Chapter 341: Go All Out
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
A feminine voice could be heard from the other end of the phone call. “Chief Zheng, I’m Old Zhou from ortho.”
Dr. Zhou in orthopedic was a good man but spoke in a feminine manner.
His voice was too distinct, so Zheng Ren was able to recognize him immediately.
“Brother Zhou, what is it?”
“Are you busy? There’s this interventional surgery on a patient who needs vertebral column resection surgery…” The voice over the phone hesitated, “Can you perform the surgery later?”
Hmm? Why was he in such a hurry?
“I have some free time. Has the patient finished fasting?” Zheng Ren asked nonchalantly.
“Yes! Yes!” Dr. Zhou replied instantly. “We actually invited a professor from the Imperial Capital to perform this surgery, but the professor had an emergency and could only fly in tomorrow morning or he would need to delay the surgery for another 3 to 5 days.” Dr. Zhou explained hurriedly.
It was almost time to leave work. Zheng Ren’s agreement to do this surgery would depend on his personal ties with him.
“The patient is in a lot of pain, requiring plenty of pain meds to suppress the pain. I’m thinking that if we could do the surgery earlier, the patient wouldn’t have to suffer as much.”
“No worries, Brother Zhou. I don’t have any emergency surgeries here at the moment. If it’s convenient, you can ask the family members to sign the consent and just send the patient over to me,” Zheng Ren said while chuckling.
“Oh, okay,” Dr. Zhou hastily agreed. “I’ll refer you to the family members now.”
He hung up right after.
Zheng Ren immediately started writing the pre-operative briefing. Since this was the first time they would be attempting this new method, Zheng Ren was figuring out the possible complications that could arise and noted them down.
The professor saw Zheng Ren start working and approached him. “Boss Zheng, are you going into surgery now?”
“Uhm,” Zheng Ren replied.
“You guys work all day and night.” As the stereotypical German, the professor had opinions on him going into surgery right when they were about to leave work.
The time after working hours was personal. The professor was not accustomed to such an unbalanced work-life schedule.
They were not living, simply enslaved to the hospital.
Nevertheless, the professor was unwilling to leave and even if he did, Zheng Ren would not stop him.
The 64-slice CT scan with three-dimensional image reconstruction from this afternoon opened new doors for the professor, allowing him to take a peek of a whole new world.
He could probably catch a glimpse of the new world from this surgery.
The professor only wavered for a second before he decided to stay.
Zheng Ren was totally unaware of the drama happening inside the professor’s mind as he was busy assessing the preoperative checklist. When the young lady arrived, Zheng Ren was still deep in thoughts about the possible complications.
He wrote down those that he could think of so that he would be able to brief the family members.
The young lady was not affected by it. In her words, this was the time for family members to give their best support to the patient and leave the rest to the doctors.
She was also mentally prepared if the patient would not come off from the operating table alive so that she would be less burdened.
She willingly signed the preoperative forms that Zheng Ren drafted. She then went back and brought over the patient to the emergency ward to prepare for surgery.
Zheng Ren called the operating room to prepare for surgery, bringing the professor to the operating room without notifying Su Yun.
The professor, who had been waiting for Zheng Ren to be free, kept bombarding him with questions about the 64-slice CT scan with three-dimensional image reconstruction.
Zheng Ren did not pay much attention to the professor’s questions. He kept his head lowered and changed, occasionally replying the professor.
His mind was filled with questions related to the lumbar artery embolization.
He needed to go to the System’s operation room to practice. He figured he would have sufficient experience after ten to twenty surgeries.
Now that Zheng Ren was rich in resources, he had decided to splurge on ten to twenty trials on this new surgical method without even thinking.
He was also not concerned about the surgical time required per trial.
In the past, he would definitely not do this.
It was easy to go down the slippery slope of luxury.
After he finished changing, Zheng Ren told Professor Rudolf to prepare the preoperative measures. He then entered the smoking-room and lit up a cigarette before entering the System.
He bought some surgical training time. The System’s operating room emerged from the ground and the simulation mannequin appeared right in front of Zheng Ren.
The lumbar arteries were parallel with the intercostals. There were usually four of them, two each arising from the front and back of the intervertebral foramen.
The arteries in front passed through the transverse process, which continued along the intertransverse ligament. They then pierced through the posterior aponeurosis of the transversus abdominis and were carried forward between this muscle and the obliquus internus to supply blood to the posterior abdominal wall.
The arteries at the back passed through a finer intervertebral foramen into the spinal canal to provide blood supply to the anterior spinal dura mater and the posterior vertebral column.
At the same location, the posterior branch then continued behind to supply the lumbar plexus.
Not only did he need to perform embolization on the posterior branch, but he also had to embolize the abnormal growth of blood vessels from the main branches and the tumor.
He had already confirmed this in the afternoon when he did the 64-slice CT scan with three-dimensional image reconstruction.
Since the patient had an advanced tumor, this was also considered to be a palliative surgery to improve the patient’s quality of life post-surgery. Therefore, they had to try their best to block the abnormal arteries supplying to the spine and avoid introducing complications at the same time.
A simple destructive operation would not be this difficult. Without the embolization of the lumbar arteries in the past, the bleeding volume during surgery would be around 3 to 5 liters.
This was a terrifying number.
If they embolized the lumbar arteries, the bleeding could be controlled under an acceptable range of 1.5 to 2 liters.
Zheng Ren used almost 3 hours to complete his first surgical training.
Zheng Ren decided that he was not only going to embolize the posterior branch even though that method would be much easier and satisfy the requirements of an orthopedic surgeon from Imperial Capital.
However, losing 1.5 liters of blood would significantly affect the patient’s life.
In order to increase the patient’s quality of life in their last remaining days, they needed to minimize the bleeding.
He needed to embolize the intercostal arteries on both sides, the lumbar arteries, and the surrounding capillaries in order to reduce blood loss during surgery.
In reality, there was no need for Zheng Ren to do that.
However, as a doctor, one would always give their best to improve the patient’s recovery if the situation allowed. If there was no chance of recovery, they would always try to improve their quality of life.
The blood supply to the spinal cord was very rich. Other than the need to avoid the Adamkiewicz artery, Zheng Ren would need to carefully scan the other arteries and check if they were connected to other organs or the spinal cord. It was only then that he would cut off the arteries that supplied blood only to the tumor.
The surgery progressed very slowly. Zheng Ren gradually got a grasp on the embolization techniques.
It was not easy to be at the Grandmaster level.
Even after completing 10 surgical training, Zheng Ren could only complete the lumbar artery embolization surgery within two hours.
Just to qualify under Zheng Ren’s standards, this surgery was much more difficult than prostate interventional surgery.
This was because even if he embolized the wrong capillaries in the prostate, it would not cost the patient’s life.
Similar to the patient treated by Professor Rudolf Wagner whose superior vesical artery got embolized, the patient only had urinary incontinence which could be solved by a urinary catheter.
This time, he was going to embolize arteries from the spinal cord’s blood supply.
One mistake would paralyze the patient’s lower body and even cause respiratory arrest and lead to the patient’s death.