godfather of surgery

Chapter 1178 Bloodless Spellfield

When Maurice saw his daughter's skull opened and her brainstem exposed, he couldn't help but feel nervous, as if his heart was being gripped in his hands.

He stared intently at the screen, his hands clenched into fists, trying to keep his breathing even.

At that moment, his daughters' lives were in the hands of the surgeon's scalpel. As a family member, he felt for the first time the sacredness of the surgeon's profession, and this feeling was unforgettable.

It was as if with each cut the doctor made into his heart, his heart would involuntarily tighten.

The most crucial step of the surgery has begun. The brainstem has been exposed, and now it needs to be cut open and separated into two halves. This step is critical; a mistake could cause irreversible cardiac and respiratory arrest.

Everyone held their breath, their eyes glued to the screen, because they all knew that the success or failure of the surgery hinged on this step; the slightest mistake could cause the patient's heartbeat and breathing to stop.

Their conjoined brainstem is no longer a normal anatomy, because it is equivalent to two underdeveloped brainstems mixed together, and the nerve nuclei are also intertwined and mixed. It is not simply cut from the midline, which is why no doctor can perform this surgery.

Nobody knows how to cut it open or how the scalpel will go.

“You don’t need to be so nervous. The surgeon is none other than Professor Yang. You can completely relax,” Johannesson reassured Morris.

But Maurice couldn't relax: "The person lying on the operating table is my daughter."

"You're a surgeon, you operate on patients every day, how can you be so nervous?" Johannesson asked Morris, puzzled.

Morris said, "That's different. Doctors and patients' families are completely different things, two different mindsets. You can't understand how I feel right now."

At this point, the surgeon switched from using a regular scalpel to a laser scalpel, which he was going to use to separate the brainstem.

The familiar laser scalpel—Johnson will never forget this model of laser scalpel. It was back in Shanghai that this laser scalpel left a deep impression on him.

That was Professor Feng Tiancheng's brainstem tumor removal in Shanghai. It was this laser scalpel that allowed Johannesson to witness the world's most advanced surgery.

The precision of a laser scalpel far exceeds that of a regular scalpel, making it ideal for this type of brainstem surgery.

The laser scalpel draws a shallow curve on the surface of the brainstem. The interface through which the brainstem is cut will be a complex curved surface. This curved surface is not consistent with the surface curve. It will meander and twist through the gaps between one neural nucleus after another.

Everyone noticed a very unusual thing: so far, the entire surgical procedure was very clean, with almost no blood visible. This hemostasis technique is unparalleled in the world, and Johannesson certainly felt he couldn't do it.

By this point in the surgery, many people had already noticed something unusual about it.
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At this moment, Dr. Raymond, the furious head of neurosurgery at Johns Hopkins Hospital, finally calmed down and decided to watch the surgery.

Because no bleeding was observed during the entire surgical procedure, the surgeon's hemostasis technique was both fast and accurate. His bipolar electrocautery device was always able to clamp the bleeding point before the blood pressure rose, performing extremely precise and reliable electrocautery.

To achieve this level of hemostasis, there is only one possibility: the surgeon must possess extremely strong predictive abilities, able to anticipate which blood vessels will bleed each time, including small arteries and veins.

To make such a prediction is easier said than done; in reality, it's impossible. No one possesses such thorough anatomical knowledge and extensive surgical experience.

Having extremely proficient anatomical knowledge and rich surgical experience is not enough; one also needs a strong spatial imagination ability to translate the anatomical understanding of the surgical target in one's mind into precise hand movements.

Raymond stopped nagging and criticizing the surgeon.

“See? No one else in the world can do this kind of superb hemostasis technique. Even if we had another thirty years, we still couldn’t do it. This is a gap that can’t be narrowed by hard work.” Massimo had already noticed the change in Raymond’s expression beside him.

From disdain, contempt, and anger, to surprise, confusion, and disbelief.

This was within Massimo's expectations; he himself had gone through this process, and every doctor who didn't personally witness Professor Yang's surgery would go through it.

The entire meeting has now become very quiet, after being noisy and chaotic.

At the beginning of the surgery, Raymond's evaluation created a preconceived notion about the procedure, causing these doctors to underestimate Professor Yang's surgery. As a result, many people did not watch carefully and were whispering among themselves, with some even discussing the recent stock market fluctuations.

However, when someone glanced up occasionally, they suddenly noticed that the surgical footage looked a little different, but they couldn't quite put their finger on what it was.

Oh, so the surgical field was missing something: bright red blood. The head has a very rich blood supply, so how could there not be bleeding, unless the surgery was performed on a "corpse"?

However, the voices of the two girls could be clearly heard in the video, or perhaps the surgeon did this intentionally so that observers could freely sense the patient's state of consciousness.

Even the slightest change in tone caused by pain can be detected.

However, the conversation between the child patients was relaxed and they did not feel any pain at all.

This made the observers, who initially thought that surgery could not be completed under local anesthesia, re-examine the surgery and had to take a closer look at what was going on.

"The hemostasis technique is truly amazing. The brainstem was exposed, yet no bleeding could be seen. Not even a piece of gauze was used."

"Look, the gauze that the assistant has prepared has been waiting for a long time, but it hasn't been used yet."

"If our chief surgeon were to perform this kind of surgery, he would probably have used more than a dozen pieces of bright red gauze by now."

“Our director can’t perform this kind of surgery. These two sisters came to us, and we discussed it for a month. In the end, we concluded that surgery was not possible. Separating their heads would inevitably lead to the patients’ death.”

"Of course I know Dr. Raymond can't do this kind of surgery. What I mean is that when he performed brainstem tumor surgery, he used more than a dozen pieces of gauze soaked in blood when he got to the point of exposing the brainstem."

"Keep your voice down."

"Oh my god, did he not hear me? I didn't mean to."

"He probably didn't hear it; he never turned around."

The younger doctors behind them were already buzzing with discussion, because such a bloodless, clean surgical field was incredibly impactful for surgeons. It meant the surgeon's hemostasis skills were extremely high; in fact, surgical bleeding often reflects the surgeon's skill level. In a similar surgery, less bleeding doesn't necessarily mean higher surgical quality, but more bleeding definitely indicates lower surgical quality.

If you can't even stop the bleeding properly, how can you expect to perform a good surgery?

Raymond had actually heard the doctors' conversation clearly, but he pretended not to. These doctors weren't belittling him; they were just stating the facts. He couldn't possibly turn around and yell at the doctors who were talking; that would make him seem too rude. It was better to pretend he knew nothing.

Yes, he's right. Raymond is not qualified to perform this kind of surgery. But not only is he not qualified, no doctor in the entire United States is qualified to perform it, not even Johannesson.

Even Raymond couldn't have achieved such a clean and neat hemostasis during surgery. The doctor was right; it's no exaggeration to say that a dozen or so gauze pads are needed to reach this stage of brainstem surgery. Johannesson's skill level is probably about the same.

Thinking this way, Raymond felt much better and wasn't too annoyed by the private gossip.

No, that was the old Johannesson. Now Johannesson seems to have improved a lot. His brainstem tumor surgery, in terms of both the number of cases and the success rate, has far surpassed Raymond's.

It's infuriating! Raymond is still angry with this guy.
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At Mayo Clinic and Charité Hospital, all the doctors were completely focused, unwilling to overlook any detail.

Laser scalpels have a limited cutting thickness per cut, so you need to be patient and cut and separate little by little. At this point, it is sometimes difficult to balance precision and efficiency. If the laser scalpel cuts too much thickness each time, it will lose precision and easily damage the surrounding non-target tissue.

The meninges of the brainstem were cut open, and the laser scalpel began to cut through the brainstem tissue. The spatial distribution of the brainstem's neural nuclei was already clearly visible in Yang Ping's mind. Through long-term training, he had developed a powerful ability to visualize three-dimensional space. The three-dimensional anatomical diagram of the entire brainstem was imprinted in his mind, and this diagram could guide his hands to perform precise operations. This was an ability acquired through long-term systematic spatial training, which was extremely useful in surgery, especially when performing operations requiring precise positioning.

Meanwhile, a ceiling-mounted electronic screen in the operating room displayed a three-dimensional anatomical diagram of the patient's brain tissue. The entire brain was divided into two parts, blue and yellow. Blue represents the older sister, and yellow represents the younger sister. The neural nuclei were labeled green and red, with green belonging to the older sister and red to the younger sister.

This is an anatomical diagram created by a large-scale artificial intelligence model, used to guide Yang Ping's surgery. Transforming a diagram into surgical procedures requires extremely high skill.

"How is everyone? You are all superheroes. I feel great right now, and I don't feel uncomfortable at all."

"Me too. Has the surgery started yet? I don't feel anything, not a bit of pain. I'm not sure if the surgery has started."

Because this type of conscious craniotomy allows the patient to maintain an excellent level of alertness and be able to communicate with the doctor, it's a good thing, which the talkative sisters thoroughly enjoyed.

"Are you breathing okay? Do you feel any difficulty breathing, like you can't catch your breath?"

Fatty Liang spoke to the little girl in English.

"No problem, you can proceed with the surgery without worrying about us. Has the surgery started yet? Don't worry about us, we're not afraid of surgery."

In this type of surgery where Yang Ping personally performs the procedure under local anesthesia, Liang Pangzi's responsibility is actually to monitor the patient's vital signs, provide timely feedback to the surgeon, and take appropriate action in case of any unexpected events.

During this surgery, Fatty Liang's job was to talk to the two sisters to assess their level of consciousness.

"The surgery has begun and we are going through a crucial step. You just need to lie still and talk to me. Don't move around too much."

"Don't worry, we won't move around. Can we sing?"

"Of course you can, but try to keep your voices moderate. If your singing is beautiful, you can sing a few more songs. If your singing isn't so pleasant, it's best to sing just one. We want to give the surgeons a good mood." Fatty Liang sat down next to them and chatted.

"Okay, if we sing well, you can listen. If we sing badly, you can interrupt me anytime, we won't be angry."

"What song should we sing? Let me think."

The two sisters actually started arguing over singing that song, neither willing to give in.

"Kids, don't argue. Arguing will ruin the pleasant atmosphere in the operating room. If we can't reach an agreement, let's not sing for now and talk about something else," Fatty Liang stopped them.

“Okay, actually we can each sing our own songs, but that would sound terrible, no different from noise.”

“Where is our dad? I want to talk to him. He’s actually a great guy. I was just angry that day, so I belittled him.”

“Your father is currently watching your surgery in the demonstration room. He’s not here, but he should be able to hear you. If you need to say anything to him, please go ahead,” said Fatty Liang.

"Alright then, I'll say it: Dad, I love you. Please don't be angry with us, right, sister?"

"Yes, I agree. Actually, Dad, you are also an excellent doctor. It's just that you don't have much talent. Oh, I'm sorry, I mean, it's already amazing that you can do so well even though you don't have much talent. In our hearts, you will always be the best."

"You shouldn't have said that Dad has no talent. It would have made him sad."

"I'm just stating the facts."

"I know it's true, but you shouldn't say it out loud. You should keep it to yourself. Saying it will make Dad very sad."

"Oh, really? Then I take back what I just said, Dad, you actually have a lot of talent."

Morris sat in the demonstration room, listening to the two sisters' conversation, and a smile appeared on his lips. What a lovely pair of darlings.

"After the surgery is successful, I want to go to the movies. I like DC movies."

"I love Marvel. I want to sit in the movie theater all by myself and watch all of Marvel's movies. I'll never ask for your opinion again."

"Also, I hate eating durian, but you love it. I have to endure the awful smell when you eat it, and I feel like throwing up every time you enjoy it."

"Don't you like bananas too? They're my least favorite fruit, but I still watch you eat those damn bananas."

"I want to learn to swim on my own, so the coach will never have to worry about how to coordinate our limbs again."

"Yes, that's a great suggestion."