Chapter 1705: Chapter 1709: Successful Operation? Failed Operation! (Part 1)
Under the watchful eyes of countless onlookers.
The surgery began.
This might be the first heart-lung transplant surgery worldwide to treat congenital heart disease combined with pulmonary hypertension.
Naturally, it attracted more and more attention.
Both the difficulty and intent of the surgery were highly controversial.
Therefore, the moment Chen Cang announced that the surgery would be live-streamed, it almost instantly became a trending topic on Weibo.
Whether professionals or ordinary citizens, everyone held different attitudes and wanted to observe the surgery.
In fact!
For Chen Cang, the significance of live-streaming the surgery was not about showcasing its might!
Rather, he hoped people would see the harshness and reality of surgery.
Medicine has never been as blissful as people imagine!
Behind every surgical miracle lay unknown full efforts and dangers, but even so, reality never shows any mercy!
Exactly!
Surgical instruments are compassionate.
But diseases are merciless.
The heart-lung transplant surgery itself is extremely complex, especially when the patient has congenital heart disease combined with pulmonary hypertension against medical advice.
Many experts from the American Association for Thoracic Surgery (AATS), upon learning Chen Cang was performing this surgery, collectively sighed!
In today’s world of humanitarianism, much consideration is given to the patient’s rights, but how many consider the doctor’s rights?
Patients have the right to choose.
But, if you are a doctor facing such a situation, do you have the right to choose?
It’s like a frozen pool with barriers set up by staff worried about accidents, preventing people from skating, yet someone unbelievingly defies it, assuming they are chosen by fate, and skates!
If they accidentally fall into the river and are in life-threatening danger, staff nearby see it; you say, should they save the person?
Save?
They don’t have adequate protective measures!
Do not save?
Many discussions and questions follow.
Never underestimate the attitude of certain bystanders who love drama, not aware of how many healthcare workers succumb to public pressure, choosing suicide!
They save, but the rescued has defects or illnesses, blaming you for not timely saving, without considering the pressure you’ve borne!
You die, and they also die, blaming imperfect hospital systems and limited doctor skills!
The rescuer dies, and the saved lives, at most a trophy, who cares? Is it the rescuer who cares, or their family?
Do not save? Ha! You’re completely done for, lacking professional ethics, compassion, and medical virtue. You’re trash! Who can withstand such diverse condemning words?
Everyone is human; don’t think they are obliged because of different professions.
In this world, there should be no ’should’ or ’should not,’ and no absolute right or wrong!
Looking at issues by stripping everything away, humans are ultimately selfish!
...
The AATS President Sabrina stood up this time, boldly supporting Chen Cang!
Even the elder Mr. Zhong from the Chinese Medical Association, upon learning of this, arrived personally at Anyang!
It’s all for this surgery!
Mr. Zhong has weathered countless storms over the years, and he’s seen plenty of such incidents. His purpose isn’t for the success of the surgery—honestly, he can’t help much with the surgery—his goal is for Chen Cang!
Also for this incident.
While Mr. Zhong may not represent absolute strength, he is authoritative in the medical field!
He’s here to protect Chen Cang.
...
...
For a doctor, the greatest consideration isn’t technique, but humanity!
Often, standing from different perspectives leads to varied thoughts and decisions.
From the patient’s perspective, Guo Xue might genuinely want a child, even willing to sacrifice her life for the child’s birth.
If this child learns of this, they might thank their mother for giving them the opportunity for life.
Even if this story is spun open in any novel, this child can serve as a protagonist model.
Isn’t it?
Moreover, from most people’s viewpoint, the most anticipated scene is Professor Chen reversing dangers, surgery going smoothly, mother and child safe, crafting a legendary tale!
Even many doctors think so!
For instance, Meng Xi, who was initially a non-marriage advocate, facing such a situation, as a woman, would likely want to help.
She sees a mother’s greatness, hoping Chen Cang saves them; because Meng Xi knows surgery carries risks, and failure just means failure, but doing or not is a different matter.
Meng Xi never considered the complex implications behind this matter.
But upon reflection.
Meng Xi voiced it.
How many present didn’t articulate these words then?
Chen Cang has added much in the way of understanding, seeing issues more thoroughly, but that doesn’t mean everyone can conceive as deeply.
This surgery, seemingly validating love, is actually a surgery using love to manipulate.
Many things aren’t visible to all; Meng Xi is just in her early thirties as a Ph.D., ultimately looking at issues from a less mature angle than Chen Cang!
Hmm... Losing physically doesn’t mean the heart matures.
Chen Cang’s intelligence, thought process, intuition, and response are quick, allowing him to conceive of these things in a short time!
Chen Cang doesn’t blame Meng Xi, aligning with what Professor Meng does.
However, Mr. Zhong’s arrival surprised Chen Cang.
"Teacher Zhong, why have you come?" Chen Cang couldn’t help but ask.
Mr. Zhong smiled slightly: "This surgery not only requires exceptional skill but also needs handling of many matters, and I’m here to help solve some difficulties."
Chen Cang was naturally deeply grateful for Mr. Zhong’s proactive assistance.
Thus, with Mr. Zhong’s involvement.
Chen Cang united the obstetrics, hematology, anesthesiology, infectious diseases, cardiology, and pulmonology departments—almost ten departments—to conduct the final pre-surgery discussion!
Mr. Zhong’s arrival brought more safety assurance to the surgery.
Currently, Guo Xue is already showing a trend of severe heart and lung function failure.
Continuing this way, it is bound to affect the fetus.
Just as Chen Cang and others pondered how to conduct the transplant operation without affecting the fetus.
Mr. Zhong suddenly suggested: "Perform a cesarean section first, then conduct the heart-lung transplant!"
Indeed, wisdom comes with age.
Everyone immediately commenced a new discussion based on this plan.
Zhang Jinfeng, a gynecology expert, decisively stated that this surgery could only proceed with a cesarean: "The fetus is now 28 weeks old, and a cesarean can be done; afterward, placed in an incubator for treatment, it would not be affected."
Zhang Jinfeng suddenly remarked: "Seven months already, truly puzzled how this young lady managed to endure this far; nonetheless, let’s all try our best, it would be optimal to save this child."
Everyone nodded in agreement; indeed, saving the child might already be the greatest possibility.
Because most people simply can’t endure seven months!
Congenital heart disease combined with pulmonary hypertension, wanting to endure seven months of pregnancy, such suffering isn’t something the average person can bear.
At this time, Chen Cang curiously asked: "Director Zhang, is there really such a saying as seven to eight months of pregnancy not succeeding?"
Zhang Jinfeng shook his head: "How to put this, it’s somewhat one-sided."
"If the health conditions of the mother and fetus are normal, this statement is entirely mistaken. After all, as time progresses, the fetus gradually matures, so naturally eight months are better than seven."
"At 7 months of pregnancy, the fetus’ lungs are equipped with basic respiratory functions, which is also the basic condition for the newborn’s survival, hence the expression ’seven months can be done.’
At this point, Zhang Jinfeng smiled: "Of course, actually, saying ’seven is possible, eight is not’ is not absolutely wrong. I think the ancients might have been studying a pathological state."
"If the mother’s body develops an illness during pregnancy and has to deliver prematurely, like Guo Xue, her physical condition deteriorates to the extent that it can only bring many adverse effects to the child. At this time, if it meets about seven months, it’s okay to deliver early. Delaying it further is not a good thing."
"Of course, there are also reasons why the fetus, due to its own reasons, cannot survive in the womb and suddenly delivers early in the eighth month, but this is caused by the fetus itself, leading to a high mortality rate. Hence, the saying ’seven is possible, eight is not.’"
After this explanation, everyone was relieved.
(This is something everyone can remember. After all, many elderly people still hold this belief. Do not blindly trust it.)
The surgical plan was further revised and formulated.
It was decided to perform a cesarean section for Guo Xue tonight.
At the same time, Chen Cang would perform donor heart and lung resection surgery.
During the patient’s anesthesia, an artificial heart-lung machine would be used for support.
Then, a heart-lung transplant surgery would be performed.
These few steps may seem simple, but they are extremely risky!
With the help of the staff, after returning to Anyang, Chen Cang performed the first high-difficulty, even the world’s first, heart-lung transplant surgery for a pulmonary hypertension patient combined with pregnancy risk!
This time, the health commission did not get involved.
However, the arrival of Mr. Zhong indicated the attitude of this group of physicians, after all, he is the president of the Chinese Medical Association.
That night, the surgery began!
The donor for the heart and lung transplant was a brain-dead patient after a car accident!
This had to be said: Guo Xue’s family spent a lot of money to support her.
Because organ transplants can’t wait for you!
After all, organs are not like pork, you can’t just freeze them and use them later.
Put simply, every organ in the human body is life, the life of cells, nerves, and tissues.
However, over the past ten years, due to advances in medical technology, when a person is declared brain-dead, doctors can maintain their breathing, heartbeat, and blood pressure using ventilators and medication for more than two weeks.
But once these supportive measures are removed, the patient can no longer breathe on their own, and the heart will stop beating.
Under such circumstances, if there are no other special diseases, except for the death of brain cells, the organs and tissues in other parts of the body remain healthy.
In the operating room!
Teams worked in parallel.
One side performed a complex cesarean section while the other side was intensively preparing for organ transplantation!
The heart-lung transplantation requires extracting the donor heart and lung as a whole.
This means the complexity of the surgery is very high, as it involves many blood vessels and nerve tissues, so there can be no damage during the operation.
At this time, DXY and Chen Cang had collaborated many times before, but even so, this surgery livestream was beyond their expectations!
Because this time, both overseas and domestic, the number of people watching the surgery had skyrocketed, surpassing several times the usual!
A special patient!
A special surgery!
Everyone joked that this might be the most popular event in the live streaming industry!
Medical personnel watching the surgery were there to witness such a high-difficulty operation.
Audiences, on the other hand, were there for the excitement and also wanted to witness the surgery’s reality.
This time, DXY prepared two national cardiac surgery academicians to act as guest commentators to explain the surgery to most of the audience.
After all, it’s so professional that it might be hard for everyone to understand!
This time, Chen Cang performing surgery under the public’s gaze effectively prevented the possibility of the patient and their family causing trouble post-operation, and the media and reporters misrepresenting the facts!
At the same time, the two guests from DXY were Xiehe’s cardiac surgery director Wang Tong and lung transplant expert, China’s foremost lung transplantation figure, Chen Jing academician.
The host began the interview: "Two experts, what are your thoughts on today’s surgery?"
Upon hearing this, Chen Jing couldn’t help but say: "Actually, to be fair, just the fact that Professor Chen can perform this surgery in front of so many people in the nation, even with world experts, everyone should be reassured!"
"Because Professor Chen is doing his utmost!"
Wang Tong nodded: "I haven’t seen Professor Chen’s heart transplants many times, but I believe that if he was willing to operate on Guo Xue, it already says a lot. Because when Guo Xue approached me, I refused!"
Chen Jing spoke candidly: "Actually, does the result of this surgery matter? Honestly, it doesn’t for me!"
"For a surgery that is known to be risky and still goes ahead, I don’t approve, but sometimes medical ethics, humanities, ethics, medical ethics, social moral... etc., facilitated such a surgery!"
"This is a kind of coercion in the name of love. So, as Professor Chen said, this kind of surgery, he’ll only perform once in his lifetime, regardless of success or failure!"
After listening to Chen Jing’s words, everyone watching the livestream began to reflect silently.
Perhaps sometimes, there truly needs to be stronger communication and connection between doctors and patients.
And such a surgery livestream aimed at ordinary people may indeed be meaningful.
To let people genuinely experience such a surgery livestream!
The purpose of live broadcasting is definitely not just for a happy ending, but for an unpredictable future.
To let patients understand the unpredictability and risks of medicine, and the uncertainties in medical treatment, all of this is necessary!
Actually, today, what Chen Cang has done is for this reason.
Speaking here, Chen Jing couldn’t help but marvel: "Actually, if I hadn’t seen it with my own eyes, I wouldn’t have believed that Professor Chen is under thirty; his vision, the solutions he came up with, and even his courage are far beyond our generation!"
Wang Tong nodded approvingly: "Yes, I am very hopeful that Mr. Chen can lead China’s medical field to a better step."
"The surgery has started, let’s switch back to the scene!"
...
After the broadcast started, Chen Cang didn’t say a word.
Although he had the perfect level of [Heart-Lung Transplantation].
But internally, he didn’t feel secure.
Because with the patient’s condition, there is a ninety percent possibility of complications after surgery!
With this physical condition, not doing a heart-lung transplant means death!
If performing a heart-lung transplant, the probability of post-operative complication rejection is very high, as it involves tissues from a different body.
Of course, there’s another situation that Chen Cang fears the most: post-operative infection!
Looking at the brain-dead patient, Chen Cang couldn’t help but sigh!
If the surgery fails, damn, it’ll waste a good heart and lungs!
This set of heart and lungs might save two more people!
As they spoke, the surgery officially began!
Chen Cang looked at Meng Xi: "Give me the scalpel!"
Meng Xi nodded obediently.
This event brought a significant change to Meng Xi as well.
In medicine, one should consider not only the patient but also many other aspects!
Chen Cang took the scalpel, took a deep breath, and made an incision along the midline of the chest.
As he cut layer by layer through the skin, fat, and fascia...
Just like a song: cutting open, layer by layer!
After opening the chest, Tao Zi and Meng Xi quickly applied instruments to retract!
In the view, the pericardium was exposed.
Chen Cang began widely dissecting towards the pulmonary veins with his scalpel.
Then carefully dissected the ascending aorta, brachiocephalic artery, and superior vena cava.
His hands were extremely skillful, almost as if they had a life of their own.
Watching Chen Cang respectively banding and ligating the azygos vein and dissecting the trachea...
These subtle and exquisite operations opened the eyes of those ordinary people watching surgery for the first time!
This... guy!
Not even artisans have such nimble hands, right?
Seeing the vibrant blood vessels, trachea, and nerves densely distributed in the thoracic cavity, yet Chen Cang’s hands could skillfully manage these complexities and then delicately separate them.
Seeing this scene, most of the onlookers were filled with admiration.
Surgery, can be truly dangerous!
Besides exquisite skills, it also requires comprehensive considerations.
Chen Cang began issuing various medical orders as he operated.
"Intravenous injection of heparin!"
"Prostaglandin E1 20ng/(kg·min)!"
...
Initially, the atmosphere was quite relaxed, but gradually, as Chen Cang issued one command after another.
The entire operating room began to fill with a tense atmosphere, akin to a battlefield!
Solemn!
Yet filled with tension.
Chen Cang swiftly completed the high-level ligation!
Following that was the severance of the superior vena cava, clipping close to the diaphragm, using vascular clamps to hold the inferior vena cava, and cutting it above the clamp.
The entire series of actions executed smoothly, scaring those watching the live broadcast!
While narrating, Wang Tong and Chen Jing couldn’t help but say, "This might be the smoothest heart-lung procurement surgery I’ve ever seen!"
In less than half an hour, Chen Cang had deftly cut open the left atrial appendage, drained the lung perfusion fluid, and then severed the ascending aorta at the plane of the anonyma.
Then, moving from below upward, he separated the heart and lung from the posterior mediastinum, ligated and severed the inferior pulmonary ligaments, and removed the heart and lung from the chest cavity.
When the removed heart, still showing a slight beating, was seen the live chat room erupted in excitement.
On this side, Meng Xi had already brought the container, and Chen Cang carefully immersed the isolated heart-lung tissue into 4°C physiological saline!
Meanwhile, on the patient’s side, a cesarean section was being performed!
Chen Cang also began to skillfully change the surgical attire, wash, then don the patient’s new gown, and entered the operating room where Guo Xue was.
Chen Cang needed to ensure that all conditions that could be ensured were in place, to prevent complications or infections.
Meanwhile, Zhang Jinfeng had already led the team to proceed with further laparotomy!
This step wasn’t difficult!
However, the patient’s condition was unstable.
Just after the abdominal wall was cut open, the sound of beeps began to ring!
It was very alarming.
Everyone watching the surgery was suddenly startled!
"Low blood pressure!"
Zhang Jinfeng, calm and decisive, said: "Replenish blood volume!"
Zhang Yan quickly nodded, began to handle it, and promptly replenished.
However, the good times didn’t last long, within ten minutes, an unexpected situation occurred again!
"Blood pressure is continuously dropping!"
At this moment, Zhang Jinfeng’s brow furrowed tightly.
What exactly caused the sudden low blood pressure?
Who could have anticipated that sudden hypotension would be induced at this moment?
The patient already had pulmonary hypertension, and now this sudden low blood pressure occurred.
While everyone was feeling uneasy, Chen Cang walked in just in time!
"What’s going on?"
Zhang Jinfeng quickly replied: "The patient is experiencing unexplained hypotension!"
Chen Cang immediately frowned: "Is there any bleeding?"
The ultrasound doctor quickly started to check: "No abnormal uterine bleeding found!"
Chen Cang donned his surgical gown, hurried toward the front.
At this moment!
In the live chat room, Wang Tong and Chen Jing also suddenly became tense.
There were many people watching the surgery live!
Everyone was talking at once, and no one could explain it clearly.
How could hypotension suddenly occur out of nowhere?
It was quite bewildering.
"Blood pressure 60/30mmHg!"
"Still dropping!"
Each alarm sound, like a death knell, made everyone’s heart race uncontrollably!
This was the first time everyone had come into close contact with an operating room!
It was also their first glimpse of the dangers of surgery.
At this moment, they seemed to realize: perhaps no one can ensure the success of an operation!
The risk truly occurs in places you can’t see!
In ways you never imagined!
Zhang Jinfeng had contemplated abnormal fetal position, umbilical cord issues, and even intraoperative hemorrhaging, but never expected such an incident from the start!
Wang Tong and Chen Jing began discussing the reasons for the occurrence of hypotension!
But couldn’t figure it out.
The spectators also subconsciously broke into a cold sweat!
Would this sudden situation lead to simultaneous deaths?
Thinking of this, everyone started to feel scared!
Different "protection" remarks began to appear on the bullet screen.
Indeed!
This was true live broadcasting, who could predict what the next minute would bring?
There was even the possibility of the patient’s sudden death!
This wasn’t a video game, where you can continue to play after dying!
These were living beings!
Once they’re dead, they’re truly gone!
How could people not be afraid?
Watching this scalpel even made them feel as though it was being used on themselves!
At this moment, Chen Cang, observing all of the patient’s conditions, carefully analyzed, and the four-dimensional model in his mind began to activate.
Diagnosis reached an unprecedented level of tension!
What cause could provoke hypotension!
This wasn’t speculation, but a diagnosis and treatment that must be conducted within minutes.
At this moment, the four-dimensional model began simulating all of the patient’s indicators.
Bleeding?
No!
Insufficient perfusion?
Also no!
...
Various deductions flashed through Chen Cang’s mind.
Finally!
His eyes brightened!
He found it.
The cause was found!
Chen Cang looked at the anesthetist and asked: "Epidural anesthesia?"
The anesthetist quickly nodded: "That’s right!"
Thinking of this, Chen Cang quickly said: "Administer 20mg of ephedrine intravenously and stop the procedure, wait for the blood pressure to rise!"
"Increase the oxygen flow!"
Upon hearing Chen Cang’s words, the nurse quickly nodded and began to operate!
Soon, the medication was administered!
Everyone started to wait.
There was some unease.
Can it really recover?
At this moment, every minute and every second felt extremely heavy.
Not only in the operating room, but everyone watching the surgery felt a heart-stopping fear!
minute... 2 minutes... 3 minutes...
After three minutes, the nurse exclaimed: "Blood pressure is rising!"
"36/70mmHg!"
"45/80mmHg!"
...
Upon hearing, everyone was overjoyed!
Countless people watching the live broadcast stood up and cheered!
"Chen Cang is awesome!"
"Wow, this is too awesome!"
"That just scared me, watching this is scarier than watching a horror movie!"
"I feel like this surgery is like a detective movie, disease is like the culprit, you don’t know where it will pop out from! Too scary!"
"Who doesn’t think so! But this Professor Chen is really awesome, handling it effortlessly!"
"This must be what a master is like!"
"Yeah, what exactly was the reason?"
No matter how excited the outside spectators were, inside the operating room, everyone was quite calm!
Then Zhang Jinfeng led everyone in the next wave of operations!
It seemed as if the previous incident was very trivial!
Isn’t this worth excitement and celebration?
For a moment, the comment section exploded:
"Isn’t this worth getting excited about?"
"Excited about what? These kinds of situations are common operations in the ER and operating room!"
"Before the surgery is over, any stage victory is insignificant!"
"This... is surgery!"
"It’s really difficult!"
"Are there any experts? Explain what just happened?"
Here, Chen Jing and Wang Tong also saw everyone’s chat.
Explained: "As everyone has seen, all sorts of things can happen in the operating room, you can never anticipate what will happen next, and similarly, every minute is precious and must be handled properly."
"However, Director Wang, did you just see why the patient had low blood pressure?"
Wang Tong slightly frowned, thought for a moment, and said: "It must have been neurogenic hypotension just now!"
"After anesthesia, the patient’s sympathetic nerves are broadly blocked, causing peripheral blood vessel dilation, reduced venous return, generally not affecting."
"But you have to consider that the patient has severe pulmonary hypertension, so combined, due to sympathetic nerve blockade, coupled with weakened myocardial contraction, effective circulating blood volume decreases, leading to hypotension!"
Wang Tong said with some emotion: "Actually, this was the result I reverse-engineered after hearing Teacher Chen’s solution!"
After finishing, Wang Tong explained: "So the surgeries everyone sees are absolutely not just about manual skills, but about comprehensive capabilities, medicine requires not only craftsmanship but also academic thinking."
After hearing Wang Tong’s explanation, everyone was deeply touched!
"It’s too difficult!"
"Yeah!"
"I really wish I could meet someone like Professor Chen during my surgery!"
"Surgery is too dangerous, cherish life!"
"Yes, diet tomorrow, no, start tonight!"
...
Looking at the comments, Wang Tong suddenly felt that Professor Chen’s operation live stream, although difficult, might have really good effects!
The operation continued!
Zhang Jinfeng and Zhang Yan could already handle these things.
Zhang Jinfeng personally took charge, cautiously explored the abdominal cavity, fearing any accident.
Then, she carefully pushed the bladder aside, exposing the lower uterine segment.
Next, what needs to be done is to cut open the uterus and remove the fetus!
This is everyone’s first time watching childbirth!
Originally thought it should be very simple to come out, but... when they saw the bloody scene, everyone fell silent!
Seeing the incision on the uterus, blood flowing out, everyone’s expression changed!
This may be the first time in a lifetime that ordinary viewers see a caesarean operation so clearly!
In fact, many parents called their young children over, opened the video, and let them watch!
Let them see firsthand that your mother endured such pressure and pain to bring you into the world.
Childbirth is really not that simple, nor that beautiful, it’s a surgical procedure!
There may be massive bleeding, there may be death.
When these teenage kids saw this, their hearts were truly touched!
The gratitude towards their mothers arose from the bottom of their hearts!
Watching the fetus being removed from the uterus, cleaning the uterine cavity, stitching the uterus...
There’s really nothing beautiful about it.
This might be what surgery should look like.
Gradually, many children who had watched the surgery couldn’t help but say to their mothers:
"Mom, you’ve worked hard!"
"Mom, I will be filial to you!"
"Thank you, mom!"
These words of greeting made everyone who was originally watching the surgery stunned!
Everyone looked up at their children, and had an indescribable feeling!
Is it happiness?
Is it gratitude?
Or what?
Even Chen Cang himself didn’t expect that this surgery would have such unexpected results.
At this moment, guest Wang Tong and Chen Jing were also overjoyed seeing the various voices about mothers on the comment section.
Perhaps this is also a form of correct guidance!
Let many children genuinely understand some of the things they need to know!