Chapter 202: I Know Just A Little (Part 4 of 5)
After changing into surgical attire, Zheng Ren and Su Yun stood aside as observers while Chief w.a.n.g performed the surgery with a resident doctor as his a.s.sistant.
From Chief w.a.n.g’s proficiency and professionalism, Zheng Ren figured that the man had reached the Master rank in surgery.
Once the peritoneal cavity was exposed, the strangulated intestine was clearly visible within the operative field.
There was a lack of blood supply to a segment of the intestine, causing it to become greyish, a sign of necrosis.
The bowels were released and covered with warm normal saline-soaked gauze first before Chief w.a.n.g attentively observed them for over ten minutes. After confirming that the intestine had undergone necrosis due to the absence of blood flow, he began to remove the affected bowel.
Fortunately, the necrotic intestine was merely thirty to forty centimeters long.
Of course, total bowel resection was also an option, but the patient would face physical and economic problems postoperatively.
Many years ago, when lipid emulsion was first introduced to the country, a case that required total bowel resection had been admitted to a hospital. In order to publicize its product, a foreign lipid emulsion manufacturer had allowed lifetime cost exemption for the patient.
The patient had even conceived and gave birth to a child afterward.
However, a few hundred yuan daily for years was beyond an ordinary family’s affordability.
It was better to surgically remove the minimum length of the diseased bowel for the patient’s sake.
This was precisely why they had to perform the surgery as soon as possible. If the surgeon had performed the laparotomy one minute earlier, one centimeter of the intestine could have been saved.
Chief w.a.n.g was obviously a skillful and experienced surgeon.
Once the necrotic bowel was removed, he cut it open out of curiosity.
There were indeed seven to eight polyps residing in the intestine.
Unlike ordinary polyps, these ones had long, twisted pedicles, which had caused the patient’s intussusception.
Seeing them, Chief w.a.n.g was amazed.
Boss Zheng was indeed an expert. No wonder even the unruly Brother Yun addressed him as his boss.
Once the pathology was confirmed, he began to anastomose the bowel. Everything was done neatly and cleanly, a prerequisite in every surgery, and even Zheng Ren was unable to find flaws in his manipulation.
After anastomosis was complete and the peritoneal cavity irrigated, Chief w.a.n.g was prepared to end the surgery.
Suddenly, Zheng Ren said, “Chief w.a.n.g, can you check the intestine again? If you find any large polyps with long pedicles, you can surgically remove them now.”
“Huh?” Chief w.a.n.g was startled.
“This patient has a large number of intestinal polyps. A similar situation might occur after surgery due to its effects and that of postoperative fasting.”
Zheng Ren’s hypothesis… was too dangerous. Chief w.a.n.g’s surgical cap was instantly drenched in sweat.
If intussusception recurred after surgery, would it be due to the surgeon’s inexperience or relapse of the disease? Chief w.a.n.g was immediately aware of this. If the condition recurred, even if it was not the surgeon’s fault, a reoperation would take a toll on the patient’s health.
Forty centimeters of the intestine had been resected. If he had to remove more intestine and cause postoperative complications such as short bowel syndrome…
“Okay,” replied Chief w.a.n.g without hesitation.
However, therein laid the next problem. Chief w.a.n.g had never performed such an operation, and he lacked the experience to detect the size and number of the polyps, as well as the length of pedicles along the intestine, bare-handed.
The surgery was proceeding at a snail’s pace. After spending almost the same amount of time that he had taken to anastomose the intestine, he finally located and removed a polyp with a ten-centimeter long pedicle.
“Wipe my sweat.” Chief w.a.n.g turned his head and let a circulating nurse use sterile gauze to dry off the sweat that had soaked his surgical cap.
He took this opportunity to peek at Zheng Ren.
They immediately understood each other when their gazes connected.
“Chief w.a.n.g, shall I give it a try?” asked Zheng Ren.
Chief w.a.n.g almost burst into tears.
He had been waiting for Zheng Ren to say this for the past ten minutes. As he had run his fingers along the intestine, that time had inched by.
“Sure. I’m sorry to trouble you again, Boss Zheng.” Chief w.a.n.g immediately agreed.
Zheng Ren smiled and went to perform a surgical scrub.
Su Yun lowered his head and followed Zheng Ren to scrub up together.
Zheng Ren dived into the System and purchased surgery intensive training time during his scrubbing.
As the System’s operating theater rose from the ground, the mannequins appeared before him.
Intestinal resection for polyps removal was an old technique that had been used before the spread of colonoscopy many years ago, and barely any surgeons practiced it nowadays.
Due to its rarity and obsolescence, Chief w.a.n.g was inexperienced in the field.
Zheng Ren merely converted some of his points to ten hours of intensive training time.
In general, this operation was merely child’s play when he had already achieved the Master rank in general surgery. The only thing he lacked right now was experience.
Zheng Ren removed hundreds of polyps and finally mastered the technique in ten hours. Even though he was not proficient enough to perform the surgery with his eyes closed, his current ability was more than enough to handle the case at hand.
As soon as the surgery intensive training time was up, Zheng Ren heard the familiar bell. “Ding-dong!”
[General Mission: Help A Man In Need.
[Task: Complete a case of polypectomy for P-J syndrome.
[Reward: 300 skill points and 3000 experience points. Since this is a rare disease, an additional 1000 experience points will be awarded.
[Time: 5 hours.]
A mission, huh? Zheng Ren happily accepted it. Since he had decided to take over the operation anyway, he may as well receive the rewards to make up for the surgery intensive training time he had consumed.
After putting on his surgical gown, Zheng Ren made for the second surgical a.s.sistant’s position, but was stopped by Chief w.a.n.g, who wanted him to take over the operation as the chief surgeon.
Meanwhile, Su Yun brazenly squeezed past the first a.s.sistant.
The resident doctor was dumbfounded. Who the h.e.l.l were these guys, and why was the handsome man beside him acting so rudely?
“I suggest you step away from the operating table. This surgery doesn’t require four men.”
He had failed to antic.i.p.ate the even harsher words that followed almost instantaneously.
Chief w.a.n.g knew Su Yun very well and was reluctant to let the resident doctor be shamed like this, so he said, “Step down and show the resected polyp to the patient’s family.”
The resident doctor sighed and walked out of the operating theater, holding a specimen container containing the resected polyp and its pedicle.
He was also curious and wanted to observe the surgery…
Zheng Ren occupied the chief surgeon’s position calmly.
He was unable to smoothly work around the field with his left hand due to pain flas.h.i.+ng at every movement. Thus, he had no choice but to search for polyps along the intestine with his right hand.
Experience was king.
After ten seconds, Zheng Ren found a polyp.
He extended his hand, but the familiar weight of a scalpel being placed on his palm did not present itself.
The atmosphere became awkward immediately.
“Scalpel, and prepare an atraumatic suture needle with triple zero thread.” Zheng Ren did not mind it, but he suddenly missed Xie Yiren.
“Okay.” The scrub nurse was stunned as she had no idea what Zheng Ren’s surgery habits were. At his instructions, she immediately placed a scalpel on his palm.
He made a one-centimeter cut and separated the mucous and serous layer from the base of the polyp. Then, he carefully extricated a polyp with a fifteen-centimeter pedicle as if the tissue was a muskmelon.
The nurse was flabbergasted. Such proficiency… No wonder Chief w.a.n.g was willing to surrender his position to this stranger.
Chief w.a.n.g was dumbfounded as well. Was a mere human capable of performing such a delicate task?
His skill at surgery allowed him to grasp a few important points.
Zheng Ren’s left hand was stiff and merely played an auxiliary role in the operation. He had basically removed the polyp only with one hand. Secondly, he had run his fingers along more than ten centimeters of the intestine and skipped a few possible spots along the way. The accuracy of his selection was simply incomprehensible.
How could he have known that this polyp had a long pedicle through the intestinal walls?
Since this patient had many polyps, being completely cured through surgery alone was impossible. Well, it would be possible with total bowel resection, but the patient would not be able to physically withstand it and… Chief w.a.n.g did not have a death wish.
The purpose of this surgery now was to eliminate all potential danger, and as for the smaller polyps, he could undergo colonoscopy for polypectomy when the time came.
However… Zheng Ren’s words swirled through his mind again—’I know just a little’.
What the f*ck! Was this “knowing just a little”?!