Chapter 1453: with translation of chapter title

Lei Yinghua

Peng Jia

He

While watching the operation on the screen, they stole glances at Lei Yinghua's expression.

Lei Yinghua, Director Lei

Peng Jia thought.

He absentmindedly drifted off.

He had too many things on his mind, too much pressure; this is a self‑protective mechanism of the body.

Shou Bing, when I first started watching, there was still some novelty.

The red‑and‑white striped intestine formed the background, with endoscopic knives, dissectors and other endoscopic equipment inside it, moving in an orderly but somewhat dull fashion.

There was no bleeding that made the heart skip a beat, nor any mishap.

All the operations exuded a sense of calm, even a touch of indifference.

Although Peng Jia knew this situation meant the operator had full control of the Shou Bing, from his viewing perspective he felt it wasn't the best approach.

Only with twists and turns can it attract people.

But not everyone shared Peng Jia's thoughts; Lei Yinghua, Director Lei, stared at the LCD screen without blinking.

Peng Jia could feel that his breathing was uneven.

During certain moments of dissecting and removing polyps, Lei Yinghua's breathing would briefly disappear.

At 58:22, Lei Yinghua felt no fatigue; when a 2‑3 cm polyp appeared in the endoscopic view, he straightened his back.

The spray tube evenly sprayed the dye, the endoscopic knife cut, and the dissection proceeded layer by layer.

It seemed the operator didn't realize that this large polyp differed from the others.

"Director Lei, this polyp should have invaded the muscular layer, right?" Peng Jia partly understood, and he whispered to Lei Yinghua's side.

"Hmm." Lei Yinghua said in a low voice: "During dissection, the muscular layer is easily perforated, leading to intestinal rupture."

Peng Jia was a little worried.

But when he saw the dissecting forceps on the screen, an inexplicable confidence suddenly arose.

Could Zheng Lao Ban make a mistake?

Impossible!

This inexplicable confidence came from countless Shou Bing accumulated over time; Peng Jia just hadn't noticed it.

After the cut, the image on the screen paused slightly, as if the operator also realized this spot differed from the smaller polyps before.

But after 6 seconds, the view began to change, and the endoscopic lens' resolution was set to maximum.

Some endoscopes have this function, and Lei Yinghua knows it.

But he had never used it before, and doctors in the laparoscopy room rarely do either. This is already at the level of microscopic surgery, which has little relation to gastroenterology surgery.

He stared in astonishment as the colonic mucosa extended numerous finger‑like projections into the lumen, each looking huge, like a forest.

The style suddenly shifted, from a rigorous endoscopic procedure to a fantastical, sci‑fi vibe, and Lei Yinghua jumped up.

But he soon realized his action was stiff, overly excited, forgetting that he was watching a junior doctor's Endoscopic Submucosal Dissection.

He felt embarrassed.

"Director Lei, could you explain this to us? We can't understand it anymore." Peng Jia quickly stood up and said humbly.

"Sure." Lei Yinghua immediately said, then lifted his leg and walked to the LCD screen.

An assistant handed over a laser pointer, and Lei Yinghua turned it on.

Under the high‑power microscopic mode, the intestinal anatomy was something he'd never seen before; but his solid theoretical foundation cleared all obstacles.

"Here are the villi of the small‑intestinal mucosa, also a very important digestive organ." Lei Yinghua pointed the laser at the "huge" villi appearing on the screen, striving to stay calm and composed.

But he didn't notice that his voice had started to hoarsen.

The image shifted slightly, as if a microscopic stabilizer were supporting the lens.

The operator's movements were slow, and he was also searching for the anatomical structure.

"This is the small‑intestinal gland, its opening lies between the villi. If a pathological examination were done, one would find the glandular cells are columnar or cuboidal." Lei Yinghua pointed to a dot that only became faintly visible after several magnifications, and said:

"The mucosa of the small intestine also has a muscular layer—inner circular and outer longitudinal smooth muscle…" Just as he said that, the dissecting forceps appeared on the screen.

On the LCD screen, the forceps looked enormous, occupying about half the field of view.

But Lei Yinghua knew this was just the tip; the operator was controlling the advance of the dissecting forceps.

Is this a 50‑fold view? Can human means really control it so precisely? Lei Yinghua felt a bit dazed.

But the dissecting forceps didn't directly separate; the endoscopic knife appeared, touched the mucosal muscle layer, then disappeared.

Now it made sense; after seeing this segment, Lei Yinghua understood why his earlier observation of the slightly aloof operation was what it was.

No wonder the bleeding was so slight!

The operator wasn't violently cutting the mucosal muscle with the knife; instead, he made a light touch and then used the dissecting forceps for blunt dissection.

It's obvious that the operation in the 50‑fold view fully displayed the operator's surgical skill.

Because under normal view, one simply cannot notice that the operator actually performed so many maneuvers.

But only someone like Lei Yinghua, an expert at ESD, could do this; if anyone else tried, even with high magnification, about 99% of doctors wouldn't grasp how forceful the maneuver is.

Some steps might even be seen as ineffective maneuvers.

"Here is the inner circular smooth muscle of the intestinal mucosal layer; it's thin and hard to see." Lei Yinghua had already become somewhat excited.

That's how it's written in textbooks, but he had never seen it so clearly before.

It's somewhat different from what he imagined; Lei Yinghua, while explaining, silently memorized the microscopic anatomical structure.

The dissecting forceps moved lightly beneath the inner circular smooth muscle of the mucosal muscle layer, wandering in the submucosal connective tissue between the inner circular smooth muscle and the intestinal muscular layer.

The pace was neither fast nor slow; Lei Yinghua saw no Confusion in the practitioner regarding the microscopic operation. This extremely delicate microscopic operation also imposed no burden on the practitioner, just as before, the Shou Bing proceeded at an unhurried pace.

"Here is the Blood Vessel beneath the intestinal mucosal layer—MD, how could it be so thick…" Lei Yinghua couldn't help but exclaim.

Usually, he would just skim past this section.

Under 50× magnification, a thick Blood Vessel appeared in the field of view. The practitioner stopped, used separating forceps to dissect the connective tissue, then saw electrocautery appear; a light touch, and a wisp of blue smoke later the Blood Vessel was burned through.

The severed end clotted, with not a trace of bleeding.

"The Shou Bing is extremely fine; the Blood Vessel at this spot is hard to see with the naked eye." Lei Yinghua's voice sounded a little hoarse.

He finally realized the reason the Shou Bing had been slightly slow before.