Chapter 163 - Hybrid Surgery
Chapter 163: Hybrid Surgery
Unlike a dextrose solution, low molecular weight dextran and amino acid solution—abbreviated to LMH Dextran—was a colloid and a necessity in fluid resuscitation.
Many disliked the usage of LMH Dextran due to the rare possibility of an allergic reaction.
However, under current circumstances where plasma and red blood cells had not been delivered, it was the correct decision to administer dextrose solution and LMH Dextran at the same time.
As for the allergic reaction…
Rather than worrying about such small risks, it was better to treat the hemorrhagic shock first.
“Speed up the blood delivery, and send a doctor to wait at the blood transfusion department!” Zheng Ren continued to give orders without considering himself an outsider.
The doctors in the blood transfusion department had no idea whether the patient was in a critical state, dying or just having a normal disease. If blood retrieval was handled according to the waiting list, the patient would be dead before the blood bags were delivered.
Moreover, nurses carried no weight with the blood retrieval process as it was basically one of their jobs.
If a doctor was sent to explain the situation to the blood transfusion department, every procedure would be performed urgently, and blood could be transfused before Miao Xiaohui departed this life.
There was not much time left for Zheng Ren. This was the only way.
More importantly, there were plenty of staff working in the day.
Removing the pair of sterile gloves, Zheng Ren took out his phone, dialed a number and said in a croaky voice, “Gastroenterology, resuscitation, come immediately.”
He hung up immediately after.
A nurse standing beside the infusion stand used a pressure bag to increase the infusion rate of LMH Dextran.
Zheng Ren began to examine Miao Xiaohua. She had lost consciousness and her abdomen was distended, presumably due to blood accumulation. There was no way he could locate the source of the bleeding under such circumstances.
‘F*ck you, System!’ he grumbled internally.
He had been complacent when he first acquired the power of the System because it was simply an awesome hack, but he once again felt powerless after consecutively encountering numerous critically ill, dying patients.
‘Why don’t you tell me where the source of the bleeding is?! A diagnosis of ruptured pancreatic pseudocyst complicated with hemorrhagic shock isn’t enough!’
He also had to have a rough idea of potential bleeding spots before proceeding with exploratory laparotomy. If he had to search for everything under a surgical lighthead, Miao Xiaohua would most likely be dead by then.
A few minutes later, Su Yun arrived at the resuscitation room in the gastroenterology department.
He immediately understood the situation after a quick scan and approached Zheng Ren, asking softly, “What’s the diagnosis?”
“Ruptured pancreatic pseudocyst complicated with hemorrhagic shock,” said Zheng Ren.
“…” Su Yun was dumbfounded.
The rarer the disease, the more difficult it was to manage due to lack of clinical experience.
The chances of survival in an acute exacerbation of a rare disease was almost zero.
“Do you know which blood vessel has ruptured?” asked Su Yun, understanding the primary focus of the matter.
“I don’t know.” Zheng Ren shook his head and immediately made up his mind. “Perform an angiography in the interventional radiology suite and proceed with laparotomy afterward.”
“…”
This was the second time Su Yun felt speechless today.
Even though he was a postgraduate student from a well-reputed medical institution with powerful innate talent, he had never seen a hybrid surgery before.
The international radiology suite was actually a hybrid operating theater, but no one had performed any open surgery there, nor was anyone experienced in this domain.
“Are you sure?”
“There is no other way.”
“Okay.” Su Yun, the perfect surgical assistant, did not question Zheng Ren’s decision.
After glancing at the data on the ECG monitor beside Miao Xiaohua, Su Yun and the medical staff of the gastroenterology department started performing their duties.
The transferral from the gastroenterology department resuscitation room to the interventional radiology suite in the emergency department carried a huge risk—the possibility of Miao Xiaohua going into cardiac arrest during the journey was over thirty percent.
Thirty percent seemed small but was an unbearable possibility to everyone involved.
Chu Yanzhi, who had been informed of the situation, rushed over with a tracheal intubation kit.
In less than ten minutes, 10U fresh frozen red blood cells, thawed by the doctor and nurse of the gastroenterology department along the way, were delivered to the emergency building; the patient was already intubated with a self-inflating bag.
Fortunately, the hospital bed elevator was unoccupied and the journey went on smoothly.
Apart from a quick halt to change a blood bag, they wasted no time along the entire way.
Miao Xiaohua’s blood pressure was already undetectable when she was transferred to the operating table in the interventional radiology suite.
Chu Yanran, who had performed all necessary anesthesia preparations, immediately administered the necessary drugs for surgery.
Old Chief Physician Pan, who had also arrived at the scene, began to perform every legal procedure from the hospital’s perspective. Even though Miao Xiaohua was a nurse in the hospital, he remained cautious and summoned staff from the medical administration division, adhering to standard medical protocol when informed consent was unobtainable.
Xie Yiren followed the stretcher trolley to the emergency building, and as usual, changed her attire and performed a surgical scrub.
However, as soon as she stood before the instrument table, tears started to stream down her cheeks.
Fortunately, the concept of asepsis had embedded itself into the deepest part of Xie Yiren’s soul, so she subconsciously moved away from the instrument table, preventing its contamination that would necessitate a new sterile surgical kit being opened.
It was not because of the cost of a surgical kit, but the waste of precious time.
This hybrid surgery was unprecedented in Sea City General Hospital, or in fact, Sea City itself.
Despite the lack of communication, everyone coordinated with each other smoothly.
Old Chief Physician Pan handled every procedure outside the suite and sorted out every detail in an orderly manner.
The matron of the operating theater immediately put on a lead apron and entered the suite to prepare the necessary surgical instruments for laparotomy for Zheng Ren’s interventional surgery later.
Even though Miao Xiaohua did not have cardiac arrest, the ECG monitor reported that she was currently having atrial fibrillation. Since medication had to be administered to prevent deterioration, Chu Yanran and another nurse also put on lead aprons and entered the operating theater to stand by for further instructions.
This operation was completely different from any they had had in the past. No one was trained for this, and there was no response plan, either.
However, thanks to all involved personnel’s combined effort, all preoperative preparations were complete within twenty minutes.
As Su Yun put on his lead apron and scrubbed up, Zheng Ren began to disinfect and drape the surgical site before inserting the needle.
The surgery was once again broadcast live in Xinglin Garden.
[It’s boring to watch surgery all the time; can the god sing for us?]
[You don’t have to stick to this channel. There are many beautiful girls in other livestreams.]
[That’s right. You have a severe disease, best if you can get yourself checked.]
A few comments flew across the screen as soon as the livestream started.
Since all surgery recordings had been deleted, everyone who had subscribed to this channel knew that they had to read the case first and gain information before the surgery began. That way, it would be more rewarding when the host surgeon performed a complicated, uncommon operation.
The comments were surprisingly few today. Most viewers had turned off the comment section, refusing to communicate as they wanted to concentrate on watching the livestream.
However, dead silence dominated the live broadcast room after they read the case.
A hybrid surgery. The host surgeon was broadcasting a hybrid surgery today!