Great Doctor Ling Ran Chapter 535
536 Large Tumor
The act of removing the tumor was as standard, but the difficulty was completely different.
The simplest of all tumor removals was the removal of benign tumor on the skin. Perhaps it would disappear without any dignity once someone grabbed it and plucked it off.
Benign tumors in the body were more complicated. For doctors, the main problem was their location and size.
The worst position of a tumor would be at the brain, and many benign tumors in the brain could lead to death. Removing it was even riskier. Some of them were located too deeply inside the brain, and there was basically no reason for the patient to receive treatment anymore.
However, the size of the tumor was actually more important than its location.
In particular, tumors with a diameter of more than four inches was in itself an invasion in the body, and it will cause numerous problems to the person. Besides, there were risk factors, such as arteriovenous vessels surrounding the tumor.
Guan Fei used his hand to scratch the tumor that was as big as her own head. She could not cry even if she wanted to.
Just before her eyes was a blood vessel as thick as a thumb and a blood vessel wall so thin that she could almost see the blood flowing inside.
Guan Fei could imagine accidentally slipping her hand and rupturing such a large blood vessel located below the tumor, the patient's blood loss would be more than 1,000 or 2,000cc in just a few minutes.
The tension rendered her speechless. She could not curse anyone either, and her hands and feet were so stiff, but she did not dare to move.
"It feels like when I was in elementary school, I was punished by the teacher to stand at the back when I couldn't memorize the text." Zheng Jun was squashed against Guan Fei. He used up all his strength to stand on his toes and whispered. Two people were needed to deal with this tumor to ensure the patient's safety.
A small sized tumor would not even provide enough room for two persons.
Guan Fei hummed. "It's really torture. Could you use more strength?"
"I'm already using a lot of strength. Can you hold it more steadily? If you slip, things will be really bad." Zheng Jun was in a bit of a bad mood. In order to show his grace, he chose a position that was harder to exert force. Now, he regretted it.
Guan Fei stood closer to Ling Ran. She could see clearer, and she did not have to stand in such a slanted position.
Zheng Jun was miserable. He had to stretch one of his hands far outward, and he even had to stand on tiptoes. The posture was very uncomfortable.
However, Guan Fei obviously did not show any appreciation.
Because her position was also very difficult to maintain, so unfortunately, she could not understand that Zheng Jun was actually in an even more uncomfortable position.
Zheng Jun snorted inwardly.
For him, this was the equivalent of him learning a lesson: a price had to be paid for anyone who showed any signs of chivalry in the hospital. For Zheng Jun right now, the amount he had to pay was truly unbearably painful.
Being punished to stand still for one or two classes was already very exhausting for a child. It was even more uncomfortable to stand with a distorted posture for more than an hour but still think of a way to watch the surgery.
"Please hold it firmly, if you guys slip, the patient will die." He Yuanzheng cast a glance at Guan Fei and Zheng Jun and reminded them.
Zheng Jun quickly agreed.
Guan Fei said a little squeamishly, "It's too slippery, it's not easy to hold it."
When Ling Ran heard her say this, he said without raising his head, "Xiang Xueming, come and replace Guan Fei."
"Ah!" Guan Fei cried out and quickly said, "No, I can still handle it, I'm just..."
"There is no need to force yourself." Ling Ran interrupted Guan Fei and said to He Yuanzheng, "I will block the left hepatic portal and cut the middle hepatic vein."
"Okay, the patient's signs are stable." He Yuanzheng looked at the monitor and reported to the chief surgeon.
Even sneaking a glance was relatively difficult.
If a young assistant had been in his place, the young assistant would either be too busy or frightened, and the young assistant would not even dare to turn his neck to look at the monitor.
Ling Ran did not need to look at the monitor if He Yuanzheng kept an eye on it. This not only saved time and energy, but was also good for the continuity of the surgery. For example, it was very easy for a person to be killed in a game when the gamer was playing a game in class but looked up to sneak a glance at the door to keep an eye on the teacher. Similarly, the surgeon would be more willing to continue monitoring the surgical field.
As Ling Ran silently fiddled with the primary porta hepatis, Xiang Xueming dressed up in his surgical gown and went up to replace Guan Fei.
Guan Fei whispered unhappily, "I can still carry on."
"You can tell that to Doctor Ling. Turn around, we'll switch positions with our backs against each other," Xiang Xueming whispered softly.
Guan Fei did not dare to bother Ling Ran. There were several department's doctors at the scene. If she argued over such a small matter now, she would lose a lot of marks. In addition, Ling Ran had never fallen for coquetry. Although this was also the reason why Guan Fei thought that Ling Ran was cool, distant, and handsome, this time, it affected her performance.
Guan Fei had to change positions with Xiang Xueming using her back.
After taking off her surgical gown and gloves, she stood at an open space, and Guan Fei felt that her entire body had relaxed. There was no need for her to carry the heavy tumor anymore. She could also stand wherever she wanted, but Guan Fei was still a little bit disappointed and desolate.
It was difficult to fight for the opportunity... No, she should say that she lost the opportunity to practice her skills on the giant tumor, even though it had been handed to her on a silver platter.
Guan Fei was very certain that a person like Xiang Xueming was willing to stand until his leg broke just to watch the operation.
"Hmm." The circulating nurse came over and gestured with her chin at Guan Fei.
"I'll leave immediately." Guan Fei quickly took a few steps back and joined the viewing area.
Standing on her left were two General Surgery Department's assistant lecturers, and on her right was a Department of Urology's assistant lecturer. Everyone stood obediently behind the red line and watched the surgery. Guan Fei, naturally, could only obediently crane her neck to look.
However, while the others watched Ling Ran's operation, Guan Fei watched Xiang Xueming in great displeasure.
She saw that Xiang Xueming had taken over in holding the tumor. He was still standing sideways and across Zheng Jun, but the position between the two was turning dangerously intimate.
The amount of space thatXiang Xueming took up was more than twice of what Guan Fei took up. Since there was limited space at the operating table, it meant that his posture was even more distorted.
Xiang Xueming did not seem to mind.
From his angle, he could almost see all of the chief surgeon's maneuvers. He can also see some of the first assistant's operation. It can be said to be a golden position.
There was a saying that was often repeated among surgeons, "Watch one surgery, and you learn it, then you can perform it."
It can be said that most of the minor operations were operations where the surgeon who had assisted three cases could try performing a surgery by himself.
Today's hospitals tended to be more cautious, and with the scarcity of surgical resources, young doctors often did not have any surgeries to do. It was not because they could not perform the surgery. Of course, the specifics about the surgery's outcome depended on how well was the doctor's comprehensive abilities.
Xiang Xueming pretended to look like he was craning his neck as he secretly snuck a few glances at Ling Ran.
Ling Ran, who graduated in the same year from the same university as he did, was waving the scalpel easily while he was aided by Yun Hua Hospital's director of the Department of Hepatobiliary and Pancreatic Surgery.
"Now let's treat the porta hepatis," Ling Ran asked the assistant to pull the liver down, revealing the porta hepatis from the liver septum, and he began to separate the superior and inferior vena cava.
The most troublesome part of performing liver surgery was that its blood supply was rich, and there were many thick blood vessels over there. They cannot be cut off as the surgeon liked. When they were cut, they had to be cut and ligated separately, if not, it would result in a hemorrhage.
In liver surgery, the most troublesome part was the treatment of the hepatic portal.
In a department like the Department of Hepatobiliary and Pancreatic Surgery, as long as the hepatic portal was involved, the starting price for that surgery would be the monthly pay for an assistant lecturer, because only assistant lecturers would dare to work on them. A tumor that invaded two hepatic hilum systems like this huge tumor was something that ordinary lecturers would not dare to handle.
One such example was He Yuanzheng, who had hesitated many times, which was why his power as the chief surgeon was taken away by Ling Ran.
In truth, if he had persisted, Ling Ran would not be able to take away his surgery by force. Once Zuo Cidian communicated with him, there was a high chance he will convince Ling Ran to give up.
However, He Yuanzheng was really not confident in performing this surgery.
At this point, he also paid more attention to Ling Ran's operation.
He just saw Ling Ran separating one vein after another all the way down until he separated the base of the vein at the right lobe of the liver
As He Yuanzheng watched, he suddenly realized that the porta hepatis had been separated from the rest of the body.
He Yuanzheng could not help but raised his head and glanced at Ling Ran.
"Wipe off my sweat." Ling Ran was also little exhausted. He raised his head.
Su Mengxue quickly used gauze to wipe off the fine sweat on his head.
"Let's continue." Ling Ran rested for half a minute before he put his attention into separating from the body again.
For him, this operation was definitely somewhat challenging, but the level of difficulty was just right.
Compared to an ordinary hepatectomy, Ling Ran was required to be more careful and to think a little more.
However, the surgery itself was ultimately lower than his limits.
As long as Ling Ran became serious in performing the surgery, the sense of accomplishment from the result would not be lesser.
Moreover, there was nothing about the surgery where he would truly be stuck.
Ling Ran made it a habit for himself to always do a lot of preparation work.
With Master Level Hepatectomy along with complete preparation coming at it, this one large but singular tumor will just face a greater burden in maintaining its own existence.
It should not be treated gently even if it looked like a beef tenderloin.
The tumor gradually separated.
At the last moment, Xiang Xueming and Zheng Jun held the big shuttle-shaped tumor and placed it on the tray.
"It's really heavy." Xiang Xueming giggled. He was really dead tired.
"23.6 pounds." Lu Wenbin was so exhausted that his arms had fallen asleep, but he still estimated the number.
Xiang Xueming smiled. He carried it together with Zheng Jun to place it on the electronic scale.
"24.5 pounds." Xiang Xueming read the number, and he clicked his tongue and said, "It's so heavy! Doctor Lu, your guess was quite accurate."
"You didn't deduct the weight of the tray." Lu Wenbin smiled faintly.
Xiang Xueming was stunned. He really did not weigh the weight of the tray before he weighed the tumor.
*Snap snap snap*
A Medical Affairs Department's junior officer was so excited that his whole face was flushed as he started taking pictures like crazy.
"This is the biggest liver tumor in our hospital in recent years." The junior officer could not even recall how many years it had been. In short, it will be good if he just recorded such a major event.
Ling Ran was still performing the surgery on the operating table. There were plenty of things to do to wrap up such a major surgery.
The junior Medical Affairs Department officer took photos from every direction. In the end, he started snapping photos at Ling Ran madly.
Ling Ran, who was in the aperture, was as bright as the sun, as cool as Jupiter, and as dazzling as the galaxy.