Chapter 275 - Unintentional Reveal (Part 4 of 5)
Chapter 275: Unintentional Reveal (Part 4 of 5)
In the live surgery broadcasting room of Xinglin Garden, another surgery broadcast began.
[What kind of advanced surgery will the surgeon perform? Is the hater from yesterday still alive?]
[I wanted to ask the same question.]
[I kept saying that this surgeon has great skill, but the doubting Thomas could not be persuaded. Such people would not survive three episodes in a drama series. By the way, after yesterday’s observation, I noticed that the surgeon’s interventional and general surgical skills have improved. Is this another genius professor starting a livestream?]
[The more I watch, the more I believe that there’s a team behind this live surgery broadcast. It’s impossible for all of these surgeries to be done by one person. Has anyone here gone on an exchange to Montreal Medical Center, Canada? Can you share your experience?]
After some idle chatter, everyone went through the patient’s medical records to understand the situation.
The documentation was not that complicated. There was no need to crack one’s brain and provide a differential diagnosis. The details shared in the livestream room had always been simple and to-the-point, and were always proven right no matter how bizarre they seemed.
After completing sterilization, Zheng Ren raised his hand and a scalpel handle appeared in it.
At that point, most viewers had glanced through the records and returned to the live surgery broadcasting room.
[Such serious injuries were most likely sustained from a high fall.]
[It’s a young woman, did she attempt suicide because of relationship problems?]
[Please focus on the surgery, your bullet-screen gossip is blocking my view.]
The surgery was straightforward; a laparotomy would be done to repair the liver and remove the spleen. As for the rest… After the patient’s condition stabilized, they would send her to orthopedics to fix her secondary fractures.
The situation was as critical as that from yesterday’s live broadcast, but to any surgeon, it was significantly less complicated.
Most doctors watching the broadcast had encountered patients with fall injuries.
Zheng Ren made a 15 cm long median incision.
It was larger than usual as this was an emergency surgery; an unobstructed view of the trauma was more important than appearances.
Ths skin and subcutaneous tissue were an eerie pale color due to blood loss, and under the stark light of the surgical lamp, resembled a mourning shroud.
However, Zheng Ren had no time for sorrow.
When he saw that there was no blood underneath the patient’s skin, he immediately ordered, “Get the emergency department to hurry the blood along. We may need more of it. If our blood bank doesn’t have enough, go to the city’s and demand some.”
“Okay.” Chu Yanran hurried away to contact them.
His instructions were given as he performed blunt dissection, reaching the peritoneum quickly. He extended his hand and a covered aspirator was passed to him.
With the scalpel, he made a small incision on the peritoneum and inserted the aspirator.
Dark red blood immediately began draining from it.
While the blood was being removed, Zheng Ren checked the patient’s blood pressure: 50/30 mm Hg.
“Is Su Yun here yet?” he asked.
“‘I’ve called him; he said that he has just finished with the consent form and passed it on to Old Chief Physician Pan. He’s scrubbing in now,” Chu Yanzhi yelled from the corridor.
Zheng Ren looked down at the operative field and saw the blood in the patient’s peritoneal cavity slowly being siphoned away.
Before the blood was completely gone, Zheng Ren glanced up at Little Yiren, who instantly understood him and took over the aspirator.
He started to open the peritoneum, Xie Yiren handing him the tools with her other hand.
The peritoneum revealed, Zheng Ren reached into the liver and started to feel its surface.
There was a lesion with an approximate length of 5 cm. He reached further to the hilar area; crossing his arms, he opened his palm and received a pair of hemostatic forceps with tubing clamps.
Xie Yiren had anticipated it in advance despite it not being standard protocol. Zheng Ren was pleased.
The rubber tubing on the hemostatic forceps served to control bleeding from the liver. The tubing lowered the risk of inflicting secondary injuries to the hilar region.
Xie Yiren had deduced it herself after understanding the patient’s condition in her short time on the operating table.
It felt good to have Xie Yiren assisting him. Zheng Ren was smitten, his blood pressure rising along with his heart rate from dopamine and adrenaline[1].
He clamped down the artery at the hepatic hilum with just enough force.
Then, Zheng Ren moved on to the spleen.
The spleen was more fragile and had a much bigger lesion than the liver did. Zheng Ren blindly groped around; he started blunt exploration when he reached the gastrosplenic ligament, preparing to cut it when he reached the short gastric arteries.
At that moment, the peritoneal cavity was finally drained of all its accumulated blood. Zheng Ren used both hands to scoop out two large blobs of clotted blood and threw them into a basin Xie Yiren passed to him.
He then started cutting the gastrosplenic ligament and cleaning up the splenic arteries.
“Why do you think she attempted suicide?” Su Yun asked, sauntering into the operating theater.
Silence greeted him.
“You guys are really boring,” he said.
“Put on your lead apron, scrub in and stop dawdling. Check for any ruptures in the intestines and any remaining bleeding areas in the peritoneal cavity that I missed,” Zheng Ren said.
“What will you do?”
“I’m going to do an interventional embolization. The patient has retroperitoneal hematoma and I will also need to deal with the arteries ruptured by the pelvic fracture.”
Flabbergasted beyond words, Su Yun wasted no more time and scrubbed in.
When he reached the operating table, Zheng Ren had already removed the spleen and put it into the specimen basin to send to pathology post-surgery.
Su Yun was unsurprised by Zheng Ren’s efficiency; it would be more unusual for the man to be any slower.
The surgery from yesterday night was one example.
Su Yun requested a large surgical hook to provide a better view to Zheng Ren, who began performing a mattress suture on the ruptured liver.
He was a little dazed by the man’s swift stitching, but forced himself to regain focus and said, “Boss, the patient has adenomyosis.”
“Mmm,” Zheng Ren humphed in reply.
“She wanted a child and refused to remove her uterus, saying that she would rather die than not give birth,” Su Yun continued, “The pain from her adenomyosis today was so extreme that she gave up on life and jumped out of a sixth floor window right in front of her parents and fiancé.”
Adenomyosis was a common gynecological disorder caused by the growth and penetration of basal endometrium into the uterine wall in a localized or diffused manner.
In the past, it was usually seen in women above forty who had already given birth, but it had been diagnosed in increasingly younger patients recently.
The immense pain from adenomyosis was truly unbearable.
There were people who jumped off buildings or slit their wrists rather than continue in agony.
“Is it treatable?” Su Yun asked softly.
Zheng Ren chuckled. Su Yun always pretended to be indifferent and unattached, bragging about opening a veterinary hospital and trying to get Zheng Ren to operate on dogs and cats.
However, he had not left the medical profession after returning from Imperial Capital, opting to stay in the Sea City General Hospital ICU. His actions spoke louder than his words.
He was probably unaware of the soft spot in his heart.
Or, perhaps he was deliberately ignoring it.
Just then,
With one slip-up,
He had bared it all.
[1] The author described a decreasing heart rate (心率也有所下降), which contradicts the physiological effects of dopamine and adrenaline. Translated as increased heart rate instead.