ren start working and approached him. "Boss Zheng, are you going into surgery now?"
"Uhm," Zheng Ren replied.
"You guys work all day and night." As the stereotypical German, the professor had opinions on him going into surgery right when they were about to leave work.
The time after working hours was personal. The professor was not accustomed to such an unbalanced work-life schedule.
They were not living, simply enslaved to the hospital.
Nevertheless, the professor was unwilling to leave and even if he did, Zheng Ren would not stop him.
The 64-slice CT scan with three-dimensional image reconstruction from this afternoon opened new doors for the professor, allowing him to take a peek of a whole new world.
He could probably catch a glimpse of the new world from this surgery.
The professor only wavered for a second before he decided to stay.
Zheng Ren was totally unaware of the drama happening inside
the professor's mind as he was busy assessing the preoperative checklist. When the young lady arrived, Zheng Ren was still deep in thoughts about the possible complications.
He wrote down those that he could think of so that he would be able to brief the family members.
The young lady was not affected by it. In her words, this was the time for family members to give their best support to the patient and leave the rest to the doctors.
She was also mentally prepared if the patient would not come off from the operating table alive so that she would be less burdened.
She willingly signed the preoperative forms that Zheng Ren drafted. She then went back and brought over the patient to the emergency ward to prepare for surgery.
Zheng Ren called the operating room to prepare for surgery, bringing the professor to the operating room without notifying Su Yun.
The professor, who had been waiting for Zheng Ren to be free, kept bombarding him with questions about the 64-slice CT scan with three-dimensional image reconstruction.
Zheng Ren did not pay much attention to the professor's questions. He kept his head lowered and changed, occasionally replying the professor.
His mind was filled with questions related to the lumbar artery embolization.
He needed to go to the System's operation room to practice. He figured he would have sufficient experience after ten to twenty surgeries.
Now that Zheng Ren was rich in resources, he had decided to splurge on ten to twenty trials on this new surgical method without even thinking.
He was also not concerned about the surgical time required per trial.
In the past, he would definitely not do this.
It was easy to go down the slippery slope of luxury.
After he finished changing, Zheng Ren told Professor Rudolf to prepare the preoperative measures. He then entered the smoking-room and lit up a cigarette before entering the System.
He bought some surgical training time. The System's operating room emerged from the ground and the simulation mannequin appeared right in front of Zheng Ren.
The lumbar arteries were parallel with the intercostals. There were usually four of them, two each arising from the front and back of the intervertebral foramen.
The arteries in front passed through the transverse process, which continued along the intertransverse ligament. They then pierced through the posterior aponeurosis of the transversus abdominis and were carried forward between this muscle and the obliquus internus to supply blood to the posterior abdominal wall.
The arteries at the back passed through a finer intervertebral foramen into the spinal canal to provide blood supply to the anterior spinal dura mater and the posterior vertebral column.
At the same location, the posterior branch then continued behind to supply the lumbar plexus.
Not only did he need to perform embolization on the posterior branch, but he also had to embolize the abnormal growth of blood vessels from the main branches and the tumor.
He had already confirmed this in the afternoon when he did the 64-slice CT scan with three-dimensional image reconstruction.
Since the patient had an advanced tumor, this was also considered to be a palliative surgery to improve the patient's quality of life post-surgery. Therefore, they had to try their best to block the abnormal arteries supplying to the spine and avoid introducing complications at the same time.
A simple destructive operation would not be this difficult. Without the embolization of the lumbar arteries in the past, the bleeding volume during surgery would be around 3 to 5 liters.
This was a terrifying number.
If they embolized the lumbar arteries, the bleeding could be controlled under an acceptable range of 1.5 to 2 liters.
Zheng Ren used almost 3 hours to complete his first surgical training.
Zheng Ren decided that he was not only going to embolize the posterior branch even though that method would be much easier and satisfy the requirements of an orthopedic surgeon from Imperial Capital.
However, losing 1.5 liters of blood would significantly affect the patient's life.
In order to increase the patient's quality of life in their last remaining days, they needed to minimize the bleeding.
He needed to embolize the intercostal arteries on both sides, the lumbar arteries, and the surrounding capillaries in order to reduce blood loss during surgery.
In reality, there was no need for Zheng Ren to do that.
However, as a doctor, one would always give their best to improve the patient's recovery if the situation allowed. If there was no chance of recovery, they would always try to improve their quality of life.
The blood supply to the spinal cord was very rich. Other than the need to avoid the Adamkiewicz artery, Zheng Ren would need to carefully scan the other arteries and check if they were connected to other organs or the spinal cord. It was only then that he would cut off the arteries that supplied blood only to the tumor.
The surgery progressed very slowly. Zheng Ren gradually got a grasp on the embolization techniques.
It was not easy to be at the Grandmaster level.
Even after completing 10 surgical training, Zheng Ren could only complete the lumbar artery embolization surgery within two hours.
Just to qualify under Zheng Ren's standards, this surgery was much more difficult than prostate interventional surgery.
This was because even if he embolized the wrong capillaries in the prostate, it would not cost the patient's life.
Similar to the patient treated by Professor Rudolf Wagner whose superior vesical artery got embolized, the patient only had urinary incontinence which could be solved by a urinary catheter.
This time, he was going to embolize arteries from the spinal cord's blood supply.
One mistake would paralyze the patient's lower body and even cause respiratory arrest and lead to the patient's death.
Chapter 342 - Working the Professor Like A Servant
Zheng Ren took a drag on his cigarette after exiting the System's operating room. He then crushed the b.u.t.t and placed the second half of the cigarette back into the box.
Chang Yue used to tease him about this.
However, it became a habit that he found difficult to change. Besides, there was no need to change it either.
When he arrived at the operating room, the patient was positioned accordingly. Dr. Zhou greeted Zheng Ren from the operating console room.
"Brother Zhou, you're here." Zheng Ren began to scrub in.
"I'm troubling you at such a late hour. It wouldn't be right if I didn't accompany you," Dr. Zhou said with a smile.
"Right, who's the guy inside?" Dr. Zhou asked, pouting.
"Oh, he's a professor from Germany. He's here to observe," Zheng Ren answered briefly.
"..." Dr. Zhou was at a loss for words.
A German professor here to observe? More like he was gracing them with his presence. Instead, you use him like a servant and made him do all the work while you stand outside chatting happily like a department chief.
Even though Dr. Zhou had questions, he only gave him a smile and kept quiet.
He asked a neutral question. "Which university is the professor from?"
"He's Professor Rudolf Wagner from Heidelberg University," Zheng Ren answered. He saw that the professor had completed the preoperative work and notified Dr. Zhou before entering the operating theatre.
Professor Rudolf Wagner, Heidelberg, why did that all sound so familiar?
The surgery had begun.
People were waiting excitedly for the live surgery broadcast in Xinglin Garden.
The interventional doctor from the Class Two Grade A Hospital in Horqin Right Middle Banner of Inner Mongolia had set a unique ringtone on his phone. Once he heard it, he would spring up like Pavlov's dogs and switched on his phone at the speed of light.
The interventional doctor and the chief of general surgery were exchanging formalities over a meal after the surgery. The chief was not very p
leased when he saw him suddenly whip out his phone at the table.
"It's the live broadcast in Xinglin Garden," the interventional doctor explained.
The general surgery chief's face lit up. He logged into the broadcasting room of Xinglin Garden with his subordinates' help.
The general surgery chief was disappointed when he saw the diagnosis.
It was not a general surgery. Embolization on the lumbar arteries?
From an anatomical perspective, the lumbar arteries supplied blood to the abdomen. There would be serious consequences after the embolization.
Medical care in Canada was really so advanced if they were able to perform surgeries like these.
"Too bad Chief Han from ortho is not here. He'd be very interested in this." The interventional doctor's eyes were fixed on the screen. The general surgery chief thought about it and dialed Chief Han's number.
The hospital was not very big. Even though they had over a thousand employees, most of them were office staff and at least 20% of them usually skipped work.
The department chiefs were very familiar with one another.
The live surgery broadcast was just an excuse for them to gather and drink. It was also for them to brag about the surgery they performed today.
In Xinglin Garden, half of the viewers were shocked after reading the diagnosis.
Embolization of the lumbar artery?
Why did it sound so far-fetched?
[Why would they embolize the lumbar artery. Thoughts, anyone?]
[Yeah, the patient has an advanced tumor. What's the point of lumbar artery embolization?]
[Thanks for the invitation. Let me explain to you guys briefly from an orthopedics surgeon's perspective.
To remove the spinal cord tumor, it would involve complicated operations to resect the vertebra. In order to reduce the amount of blood loss that could lead to death, the patients should undergo embolization on the tumor arteries, with selective sectioning radiography on the c.h.e.s.t and spine 24 or 48 hours before the surgery.]
[Uhm, not too long ago, our hospital did the first spinal cord tumor resection. We did not perform embolization and the patient lost 6 liters of blood. Blood was flowing out even under constant transfusion. The orthopedic surgeon almost peed his pants.]
The Surgeon's Studio c1-799 Page 162
