Chapter 23

Chapter 23: Operation: Blind Appendectomy

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
Standing behind Chief Surgeon Liu, Cen Meng’s face was pale.
As the chief resident in the general surgery department, he had not considered Zheng Ren a rival. He figured some quiet guy who did not curry favor would not be likable to anyone.
Hence, Zheng Ren had never gotten the chance to operate solo and was not a threat to him.
However, after three non-standard appendectomies in a row, Cen Meng had to face the fact that Zheng Ren was definitely miles ahead of him. Zheng Ren’s skills might even surpass that of the Sea City Supreme Scalpel, Chief Surgeon Liu.
“Has the laparoscope been fixed?” Chief Surgeon Liu asked knowingly. He did not bother to lower his voice, wanting Old Chief Physician Pan to know.
“Chief, did you forget? The laparoscope broke down three days ago and was sent out for repair. The vendor said they need a week before it can be sent back,” Cen Meng replied.
The best practice for an appendectomy on a bariatric patient was to use a laparoscope. After the previous success, Chief Surgeon Liu was glad he checked the laparoscope’s availability. What was Zheng Ren going to do now?
Old Chief Physician Pan frowned. The tapping on the old copy of Limited Views picked up.
When the full details of the case were revealed, the chatroom of Xinglin Garden turned to chaos.
More than ten users went on long rants.
[A fatty, oh, the horror.]
[Three years ago, I did an appendectomy on a patient who had adipose tissue that was ten centimeters thick. There was fat liquefaction post-surgery and I did the dressing change for a month straight. I still have nightmares about it.]
[I feel you.]
[Same +1]
…
[Agreed +10086]
3Fat liquefaction was a problematic issue. At certain levels, it could be even more troublesome than the appendectomy during pregnancy.
If an attending surgeon received a case of acute appendicitis in pregnancy, they could request for the chief surgeon to perform the surgery. No one would blame them.
However, if the patient was obese and the chief surgeon was requested to take on the case… Well, the attending surgeon had better be directly descended from the chief surgeon, or pray the chief surgeon was in an ecstatic mood from winning the lottery grand prize, or else they were in for a good lecture.
During the appendectomy on the pregnant lady, everyone was shouting praise as it was a rare and difficult procedure.
An appendectomy on a bariatric patient was something almost every doctor has witnessed and experienced. The barrage of live comments obscured the view of the operative field.
1The continuous epidural anesthesia was set up efficiently. Zheng Ren began disinfecting the skin while Xie Yiren stood by the surgical tray, waiting for the start of a new battle.
The disinfection was complete. Zheng Ren held his hand out and a scalpel appeared.
A five-centimeter incision.
Just as the users were quieting down to watch the surgery, this decision gave rise to an explosion of live comments.
[Such a small incision. What is the god thinking?]
[Damn, such a small incision wouldn’t even grant you a peek of the peritoneum.]
[Which hospital is this? I want to intern there.]
Every doctor watching the livestream had the same thought—a five-centimeter incision was adequate for a normal appendectomy. Some might even call it a smaller than average incision. On a patient with an adipose layer of ten to twelve centimeters thick, the incision granted no access to the appendix.
[Should be a laparoscopic procedure.]
[Agreed. Must be a laparoscopy.]
[Don’t be stupid. Do you see any laparoscope set up? This god is challenging the human limit. Bow before him, trembling peasants!]
1Zheng Ren was not aware that the laparoscope was not functioning, but had never planned to perform a laparoscopic appendectomy from the get-go. His appendectomy training in the System taught him that laparoscopy could not achieve the perfection he was aiming for.
This was because a laparoscopy relied on electrocutting and electrocoagulation to manipulate the adipose layer, resulting in a higher risk of fat liquefaction.
Hence, he decided to use a small incision to complete the appendectomy—something no doctor believed was possible.
To reduce fat liquefaction, the first step was to avoid electrocauterization. The second was to minimize contamination and the third was to apply negative pressure wound therapy for two to three days as part of post-surgery wound care.
1That last step had been proven crucial to minimize fat liquefaction, but Zheng Ren could not go ahead with it. Once a negative pressure drainage tube was used, the case would be disqualified from being a perfect surgery.
Fortunately, he had other ways to ensure a near-perfect surgery.
After all, Zheng Ren was a man who had foregone food, water, and sleep to perform a thousand appendectomies!
Once the skin was peeled back, Zheng Ren plunged the scalpel deep into the adipose layer. His movement was confident and firm even as the scalpel handle disappeared beyond the layer of fat.
This maneuver shocked the audience as if the scalpel was aimed at their own hearts.
Old Chief Physician Pan’s frown deepened. At the same time, the livestream exploded with comments.
[Are we witnessing a murder?]
[Is he that confident? Logically speaking, no matter how much presurgical prep was done, there would be changes when the patient is supine. This maneuver is too risky. A minor miscalculation and there will be damage to the intestines.]
[I’ve been shocked into respiratory arrest. If I don’t turn up tomorrow, please inform my colleagues to pick up my corpse.]
1Zheng Ren was oblivious to the whole discourse surrounding his method.
He pulled out the scalpel and asked for an iodoform gauze from Xie Yiren. Wiping his left middle finger with it, he then plunged the digit into the small incision. At the same time, a pair of large curved forceps held in his right hand followed suit.
The operative view became blank.
No matter how impressive the System was, it would not livestream the happenings in the patient’s cavity. If it did, Zheng Ren would probably be called up for a chat by some department.
Old Chief Physician Pan, Chief Surgeon Liu, and the audience were silent as they watched Zheng Ren’s imperceptible maneuvering of his finger and the forceps.
No one had expected this to happen.
As quick as it happened, Zheng Ren took out his finger and the forceps. He motioned for a sterile gauze and covered the incision to prevent contamination from pus.
It turned out he had been slowly separating the adipose layer, muscle, and fascia to reach the peritoneum.
Everyone was speechless as they watched Zheng Ren push two pieces of sterile gauze into the incision. No one could tell what was happening inside the patient, no matter audience or the surgeon.
Zheng Ren’s next move stunned everyone.
He disinfected the same finger and reached in again, this time with a pair of extra-long curved forceps.
[I… am speechless. If the first surgery was anything like this, I would have called the cops and told them that someone was livestreaming a murder.]
[Is this the legendary blind operation? Can someone enlighten me?]
[What is the surgeon doing? Such outrageous stunts have blinded my fragile eyes.]
Countless messages flashed across the stream as Zheng Ren asked for another pair of extra-long curved forceps. The two pairs of instruments occupied the open incision—it was difficult for even a finger to enter.
What was the significance of the two forceps placed inside the abdomen? That was the question on everyone’s mind.
In the short period when the operative view turned blank, the surgeon had managed to make an educated guess based on his clinical experience and proceeded to ligate the ligaments and arteries.
The livestream was silent now—not a single comment came on the screen.
The unimaginable and the impossible just happened. This man must be possessed by the devil.
Comments? They were nonexistent as everyone stared dumbfounded.
Even the anesthesiologist beside Zheng Ren was wide-eyed. His jaw hung open as he watched Zheng Ren operate.
Only the lionhearted Xie Yiren disregarded what Zheng Ren was doing. She just followed her instincts, predicted what Zheng Ren would do next, and handed him the appropriate instruments.
She had faith in him.
There were no dazzling magic tricks in this operation. The doctors were familiar with every step Zheng Ren took. What step he would take next was also very clear, and yet, it was all completely unbelievable.
This was because he was performing the surgery blind.
The next step would be to cut the appendicular artery…
They then saw Zheng Ren hold the smallest scalpel with the tip of the extra-long curved forceps and plunge it into the abdomen.
1Then…
Then…
If that was successful, the operation should be over.
As the audience wondered about the outcome, Zheng Ren retracted the forceps.
A blind operation without any visual assistance. Was the appendix removed? Was the appendicular artery ligation secure? Would there be bleeding?