The Surgeon’s Studio Chapter 63 - Parasites In The Biliary Tract

Chapter 63: Parasites In The Biliary Tract

The doctors in Xinglin Garden understood everything that had been done up to this point.
It did not matter if they could perform the exact same procedures, but it would be humiliating if it had all been Greek to them.
Doctors who had received professional training still possessed this basic quality, at least.
‘It’s time to extract the gallstones.’ Everyone had the same thought on their minds. Since the common bile duct had been incised, the next step would be gallstone extraction to alleviate the patient’s obstructive jaundice symptoms.
A pair of custom-made lithotomy forceps, a conventional but rarely-used instrument in the operating theater, was then placed in Zheng Ren’s extended palm. Xie Yiren had been attentively observing Zheng Ren’s movements and necessary instruments would be handed over whenever required.
Many viewers in the Xinglin Garden live broadcast room were envious.
The host surgeon’s scrub nurse was competent and far better than their own. Not only were theirs bad-tempered, they even needed to be reminded to pass the lithotomy forceps during unconventional surgical manipulation.
In most cases, they would realize that they had not prepared the lithotomy forceps and circulating nurses would be instructed to retrieve a pack of sterile lithotomy forceps from the sterilization room.
Inevitably, this trip would delay the surgery for a few minutes, but this was not the case for the host surgeon, who could perform the operation in a relaxed manner.
There was a more outrageous possibility—that the nurses returned with a pair of unsterilized lithotomy forceps! That was a nightmare!
Despite the doctors’ envy, life still had to go on, right?
The forceps entered the common bile duct. One, two, three… Something was wrong. Why were the gallstones oddly shaped? Was it possible that those were not stones?
[Based on my decades of clinical experience, it seems like a biliary parasite.]
[Decades of clinical experience, are you bullsh*tting me? I don’t even think experienced, elderly senior consultants know how to log into Xinglin Garden.]
[I’m now fifty-nine years old, so I’m actually a senior consultant with decades of experience who keeps up with the times. What are you going to do about it?]
The subject in the Xinglin Garden live broadcast room changed in that instant.
However, judging by the strange shapes that emerged, they did not seem to be ordinary gallstones.
After removing the gallstones in the cystic duct and left and right hepatic ducts, the host surgeon began irrigating the ducts with warm normal saline while aspirating more sediment-like stones.
Then, a rare event occurred—the surgery came to a halt.
[Mayday, mayday. Did the live broadcast just crash? Anyone who sees this comment, please respond. I repeat, please respond.]
[Same. I feel so much better after seeing your comment.]
[It isn’t a crash. The host surgeon is preparing the next equipment. I’m guessing a choledochoscope.]
After ensuring that there was no connection issue or livestream problem, this particularly uncommon surgery having an interlude was instantly barraged with comments.
All of them were guessing what had actually happened.
[I think the host surgeon is having diarrhea. I once suffered from acute enteritis and had to visit the toilet eight times while performing an appendectomy. Every time after I scrubbed up and changed into a surgical gown, diarrhea struck me again. That was indeed a tragic experience and makes me feel uneasy even until now. I’m looking for consolation.]
[Perhaps he wants to check if there is any malignant transformation after opening the gallbladder.]
[Maybe the host surgeon fainted.]
Hundreds of comments flooded the screen, which reflected the joyful atmosphere of the moment, but none of them worried about the surgery at all.
What a joke. Disregarding everything else, the blunt dissection and profound anatomical knowledge of the host surgeon were more than enough to fuel speculations that they were an elderly professor in their sixties. How was it possible that they could not complete a tier-three surgery?
In the operating theater, Zheng Ren had temporarily stopped the surgery to allow Chu Yanzhi to unpack the equipment he had purchased in the System, place the fiberscope on the surgical instrument table and put the connector on Zheng Ren. That way, he could see the operative field through the imaging in the fiberscope with his naked eyes.
Chu Yanzhi’s height was the same as Zheng Ren’s—172 centimeters. Therefore, she had to use a stool in order to put the connector on Zheng Ren’s head.
“Chief Zheng, where did you get this equipment?” Chu Yanzhi had assisted in similar surgeries in West China Hospital but had never seen such tools.
“I made it myself.” Zheng Ren shut down the whole conversation with a simple sentence.
“What a stingy person,” Chu Yanzhi said, annoyed, “I’m not going to take it from you, so why can’t you tell me?”
Zheng Ren felt helpless. He could not possibly tell her that he bought it from the System’s Shop, and perfunctorily made-up a place was not a viable option either. What would happen if she decided to visit it for equipment purchase? Deception was a better course of action in this case.
His imagination suddenly ran wild like a dog that had broken its leash. If women had access to the System’s Shop, would there be a big sale on Double Eleven?
After assisting Zheng Ren with the equipment installation, Chu Yanzhi said with excited curiosity, “Sis, we can perhaps write an SCI if this surgery is successful.”
“It’s possible as the impact factor should be equal to or more than three.” Chu Yanran, who was sitting beside the ventilator with an anesthesia monitoring form in her hands, quietly observed the various data displayed on the ventilator and monitors, adjusting the drug dosage accordingly.
The Chu sisters would behave distinctively only during a surgery.
Zheng Ren was unsure whether this was the only odd way to accurately distinguish them.
The image in Xinglin Garden distorted for a moment before it switched to the fiberscope view.
[What the f*ck, it’s a fiberscope!]
[That’s indeed high class. We normally use a size-five urinary catheter for continuous irrigation to ensure that there aren’t any residual stones in the ducts.]
[I have professors who know how to handle a fiberscope, but they seldom use it. Most people can’t use it well, especially with forceps integrated with a fiberscope for the removal of residual tiny stones. This kind of microsurgery is on the same level as neurosurgery.]
The fiberscope advanced deeper and the atmosphere in the live broadcast room became tense and quiet.
The comments disappeared as everyone stared at the white silk thread attached to the walls of the common bile duct in shock.
They were not gallstones, but parasites!
These white silk threads were clearly not suppuration caused by inflammatory exudation, but rather elongated parasites dwelling in the common bile duct.
The gallstones that had been extracted were likely the end products of these parasites that had been wrapped and organized by inflammatory reactions.
[Who can guide me on the treatment in a parasitic infestation? I’m waiting. It’s urgent.]
A junior doctor sought guidance in the livestream.
Generally, if someone took the lead, others would follow suit. This was a common phenomenon in the operating theater, but in the live broadcast room, not only was the situation similar, it was more unbridled.
However, this time, an eerie silence reigned in the live broadcast room. The lone comment flew from the right side of the screen to the left with no response.
The junior doctor was smart enough to remain silent.
Every doctor watching the livestream had a bad feeling. This surgery would very likely end in failure.
Was it possible that the host surgeon would observe the condition, performatively try to remove the parasites and give up after realizing that they had embedded themselves into the mucosal layer? After all, they could accidentally damage the common bile duct during parasite removal.
It was highly probable.
However, everyone was greatly satisfied after seeing the parasites cluster like dense, white silk threads.
Moreover, many viewers blindly trusted the host surgeon because they were omnipotent! Since they dared to broadcast their surgery live, they must have anticipated this condition.
They were again astonished upon recalling the earlier intermission in surgery.
Could it be that the host surgeon had diagnosed the patient with parasitic biliary obstruction and the necessary instruments had been prepared in advance?
Even if the instruments had been prepared, though, nothing could be done in this situation.
Parasite removal surgery was still in the preliminary stage in the current medical trend. After all, the risk of parasitic infection was low in developed countries, and most parasitic diseases remained in Africa.
Besides, expecting random medical experts to specialize in the surgical removal of parasites… was basically impossible.
Even if any doctor was willing to learn for the sake of boundless love, to improve their medical skill and for nobility, medical device companies would never invest in or design equipment specifically for surgical removal of parasites.
Even if the equipment was manufactured, Africa had limited financial power to purchase it.
This surgery had evolved from an incision and drainage of a “simple” obstructive suppurative cholangitis to an unfamiliar procedure.
What would the host surgeon do to complete this surgery with an unknown difficulty level?
Perhaps he just wanted to observe the situation and give up in the end?