Chapter 495: Chapter 283: Revealing His Edge! The First Surgery of the Training Camp

In the patient wards of Ward Three, Wu Ting and Hu Zhipeng joined Director Ren Anyi for rounds.

For the past few days, their clinical practice had consisted mainly of rounds, with occasional opportunities to observe the senior directors’ surgeries.

According to the training camp’s schedule, the first week of clinical practice was dedicated to getting familiar with the ward’s operations and getting to know the relevant personnel.

Haste makes waste, so Director Ren Anyi and the other senior directors arranged the clinical practice at a deliberate, methodical pace.

This was the same excuse Director He Guangzong had used previously, suggesting Wu Ting first get familiar with the environment in Ward Three and wait for his official advanced training to begin before receiving any assignments.

However, once he learned of Wu Ting’s true identity, it was too late to go back to Ren Anyi and ask for him.

Ren Anyi refused to budge. He even took a screenshot of their previous chat history and sent it right back to He Guangzong.

He Guangzong was thoroughly frustrated and went to find Scholar Jiang, but this time, even Scholar Jiang sided with Ren Anyi.

After all, Ren Anyi had communicated with He Guangzong beforehand and only proceeded after receiving confirmation. He then notified the medical affairs department, ensuring that Wu Ting’s advanced training placement in Ward Three after the international competition was all properly arranged.

Although He Guangzong could be a bit of a maverick and was a dominant figure in the department, he was clearly in the wrong on this matter. He had no choice but to swallow the bitter pill.

Time in the training camp flew by. Everyone felt both fulfilled and tormented, and the first week was over in a flash.

As the new week of clinical practice began, the trainees were finally assigned to specific patients. They would now participate in consultations and enter the operating room to perform assisting tasks.

The group personally led by Ren Anyi included two trainees: Wu Ting and Hu Zhipeng.

For Hu Zhipeng, working with Ren Anyi was second nature, but for Wu Ting, this was his very first time.

Ren Anyi planned to decide Wu Ting’s role for the remainder of the clinical practice based on his performance today.

Ren Anyi deeply admired and valued Wu Ting. Consequently, he was very cautious about his training, hoping to map out the most suitable learning curve for his development.

Going too far was as bad as not going far enough, and more haste meant less speed. Wu Ting was still young. While this training camp and the international competition would be a major highlight on his resume, they were but a brief moment in the grand scheme of his entire career.

Ren Anyi was focused on Wu Ting’s long-term development, and the patient he had chosen for today was a highly representative case.

The consultation team, besides Ren Anyi, Hu Zhipeng, and Wu Ting, included several other staff physicians from the surgical team.

Ren Anyi placed great importance on building his team’s structure. A well-rounded, mature team required three generations of doctors—senior, mid-career, and junior—and the staffing should form a pyramid structure.

Hu Zhipeng and Wu Ting were still young. Despite their outstanding talent, they were currently at the base of the pyramid. For this surgery, Ren Anyi’s role for them was primarily to learn and listen.

Ren Anyi and the other senior doctors began their discussion.

"The patient is a 69-year-old male who presented with an acute myocardial infarction, resulting in functional myocardial loss in some areas... The surrounding non-infarcted myocardial tissue is also undergoing rapid adaptive changes..."

"The best option right now is to use Hybrid Technology to perform an on-pump coronary artery bypass graft. We’d use intraoperative cardiac arrest, aortic cross-clamping, and cardiopulmonary bypass to create the necessary surgical field to complete the operation..."

"The problem is, the patient is older and has localized functional myocardial loss. If we put him on pump and induce cardiac arrest, it’s highly likely to trigger an inflammatory response..."

"Furthermore, the ischemia-reperfusion would also cause a certain degree of injury..."

Listening to their opinions, Ren Anyi felt a sense of helplessness as well.

Just then, another director proposed an idea.

"Director Ren, I have an idea. What about performing an off-pump coronary artery bypass graft?"

"The off-pump technique can significantly reduce postoperative mortality and complications, especially for high-risk, elderly patients."

Ren Anyi considered this director’s idea.

"Director Zhao, I’ve considered an off-pump coronary artery bypass graft as well. But that Surgical Technique hasn’t been around for very long."

"Besides, this Surgical Technique has always been highly controversial. The main issue is that it doesn’t allow for effective exposure of the target vessels, placing extremely high demands on the Technician’s skill. There’s also a degree of chance and luck involved... If it goes smoothly, the potential upside is huge. But if something goes wrong..."

"If we can’t achieve complete coronary revascularization, the patient will most likely die from complications."

Ren Anyi was skeptical about the off-pump coronary artery bypass graft.

The risks of an on-pump coronary artery bypass graft were foreseeable and, relatively speaking, more controllable.

While the off-pump graft had a high ceiling, it also had a low floor. Success depended entirely on the patient’s specific physical condition and the Technician’s performance in the moment.

With the directors unable to reach a consensus, Ren Anyi thought for a moment and said:

"Let’s do this. I’ll ask Director He Guangzong to come over. He’s the most skilled surgeon in our entire Cardiovascular Surgery department when it comes to off-pump grafts. If even Director He thinks the risk is too great, then we’ll stick with the more controllable on-pump option."

Everyone agreed with Ren Anyi’s plan.

The name "He Guangzong" was the very brand of Fuwai’s cardiovascular surgery department, possessing the power to stabilize any situation and put everyone’s minds at ease.

When it came to difficult and complicated cases, as long as he had the time and was confident in the outcome, Director He never turned one down and always delivered a flawless result.

Ever since he started serving as a lead surgeon, Director He had never made a mistake in an operation he was confident he could perform.

Ren Anyi, and indeed all the cardiac surgeons at Fuwai, had absolute trust in and admiration for He Guangzong.

Hu Zhipeng was thrilled. To be able to enter the operating room and watch Director He perform surgery up close would be a remarkable achievement.

Wu Ting was also filled with anticipation for this formidable man, who had yielded a "black entry" on their very first meeting.

While they waited for Director He to arrive, Ren Anyi had Director Zhao go find the patient’s family to inform them of the situation and issue a critical condition notice.

Later, depending on Director He’s assessment, they would present the family with a choice of surgical options.

Major cardiac surgery was a solemn and serious affair; the slightest mishap could be fatal.

A few minutes later, He Guangzong hurried over.

He was taking this patient’s case very seriously.

Facing a life-or-death situation, He Guangzong had no time for anything else. He gave Wu Ting and the others a hurried greeting and immediately began his analysis.

After reviewing the patient’s various metrics, He Guangzong’s expression grew stern.

"Director Ren, forgive me for being blunt, but the patient’s condition is dire. Look at these numbers..."

"It’s obvious that due to his age, his physiological functions are diminished. This is especially true for the infarcted area—the myocardium there has essentially lost all function."

"He’s burned through large amounts of adenosine triphosphate, phosphocreatine, and glycogen. Correspondingly, his lactic acid levels and oxygen consumption will rise significantly. Based on these indicators, I can say with certainty that if we put him on pump—once we induce cardiac arrest and clamp the aorta—the resulting ischemia-reperfusion injury will cause that area of the myocardium to lose function completely."

"Even if we restore circulation, it would lead to severe, irreversible myocardial damage, followed by poor short-term and long-term cardiac remodeling..."

Director He then pointed to another image from the patient’s file.

"Look here... Postoperatively, there’s a high probability of vascular endothelial damage and plaque rupture... which would lead to new embolisms."

With regret, He Guangzong declared the first option untenable.

That left only the second option: the off-pump procedure.

He Guangzong’s mind raced, already running a simulation of the surgery. His confidence wasn’t high, but it was the best plan they had to improve the patient’s long-term survival rate.

He Guangzong didn’t hesitate.

"Director Ren, everyone. Although the off-pump approach doesn’t provide good exposure of the target vessels, I can try operating blind. I’ll use my experience and fine motor skills to compensate for the inherent flaws of the Surgical Technique."

"Furthermore, I’m very experienced with revascularization. I’m about eighty percent confident I can ensure it... Of course, ultimate success is never guaranteed."

"Director Ren, please arrange the final meeting with the family. I can’t make any guarantees, but I will give it my all."

At a time like this, for a high-risk procedure with no guarantee of success, he was the only one who would step up. As the top surgeon of the "Blade Ward" within the Cardiovascular Surgery Center, He Guangzong was willing—and obligated—to shoulder this responsibility.

Hearing Director He’s words, Director Ren and the other directors felt a sting in their noses. In moments of crisis like this, he was always the one to step forward.

Hu Zhipeng watched Director He with admiration. He was his role model, his goal.

This was the first time Wu Ting had seen Director He in person, and he was just as impressed.

’So this is Fuwai Hospital,’ he thought, ’the absolute pinnacle of cardiac surgery in the country!’

Wu Ting had originally planned to just quietly observe the entire surgery with Hu Zhipeng, but Director He’s spirit was infectious.

After a moment of thought, Wu Ting decided to share the new skill he had just acquired—a Hybrid auxiliary technique: Beating-Heart Technology (Black).

"Director He," he said, "perhaps we could try another surgical approach!"

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