Great Doctor Ling Ran Chapter 663
As Ling Ran had been operating on quite a lot of elderly patients suffering from liver cancer lately, he had learned much from it.
When he practiced on the simulation today, he did not cut open the liver to see the degree to which the cancerous cells had spread. Instead, he sliced off a chunk of tissue straight away to see how good his judgment was.
As it turned out, the cut he made was very accurate.
There was less than 0.4 inch of extra tissues.
In comparison, the normal practice during ordinary hepatectomy was to cut off an extra 1.2 inches or so of normal tissues. Patients who were in better health condition were able to take it, but elderly patients with weak liver function had a low likelihood of surviving the surgery. If they were to undergo normal hepatectomy, there was a very high chance that they would not wake up after the surgery.
The key to making a precise cut was a good judgment and practice.
Ling Ran spent a few minutes judging the accuracy of his handiwork. He planned to try to stop using the Virtual Human for the upcoming surgeries.
This was because he only had access to simulations of patients' body for a limited time. Besides, it was not like he could share this feature with other doctors. At the end of the day, he would need to operate on patients like a normal person.
Clinical medicine relies heavily on experience, to begin with, and many things require plenty of practice. Theories were pointless. A person could also look at it another way: there was nothing wrong with talking about theories, but there was no need to tell the truth.
Take CPR as an example. The theory of CPR had changed greatly ever since people started using it. Correspondingly, CPR strategies had also undergone continuous changes. Even though we have entered the twenty-first century, the CPR manual was still constantly being updated.
Even though evidence-based medicine was all the rage now and had been infiltrating the field of medicine, it did not mean that doctors had stopped relying on experience.
Similarly, the theory behind how the defibrillator worked had been evolving too. As for nitroglycerin, the mechanism behind its efficacy was only discovered more than a hundred years after people started using it, after it had saved countless lives. A researcher concluded that nitroglycerin worked to loosen the cells in the endothelium and won the Nobel prize for it. The component inside nitroglycerin that loosened the cells in the endothelium was then used to make Viagra.
The field of surgery drew even more on experience.
For example, no one ever came to an agreement about the period of time where hepatic blood flow could be obstructed. In the beginning, surgeons were saying that it could only be done for fifteen minutes. Back then, one hour was fine. After that, some of them suggested that for every fifteen minutes where hepatic blood flow was obstructed, it should be resumed for five minutes. No one actually came out with any explanation, and they offered these suggestions based on experience.
Most of the time, the reason behind the importance of seniority in the field of surgery was because doctors who had worked for longer had more experience. Junior doctors had no choice but to be obedient so that they could learn from senior doctors.
Even though the field of surgery was evolving, most of the time, the more advanced a skill was, the more it could not be explained.
Ling Ran did not intend to talk about the theory behind the Ling Hepatectomy Technique either. There was no point in it as the technique was a good one anyway. It was truly able to save lives. Patients did not need theories from doctors either. All they wanted was to get cured and stay alive for a long as possible.
Surgeons were not very reasonable people.
Many of the methods employed by surgeons could not be explained, and even if those surgeons were to offer an explanation, it might not be the truth.
Ling Ran did not find it a problem at all.
He just needed to make sure that the Ling Hepatectomy Technique could be carried out without a simulation. It would not be a problem even if a surgeon needed to participate in a couple of dozens or a few hundred surgeries as an assistant to learn how to do it. It was very normal for surgeons to learn a new surgical method by first observing before assisting other doctors for two or three years anyway.
Even ordinary hepatectomy was not an easy surgical method, and for the longest time, it carried a very high mortality rate.
As more and more surgeons learned how to perform hepatectomy, all of them contributed their experience to the study of the surgical method. This was how the mortality rate slowly became lower.
Liver cancer in elderly patients was not an easy illness to treat, to begin with. Ling Ran walked over to the operating table and glanced at the old lady on it. He then gestured to the anesthetist to carry on before returning to his position and saying, "Let's prepare to start the surgery."
The surgery group who had been baffled by the long wait finally perked up.
Compared to the Department of Surgery of Beijing Sixth University Hospital, the surgery group Donghuang Regional Hospital assigned to Ling Ran was obviously weaker. They moved a little more slowly, and they were not so good when it came to teamwork. Even though they were better than the average surgeons and were quite provocative, it was evident that the standard of surgeons in the hospital were not as high as those in Yun Hua Hospital.
But they were after all, from a tertiary Grade A hospital, so there was a limit to how bad they could be. Ling Ran slowed down a little before picking up his pace again so that the surgery group could get used to it.
The doctors who were watching the surgery felt pretty relaxed because of this.
"He's pretty good." The department director of the General Surgery Department, Xu Jinyi was standing right opposite Ling Ran. Both he and the associate hospital director were standing on a bench with their arms crossed. They had a good view of the surgical field.
As the operating theaters of Donghuang Regional Hospital were not equipped with visitation rooms, it was more comfortable to watch the surgery in the operating theater.
An associate chief physician from the General Surgery Department who was standing beside Xu Jinyi, too, nodded with a smile and said, "He's quite good."
Even though both of them were praising Ling Ran, they were implying that they could achieve the same feat too. At the same time, they were being pretty amicable.
As the execution of the surgery did not seem difficult, they could easily learn the surgical method. Hence, they naturally showered Ling Ran with praises.
The other associate chief physicians from the General Surgery Department were also chit-chatting and laughing in a low voice. As there was no Department of Hepatobiliary and Pancreatic Surgery in Donghuang Regional Hospital, the department director and the associate chief physicians of the General Surgery Department were the ones who carried out liver-related surgeries.
This was also mainly because Xu Jinyi, their department director knew how to carry out pancreas-related surgery. Because of this, whether the associate physicians knew how to do the same thing or not, they did not have the opportunity to do so. Hence, all of them were scrambling for liver-related surgeries.
After the department director retired in four or five years, the associate chief physicians would be engaging in a fiery battle. The winner would become the department director of the General Surgery Department, and even among the losers, one of them might have the chance to start a Department of Hepatobiliary and Pancreatic Surgery.
As a whole, the relationship between the doctors in the General Surgery Department of Donghuang Regional Hospital was pretty good, and the associate chief physicians were open to learning new things too. Now that they realized that Ling Ran's maneuvers were slow and simple, they were in a pretty good mood.
Ling Ran naturally did not have the intention to care about other people. He moved slowly up to the point where he needed to start severing the hepatic ligaments. He then glanced at the clock and started picking up the pace.
The members of the surgery group naturally matched his pace.
They severed the round ligament, falciform ligament, right triangular ligament, left triangular ligament, coronary ligament, and the other ligaments. Every time they reached a new ligament, Ling Ran picked up his pace a little. By the time they were working on severing the hepatoduodenal ligament, everyone around them were slowly lowering their voices.
All the surgeons had been operating on patients for more than ten years. When they saw how at ease Ling Ran was even though he was working very quickly, they understood why there was a change in pace.
"How amazing." Xu Jinyi suddenly laughed out loud.
Feng Zhixiang was his friend, and when he heard this, he laughed too. "The legendary moment is yet to come."
He was thinking about the way Ling Ran sutured blood vessels. It was so effortless that it was as if Ling Ran was eating a walnut cake.
The old woman on the operating table was a lot healthier than most of Ling Ran's elderly patients. Truth be told, if it were not for the fact that the old woman could almost qualify for normal hepatectomy, Donghuang Regional Hospital would not have dared to invite Ling Ran over for a freelance surgery.
As Xu Jinyi and Feng Zhixiang spoke, Ling Ran exposed the patient's porta hepatis and started obstructing the blood flow. He then exposed the veins...
If another surgeon were doing the same thing, he would have gotten slower and slower. However, Ling Ran was picking up pace instead.
Ling Ran was shouldering all the burden of the surgery. From the perspective of the scrub nurse beside Ling Ran, Ling Ran was not changing instruments at a faster pace compared to before. The anesthetist had it even easier as there was not much bleeding and Ling Ran's movements were gentle. The patient's vitals were relatively stable too.
Thought the doctors watching the surgery were speechless as they glanced at one another.
Ling Ran only took a few minutes to make a pre-cut and separate the liver by blunt force.
"Send it for pathological examination." After the nurse left the room with the tissue sample, Ling Ran took off his slippery gloves. He then took a new pair of gloves and put them on.
Only then did the doctors in the operating theater start discussing the surgery.
"What the heck!"
"It took my breath away!"
"What just happened was totally beyond my wildest imaginations."
After a while, the result was out. "The boundaries are clear."
The doctors in the operating theater started racking their brains for words to praise Ling Ran again.
This was when Xu Jinyi quietly called Feng Zhixiang over and led him out of the operating theater. He then said in a low voice, "Professor Feng, can you do me a favor?"
Feng Zhixiang chuckled as he asked, "What's the matter?"
Xu Jinyi said, "I would like Doctor Ling to operate on me."