Chapter 55: A Live Broadcast of Cholecystectomy
Single room 303 in the special demands ward.
Chief Surgeon Liu Tianxing lay quietly on the bed as Cen Meng sat by him. Neither of them said anything as they were immersed in their own trains of thought.
Random dot-pixel patterns of static flickered on the television on the wall opposite them with its monotonous, dull noise lingering in the room.
Chief Surgeon Liu broke the silence after a while.
“The patient’s diagnosis is correct?” asked Chief Surgeon Liu in a croaky voice.
“Yes. Preoperative preparations have been completed and the patient is undergoing general anesthesia now,” answered Cen Meng.
“This is a difficult cholecystectomy. First time… Are you sure Zheng Ren is performing laparoscopic cholecystectomy for the first time?” asked Chief Surgeon Liu suddenly.
“I’m sure. He has done a few appendectomies, and he is probably talented in this field as all of them were done well, but I’m sure he has never performed any cholecystectomy—laparoscopic or open surgery—before this!” replied Cen Meng.
“He did a.s.sist in cholecystectomy, if I’m not mistaken.”
The surgical a.s.sistant’s main responsibility in laparoscopic cholecystectomy was to hold the laparoscope, a task far more boring than holding a retractor in an open surgery.
It was fine as long as he had not performed it personally.
Chief Surgeon Liu nodded and closed his eyes. “Youngsters have a tendency to act high and mighty after learning one or two surgical techniques. This sort of att.i.tude will do him no good.”
“Yes.” Cen Meng was aware that Chief Surgeon Liu was going to deliver a speech. As a firm supporter, his job was very simple—answering yes or no would be enough.
“When you’re performing surgery, especially an unfamiliar one, accidents are bound to happen without the supervision of a senior surgeon,” Chief Surgeon Liu mumbled with his eyes closed as if recalling something from his past and added, “Cholecystectomy is just a tier-one surgery, but do you know why surgeons below chief resident rank are not allowed to perform it?”
“Sometimes there will be morphological changes in the cystic and common hepatic ducts due to inflammatory reactions. The damage will be irreversible once the common hepatic duct is cut.” Cen Meng had personally performed more than ten laparoscopic cholecystectomies, so he clearly remembered these precautions.
“Correct, what more with beginners, who can’t even differentiate left and right, using a laparoscope for the first time. Chief Physician Pan really has gotten old. How could he let Zheng Ren perform a surgery that he doesn’t even know how to do?”
“Accidents will definitely happen with such bold courage.”
“We just need to quietly watch the show.”
Chief Surgeon Liu opened his eyes as the sound of static from the television suddenly disappeared.
The anesthesiologist seconded to the emergency operating theater today was Cen Meng’s cla.s.smate, so he would know exactly what Zheng Ren was doing through his “double agent”.
A camera system with video recording and streaming functions had been installed in the laparoscope, but no surgeon wanted to broadcast their surgery live and let others observe their operation.
After persistent requests and some unknown promises, Cen Meng’s cla.s.smate finally agreed to furtively upload the surgery process to him via Bluetooth.
Cen Meng knew that Zheng Ren had no experience in laparoscopic cholecystectomy. In order to make Chief Surgeon Liu happy, he had connected the footage to the television in the special demands ward so that they could watch Zheng Ren’s surgery in real-time.
There was no sound, but the laparoscope had been turned on. Perhaps he was insufflating carbon dioxide into the peritoneal cavity to create a pneumoperitoneum.
The laparoscopic camera soon began to shake. The duo spying on Zheng Ren’s surgery from the special demands ward were experts, so they knew that he had made a hole and was prepared to insert the laparoscope into the peritoneal cavity.
Silence reigned in the ward, causing the atmosphere to become tense as they felt more anxious watching the surgery than if they had been performing the surgery themselves.
Zheng Ren’s sensational forty-nine appendectomies in one night and endoscopic transrectal appendectomy as his coup de grace, a surgery even Chief Surgeon Liu had never heard of, had anxiety gnawing at Cen Meng.
He must have no clue how to perform this surgery. Moreover, this patient had had exudative inflammation for five days and the adhesions would be very severe, which would make the surgery even more difficult.
…
…
There was a sudden change in the traffic monitoring of Xinglin Garden.
Hundreds of viewers swarmed into a single live broadcast room, but after learning from his mistakes last time, CEO Peng Jia had adjusted the maximum viewer capacity of this particular account to ten thousand viewers and even made a contingency plan in case of system failure.
[G.o.d hasn’t performed surgery for days. I really miss his awesome and smooth appendectomies.]
[What surgery is he performing this time? Let me have a look…]
[Laparoscopy! Laparoscopy! I’m so excited because I’ve just started learning laparoscopic surgery. I’m not sure how good this G.o.d is in performing laparoscopy.]
[Would you dare broadcast your surgery live if you’re in his position? He must be very skillful!]
Hundreds of viewers came into the chat shouting ‘666’.
Everyone was still buoyed by the crazy night of appendectomies a few days ago, but how good the surgeon was in performing laparoscopic surgery was an entirely different issue.
The atmosphere in the special demands ward was not as lively as that of the live broadcast room. Even though Chief Surgeon Liu and Cen Meng were convinced that Zheng Ren had never performed or underwent any training for laparoscopic surgery before this, they could not help but feel nervous about this operation.
Soon, the laparoscope entered the peritoneal cavity and the triangle of Calot appeared on the television with severe adhesions .
This sight finally put a satisfied smile on Chief Surgeon Liu’s face.
If he had been the one performing this surgery, he would need to brace himself and lyse the adhesions within the triangle of Calot very carefully. Otherwise, any iatrogenic perforation would end up killing the patient.
If the surgeon was a beginner… No, even if Cen Meng was the surgeon, the only solution upon seeing this would be to transfer the case to Chief Surgeon Liu as he simply lacked the courage to perform such a difficult surgery without supervision.
[Wow, this is actually a laparoscopic cholecystectomy!]
[Who said the G.o.d doesn’t know how to perform laparoscopic surgery? Come out, I promise I won’t kill you.]
[It seems like the host surgeon doesn’t perform laparoscopic appendectomies because his incision is so small that he just simply doesn’t need to use a laparoscope at all.]
The viewers were very excited to watch this surgery in Xinglin Garden. No matter how proficient the surgeon was at appendectomies, it was still a simple appendix resection and a normal resident surgeon’s job after all.
There was a saying that only a master chef could cook simple Chinese cabbage with potatoes well.
The same phrase applied to appendectomy as well. Judging by the flawless appendectomies the host surgeon had performed in the live broadcast so far, the viewers had concluded that he was a demon with a high skill level.
Even so, everyone was born with different innate talents and it would be impossible to improve one’s abilities any further once a certain standard had been reached.
Appendectomy observation was meaningless as it was impossible to use it as a reference in terms of skill level or… physical strength.
However, laparoscopic cholecystectomies were different.
At the beginning of the twenty-first century, domestic hospitals had just started performing laparoscopic surgery and many departments—thoracic surgery, general surgery, and gynecology—had also gradually begun to popularize minimally invasive surgeries.
When the older senior consultants of various departments resigned ten years later, the new generation who had mastered the art of laparoscopy became frontline surgeons and made laparoscopic surgery a common practice in the country.
The advancement of minimally invasive surgery with laparoscopy had been rapid since then.
In 2001, a surgeon from Imperial Capital took eight hours to treat a patient with esophageal carcinoma using a thoracoscope. Now, as long as the tumor was not situated at the higher level of the esophagus, the surgery could be finished within two hours.
Laparoscopic surgery had replaced traditional open surgery as the mainstay of modern medicine.
When the severe adhesions in the triangle of Calot appeared onscreen in Xinglin Garden’s live broadcast room, countless comments began flooding the screen.
[The G.o.d really likes to perform difficult surgery, huh?]
[The triangle of Calot is in a chaotic mess. I’m guessing that the host surgeon will need around three hours to complete the surgery.]
[How is he going to separate the structures when the gallbladder neck is covered in adhesions?]
The closer they looked, the more anxious they felt. The gallbladder was almost completely covered by a thin membranous layer due to exudative inflammation. Forget the dissection of the anatomical structure, even the gallbladder itself was indistinguishable.
Chief Surgeon Liu and Cen Meng were instantly relieved and put on satisfied smiles upon seeing this.