Surgery Godfather-Chapter 412 - 0384 Extreme Thief

Chapter 412: Chapter 0384: Extreme Thief

Chapter 412: Chapter 0384: Extreme Thief

A brain weighing about 1400 grams, harboring hundreds of billions of cells, with various electrochemical signals constantly transmitting along extremely intricate and complex pathways – its structure is millions of times more complex than our most advanced chips.

The thumb-size brainstem deep within the human brain governs heartbeat and respiration. It is packed with critical groups of neurons and conduction bundles. The vertebral arteries, vital for supplying blood to the brain, also pass through this area.

In such a perilous, complex, and narrow zone, often the room for surgery is measured in millimeters.

Old Feng’s tumor takes on the convoluted shape of a tree root, entwining in the crevices between these neuronal groups and conduction bundles. Some are even attached to the neuronal clusters, making it challenging to differentiate between the two.

The tumor has the most tenacious attachment to the dorsal nucleus of the vagus nerve. A slight deviation of the scalpel could cease both respiration and heartbeat.

Professor Feng’s spontaneous breathing was suppressed by anesthesia, and a ventilator took over his breathing at a rate of 20 breaths per minute. Meanwhile, under the anesthesiologist’s control, his heart rate was maintained around 70 bpm.

Unlike in a spinal correction operation, in this kind of surgery, you cannot just speed through to the end. Yang Ping would stop after every step, instructing the nurse to prepare the instruments for the next step and coaching the assistant on the crucial points to note.

Under the microscope, the various structures are magnified, appearing clearer and more precise. The laser knife accurately separates the tissue. The concomitant minor thermal effect shrinks the fine blood vessels, thereby achieving hemostasis without damaging the surrounding tissue.

The delicate, pointed tip of the laser knife, compared to the blade of the traditional scalpel, does not exert pressure on the surrounding tissue. It is also more suitable for operating in narrow spaces.

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The scalpel incision followed the midline groove at the back, extending from the medulla oblongata in the head all the way down to the cervical spinal cord at the top of the cervical spine. The arachnoid membrane was incised, the pia mater was cut open, and the grey-white brain tissue, soft as tofu, gradually splitting longitudinally under the precise carving of the laser knife.

Going deeper bit by bit, every recurring linear incision did not deviate at all, always following the same route and matching the anatomical gap. This process of working within the tissue gaps ensured safety.

Carrying bloodless operations to the extreme, showing utmost care for the tissue, the tumor gradually revealed itself.

Yang Ping began separating the tumor. The tumor had intertwined with normal tissue, lacked a capsule, and essentially had no discernible boundary.

However, Yang Ping managed to locate their intertwined boundaries. Under the laser knife’s precision of 0.1 millimeters, Professor Feng’s vital signs temporarily remained stable, and the ECG maintained a normal sinus rhythm.

“No use of fluorescence imaging?” John Ansen was surprised.

Typically for such a surgery, to ascertain the boundaries between the tumor and normal tissue, a special fluorescent imaging agent is injected into the patient pre-surgery. During the operation, the microscope is set to fluorescent mode.

This allows the surgeon to clearly differentiate the fluorescently lit tumor from the non-fluorescent normal tissue and proceed with precise tumor resection under the guidance of the navigation system.

Regrettably, even with these advances, the success rate for treating a tumor like Old Feng’s still falls short of 1 percent.

“There’s no use of navigation equipment either?” John Ansen couldn’t comprehend.

It’s impossible to perform this operation without these two technologies, let alone achieve a successful outcome.

Professor Fu from Mo Sixth Neurosurgery was also taken aback. During their pre-operative discussions, Yang Ping had not mentioned this. Everyone assumed that these were routine matters that did not need mentioning. But now, looking at the surgical field, there was neither the use of fluorescence imaging nor navigation equipment. What was going on?

This doctor who graduated from the Temple of Heaven Hospital was supervised by the nation’s top neurosurgery experts and, under their attentive tutelage, he too had become a first-rate neurosurgeon.

“We aren’t using fluorescent imaging agent?” Wen Rentao also realized and asked.

While operating, Yang Ping replied, “It’s not needed. The fluorescent imaging under the microscope would interfere with my judgement. Although navigation is precise, it only provides indirect images derived from CT scans, which is of little help to me.”

For Yang Ping, his countless surgeries and anatomical studies in the system space yielded true tumor anatomical images far more precise than what both fluorescence imaging and navigation could provide.

To an ordinary person, or even top experts like John Ansen, fluorescence imaging and navigation are essential. However, for Yang Ping, these became a burden.

The faint flickering of fluorescence could interfere with Yang Ping’s visual judgement during surgery and disrupt the comparison between the live anatomical structures and the images in his mind.

The picture in his mind had far surpassed any fluorescent imaging.

The image in his mind, formed by hundreds and thousands of images from Professor Feng’s study, was more accurate than any imaging or navigation system.

Despite their doubts, both John Ansen and Professor Fu guessed that Yang Ping, with his systematic and meticulous surgical planning and ability to anticipate momentary cardiac arrests when disturbing the nerve clusters, must have had a superior method to carry out the surgery; otherwise, he wouldn’t have discarded the usual essential techniques.

The delicate bipolar forceps took the shape of a pistol when not used for coagulation. Paired with the laser knife, the tumor’s outline gradually became clearer and the deeply buried tumor began to surface.

Both Wen Rentao and Zeng Ran sat beside him, retracting. Wen Rentao was also responsible for suction, though thus far, his aspirator hadn’t been needed. Until now, almost no blood was visible during the surgery.

The brain tissue was filled with interwoven blood vessels. The laser knife could smoothly operate within the gaps of these vessels. Even when small blood vessels inevitably got damaged, they were electrically coagulated in advance.