Top-tier doctoral supervisor, reborn as a first-year graduate student in standardized residency trai

On the screen, the predicted route for the gastric tube was marked as two lines.

One is the original plan.

One is the path adjusted by Gu Linshu.

Looking at the distance alone, the difference is not exaggerated.

However, once the esophageal stump, the posterior mediastinal passage, and the gastric tube elevation angle are all placed together, the difference between the two paths immediately becomes obvious.

The original plan seemed to fit, but there was a very awkward bend in it.

Gu Lin raised his hand and pointed to that spot.

"This will create a continuous traction."

"During surgery under anesthesia, the patient's muscles are relaxed, and the intrathoracic pressure is not entirely the same as after surgery."

"So it looks like it fits."

He switched to the next image.

"But after the patient wakes up, coughing, breathing, mediastinal rebound, and tissue edema will all amplify the tension in this area."

"The anastomosis won't collapse immediately; it will be gradually pulled apart."

The demonstration room was quiet, with only the scratching sound of pens slicing across paper.

Several attending thoracic surgeons, who had initially been expecting a debriefing of the surgery, now had changed expressions.

Because what Gu Lin was talking about was not simply intraoperative procedures.

Instead, they dissected the postoperative changes that are most easily overlooked by patients, layer by layer.

Ji Feng leaned back in his chair, tapping his finger lightly on the table as if deep in thought.

A deputy director of thoracic surgery next to him looked at the screen, his brows slowly furrowing.

"So your intraoperative assessment of tension was incorrect, not because the gastric tube wasn't long enough?"

Gu Lin nodded.

"Length is only the surface."

"If you simply want to increase the length, you can continue to detach, but continuing to detach will sacrifice fixation and blood supply."

He accessed the intraoperative photo, which showed the state of the gastric tube just after it was lifted, with slightly white edges.

"If you don't address the direction of the forces and only pursue a long enough length, it might end up becoming another problem."

"It's enough, but I can't live well."

As soon as those four words were spoken, some people in the back row visibly straightened up a bit.

Lin Xiuyuan stood to the side and behind, holding a pen in his hand, his gaze fixed on the screen.

This statement is too straightforward and too accurate.

Surgery often strives to "get things done".

Cut, connect, close the abdomen, send to ICU.

But what Gu Lin just said was something else entirely.

The question isn't whether it's possible to do it, but whether the structure can truly survive after it's done.

Lin Xiuyuan suddenly felt a very slight sense of suffocation.

It's like a line of thinking that has always been considered correct has been dismantled from a higher perspective.

Gu Lin didn't stop; he put the before-and-after comparison images of the intraoperative adjustments on the same page.

"Before the adjustment, the edges of the gastric tube turned white when it was lifted."

"After adjustment, the edge color was restored, and the fitting angle of the joint became more natural."

"The core of the steps I took during the procedure was not 'lengthening'."

"Instead, it releases the fixed point that restricts the direction and recalibrates the line of force."

Song Zhe sat in the back row, and the more he listened, the more his scalp tingled.

He had already seen it once in the operating room during the day, but now, listening to Gu Lin explain it in detail, he felt it was completely different.

On the operating table, it seemed like Gu Lin made a few random changes, but after reviewing the process, it became clear that each of those changes had a purpose.

It wasn't luck, it wasn't a matter of feel.

The possible points of error in the entire surgery were predicted before the operation.

The deputy director in charge of chest surgery, who had previously raised questions, remained silent for a moment before continuing.

"However, there will always be discrepancies between the actual situation during surgery and the preoperative planning."

"If the tumor's upper margin were a little higher, would your treatment plan still be sufficient?"

This isn't a difficult question; on the contrary, it's quite crucial.

All eyes turned back to Gu Lin.

Gu Lin pulled up the last page of the backup plan.

"So I prepared a second route."

A new labeled image reappears on the screen.

No one spoke in the demonstration room; even Ji Feng's fingers stopped moving.

Gu Lin tapped the large screen with his fingertip, his tone calm.

"If the upper incision margin continues to move upward during the operation, the first approach can only reduce tension, but cannot guarantee the safety of the anastomosis."

"In this case, we cannot force an intrathoracic anastomosis. We must either change the anastomosis location or consider staged reconstruction."

He paused briefly when he got to this point.

"But today, the actual surgical margin did not exceed this range, so the first approach was perfectly adequate."

After he finished speaking, the demonstration room fell silent for a few seconds.

That silence wasn't the bewilderment that comes from not understanding.

Instead, everyone realized at that moment that Gu Lin had prepared more than just the plan in front of them.

He had even thought ahead about how to get a refund if the plan failed.

Ji Feng looked up at the screen and remained silent for a long time.

Having worked in thoracic surgery for so many years, he knows all too well what it means to leave yourself an escape route in advance.

That's not just experience, but a way of thinking that's beginning to resemble that of a mature practitioner.

Lin Hanchuan sat in the first row, his expression calm as if he had expected this to happen.

But only he knew that when Gu Lin released the second path, the emotions he had been suppressing still trembled slightly.

He originally thought Gu Lin was just quick to react during the operation.

Only now do I realize that I underestimated Gu Lin.

Song Zhe was completely convinced. He used to think that Gu Lin was the kind of monster who could pull off a brilliant move at a crucial moment, but it turned out that he was not at all.

What's truly outrageous about Gu Lin is that he never pushes himself to the point where there's only one way out.

He always prepares for the next step, and even the step after that, in advance.

Ji Feng put down his pen, his tone tinged with regret.

Why wasn't the backup plan discussed in detail before the surgery?

Gu Lin paused for a moment.

"There's not enough time."

Someone in the demonstration room couldn't help but laugh, and Ji Feng was also momentarily speechless at his reply.

"Not enough time?"

Gu Lin nodded seriously.

"The main purpose of the MDT in the morning was to determine whether the original plan needed to be adjusted."

"If we explore all the alternative paths from the outset, the discussion will drag on for too long."

"Moreover, the patient had not yet reached the point where a second treatment plan was necessary."

Ji Feng looked at him and suddenly smiled.

This laugh wasn't a joke; it was more like a sense of helplessness after finally confirming the truth.

"Old Lin."

He turned to look at Lin Hanchuan.

"Your brain is really not that of a first-year graduate student."

Lin Hanchuan's lips curved into a smile, his eyes filled with barely suppressed satisfaction.

He never really looked like it.

Ji Feng: "..."

Song Zhe sat in the back row, his lips curling into a wide grin.

That's awesome, so awesome!

For the first time, he felt that attending meetings with Gu Lin was more exciting than performing surgery.

The debriefing continued, and Lin Xiuyuan remained silent until Ji Feng turned around and glanced at him.

"Xiuyuan, is there anything you want to ask?"

Lin Xiuyuan then put down his pen. He no longer focused on whether the surgery could be completed, but instead stared at the intraoperative comparison image and asked questions very slowly.

"If there is a conflict between blood supply and tension during the operation."

"For example, continuing to release the gastric tube can reduce tension, but it will affect the blood supply to the edge of the tube. Which side would you prioritize saving?"

As soon as this question was raised, more than a dozen gazes fell on Gu Lin.

This is a core issue in reconstruction; too much tension leads to leakage, and poor blood supply also causes leakage.

Often, it's not possible to perfectly balance both.

Gu Lin thought for a moment. This time, he didn't answer immediately. Instead, he zoomed in on the intraoperative photos to the edge of the gastric tube.

"It depends on the severity. If it's just mild tension, I'll prioritize preserving blood supply."

"Because once the blood supply is cut off, there is no way to remedy the situation."

"But if the tension has already caused the edges of the anastomosis to turn white, then it cannot be forced together."