Surgery Godfather-Chapter 335 - 0318: Ambush on All Sides_2
Chapter 335: Chapter 0318: Ambush on All Sides_2
Irrigation, numerous washes with a large amount of saline solution, alternating between hydrogen peroxide, saline solution, povidone-iodine-solution, and saline solution, immense quantities used interchangeably.
The large amount of feces contaminating the abdominal cavity significantly increases the chance of infection. Many open pelvic fractures are contaminated by feces, ultimately resulting in severe infection leading to the death of the patient.
Irrigation, ceaseless irrigation, continuously diluting the bacteria, this is the best method.
Driven by an almost obsessive need, Yang Ping irrigates, diluting the mix of clotting blood and feces again and again.
His sterile-gloved hands stirred within the abdomen, ensuring that the pulsating spray head in Song Zimo’s hands reached every corner.
The three-liter bag of saline solution is hung, connected through the pulse irrigation machine, connecting the irrigation pipes, water spraying from the irrigation head.
...
The saline solution is rapidly depleted, and the circulating nurse continuously replaces it. The bucket designated for empty bags has already filled with more than twenty bags.
The bucket collecting fluids however, sees a constant rise in liquid levels, it contains a substantial amount of impurities.
Only when the irrigation fluid became clear did Yang Ping and Song Zimo leave to scrub their hands and sanitize.
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Zhang Lin Xiaowu, who had already scrubbed his hands, began to disinfect the cover sheets, flawlessly picking up where they left off.
To save time, Yang Ping scrubbed much faster than usual, simplifying the process.
The electric knife, bipolar electrocoagulation, suction tube, irrigation tube were all properly connected.
Yang Ping dressed in surgical scrubs, put on gloves, and began the surgery. The usual preoperative procedure was naturally omitted.
The scalpel was used to extend the abdominal wound, attempting to expose the entire abdomen.
Two large S-shaped retraction hooks were gently placed, and Zhang Lin Xiaowu took his position.
A complete new set of tubes were arranged to continue the irrigation. Once irrigation was completed, everyone changed gloves.
With both hands, Yang Ping stretched inside, carefully examining each organ in the abdominal cavity, determining which ones were worth repairing, and which ones needed to be surgically removed without hesitation.
The spleen was already shattered, often Yang Ping would ligate blood vessels, sometimes he’d separate with his fingers, sometimes with surgical scissors, the dazzling array of surgical instrument switches caused confusion.
Moving so quickly, the steps weren’t clear, the fact that the destroyed spleen was successfully removed and thrown into a metal basin happened in the blink of an eye.
Without wasting a moment, he began working on the removal of the shattered right liver lobe, a normally tricky procedure handled with dexterity, even performing some steps all through touch without exposure.
Things like ligating vessels, removing the gall bladder, separating the right liver lobe were done so quickly, you couldn’t clearly see the procedure. The hemostatic forceps were threaded, tied, then forceps were used to separate. After a few rounds, the gall bladder was removed, followed swiftly by the shattered right liver lobe.
From the head to the tail of the pancreas, Yang Ping’s hands swiftly but carefully examine, flip and probe, noting light bruising on the pancreas, requiring attention for possible traumatic pancreatitis postoperatively.
Having assessed the pancreas, he immediately moves to the stomach, continuing from top to bottom, probing through the whole gastrointestinal tract in the abdominal cavity. He turns over the small intestine in his hand while examining it, allowing his eyes to see the entire perimeter of the intestine and mesenteric vessels. The information collected visually and tactilely are merged in his mind into an absolutely precise judgment.
Yang Ping’s familiarity with anatomy has elevated to an unrestricted level of freedom; sometimes he doesn’t even have to look, simply feeling with both hands he can accurately identify anatomical structures.
His hand reaches out, catching the scalpel handle, before anyone catches their breath, the small intestine had a reduction incision, his hand continues downward, holding slippery, smooth intestinal tracts, even the appendix is not spared. Following this, the ascending and descending colons and the sigmoid colon were retained. The sigmoid and rectum were completely removed and taken out.
The large metal basin that harbours the removed tissues was meticulously set on a sterile cart. A few of them were already full.
He examined the kidneys and the adrenal glands on both sides, two hands simultaneously probing, tracing down the urinary tract after the kidneys to the bladder and further to the urethra.
As he continued probing, Yang Ping reported out damage areas and degrees, as well as the upcoming operative plan.
“Kidney, adrenal gland, no noticeable injury. Both ureters ruptured, bladder burst, urethra damaged.”
His voice echoed loud and clear, but remained extremely calm, no yelling, no pressure.
However, everyone tried their best to keep up with his pace, especially Song Zimo, who was paying close attention and dared not slack off.
Everyone understood, at this moment, Yang Ping was contending with death. Any negligence, and death would snatch life right out of their hands.
The ovaries are fine, but the fallopian tubes have lacerations and the uterus has contusions.
The exploration and repair of these organs are done simultaneously with suturing, ligation, or electrocoagulation of blood vessels.
The bilateral internal and external iliac veins, left renal vein, and both lower abdominal wall veins are ligated; the sacral venous plexus, on the other hand, is either sutured or electrocoagulated from time to time.
These operations are ongoing and may seem disordered, yet they follow the most optimized order.
When all exploratory measures are completed, the whole omentum is lifted out of the abdominal cavity and dumped into a metal basin.
Turns out, while examining and repairing the organs, the surgeon was also removing the omentum. Upon the completion of the exploration, the omentum was naturally fully excised.
“Microscope!”
Zhou Can had already prepared and pushed it into the operating area, Yang Ping yelled for Song Zimo to adjust the focus and interpupillary distance.
Under the microscope, both ureteral anastomosis and bilateral ureteral stent nephrostomy were performed, and the ruptured bladder was repaired.
Additionally, the stump of the cystic duct was inserted with a T-tube to create a biliary fistula; a drainage tube was also placed where the spleen originally was.
A bladder fistula and a colostomy of the descending colon were performed, leading to a series of fistulas.
No urethra, therefore a temporary bladder fistula was performed. No rectum or anus, thus a temporary descending colostomy was performed to maintain ephemeral urinary and fecal excretion after the operation.
In the end, a beautiful skin flap was used to repair the remaining wound.
Three drainage tubes were placed into the wound to drain it, adding to the various tubes already in the abdominal cavity. A total of over ten drainage tubes extended out from the body.
During the operation, 20,000 milliliters of fluids were transfused just to barely maintain blood pressure.
Finally, the entire lower body was detached; the remaining body resembled a heap of mud, leaving the casualty’s body.
A person taller than one meter and sixty had become a ‘half-man’, about seventy centimeters tall, like a half porcelain doll.
The operating room was eerily quiet. Takahashi, staring at the screen, watched the entire operation. He precisely calculated the time, from prepping to the start, it took only thirty-five minutes.
Moreover, each step was executed without any pause or hesitation, as if every single move was crystal clear. Knowing what process was needed at each step, with consciousness leading the hand, every action was accurately accomplished.
Countless operations were not conducted routinely but were interweaved, flexibly combined without any dissonance.
Such combination was not about performing surgeries one by one. To save time, the surgeon integrated the steps of all independent procedures, scrambled them, mixed them all together. There were operations inserted into operations, with operations accompanying other operations.
Like a DJ spinning a record, speeding it up here, inserting it there, suddenly stopping this part and connecting another part. Each hand moving within the abdominal cavity, coordinating when needed and operating independently when required. With seamless transitions, no discordance could be felt.
The entire operation was completed under the pressure of death, an experience that was tense, thrilling, and exciting.
A surge of great power, like an incoming tsunami, overwhelmed Takahashi, making him feel a tremendous pressure, a pressure so strong that he felt like surrendering and kneeling down.
Yang Ping gently placed the needle holder into the sharp object transfer tube and asked, “Vital signs?”
“Blood pressure is 102/60mmHg, heart rate 102 beats per minute, low flow oxygen, mechanical ventilation, oxygen saturation 100%.”
“She has gotten past the first Ghost Gate, but many more are waiting for her.” Yang Ping let out a sigh of relief.
“I’ll take care of this patient.” Song Zimo looked at the monitor.
“You’ll be responsible for assembling the medical team and include Takahashi as well. I’ll discuss with the head nurse about forming a nursing team. If the patient is to survive, a dedicated team must be in charge. Any minor mistake could result in failure, and death could strike at any moment.”
“In addition to this case, there are only two examples of high-level ‘half-men’ in China. One was reported in Shanghai, but died six days after the operation—”
Takahashi was very familiar with these cases.
