CHAPTER 317: 317 STONE FALLEN

"This has become quite problematic. Currently, our only suspicion is the left ovary, which shows slight inflammation. Do you all really think the teratoma could be this small?" Liu Banxia gathered everyone together again.

Looking at the MRI results, everyone was just as confused as he was. If the MRI couldn’t detect it, then how small could this teratoma possibly be?

"Any suggestions?" Seeing that everyone was silent, Liu Banxia asked helplessly.

"President Liu, the only option now is a laparoscopic exploration. Perhaps the teratoma is encased in a very small amount of tissue? Maybe just a tiny bit of brain tissue?" Wang Huan said.

"Regardless, the left ovary is currently inflamed and enlarged, while other organs show no symptoms. I believe our suspicion is likely correct. A laparoscopic exploration won’t cause significant harm and will give us a clearer picture of the situation."

"Is this the only way then? This isn’t our area, Zhang Xiao and I. President Liu, you’ll have to handle this one yourself," Zhao Bo said with a smile.

"Sigh... I’m afraid we still won’t find anything even with an exploratory laparoscopy," Liu Banxia sighed.

"At that point, the only remaining option would be to remove the left ovary. That’s a hard decision to make. What if it’s not there?"

Hearing his words, everyone fell silent. Even Xu Yino, who had been somewhat excited just a moment ago, became quiet.

The patient was very young and not yet married. If an ovary were removed unnecessarily, it could lead to serious consequences. The Emergency Center was still in its early days. If Liu Banxia were to cause such a major incident now, how could they continue their work in the future?

This was a significant gamble. They could obtain consent from the patient’s family for the exploration and then decide whether to remove the ovary based on the actual findings. Procedurally, as long as the family agreed and signed the consent form, there would be no issue. However, that only covered the procedural aspect. The procedure being correct was one thing; whether the patient and their family would cause a fuss later was an entirely different matter.

But considering the current situation, Liu Banxia couldn’t think of any other possible locations. The MRI scan had already been performed, and this was the only area showing any abnormality.

He went outside and carefully explained the outcome of their discussion to the patient’s parents. He even included some of their own speculations.

Despite their desperate wish for their daughter’s recovery, this potential course of action made them hesitate. The importance of the ovaries is undeniable. Even removing one could affect future childbearing potential.

"This is the primary diagnosis we can currently make. While we can’t be one hundred percent certain that this ovary contains a teratoma, the probability is very high," Liu Banxia continued.

"Then... if it’s not there, can you put it back in?" the patient’s mother asked.

Liu Banxia shook his head. "Even if we could reattach it, there would be significant risks. Not to mention, we would still need to perform a pathological examination on the entire ovary to check for any teratoma cells."

"The only choice we have right now is this one. The alternative is to forgo treatment. However, even if it is a teratoma, this particular one is presenting with unusual specificity."

"Usually, teratomas are encapsulated in cysts and might contain elements like teeth or hair. Given your daughter’s current condition, it might only consist of a small amount of residual brain tissue cells."

Liu Banxia didn’t dare say more. Saying more might mislead the patient’s family. As always, the decision rested with them; doctors only have the authority to offer recommendations.

They also knew that if they truly gave up on treatment, their daughter might face life-threatening danger in the near future.

Her epileptic seizures were occurring with alarming frequency, far beyond what was considered normal. They also knew she suffered from headaches every morning. She had taken numerous medications, but now even painkillers were ineffective.

"Let’s do it. We choose to trust you." After a moment of hesitation, the patient’s father nodded firmly.

"Alright. Please wait for our news. After the exploration, I will inform you of what I see and my assessment," Liu Banxia also nodded firmly.

This trust from the patient’s family was a heavy burden. Although he hadn’t misled them, his description of the situation hadn’t left them with many viable alternatives.

Although it was currently just an exploratory laparoscopic surgery, it could very well escalate into an ovarian removal. The likelihood was extremely high.

While there was no procedural risk associated with the surgery, there was a significant moral one. Even the interns who followed Liu Banxia into the operating room weren’t as excited as they usually were.

"Li Hao, first port. Liu Yiqing, second. Huang Bo, third. Xu Yino, you’ll be first assistant," Liu Banxia instructed upon entering the operating room.

"What are the chances it’s a teratoma?" Wang Lei asked curiously.

"It’s hard to say. Teratomas in women are most commonly found in the ovaries. However, this patient presents with headaches, epilepsy, and hemolytic anemia, but no abdominal pain. The MRI also didn’t detect any cysts or masses," Liu Banxia said.

Wang Lei nodded.

"Teacher Liu, I’m done," Li Hao reported. He had completed his part of the procedure and inserted the laparoscope.

Liu Banxia walked over, took control of the laparoscope, and carefully scrutinized the pelvic cavity.

"The exploration reveals adhesions and edema on the superior aspect of the left ovary," Liu Banxia announced after observing for a while.

"Look at the site of the edema. Right here. Does it look like hair? It’s about one centimeter long. I’m worried my own bias is influencing my perception, but it looks like hair to me."

Everyone was staring at the screen. They could all see the line now, but they were equally uncertain. If it were hair, it certainly resembled it, but it also looked like a capillary. It wasn’t as distinctly black as normal human hair; it was a bit lighter in color.

If there were a cyst, the solution would be simple: just dissect and remove the cyst. But now, all they could see were adhesions, edema, and this suspected hair-like fiber, less than a centimeter long. It was incredibly difficult to be certain.

He had no other option but to go outside and communicate with the patient’s family.

"Doctor Liang, do you think the patient’s parents will agree?" Xu Yino asked curiously.

"They’ll most likely agree. Even without a definitive indication, for ordinary people, their only choice is to trust the doctors," Liang Xiaolin mused.

"But what if it really isn’t what we think it is?" Xu Yino said.

"Even if it isn’t, they’ll have to go through with it. This is genuinely too hard to distinguish," Wang Lei added.

"Teacher Wang, haven you not seen this type of teratoma before?" Liu Yiqing asked this time.

"Diseases manifest in many ways. I’ve also reviewed the preoperative data. Even though I’m just an anesthesiologist, I agree with Banxia’s judgment."

"If brain tissue were present in extremely minute quantities scattered within a certain area, an MRI might genuinely not detect it. Besides, the ovary is currently swollen and has surrounding adhesions, which are already signs of inflammation."

"It’s only because today is the Emergency Center’s grand opening that Banxia is being so exceedingly cautious. He’s terrified of causing any trouble for the Emergency Center, especially since so many people are watching it right now."

"As doctors, we often have to face difficult choices. Sometimes, you just have to bite the bullet and make those tough calls. Not every situation can be perfectly clear-cut."

Just as they were speaking, Liu Banxia returned. However, his brow was still deeply furrowed, and no one dared to ask the outcome.

Upon returning, Liu Banxia once again meticulously observed the entire ovary, focusing on the spot with the suspected hair. It was incredibly difficult to discern, especially since it wasn’t on the surface of the ovary.

This re-examination lasted nearly twenty minutes.

"Cut."

Liu Banxia, who had been silent all this time, finally uttered a single word.

The operating room fell silent. For him to hesitate for so long before making a decision, one could only imagine the immense pressure he was under.

The surgical consent form had been signed before they even entered the operating room. Even if Liu Banxia hadn’t stepped out to consult again and hadn’t hesitated, he could have proceeded with the removal based on the signed consent.

Although this was Liu Banxia’s first time performing such a surgery, his anatomical knowledge of the abdominal and pelvic cavities was exceptionally comprehensive. So, despite it being his first, the procedure went very smoothly.

DING! Operation complete.

Gained 100 experience points.

Diagnosis Skill Proficiency: +50 points.

Dressing Technique Skill Proficiency: +50 points.

Suturing Technique Skill Proficiency: +50 points.

Ovarian Surgery Skill Proficiency: +400 points.

This was a routine ovarian removal surgery, so it didn’t award many experience points for his fundamental skills.

"Doctor Liang, take this directly to the pathology department. Please ask them to prioritize the examination and be thorough," Liu Banxia said.

"Oh, okay," Liang Xiaolin glanced at him and responded.

Liu Banxia was normally such a decisive person; she was surprised to see him so hesitant today. Was this the first time she’d seen him like this?

"Why did it take so long?" Shi Lei asked when Liu Banxia returned to the main hall.

"Sigh... I hesitated. I weighed the options for a long time before deciding to remove it. There were adhesions and edema, but no visible cyst. Initially, there was a one-centimeter substance that looked like hair, but it turned out to be just capillaries," Liu Banxia said with a bitter smile.

"I just had this gut feeling that the ovary wasn’t normal, but I didn’t have any hard data to back it up. If it turns out I made the wrong call, I’ll go and apologize to the patient personally."

Shi Lei patted his shoulder. He had wanted to offer some words of comfort but ultimately said nothing.

The wait dragged on, feeling longer and longer. Even though the Emergency Center had its own pathology department and would prioritize Liu Banxia’s request, the examination itself inevitably took time.

The wait stretched past dinnertime. Suddenly, they saw Liang Xiaolin running like the wind from the direction of the pathology lab.

She was shouting at the top of her lungs before she even reached them, "It’s confirmed! It really is a teratoma!"

DING! Patient diagnosis complete.

Gained 500 experience points, Diagnosis Skill Proficiency +500 points, Glory Points +3.

Task Rating: Flawless.

Bonus: Experience Points +500, Diagnosis Skill Proficiency +300 points, Glory Points +5.

After a moment of stunned silence, Liu Banxia threw a triumphant punch in the air. The enormous weight that had been pressing down on his heart could finally be lifted.

He then scanned the room. Shi Lei, quickly grasping the situation, beat a hasty retreat. Wang Chao, still chuckling obliviously, was promptly swept up into Liu Banxia’s arms and spun around in a joyous circle.