Ling Ran had recently performed a lot of hepatectomy on elderly patients with liver cancer, and he had developed a sense of familiarity with it.
Today, he was testing his skills. He did not first cut the liver to see the infiltration area of the cancer cells. Instead, he cut it to test his judgment.
It turned out that the incision was indeed very accurate.
The extra part of the liver that was cut was no more than one centimeter.
In comparison, in normal hepatectomy, the surgeon's habit was to cut an extra three centimeters or so. For patients with better physical conditions, it was still bearable, but for elderly patients with weak liver function, the survival rate was too low. If the surgery was done according to the usual procedure, it was very likely that the patient would not wake up.
The key to accurate incision was both judgment and proficiency.
Ling Ran spent a few more minutes examining the accuracy of his hepatectomy. According to his plan, he could try not to use the Virtual Human in the next surgery.
The time of the Virtual Human was limited, and it was not good to promote it to other hospitals. In the end, he had to perform the surgery like a normal person.
Clinical medicine had always been empirical medicine. There were too many things that could be learned through practice, and there was no need to really talk about principles. In other words, it was okay to talk about principles, but there was no need to talk about the truth.
Take cardiopulmonary resuscitation for example. The principles taught in the beginning were completely different from the principles taught now. Correspondingly, cardiopulmonary resuscitation strategies were also constantly changing. Even in the 21st century, the guidelines for cardiopulmonary resuscitation were still constantly changing.
The latest evidence-based medicine was trying to continuously improve empirical medicine, but this did not mean that the use of empirical medicine should be immediately stopped.
Similarly, the principles of defibrillators were also constantly changing. Nitroglycerin was used for more than a hundred years and saved countless lives before someone summed up the principle and attributed it to endothelial cell relaxation factor, and won the Nobel Prize for it. Endothelial cell relaxation factor brought the world Viagra.
Even if it was limited to the field of surgery, there were more things that came from experience.
For example, during hepatectomy, there had never been a definite method for blocking the blood flow to the liver. In the beginning, the surgical experts said that it was possible to block the blood flow for fifteen minutes. Later, they said that it was okay to block the blood flow for one hour. Later, they suggested to block the blood flow for five minutes every fifteen minutes … There was no principle behind it. It was just a statistical result.
The reason why the major surgeries had a very strict superior-subordinate relationship was mostly because of the mastery of experience. If the junior doctors wanted to learn from the senior doctors, they naturally had to be obedient.
Even though the surgical skills passed down from master to disciple were gradually being perfected, the more advanced a skill was, the more unreasonable it was.
Ling Ran did not intend to talk about the principles of hepatectomy. It was fine as long as the method was effective. The lives saved were real. Patients never needed doctors to reason with them. They just wanted to be cured, to survive, and to live longer.
And surgeons were actually not that reasonable.
Many surgeons used methods that could not be explained clearly, and they were not necessarily the truth.
Ling Ran did not feel so conflicted.
As long as he was sure that he could cut it without the Virtual Human, it would not be a problem even if he had to train for dozens or hundreds of cases. It was very common for surgeons to spend two to three years learning a surgical method by observing the patient first before assisting the patient.
Ordinary hepatectomy was not an easy task, and for a long time, it was known for its high mortality rate.
With more people learning and using it, the death rate slowly decreased.
Liver cancer in elderly patients was not an easy disease. Ling Ran went to the operating table and glanced at the old lady on the operating table. He gestured for the anesthetist to continue pushing the medicine before he returned to the operating table and said, "Prepare for surgery."
The surgery group, which had been waiting for a long time, finally became active.
Compared to the Department of Surgery of Beijing University Sixth Hospital, the surgery group sent by Donghuang Regional Hospital was obviously weaker. Their movements and organization were more lax. Although they were above the standard and were quite active, it could be seen that their daily surgical training was definitely not up to Yun Hua Hospital's standards.
However, it was still a tertiary grade A hospital, and there was always a limit to what they could do. Ling Ran slowed down a little, and then slowly increased his speed so that the surgery group could get used to it.
The doctors who came to watch the surgery were also quite relaxed.
"You did quite well." The department director of the General Surgery Department, Xu Jinyi, stood in front of Ling Ran. He and the associate hospital director both stepped on a stepping stool. Both of them crossed their arms in front of their chests, and their field of vision was very clear.
Donghuang Regional Hospital did not have the facilities of a visitation room. It was just that the scene looked more comfortable.
The associate chief physician of the General Surgery Department also smiled and nodded. "You did quite well."
Both of their praises contained a sense of superiority that said, "I can do it too". At the same time, their attitudes were quite friendly.
If they were only at this level, learning a new surgical method with ease would naturally be "quite good" and "quite good".
The other associate chief physicians of the General Surgery Department also chatted and laughed in low voices. Donghuang Regional Hospital did not have a specialized Department of Hepatobiliary and Pancreatic Surgery, so the department director and a few associate chief physicians could perform liver surgery.
This was mainly because Department Director Xu Jinyi could perform pancreatic surgery. Therefore, the pancreas became the department director's private domain. Regardless of whether the associate chief physicians knew how to perform it, they were not allowed to touch it. As a result, everyone started to fight over it with all their might.
After four or five years, when the department director retired, these associate chief physicians would fight it out. The winner would become the department director of the General Surgery Department, and the outstanding one among the losers might even have the possibility of forming the Department of Hepatobiliary and Pancreatic Surgery.
All in all, the current atmosphere in Donghuang Regional Hospital was quite good. The associate chief physicians also wanted to learn. Now, when they saw Ling Ran's simple and slow movements, they were in a good mood.
Ling Ran naturally did not care about other people's thoughts. He slowly separated the hepatic ligament, looked at the time, and began to speed up.
The entire surgical group was naturally brought up by him.
He cut the round ligament of the liver, the falciform ligament of the liver, the right triangular ligament, the left triangular ligament, and the coronary ligament of the liver … Ling Ran increased his speed a little every time he completed a step. When he reached the hepatoduodenal ligament, the voices around him gradually became softer.
A group of doctors who had been in the field of surgery for more than ten years watched Ling Ran operate with ease, and they all understood the reason for the change in his speed.
"So awesome." Xu Jinyi, the department director of the General Surgery Department, suddenly laughed out loud.
Feng Zhixiang knew him, and he also laughed out loud when he heard that. "It's not time to be awesome yet."
In his mind, he was thinking about the suturing of the peach-like blood vessels.
Right now, the body condition of the old lady on the operating table was much better. In fact, if it were not for the fact that the old lady's body condition was between normal and unsuitable for surgery, Donghuang Regional Hospital would not have dared to invite him for freelance surgery.
As he spoke, Ling Ran revealed the second hepatic portal. Then, he began to block the blood flow and exposed the veins …
If it were any other surgeon, this series of movements would have become slower and slower. However, Ling Ran's movements became faster and faster.
This was because the difficulty was all on him. For the scrub nurse beside him, Ling Ran's speed of changing instruments might not be as fast as his previous surgeries. The anesthetist's work was even simpler because Ling Ran's surgeries had less blood loss, and there were fewer violent cuts. The patient's vital signs were also relatively stable …
However, the doctors who were watching the surgery were a little speechless.
In just a few minutes, Ling Ran completed the precut line and sharply separated the liver.
"Send it for examination." Ling Ran waited for the nurse to leave the room before he took off his slippery gloves, washed his hands, and changed his gloves.
Only then did the operating theater burst into discussion.
"What the heck?!"
"I'm so amazed!"
"I look up to the high mountains, and I do everything I can."
After a while, the results of the examination came back. "The borders are clear."
The doctors in the operating theater racked their brains to come up with a poem.
At this time, Department Director Xu Jinyi quietly grabbed Feng Zhixiang and brought him out of the operating theater. He then said in a low voice, "Professor Feng, I would like to ask you for a favor."
Feng Zhixiang chuckled and said, "Go ahead."
Xu Jinyi said, "I would like to ask Doctor Ling to operate on me."
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