Chapter 1280: 1242 Metamorphosis from Cocoon to Butterfly

Zheng Ren silently glanced at the patient's condition; general anesthesia was complete and he could start anytime. The familiar tune of Good Luck Come was automatically muted by him, and he went to scrub in silence.

Someone who sings off-key has no concept of any music.

Clear water gushed from the stainless steel faucet, and Zheng Ren entered the System Space.

At the same time, a clear ding-dong sound came.

【Emergency Task: Metamorphosis from Cocoon to Butterfly

Task Content: Treat one patient with abdominal cocoon disease.

Task Reward: 3000 skill points, 100,000 experience points, and 2 vials of energy potion.

Task Duration: 15 hours.】

Huh? Big Pig Trotter gave a mission?

This is indeed an unexpected joy, but the mission rewards can only be claimed after completion, so they're not usable now.

Only the universal language proficiency was given in advance; this point, Big Pig Trotter handled it fairly, and Zheng Ren had nothing to complain about.

Footsteps sounded outside; Zheng Ren guessed it should be Director Wei.

He opened the system store menu, selected to purchase surgical time. The System Operating Room rose from the ground, and Zheng Ren entered without hesitation.

The experimental subject lay on the operating table; Zheng Ren had nothing to hesitate about. Although the 【Metamorphosis from Cocoon to Butterfly】 task provided a supplement, having once exhausted his surgical training time, Zheng Ren now pinched every minute and second like a miser.

On the system operating table, the experimental subject lay supine; iodine-alcohol routinely disinfected the skin, sterile drapes and a large surgical sheet were layered, and via a right-sided rectus muscle exploratory incision into the abdomen, the incision about 18 cm long was made layer by layer, lifted, and the peritoneum cut.

This routine sequence also wasted Zheng Ren nearly three minutes of his time.

Feeling a bit reluctant, Zheng Ren restrained the urge to dissect the experimental subject outright. He still feared that if he became accustomed to dissection, he might develop symptoms of split personality.

I am a doctor, not a butcher.

After cutting the peritoneum, the inside was a white expanse, dense like an oilcloth, with no other tissue visible.

Abdominal cocoon disease—could it really be this severe? Zheng Ren found it hard to believe.

Zheng Ren held a hemostatic forcep in his left hand, clamped a piece of tissue, and with his right hand carefully snipped it with blunt scissors.

Below…… it wasn't intestine, but a layer of greater omentum.

How many layers are wrapped up like this? Zheng Ren didn't understand. Theoretically the greater omentum is a protective barrier for the abdominal cavity, but the experimental subject's greater omentum had lost that function, being encased in layer after layer of cocoon.

Like a silkworm baby, it added countless variables to the surgery.

One can imagine that the internal space is also connective tissue wrapping the intestines, with more connective tissue outside the intestines, layer upon layer—just thinking about it gives a headache.

Since it's just an experimental subject, although Zheng Ren restrained his urge to dissect, making the incision a bit larger was still fine.

Upon upward exploration, the gallbladder was large, its wall showed no congestion or edema, and the liver and spleen displayed no obvious abnormalities.

Everything above was fine, good, good. If it were a disease like a ruptured common bile duct, Zheng Ren would be helpless.

If that were the case, not a single minute of surgical training time would remain.

Zheng Ren carefully opened the dense connective tissue beneath the greater omentum; the cavity contained about 30 ml of clear pale yellow fluid, which the suction device cleared. He didn't know how many such cavities there were, so he focused on the present, rushing to handle what lay before him.

Examining the intestinal tract, he saw the intestinal wall adhered to surrounding connective tissue. Using blunt scissors and hemostatic forceps together, he separated them bit by bit, gently and carefully.

Even with Zheng Ren's master-level surgical skill, achieving damage-free handling was difficult. Yet each mistake he made, he would note the difficulty here—how much force to use, whether to use his hand or blunt scissors.

At the damaged sites, Zheng Ren also performed suturing.

At a point 25 cm from the cecum, the intestinal tract was tightly adhered; Zheng Ren applied a bit of force, the intestine tore slightly, opening a 2–3 cm hole.

This segment of intestine was severely edematous, making suturing impossible.

Zheng Ren sighed; this surgery was likely a failure.

He had no choice but to proceed roughly, beginning to dissect the experimental subject. While dissecting, he reminded himself that this was the surgical training room, and the experimental subject was provided by Big Pig Trotter; outside, he certainly could not act so arbitrarily.

This was something Zheng Ren had always carefully avoided.

He truly feared that a momentary impulse might cause an irreparable mistake outside.

After dissection, Zheng Ren discovered that the patient's intestines were wrapped in countless layers, not only outside but also inside.

The cocoon wasn't just encircling the peritoneum and wrapping all intestines; it enveloped each individual intestine completely.

After loosening a segment of intestine, what lay beneath was still connective tissue.

Faced with this situation, the best approach was to perform intestinal resection—simply and crudely cut out all severely adhered portions.

But…… the experimental subject's intestines were almost entirely wrapped, leaving Zheng Ren no space to resect.

Total intestinal resection would mean that even if the patient survived, they would require lifelong intravenous hyperalimentation.

Most importantly, the patient was already 72 years old and could not withstand such severe surgical trauma.

Better to peel it off bit by bit honestly; although the surgery is difficult, this is the only way Zheng Ren can think of to succeed.

Zheng Ren had considerable confidence in his blunt dissection skills, plus Charles's surgical box and handy instruments. If he couldn't do it, hardly anyone in the world could.

After dissection, Zheng Ren had a certain grasp of the experimental subject's anatomical structure, so the second surgery would be much quicker.

Having passed the site of the previous intestinal rupture, Zheng Ren exercised twelvefold caution, peeling off connective tissue bit by bit and gradually adapting to the force each intestinal wall could tolerate.

The experimental subject's intestinal tissue was so fragile that even the simple act of clamping with a hemostatic forcep and lifting upward could cause injury.

There was no alternative; Zheng Ren could only summarize lessons from repeated failures—how much force each intestinal wall could withstand and what instruments were needed.

Fortunately, Zheng Ren's memory has always been good, and with Big Pig Trotter's intangible blessing, he could still barely remember.

After nineteen consecutive failures, Zheng Ren finally managed to completely peel away those layers of membrane.

But just as Zheng Ren was about to reposition the intestine, he suddenly saw severe infection with dense wrapping at both ovaries of the patient.

So that's how it is!

Zheng Ren recalled reading in a document that the etiology of abdominal cocoon disease is divided into primary and secondary types.

Primary abdominal cocoon disease, also called idiopathic abdominal cocoon disease, commonly occurs in young women in tropical or subtropical regions; its cause may be related to fallopian tube infection or retrograde menstruation leading to pelvic infection and autoimmune response.

The patient's age, she had long been postmenopausal. Yet the infection still came from the ovaries and pelvic cavity—this is the source of the pathogen.

What to do? Zheng Ren froze.

Are we going to change to Obstetrics Department Shou Bing next? He looked at the pelvic part, feeling somewhat torn inside.