Xie Yiren was facing a similar situation. Once the surgical instruments were prepared, she was left with nothing to do.
The patient was transported in. Her blood pressure was at 70/50 mmHg, her breathing rate was 25 breaths per minute and her blood oxygen saturation was at 92%. Her face was pale and she was sweating profusely, the classic symptoms of hemorrhagic shock.
Her intravenous tube was connected to a fresh bag of blood. The dark red flow was symbolic of the patient's lifeline.
Those present knew that the blood transfusion was short-term treatment. Excessive bleeding would lead to severe complications such as disseminated intravascular coagulation.
Stopping the bleed was imperative and Zheng Ren would decide whether it would be by a drastic hysterectomy or a minimally-invasive interventional surgery.
Chapter 73 - Alone Without Assistance (Part II)
Preoperative preparations were completed with commendable efficiency. The general hospital doctors and nurses did quality work, as expected.
No one wanted the young lady to lose her reproductive ability, especially when she had no children yet.
Obstetric and Gynecology Department Chief Su was informing the family about the surgery. He had little faith in Zheng Ren's abilities but respected Old Chief Physician Pan's judgment. The preparation and the blood transfusion for the patient took some time but the most time-consuming process was informing the family.
It took skill to deliver bad news to family members calmly and persuade them to make the right decision.
Chief Su decided to have a go at it.
It would not impact preparation for his surgery, so why not?
Shielded by lead glass windows, the other department chiefs stood in the control room and watched Zheng Ren's lonely operation.
Anesthesiology Department Chief Wang raised a question, "I heard the guy did 49 appendectomies a few days ago."
"Yes. The young man has great qualities. He has high quality work, good work ethic and is reliable." Old Chief Physician Pan gave a positive review of Zheng Ren.
Quality work, strong work ethic and the willingness to work. It was the ultimate praise for a doctor.
Su Yun stood at the back of the room with his back against the wall. His jet-black hair was tousled and the way they fell across his face was indescribably pretty. He silently observed Zheng Ren's movements in the operating theater. The way Zheng Ren opened the catheterization kit indicated proficiency, and even local anesthesia was accomplished swiftly.
The Seldinger technique was used to access the femoral artery and a vascular sheath was inserted. Each step was done expertly. This surgery was getting interesting.
Su Yun's eyes gleamed.
He turned heads whenever he walked around the hospital. The bold would come up to him and take their chances. However, inside the control room, no one paid him any attention. All eyes were fixed on Zheng Ren even if they could not decipher his actions.
On Xinglin Garden, a livestream started.
Hundreds of doctors flocked to the stream within a minute of going live. The livestream was akin to an observation class. Many who joined did not even read the case study but typed away regardless. Doctors who did not know what was going on flirted with the pretty robot nurse. The livestream was brimming with excitement and activity.
[Salute to the surgeon! He's starting another surgery.]
[I rewatched the worm removal surgery at least ten times, my balls are on fire!]
[High temperature can reduce s.p.e.r.m motility. Are you trying to save on c.o.n.d.o.ms? Even c.o.n.d.o.ms are not a guarantee, though.]
[Agreed. A few days back, our hospital delivered a newborn who had a c.o.n.d.o.m clutched in his hand.]
[That's one fortunate baby. Bless me with some of his luck.]
Most of the doctors in the livestream were general surgeons of various ranks. Their typing speed could match that of an esports gamer and the screen was filled with comments. One could say that there was a camaraderie among the viewers.
A moment later, the bullet comments vanished.
The viewers noticed the surgeon was performing local infiltration anesthesia over a large surface area.
The injector was used to administer the anesthetic. It did not remain in the subcutaneous layer and was pulled out after injection.
[Can't tell what the god is doing.]
[Judging from the position, could it be a femoral artery ablation?]
[What are you going to do with a femoral artery ablation? A bypass surgery wouldn't require you to touch that artery. Perhaps a thrombectomy? Congrats to the endovascular comrades, you guys will have something new to learn today.]
A few messages shot across the screen. They were surprised to see the livestream change to the view of the catheter needle and vascular sheath.
Then they saw the guide wire snake out.
Once a predefined length of the guide wire was inserted, another view appeared below the initial livestream. The second screen showed the guide wire travelling along the artery.
[It's an interventional radiology-assisted surgery? Is this a different surgeon?]
[Maybe this anon is a marketer from some private hospital who selected some surgeries as advertis.e.m.e.nt?]
[I feel the same way but logically speaking, a private hospital wouldn't advertise something simple like an inguinal hernia repair. It costs a few hundred yuan per surgery, there's no profit for them.]
[Also, a private hospital wouldn't do 49 appendectomies overnight.]
As the viewers debated the surgeon's origin, the guide wire had moved along the femoral artery and entered the bilateral internal iliac artery.
The contrast agent was administered. A pall of black smoke appeared on the image of the uterus.
Although the general surgeons had little experience in interventional surgery, they knew that the black smoke was due to the radiation from the contrast agent.
The agent covered a large area of the screen with the dark, intense smoke, indicating major bleeding in the patient's uterus.
[I'm an endovascular surgeon. The surgeon's guide wire doesn't look like a standard Cobra guide wire. It seems to be extremely soft and flexible.]
[And yet the surgeon has managed to guide the wire from the femoral artery into the internal iliac artery in a single attempt. Even with the Cobra wire, I couldn't guarantee a success on the first try.]
In the operating control room, there were two 40-inch LCD screens displaying the ongoing surgery.
Those in the room were all chiefs of their respective departments. None of them practised intervention surgery, but that did not stop them from lobbing criticism and unnecessary commentaries.
Not everyone could perform surgery but anyone could make disparaging remarks.
The ICU chief did not even give Zheng Ren the benefit of the doubt. He was waiting expectantly for the whole drama to end so that Chief Su could start the hysterectomy after obtaining the family's consent.
However… This surgery was progressing without a hitch…
The femoral artery puncture saw blood at the first attempt.
Not everyone had such skill, and it was doubly difficult when the patient had low blood volume due to hemorrhaging. 'This could be attributed to the nitrite poisoning cases a few days back', the ICU chief reminded himself.
When the guide wire was inserted, Zheng Ren switched on the imaging system. The image was broadcasted to the control room screens and the ICU chief saw the guide wire was at the branching of the internal iliac artery.
Now, the level of expertise required to achieve this was astounding.
The contrast medium showed that there was a massive bleed in the uterus, more severe than previously estimated.
The ICU chief was slightly panicked. If too much blood was lost, by the time the family members agreed to a hysterectomy, the patient might not survive.
Through the Xinglin Garden livestream, the doctors could see the severity of the bleed. A nervousness ran
through the viewers.
Even though they did not know the identity or location of the patient, the doctors online went into emergency rescue mode.
[My god, that's a lot of blood! Looks like an aortic rupture.]
[Must be a placental abruption that tore open the uterine artery. What else can it be?]
[The blood pressure is dropping. The patient might go into cardiac arrest due to hypovolemia.]
[The god is in the middle of an emergency rescue, not some… Damn, he's livestreaming this. He can't be that confident?]
The numbers on the vital signs monitor were evident to all who witnessed. The patient had lost too much blood and was on death's door.
Chapter 74 - Alone Without Assistance (Part III)
"Bang!" The emergency operating theater door flung open and one of the Chu sisters rushed in with a sterile package in her hands.
"Chief Physician Pan, the absorbable gelatin sponge!"
Sure enough, the medical supply Old Chief Physician Pan demanded had been delivered within ten minutes. It was also fortunate that Sea City General Hospital was located in the city center, surrounded by the headquarters of many medical device companies. If the hospital was in a suburb, the delivery would not have been as quick even if a helicopter was involved.
Two units of fresh frozen red blood cells were quickly consumed. Xie Yiren, who had been attentively watching the infusion, put a lead apron without hesitation.
The lead apron was heavy, but she was determined despite the strenuous effort.
"Put it away," a voice said lazily, "This is a man's job."
Stunned, Xie Yiren saw Su Yun, who had been standing beside her all along, picking up a lead apron and putting it on. After that, he walked toward the console and pressed the intercom button.
"Zheng Ren, stop the procedure temporarily, we ran out of blood."
Then, he brushed the black hair falling on his forehead aside.
"Do you know how to do it?" asked Xie Yiren.
"I'm the smartest man in the world. I know everything," answered Su Yun.
Even in the presence of so many senior consultants, he could still casually utter all manner of childish statements with no hint of shame.
Su Yun was definitely a weirdo.
After Zheng Ren made a gesture, Su Yun opened the thick lead door and entered the room.
The surgery continued as soon as the lead door was closed.
In Xinglin Garden, after a short pause of the livestream, the host surgeon started performing superselective catheterization using a micro-guidewire.
The so-called superselective catheterization referred to the usage of a micro-guidewire for the superselection of small arteries branching at an acute angle from a large parent artery.
The concept was similar to a mainstream forking off to several branches. Any expert helmsman would know that it was extremely difficult to maneuver the boat into a particular branch smoothly when facing turbulent flow and inertia from the trunk. It required lots of experience.
The same rules applied to this surgery as well.
The guidewire in the left internal iliac artery was directly superselected into the left uterine artery without any trouble.
[What a smooth entrance. Sure looks like it isn't difficult at all.]
[This surgery is awesome!]
[Uh… This vascular surgeon is in shock. The manipulation is simply fascinating.]
Even if they were professional doctors, the differences in subspecialties made them feel worlds apart.
After the smooth entry of guidewire into the left uterine artery from the left internal iliac artery, the comments in Xinglin Garden were immediately divided into two groups—the ignorant merely assuming that it was an easy task, and those who understood the procedure sending their reverence without a second thought.
After the guidewire entered the d.e.s.i.r.ed artery, microcatheterization began.
The microcatheter waltzed through all the tough spots and acute corners without brute force, and the whole process was smooth-sailing.
Following the injection of the absorbable gelatin sponge, embolization of the left uterine artery was complete.
Since the first embolization had been successful, what were the odds of failure for the next one?
Two minutes later, the right uterine artery was embolized as well.
Zheng Ren waited one minute before performing the angiography again. Fortunately, the deadly "smoke" sign in the uterine arteries did not appear again.
He withdrew the guidewire and microcatheter before applying pressure on the wound. The surgery was officially complete.
Su Yun had nothing else to do after changing one pack of fresh frozen red blood cells. He initially thought that the procedure would take at least fifteen minutes, but he did not expect Zheng Ren to complete it in just a few minutes.
After staring at Zheng Ren for a few seconds, he brushed the black hair on his forehead to the side and smiled.
Pretty as a picture.
"Chief Zheng, is there a shortage of staff in the emergency department?"
That was unexpected. Confused, Zheng Ren asked subconsciously while maintaining pressure on the wound, "What?"
"I heard that you've been performing surgeries independently these past few days. Poor bachelor, you even have to perform operations alone." The pretty Su Yun was indeed a sharp-tongued man. It was clearly a compliment, but somehow it became foul as soon as it left his mouth. "Do you need a competent assistant who is ten thousand times more beautiful than you?"
"..." Were it not for the fact that Zheng Ren was compressing the wound to achieve hemostasis, he would have surely slapped the bastard to death.
In the operator console room, many senior consultants were flabbergasted.
The bewildered Chief Wang of the anesthesiology department looked at the clock hanging on the wall. The surgery time… was more than six minutes, which seemed to be longer than what Zheng Ren initially promised, but was that a problem?
Not at all.
Old Chief Physician Pan looked proud with a smile hanging on his face and arms crossed over his c.h.e.s.t. The fact that Zheng Ren finished the surgery successfully gave him more satisfaction than if he had completed the operation himself.
The ICU chief's mind was in chaos after receiving a critical hit as he had been the one insisting on a hysterectomy from the beginning. After all, the patient's life was far more important than her reproductive ability. In his opinion, anyone who hesitated on this simple multiple-choice question was undoubtedly idiotic.
Thus, he had great prejudice against both Old Chief Physician Pan and Zheng Ren.
However… he had not foreseen that Zheng Ren had completed the uterine arteries' embolization in just a few minutes.
What the f*ck!
He was dazed and confused despite his happiness.
All of these went against his knowledge of medicine. Since when were general surgeons so skillful, even knowing how to perform a catheter embolization?
"Bang!" The operator console room door was flung open again.
Poor door. It was always the target of critical damage during an emergency.
"The patient's family agreed to a hysterectomy. The anesthesiologist will begin administering anesthesia and the nurses will prepare the instruments. Let's get ready for surgery!" Chief Su of the obstetrics department quickly instructed with a dark expression. Obviously, her attempt to communicate with the family members had not gone well and led to a choice between life and death for the patient.
However, no one in the operator console room moved a muscle, as if they had not heard her commands at all. Her suppressed emotions burst forth instantly.
"What the f*ck are you guys waiting for?!"
Every senior consultant possessed an awe-inspiring aura and that aura intensified especially in an emergency.
There was no superior-subordinate relationship or deception at that point. Everyone had to go all out in the rescue operation and try their ver
y best to pull the patient back from the brink of death.
Blurting out swear words did not mean that the doctor was without manners.
"Chief Su, the surgery is complete and the uterine arteries have been embolized. The hemorrhage… The huge hemorrhage has stopped." Old Chief Physician Pan, who had a cruel sense of humor, paused for a brief moment and savored the anxious look on Chief Su's face before continuing, "Use v.a.g.i.n.a.l packing for hemostasis and labor induction can be commenced in one to two days."
"..." Chief Su's eyes widened and her pupils dilated immediately as if there was a complete absence of pupillary light reflex.
"What?!" Her voice was sharp like a shattered glass piercing everyone's eardrums. She simply refused to believe such an outrageous claim.
"The surgery is complete, and the patient's uterus and life have been saved." Old Chief Physician Pan slowly added, "Whether the patient will have DIC or unsuccessful labor induction in the future is none of my concern."
His current expression was full of pride. "How can you not let the emergency department handle emergency cases?"
"Uh…" Chief Su finally noticed the imaging video that was running in a loop in the console.
From the initial pall of black smoke in the angiogram, to smooth embolizations, until the smoke sign completely disappeared in the second imaging. What did that mean? Naturally, Chief Su understood it perfectly.
Was it a success?
Her previous perturbation instantly vanished into thin air. The moment she left her distressed state, energy drained from her body and she slumped down on a chair. "That's good. That's very good."
Chapter 75 - Reward—Master Rank In Interventional Radiology
[His general surgery skill should be one of the best in this country. I don't know anything about interventional radiology, but I've consulted my colleagues in the cardiovascular department. Any surgeon who can embolize a uterine artery within five to six minutes is unrivaled in the province. However, it was impossible for the same surgeon to achieve such a high standard in different surgery subspecialties. Therefore, I suspect that this is actually an official account. Evaluation complete.]
The Surgeon's Studio c1-799 Page 42
