Special Forces Medic-Chapter 861 - 834: Surgery (5)
If the upcoming surgery causes the patient to die, he definitely won't let this matter rest as it is. Their military district hospital will definitely not acknowledge this issue. After making up his mind, the elder sat with his arms crossed, waiting for the result.
"Calculate the time for the Porta Hepatis Occlusion procedure, and notify me to restore liver blood supply when the time is up!" Xiao Lin instructed the circulating nurse. With Mu Rongyun's assertive attitude, it indeed made everyone else shut their mouths obediently, some returning to their positions, with only Tang Ji and another person still standing hesitantly by the side.
"Yes!" The circulating nurse responded. As long as the attending doctor hasn't declared the end, they must remain at their posts. That is the duty of a nurse.
"Head nurse, check the plasma and timely crossmatch the blood!"
"Yes!"
"Military Doctor, can you tell us what you plan to do next?" Tang Ji stood on the side observing, having given up the second assistant position at the surgical site completely.
"Heart suturing!" Xiao Lin glanced at Tang Ji and said expressionlessly.
"What?" Tang Ji exclaimed unknowingly. "You're not choosing to restore the heart's rhythm, but instead doing heart suturing? What a joke!"
"Mu Forensic Doctor, please!" Xiao Lin winked at Mu Rongyun, who snorted coldly and turned to confront Tang Ji.
"I think I've made myself very clear earlier. Do you want to leave on your own, or do I need to throw you out?"
"Mu Forensic Doctor, we don't have much time. Let's handle this quickly."
"What are you rushing for? You can manage this kind of surgery by yourself." Mu Rongyun replied impatiently to Xiao Lin, while already forcing Tang Ji towards the door.
"This is too rude. How can you treat a doctor with considerable authority like this, throwing someone out of the operating room? This is the first time I've seen such behavior." The elder sitting next to Xiao Zhenfeng couldn't tolerate it any longer. That was his disciple being treated with disrespect and thrown out of the operating room, which was a humiliation for any doctor.
"Quiet! I can't hear the situation inside." Xiao Zhenfeng pulled the elder back onto his seat, applying some force to keep him seated.
"But..."
"If you don't want to lose your dignity as the chief dean, just sit quietly. Don't make me repeat myself." Xiao Lin's attitude was somewhat arrogant, and that Mu Rongyun was even more insolent. These two brothers were indeed a perfect pair, and just when he thought of leaving, he chose to wait until the end.
"Expose the heart wound for me to see." Mu Rongyun had returned to his place, having already acted accordingly before Xiao Lin issued any orders. This understanding was something others found hard to describe with words.
With the heart turned outward, the wound was positioned in front of Xiao Lin. "Chromic gut suture, needle, give Mu Forensic Doctor a pair of scissors." Xiao Lin called to the Instrument Master.
"Can you manage with one hand?" Xiao Lin asked Mu Rongyun, who nodded.
Handling the needle instrument for suturing and knotting, Mu Rongyun held the heart, freeing one hand to help cut the suture. In their coordination, the heart wound was quickly sutured, completing a task that typically required several people, done cleanly and efficiently. The blood gradually oozing from the heart was promptly stopped.
Meanwhile, the surgeon who returned to his position seized the opportunity to completely suction out the residual blood in the chest cavity, shortening the time for Xiao Lin and the others.
"Found the bullet." Xiao Lin, after completing the suturing, prepared to examine the heart for any more significant contusions. An inadvertent glance revealed an amber bullet lodged in the pericardium of the left chest cavity. Staring at the bullet, he quietly calculated in his mind. Judging by the bullet's position, the residual heat on the bullet must have also damaged the heart. However, there was no time to linger on these matters.
Taking the tweezers handed to him from the side, he was briefly astonished at how well the Instrument Master anticipated his next move. Just as he was in this curious state, a voice came from overhead.
"Cardiac arrest time is two minutes, hurry up." Mu Rongyun wasn't accustomed to spending a long time on the operating table. Such vital critical work led him to choose a path as a forensic doctor in the police department over being a surgeon, as wielding a scalpel on the deceased was far simpler than on the living.
His right hand cautiously probed beneath the heart that Mu Rongyun was supporting, carefully extracting the bullet from the pericardium. With a clank, Xiao Lin tossed the extracted bullet and tweezers into a nearby iron tray.
The bullet entry inherently carried a high heat concentration, causing burns. A surgeon standing in the second assistant position realized this and suspiciously looked at the removed bullet, wondering what Xiao Lin would do next.
Xiao Lin frowned deeply. The bullet must have scorched the underside of the heart. If they were to repair the heart's burn site, they would have to use a polyester or autologous pericardial patch or employ a 4-0 polypropylene suture in a figure-eight or interrupted horizontal mattress technique. However, these suturing methods would significantly shorten the heart's resuscitation time. Even with successful complete repair, if the heart cannot be successfully resuscitated before brain death, all efforts would be in vain.
Conversely, if they skipped suturing and proceeded straight to cardiac resuscitation, given the bullet's position, if the heart excitedly contracts and the scorched outer heart wall bursts without immediate hemostasis, it would likewise face the threat of hemorrhagic death.
The surgical procedure has become more challenging.
"Nurse, report the time of cardiac arrest for the one surnamed Zhang, and the duration of the Porta Hepatis Occlusion procedure." There was no time left; Xiao Lin gritted his teeth, as if his eyes ignited with two flames.
"Heart stopped for 2 minutes and 35 seconds, porta hepatis occlusion has been going on for 4 minutes."
"Prepare 1MG adrenaline for apical injection."
Xiao Lin glanced at Mu Rongyun. After hearing the two orders he gave to the nurse, Xiao Lin already understood what he was going to do. He nodded towards Xiao Lin.
Receiving the heart from Mu Rongyun's hands, he slowly placed it into the pericardium, pressed it twice with his right hand, signaling to the nurse to inject the adrenaline.
Once, twice, four times...
Simulating the flexible pressing of a normal heart beat.
Time ticked away, the familiar feeling of the heart's 'thump thump' beat, Xiao Lin excitedly squinted his eyes.
The anesthetist beside the monitor also stared at the screen unblinking, suddenly the heart rate waves reacted. "There's a heartbeat index! There's a heartbeat."
Whew, Xiao Lin truly exhaled a breath, slowly released his grip from the heart. 𝑓𝘳𝘦𝑒𝑤𝑒𝘣𝘯ℴ𝘷𝘦𝓁.𝑐𝑜𝑚
The small red thing was tirelessly 'thump! thump' beating again.
"Heartbeat revived, successful!"
As everyone was immersed in joyous excitement, Xiao Lin glanced at the data on the monitor, then looked down at the beating heart in the chest cavity; the next part was critical. Besides the gunshot wound and the stabbed liver, multiple rib fractures had caused various degrees of damage to internal abdominal organs, increasing the difficulty of the surgery undoubtedly.
"It seems we encountered a bit of trouble. The bullet you just removed was inside the pericardium, meaning there's a slight injury on the heart," Mu Rongyun said while using a suction device to remove blood from the thoracic and abdominal cavities. "The lungs and spleen are still bleeding, too many places need repair." As he spoke, everyone fell silent. His words indirectly indicated one thing, Hua Muyun still had a possibility of dying from excessive blood loss.
The blood from the lungs and spleen could still be controlled with suction now, but continuing to repair the heart, the liver repair surgery would inevitably be unable to complete later, releasing the occlusion, the suction device surely couldn't control it.
"Which one do you do first?" Mu Rongyun pressed a question. This was a single choice between A and B, although simple, reversing the order could very likely lead this surgery to the brink of failure, the person lying above might never wake up.
"Repair the heart!" Xiao Lin decisively made his choice; he didn't even consider the other possibility. For him, ensuring the elimination of hazards first, then addressing the liver locally, such a procedure didn't need to consider other possibilities at all.
Beep beep beep, just as Xiao Lin was preparing to once again hold the heart out, the instrument cart made a piercing noise, Xiao Lin's expression changed.
"It's ventricular fibrillation!" Mu Rongyun anxiously shouted.
"Defibrillator! 2% lidocaine 2MG intravenous injection!"
The instrument master handed the saline-coated electrode plates to Xiao Lin's hands while the nurse injected the syringe into the tube, no need for many instructions given their mutual understanding from earlier.
"50 joules! Ready."
"Ready!"
"Clear!" Xiao Lin shouted, both electrode plates tightly pressed against the left and right ventricular walls, delivering 50 joules DC shock defibrillation.
"Stayed on VARICOSEFIBER, no response."
"Saline!" Once the instrument master wetted the electrode plates, he turned and shouted, "70 joules!"
The increased energy caused the monitor to respond, the anesthetist shouted gleefully that there was a response, blood pressure gradually climbed, heartbeat restored.
"We'll start hidden hazard repair work, Mu Forensics, the rest is up to you." Xiao Lin chuckled twice towards Mu Rongyun, how can it always be himself doing it, otherwise calling this guy over would be meaningless.
Boldly put his work down and retreated to the assistant seat, in front of others, Murong Yu couldn't refuse, he obediently took Xiao Lin's position, only his jet-black eyes carried anger.
"Remember, my appearance fee is very expensive."
Xiao Lin chuckled twice, though already retreating to the assistant seat, he never intended to help at all, same jet-black eyes watched Mu Rongyun's techniques, admittedly Mu Rongyun's technical skills were unlike others, even such a simple act as suturing he could perform in a special way. Xiao Lin exited the operation room, leaving the inside for Mu Rongyun to complete alone, believing even if unforeseen incidents arose, he could easily handle it. (To be continued. If you like this work, you're welcome to come to Qidian (qidian.com) and vote for recommendation tickets, monthly tickets, your support is the greatest motivation for me.)
