Doctor: I Can Synthesize Infinite Entries

Chapter 141: Chapter 135: Aiding the First Affiliated Hospital of Jinggang University

Shen Guofeng looked over. Inside the conference room, besides Director Shen Xiaofei from Hepatobiliary Surgery, were the Director of Anesthesiology, Guo Chaocheng; the Director of Ultrasound, Sha Zhou; and the Vice Dean, Xu Zhisheng.

In response to Shen Guofeng’s reaction, Shen Xiaofei offered an explanation.

”Professor Shen, this patient is a bit special. She’s the aunt of our Dean Song. The hospital administration is taking this very seriously, so we’re holding a joint consultation.”

Dean Song was the dean and director of Jinggang University Affiliated First Hospital, the true person in charge. Of course the hospital would place great importance on his aunt.

This diagnostic and treatment team was being personally led by Vice Dean Xu Zhisheng.

”Guofeng, Ms. Song Ying’s condition is quite unique, which is why I’ve asked you to join the consultation.”

Dean Xu had Director Shen Xiaofei present the case.

”Ms. Song Ying’s diagnosis is primary liver cancer, one of the more common malignant tumors. Because it was already in the middle-to-late stages at the time of initial diagnosis, the difficulty of this resection is quite high...”

As the director of Hepatobiliary Surgery, Shen Xiaofei was under a great deal of pressure. He displayed the patient’s specific imaging results.

”Everyone, take a look. The patient has liver cancer complicated by severe cirrhosis. The main difficulty of this operation will be how to accurately locate the lesion intraoperatively.”

The method Shen Xiaofei was considering was the most traditional one, which mainly involved using CT and MRI cross-sectional images to conceptualize the tumor’s size, shape, and relationship with surrounding tissues.

Looking at these traditional images, under normal circumstances, Shen Guofeng would have simply begun formulating a surgical plan based on this data.

However, for a patient with both cirrhosis and liver cancer, the liver is adjacent to many other organs, and its internal anatomical structure is complex.

”Due to the patient’s severe cirrhosis, there are large regenerative nodules on the surface, extensive collateral circulation in the portal vein system, and impaired liver reserve function. Therefore, it’s very difficult to accurately render the liver’s surface structure with the current imaging data, and observation of the cirrhotic nodules around the cancerous lesion is imprecise...”

Shen Xiaofei pointed out the crux of the surgical difficulty, then looked toward Professor Shen.

”Professor Shen, I remember that in your team, Dr. Yan Xi has been developing an indocyanine green fluorescence-guided technology. Could that be of any help to us in this surgery?”

At the mention of fluorescence technology, before Shen Guofeng could even speak, Director Sha from the Ultrasound Department cut in first.

He was very familiar with the subject. Shaking his head, he said, ”Fluorescence technology certainly has its merits. But with the current liver cancer fluorescent staining techniques, tissue penetration depth is insufficient, limiting its application for deep-seated liver tumors. Moreover, it’s unavoidable that cirrhotic nodules, not just the cancerous ones, will also be stained, which will interfere with the technician’s ability to identify the lesion.”

Director Sha was well-versed in cutting-edge technologies.

”In the current research landscape, I don’t think fluorescence technology alone is enough. Furthermore, even our current ultrasound examinations have difficulty with localization against the background of severe cirrhosis. Today’s imaging technology is insufficient for the precise localization of liver cancer complicated by severe cirrhosis.”

”So, in the end, we still have to rely on the lead physician’s experience and skill during the operation to compensate for the limitations of preoperative imaging.”

Director Sha looked at Professor Shen.

”As it stands, in our hospital, Professor Shen has the highest chance of success for a liver cancer resection. But even so, it will still depend on the specific situation during the surgery.”

Director Sha had already performed a detailed ultrasound examination on the patient.

”Director Shen, Professor Shen, Dean Xu, look. The patient’s liver cancer is located in segment VII. A tumor in this location is already beyond the reach of ultrasound. In addition, the surface of the tumor is covered by a thickened liver capsule, making it impossible to locate the lesion by direct vision. The cirrhosis is also severe. Even if we introduce Professor Shen’s team’s indocyanine green fluorescence technology, it will still be confounded by the regenerative nodules... This is extremely difficult!”

After listening to the introduction, Dean Xu was also getting nervous.

”Guofeng, give us your assessment. I remember you’ve performed several Sg7 liver cancer resections before. Your control of intraoperative bleeding and liver trauma was quite good.”

Dean Xu looked at Shen Guofeng expectantly.

In the past, Professor Shen truly wouldn’t have been very confident. After all, Ms. Song Ying’s combination of cirrhosis and liver cancer introduced too many uncertainties.

However, after having cooperated once with Wu Ting’s team at Fan City First Hospital, he thought, ’If I could combine it with Wu Ting’s 3D imaging navigation platform, along with Director Sha’s ultrasound support, it would be a three-pronged approach. With my extensive experience in this type of surgery, the success rate would be very high.’

Shen Guofeng had originally planned to wait until all of Wu Ting’s papers were published and the surgical technique was fully mature before introducing it to Jinggang University Affiliated First Hospital. But now, under these circumstances, it seemed like a good opportunity for an early debut.

”Dean Xu, Director Sha, Director Shen, Director Guo, to be honest, if we were using traditional methods for Ms. Song Ying’s surgery, my confidence wouldn’t be very high.”

”However, I happen to have a brand-new, combined-assistance technique for liver cancer resection.”

Hearing Shen Guofeng’s words, the others were all a bit puzzled.

Shen Guofeng could only offer a simple explanation.

”Recently, our department, in collaboration with Xianglin City Saint An Hospital and Qinghe City Jiuhua Hospital, jointly established a laparoscopic diagnosis and treatment technology research center at Fan City First Hospital. My student, Yan Xi, is there working with the research center’s team. She, along with Professor Ma Mengchao’s doctoral student Ling Ling and City First Hospital’s Dr. Wu Ting, have co-developed an application that combines indocyanine green fluorescence technology with a 3D imaging navigation platform.”

”It’s a completely new real-time 3D imaging technology. I performed one liver cancer resection at City First Hospital with their assistance. Of course, that was just a simple malignant liver tumor, but the surgery was a great success.”

”Therefore, I believe we can try this new technology. I will be the lead surgeon, with the team from the City First Hospital Research Center assisting.”

”Of course, I still need to contact Wu Ting’s team to confirm the surgery time and a specific plan.”

Professor Shen’s proposal was clearly unexpected for Dean Xu. Although he was aware of the research center project at Fan City First Hospital, he hadn’t expected it to produce results so quickly.

Director Sha, however, was skeptical. He asked, puzzled, ”I’m somewhat familiar with 3D visualization technology. But the liver’s shape, its borders, the adjacent organs, the major vessels... it’s all extremely complex. Even if you render a 3D model from CT slices, it’s very difficult to maintain consistency with the surgical field.”

”I remember just two months ago, when I was in Qinghe City for an observational study, I saw the latest 3D model visualization technology from the team at Jin Country General Hospital’s laboratory. It was still in the animal testing phase and was very crude. It was nowhere near ready for human surgery.”

Shen Guofeng explained, ”That’s true for conventional 3D model visualization. But our Dr. Wu’s team has developed an original, newly improved version. It uses AI algorithms, automated procedures, and real-time rendering. It also integrates coordinate system transformation and one-to-many matching algorithms. The final result is a 3D image that can be fused with fluorescent imaging and synchronized with the surgical field in real-time, directly highlighting the lesion...”

As Professor Shen explained, Director Sha’s jaw dropped. When he had previously spoken with Dean Liu Rong of Jin Country General Hospital, he’d learned that the biggest challenge for this 3D visualization technology was the perfect fusion of algorithms and clinical medicine.

Top-tier programmers don’t understand medicine, and top-tier doctors lack such strong programming and algorithmic skills. Merging the two was incredibly difficult. He never expected the research center at Fan City First Hospital to have produced a team with such seamless cooperation.

Director Sha was now eager to see this assistive technology, but also worried.

”It’s just that, for a first-time collaboration, I don’t know if my ultrasound assistance can coordinate smoothly with their technology. After all, there can be no mistakes in this surgery. We must be perfectly prepared before the operation.”

Dean Xu deeply agreed. They had to come up with a mature plan; there could be no surprises during surgery.

Director Guo and Shen Xiaofei also waited for Shen Guofeng to contact Wu Ting’s team.

Shen Guofeng dialed Wu Ting’s number directly. A short while later, he returned to the conference room and said to the group:

”I’ve just spoken with Wu Ting’s team at Fan City First Hospital. There’s one piece of good news and one piece of bad news.”

Shen Guofeng didn’t keep them in suspense and explained directly:

”The good news is that, with the addition of Dr. Jin Yan from Saint An Hospital, Wu Ting’s team has perfectly integrated ultrasound assistance into their combined technique. In other words, the combined technique is now mature.”

”Dr. Wu calls it: the Perfect Triple-Assistance Laparoscopic Technique!”

”The bad news is that, for now, the only place with the perfectly calibrated equipment is the specialized operating room at the Fan City First Hospital Research Center. The technique is still in its early stages and hasn’t been widely adopted. Currently, it can only be performed by Dr. Wu leading the three doctors.”

”Wu Ting coordinates and takes overall control, Dr. Yan Xi is responsible for the indocyanine green fluorescence assistance, Dr. Ling Ling operates the 3D imaging navigation platform, and Dr. Jin Yan handles the ultrasound assistance. This joint surgical technique requires seamless cooperation, and since each part is original, only this four-person team can perform it until it has been taught and popularized.”

”Therefore, we will need to transfer Ms. Song Ying to the Fan City First Hospital Laparoscopic Diagnosis and Treatment Technology Research Center. There, in the specialized operating room, I will perform the surgery as lead surgeon, with Wu Ting and his team of three doctors assisting in her treatment.”