Surgery Godfather
Chapter 834 - 745: Clearing the Field for This Kind of Surgery? That’s Blatantly Bullying!_2

Chapter 834: Chapter 745: Clearing the Field for This Kind of Surgery? That’s Blatantly Bullying!_2

The appendix, this little fellow, is a "small tail" on the colon, located between the human body’s cecum and colon, a tube-like organ with a closed end and an opening near the cecum to the proximal side. The so-called blind tube is much like a super narrow dead-end street.

Given that it is an extremely narrow dead-end, it is prone to traffic jams, such as fecaliths, food, foreign bodies, or hyperplasia of lymphoid cells, which can easily get into this dead-end and then become stuck and unable to get out, leading to infection and triggering appendicitis.

The incidence of appendicitis is actually quite high, reaching up to 10% in Western countries, while in China, the incidence is between 4%-8.5%, accounting for 20%-30% of patients with acute abdomen conditions.

In ancient times, if one developed appendicitis, it essentially meant a fight for life. With good luck and strong immunity, one could survive the infection; but with weak immunity failing to control the infection, there was no hope.

Later, with the surgical procedure to remove the appendix, appendicitis was no longer to be feared.

The traditional method of surgery was to make an incision and cut out the appendix, also known as an appendectomy, a procedure that has been around for over 100 years. Subsequently, with the development of laparoscopic minimally invasive technology, laparoscopic appendectomy was introduced.

With this technique, there is no need to leave a scar on the abdomen, but there are still a few small scars left, after all, it is necessary to make holes in the abdomen.

More recently, some brand-new surgical techniques have been developed, like transgastric appendectomy and transvaginal appendectomy. Whether through the stomach or the vagina, a small incision is made internally as an entry and exit point for instruments and the camera. Through this small opening, the camera and instruments enter the abdominal cavity, and then directly reach the appendix area to perform the surgery.

These techniques leave no external scars, but there are internal scars, and they damage the stomach and vagina.

With the advancement of surgical technology, a new technique has evolved—the endoscopic transcecal appendectomy. This method requires no incisions, internal or external. The camera and instruments are inserted through the anus, ascend retrograde through the anal canal, pass the rectum, reach the cecum, find the opening of the appendix, make an incision around the opening, and then remove the appendix.

This is the miraculous endoscopic transcecal appendectomy, suitable for those who are extremely concerned about aesthetics.

The endoscopic antegrade appendiceal cavity treatment technique, also known as appendix-preserving surgery, involves treating appendicitis without removing the appendix.

Previously, it was thought the appendix was a useless organ and that removing it would not affect anything.

Modern research suggests the appendix is useful—it is an immune organ, with specific functions similar to those of the mesenteric lymph node cluster and the tonsils. It can kill a portion of bacterial microbes and can also pass their genetic information to lymph cells, enabling the body to develop immunity to these microbes and enhance the body’s immune function.

In addition, it can also store a large number of probiotics, helping to prevent intestinal flora imbalance and reducing the incidence of intestinal inflammation; it can also improve digestive function and prevent indigestion.

So, once the appendix has problems, surgeons nowadays do not simply cut it out; they also consider preserving it.

Of course, if the appendix is already necrotic and perforated, there is no way to preserve it. But if the appendix has not necrotized or perforated, instruments can enter through the internal opening of the appendix, remove the obstructing materials such as fecaliths, then irrigate the appendiceal cavity, insert a drain, and remove the drain after a few days post-surgery—the appendicitis is also cured.

Director Fang also likes to delve into business matters. Now, with new technologies in General Surgery, he is always keen to study them, such as Da Vinci robotic surgery. Given that he has conducted many such surgeries at Sanbo Hospital, it is not surprising that he would research cutting-edge procedures like ETA and ERAT.

"Director Fang, let’s analyze the surface ultrasound. Doctor Song, bring up the ultrasound images," said Yang Ping as he sat down beside Director Fang and called up the images.

The internal systems at Sanbo Hospital are interconnected, allowing the operating room to access any image picture at any time.

Analyze the surface ultrasound?

Director Fang was puzzled. What was there to see in the ultrasound? Besides, surgeons usually don’t read ultrasounds; they typically look at ultrasound reports.

"Actually, laparoscopic surgery would be more convenient for today’s operation. However, due to the patient’s scar constitution and high aesthetic demands, even the few small scars from laparoscopy are unacceptable. This forced us to use the endoscopic transcecal operation, which has limited operating space and can only be carried out near the appendix. If a large abscess forms, resulting in intestinal adhesion, it is not suitable for this kind of surgery," Yang Ping explained to Director Fang.

The more Director Fang listened, the more confused he became. If it was unsuitable, that would be a relative contraindication, so why still use this method?

Besides, with such a severe condition, why bother with fancy techniques? The best choice would be to operate immediately to save the patient’s life, at most using laparoscopic procedures, which would already be showing off skills.

"With this patient’s large abscess and intestinal adhesions, the difficulty of an endoscopic transcecal procedure is very high, Professor Yang. Let’s switch to laparoscopy instead," said Director Fang.

Director Fang had just heard a reminder from the ultrasound physician and now reiterated the caution.

Being colleagues, reminding each other to avoid pitfalls was not just a duty but also a matter of integrity. Yang Ping was highly skilled and often seemed magical, which Director Fang knew, but this was surgery, and the patient lying on the operating table could afford no jokes. If time was wasted, it would be too late for regrets if a life was lost.

Walking by the river often, how can one not wet their shoes? If one harbors a mentality to show off, it’s extremely dangerous.

"It’s not a big deal. Although it’s difficult, it’s not like there’s no solution." Yang Ping was very calm.

---

Family waiting area.

Liao Yiyi’s parents were anxious and uneasy, since their child was on the operating table, it’s natural for parents to worry.

"Old Liao, do you think Yiyi will be okay?"

"Don’t worry, Xiao Liang is there, didn’t you hear what Yu Yihan said? The team at Sanbo Integrated Surgery is world-class. Just look at Xiao Liang, one phone call and he can summon a medical helicopter."

The couple also felt very guilty, a mix of regret and worry. At first, out of heartache for their daughter, they inquired everywhere whether surgery could be avoided, delaying a lot of time and aggravating the illness. Now, she’s in shock, and they heard that she could be in danger of losing her life at any moment.

"Xiao Zhang, what did your dad’s friend say?" Liao Yiyi’s mother asked Zhang Zikun.

Zhang Zikun had just called his dad’s friend, the head of the General Surgery Department at one of Beijing’s top hospitals. Hearing about acute appendicitis with necrosis, perforation, a large amount of abscess formation around it, and intestinal adhesion, the director blew up on the phone:

"Nonsense, the person is in shock and in imminent danger of losing their life. Either go for surgery directly or, if skilled in laparoscopy, use a laparoscope; never heard of doing this kind of surgery through an endoscope via the cecum, thinking they’re some kind of demi-god, not realizing the depth of the situation—"

"They said she’s already in shock, human life is of paramount importance, lifesaving is crucial; either go for surgery or make an incision. That nonsense about doing surgery through the anus, that’s utter crap and could cost someone their life." Zhang Zikun said indignantly.

Could cost someone their life?

"Oh my!—" Liao Yiyi’s mother threw back her head, leaning against the chair back, her body limp like mud, and she actually began crying.

Liao Yiyi’s father, however, was much calmer, "Keep it down, why cry? What kind of expert is he, he hasn’t even seen the patient face to face. A few words over the phone, and you believe him? Isn’t Xiao Liang inside? What’s there to worry about?"

Upon hearing the name Xiao Liang, Zhang Zikun got annoyed, "Could an expert speak without sense?"

"Alright, Xiao Zhang, have a seat, let’s just wait and see, it’s only been ten to twenty minutes." Liao Yiyi’s father was quite displeased with Zhang Zikun.

But his heart also began to pound; previously at Fuer, the doctor had said that Yiyi was already in shock and needed immediate surgery to save her life, even suggesting they hurry to move her up the surgery schedule.

However, since the medical helicopter would possibly enable a quicker transfer, they had hurriedly moved to this hospital.

"Yu Yihan, check the time, what time is it?" Liao Yiyi’s father also became nervous.

Human life is of paramount importance, it’s not a joke.

Whether or not to proceed with surgery was now irrelevant, as long as they could perform the surgery and their daughter was alright.

"It’s only been eighteen minutes. Uncle, Auntie, don’t be anxious."

Yu Yihan, on the other hand, was not worried. As a young girl, having seen Dr. Liang’s powerful presence, combined with the whirring arrival of the helicopter, Yu Yihan had complete faith in Dr. Liang.

This time was truly torturous, each minute felt like an hour, passing so slowly.

"Old Liao, it’s been so long, why haven’t they come out yet? Could something have gone wrong?" Liao Yiyi’s mother stared at the operating room entrance.

Liao Yiyi’s father said, "Don’t talk nonsense!"

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