Chapter 27: Tumor Encasing the Aorta
As a physician employed by the Continental, he naturally possessed considerable skill.
Under maximum effort to suppress the pressure of imminent death, Caesar—serving as first assistant—made an extremely steady incision.
His hands were rock-solid, like the most precise surgical robot.
Skin, subcutaneous tissue, muscle, peritoneum—opened layer by layer under Caesar's expert scalpel, like peeling an onion.
Under his meticulous technique, even the hemorrhaging was controlled within minimal parameters.
David also reported Wesker's vitals in real-time.
"BP 120 over 70, heart rate 60, stable."
Just then, the older surgeon serving as attending suddenly spoke:
"We need better tumor exposure. Deep retraction!"
David quickly handed the deep tissue retractor to the second assistant.
The second and third assistants worked in tandem to spread the incision wider, exposing more of the surgical field to the attending's view.
But then came prolonged silence.
David noticed perspiration beginning to bead on the attending's forehead.
This tumor's presentation clearly exceeded his expectations.
Caesar's voice came out slightly trembling:
"Are you seeing his vasculature? I can't even visualize the abdominal aorta—this tumor completely encases it!"
The attending's voice was equally grim; he said hoarsely:
"The tumor burden is far beyond what the CT imaging suggested.
In this situation, there's absolutely no way we can perform a safe resection. The risk is astronomical!"
A flicker of concern crossed second assistant Wendy's eyes:
"We need to do a frozen section to define the margins. After that, it's just prayer."
The attending took a deep breath, flexed his slightly trembling hands, and said:
"I'll handle it. Fourth assistant, take the sample to the pathology lab on the first floor for frozen section."
Soon, the specimen was handed to David.
Next came an excruciating wait.
When David returned to the OR with the results, the four surgeons were desperately brainstorming alternatives.
"If the tumor hasn't invaded the arterial wall, there's still a chance—we can create a dissection plane."
"If it's a non-infiltrating liposarcoma, we can approach it from the periphery, using blunt dissection and careful tissue manipulation to debulk it piece by piece..."
As he spoke, they noticed David's return and immediately focused on this final hope.
Everything they'd just discussed were best-case scenarios—the true situation depended on the pathology report.
David entered, opened the laptop, entered the pairing code, and the frozen section report appeared on screen.
Seeing the report displayed, despair washed over every face.
Leiomyosarcoma. A massive leiomyosarcoma could only be approached with blind resection without clear surgical planes!
But it would be incredibly easy to nick that abdominal aorta!
This essentially meant zero chance of success!
The moment they saw the report, feelings of hopelessness and defeatism began spreading.
All four surgeons simultaneously pulled out their phones and started making calls.
Hearing fragments of their conversations, David confirmed they were saying their final goodbyes.
It seemed they had zero confidence in the blind resection success rate and understood the consequences of surgical failure, so they could only make arrangements while they still could.
David shook his head, exasperated at these physicians who'd rather accept brain surgery than think of alternative approaches.
He picked up a scalpel from the instrument tray, ready to take over himself.
Seeing David's action, everyone hastily put down their phones to stop him.
"Hey! New guy! What the hell are you doing! Put down that scalpel!"
"Stop it! You'll get us all killed!"
"Wait, wait—stop! Let's talk this through first!"
"Please, don't go rogue on us! This is way beyond your pay grade!"
Someone even lunged forward and grabbed David's legs, making it difficult for him to approach the table.
David looked helplessly at the attending surgeon, who was old enough to be his grandfather, now clutching his ankles:
"Haven't you all already given up? I heard you making your goodbyes, so why not let me try?
Maybe my approach will work?"
Hearing David claim he had a method, Caesar scoffed:
"Don't even bother. Although the odds are terrible, blind resection at least has some possibility of success.
But if you start improvising, you'll extinguish our last shred of hope!"
The attending on the floor added:
"Exactly. Although blind resection is incredibly difficult, I've performed it during my surgical career. My success rate is definitely higher than yours!"
David smiled, looked down, and asked:
"So how many times have you succeeded with blind resection?"
An embarrassed expression flashed across the attending's face. After a long pause, he admitted:
"Two out of seven."
As soon as he said this, everyone's breathing hitched.
A seventy percent mortality rate? Were they really going to gamble on those odds?
The attending understood the subtext from the crowd's silence. His face flushed as he said:
"What? If anyone here has a better blind resection success rate than me, I'll step aside and let you be attending!
Can you do it? Honestly, you're all no different from residents to me!
You're a bunch of kids who've barely held a scalpel. You should count yourselves lucky to have me!"
Hearing the attending's words, Caesar bristled first.
Moreover, under the pressure of imminent death, he'd been desperate for an outlet to vent his anxiety.
So he immediately pointed at the attending and exploded:
"You old bastard, have you spent your entire career learning nothing?
If your surgical experience was worth a damn, we wouldn't be making our final phone calls right now!
And we should count ourselves lucky? Lucky to get stuck with a massive leiomyosarcoma wrapped around the abdominal aorta!
If anyone brought bad luck here, it's—"
The more Caesar spoke, the angrier he became. After berating the attending, he still wasn't satisfied, so he turned toward David, who was holding the scalpel:
"Actually, if anyone jinxed this operation, it must be you!
If you'd been luckier, the result you brought back wouldn't be this!
Couldn't you have brought back a diagnosis of non-infiltrating liposarcoma?!
It just had to be leiomyosarcoma! Absolutely infuriating! You walking jinx!"
Unlike the attending who wilted under Caesar's tirade, David wasn't about to indulge him.
His calm expression immediately hardened:
"I do have a method to resolve the current situation and keep everyone alive. The success rate is significantly higher than blind resection.
But if Caesar doesn't apologize, I guarantee you won't even have that last sliver of hope for survival."
Caesar scoffed and said to those around him:
"Apologize? Is this kid delusional? Does he even comprehend what he's saying?"
But what he failed to notice was that except for him, the other three had looks of genuine interest.
What if? What if this kid actually had a solution?
Even blind resection—a procedure with abysmal success rates—was under consideration. Hearing this young surgeon's suggestion couldn't hurt, right?
If there was genuinely a higher probability of survival, they'd absolutely take that chance.
So Caesar soon felt a sharp object pressing into his lower back.
Simultaneously, the third assistant's voice came from behind him:
"Apologize to him. Immediately. Right now!"
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