The most famous scientist in this field is Professor Lin Tien-yu, an expert with an international reputation. Mention of Prof. Lin's name in medical circles immediately brings to mind his technique of "finger fracture." The method, utilizing the fingers during liver cancer operations, was developed by Prof. Lin and is now popular with surgeons throughout the world.
The secret of this unique method of surgery is derivative of the history of liver surgery.
The liver is an organ with many blood vessels, in some ways resembling a sponge. It is an extremely delicate organ; once bleeding in the liver starts, it is difficult to stop. In the past, doctors were fearful of operating, making progress in the field rather slow. In fact, it was not until 1952 that Western surgeons performed their first successful operation.
At that time the method used was to first separate the blood vessels, cut them and seal them for the duration of the operation. However, the blood vessels in the liver are small and fragile, and sometimes their rupture during the operation caused so much bleeding that the patient died on the operating table or of the operation's after effects. Little wonder that liver cancer surgery was once considered the most dangerous operation one could undertake.
In 1951 Prof. Lin returned from the U.S. to work at the National Taiwan University Medical School Hospital. There, during lung operations, he used his fingers to crush sections of lung to facilitate their removal. As the problems of lung surgery and liver surgery are similar, this method greatly simplified surgery and reduced the danger to patients of fatal bleeding during the operation.
In 1954 he tried the method for the first time on a patient who had cancer on the left side of his liver. Prof. Lin was extremely nervous, and in his book, "Recollections of an Ivory Tower Dream," he gives a vivid description of what happened during this pioneering operation:
"Just as I was about to stick my finger into the liver, I wondered whether it would cause uncontrollable bleeding. I broke out in a cold sweat. Even a pinprick-sized incision into the liver for the purpose of acquiring a sample for testing could cause profuse bleeding. What would an object like the size of a finger do? These were the thoughts going through my mind as I cut away the liver's protective membrane. When I was ready, I gave a precautionary order to speed up the blood transfusion. As it turned out, there was no serious bleeding, and in less than ten minutes the affected part of the liver was successfully removed."
Prof. Lin was overjoyed at the success. Soon after, he operated on three other patients using the same technique, and the results were all satisfactory. In 1958 he published a paper on the new surgical method in the Journal of Taiwan Medical Association. In 1959 he successfully operated on larger cancers on the right side of the liver. In 1960 he published the results of his research in America's most authoritative medical journal. He attracted worldwide attention and his method was universally recognized as a breakthrough in liver surgery. Invitations to lecture on and demonstrate the new technique streamed in from almost every country.
After his initial successes Prof. Lin's interest in researching liver surgery increased. He points out that, although research into heart and lung surgery is important, Taiwan did not have the facilities or the resources to engage efficiently in such research work. For this reason he decided to concentrate on an area of research characterized to that time by insufficient or unsuccessful work. Thus he chose to concentrate his efforts on liver cancer surgery.
In the West the liver cancer rate is about 0.2 percent, but in Asia and Africa it is between 3 and 5 percent, a very high figure. The number of such people who undergo liver cancer surgery is now growing daily because the success rate is high. Prof. Lin has performed the largest number of successful operations of any doctor in the world.
Although the finger fracture method seems quite simple, it must be completed within ten minutes as some bleeding still occurs, making it a difficult operation to perform. In 1970 Prof. Lin developed a unique liver clamp which reduces problematic bleeding substantially, greatly improving "visibility" during the operation.
In 1973 he further improved the technique by employing a special crush clamp to take over the work previously done by fingers, making the operation even safer. His method is now perfected, and reference is made to it in medical textbooks throughout the world.
Five years ago Prof. Lin retired from the Taiwan University Medical School, though he still trains interns at the School's hospital and works as a consultant at Changken Hospital, as well as continuing research into liver surgery. He is concurrently editor-in-chief of the "Encyclopedia of Modern Chinese Surgery," which is scheduled for publication at the end of this year. It is the first publication of its kind by a Chinese scientist.
Prof. Lin has been in the medical profession for fifty years. His first book was widely praised; his second and third books, "Loitering" and "Spring Return," when completed, will be published together with the first under a volume title, "Passing Time in an Ivory Tower." Prof. Lin hopes that this presentation of his struggles and experiences as a doctor for over fifty years will provide some encouragement to the younger medical generation in their efforts for medical research. - Translated from the "Central Daily News" by Martin Merz