Chapter 218: A Surgical Breakthrough Amid Ancient Secrets

During the operation, if the gloves become contaminated, they must be replaced immediately to prevent patient infection.

This isn’t wasteful spending by doctors; it’s all for surgical safety.

Even in ancient times, a simple amputation could lead to fatal infections. In those medically primitive eras, losing a limb meant a very high risk of death.

Here, we must give credit to the genius of traditional Chinese medicine.

The earliest full-body anesthetic surgeries were performed by Hua Tuo during the Eastern Han Dynasty. Even then, surgeons could open the abdomen to remove tumors—documented in both lore and history, leaving no room for doubt.

In fact, some methods invented by ancient Chinese for hemorrhage control and infection prevention predate the Eastern Han.

Emperor Qin Shi Huang, notorious as a tyrant who unified currency and built the Great Wall, is still celebrated by historians for his monumental achievements despite his brutality.

Few realize that techniques for hemorrhage control and preventing infections were discovered during his reign.

In those days, criminals were routinely subjected to severe corporal punishments.

Such measures included facial tattooing and even more brutal punishments like genital mutilation and evisceration.

Initially, most condemned prisoners died quickly from blood loss or infection—until one jailer named Zhang Shou accidentally discovered that branding a wound with a red-hot iron, though excruciating, prevented bleeding.

Later, after collecting money from a prisoner’s family, several inmates, each having had three fingers severed during interrogation, were left in a state of relentless bloodshed and agony.

Unable to watch the prisoner die, Zhang Shou, in a moment of inspiration, applied the red-hot branding iron to the severed finger area.

The prisoner cursed Zhang Shou bitterly as the pain overwhelmed him.

In the end, the man lost consciousness from the excruciating pain.

Out of eleven prisoners who had their fingers severed, only the one treated with the hot branding iron survived.

That prisoner soon realized that Zhang Shou had secretly saved his life.

After his release, his family rewarded Zhang Shou handsomely—no need to mention the amount.

This incident revealed a huge business opportunity to Zhang Shou. He began studying how a heated branding iron could control bleeding and help prisoners survive.

He soon made a fortune from the kickbacks given by grateful families.

Later, Zhang Shou amassed wealth by purchasing fine farmland and estates, marrying several beautiful wives, and fathering numerous children.

To avoid military conscription, his sons were all placed within the prison system through his arrangements.

By this time, Zhang Shou was no longer an obscure jailer but a man of influence, having forged connections with many officials.

Leveraging these relationships, he secured positions for his sons as prison wardens.

He also shared the secret of using the heated branding iron for hemorrhage control so they, too, could prosper.

His youngest son later refined the technique further, even devising a method using a heated blade during executions that resulted in higher survival rates—with less bleeding, fewer infections, and minimal suppuration.

In those scientifically undeveloped times, such discoveries were nothing short of remarkable.

It’s likely that this breakthrough laid the foundation for Eastern Han surgical practices.

Zhou Can donned sterile gloves and grasped his scalpel, ready to operate on the patient.

The cold, sharp scalpel seemed almost alive in his hands as it effortlessly sliced through the surface skin of the fatty tumor.

Then, using curved hemostatic forceps, he carefully separated the tumor from its capsule.

He clamped and ligated every visible blood vessel.

His fifth-level hemostasis technique, paired with precise fifth-level ligation of the vessels, was deft, accurate, and swift. Not only did he avoid injuring surrounding tissues, but his ligatures were perfectly secure.

As a deputy chief surgeon, his work could be summed up in four words: smooth, slick, and flawless.

Now, however, Zhou Can’s four fundamental surgical skills had only advanced to the incision stage, not yet reaching Level 5.

Currently, his incision technique is nearly at the level of a mid-level attending.

He still has a long way to go before ascending to Level 5.

He realized that once reaching Level 4, rapid advancement requires not just routine surgeries but also tackling more challenging procedures.

Every first-time procedure is as valuable as a girl’s first experience.

Almost every time, it rewards him with 100 experience points.

For a woman, preserving her first experience for her husband can contribute to marital stability, happiness, and post-wedding status.

After painstakingly separating the massive tumor, Zhou Can heaved a huge sigh of relief.

【Separation Experience +1.】

【For successfully separating your first massive facial subcutaneous tumor, you earn Separation Technique Experience +100.】

What a rush.

101 points of separation experience have been credited.

That’s equivalent to performing over a hundred minor separation surgeries.

Scoring high reward experience points from the system is a technical feat. Each challenge brings enormous rewards that Zhou Can finds exhilarating.

Now that the fatty tumor has been separated and its vessels ligated, it’s time to excise it.

Removing this enormous fatty tumor is challenging, but he’s confident he can do it.

“Strange, where does this lingering sense of danger come from?”

Zhou Can couldn’t help but wonder to himself.

He had assumed the greatest risk would lie in separating the tumor from the surrounding tissue—the hardest part.

Even using his rapid scalpel technique to handle the Level 4 separation, he encountered several tough spots.

Fortunately, he managed to overcome them all.

Now that the tumor is separated, the sense of danger hasn’t faded—it has actually intensified.

Which part of the procedure is causing this ominous feeling?

Could excising this tumor be dangerous?

The removal isn’t as challenging as the separation; it shouldn’t be hazardous.

Zhou Can even wondered if knowing too much made him overly cautious.

Many veteran surgeons are extremely careful when treating patients, often appearing overly timid.

Now, it seemed Zhou Can was catching those same ‘nervous habits’ that older doctors have.

“Mr. Liu, do you think excising this tumor carries any major risks?”

Zhou Can had no choice but to seek Mr. Liu’s advice.

“With your anatomical skills, you can safely remove this fatty tumor. Don’t overthink it; as surgeons, we must be both bold and meticulous. Where is that confident, challenge-ready Zhou Can? Show some courage! Even I, your supervising doctor, have no fear—what are you afraid of?”

Mr. Liu offered him his strongest encouragement.

Having collaborated on seven or eight hundred surgeries, Mr. Liu fully trusted Zhou Can’s abilities. Even when doubts crept in, Mr. Liu insisted he continue, aiming to nurture his talent.

The goal was to hone Zhou Can’s surgical skills.

To help him advance as a surgeon.

Many high-difficulty surgeries are so rare that not only a trainee like Zhou Can but also seasoned chief physicians might never encounter them—unless they dare to try.

One must simply face these challenges head-on.

There are too many hurdles in life not to take risks.

“Alright, let’s begin the excision!”

Steadying his nerves, Zhou Can began to remove the massive tumor.

Swish, swish, swish!

The monopolar electrotome effortlessly severed the fatty tumor at its base.

To prevent recurrence, he even removed some adjacent healthy tissue.

Any tumor—whether benign or malignant—if not completely excised, is prone to recur, a fact often overlooked by novice surgeons.

Even some mid-level attending physicians with decades of experience sometimes fail to remove tumors entirely for various reasons.

Compared to a scalpel, an electrotome offers several advantages.

It cuts quickly, provides excellent hemostasis, is simple to operate, and effectively reduces complications.

When excising tissue from the subcutaneous layer, abdominal cavity, or thoracic cavity, doctors often opt for an electrotome.

However, some veteran surgeons still insist on using a traditional scalpel.

They believe a scalpel offers better control. It’s said that the top hospital in the capital employs a North Star-level surgical expert who never uses an electrotome.

This expert has successfully performed countless ultra-precise, high-difficulty surgeries.

It’s nothing short of a miracle.

Zhou Can’s own scalpel technique and anatomical skills remain only average—far from understanding why that top expert insists on a traditional blade.

One thing is certain: even today, Tuyu Hospital and many top hospitals outside the province still cannot perform brain surgeries without risk.

The brainstem remains off-limits for most surgeons.

Even the much-hyped robotic surgeries abroad have yet to dare tackle brainstem procedures.

Yet that top expert in the capital dares to operate there—not just once, but repeatedly.

Thus, debates over the strengths of the traditional scalpel versus high-tech electrotomes, LEEP knives, or low-temperature plasma ablation devices persist endlessly.

To date, traditional scalpels have not been phased out and remain widely used—a fact that can’t be argued.

Zhou Can neither dismiss the traditional ‘cold weapon’ nor idolize modern electrotomes.

He simply uses whichever tool is most convenient.

For instance, the Great Saphenous Vein Rotational Cutter is a high-tech tool that avoids multiple incisions, thereby minimizing patient trauma.

Then there’s the Ultrasonic Emulsification Aspiration Knife, which not only minimizes bleeding and postoperative complications but also speeds up recovery. It combines ultrasonic emulsification, aspiration, irrigation, ultrasonic cutting, hemostasis, and debridement.

It is incomparable to any ordinary scalpel.

Using it to separate blood vessels or bile ducts is both safe and precise—a true surgical marvel in hepatobiliary procedures.

For surgeons less adept at separation techniques, it’s nothing short of a lifesaver.

Typically, a resident’s separation skills might be mediocre, but with this tool, they can immediately reach an excellent level.

The medical advances brought by technology are undeniable.

Using the electrotome, Zhou Can safely excised the fatty tumor without any mishaps.

【Incision Technique Experience +1.】

【For successfully excising your first massive facial subcutaneous tumor, you earn Incision Technique Experience +100.】

Performing this high-difficulty surgery is incredibly satisfying.

He earned another 101 Incision Technique experience points.

These experience points are hard-earned in this field.

Earning such a large sum in one go left Zhou Can elated.

At the same time, he felt his anatomical skills had improved significantly.

A quick review revealed that his incision technique had advanced to a mid-level attending status.

This level is roughly equivalent to that of a highly experienced attending surgeon.

“Wow, I’ve never seen such a huge fatty tumor before!”

Upon seeing Zhou Can successfully remove the tumor, Wu Ziyu immediately used forceps to lift it out and placed it in a basin.

Fatty tumors are usually lobulated and irregular in shape.

Though this tumor had an irregular shape, it wasn’t lobulated.

Zhou Can felt little joy, as a more pressing sense of danger clouded his thoughts.

From the moment he excised the tumor, an inexplicable unease took hold.

A careful inspection revealed that the tumor’s base had been excised cleanly, with no residue, no heavy bleeding, and no damage to vital nerves.

This surgery could be considered exceptionally well done.

After several thorough checks confirmed no hidden issues, Zhou Can looked up at Mr. Liu.

“Mr. Liu, do you think it’s time to suture the wound?”

“Yes, suture it! The operation went very well!”

Mr. Liu was not one to offer praise lightly.

When he says it’s good, it truly is.

Without hesitation, Zhou Can sutured the wound and performed some flap repair.

Since facial suturing demands high skill to avoid unsightly scars, doing it himself was a blessing for the patient.

Being sutured by Zhou Can was truly a stroke of luck for this patient.

Typically, chief surgeons delegate suturing to mid-level attendings.

No other mid-level attending’s suturing skills compare to Zhou Can’s.

Except perhaps Dr. Xu, a special mid-level attending promoted from chief physician.

Once the wound was sutured, the patient’s vital signs stabilized with no adverse events.

Zhou Can’s anxious heart finally found some relief.

It was odd—achieving Level 3 in anesthesia should have been good news, yet a strange sense of danger still lingered.

It had kept Zhou Can on edge for hours for no apparent reason.

“Zhou Can, you did a great job today! But why do you seem so off? You look burdened by worries.”

Mr. Liu noticed subtle changes in Zhou Can’s expression.

He couldn’t help but ask what was troubling him.

“I can’t explain it. During the surgery, I felt an inexplicable sense of danger.”

Zhou Can confessed his inner doubts.

“Hey, I’ve felt that way too. Every major surgery sets everyone’s nerves on edge. It’s perfectly normal to be tense and worried. Now that the surgery is over and all is well, don’t dwell on it. Relax and move on to the next case—there are many more waiting for you!”

Mr. Liu was determined not to see his top assistant falter.

He immediately offered Zhou Can further encouragement.

To comfort him.

“Alright! Perhaps I’m just overthinking it.”

With his mood lifted, Zhou Can braced himself for the next surgery.

Anesthesiologist Dr. Feng had finished cleaning up and, before leaving, told Zhou Can, “If your instincts are right, the danger may stem from postoperative complications. Monitor the patient’s recovery closely.”

After his words, Dr. Feng departed.

Postoperative complications?

Zhou Can’s heart skipped a beat, accompanied by a sudden insight.

No wonder he’d been so uneasy—surgical risks can emerge not only during the operation but also afterward.

He had simply overlooked that possibility.

“Please instruct the floor doctor to keep a close watch on this patient,” he ordered.

Zhou Can addressed the nurse firmly.

“Okay, got it!”

The attending nurse agreed and wheeled the patient to the recovery room for anesthesia to wear off.

Within the department, Zhou Can held considerable informal authority; even attending physicians, residents, chief surgeons, and deputy chiefs treated him with respect.

As long as they weren’t out of their minds, the floor doctors took his orders seriously.

Zhou Can’s instructions carried the same weight as Mr. Liu’s own.

After sending the patient off, the next surgical candidate was brought in by an intern.

Interns assist by inserting urinary catheters, prepping the patient’s skin, and conducting routine checks on blood pressure, heart rate, and temperature before surgery.

Once everything was set, they transported the patient to the operating room on schedule.

Sometimes, the chief surgeon performs the operation without verifying patient information, leaving the intern responsible for ensuring the correct patient is in the room. A mistake here could ruin everything.

In such cases, the chief surgeon also suffers the consequences.

Having his surgical privileges revoked is the least severe penalty.

Though such errors are rare, they can still occur.

From this perspective, the seemingly unimportant intern actually plays a critical role.