Chapter 302 - Success and Failure Separated by a Hair’s Breadth (Part 2 of 4)
Chapter 302: Success and Failure Separated by a Hair’s Breadth (Part 2 of 4)
The viewers digressed further and further, like it was a self-defense mechanism against anxiety.
In the operating room, upon encountering an accident, a surgeon would either take out their anger on their equipment or remain silent.
In the live surgery broadcasting room, they did not throw their tools and lash out at their assistants as they were not the ones operating. It was more relaxing to observe than to perform.
The host surgeon had failed at another attempt, but the viewers could not blame it on the surgeon and thus resorted to telling jokes for fun.
In the operating console room, Professor Rudolf Wagner stared at the images with piercing eyes.
He found it hard to believe that this was Zheng Ren’s first TIPS surgery.
The man was so proficient! Were it not for the patient’s sudden hematemesis, the third puncture would have succeeded.
Zheng Ren’s talents were so exceptional they were borderline enviable, Professor Rudolf Wagner thought.
Su Yun felt sorry, but was not surprised.
He had already overlooked the fact that Zheng Ren’s first TIPS surgery had been exceedingly skilled.
Something that happened so often would lose its novelty. Were Su Yun to be surprised every single time, his jaw would have fallen off by now.
He was numb to it, subconsciously expecting such performance.
Perhaps it was the same frustration that others once felt when they looked at him.
“Emergency surgeries are all like this, just be patient,” Su Yun comforted him calmly.
“Sure.” Zheng Ren nodded, nonchalantly pushing aside the mote of regret in his heart before adjusting and repositioning the guide wire to prepare for another puncture.
He observed the venogram carefully and noticed that the wire was not very far from the location, possibly not having moved much at all.
Maybe Su Yun’s hand had followed the motion of the patient vomiting. There was no other explanation.
Such a perfect assistant. At least to Zheng Ren, Su Yun was indeed flawless.
“Move forward 0.5 cm, 25 degrees to the right… 23 degrees,” Zheng Ren estimated.
Soon, the guide wire was back in position.
The experience he had gained from surgery on the simulation mannequin in the System’s operating room had been tempered on the anvil of reality, and it felt transcendental.
This had to be it. Although Zheng Ren had failed again, he was never more confident.
He did not comfort the patient or tell the patient to stop moving.
This was not the emergency treatment room. The patient was not throwing a tantrum.
The rupture of the gastric varices resulted in a large amount of blood accumulated in one’s stomach. It was an involuntary biological response, uncontrollable by the individual.
Like a burp or a fever, no one could decide if it came or went.
He had to use this short window of recovery between the patient’s intermittent vomiting to operate quickly.
The patient had rapid, shallow breathing, but no signs of agitation.
Zheng Ren pushed the button.
From imaging, the dark shadow of the angiographic needle advanced through the hepatic portal and reached the branch of the portal vein.
Su Yun barely managed to suppress his shout. “It went in!”
“Hold it.” Zheng Ren was not in a hurry. He was stable and determined like a ballast, keeping their boat afloat to conquer the raging waves and reach the shore of victory.
“Yes,” Su Yun responded.
A successful puncture was just one of the key steps. Any mistakes after this would cause the surgery to fail, requiring the whole process to be repeated.
Everything had to be carried out cautiously, as if walking on thin ice.
[Damn… success on the fourth attempt! Awesome!]
[The third puncture could’ve been the one.]
[This surgeon has once again exceeded my expectations. From what I remember, our hospital has performed over dozens of TIPS surgeries and their average duration exceeds 4 hours with about 20 puncture attempts.]
Xinglin Garden was joyous. Even the physicians who had expected failure were relieved.
They did not want the surgery to fail, no matter if it was overseas or not.
There were not many bullet comments left. Although the most crucial step was done, the subsequent procedure was also very important—deployment of the stent graft.
There were two different views on the choice of stents.
An uncovered stent had the advantage of stability. Its metal mesh formed a cylindrical structure that could be anchored by the hepatic parenchyma cells, creating strong friction that prevented it from dislodging post-surgery.
However, the robust regeneration of the liver was a complicating factor.
After a year or more, the stent and thus the tract created from the TIPS surgery could become blocked by the regenerated liver.
On the other hand, a stent graft could prevent the risk regenerated cells blocking the tract, but required more skill to secure in place due to the lack of friction between the stent and parenchyma cells.
It all depended on how the surgeon would employ it.
After repeated experimentation in the System’s operating room and thorough literary research, Zheng Ren had chosen to use a stent graft.
He was certain that he could secure it in the channel made by the angiographic needle.
Professor Rudolf Wagner remained silent in the operating console room.
This could not be Zheng Ren’s first TIPS surgery! If one could demonstrate such competency in their first attempt, how could TIPS surgery be referred to as the crown jewel?
He had performed this procedure so many times and understood its difficulty intimately, which was why he was flabbergasted.
How many times had he been berated when learning TIPS? How many failures had he encountered? How thrilling had his very first success been?
The professor’s mind was consumed by a series of flashbacks.
Impossible. This was definitely not Zheng Ren’s first time performing TIPS surgery.
Even with the professor’s current skill, he was unlikely to succeed with the third puncture, especially in an emergency where the patient was vomiting blood.
However, after the third attempt and failure, Zheng Ren had remained as steady as the position of the guide wire.
And the fourth puncture was successful!
Professor Rudolf Wagner fully knew how tremendous that had been.
Zheng’s hands were God’s own. The man’s sole purpose of existence seemed to be for interventional surgery.
Professor Wagner’s decision to bring Zheng Ren to his research lab in Heidelberg University was further reinforced, rock-solid as the Alps themselves.
Zheng Ren held onto the guide wire while observing the patient’s condition closely. If the patient had any intense movements due to vomiting in the next second, it would result in the withdrawal of the guide wire…
That would f*ck things up.
Su Yun inserted a 10 mm stent graft along the wire.
They both switched the position of their hands. So experienced with each other were they that their cooperation was seamless.
The stent was successfully deployed.
Since this was his first actual TIPS surgery and the patient was intermittently vomiting blood, the guide wire could deviate from its position at any time.
Therefore, Zheng Ren kept the angiography on to observe the wire and stent in real time.
Suddenly, the patient started puking intensely, filling the operating room with a thick scent of blood.
They had to stop inserting the stent. Zheng Ren and Su Yun carefully held onto the wire, fearing it would be drawn out a few centimeters and cost them the surgery.
Redoing the entire operation was not the issue.
However, if they could not resolve the pressure buildup in the portal vein and gastric varices, the patient would die of massive blood loss.
It was a race against death itself. Each detail had to be perfectly executed.
Even so, a doctor could only do so much when up against the grim reaper. Not only did the execution need to be perfect, it had to be swift!
The faster, the better.
The patient finally stopped vomiting after half a minute, seemingly exhausted beyond measure.
Zheng Ren glanced at the man’s vitals on the monitor and abruptly yelled, “Put me through the phone!”
The operating console room was to the right of the first assistant’s position. Su Yun had only just allowed himself some relief that the patient had stopped vomiting blood with the guide wire’s position still intact.
When he heard Zheng Ren shouting, he instinctively hit the covered button on the intercom to the operating console room.
“Yanran, Yiren, put on lead aprons and come in now. The patient’s suffering aspiration!” Zheng Ren roared.
Since interventional surgery required exposure to radiation, Zheng Ren preferred not to let the girls in if possible.
However… complications had arisen when he was about to insert the stent.
Due to the intense vomiting, blood had been aspirated into the patient’s airway.
The monitor alarm began blaring loudly.
There was instantaneous scrambling outside the room.
Chief Xia put on a lead apron and entered the operating room with Xie Yiren and Chu Yanran.
Zheng Ren had kept the radiation active since he needed to constantly monitor the position of the guide wire.
When the door opened, there would be a certain amount of radiation let into the operating console room… but not sufficient to cause an effect on the human body.
After all, X-rays travelled in straight lines…
“Suction!” Chu Yanran called out while she put on sterile gloves.
In an unexpected emergency, not only did everyone move faster, their voices were louder as well.
Almost every word was conveyed by yelling. It was an overall risk that one’s demands would be buried under another’s anxiety and become overlooked.
Chu Yanran reached her hand into the patient’s mouth and removed the remaining blood clots piece by piece.
Xie Yiren quickly turned on an aspirator and inserted the tube along the corner of the patient’s mouth.
“Not enough,” Chief Xia said loudly, “Pass it to me.”
She snatched the suction tube from Xie Yiren and glanced at Zheng Ren before saying, “I’m going to insert the suction tube from the patient’s nasal cavity. It might cause agitation.”
“Wait, give me ten seconds!” Zheng Ren said.
A suction tube entering the nasal cavity would induce the patient’s gag reflex, causing coughing and retching.
The recently-inserted guide wire was in a precarious position, like a small boat in danger of being drowned by giant waves at any moment.
Given the patient’s blood pressure was at a dangerous level, Zheng Ren did not have the time for another puncture.
It was a choice between saving the patient from aspiration or blood loss.
Chief Xia looked at Zheng Ren with astonishment and confusion.
The patient was suffocating, but this man wanted to wait for another ten seconds?
Was he that confident in his success within that time?
Success or failure,
Separated by a hair’s breadth.