Chapter 1577: 1528 False Medical Record

The patient's liver shows signs of nodular cirrhosis, with obvious overall atrophy.

Zheng Ren reached out, and a rubber tube fell into his hand.

He used the rubber tube to pass through the small omental foramen, wrapping around the hepatoduodenal ligament in preparation for blocking hepatic blood flow.

Then he lifted the right liver, placed a towel under the right diaphragm, and exposed the right liver.

"Can you feel it?" Su Yun asked.

"Yes, the border is still fairly clear." Zheng Ren said.

After saying that, he moved his hand away from the liver, and Su Yun's hand reached over.

Lightly touching the right liver with a bit of force, one could feel a relatively large mass inside the liver.

After Su Yun finished feeling, Professor Yang placed his hand on the body to feel.

The feel……was harder than the liver tumor he imagined, not just a little bit harder.

Could it be that the change after tumor necrosis from embolization is this great? Professor Yang was somewhat puzzled.

Normally, tumor tissue should be somewhat harder than surrounding normal tissue, but it definitely shouldn't be this hard.

Using an electrocautery, he made an incision margin about 2 cm from the tumor on the liver capsule, and on both sides of the margin he placed a large needle with #7 suture in a locked stitch.

This step is prepared for the assistant: to lift the liver tissue, expose the field, relying on the #7 suture traction.

Su Yun and Professor Yang each pulled one suture, exposing the liver.

Zheng Ren looked at the operative field, reached out, and the ultrasonic scalpel lightly tapped into his hand.

He began using the clamp on the ultrasonic scalpel tip to perform blunt dissection.

Pop-pop, the sound of slow coagulation kept ringing.

Small vessels, with low-power slow coagulation, make a pop-pop sound; larger vessels need high-power fast coagulation, emitting a pop-pop-pop-pop sound.

The surgery proceeded at a speed that was not fast, yet not slow either.

To the background music of Good Luck Come, the pop-pop-pop sound kept ringing. In Professor Yang's view, Zheng Ren's hands seemed to have a wonderful rhythm.

Small vessels and bile ducts were closed and cut with the ultrasonic scalpel. For those 4–5 mm or larger, Zheng Ren did not use the ultrasonic scalpel's high power but chose to clamp them with titanium clips and cut.

"Boss Zheng, the ultrasonic scalpel can at most cut vessels up to 6 mm." Professor Yang reminded.

"There are reports saying that using the ultrasonic scalpel to cut vessels over 4 mm in diameter carries a 3–5% chance of postoperative rupture and bleeding." Zheng Ren said while performing the surgery: "Although the pressure inside is relatively high after surgery, and even if bleeding occurs it can be stopped, there's no need."

Professor Yang thought for a moment; he had not seen such a report before.

However, Boss Zheng's surgery was truly clean—the liver had been split, the operative field had little blood. He kept holding the suction device in his hand, the hissing sound indicating the suction device was ready.

But the suction device's tubing contained only a few drops of blood; throughout the liver splitting process, there was almost no bleeding.

As the second assistant, Su Yun held a piece of gauze clamped with hemostatic forceps, occasionally dabbing blood, to expose a clear operative field for the surgeon.

On the white gauze, specks of red bloodstains resembled plum blossoms in the twelfth lunar month.

The bleeding was so little it was hard to believe.

A black, hard tumor tissue appeared in the operative field.

"It looks somewhat different from a normal liver tumor." Su Yun whispered after seeing it.

"The difference is significant; you'll see when we dissect it." Zheng Ren said.

"Boss Zheng, is it because the supplying artery was embolized?" Professor Yang asked.

"There is some truth to that, but more so because the tumor tissue is necrotic and differs greatly from normal tissue. The surgery is more precise and simpler." Zheng Ren, looking at the operative field, said.

This is a surgery live broadcast. Zheng Ren drew on the experience and lesson from the previous surgery and his exchanged glances with Xie Yiren; he never lifted his head, keeping his gaze fixed on the liver tumor in the operative field.

Begin dissecting the tumor.

Zheng Ren placed the ultrasonic scalpel and titanium clip on the upper half of the tumor; the dissected tissue was about 0.7 cm away from the tumor tissue.

Soon Professor Yang noticed something different.

Just as Zheng Ren said, the surgery seemed much simpler than he had expected, with little bleeding.

In the hepatobiliary surgery department, they also use the ultrasonic scalpel for routine operations. Even the argon laser, a high-cost consumable resembling a welding torch, is occasionally used when bleeding cannot be controlled.

Surgery, is still surgery.

Under Boss Zheng's hands, it suddenly seemed extremely simple.

The clamp on the ultrasonic scalpel tip continuously performed blunt dissection, the pop-pop-pop sound ongoing, the surgery proceeding very smoothly.

Bleeding?

Professor Yang glanced at the suction device in his hand and the gauze in Su Yun's hand.

To say there is none would be nonsense.

But the specks of bleeding……how should the surgical record note it? 3 ml of bleeding?

MD! If written like that, would it be considered a false medical record?

"Director Zhou, the boss is about to cut off the blood vessel supplying from the diaphragmatic artery." Su Yun suddenly said.

Zhou Chun Yong, after stepping onto the operating table, remained silent and observed carefully.

This was the first time he had personally seen the postoperative anatomical structure of liver cancer after embolization.

Branches of the diaphragmatic artery?

Zhou Chun Yong still remembered that during the embolization procedure, he could not find this artery on the preoperative images.

Boss Zheng's super-selective embolization process, he also did not see.

But……where is it?

Pop-pop, the sound rang out; Zheng Ren continued downward dissection. Zhou Chun Yong looked a bit dazed, softly asking: "Doctor Su, where is it?"

"That's what the ultrasonic scalpel just cut." Su Yun said: "You didn't see it?"

"Oh oh, that's it." Zhou Chun Yong said embarrassedly, pretending he had seen it.

He felt ashamed in his heart.

I'm not involved in surgery; anatomical structure is something I only learned from images and books.

If I really had to open up the abdomen and see the actual situation with my own eyes, I would be completely dumbfounded.

I can't see a thing! Apart from there being little bleeding and the Shou Bing being clean, I can't see any benefit.

But Zhou Chun Yong knows, a clean Shou Bing is good!

Professor Yang of the 912 Hepatobiliary department said before the surgery that we should prepare blood, but looking now, it's completely unnecessary.

«Director Zhou, an ordinary hepatic lobectomy Shou Bing, even if I did it, the bleeding should be around 100ml by now. » Zheng Ren said: «The bleeding is low because I embolized the tumor's feeding Blood Vessel. »

Hearing Zheng Ren's hint, Zhou Chun Yong felt an indescribable emotion well up inside.

My work, done for over twenty years, this is the first time I've seen it with my own eyes, and I still need Zheng Lao Ban to tell me what the effect is.

This…… sigh.

Professor Yang felt even worse after hearing Zheng Ren's words.

Without preoperative combined liver Interventional embolization Shou Bing, an ordinary hepatic lobectomy Shou Bing, if I were to do it, the bleeding would be at least 500ml by now.

Hmm, this is all beyond normal performance.

Just in case, they've already started a blood transfusion.

But according to Zheng Lao Ban's statement, if he did it, the bleeding would be only 100ml now?

That's impossible, bragging on the operating table can't be taken seriously; Professor Yang comforted himself.