Chinese medicine: from rural hospitals to top three hospitals in Kyoto

Surgery day.

Inside the largest hybrid operating room at Kyoto International Medical Center, the shadowless lamps illuminate the entire space with crystal clarity, like a snow-covered field at midday, dazzling and solemn.

The air was thick with the pungent smell of disinfectant, as if reminding everyone that this was a direct confrontation with death.

Various top-of-the-line monitoring instruments, DSA angiography machines, extracorporeal circulation machines, and ultrasound equipment stood ready like soldiers in formation, their cold metal surfaces reflecting a tense light.

The patient, Jack, lay quietly on the operating table. His small body was surrounded by various tubes and electrodes, making him appear even more fragile, like a small boat in a storm.

The observation room was packed with people, including Stevenson and Smith, as well as experts from several top hospitals in China who had come after hearing the news.

Han Zhiyuan from Peking Union Medical College Hospital, Gao Zhengbin from Kyoto Hospital...

"Mr. Mo, you've come too."

As Mo Xinzhi entered the observation room, Han Zhiyuan and the others greeted him.

"I've come to take a look too," Mo Xinzhi said with a smile.

As they spoke, everyone turned their attention to the large screen in the observation room.

Inside the operating room, Chen Yang's entire team was present.

Chen Yang remained standing in his usual command position, his gaze as calm as an ancient well, undisturbed.

He Yonghua performed the cardiac surgery, Zhong Dongyang was responsible for the lymphangioma removal, and Qu Haoran oversaw the interventional embolization...

Everyone took their positions, like soldiers about to go into battle, their eyes burning with unwavering determination.

"Begin." Chen Yang's voice came through the mask, clear and calm, reaching everyone's ears and marking the start of this life-or-death battle.

The first step was interventional embolization, led by Qu Haoran.

Under the real-time guidance of DSA, Qu Haoran was completely focused, as if he had entered a pure world.

Qu Haoran manipulated the hair-thin microcatheter, as if manipulating invisible threads, carefully navigating the intricate labyrinth of blood vessels within Jack's body.

His target was the main blood vessels that supplied the lymphangioma—these vessels were like the tumor's lifeline and had to be precisely severed.

This is an extremely demanding process that requires patience and precision. Blood vessels are as winding as a maze, making localization extremely difficult, and all important normal blood vessel branches must be avoided; even the slightest deviation can cause irreversible damage.

Qu Haoran's hands were as steady as a rock, but his heart was as taut as a bowstring. Fine beads of sweat gradually seeped from his forehead, revealing his highly focused state of mind. The nurse carefully wiped them away, afraid of disturbing this exquisite operation.

Chen Yang stared intently at the image on the screen, his eyes as sharp as a hawk's. He occasionally spoke up to remind people: "Shift the angle five degrees to the left... watch out for that small branch of the intercostal artery... slow down the injection of the embolizing agent..." Every instruction he gave was precise and accurate, as if he had the ability to see through everything.

Time flowed slowly in silence, each second like a stretched rubber band.

Finally, after nearly three hours, several major nutrient vessels were successfully embolized, and DSA angiography showed that the contrast of some lymphangioma areas was significantly reduced.

"The first step was a success."

Qu Haoran let out a long sigh, his voice hoarse with exhaustion, but his eyes gleamed with excitement. At this moment, he felt an unprecedented sense of accomplishment, as if he had just walked a tightrope over a bottomless abyss.

Without stopping, the surgery immediately moved into the second step, which was also the most crucial and dangerous step—opening the chest and removing the lymphangioma.

He Yonghua and Zhong Dongyang exchanged a glance and stepped forward at the same time.

When the sternum was carefully sawed open and the mediastinum was exposed, a collective gasp filled the observation room.

The heart and major blood vessels, tightly wrapped by grayish-red, fragile lymphangioma tissue resembling bunches of grapes, presented a chilling sight. The situation was even worse than the images showed! The degree of adhesion between the tumor and the tissue far exceeded everyone's expectations.

Smith's face turned deathly pale, his palms clenched with sweat; he almost doubted the possibility of the surgery's success. Stevenson also held his breath, his mind reeling from the horrific lesion before him.

Han Zhiyuan stared intently at the large screen. As the chief physician at Peking Union Medical College Hospital, Han Zhiyuan was well aware of the complexity of this surgery.

“Magnifying glass,” Zhong Dongyang said in a deep voice, his tone revealing an undeniable firmness.

With a high-magnification surgical microscope on his head, Zhong Dongyang picked up a delicate ultrasonic scalpel and bipolar electrocautery forceps, and like a most patient sculptor, began his performance of "dancing on the tip of a knife".

Zhong Dongyang's movements were extremely gentle, with each cut and each electrocoagulation controlled to the millimeter level.

He had to carefully peel the tumor tissue away from the pulsating blood vessels and fragile pericardium along that almost non-existent boundary, as if walking on thin ice or carving on a spider web.

It was a slow, suffocating process. The operating room was so quiet that only the regular ticking of the monitors and the faint hum of the equipment could be heard; every second felt like an eternity.

"Director Zhong's skills have improved very quickly," Gao Zhengbin couldn't help but say.

Gao Zhengbin and Zhong Dongyang were old acquaintances, having worked together for many years, and he knew Zhong Dongyang's abilities very well.

“How could I not improve if I followed Chen Yang?” Han Zhiyuan said softly.

"Here, the blood supply comes from a small branch of the diaphragmatic artery, which first clots."

"Note that there are adhesions in the adventitia of the aorta. Use blunt dissection, never use sharp instruments."

"The posterior view of the main pulmonary artery is unclear; use endoscopy to assist."

Chen Yang's voice rang out intermittently, precisely guiding the key points. His calmness and determination were like a lighthouse in a storm, giving the lead surgeons, Zhong Dongyang and He Yonghua, great peace of mind.

However, the accident still happened.

While separating a tumor that was tightly adhered to the superior vena cava, despite Zhong Dongyang's utmost care, an extremely fragile tumor cyst wall ruptured, and pale yellow lymph fluid gushed out instantly, accompanied by pulsating bleeding from small arteries! At that moment, Zhong Dongyang's heart nearly jumped into his throat.

"Suction device! Compression!" Zhong Dongyang reacted extremely quickly, immediately pressing the bleeding point with a small piece of gauze, but his vision was instantly blurred by lymph fluid and blood.

Inside the observation room, everyone's hearts were in their throats!

Smith even instinctively took a step forward, his face deathly pale. His worst fears seemed to have come true!

Stevenson gripped the armrest of his seat tightly.

"calm."

Chen Yang's voice remained steady and calm, without the slightest fluctuation. This composure acted like a stabilizing force, instantly calming everyone's emotions.

"Director He, assist with the exposure. Director Zhong, use 6-0 Prolene sutures to suture the wound under a magnifying glass. Director Qu, prepare biological protein glue and hemostatic gauze."

Chen Yang's instructions were clear and swift, as if he had anticipated this situation and was confident in his abilities.

With He Yonghua's help, Zhong Dongyang calmed himself down and suppressed his panic. Under a magnifying glass, he precisely sutured the ruptured blood vessel with sutures finer than a hair, while quickly cleaning up the leaking lymph fluid. Qu Haoran immediately handed over the prepared biological protein glue and hemostatic gauze, which were then applied to the dissected wound.