Chapter 317: 311 Sewage Pool Handler (3/4)

Actually, in terms of surgical choice, the method causing the least trauma to the patient is endoscopic sphincterotomy plus bile duct clearance.

However, according to literature reports from around the world, although the trauma is small, the possibility of postoperative recurrence is high, about 30%.

The patient is not young; if recurrence occurs in 5–10 years, the patient will be around 70, and surgery would entail great risk.

Therefore, Zheng Renyi ruled out the possibility of endoscopic sphincterotomy plus bile duct clearance from the start.

We must consider not only the immediate therapeutic effect but also the long-term effect.

Entering the operating area, Xie Yiren had already scrubbed her hands, and with the circulating nurse's assistance opened the sterile surgical pack and began preparing instruments.

"Zheng Ren, what procedure are you doing?" Xie Yiren asked.

In the operating room, plus the emergency ward, only two people directly call Zheng Ren by name—Director Pan and Xie Yiren.

"Oddi sphincteroplasty plus bile duct clearance plus hepatic abscess drainage." Zheng Ren said.

Xie Yiren nodded, feeling that adding another procedure would not be particularly difficult.

She also had the circulating nurse fetch any instruments that might be used; if none were ready, she directly sterilized them in a pressure cooker.

What a relief—seeing Xiao Yi Ren busy, Zheng Ren felt pleased.

Together with Su Yun and Yang Lei, they lifted the patient onto the operating table, and Chu Yanran began anesthesia. The professor did not lend a hand; perhaps in his view these tasks were not his, so he habitually stayed away.

Anesthesia, disinfection, laying out sterile drapes—the surgery began.

Standing before the operating table, Zheng Ren heard a "ding-dong" sound in his ear as the system issued a mission.

{Emergency Mission: Sewage Pool Handler.

Mission Content: Complete surgical treatment of a patient with sewage pool syndrome.

Mission Reward: 2000 skill points, 25000 experience points.

Mission Time: 4 hours. }

The mission is fairly routine; for Zheng Ren it poses no difficulty. Having just finished the first stage of the "Pearl on the Crown" mission, Zheng Ren is in the burst‑out phase.

He glanced at the mission, checked the time limit, Zheng Ren reached out and the hemostatic forceps, clamped with iodophor gauze, landed in his hand.

In the Xinglin Yuan live‑broadcast room, the surgery live‑stream opened as scheduled.

{What surgery is today? }

{Just finished watching, it's sewage pool syndrome… Speaking of which, the surgeon's operations are getting stranger and stranger; although I'm not a general surgeon, most procedures I've at least heard of. But this name I've never heard before. }

{Very high‑end, this surgical procedure is also unfamiliar to me. }

{The more unfamiliar things, the Montreal Medical Center, which is a top‑five global medical institution, what rare case haven't they seen?

I estimate many more cases they simply wouldn't broadcast.

{Poor me, a neurosurgeon, I daily hold my phone to watch general‑surgery and interventional‑surgery operations. I don't know when I'll get my turn to also broadcast a neurosurgery operation. }

In the live‑chat, after learning the condition, people began casual talk. The initial steps weren't much to see; the surgeon chose a right subcostal oblique incision, about 15 cm long.

Because the patient already had a surgical scar, scar tissue needed to be avoided, so the incision looked somewhat odd in shape.

Next came blunt dissection, opening the peritoneum; only then would the surgery be worth watching, so everyone hurried to increase their hand speed and send barrage messages.

The neurosurgeon's remarks resonated with many, and they complained.

In the surgery live‑broadcast, viewing from the surgeon's angle, doctors gain experience points far exceeding those from a regular surgery observation platform, even better than the view of a first assistant.

Modern medicine is an empirical science; having an experienced surgeon demonstrate operations and various difficult cases, such an opportunity is rare, and all the doctors watching the live‑stream in Xinglin Yuan know this.

But so far, only general‑surgery and interventional‑surgery procedures have been shown; they feel regretful, yet also harbor greater anticipation.

The barrage drifted for a few minutes; after the peritoneum was opened, everyone unconsciously reduced their barrage posts and watched the surgery attentively.

Inside the abdominal cavity, because of a prior surgery, the normal physiological structure has been altered.

Added to this illness's inflammatory stimulus, what meets the eye are inflammatory edema and adhesions where tissue structure cannot be distinguished.

{If I put myself in that position, I think I could give up the surgery now—just do a shunt procedure so the patient doesn't have to come down from the table. }

{With adhesions this severe, could it damage the proliferating blood vessels? }

{Yes, the tissue structure is completely indiscernible. This surgery…… just looking at it makes one want to give up. }

Zheng Ren saw the intra‑abdominal situation, his expression unchanged; he reached out, and Xie Yiren slapped the blunt scissors into his palm.

The blunt scissors, with their blunt tips, separated the proliferating connective tissue—sometimes peeling, sometimes cutting—motion neither hurried nor slow, extremely stable.

Blunt Scissors blunt tip separates the proliferated connective tissue, sometimes peeling, sometimes cutting, the motion neither hurried nor slow, extremely stable.

With such severe adhesions, how does Zheng Ren distinguish where the abnormally proliferating blood vessels are?

This is absolutely not knowledge that can be written in textbooks.

It's too strange.

Yang Lei had approached Zheng Ren wanting to learn more surgical skills, but when he brought him onto the stage, he realized he could not understand Zheng Ren's surgical method at all.

When Zheng Ren had dissected, clamped, and ligated a slightly thick vessel with 4‑0 suture, Su Yun asked: "How did you discover there was a blood vessel here?"

When Zheng Ren separated, clamped, and ligated a slightly thick Blood Vessel with 4# thread, Su Yun asked: "How did you discover there is a Blood Vessel here?"

He devoted all his attention to the patient's surgery, having no time to explain to Su Yun that even aberrantly proliferating blood vessels have a pulse, and if the fingertips could sensitively feel that pulsation, one could know it intuitively.

Zheng Ren also mastered this technique after countless refinements in the system operating room.

Most importantly, Zheng Ren doesn't know how to describe this technique that looks minor but is actually crucial.

{Suddenly I felt the surgeon had X‑ray vision, able to see the abnormal vessels hidden in the connective tissue. }

{Yes, I have that feeling too; otherwise I couldn't explain how the surgeon could rapidly perform blunt dissection of the connective tissue without damaging the vessels. }

{So far, surgical bleeding is still under 5 ml—one could say it's god‑like skill. }

The doctors in Xinglin Yuan were also amazed by this, but…… they simply could not comprehend how Zheng Ren operated.

Layer by layer, Zheng Ren broke down the tissues, and the complex anomalous anatomy became clear.

Although Su Yun didn't know how Zheng Ren located the vessels, he fully understood the meaning of each of Zheng Ren's movements.

Although Su Yun didn't know how Zheng Ren found the Blood Vessel, he fully understood the meaning of each of Zheng Ren's movements.

The appendiceal retractor and small retractor in his hand always appeared where they should, helping Zheng Ren expose the next step's view.

Finally, after 5 Minute, Zheng Ren peeled away the last layer of connective tissue, and a foul, rotten smell of pus spread out.