The Surgeon's Studio

Panda Novel

Zheng Ren raised his head and stared at the screen opposite him. The internal walls of the patient’s intestines were pink, and intestinal motility was slow because of general anesthesia. The colonoscope quickly passed through the rectum and entered the colon.

[Why is he moving so fast? Isn’t he worried about intestinal perforation?]

[There is no such thing as “slow” for a man who can complete a simple appendectomy within three minutes.]

[That’s right. Stronger animals are usually faster in the animal kingdom. A tiger can actually shoot its load more than ten times in just a minute.]

5The live broadcast room had a tendency to become a real-life operating theater when the viewers, who were actually “experienced” individuals, could make dirty jokes naturally and shamelessly.

The atmosphere suddenly became naughty, peaceful, and harmonious.

[He didn’t stop or even probe when the colonoscope reached the splenic flexure. Oh my God, that was terrifying…]

[Didn’t you notice that the lens moved a little just now? I assumed that there was a flick in the surgeon’s wrist which caused the colonoscope to drift around the corner.]

3[Is he really that good? Any anatomy gods here? Please come forward and explain. The colonoscope should reach the appendix soon, right?]

…

…

Zheng Ren’s movement was swift as he had performed more than a hundred similar cases in the System last time.

Zheng Ren believed that there were many surgeons who had performed more appendectomies than him in this country, but using a colonoscope to resect an inflamed appendix? He was undoubtedly the most trained surgeon in this field.

More surgical training resulted in proficiency. There would be solutions to mistakes encountered which meant that the chances of unforeseen events would decrease tremendously.

The colon and appendix appeared on the screen.

He then used an injector with a mixed solution—indigo carmine, epinephrine, and normal saline—to improve the delineation of the appendix.

Zheng Ren started incising the mucosal layer with the instrument.

His hand movements and manipulation of the instrument had to be performed in reverse, just like an inverted image in a mirror. That was the difference between this surgery and open surgery.

The blood vessels were clearly visible after one mucosal layer was incised with a needle knife. After that, a pair of forceps was used to initiate the blunt dissection of the submucosal layer.

1This was a delicate surgical task as performing the blunt dissection of the submucosal layer through the colonoscope was much more difficult than under direct vision.

The anesthesiologist beside Zheng Ren was captivated by the swift movement on the screen.

She had worked in the operating theater for many years, so it was natural that she knew its difficulty even though she had not performed it personally.

Blunt dissection was preferred by most high-skilled surgeons due to advantages such as decreased trauma and less bleeding from the dissected edge. However, if something went wrong with the procedure—from uncontrolled strength or a lack of anatomical knowledge—and an iatrogenic intestinal perforation arose, excreta in the intestines would flow right into the peritoneal cavity.

This medical error would lead to a severe peritonitis, which was treatable if the patient was lucky. Otherwise, they would have to receive treatment under observation in the ICU for approximately ten days. If luck was not on their side and the condition was complicated with septic shock, they risked losing their life.

Thus, the surgeon’s skill and overall qualities were the most important factors in performing a blunt dissection.

However, blunt dissection was usually performed using fingers or a pair of hemostatic forceps under direct vision.

Zheng Ren’s method was to manipulate the colonoscope and a pair of forceps through the instrument port outside the body. One could only imagine the extreme difficulty of such a delicate task.

‘Please don’t make any mistakes,’ the anesthesiologist prayed in her heart and fought the urge to remind Zheng Ren of it. He was manipulating the instruments with undivided attention and the patient’s assistant was on the scene as well. If he was distracted for even one second and perforated the intestine…

Fortunately, what she was afraid of did not come to pass. Zheng Ren manipulated the colonoscope and forceps dexterously while dissecting the mucosal layers as if with his own bare hands. Whenever a blood vessel was encountered, he would use the hook knife to cut it directly instead of rupturing it, causing it to bleed before using the knife to achieve a hemostatic effect.

There was a huge difference between these two methods, and the anesthesiologist, who was highly experienced, admired Zheng Ren for his superb standards.

Soon, the submucosal layer was exposed.

Zheng Ren replaced the forceps with a transparent cap to push the connective tissues away from the submucosal layer and dissected the layer further with the endoscopic electric knife.

After the dissection was complete, the intestinal wall was then incised and the colonoscope entered the peritoneal cavity.

The mesoappendix was divided, the appendix well skeletonized, and the appendiceal artery ligated.

After that, Zheng Ren replaced the instrument again and inserted the endoclip purchased from the System into the instrument port.

The inflamed appendix was in a severe edematous state due to failed conservative treatment for three days and was on the verge of perforation. Any unnecessary increase in strength would cause it to burst and the surgery would end in failure.

The anesthesiologist involuntarily held her breath upon seeing this as though her heavy breathing would cause the edematous appendix to rupture.

Holding the inflamed appendix with a pair of forceps and placing the endoclip at the base of the organ, Zheng Ren resected it and clipped the mucosal surfaces together.

The endoclip with the resected appendix was removed and the intestines were irrigated. After ensuring that there were no obvious bleeding spots and the mucosal surfaces were tightly sealed, the colonoscope was then removed.

“The surgery is complete. You can administer drugs now,” said Zheng Ren.

“Huh?” The anesthesiologist was taken by surprise. That was true. The surgery was basically complete after the appendix was resected.

However, something seemed wrong. She had expected the surgery to go on for five hours, but how long had it been?

She glanced at the time on her cell phone—merely nine minutes had passed.

“Chief… Chief Zheng, is it really over? You don’t need to recheck the surgical site?” the anesthesiologist started stuttering.

“Recheck? I’ve done that.” Zheng Ren took off his surgical gloves, folded both arms across his chest, and sat on a stool against the wall.

“Er…” The anesthesiologist was left speechless. Staring at Zheng Ren’s confident expression, she really wanted to pinch his ear and roar, ‘Can’t you just check it again? Don’t you know that the hospital management places a high value on this surgery?!’

However, she fought the urge to do so in the end.

She had already calculated the required dosage of reversal agents to let the patient regain consciousness, but had not expected to perform the injection so soon.

According to its precalculated value, a reversal agent was intravenously injected to reverse the effects of muscle relaxant, and a mixture of atropine and neostigmine in a 1:1 ratio was injected afterward.

Slight movement was noted in the patient two minutes later.

The anesthesiologist glanced at the patient’s vital signs on the electrocardiogram and yelled into her ear, “Zhou Jinxi, Zhou Jinxi!”

“Huh?” Zhou Jinxi mumbled through her nose.

“The patient is awake. Come and transfer the patient,” the anesthesiologist announced to Zheng Ren after confirming the patient’s status one last time.

“Doctor Zheng, I’m sorry to bother you.” Zhou Jinxi’s assistant stood in front of Zheng Ren and bowed apologetically.

Apology? He must be exhausted. Otherwise, why would he hear traces of apology when the assistant expressed her gratitude? However, the inside of her surgical gown became clearly visible when she bowed and allowed gravity to pull her gown downward.

‘Those are rather small…’ The thought flashed past Zheng Ren’s mind.

4“Please leave first. We’ve arranged nurses to escort Miss Zhou back to her sick room,” said the assistant softly but firmly.

Oh, so that was what all this was about. Zheng Ren smiled after realizing that the assistant preferred not to expose Zhou Jinxi’s private parts to a man.

Well, it was understandable as she had the potential to be very popular in the future. Some day, if someone spread today’s incident onto the internet, tut-tut… That would be troublesome.

Zheng Ren nodded in response and left the operating theater.

He had no idea that the entirety Xinglin Garden had entered a half-paralyzed state because of this surgery.

1A live broadcast room could accommodate one thousand viewers at most. The moment Zheng Ren resected the appendix and clipped the mucosal surfaces with the endoclip, thousands of comments flooded the entire screen which exceeded the threshold of the technical bandwidth. As a result, the livestream crashed and one thousand viewers were disconnected at the same time.

The hornet’s nest was immediately stirred up.

When viewers reconnected to Xinglin Garden and realized that the livestream had turned off after the surgery was complete, they started expressing their dissatisfaction by turning the forums upside down.

Numerous phone calls began bombarding the CEO of Xinglin Garden as well.

How could a professional website be established without financial investment from a few moguls?

It was beneficial to be acquainted with more of them as the website grew further.

However, that was also the reason why the CEO had to feel their wrath today.

There were various types of senior experts supporting the website. Some of them were cultivated, some were easily irritable, but all of them shared a similar quality—they were intellectual individuals.

That the CEO had to feel their wrath was an exaggeration, but the fact that they had expressed their dissatisfaction and disappointment was more than enough to drench the CEO of Xinglin Garden in cold sweat.

Hence, a group of skillful technicians started improving the website and gave Xinglin Garden a system upgrade. Who actually caused so many professors to be unhappy at the same time? What happened in the livestream that actually crashed the entire live broadcast room? These questions had piqued the CEO’s curiosity.

Their answers, though, were completely beyond his imagination.