The Surgeon’s Studio

1.0095 You Don’t Know The Pain of An Interventional Surgeon

The special lead apron from the System was similar to the one in the hospital. The color and make allowed it to blend in with the other lead aprons on the clothes rack.

However, the System did not provide any explanation as to how the lead apron could transform radiation into energy. The getup only consisted of a vest with no apron skirt, headwear or goggles. Zheng Ren was mystified.

Whatever.

Zheng Ren had no time to investigate it further, so he put on the special lead apron alongside other normal gear. At the same time, the Chu sisters were starting general anesthesia.

General anesthesia was not necessary for interventional embolization surgery, but as the patient was in a state of hemorrhagic shock, seizures were a concern. If the guide wire broke in the patient’s blood vessel… Now, that would make for an interesting day.

He washed his hands thoroughly and put on the sterile scrubs. The general anesthesia was complete and thus the surgery began.

“Do you have experience in interventional surgery?” Zheng Ren asked Su Yun.

Su Yun was already geared up and standing beside Zheng Ren like a shadow. Zheng Ren could only hope for such a handsome silhouette for himself but alas, life was unfair.

“Nope,” Su Yun answered with a smirk. His eyes crinkled attractively.

Zheng Ren was speechless.

“I’ve seen you do it once, so I more or less know what to do,” Su Yun said in earnest.

‘Huh, do you think you’re Saint Seiya? What doesn’t kill you makes you stronger?’ Zheng Ren thought.

Zheng Ren had nothing to say, but at least he had an assistant now. It would be much better than operating alone.

He would take Su Yun as an accompanying houseman.

The patient’s blood pressure was at 60/40mmHg. Without saying another word, Zheng Ren opened the catheterization kit and took out his materials.

After disinfection, the first puncture attempt yielded blood.

It was a skill that Zheng Ren picked up after hours of intensive training in the System. He had also performed hundreds of catheterizations during the nitrite poisoning incident.

Su Yun’s eyes brightened at this show of skill.

The first time he had witnessed Zheng Ren’s skill at catheterization was during the placenta abruption case. He had dismissed it as a one-off stroke of luck. Now, this was the second time Zheng Ren managed to find the vessel at the first puncture. It could not be a coincidence.

Zheng Ren must have incredible skill to be successful on the first attempt, especially since the patient’s blood pressure was so low.

Su Yun was quick to criticize but could recognize skill and talent.

“Guide wire.” Zheng Ren held on to the vascular sheath and motioned with his other hand.

The wire was placed in his hand before he had even finished his sentence.

Zheng Ren was mildly impressed by the man. He had no experience in interventional surgery but knew what the next step was.

Su Yun was as quick as Xie Yiren when assisting in general surgery. This combination might work out.

Huh, he was quite the genius.

Thoughts were running through Zheng Ren’s mind as he slowly inserted the guide wire into the vascular sheath within the femoral artery.

On the Xinglin Garden livestream, the bullet comments were flying.

[The surgeon just completed a spleen removal and liver trauma surgery. Now he’s onto a pelvic fracture interventional embolization surgery? Which hospital does this stream belong to?]

[My mentor called up Xinglin Garden. They said the transmission originates from a teaching hospital in Montreal, Canada.]

[Oh? That’s the hometown of Norman Bethune. Could it be that Old Mr. Bethune¹ is starting a livestream to teach surgery?]

The origin of these mysterious livestreams was twisted into an unrecognizable mess.

Regardless of their identity, be they a foreigner or a Chinese citizen in a public or private hospital, the skills of the host surgeon or surgeons were indubitable.

For now, most people believed that it was a group of surgeons performing different types of surgeries. Hence, that it was a livestream from Canada was believable.

[Anyone who specializes in interventional surgery care to shed some light?]

[Yeah, I totally can’t tell what’s going on. I’ve seen a case like this in my hospital before. We didn’t have an interventional suite. After getting informed consent from the family, they opened up the retroperitoneum and it was bad. Blood was everywhere. There was nothing we could do…]

[Thanks for the request! Pelvic fracture interventional embolization surgery mainly focuses on the internal and external iliac blood vessels. If the veins are damaged, the high pressure in the retroperitoneal space will stop the bleeding. It will be more complicated if the arteries are damaged, but simply put, the internal iliac artery can be embolized without much consequences…]

An interventional surgeon from a third-tier city explained away in the chat.

He specialized in interventional radiology-assisted surgery, but found the field was only known for coronary bypass and stent surgeries.

He had watched the livestream of the placenta abruption surgery multiple times and concluded that his skill was on par with the widely popular surgeon on screen.

Maybe not the same level, but close enough.

His conclusion gave him a confidence boost and since then, he had looked forward to the next livestream.

The life of an interventional surgeon was lonely.

Even when he was in the hospital, 95% of the staff had little knowledge of interventional radiology-assisted surgery, let alone an average Joe.

Hence, he visited Xinglin Garden every day hoping to catch the opportunity to talk about his field. Now, he got to showcase his knowledge in front of a few thousand doctors.

[Why? Wouldn’t embolization of the artery cause ischemia?]

[If you refer to an anatomy diagram, the internal iliac artery has multiple branches. The external iliac artery is another case, though, as total embolization will cut off the femoral artery. It can lead to the loss of function in the whole leg. Hence, the difficult part of this surgery is the treatment of the external iliac artery.]

[Okay, I think I understood that. How hard will this surgery be?]

[I’ve done around 20 surgeries; the average duration of one was four hours. You guys don’t know the pain of an interventional surgeon.]

As the third-tier city doctor explained the basics on Xinglin Garden, the livestream had already changed to the inside view. The guide wire and guide catheter had been inserted with the utmost precision and the embolization coil followed suit to seal off the ruptured internal iliac artery.

[The surgery was faster than your explanation.]

[What a quick surgery. God damn.]

[I am envious but as I’ve said, the surgery’s difficulty is not in the embolization of the internal iliac artery but the superselection of the external iliac artery.]

Onscreen, behind the flurry of comments, a guide wire began the process of superselection of the external iliac artery.

The wire was very soft and thin, hence leading it into a blood vessel that was not much thicker was very difficult.

It was akin to playing table tennis with a whip: incredibly complicated. The superselection of the blood vessel was ten times more difficult, however.

[Look, this is where the real surgery begins.]

The interventional surgeon started to explain himself. Interventional surgery was rare in the country. In third-tier cities, there would only be one hospital that had an interventional radiology department and possibly three to five specialists shared among them.

In second-tier cities, there could be two departments in total but no more.

Every year, there was a significant number of liver cancer patients rushed into the Vice City hepatology department for fifteen-minute interventional radiology treatment.

However, actual super selective chemoembolization for liver cancer would require more time. Fifteen minutes was likely just enough to take an image.

However, there was a high volume of patients and very few doctors, so some corners were cut.

The interventional surgeon who rarely got to speak finally had the opportunity to share his insights on Xinglin Garden. His eager words began to flow across the screen.

[The superselection has to go beyond the 2nd-grade artery, possibly even the 4th-grade artery to avoid issues. Hence, every pelvic fracture embolization surgery takes a long time to complete successfully.]

This interventional surgeon stared at his phone and typed out each character diligently. He was thrilled at this chance to educate other doctors.

They would finally learn about the advantages of interventional surgery. He was cheery even though he was not at the operating table.

However, he had the fortune of explaining the details of a pelvic fracture embolization surgery to a few thousand doctors, live. He was ecstatic.

His eyes were fixated intensely on the phone screen to the point of watering.

Behind the stream of comments… It seemed like the superselection of the deep circumflex iliac artery was already complete. The contrast agent was being administered.

No, it must be a trick. His eyes were probably deceived. The doctor shook his head and blinked a few times. He looked back at the livestream and saw, right behind his wall of text, the deep circumflex iliac artery had been selected and the leak located. The embolization step was happening right now.

God! That was ridiculously fast! Had it even taken three seconds?