Doctor: I Can Synthesize Infinite Entries

Chapter 66: Chapter 66: A Heavenly Show: Wu Ting’s Performance

Director Zheng completed the laparoscopic appendectomy in a deeply satisfying manner. It wasn’t until the surgery was over that he suddenly realized it.

’Damn, this surgery is another one of my masterpieces, both in terms of time and quality.’

’Not bad, not bad at all. When this exchange is over, I have to copy this surgical recording and take it back for the junior doctors in my department to study.’

Director Zheng was in a great mood. This Wu Ting was a real lucky charm, catching him at the peak of his performance.

”Wu Ting, our teamwork on this surgery was seamless. You did very well.”

Director Zheng was completely unaware of why he had been in such excellent form.

”Yes, Director Zheng, you’re truly amazing. Through this surgery, I’ve also gained a deeper understanding of laparoscopic appendectomy.”

Wu Ting offered some professional praise, which put Director Zheng in a pleasant mood.

”Alright, for the next one, I’ll hold the camera for you, and you’ll be the lead surgeon. Don’t worry, I’ll guide you and give you reminders the whole way through.”

From Wu Ting’s coordination while holding the camera, Director Zheng knew that Wu Ting had a very deep understanding of laparoscopic surgery, so he was quite confident letting him take the lead.

He also planned to supervise the key steps to come.

In the observation room, the junior doctors were full of admiration for Director Zheng. The surgery was truly performed perfectly.

”Director Zheng is so incredible. The completion time for this surgery was so fast. He’s truly an expert from City First Hospital. I’ve learned so much.”

The junior doctors couldn’t see the underlying truth, and Zheng Duqing, being in the thick of it, was oblivious. Only Zhang Zhong, the onlooker, saw things clearly.

Hearing the junior doctors’ admiration for Director Zheng, which indirectly made him seem weak by comparison, Zhang Zhong’s mouth twitched.

’That guy, Old Zheng... He really got to show off!’

’Sigh, if I had an assistant like Wu Ting, I could perform just as smoothly and effortlessly.’

After changing into fresh surgical gowns and taking a short break, the second surgery began.

The patient was a 37-year-old male, admitted for upper abdominal pain with fever for five days, which had worsened over the past eight hours. The pain had spread to his entire abdomen... The diagnosis was acute appendicitis.

The patient was intubated via laryngoscopy, placed under general anesthesia, and prepped in a supine position.

For this surgery, although Wu Ting knew a better, scar-concealing laparoscopic appendectomy technique, the surgical plan had already been set. Wu Ting also chose the classic three-port laparoscopic technique.

The classic method was also the best test of solid fundamental skills.

After the surgical area was thoroughly disinfected and draped, a small incision was made at the patient’s umbilicus, and a trocar was inserted...

”CO₂ insufflation, 15 mmHg... Establishing pneumoperitoneum...”

Wu Ting gave the orders clearly.

In laparoscopic surgery, CO₂ is used to establish pneumoperitoneum because it is an inert gas. This prevents the generation of excessive smoke when using instruments like an electrocautery knife or ultrasonic scalpel inside the abdominal cavity, which would obstruct the view.

Additionally, CO₂ has high solubility and can be absorbed by the body without causing hypercapnia. This insufflation distends the abdomen, creating a larger operating space, which facilitates the procedure and provides a better field of view.

Next, Wu Ting precisely made two more accessory ports. Director Zheng had been wondering if he should remind Wu Ting of the steps, but seeing Wu Ting’s rapid pace, he immediately began to coordinate, holding the laparoscope to provide a view.

Director Zheng was, after all, a senior lead surgeon, and his understanding of camera work was top-notch. He coordinated with Wu Ting and began the exploration.

”Routine exploration. Check for any trocar injuries, then, in order: liver, gallbladder, stomach, duodenum...”

Hearing Wu Ting’s commands, Director Zheng felt a bit unaccustomed. It had been many years since he had acted as someone’s assistant.

However, Wu Ting’s pace was just too fast, leaving him no time for idle thoughts.

Soon, Director Zheng had completed the routine exploration in coordination with Wu Ting.

”Beginning search for the appendix... cecum... along the colon...”

Director Zheng felt that something wasn’t quite right, but Wu Ting’s thought process was too quick, and he instinctively followed the commands and began the exploration.

”Intraoperative findings show no obvious lesions on the appendix... Explore the terminal ileum and pelvic organs...”

Wu Ting continued to guide Director Zheng, who followed along instinctively. With Wu Ting’s directions, his muscle memory took over, and he didn’t even need to think.

Wu Ting quickly began to aspirate the peritoneal fluid...

He pushed aside the greater omentum and began to dissect the adhesions around the appendix...

Shortly after, he began using atraumatic grasping forceps to clamp the edge of the mesentery at the appendix’s tip and lift the appendix...

Watching Wu Ting’s technique, Zhang Zhong, in the observation room, was clearly surprised.

’Dr. Wu really has some skill. Impressive.’

’Not only is he controlling the pace of the entire surgery, but his handling of the mesoappendix is also that of a seasoned expert!’

Zhang Zhong directly explained to his junior doctors:

”Besides studying Dr. Wu’s clinical thinking and overall control, you must pay even more attention to his surgical details.”

”There are many ways to handle the mesoappendix.”

”For a typical beginner, I would recommend using titanium clips. They can ligate the mesoappendix and its artery in one or several steps, then use an electrocautery hook to dissect the distal end until the appendix is separated at its base. This method is the simplest to perform and easiest to master.”

”Alternatively, one could use electrocoagulation to seal the mesenteric vessels for 3-5 seconds until the mesentery turns white. This method is generally used by physicians with some experience, but one must be careful about collateral damage. The trauma area is relatively large, and a few patients experience postoperative pain in the lower right abdomen. Therefore, usually only experienced doctors dare to use it.”

”But look, Dr. Wu is using the most difficult method: ligating the mesoappendix twice with absorbable sutures and then dissecting the distal end with electrocautery. This method is undoubtedly highly demanding of the Technician, but it also results in the least trauma and fewest side effects for the patient.”

”This Dr. Wu, his fundamentals are truly solid!”

”This isn’t a traditional open surgery. To perform an appendiceal ligation with absorbable sutures through such tiny operating ports... This Dr. Wu is truly a case of boldness born from great skill!”

The more Zhang Zhong watched, the more impressed he became.

This learning exchange was definitely not a waste. Being able to keep a textbook-level surgical recording like this would be an invaluable teaching resource for the Military Hospital’s general surgery department.

On the operating table, Wu Ting began to deal with the fecalith present at the base of the appendix.

There were also many ways to handle the base.

Wu Ting once again chose the method with the least trauma and highest skill requirement: using an absorbable suture to perform a purse-string closure, burying the stump.

”Amazing, Dr. Wu’s fundamental suturing skills are so solid.”

After completing this step, he began to remove the appendix.

”Scrub nurse... Specimen bag...”

Wu Ting’s mind was sharp, and he issued the next command without the slightest hesitation.

Never mind the observation room; even Director Zheng in the first assistant’s position hadn’t reacted yet.

Director Zheng had already sunk into the effortless joy of operating on pure instinct, his brain switched off.

In the observation room, a few junior doctors asked, confused:

”Director Zhang, why is Dr. Wu getting a specimen bag? Why is his technique different from Director Zheng’s before?”

Zhang Zhong also hadn’t expected Wu Ting to make his judgment so quickly.

”This comes down to judgment in handling the appendix. Conventionally, if the appendix is not larger than the trocar, we would pull it out along with the trocar.”

”However, if the appendix is large and the mesentery is thick, and it can’t be pulled out directly, it would be trimmed and removed in pieces through the trocar. But this method carries a certain risk of incisional contamination.”

”Therefore, some highly skilled physicians with nimble hands and excellent fine motor control will place the appendix into a specimen bag inside the abdominal cavity first. This way, it can be handled inside the bag before being pulled out, effectively preventing incisional contamination.”

”It’s just that this kind of judgment requires the accumulated experience of many surgeries to be able to make the best decision in an instant.”

Listening to Director Zhang’s explanation, the junior doctors finally understood the subtlety in Wu Ting’s technique.

All the doctors had completely forgotten that Wu Ting was a resident trainee, even younger than them. Watching Wu Ting’s surgery, they were truly broadening their knowledge.

”So there are this many operating techniques. For Dr. Wu to be able to decisively choose the best option on the spot is truly incredible.”

After this step, Wu Ting began to irrigate the abdominal cavity and place a drainage tube.

The entire surgery was completed as smoothly as flowing water.

”It’s over?”

Director Zheng’s brain finally came back online. ’That surgery felt so easy!’

In the observation room, everyone stood up and applauded, still wanting more. They had just witnessed a perfect performance.