Chapter 616: Send for Pathological Examination
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Doctor Ling, is this all that we’re going to cut off?” Liu Cishan from the First People’s Hospital of Wuxin City was an associate chief physician who specialized in hepatobiliary and pancreatic surgery. Of course, before he met Ling Ran, he basically did not dare to carry out any liver surgery. He mainly carried out gallbladder-related surgery and wrote some research papers about the liver.
Ever since Ling Ran started carrying out hepatectomy in the First People’s Hospital of Wuxin City on a frequent basis, Liu Cishan and his colleagues had become a lot more skillful. Nowadays, Liu Cishan was already capable of acting as chief surgeon for minor surgeries related to the liver and pancreas. However, Ling Ran’s supervision was still needed, as they would not be able to send the patient to Yun Hua Hospital in time if an accident were to happen.
With Ling Ran’s personality, even though he was paid to participate in guided surgeries, he would still say whatever was on his mind. In the beginning, this often made the doctors in the First People’s Hospital of Wuxin City unhappy. But nowadays, Liu Cishan and his colleagues were used to being unhappy.
Whenever Liu Cishan operated on a patient together with Ling Ran, he was used to asking Ling Ran whatever question that was on his mind.
As an associate chief physician who was almost fifty years old, he, too, aimed to treat patients who were suffering from liver cancer.
Ling Ran answered Liu Cishan’s question in a very straightforward manner, “Try to cut off as little normal tissue as possible because it’s better for postoperative recovery.”
Liu Cishan was not really used to this. “But… we won’t be able to clear the liver off all the cancerous cells this way, right?”
“Let’s wait for the examination results.”
Liu Chishan thought that he had misheard what Ling Ran said. He could not help but ask, “What do we do if the examination results show that there are still cancerous cells in the liver?”
“We’ll make another cut and send it for pathological examination again, then.”
“What if by then, there are still cancerous cells in the liver?”
“We’ll make one more cut and end the surgery, then.” Ling Ran was not delusional. If they were unable to clear the patient’s liver off all the cancerous cells even after making three cuts, it was obvious that even if they tried to stubbornly preserve more parts of the organ by that point, it was futile.
However, if they ended up cutting too much of the organ of today’s patient, he might not even make it out of the operating theater alive. Hence, all the surgeons were faced with a tricky situation.
Seriously though, Meng Shan from Eastern Science Hospital really found the perfect patient to make Ling Ran’s life difficult.
If Ling Ran did his job well, he would get a bonus from the hospital. If he were to screw up, the hospital would probably give him a dismissal pay.
Meanwhile, all the surgeons in the operating theater stared at one another.
From their perspective, Ling Ran seemed a little nonchalant. But at the same time, if they thought carefully about it, it might also be because he was taking things too seriously.
Liu Cishan said in a low voice, “But hepatectomy doesn’t usually provide enough time for us to send the samples for pathological examination for so many times. Once or twice is doable, but thrice is quite impossible, isn’t it?”
Ordinarily, the blood supply to the liver would only be cut off for one hour or less than that. And it would take one hour for the samples to be sent for pathological examination three times. Moreover, hepatectomy was an extremely complicated surgery. Every single time a chunk of the liver was cut off, bleeding control and suturing took up a lot of time.
Ling Ran said, “I said three times because I want to play safe. Normally, it would only take two times for me to get rid of all the cancerous cells.”
“I don’t understand.” Liu Cishan was obviously educated, or else, he would not dare to express his lack of understanding like this.
As they had already made the first cut, all the doctors were waiting for the pathological examination results with bated breath. Ling Ran simply started explaining things to the other doctors. “The patient, Qi Yuquan is seventy-three years old, and his liver functions are relatively weak. Even after we took measures to take care of his liver, all his indices barely hit the normal values. Because of this, we have to try cutting off as little of his normal tissues as possible. At the same time, we have to try our best to get rid of all the cancerous cells as the patient wouldn’t really be able to take chemotherapy either. So, the only way to go about this is to rely on the pathological examination results and cut off as little of his normal tissues as possible while getting rid of all his cancerous cells.”
If the doctors were able to get rid of all of Qi Yuquan’s cancerous cells, he would not need much chemotherapy. At most, he would need to receive low doses of preventive chemotherapy once or twice.
However, if they failed to clear all the cancerous cells off Qi Yuquan’s liver, he would need to receive chemotherapy at a higher dose and frequency. Ling Ran did not believe that Qi Yuquan’s body would be able to take it.
The doctors from other hospitals were extremely hesitant. There were a lot of things they wanted to say, but they were not brave enough to do so.
“It’s because this kind of patient isn’t suitable for surgery at all!”
In a conference room in Eastern Science Hospital, a group of doctors was watching the live stream of the surgery and laughing.
“You’re right, Professor Bao,” Meng Shan said nonchalantly.
Professor Bao, who was sitting opposite Meng Shan, was the first doctor whom Meng Shan consulted. However, unlike Meng Shan, Professor Bao was still working in a public hospital. He only came over to Eastern Science Hospital, which was a private hospital, every now and then whenever a patient sought for him.
This was the way it was with most doctors working in private hospitals. They would treat ordinary patients at government hospitals and treat rich patients at private hospitals. Whereas, they would treat powerful patients in the VIP patient building. You could say that they were very realistic.
Professor Bao was a specialist in general surgery. He said as he stared at the screen, “Qi Yuquan’s family owns a mine. A really huge mine. This is why after he got sick, he consulted doctors in many different hospitals. If a hospital in the United States were to offer to operate on him, he would have gone to the United States. He doesn’t even need to go to Yun Hua Hospital.”
“The doctors in the United States won’t even dare to operate on him.”
“Because there’s no way to go about it. When it comes to cancer, some people can be treated via surgery, but for other patients, it’s just impossible. There’s nothing we can do to change that,” Professor Bao said calmly, “Young people always think that they can move mountains. Truth be told, sometimes, you have to admit defeat to achieve great things.”
“You’re definitely right.” Meng Shan had always like to flatter these part-time professors.
Part-time professors get paid according to their workload. Since private hospitals did not have many patients to begin with, one would have to be nice to these part-time professors to make them stay.
Of course, full-time associate hospital directors like Meng Shan get paid a huge sum of money every month. Hence, he did not mind flattering his colleagues a little.
Professor Bao was very happy upon hearing Meng Shan’s words. He continued, “As surgeons, we should know our limits. With the condition of Qi Yuquan’s health and his age, we can only provide palliative treatment. Of course, this lad called Ling Ran came out with a pretty good idea by deciding to carry out pathological examination during the surgery like how we do with patients suffering from colon cancer. But I wonder why it didn’t cross his mind that others would have done the same long ago if this is even a possibility…”
“It’s not possible indeed.” The doctor sitting beside Professor Bao was also a specialist in general surgery, and he took the opportunity to flatter Professor Bao.
Professor Bao nodded. “They’re just wasting time by doing this. With the way they are going, it would be a miracle if the patient is able to make it out of the operating theater alive. Can a seventy-three-year-old man’s body really withstand such a prolonged surgery?”
“There’s only a need for surgery if there’s the possibility of the organ being cleared of all cancerous cells, as otherwise, it would just endanger the patient for no reason.”
“So, he would definitely need to cut off extra normal tissues…”
The moment Professor Bao finished speaking, everyone heard through the live stream that the phone in the operating theater was ringing.
“Operating Theater 1.” The circulating nurse picked up the call.
A few seconds later, the circulating nurse hung up and shook her head at Ling Ran. “The boundary isn’t clear.”
Everyone in the operating theater sighed in unison.
The doctors from all over the country who were watching the live stream could not keep calm at all.
Lu Wenbin and Yu Yuan, who were acting as Ling Ran’s assistants, looked a little uneasily at Ling Ran.
“We just need to cut off a bit more, and it should be fine.” Ling Ran, though, merely flashed a smile and repeated what he did earlier. He cut off a thin slice of the patient’s liver.
He was actually cutting very close to the boundary just now. After all, during the actual surgery, he had to operate based on what he remembered from the simulation. If he was not careful enough, he might cut off an extra 0.3 inch of Qi Yuquan’s liver. And for a patient like Qi Yuquan, having an extra 0.3 inch of liver cells made a world of difference.
Hence, Ling Ran was playing very safe. He did not mind not being able to clear the liver off all its cancerous cells the first time around. The blood supply to the liver had already been cut off anyway, and as long as he kept things within an hour, there would not be much of a difference.
Now, after Ling Ran cut off a bit more of Qi Yuquan’s liver, not only could he ensure that all the cancerous cells were gone, but he could also retain more of Qi Yuquan’s liver tissues.
Ling Ran confidently cut the liver and asked the nurse to send it for pathological examination. He raised his head after he was done, and saw that everyone in the operating theater was wearing a worried expression.
“Doctor Ling, why don’t you play it safe a little and cut off a little more of the patient’s liver?”
“Let’s not send it for a second pathological examination.”
“That slice is too thin. Why don’t you make another cut?”
Most doctors were just trying to ensure that all the cancerous cells were gone. Since they did not have access to a simulation of Qi Yuquan’s body, they could only offer Ling Ran their advice based on what they knew.
Ling Ran crossed his arms. There was a smile on his face, and no one was able to change his mind.
Such a scene was a repeated occurrence in his life, and by now, Ling Ran was used to it already.
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