Great Doctor Ling Ran Chapter 612
614 Surgery Observation
Ling Ran read Qi Yuquan's scans and glanced at his biochemical report. After closing his eyes and thinking about things for a moment, he summoned the Virtual Human again.
Ling Ran rose and shrugged to exercise his muscles. He then massaged his neck using the Cervical Spine Manipulation technique.
Right after that, he saw that the simulation of Qi Yuquan's body had appeared before him in a supine position. It was glowing with a blue light, which slowly faded.
Ling Ran extended his hand, and it only took one thought from him to summon a scalpel with number 4 handle. Before the blue light even faded completely, Ling Ran made a 20-inch long L-shaped incision on the patient in a flash. Besides, Ling Ran did not bother separating various tissues into layers and directly made a deep cut.
During ordinary surgeries, various tissues such as the fascia, adipose tissues and skin had to be consciously separated into layers so that the incision could be closed more easily. Since Ling Ran was merely dealing with a simulation of a human being right now, there was no need for him to close the incision.
Ling Ran naturally chose the method that could save him more time. Even the size of the incision was far larger than what was standard.
Nowadays, doctors who carried out hepatectomy on patients with liver cancer made incisions that were only a few inches long whenever they could as this was beneficial for postoperative recovery. Needless to say, small incisions caused plenty of obstacles during the process of the surgery.
A twenty-inch incision was almost half a meter long. Other doctors would be extremely envious if they were to see this.
Ling Ran inserted his hand into the simulation's abdominal cavity. He fished out the patient's liver before taking a good look at it.
With his naked eye, Ling Ran failed to spot large chunks of cancerous tissues. However, this was not the way to a comprehensive judgment, as cancer showed itself in various shapes and forms. Hence, to lower the possibility of a recurrence, surgeons would usually remove all the normal tissues within one or two inches of the cancerous tissues.
However, with Qi Yuquan's age, the removal of normal tissues within two inches, or even one inch of his cancerous tissues might cost him his life.
With his health condition, if removal of extra tissues were to be carried out, he might need to suffer in the ICU for a few months before dying from hepatic failure. If he were lucky, his body might be able to recover from it, but it was hard to say if other illnesses would occur as a result. It was a certainty that his life expectancy would decrease and that his quality of life would plummet.
Ling Ran waved and ended the simulation session.
Right after that, Ling Ran opened Qi Yuquan's MRI scans on his computer and read them carefully.
As the saying went, "the gist of a book will come to you after you have read it a hundred times." For Ling Ran, the same applied to MRI scans.
Qi Yuquan's MRI scans were taken in a private hospital. One good thing about this was that he could bring these original scans along for a consultation in various hospitals.
Instead of the single piece of scan hospitals gave to patients, original MRI scans referred to all the image files obtained during an MRI scan. These were saved in the hospitals' computers, and there could be as many as a thousand of them. Doctors who knew how to read an MRI scan could obtain plenty of information from them.
However, the MRI data of most hospitals were inaccessible by other hospitals. And as hospitals wanted to make more money, they had no intention of sharing the patients' original scans with other hospitals. Because of this and the inherent lack of trust between doctors working in different hospitals, patients had to undergo an MRI scan all over again every time they went to a different hospital.
Qi Yuquan did not have to go through this process. The private hospital gave the entirety of his original scans to him, and these were taken with a 3 Tesla MRI scanner which had a stronger magnet. It was a lot clearer than scans that were taken using the more commonly seen 1.5 Tesla or 0.5 Tesla MRI scanners. There was only one 3 Tesla MRI scanner in Yun Hua Hospital, and the queue for it was perpetually long. No matter how much doctors hated to wait, they would not stop patients from using the 3 Tesla MRI scanner and force them to use the 1.5 Tesla MRI scanner instead.
"System, please give me a new simulation of Qi Yuquan's body." As Ling Ran had no idea how to maneuver the Virtual Human function, he decided to give orders to the system.
The system did not make things difficult for Ling Ran. A new simulation of Qi Yuquan's body appeared before Ling Ran.
Again, Ling Ran made a gigantic incision on the simulated abdomen. He then looked for a chunk of cancerous tissues that could be seen with the naked eye. He asked for a scalpel, positioned it slightly away from the cancerous tissues and cut off a chunk of the simulation's liver.
Blood immediately surged out, making the simulation's liver look like a mini fountain. Very soon, the simulation's abdominal cavity was flooded with blood.
Ling Ran did not bother to carry out bleeding control or any other measures.
"Aspirate," Ling Ran said to no one in particular, and an aspirator appeared for real. Ling Ran immediately asked, "Can you give me a microscope and other equipment for pathological examination such as microscope slides?"
Without saying a thing, the system placed a set of equipment for pathological examination, including a microscope and microscope slides, beside Ling Ran. All of them were glowing with a blue light.
"Not bad at all." Ling Ran praised the system.
Ling Ran took a thin slice of specimen from the chunk of the simulation's liver he had cut off and mounted it on the slide. He then placed a drop of stain on the tissue, placed it below the microscope and started observing it.
He was looking for the position of the cancerous cells. This was so that he could determine the border between cancerous and non-cancerous tissues.
If the borders of the cancerous tissues that could be seen under the microscope were clear, it showed that all the cancerous tissues had already been cut off. On the contrary, if the borders were vague, it indicated that there were still cancerous tissues in the patient's body and that they had spread even further. This meant that more of the patient's tissues needed to be cut off.
This method where surgeons worked together with pathologists were getting more and more widespread among hospitals. It came with obvious benefits too, as by observing the borders of the cancerous tissues, surgeons could clear the body of all cancerous cells while removing as little normal tissue as possible.
However, when this method was applied in real life, it often took time for the Pathology Department to revert the examination results. Besides, there were often times when the exact border of the cancerous tissues could not be determined even after two or three examinations. Doctors in the past did not cut off all the tissues within one or two inches of the cancerous tissues for nothing. They did this because cancerous cells usually spread one or one and a half inches away from the original cancerous tumor.
This method where pathological examination was coupled with surgery allowed surgeons to cut off half an inch or an inch less of normal tissues.
However, this method was rarely used among patients with liver cancer.
This was because the patients' abdominal cavity would have to be left open while the Pathology Department worked on getting the results out. Even though this would work well for patients undergoing surgery for colon cancer, things were not usually this easy when it came to patients with liver cancer.
Whether blood flow of the blood vessels in the hepatic portal or the blood vessels elsewhere was interrupted, the human liver could only survive safely without blood for an hour. Instead of interrupting the blood flow for more than an hour, surgeons would rather cut off an extra inch of normal tissue. This was because if they were to use this method, they could only carry out a limited number of examinations, and the interruption of blood flow would also worsen the patient's prognosis. It was pretty much pointless.
Ling Ran was not confident that he would be capable of removing all of the cancerous cells in Qi Yuquan's liver on the first or second try during the surgery. Aside from this, the presence of satellite tumors meant that he would have to cut off a huge chunk of Qi Yuquan's liver and that the surgery would be an even more complicated one. By following the standard procedure for liver tumor removal, Ling Ran would not be able to couple the surgery with pathological examination at all.
However, he could not just cut off one or two inches of normal tissues around the cancerous tissues, as it was obvious that Qi Yuquan's body could not take it.
This was also one of the reasons Meng Shan introduced Ling Ran to Qi Yuquan.
Even though Qi Yuquan's cancer was still somewhere around the early stage and middle stage, his body was already pretty battered. Because of this, it was hard to come out with a surgical plan for him.
Unless the surgeon had access to a simulation of his body, which Ling Ran did.
Ling Ran could cut off the simulation's liver and confirm the border of Qi Yuquan's cancerous tissues whenever he wanted to. He could even do that right before the surgery to see the progression of the cancer. This was way more accurate compared to reading CT and PET scans.
Ling Ran felt that this was the biggest advantage of having access to the simulation to other people's bodies.
Nothing else even came close to this.
And Ling Ran would not listen to anyone who said otherwise!
"Zuo Cidian, carry out preoperative preparations for Qi Yuquan and let Qi Yuquan himself as well as his family members sign the informed consent forms" Ling Ran checked through everything. After he confirmed that his plan was workable, he ended the simulation session.
As of right now, he still had three hours and twenty-one minutes left to use his Virtual Human.
Over the phone, Zuo Cidian was extremely anxious. He asked, "Are you really going to operate on Qi Yuquan? That old man is seventy-three years old, and you know what they say? They say that people are the most likely to die at the age of seventy-three and eighty-four."
"This surgery plan is extremely beneficial for the patient. You must explain this to the patient and his family members." Ling Ran cut Zuo Cidian off and stated his opinion.
Arrogance was a trademark trait in surgeons. In other words, they often acted in disregard of other people's opinions. It was impossible for cowardly people to become surgeons.
Just by listening to Ling Ran's tone, Zuo Cidian knew that he was incapable of convincing Ling Ran.
After the call ended, Zuo Cidian thought long and hard about it before giving Huo Congjun a call. After roughly describing the situation to Huo Congjun, Zuo Cidian dawdled toward the VIP patient building to talk to Qi Yuquan and his family members.
News had always traveled fast in the VIP patient building. The moment Zuo Cidian entered the ward and uttered the word "surgery", everyone working in the building soon knew about it.
This was because the medical staff members in the VIP patient building were a lot freer compared to the ones working in the Emergency Department.