Chapter 354: 347 Following the Melon to the Vine

"Chief Zheng, awesome." The Obstetrics Inpatient Chief stood behind, saw that under the retractor, the organ that had already shown necrosis and surrounding tissue were not connected, and exclaimed.

It's not about being convinced or not; medicine is different from other industries.

If we really followed what she said, went up for an ectopic pregnancy, opened it up and looked, we'd be screwed.

The surgeon should quickly step down and explain to the patient's family.

If we encounter a reasonable patient's family, it's fine to say. Consult General Surgery for a joint consultation, then postpone and change the surgical approach.

If we encounter a dissatisfied family, congratulations, you've won the prize!

If we encounter a family with some influence at home or ability in society, congratulations, you've won the grand prize!

So when encountering such a thing, the Obstetrics Inpatient Chief feels fortunate not to have had time yet; where would there be a competitive mindset against the Emergency Department Inpatient Chief?

"All right." Zheng Ren used forceps and hands to carefully separate the organ beside the ovary, fearing adhesions with other organs; a mistake could damage other organs.

"Is it an accessory spleen?" the Obstetrics Inpatient Chief asked.

"Let's see, first handle this side." Zheng Ren focused on processing the relationship between organs, because the blood vessel above twisted, leading to ischemic necrosis of the accessory spleen, with inflammatory exudate present; who knows what could happen.

So Zheng Ren was very cautious and did not rule out the possibility that it was a malignant tumor.

"Trouble, ask if the pathology department people have come." Zheng Ren said.

"Okay." the Obstetrics Inpatient Chief replied.

【Wow, it's an accessory spleen!】

In the Xinglin Yuan live broadcast room, the barrage surged.

【Can an accessory spleen be in such a deep position?】

【I haven't encountered it before, but it looks like it.】

【Let's first dissect it out and see; what if it's a malignant tumor?】

Although the surgeon in the live broadcast room has demonstrated superb diagnostic and surgical skills many times, the doctors of Xinglin Yuan still maintain independent thinking and do not blindly trust the first diagnosis given in the live broadcast room.

Authority?

Authority can also make mistakes.

Independent thinking is a must for a doctor.

So in the Xinglin Yuan live broadcast room, no one questions the surgeon's surgical skill, but regarding diagnosis, they still hold a cautious view.

Even if it's accurate every time.

Even despite everyone's opinion, this is the diagnosis given by Canada's international top medical center.

Having dissected the entire accessory spleen, no severe adhesions were found. Zheng Ren carefully wrapped the accessory spleen in moist gauze and felt upward along the supplying artery.

Zheng Ren's movements were very gentle and careful; throughout the dissection, he had a clear and thorough understanding of the abdominal anatomical structure, without damaging other organs.

For each tiny branch, Zheng Ren would judge and confirm before ligating and cutting.

【The surgery is done very meticulously.】

【Is this following the vine to melon?】

【No, it should be follow the melon to the vine, finally eradicate the roots.】

【Now it seems the possibility of a tumor is not great.】

【Probably; let's see how the surgeon's surgery turns out. To be honest, I've worked in General Surgery for ten years and have never seen such a long spleen stalk accessory spleen.】

【Indeed it's a bit long, looks a bit strange.】

In the live broadcast room, the atmosphere wasn't as lively as usual.

This surgery, the surgeon's displayed surgical technique wasn't particularly special.

Following the melon to the vine, then eradicating the roots—such a simple task truly doesn't show any technique.

The only highlight is that the accessory spleen's position is extremely special, quite rare.

【Have you noticed, the surgeon seems to be performing the surgery alone again.】

【Yeah, but doing this surgery alone doesn't seem to matter much. It's just ligating the accessory spleen's artery; do we need two people?】

【Probably not; in the surgeon's previous live broadcasts, cases much harder than this were also done solo.】

In the operating room, at this moment, Yang Lei rushed over.

Seeing that the surgery was already halfway done, he hastily scrubbed and went on stage.

With Yang Lei's help, the progress of dissecting the blood vessels upward sped up a lot.

After all, Xie Yiren stood at the leg side, only able to pull the retractor in this direction. When dissecting upward, a head-side retractor was needed, which Xie Yiren couldn't provide.

"Chief Zheng, is this an accessory spleen?" Yang Lei hastily pulled the retractor, then observed for a few minutes before uncertainly asking.

It's not that Yang Lei has never seen an accessory spleen; it's just that this accessory spleen is particularly special.

"Mm, it's an accessory spleen." Zheng Ren's blunt scissors and small curved forceps moved unpretentiously up and down slightly, loosening and dissecting the connective tissue around the blood vessels supplying the accessory spleen, all the way upward.

"The pathology department people have come." At this moment, the Obstetrics Inpatient Chief called back and told Zheng Ren.

"Mm, send the frozen sample in five minutes." Zheng Ren said affirmatively.

Yang Lei felt the gap between himself and Zheng Ren was growing larger.

Having rushed over, after getting on stage he just saw the situation; this side of the surgery was about to end.

He felt helpless, glanced up at Zheng Ren.

Zheng Ren focused all his attention on the surgery, eyes unblinking, concentrated to the extreme.

Yang Lei sighed inwardly; a few months ago, we were still partners doing appendectomies, how did he become a superhero now?

"Pa-pa~" the sound of forceps striking the appendectomy retractor rang out.

Yang Lei felt the appendectomy retractor in his hand tremble slightly, immediately lowered his head, and cast aside his previous confusion and incomprehension.

If it were Director Liu, zoning out on the stage, the hemostatic forceps might smash his head. The surgery… would at least have to be halted for a month.

Yang Lei focused his mind, sought Zheng Ren's surgical path, pulled open the next segment of tissue, and exposed the surgical field for Zheng Ren.

Because the accessory spleen's feeding blood vessel is relatively long, the surrounding tissue adhesions are not severe, and in the horizontal part of the duodenum we see a twisted segment of the blood vessel.

Zheng Ren did not attempt to separate this segment of blood vessel, because once opened the accessory spleen would regain blood supply and the necrotic tissue inside could possibly enter the body with the blood flow, causing secondary bacteremia.

【I saw it, it's just this twisted segment.】

【Quite a long blood vessel; judging by this, the twisting probably hasn't been long. Now it feels like an accessory spleen, and the operator's diagnosis is quite accurate.】

【Probably, but we need a pathological diagnosis to confirm it.】

Soon, following the long stalk, we reached the splenic hilum.

The arterial branch of the accessory spleen originates here.

Zheng Renyi reached out, and the hemostatic forceps were slapped into his hand.

Because the incision isn't very long, we need a retractor to expose the field; when we reached the perisplenic position, from Yang Lei's angle nothing could be seen.

Obstetrics Inpatient Chief tilted their body, looking from a special angle.

"Chief Zheng, I can't see the field; let's extend the incision." No matter what angle she tried, she couldn't see the spleen in the left upper abdomen, so she advised.

"Oh, not needed." Zheng Ren smiled.

As long as he could feel it with his hand, Zheng Ren could cut it off; this was honed from countless appendectomies when he first entered the system operating room.

If it were someone else, they wouldn't have such a good sense of touch.

After all, nobody has the opportunity to practice their touch on countless experimental subjects.

Obstetrics Inpatient Chief remained silent; she didn't understand why Zheng Ren didn't extend the incision, and with only a tiny angle, how could he be sure of the situation inside?

Just as she was wondering, Zheng Ren's hand reached out, and another hemostatic forceps was slapped into his hand.

Then Zheng Ren asked for a scalpel, and a segment of blood vessel was pulled out of the abdominal cavity.

Because the preceding dissection was clean, Zheng Ren easily lifted the long stalk, bringing the accessory spleen with necrotic changes, and threw it into the pathology basin.

"Send for frozen section."

【The operator is starting to show off; isn't he afraid of complications?】

【Those upstairs must be newcomers, definitely newcomers.】

【It's necessary; if you've watched Appendectomy Night, you wouldn't make such an exclamation.】

【Exactly, there's still space, although it's small. During Appendectomy Night, there was an appendectomy where the operator performed a blind resection.】

【To be honest, I still don't approve of the operator's approach. Although the skill is high, one still needs to be extra careful.】

The circulating nurse glanced at the tray, saw no special instruments needed, put on gloves, covered the pathology basin with a sterile opaque bag, and sent it for frozen section.

Zheng Ren reached out again, and the needle holder with needle and thread was slapped into his hand.

Suturing, maneuvering in the narrow space, the Obstetrics Inpatient Chief and Yang Lei were dumbfounded.

They couldn't see anything.

The operating field was extremely small; only Zheng Ren could faintly see a thread, while others could only infer what he was doing from the subtle movements of his hands.

Chu Yan zhi adjusted the shadowless lamp for Zheng Ren, directing the light from behind him straight into the field, so that Zheng Ren could see the operating field as clearly as possible.

Ligation, knotting, cutting.

Zheng Ren asked for warm saline gauze to cover the incision.

This time the surgery has lulled, and we must wait for the pathology report.

If it's benign, we irrigate, close the abdominal cavity, and the surgery officially ends.

If it's malignant, a series of cleanups will follow, and who knows how extensive the surgery will become.

"Chief Zheng, is the ligation secure?" The Obstetrics Inpatient Chief still wasn't at ease.

Because the angle and space for Zheng Ren to ligate the artery were extremely small, she feared he might make a mistake.

"It's fine." Zheng Ren chuckled, his tone relaxed.

"Is it malignant?" Yang Lei asked.

"No." Zheng Ren said: "The surface feels smooth, with no adhesion to surrounding tissue. Moreover, if it were a malignant tumor, connecting to the splenic hilum, it would likely have already metastasized."

Although Zheng Ren was certain it wasn't a malignant tumor, according to protocol we still had to wait for the intraoperative frozen section report.

This is to avoid that one-in-ten-thousand possibility.

【This technique, semi-blind operation, yet so smooth.】

【I've noticed a problem; where do you guys think the camera is installed?】

【Yeah, from that angle just now you could actually see the field; I feel it's installed on the shadowless lamp.】

【I think the likelihood of it being installed on the shadowless lamp is low; even if it were, there would be multiple cameras. When the shadowless lamp was just rotated, you could only see the light change, but not the silhouettes inside Shujian.】

While waiting for the pathology report, almost everyone opened the danmaku.

This is the first time the Surgery Livestream Room has had idle time, letting everyone chat and interact; otherwise, every surgery goes straight to the point.

Whether in the Operating Room or the Surgery Livestream Room, only then did they regain a bit of vitality, chatting and joking, and over forty minutes quickly passed.

The pathology department called; the pathology result was negative.

Close the abdomen, surgery ends.