There were no words between Zheng Ren and Su Yun, even as they performed a procedure as unconventional as the stent-in-stent technique.
Su Yun had gotten used to Zheng Ren’s methods of operation. As long as it existed, any technique could be carried out.
Would the perfect assistant still need to ask any further questions?
Never.
After a connection was established between the portal and hepatic veins, there was a clear decrease in portal pressure which also slowed down bleeding in the gastric varices.
This in turn made the surgery less difficult as the patient was no longer as restless.
The second stent graft was inserted, much more easily than the first, into the jugular vein, the atrium and then through the hepatic artery, finally resting on the previous stent graft as directed by the guide wire.
At that moment, Zheng Ren moved more gently and slowly. Since the images were overlapping, he could not verify what was happening using the venogram alone and was forced to estimate the location from his own experience.
When the stent reached the puncture location, Zheng Ren made a few minor adjustments before deploying it at the sheath.
The second stent was retractable. The operation was slightly different from the first, but not by much.
Even Su Yun and the professor could not tell if the location of the stent was appropriate. Only Zheng Ren could.
They performed another venogram. This time, the contrast medium passed smoothly through the stent between the hepatic and portal veins. Primary imaging of the stents also revealed that they overlapped precisely, their ends not exceeding one another.
This meant that friction between the stents were maximised with minimal risk of dislodging.
The surgery was a success!
Zheng Ren turned off the equipment and removed the guide wire.
[Awesome! This guy’s amazing!]
[Inclusive of the patient’s fits, it all took one hour and 54 minutes. This is the shortest TIPS surgery I’ve ever seen!]
[I’m just a passerby who doesn’t really understand TIPS surgery, but I think the surgeon did a great job.]
The doctors in Xinglin Garden began commenting via the bullet screen. Although the room had stopped broadcasting, they used it as a forum to continue discussing the surgery.
As Zheng Ren prepared to leave the operating table after withdrawing the guide wire, there was a crisp, pleasant notification of mission completion.
[Main Mission: The Crown Jewel – First Stage Completed.
[Mission Content: Complete a TIPS surgery
[Mission Rewards: Since it was the first TIPS surgery performed, in addition to it being an emergency surgery, its difficulty level was raised to 2. Duration of surgery was 1 hour and 54 minutes, 149 x 2 x 2 = 596 hours of surgery training time awarded. Luck points +2, two golden chests and 200,000 experience points.
[Mission Time: 6 hours, completed in 1 hour and 54 minutes, with remaining time of 4 hours and 6 minutes.]
The first stage of the main mission, The Crown Jewel, was complete. The rewards and experience points from the System were abundant.
Especially the surgery training time; he had been awarded over 600 hours!
That was equivalent to 25 days.
It was the largest hoard of wealth Zheng Ren had ever accumulated!
He was elated. Did this mean that he could afford to splurge once or twice in a blue moon?
He tore off his sterile surgical gown and entered the changing room, returning the special lead vest to the System and returning to the operating console room with a huge grin.
Professor Rudolf Wagner was deep in thought as he watched Zheng Ren enter the room, shaking his head and saying, “Zheng, your surgery was a masterpiece.”
“You’re exaggerating, professor,” Zheng Ren replied with a smile.
The professor let out a soft sigh and did not argue the matter.
Chief Xia was not specialized in interventional surgery and thus did not understand what had happened, but Zheng Ren and Professor Rudolf Wagner’s conversation implied that the surgery had been a stirring success. “Dr. Zheng, did it work?”
“You could say so,” Zheng Ren said, “We just need to be careful of postoperative complications such as hepatic encephalopathy. Also, I deployed two stents. If the hepatic encephalopathy is not serious, we can consider removing the second one to enlarge the tract between the hepatic and portal veins, increasing blood flow.”
Chief Xia nodded in silence.
“Is the patient going to be transferred to your department or the ICU?” Zheng Ren asked.
“We should be able to handle the postoperative complications better, so he’ll follow us,” Chief Xia answered with the force and dignity of a department chief.
Zheng Ren was unbothered. He had done extremely well in the surgery and deployed two stents. Since the outflow tract was slightly narrower than 8 mm, there was a much lower risk of developing hepatic encephalopathy than they would have had with a single stent.
The patient being transferred to gastroenterology was fine. After all, they were the experts in treating hepatic encephalopathy.
In the operating room, Su Yun had already bandaged the patient and, with Chu Yanran and the others, moved him onto the stretcher trolley for handover to the gastroenterology department.
Chief Xia made to leave with the stretcher trolley, but hesitated for a while before asking, “Dr. Zheng, I have a patient with decompensated cirrhosis and refractory ascites.”
“If their family members are willing to accept the high risks that come with this method, they can come in for treatment.” Zheng Ren smiled.
“Okay,” Chief Xia said curtly and left.
Zheng Ren predicted more gastroenterology patients requiring TIPS surgery in the future, as long as his patient’s postoperative condition remained stable.
From an epidemiological perspective, the 60s were rife with hepatitis B.
The country managed to bring it under control by the end of the 80s. Although it was not completely eradicated like polio, its infection rate was not as aggressive as before.
In other words, patients who had contracted hepatitis B would currently be in their sixties.
Failing to take Entecavir to control the hepatitis B virus over the years would result in symptoms similar to that of Chief Xia’s patient.
Receiving TIPS surgery to treat their high portal pressure would greatly improve their quality of life and prolong their lifespan.
No wonder the System had rewarded him so generously.
He felt like he had finally figured out the System.
Su Yun interrupted his train of thought. “What are you laughing at? Do you also think you aced the surgery?”
“Ha ha, it will be fine,” Zheng Ren replied perfunctorily.
“There are newcomers reporting in tomorrow, and you had such a huge emergency surgery today. Your luck is one of a kind.”
Zheng Ren did not understand the connection between the TIPS surgery and being able to have flexible shifts from the next day, but he could not be bothered to argue with Su Yun and simply smiled.
Professor Rudolf Wagner walked out in a daze, his eyes all over the place.
“Ah, I forgot about the professor.” Su Yun chuckled softly. “Had I known that you would pull it off it with such excellence, I wouldn’t have called the professor over.”
Zheng Ren was speechless. How would he have known otherwise?
“Will the professor think I called him over just to observe the surgery like a learning trip? If he’s the type to hold grudges, this would be a thorn in his flesh. In the future, no matter what you say in the academic world, the professor would be the first to oppose you.”
Su Yun’s logic… seemed to make sense after Zheng Ren gave it some thought.
