Chapter 2338: with translation of chapter title

Director.

I'm in the ward.

Okay, I'll wait for you.

Zheng Ren hung up Director Kong's phone and immediately entered the System Operating Room.

Su Yun wasn't there; he had gone to give a lecture to the doctors sent from Lanke, so fewer people asked why.

Entering the System Operating Room, Zheng Ren saw a pair of conjoined twins lying on the operating table.

Both infants had congenital heart disease, resulting in poor myocardial reserve function, and both also had upper respiratory tract infections. The system panel showed a bright red notation: 'Heart failure (Grade II)'.

Zheng Ren didn't rush; instead, he recalled the surgical description he had seen before.

Thoraco-abdominal conjoined twins aren't the most difficult; if the heads are joined, that's the real trouble.

The liver connection between these two heart-conjoined twins is relatively extensive.

The left halves of the infants' livers completely overlapped and fused, with a circumference of about 25 cm; the biliary and arterial-venous systems were separate, other digestive systems were separate, and during separation two thick blood vessels about 0.2 cm in diameter were found connected at the hepatic junction.

For Zheng Ren, whose general surgery skills were at their peak, separating the liver was nothing; he performed it with great ease.

This was the first surgery after his general surgery skills reached their peak, and it was completely successful.

Liver division, hemostasis, and anastomosis—amid the pap-pap-pap of the ultrasonic knife—this segment took just over thirty minutes to complete.

After finishing, Zheng Ren felt a sense of ease throughout his body.

It was exactly this feeling; when the Big Pig Trotter first arrived, it gave three minutes of peak experience time.

The feeling was identical, with no deviation.

Zheng Ren's hand rested on the infant's liver through a sterile glove; he could clearly feel the liver's texture. He knew exactly how much force to use and what to do.

That was a confidence: there was no surgery he couldn't perform, no matter how difficult, and he could complete it smoothly.

Even without wearing Zeiss microscopes, Zheng Ren could still complete the micro-anastomosis. However…

When he began opening the chest cavity, preparing to separate the hearts, Zheng Ren finally realized where the difficulty lay.

The two hearts were fused together, twisted and malformed.

This wasn't the biggest problem for Zheng Ren. The obstacle that the expert team from Philadelphia Children's Hospital and Director Han of the Women and Children's Hospital considered insurmountable, Zheng Ren didn't think much of.

The difficulty lay in the fact that the two infants' heartbeats had different rates, which greatly affected the surgery.

After several attempts, Zheng Ren still had no particularly good solution.

He let out a breath; was the Big Pig Trotter's assistant function prepared for this surgery? Probably, and this aspect of the system is quite humane.

Although Zheng Ren didn't know what impact an assistant would have on the surgery, he could only try. Following the Big Pig Trotter's prompt, he made further attempts.

Selecting assistant mode, Zheng Ren discovered that the assistant also consumed surgical training time just like him.

Moreover, since he was using it ahead of receiving any reward, the surgical training time consumption was doubled.

In other words, one surgery required the training time of three surgeries.

Zheng Ren felt somewhat helpless, but he had no choice but to select the assistant function. After selecting it, he immediately saw a series of further options, indicating that the assistant could be multiple.

If only there were more surgical training time than he could use, Zheng Ren thought.

He certainly wouldn't waste it; each surgical training session was extremely precious. After selecting one assistant, Zheng Ren immediately saw an experimental subject's appearance before him, the physique unmistakably Su Yun's.

After trying several more surgeries, Zheng Ren had a sense of the whole process. Even with an assistant, the surgery could not be completed at all.

The two hearts had different rates: about 160 beats per minute for one, and 130 beats per minute for the other.

Separating the twisted, malformed myocardium completely, while based on the beating heart, was too difficult.

The infants' heart function was poor; to succeed, the hearts had to be disconnected as quickly as possible and then repaired with patches, so both infants could survive.

If the surgery proceeded as currently done, it could not be completed at all; Zheng Ren had formed a preliminary estimate after a few failures.

Zheng Ren didn't rush out; instead, he carefully observed the infants' heart parts.

The diaphragm, mediastinum, and pleural parts were connected; the twins shared a pericardium, with the major vessels at the heart base completely separate and without communication. The atria were joined, sharing a patch of myocardium. The apical regions near the diaphragm were connected, the hearts having a small tubular connection 3 mm in diameter, while the rest of the hearts were membranously connected.

Recalling conjoined twin surgeries, although this situation isn't a single-heart shared-heart conjoined twin, it could still be considered an elementary shared-heart conjoined twin.

The surgical difficulty was far greater than he had imagined.

Blossoms sharing a stem—beautiful in name—but Zheng Ren had no idea how to perform the surgery.

Helpless, Zheng Ren left the System Space to go meet Director Kong.

Soon, Director Kong walked back briskly.

"Zheng Boss, Vice President Yuan is working onsite in the Respiratory Medicine Department. He's asking whether you can perform the conjoined twin surgery here, which seems to be a shared-heart case. The Women and Children's Hospital has a patient whose surgery they can't handle."

"I've never done it… I lack confidence." Zheng Ren sighed, saying.

Director Kong knew the situation; conjoined twins occur rarely, and doing 3-5 cases a year in Di Du is already a lot.

Moreover, it's not a severe type.

The surgery that the Women and Children's Hospital can't handle is probably so difficult it's off the charts.

"Zheng Boss, if we can't do it, we shouldn't force it; just finish the Nobel Prize project properly—this is the main thing." Director Kong whispered a reminder.

"I know, Director." Zheng Ren nodded, saying: "Let's first check the patient's condition."

"I just called the Women and Children's Hospital; they said this time they're really serious." Seeing Zheng Ren's composure, Director Kong felt more at ease and began to gossip.

"Oh?"

"They invited the expert team from Philadelphia Children's Hospital for guidance, and used 3D printing and a surgical navigation system to create a simulacrum for preoperative simulation surgery."

"…" Zheng Ren froze for a moment.

If there were a simulated surgery, after a couple of run‑throughs, he and Su Yun should be able to work in sync.

Zheng Ren couldn't say for sure; without trying, who could know?

Just like with conjoined twins, it's not about picking the surgeon with the highest skill, but choosing doctors whose abilities meet the standard and who are most familiar with each other to operate together.

Only then can the infants' atria be completely separated in the shortest time.

That side actually used the Shou Bing navigation system, pre-operative 3D printed simulation of the patient child's way to do training, the Women and Children's Hospital really spent a lot of money.

Heart-connected Conjoined twin Shou Bing in the world still has no successful precedent.

Is it really feasible?