Surgery Godfather

Chapter 252: Chapter 0236: Let Takahashi Go on Stage

The shattered half of the face and arm are still in the fridge, and now they’re dealing with this gigantic vascular tumor in the abdomen.

Imagine a patient with severe splenic rupture, the spleen must be removed to stop bleeding and save the life, because there are many “venous sinuses” in the spleen. A severely ruptured spleen would bleed everywhere, making haemostasis impossible. The only solution is to tie off the blood vessels at the base of the spleen, and cut off the organ, thus ending the bleeding from the spleen.

Now, this vascular tumor has over a hundred stems, and the tumor body itself is twisted strands of blood vessels. If seriously damaged, it could bleed even more viciously than ordinary organs.

If there were no on-site blood transfusions, the patient wouldn’t have made it to the hospital alive; even at the hospital, it’s only the constant blood transfusions and the use of autologous blood recovery equipment that’ve kept him viable for the operating table.

Autologous blood recovery machines can collect the patient’s bleeding, process it, and transfuse it back to the patient, but this process incurs some loss. So, relying solely on autologous transfusion is not sufficient, and traditional heterologous blood transfusion needs to supplement it.

This patient’s blood has been replaced several times already. Blood transfusions can only sustain life for a limited period of time; they are a makeshift measure.

If the abdominal cavity is not opened and the tumor removed, this patient will not survive.

But once the abdominal cavity is opened, to minimize bleeding, the aorta must be blocked, and the blockage time can’t be too long. The chief surgeon only has a strict 45-minute window within which to resolve the situation.

Otherwise, ischemia will cause necrosis of the abdominal organs. Once necrosis sets in, it’s immediately followed by multi-organ failure and the entire body collapses like falling dominoes, sending life along with it.

However, these cases are too rare. Any doctor would be clueless when confronted with them. Severe splenic rupture can be treated by removing the spleen to solve the bleeding problem because the spleen’s main blood vessels, the splenic artery and vein, are known and constant in location – surgeons are familiar with their anatomy and can easily ligate them. Ligate the blood vessels, separate the spleen, remove it, and haemostasis is achieved.

The difficulty in removing this huge vascular tumor lies in the fact that it has countless blood supply vessels, which are not covered in a surgeon’s anatomical knowledge.

It is a special, personalized, unprecedented tumor. Even if a doctor encounters such a rare case, the anatomical structure and source of the vessels of two tumors would not be the same.

Removing this vascular tumor is like a brutal urban guerrilla warfare, where a special forces team enters a ruined city without having any map, intelligence, knowledge of the city’s geography or military deployments, while the city is full of hidden bunkers and ambushes. In this situation, the special forces simply cannot win; they can only be eliminated during the street fight.

In contrast, normal surgeries are like the special forces already being familiar with the city, having been in and out hundreds of times. They know the city’s geography and military deployments like the backs of their hands, which significantly increases the probability of victory.

Years ago, after suffering defeat, Fujiwara Masao turned this rare surgical case into a research subject. He led Takahashi and Sasaki in conducting numerous animal experiments to tackle this devilish surgery.

They used various methods to create experimental specimens with huge sprawled vascular tumors in the abdomen of monkey embryos using drugs, then used imaging technology to locate and identify the vessels. They designed detailed surgical plans to ligate the vessels one by one and completely remove the tumor.

They had even tried using interventional methods to embolize the vascular tumor, but due to the lack of any significant main vessels in such tumors, intervention was in vain.

Through extensive research and mastering the rules of the vessels’ origins and distribution, Fujiwara’s team was able to handle surgeries on the experimental animals with ease.

It can be said that they are the only ones in the world with this kind of technical accumulation. This kind of case is too niche; no one has the time to research it.

But Fujiwara Masao is different; he wouldn’t give up on any failed case. He aimed to be the best in the world, to enhance the surgical level of his entire team through researching this devilish surgery. It was through this that Takahashi and Sasaki were trained.

—

Is there no way to complete the surgery? Should we just give up?

The image on the screen remained on the huge vascular tumor. At this point, the injected contrast agent had flowed everywhere, filling the whole abdomen.

Nobody amongst the two thousand plus doctors in attendance had probably encountered such a rare case.

But with professional common sense, they understood that the difficulty of this surgery was like climbing Mount Everest, this patient seemed almost beyond saving.

Medical skills aren’t omnipotent. Many diseases can’t be treated, and many injuries can’t be rescued. This is the helplessness of medicine, the doctor’s helplessness. The life-saving capability of medicine is limited.

“Shut down the screen. This patient can’t be saved.”

This wasn’t just one person’s idea, but the consensus of all the doctors.

—

At Tokyo University Hospital, in the Orthopedics Teaching Room.

Fujiwara Masao’s lips trembled slightly; this surgery was too hard. Even with infrared monitoring equipment allowing all the blood vessels to be seen clearly, the chances of success were still slim because of the time constraint.

This peculiar sprawling vascular tumor, irregularly shaped and growing in every direction into the interstices and inside of the organs – liver, spleen, pancreas, kidney, spinal column, it’s everywhere.

Many years ago, he’d encountered a similar case and had to watch helplessly as the patient passed away on the operating table. It was too cruel.

Even now if he were the one operating, if there was no time limit for first aid and the surgery could be scheduled, allowing the operation time to be extended indefinitely, he would have an eighty percent chance of removing this vascular tumor. @@novelbin@@

But, considering the emergency time limit and stipulating the surgery be completed within two hours, he thought his success rate would drop to a bare sixty percent, and that was with the use of his trauma surgery assistance system.

If Takahashi and Sasaki were performing the surgery, their success rate would drop to less than fifty percent.

Watching from the sidelines is a disregard for life!

Fujiwara Masao picked up his phone and dialed Takahashi: “Dr. Takahashi, in this situation, you may be the only doctor in attendance who has experience dealing with such rare cases. Even if the success rate is less than fifty percent, I ask you bravely go on the operating table. Even if you fail, you will still be my best student. Please pass the phone to Professor Han Jianguo.”

“Understood, Sensei!”

Hearing the somewhat hoarse voice of Fujiwara Masao over the phone, Takahashi straightened his back, as if Teacher Fujiwara was standing right in front of him.

Takahashi kept the phone call going, rose from his seat, and walked over to Director Han. Tang Fei immediately followed to help with translation.

Takahashi wore a serious expression: “Professor Han, this is a call from Teacher Fujiwara Masao, he wishes to speak directly with you.”

Takahashi handed over the phone with both hands. Director Han took the phone and heard Fujiwara Masao speaking in English: “Respected Professor Han, greetings, it’s an honor to converse with you. I am currently watching the surgery display at the venue in Tokyo, and it’s quite distressing. This is an extremely rare case, with zero success rate under inexperienced hands. I request you seriously allow Takahashi Fumiya to perform the surgery because he has ample experience, and the success rate could reach fifty percent. I’m making this request in the name of a medical practitioner–.”

That young surgeon from Sanbo Hospital who had just handled the cranial and thoracic trauma had performed beyond Fujiwara Masao’s expectations. Especially Song Zimo’s thoracoscopic surgery to handle the tear in the ascending aorta—performing an acrobatic act on a wire, his surgical skills were far superior to those of Niiroi and Ogawa. Fujiwara Masao felt a sense of respect rising in his heart.

“I am deeply grateful, Mr. Fujiwara. Please allow me two minutes to consider this, as the case is very special and I must make a careful decision.”

Director Han returned the phone to Takahashi who didn’t sit back down immediately, but stood beside Director Han, waiting for a reply.

Professor Su, Meng Heng, and Fu Shancheng all noted that Director Han had received a call from Fujiwara. Although they couldn’t hear what was being said, they could guess most of it based on the current situation.

At this point, only Director Han could make the decision, no one else was in a position to advise him.

Professor Su remained silent, waiting for Director Han to decide.

The difficulty of the surgery was unprecedented; an objective fact laid bare. There wasn’t many in the world who had experience with such a rare surgical procedure.

If the hospital’s top surgeon tackled this, even if the patient didn’t survive, no one would object because not surviving was expected.

Even he himself would lack sufficient research and experience tackling such a case.

If someone could successfully save the patient, even if it were the arrogant Takahashi, he should be allowed to perform the surgery. Everyone would likely feel the same.

Respect for life! After all, this was but an academic conference.

Professor Su had initially wanted to suggest having Yang Ping perform the surgery. Indeed, Yang Ping was a rare surgical talent, but surgery is a field of experience. Without enough experience, all talent falls short.

With the rare and complex massive abdominal vascular tumor trauma and life-threatening bleeding, even Yang Ping would likely be at a loss because he didn’t have the experience.

Director Han placed his hands across each other, his thumbs circling each other a few times, and inquired from Tan Boyun: “What is the patient’s vital status?”

Tan Boyun accepted the tablet from the assistant and opened the latest readings, blood routine, biochemistry, liver and kidney function, blood gas analysis, and so on for Director Han.

“Ah!” Director Han took a deep breath and made a decision: “Mr. Takahashi, would you please, I implore you to handle the surgery!”

Takahashi was thrilled by the answer. He and Sasaki were both people with a strong desire for challenges. Teacher Fujiwara had given him the opportunity, and Director Han had agreed, so why not perform an unparalleled surgery before everyone, to make up for Fujiwara’s regret?

“Thank you! I need two experienced assistants. If you don’t mind, I’d request Professor Han and Professor Tan to be my assistants!”

Takahashi bowed, and Director Han didn’t respond immediately, causing him to stay bowed.

“Alright, Professor Tan and I will be your assistants!” Director Han stated without hesitation.

Takahashi straightened up: “Let’s not waste time, let’s go to the operating room immediately. Miss Miyuki, please come with me.”

By asking Director Han and Director Tan to assist, Takahashi was acting from self-interest. It was clear to him that for the safety of the patient, Fujiwara Miyuki would’ve been his best assistant.

By inviting the two directors to assist, he wanted to show the more than two thousand Chinese doctors that the gap wasn’t easy to narrow, to satisfy his arrogant heart, and to shatter Fujiwara Miyuki’s mystification about China, to prove that he was not wrong.

Upon knowing Takahashi’s goal, Director Tan also didn’t raise any objections.

“This is a bit too much!” Meng Heng commented, observing the scene.

Fu Shancheng also felt a little uncomfortable: “This is deliberate, but saving lives is more important. If I were in his position, I wouldn’t bother arguing about it either.”

Professor Su remained silent. The chasers will catch up eventually. The pursuit of those lagging behind would definitely be painful.

“Tell Song Zimo to pause the surgery! Don’t open the abdomen!”

Director Tan immediately notified the operating room.

“Is Takahashi going on stage?”

Seeing the slight movement in front just now, and then Director Han, Director Tan, Takahashi and Fujiwara Miyuki leaving from the side door of the conference room, everyone speculated.

There was some commotion in the conference room. The surgery was too difficult for Sanbo Hospital to handle; luckily the top-notch Takahashi was present, and they were now inviting him onto the stage.

“Yes, Takahashi is going to perform the surgery.”

“He’s a trailblazer in world trauma surgery, and he’s going on stage.”

Who would’ve thought that this conference would be so exciting? A surgical demonstration encountered a rare case that happens once in a hundred years, and they’d be able to watch Takahashi’s surgery.

The atmosphere in the conference room became excited. Most of the doctors were filled with admiration for the world-class trailblazer.