Chapter 182 - 166: Shadowing at the Haijin Port Hepatobiliary Surgery Outpatient Clinic

Chapter 182: Chapter 166: Shadowing at the Haijin Port Hepatobiliary Surgery Outpatient Clinic

In the operating room, the first surgery Zhang Heng demonstrated was transcatheter arterial chemoembolization!

Before the surgery, Zhang Heng had already conducted a full range of examinations on the patient: complete blood count, urinalysis, bleeding and coagulation time, liver and kidney function tests, chest fluoroscopy, electrocardiogram, electroencephalogram, and more.

Zhang Heng’s ability to establish himself at the Jin Province Tumor Hospital was a testament to his undeniable comprehensive skills.

Transcatheter arterial chemoembolization is an extremely complex and delicate procedure, with very high technical demands during the operation.

Zhang Heng used the advanced Seldinger technique for percutaneous puncture and cannulation of the hepatic artery.

"6F sheath... angiography catheter..."

The entire procedure had to be performed under fluoroscopic guidance. Guo Guoguo, as the first assistant, expertly controlled the camera in perfect sync.

In the observation room, the assembled doctors held their breath as they watched and learned. This was, in the truest sense, City First Hospital’s first public demonstration of a transcatheter arterial chemoembolization!

Watching the screen, they saw Zhang Heng’s hands skillfully maneuvering the catheter. Through multi-angle projections, he quickly found the optimal working angle.

As this was the first time many of them were observing the entire procedure, most of the doctors were unfamiliar with this Surgical Technique. However, that didn’t stop them from appreciating Director Zhang’s professionalism and solid fundamentals.

In the observation room, Director Cai Qi was the most moved. He knew how to perform this Surgical Technique, but he was certainly no match for Zhang Heng in terms of execution and finesse.

’I never expected this Zhang Heng to have such incredible clinical talent. No wonder he’s been so high-profile.’

This was different from his admiration for Wu Ting. Wu Ting had currently only showcased his talent in a few limited, low-level Surgical Techniques.

Like the other directors, what Cai Qi valued was Wu Ting’s potential and learning ability. In terms of absolute skill, Wu Ting was only exceptional in certain specific Surgical Techniques.

From the perspective of the entire department, he was still very much lacking.

But this Zhang Heng was different. The number of Surgical Techniques he had mastered and regularly performed was vast.

Take this transcatheter arterial chemoembolization, for example. His skill had already reached the top tier within Jin Province. Only people like Director Shen Xiaofei of Haijin Port’s Hepatic and Biliary Surgery, Director Shen Guofeng of the Emergency Department, and Fu Jinfen of Hepatic Tumor Surgery could be said to surpass Zhang Heng.

Faced with Zhang Heng’s masterful performance, the other young doctors could only bow down in admiration.

And then there was the stunning Guo Guoguo. Her clinical talent was equally astonishing, and her teamwork was flawless.

’Looks like Huo Yun struck gold again.’

’Fortunately, our Hepatic and Biliary Surgery department will be heavily involved in the research project Zhang Heng is launching this time.’

Guided by Guo Guoguo’s camera work, Zhang Heng controlled the microcatheter, gently and deftly advancing it into the hepatic arterial tumor with the aid of a microwire.

He positioned the catheter tip within the first third of the tumor, selected the microcatheter’s curvature based on the tumor’s angle, and then began packing the "basket" with coils of a roughly similar diameter until the tumor cavity was densely filled!

This step was absolutely crucial!

The method of injecting chemotherapy and embolic agents into the hepatic artery to destroy tumor cells was truly a stroke of genius.

The liver has two relatively independent blood supply systems: the hepatic artery system and the portal vein system.

Normal liver cells receive their main blood supply from the portal vein system. However, 90% of the blood supply for liver cancer cells comes from the hepatic artery. Therefore, injecting chemotherapy and embolic agents into the hepatic artery, which feeds the tumor, can significantly increase the local concentration of the chemotherapy drugs while also cutting off the tumor’s nutrient blood flow—killing two birds with one stone.

What Zhang Heng was doing now was a local embolization of the hepatic arterial tumor, a procedure that severely tested the Technician’s understanding of the liver’s anatomical structure.

During embolization, the angle, force, and packing density were all of great importance.

At the same time, different hospitals and medical teams had their own variations in the formulation of chemotherapy and embolic agents.

Zhang Heng had clearly made minor improvements to the traditional, conventional drug formula. This was one of the results of his research. Of course, what he was most looking forward to was eventually testing and identifying the optimal antiviral drug!

However, that was a long road ahead, requiring a large number of clinical trials, statistical analysis, and post-operative follow-ups.

With the perfect coordination between Zhang Heng and Guo Guoguo, the surgery slowly came to a close.

Zhang Heng was very confident in his transcatheter arterial chemoembolization technique.

Considering his experience and age, he had few rivals among his peers.

Even in Xiao City, putting aside the senior generation and the various high-level directors, the only person his age he truly respected was Dr. Cao Dongge from the Hepatic and Biliary Surgery department at Jinggang University Affiliated First Hospital.

Cao Dongge was a true clinical madman. When it came to surgery, he had put in an incredible amount of hard work. In the field of hepatic tumor resection alone, focusing just on mature, widely-used Surgical Techniques, Cao Dongge was a genius who had reached the level of a chief physician while still holding the title of attending physician.

Unfortunately, while Cao Dongge was a clinical powerhouse, he was a complete amateur in research.

He had essentially given up on research to focus all his energy on clinical practice. This made him a "lame duck," and as a result, he was still just a senior attending physician and would likely remain stuck there.

Zhang Heng admired a pure surgical craftsman like Cao Dongge, but he didn’t agree with his path.

In his view, clinical practice and research should advance side-by-side. Just like him—his clinical skills were strong, but his research abilities were even more outstanding.

Otherwise, he wouldn’t have proposed such a project. He also didn’t lack ambition or courage; otherwise, he wouldn’t have chosen to come to the Fan City First Medical Center for Laparoscopic Diagnosis and Treatment Technology Research.

After flawlessly completing the surgery, Zhang Heng went to rest and prepare for the next one.

Guo Guoguo, also a person of few words, went to rest as well, readying herself for the second operation.

Song Qi stood to the side, having been of little help. ’These two are so strong!’ he thought. ’The pressure of keeping up with them is immense.’

In the observation room, everyone rose to their feet and applauded. Clearly, Zhang Heng’s debut was perfect and had left a deep impression on them.

During the break, Cai Qi, Director Mao, and Huo Yun took the opportunity to tell the crowd about Director Zhang’s new research project and his plan to recruit several doctors to join his research team.

Director Zhang promised that the invited doctors would all be key members of his research group, eligible for authorship on papers and to be listed as key personnel on future applications for the National Nature Science Foundation project.

Without a doubt, the skill Director Zhang had demonstrated, combined with the appeal of his new project, made for an offer that was hard to refuse.

After just one surgery, the relevant doctors in the observation room were already restless with anticipation.

Watching this unfold, Huo Yun couldn’t help but secretly admire Zhang Heng.

’What a remarkable young man.’

For the second surgery, Zhang Heng demonstrated the ERCP technique, which was soon to be formally launched at the Center for Laparoscopic Diagnosis and Treatment Technology.

The doctors at the research center were very familiar with this technique. They had been studying it continuously for some time, but they were still a long way from being proficient.

Qin Donglai had been worried about whether his team, in collaboration with Dr. Wang Nanjin from Haijin Port, could handle the responsibility.

He never expected Director Huo to have already solved the problem by directly bringing in Director Zhang, an already established Technician.

Qin Donglai relaxed a little, but he also felt a slight sense of bitterness.

’It seems that from now on, Zhang Heng will have the final say on this Surgical Technique within the department.’

Compared to a seasoned Technician like Zhang Heng, Qin Donglai certainly had no confidence that he could compete on equal footing.

’It’s just a shame Wu Ting’s mind isn’t on this lately. Otherwise, with his clinical talent and learning ability, he might have been the fastest to master it and could have carried the banner for us.’

As Qin Donglai felt a touch of regret, Zhang Heng and Guo Guoguo began the ERCP procedure in the operating room.

It had to be said, Zhang Heng’s technique was truly remarkable.

In terms of clinical surgical performance, at least, he was even a bit better than Dr. Wang Nanjin had been back then.

However, it was unknown if Dr. Wang Nanjin, after later breaking through their limits and setting a new personal record on the training simulator, had become more skilled than the current Zhang Heng.

The video recorded by the Haijin Port team back then had only focused on the pair of operating hands, so they had only observed the movements and hadn’t discovered Wu Ting’s true identity.

Compared to the previous surgery, this one was relatively simpler, and Zhang Heng’s performance was just as outstanding.

The observation room erupted in another round of applause.

The third operation was the most difficult of the day: a hepatic tumor resection. It was the most fundamental surgery of its kind, but also a major operation.

As Zhang Heng began, the crowd once again fell silent to observe.

...

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Meanwhile, Wu Ting was completely unaware of the situation at City First Hospital.

Today, he had come to the Hepatic and Biliary Surgery department at Jinggang University Affiliated First Hospital for a study visit.

Professor Shen Siyuan was out of town for a couple of days, attending an academic exchange in Xianglin City. Because the content was highly specialized, she didn’t ask Wu Ting to accompany her.

Since Wu Ting was insistent on conducting research on the intersection of Hepatitis B-related primary liver cancer and immunology, Shen Siyuan had him go to the Hepatic and Biliary Surgery department to learn.

Through their recent interactions, Shen Siyuan had also learned that Wu Ting was quite familiar with the people in the Hepatic and Biliary Surgery and Emergency departments.

Shen Xiaofei and Shen Guofeng both treated Wu Ting as a disciple, so she felt at ease entrusting him to the two of them.

She also hoped that through his interactions in the Hepatic and Biliary Surgery department, Wu Ting would gain a clearer idea of his own research direction.

Shen Siyuan still didn’t quite approve of Wu Ting’s idea. She felt that a research project at the intersection of Hepatitis B-related primary liver cancer and immunology was unlikely to yield results. Truly, Hepatitis B-related primary liver cancer was an insurmountable mountain for the entire medical community.

The mechanism of the Hepatitis B virus was, to some extent, still unknown to modern medicine, let alone being completely curable.

In response, Wu Ting thanked Director Shen Siyuan for her concern but maintained his attitude of not turning back until he hit a wall.

When Wu Ting arrived at the Hepatic and Biliary Surgery department, he called Shen Xiaofei directly.

When Director Shen learned of Wu Ting’s purpose for visiting, he was very welcoming. However, he was very busy himself, and the level of his research and the surgeries he performed were all highly difficult and particularly complex. For the current Wu Ting, it would be a case of rushing his development.

Therefore, Director Shen arranged for Wu Ting to go to the Hepatic and Biliary Surgery outpatient clinic and observe Attending Physician Cao Dongge, the doctor on duty today, as he diagnosed and treated patients.

Wu Ting was slightly disappointed that he couldn’t shadow a major figure like Director Shen.

But being able to follow a senior attending physician from Haijin Port like Cao Dongge was also a great opportunity. The outpatient clinic saw many different patients in a single day. He could learn and hear a lot, and he could also interact frequently with Physician Cao.

’Who knows,’ he thought, ’I might even get some special entries to drop.’

After getting properly dressed, Wu Ting went to the Hepatic and Biliary Surgery outpatient clinic as arranged by Shen Xiaofei.

Cao Dongge was already very familiar with Wu Ting. They had been in a few surgeries together before. As a clinical "madman," he felt an instinctive affinity and fondness for Wu Ting.

Dr. Cao was mainly in charge of the outpatient clinic, while Wu Ting stood behind him to learn. When necessary, he could also offer some diagnostic and treatment suggestions.

After seeing each patient, Dr. Cao would also find some valuable information to discuss with Wu Ting.