Chapter 482: Breakthrough in the Operating Room: Zhou Can’s Surgical Leap

Surgical operations are mainly divided into three categories: anatomy, repair, and transplantation.

Anatomy is easy to understand. It involves opening up layers like the skin, muscle, or even organs, then removing or cleaning out the diseased area. The cornerstone of anatomy is the incision technique.

On top of the incision technique, there are evolved skills like tissue separation and debridement.

Anatomy is pure destruction to an intact body, so to heal the patient, you have to repair what you’ve damaged—whether it’s tissue or organs.

For example, if a blood vessel is cut, you have to stop the bleeding right away.

Severed nerves, blood vessels, or tendons? They must be reconnected, too.

So, the two main areas of surgery are anatomy and repair.

As for transplantation, that’s based on actual needs.

Taking a piece of skin from the thigh and grafting it onto the face or neck is transplantation. Cutting off a head and attaching it to a new body? That’s still transplantation, though the difficulty can’t even begin to compare.

Learning any medical skill always starts with the basics, with simple practice and repetition.

Zhou Can has successfully trained his incision technique to level six—a huge milestone in the field of surgery.

This means he already has the foundation to be the chief surgeon on high-level, grade three and four surgeries.

In the past, he had to rely on the rapid and steady scalpel techniques just to finish the dissection part of those surgeries. Now, his ability to perform anatomy and resect tissue has moved to a whole new level.

For big surgeries, nothing matters more than safety.

An incision technique at the junior chief surgeon level means surgical safety has just taken a leap upwards.

He tried cutting out a lymph node cancer lesion. With one swift cut, the sensation was worlds apart from his previous level. He could feel exactly what tissue he’d cut through, how deep he’d gone, and even if he’d reached the lymph node’s edge.

He could even vaguely sense the tiny tubes and nerve endings as he operated, something he couldn’t do before.

To sense every tiny blood vessel and nerve ending during removal would probably take the incision technique to mid- or even senior chief surgeon level.

But every meal starts with the first bite.

Reaching this level, Zhou Can already felt more than satisfied.

To be bold, there probably aren’t more than forty surgeons in all of Tuyu Hospital whose incision skills are at chief surgeon level.

The level of skill in a surgical field doesn’t always match the doctor’s professional rank.

Take Director Liu in General Surgery as an example.

Because of minor gaps in his academic background, he was stuck at associate chief surgeon even into his late fifties. Yet his real-life surgical abilities possibly rival or even surpass many chief surgeons.

Of course, he’s managed to get promoted to full chief surgeon now, so his dream came true.

Right now, Zhou Can is a junior resident doctor, yet his incision technique is already at the junior chief surgeon level.

There are surely more cases like this, where titles and real ability don’t quite match up.

Some academic or research-oriented chief surgeons might not be as good in surgery as a run-of-the-mill resident. It’s not rare.

“Level six incision technique is awesome!”

After experiencing chief-level anatomy, Zhou Can’s surgical pace sped up.

Even now, his experience in incision and tissue separation is rising quickly.

All he has to do is push a little harder. With some luck, he’ll soon get tissue separation up to level six too.

Tissue separation is everywhere in difficult surgeries. Every surgeon dreads this advanced skill.

Some techniques are easy to learn but hard to master.

Take suturing, ligature, and debridement for example.

But tissue separation is hard to learn, and even harder to master.

Even someone as skilled as Dr. Hu Kan once got in trouble when separating critical diseased tissue from a major blood vessel, leading to a lasting decline in health.

That says it all—a true top-tier surgeon must raise tissue separation to a high level.

Otherwise, it’s a huge weakness that can lead to disaster at a crucial moment.

Other people might find it daunting, but Zhou Can isn’t fazed.

As long as he keeps earning experience, he can level up tissue separation—one way or another.

…

Almost three and a half hours later, this surgery finally ended.

Zhou Can came away with a major harvest from this operation.

Not only did he get incision up to level six, but tissue separation is now very close—just over 1,700 experience points left. With luck, two or three more big operations will get him there.

Lately, he’s been helping out with major surgeries in Cardiothoracic Surgery nearly every day.

Unlike before, where he just assisted Directors Xueyan or Le, these days he’s often the chief surgeon, with them acting as his first assistant.

It’s almost like they’re ‘guiding’ him from the side.

Naturally, the legal risks need to be managed carefully.

For surgeries he doesn’t need to lead, but where backup is needed, he just stays in the same operating room.

The biggest operating room in Cardiothoracic Surgery has three theaters, so three surgeries can run simultaneously.

With this advantage, it often goes like this: Director Xueyan does a surgery in one theater, Zhou Can works with Associate Director He in the next.

And if Director Xueyan’s side needs support, Zhou Can can jump over in a flash.

This approach pays off big, massively improving the turnover of tough surgeries.

Where before a night’s overtime might only finish two major operations, now it’s possible to double that.

That’s a huge plus for expanding the cardiothoracic department.

Zhou Can gained something else significant tonight. After his incision technique hit level six, he discovered a subtle link between debridement and incision techniques when clearing tumor or potentially cancerous tissue.

The connection felt almost magical.

While excising the diseased tissue, he found that the debridement technique let him faintly sense if there were any traces of diseased tissue left nearby.

For example, while removing a lymph node, he picked up on an abnormality in a large blood vessel next to it.

It was the first time he’d felt something like this, so he hesitated for a second.

To be thorough, he used his magnifying lenses to inspect that blood vessel closely. After a careful check, and comparing it to cases of cancerous vessels he’d seen before, he found a small, barely noticeable spot.

He concluded that this section of blood vessel was probably in the early stages of cancer.

As soon as he cut it out, he contacted pathology for testing.

Not long after, the results came back confirming the vessel was indeed cancerous.

Zhou Can was electrified.

If not for his level six incision and the new synergy with debridement, he’d never have caught the problem. Even the world’s most advanced diagnostic machines would have missed this early-stage cancerous vessel.

Don’t underestimate a single cancerous blood vessel—leave any behind, and the patient will soon face a relapse.

Cancer is like a patch of stubborn weeds.

Leave as little as a bit of stalk or a single leaf, and it’ll sprout and take over again in no time.

That’s why the skill Zhou Can has now is so significant.

It lets him make sure, during cancer operations, that as much of the diseased tissue is removed as possible.

Why do so many patients only find out about metastatic cancer once it’s already late-stage? The doctors say surgery is no longer an option.

Because, based on their surgical experience, operating after metastasis doesn’t do much good.

Remove the big tumor, and a smaller one grows back fast.

It just brings more pain to the patient and drains the family’s savings, doing little to buy more time.

Rather than put everyone through that, it’s kinder to let the patient spend their last days at home, comfortable and with loved ones.

That’s a bit of compassion from the doctors.

But families and patients often don’t understand. Some will curse the doctor out before leaving: “You quack, you can’t even operate on this? We’ll find someone better!”

At times like that, doctors can only bear the abuse in silence.

It was already 11:42 p.m. by the time Zhou Can left the operating room—ahead of schedule.

That’s thanks to his upgraded incision skill, which made everything much faster.

“Let’s hope every bit of the cancerous tissue is gone,” Zhou Can prayed in silence.

For this patient, there’s definitely more to come—post-op radiation to reinforce the surgery.

Right now, radiation and chemotherapy remain the two go-to ways to treat cancer.

Especially chemo—it’s practically seen as a monster.

A lot of people think chemo is a death sentence or totally useless, and it’ll destroy your body. Those views run deep with the public. The moment they hear ‘chemo,’ they start shaking their heads.

But every coin has two sides.

You can’t have the benefits without the risks.

The whole point of chemo is to kill cancer cells and prevent relapse, using chemical agents.

It’s a double-edged sword. While it kills cancer cells, chemo drugs are toxic to all cells, damaging those that grow and divide rapidly. Major organs like the liver, kidneys, heart, and lungs can take a hit. If the damage is severe, organ failure and even death can occur.

On top of that, chemo suppresses the immune system—a terrifying side effect.

Just after chemotherapy, patients have to be extra careful about all kinds of infections.

Even a regular cold could turn deadly.

Chemo is dangerous, sure, but it’s also proven effective against cancer cells.

It’s one of the few ways to hit cancer hard while giving patients a real chance at survival.

But cancer is stubborn. One round of chemo can’t wipe it all out.

It only kills some of the malignant cells.

That’s why multiple rounds are needed to see good results.

You can imagine—those with weaker bodies often don’t survive two or three rounds of chemo.

That’s a big reason why chemo has such a bad reputation.

It’s like hurting yourself even more than the enemy—something not everyone can handle.

Thankfully advanced drugs are coming out—or are in the works. Things like targeted drugs or immunotherapies. Medicines that can turn T-cells into superheroes.

The body’s immune cells are mainly two types: T-cells and B-cells. T-cells are the scouts, B-cells are the missile troops.

If T-cells can spot the invader, B-cells have a thousand ways to destroy it.

But some enemies are sly, like HIV or cancer cells—the T-cells can’t identify them, and the B-cells are left in the dark, powerless.

Western developed countries are making progress by boosting T-cells with medicines, helping them identify cancer. It’s a solid approach to cancer treatment.

Funny enough, that idea actually started out based on our traditional Chinese medicine theory.

Many developed countries are turning toward traditional Chinese medicine, studying it seriously, and seeing the benefits.

Like Japan—they’ve now got all kinds of herbal decoctions, almost too many to count.

The prices are outrageously high.

But the effectiveness of these decoctions is gaining public recognition.

Otherwise, the industry wouldn’t have grown to such a level.

No one would bother if there wasn’t profit to be had.

Meanwhile, here at home, traditional medicine struggles. Skilled practitioners grow ever fewer. It’s enough to make you sigh.

Reviving traditional medicine is a long road, and the burden heavy.

Young medical students have to believe in it, spend the time to learn, and get experience.

But the conditions for that kind of market are tough to come by.

Even when someone learns traditional medicine and becomes good, there just aren’t enough patients willing to give it a try. No demand means no momentum, and it all circles back into a dead end.

If someday a group of truly outstanding traditional practitioners rise up, gain fame, deliver real results, and strongly promote their practice, maybe the situation will turn around.

Rejuvenating traditional medicine is a challenge that will take generations.

Currently among doctors, the mainstream thinking is to recommend traditional medicine to patients who have no money, are ‘difficult’, or who think they’re sick without any real illness.

That’s not belittling traditional medicine—it’s just where things stand now for most doctors.

Doctors like Chen Guoli, true masters of traditional medicine, are rare.

“Dr. Zhou, I watched you perform that mediastinal lymph node removal today. It was truly amazing. You’re younger than me, but your surgical skill is just incredible. I really admire you.”

Dr. Pu hurried after him.

On most days, Zhou Can and Dr. Pu barely interacted.

He was newly recruited to cardiothoracic surgery, so they weren’t close at all.

But Director Le and others all had good things to say about Dr. Pu.

Dr. Pu got into the operating room this time as the attending physician—that’s why he had the chance to be there for surgery.

“You’re too kind, Dr. Pu. Honestly, you’re not far behind me. I’ve just had more chances to practice, that’s all.”

Zhou Can answered modestly.

“You’re always so humble, Dr. Zhou—in skill, ethics, and your attitude. I truly look up to all of it. Um… could I talk to you alone for a minute?”

Dr. Pu came up alongside him, clearly with something to say.

“Sure, let’s hear it—what’s on your mind?”

Zhou Can turned to face him.

“Uh… actually, can we go somewhere else? I’m worried you might say no, and I’ll lose my job. It wasn’t easy getting into Tuyu Cardiothoracic Surgery.”

Dr. Pu looked torn, like he wanted to speak but couldn’t.

“Alright, you lead the way.”

Zhou Can wondered what Dr. Pu really wanted to talk about.