Path of Medicine With a System

Chapter 127: Swift hand!

Translator: imperfectluck Editor: Kurisu

Originally, Zhang Fan had been off from work on Saturday morning, so he had wanted to accompany his sister to Bayinbrook Grassland. But now, he would have to cancel his plans due to being called in for overtime on the weekend surgery.

Bayinbrook Grassland was a mountain basin within the Tian mountain range. Snowy mountains surrounded this location which was at 2,500 meters above sea level. The total area of Bayinbrook Grassland was about 23,835 square kilometers, making it just slightly smaller than Ordos Grassland in Inner Mongolia. In the Mongolian language, Bayinbrook meant “abundant spring water”. This grassland was flat and had abundant water and plant life. It was a classical example of a meadow grassland, as well as one of the border province’s most important locations for animal husbandry. Not only was this place like a fairy realm surrounded by snowy mountains, it also had the winding Kaidu River, along with the alluring Swan Lake.

During the early periods of the Ming and the Qing Dynasty, the Yuletus River Basin was primarily an area filled with nomadic tribes. During the 39th year of Qianlong’s reign (1774), Qianlong invited Ubashi Khan to lead his Torghut people to settle here.

That aside.

The nephrectomy began on Saturday morning. The male patient wasn’t that old, and had good vitals. Heimduller purchased some meat buns and treated Zhang Fan as well as the director to breakfast as this patient was Heimduller’s. Although it was the director’s command to have Zhang Fan come assist in this Saturday surgery for overtime work, Heimduller still purchased some food to thank Zhang Fan. Heimduller even informed Zhang Fan not to eat breakfast beforehand as he was treating him. After the three doctors finished eating their meat bun breakfast, they entered the operating room. Since the patient’s family had good connections in Chasu City, Director Li even personally reassured the patient’s family that everything would be alright with this surgery. Normally, speaking to the patient’s family would be instead done by the doctor in charge of the patient. The director almost never personally did such a thing.

Inside the operating room, the patient was prepared for the surgery, and the anesthesia and disinfecting began. Director Li Jianguo was the primary surgeon. He chose to begin with a standard incision and surgical procedure as every patient’s individual situation and kidney location would be slightly different. He cut open the fascia around the kidney and used various waist incisions to reach the kidney fascia before separating the fascia and making another small incision and opening up the kidney fascia. He also paid attention to avoid injuring the patient’s peritoneum.

Heimduller was the primary surgical assistant, and Zhang Fan was the secondary surgical assistant. A nephrectomy wasn’t that difficult for a veteran doctor like Director Li Jianguo. Zhang Fan was also completely fine with the difficulty level. However, a nephrectomy was still slightly difficult for Heimduller. But, since a nephrectomy would be considered a major urological surgery, Director Li didn’t let the rotation doctor Zhang Fan be the primary surgeon or primary surgical assistant.

Li Jianguo slowly revealed the kidney by using his fingers to separate the fascia around the kidney. He started from the kidney’s back and convex surface before moving on to the upper, lower, and front portions of the kidney. Then, he followed the ureter to the renal hilus, separating the kidney from the renal pedicle.

Li Jianguo was a skilled urological surgeon. He had many years of experience and a very cautious personality, so his surgical style seemed particularly clean. He was in no hurry whatsoever to finish the surgery. He took everything slowly, one step at a time. His style was particularly solid as he made sure to stop every single point of bleeding, no matter how small. He was especially careful.

Zhang Fan also learned a lot from watching Li Jianguo perform surgery. So far, Li Jianguo was by far the most cautious primary surgeon that Zhang Fan had ever seen before. Not only that, Li Jianguo was very precise and detailed in his movements.

Li Jianguo began separating the ureter from the lumbar segment, wrapping the ureter in gauze while lifting it up and doing his best to maintain downward separation. He used two hemostats on the lowest point of separation to pinch the ureter, and then cut the ureter at the point in between the two hemostats. Li Jianguo then used cotton balls drenched in pure phenol, 75% alcohol, and saline solution to perform disinfecting before performing ligation and transfixion on the ureter.

The nephrectomy entered the latter stages. The first part of the surgery would be for the purpose of isolating the kidney, while the later part was about dealing with the kidney’s blood vessels, carefully separating the fatty tissue in the renal hilus, revealing the kidney’s arteries and veins. A pair of kidney pedicle clamps or curved hemostats would then be used to pinch the kidney’s blood vessels as the surgeon cut the blood vessel between the two hemostats and removed the diseased kidney.

However, an incident occurred at this time!

Since this patient and his family were in a great hurry to have the surgery performed, even to the point of even having a higher-ranking government official personally speak to Director Li, there wasn’t anything that Li Jianguo could do other than hurriedly begin the surgery on the patient as requested.

There were several typical pre-surgery checkups that hadn’t been done because of that. Li Jianguo was the extra cautious type to begin with during his surgeries. He was afraid of any problems appearing. Still, no matter how cautious he was, an incident still occurred.

It turned out that the patient’s kidney had a mutation. His kidney had an extra kidney blood vessel which even happened to be an artery. Although this mutated artery wasn’t very thick, it wasn’t thin, either. Since it was a mutated artery which shouldn’t have been there—being on the side of the nephridial pit at that—Li Jianguo hadn’t noticed its existence. He cut through the renal pedicle, and was about to remove the diseased kidney.

But as a result, he also cut through the mutated artery, causing blood to suddenly spurt! The mutated artery just happened to be directly facing Heimduller. The blood pressure was significant, and blood spurted all over Heimduller’s face. Heimduller was too stunned to react.

‘The blood vessels were properly ligated already, so just where is this artery blood coming from?’ thought Heimduller to himself. Additionally, with blood spurting directly in his face, Heimduller reflexively closed his eyes, and forgot to assist primary surgeon Li Jianguo!

Li Jianguo was still holding onto the pair of hemostats which were clamping the other kidney blood vessels to prevent them from bleeding, so he didn’t have any free hands to prevent the mutated artery from bleeding. Li Jianguo instantly broke out in a cold sweat as his mental voice shouted, ‘It’s all over! This is going to be a huge medical incident today!’

This type of crisis would test a surgical assistant’s skills more than anything. However, Heimduller was in a state of confusion, never expecting blood to suddenly cover his face! Also, blood had the trait of becoming stickier the moment that it cooled. It became difficult for Heimduller to even open his eyes. Li Jianguo was incredibly anxious, but there really wasn’t anything he could do, as he didn’t dare to let go of the hemostats in his hands. That would only cause even more bleeding! So, he could only shout, “Zhang Fan! Zhang Fan! Hurry and find the bleeding blood vessel!”

It would be impossible to use an aspirator to drain all of this blood, as arteries in the kidney had great blood pressure and high volume of blood flow. In just a few short seconds, the spurting blood filled the entire nephridial pit.

As Li Jianguo loudly shouted for Zhang Fan, the latter didn’t waste a single second of time. He immediately blocked the nephridial pit with his hand.

“Hurry and wipe Heimduller’s face!” Zhang Fan told the operating room nurse while stemming the bleeding with his hand. He was standing in a poor position to assist the surgery as he was only the secondary surgical assistant. This was all he could do from his position. The rest would still need to rely on the primary surgical assistant.

Zhang Fan then told the anesthesiologist, “Hurry and lower the blood pressure.” Zhang Fan successfully stemmed the flow of bleeding.

Li Jianguo was currently at maximum tension level. He hurriedly told the anesthesiologist, “Yes! Okay! That’s right! Hurry and lower the blood pressure!”

Heimduller had gone into complete despair the moment that blood blinded his eyes. Luckily, Zhang Fan was the secondary surgical assistant for today. Had the secondary surgical assistant been a regular rotation doctor, major trouble would have occurred. However, Zhang Fan’s reactions were far too quick. He had already taken the appropriate countermeasures without Li Jianguo even needing to direct him.

Zhang Fan had swiftly, accurately, and instantly stopped the bleeding with his hand, but Heimduller was still in a state of confusion even after the nurse finished wiping the blood off his face. He ended up saying the first thing that entered his mind without even thinking about it. “Did you not clamp the renal pedicle properly?”

Li Jianguo felt like he was about to erupt in anger. Heimduller was still in a state of confusion instead of immediately searching for the blood vessel that was the source of the bleeding at this time? “Stop wasting time! Are you blind!? Where did I not properly use the hemostats? This is obviously caused by a mutated blood vessel. Hurry!”

Li Jianguo’s tone was incredibly severe. Heimduller hadn’t been afraid of the blood, but he became afraid of his boss’s tone. Heimduller paused for a moment, and then realized that he had said something majorly wrong. His words had been implying that Li Jianguo hadn’t properly performed the surgery with enough caution! This was the biggest danger of performing surgery on a patient who hadn’t gone through all of the proper checkups. However, the blame for failing a surgery would still squarely fall upon the doctors, disregarding whether the surgery had to be started without the proper checkups. The higher-ranking government leader wouldn’t care that it was due to his order to rush things.

“Blood transfusion, correct the patient’s state of shock, and increase the fluid speed.” Zhang Fan ignored the emotions of the other two doctors as he began to give commands to the operating nurse.

Not only had the blood spurted all over Heimduller’s face, even the operating room’s walls had blood spurts on them.

The operating room nurse was in a state of panic over the unexpected situation, but with Zhang Fan’s commands, she knew what she had to do. As long as she had orders to follow, she would no longer be so panicked.

The blood pressure lowered, which slowed the rate of bleeding. Heimduller immediately began ligation on the mutated artery. There was now an extremely tense atmosphere within the operating room. Li Jianguo had a dark expression and spoke in an icy tone. Heimduller regretted his own behavior so much that he really wanted to slap himself hard.

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