Chapter 873 Small Incision
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“So, Doctor Ling thinks that such an incision is suitable. But what’s your opinion?” Wei Jiayou watched as the surgery progressed, and he suddenly muttered a question.
Yu Yuan, who was standing on her toes, suddenly realized how tiring the position was. She stopped tiptoeing and pointed at herself in surprise. “Are you asking me?”
“Of course.” Wei Jiayou looked around, and even though Associate Chief Physician Deng was flashing him an obsequious smile, he merely nodded.
Even a smile was enough to make Associate Chief Physician Deng from the General Surgery Department of Yun Hua Provincial Hospital extremely happy. Associate Chief Physician Deng was a student of Academician Di’s unofficial student, who in turn ended up in Changxi Province. In Wuxia terms, Associate Chief Physician Deng would be an outer sect member, while Wei Jiayou would be a last disciple. There was a huge difference between their statuses.
Hence, because of this relationship between them, Wei Jiayou could give Associate Chief Physician Deng a call and order him to make arrangements and come here. However, there was no need for Wei Jiayou to do anything in the interest of Associate Chief Physician Deng or even treat him in a friendly manner.
Right now, Wei Jiayou was paying Yu Yuan more attention compared to Associate Chief Physician Deng.
Yu Yuan had always been interested in theoretical discussions. When she heard Wei Jiayou’s question, she tilted her head and started pondering. She looked like a lopsided Shiitake mushroom. “I feel that if a doctor is skillful enough, a small incision would of course be more suitable.”
“Ah… you are still young.” Wei Jiayou could not help but reply Yu Yuan with what Academician Di often said about himself.
“What do you mean?” Yu Yuan puffed her cheeks, and she looked like a Shiitake mushroom that had been soaked in water.
“A small incision makes the surgery more difficult. You mentioned that a small incision should be made if the doctor is skillful enough. But how would the doctor know if he is skillful enough without opening the patient’s abdominal cavity? Even though hepatectomy isn’t as dangerous as cardiothoracic surgeries, it’s not a walk in the park…”
“If everyone follows your line of thought, no one would be making small incisions anymore. Everyone would make nothing but big incisions.”
“That’s why I said that you’re still young. Only young doctors like to make small incisions, as this serves as proof to their skills. As for experienced doctors, they care more about preventing errors.” Wei Jiayou paused for a moment as he pondered. He then added, “You know, if you make a bigger incision at the beginning of the surgery, no one would think that you’re a lousy surgeon. But if you only realize that the incision you have made is too small in the middle of the surgery, and have no choice but to make it bigger, everyone would know that you have made a wrong judgment earlier…”
Yu Yuan was speechless. She blinked as she looked at Wei Jiayou and said, “I’ve never thought that a ginseng baby could have such complicated thoughts. You’re actually a dang shen [1], aren’t you?”
There were many things that Wei Jiayou wanted to say, but he was unable to utter any of them. In the end, he shook his head in resignation. “In conclusion, everyone usually makes a standard incision for safety purposes. Hepatectomy is a risky surgery, and anything might happen. If an accident were to happen after you make such a non-standard small incision, you will have no way of defending yourself if the patient ends up suing you.”
Yu Yuan looked like she was deep in thought as she nodded.
Wei Jiayou could not help but flash a smile. “What I said makes sense, don’t you think so?”
“At the end of the day, you just aren’t confident when it comes to hepatectomy, right?” Yu Yuan looked at Wei Jiayou with a meaningful gaze. Thirty percent of it was the kind of look one has when he saw through another person, thirty percent of it was understanding, and forty percent of it was pity.
When Wei Jiayou heard that, he was extremely heartbroken. He said with determination, “I never lack confidence at surgery.”
“Even your grammar is wrong.” Yu Yuan pursed her lips in disdain. She looked like an examiner.
“It’s time to remove the left and right coronary ligaments,” Ling Ran reminded. He paused for a moment to let the words sink in. He then continued with the surgery.
Wei Jiayou sucked in a sharp breath when he heard that. He whispered, “It’s quite difficult to remove the coronary ligament with such a small incision.”
Yu Yuan was clumsy, but she was very well-versed when it came to medical theory. Right now, her expression was solemn too.
A coronal plane is any vertical plane that divides the body into ventral and dorsal sections. The coronary ligaments were located on the coronal plane of the liver, and they were basically parallel to the peritoneum. In other words, when a doctor operated on a patient who was in a supine position, they would not be able to get a full view of the coronary ligaments.
If the doctor had made a standard large incision, there would be many workarounds to this. However, Ling Ran had made a small incision today.
Yu Yuan could not help but feel a little worried as she looked at Ling Ran.
However, at this moment, there was a scrutinizing expression on Ling Ran’s face.
Yu Yuan took another good look at Ling Ran. She was right. Ling Ran was… finding this interesting.
Indeed, Ling Ran found this interesting.
He had made some speculations regarding the condition of the patient’s coronary ligaments when he read the patients scans. But he was only able to know the exact condition after opening the patient’s abdominal cavity.
This was also the hardest part of this surgery.
Ling Ran liked to be challenged.
It was not just about the small incision. Even smaller incisions were also possible for hepatectomy. However, the operating theater in Bazhaixiang was not that well-equipped. Aside from this, hepatectomy with a small incision, after all, required more intuition on the surgeon’s part, and it also had certain unique surgical features which were suited for it.
To Ling Ran, this kind of challenge was hard to come by.
In a way, it was also the kind of surgery that Ling Ran desired to perform but rarely had the chance to.
Whenever a challenge arose in the middle of such a surgery, Ling Ran would feel like he was served a surprise dish during a scrumptious meal.
He was not in a hurry either as he worked his way down in a leisurely manner.
He used the retractor when he should, separated tissues when he should, and obstructed blood flow when he should…
If a person was not looking at the rest of the operating table and merely focusing on Ling Ran’s hand, they would probably think that Ling Ran was a good cook who was making a delicious dish.
After they took their focus away from Ling Ran’s hands and looked at the rest of the operating table, they would notice the reality of the difficulty Ling Ran was facing in operating the patient, and this would give them a totally different realization.
“The patient’s coronary ligaments have been removed,” Ling Ran reminded his assistants again. He then examined the surgical field for a moment and said, “I’ll resume blood flow for now.”
As he spoke, Ling Ran removed a pair of forceps that was used to obstruct blood flow.
Wei Jiayou arched an eyebrow, and he put even more focus on the surgery.
“Bazhaixiang is quite a suitable place to carry out hepatectomy with a small incision, isn’t it?” Yu Yuan felt rest assured when she saw this, and she turned to look at the ginseng baby.
Wei Jiayou refused to show any signs of weakness. He insisted, “Erm… but it’s not as applicable as laparoscopy. Aside from this, it’s also safer to carry out hepatectomy with a large incision…”
“This means that making a small incision is the most suitable choice,” Yu Yuan said and snorted. “Beside, there’s something that you didn’t realize.”
“What?” Wei Jiayou immediately started racking his brain. He was wondering what he had missed.
Yu Yuan smiled and said, “Hepatectomy is cheaper when the incision made is smaller.”
Wei Jiayou was speechless. “Does this small sum of money make any difference?”
“I don’t know how things are in other places, but many of the people in Bazhaixiang aren’t well off.” Yu Yuan paused for a moment and continued, “Of course, the most important thing is making sure that the patients get well and live a little longer.”
“Of course…” Wei Jiayou’s voice drifted off as he replied.
Of course he wanted to make sure that the patient got well and save the patient’s life. But as it seemed, he would not be able to put his hepatectomy skills to use today.
“Surgical thread.” Ling Ran’s voice rang out again, snapping Wei Jiayou out of his reverie.
“Suturing a small incision… This isn’t an easy feat.” Wei Jiayou tried to emulate the maneuvers involved in stitching up a small incision with his bare hands as he watched the surgery.