Chapter 475: Chapter 248: Show Off and Run
By the time the two returned after washing their hands, Lu Cheng had already finished preparing the medium-sized sterile drapes and was changing into sterile surgical gowns with the instrument nurse to change to larger sterile drapes.
The two also followed to change into sterile surgical gowns and then began to count the instruments separately...
After placing the abdominal retractors, the three moved to the positions of the chief surgeon and assistants, beginning to clear the residual hematoma inside the abdomen.
While using the suction device to assist, Lu Cheng said, "I didn’t handle the small bleeding point of the superior mesenteric artery in the emergency room; there was no way to deal with it, and at the time, I didn’t even find the bleeding point, but it’s presumed to be minor."
"Okay." Zhang Zhong responded to Lu Cheng and started checking the blood flow of the superior mesenteric artery and intestine.
In these circumstances, ischemic necrosis of the intestine is very likely to occur. The patient has already lost a great deal of blood, and if the other surgeries are successful but necrotic intestinal areas remain, the patient might still die due to intestinal necrosis.
"I knew there was hypokalemia." Hu Yaya’s muttering broke the hard-won silence in the operating room.
Only Lu Cheng was not accustomed to her muttering, glancing in her direction, while both Song Daoneng and Zhang Zhong ignored it.
"The arterial bleeding on the pancreatic side is quite severe," Song Daoneng completed a quick exploration before Zhang Zhong and raised his head to comment.
Zhang Zhong understood that Song Daoneng meant if there was still a significant source of bleeding, it would definitely be an artery in the gastrointestinal tract, requiring more attention from him.
However, after searching around, Zhang Zhong only found two relatively small bleeding points, but these were hardly sufficient to sustain the amount of hematoma in the anterior abdominal cavity.
"Is the blood pressure still dropping?" Zhang Zhong asked.
Hu Yaya checked the blood pressure again; the blood pressure monitor hummed for a while before reporting, "It’s 67 mmHg systolic! Still dropping."
"Currently, vasopressors are being continuously pumped in."
Zhang Zhong’s eyebrows immediately furrowed, "If it’s still dropping, it proves there’s an active bleeding point that hasn’t been found."
Upon hearing Hu Yaya’s words, Lu Cheng was also filled with doubt. After a moment of thought, he asked, "Director Song, Director Zhang, did you look at the patient’s CT scan?"
"Looked at it; the rupture in the pancreatic uncinate process is quite obvious," Song Daoneng replied.
"Did you notice any other arterial damage?" Lu Cheng inquired.
Song Daoneng cleared his throat with a few "uh-huh" sounds, raising his head to look at Lu Cheng, "What are you implying by asking this? Are you suggesting we can’t read an abdominal CT scan?"
Upon hearing this from Song Daoneng, Lu Cheng didn’t dare reply, but he put down the suction device in his hand, securing it on the sterile sheet with hemostats, and then turned towards the operating room’s workstation computer.
"Circulating nurse, please pull up the patient’s CT images for me and scroll through the layers," Lu Cheng instructed quietly.
Diagnosing acute abdomen is challenging, and treatment is even more so.
Lu Cheng hadn’t seen the imaging tests, so it was difficult for him to guess where the bleeding might be.
Zhang Zhong chuckled twice without looking up, speaking calmly, "Interesting."
Though Lu Cheng didn’t answer Song Daoneng directly, his actions implied that he thought neither Song Daoneng nor Zhang Zhong could interpret the CT properly!
However, since Lu Cheng was from the emergency department, his assistance in the operating room was a favor, not an obligation.
Seeing this situation, Hu Yaya quickly stopped her muttering, looked shocked, and then hurriedly began correcting the patient’s electrolyte imbalances, calling the pharmacy to have medication sent up.
Not all necessary medications are available in the operating room’s stock.
"Pause, and flip up about five layers," Lu Cheng halted the circulating nurse.
The circulating nurse’s hand paused, slowly scrolling up, "Here?"
"Go up further," Lu Cheng instructed.
The circulating nurse complied.
"Stop right here. Enlarge the view..."
The circulating nurse continued to follow the instruction.
"Keep it at this screen," after a careful look, Lu Cheng approached the operating table.
Lu Cheng said, "Director Yao, would you mind helping check the patient’s left renal artery?"
"Check, my foot. If there’s bleeding, address it quickly," Yao Daoneng wasn’t intent on proving his unmatchable ability.
If Lu Cheng was wrong, further probing would be corrected later.
If Lu Cheng was right, it would offer the patient a chance of rescue.
The unidentified arterial bleeding currently required urgent attention.
Upon hearing Yao Daoneng, Lu Cheng stepped in where Yao Daoneng had vacated the operating space.
Lu Cheng maintained his swift actions, demonstrating deep anatomical knowledge, and shortly after exposing the left renal area, noticed red blood slowly oozing out.
This indicated not a main renal artery bleed but a branch artery bleed.
The blood loss was minor yet still dangerous!
"Oh wow," Yao Daoneng said in astonishment, as Lu Cheng’s hands swiftly entered the incision, manually compressing the patient’s left renal artery while using the suction device to evacuate the residual hematoma from the cavity.
Under these circumstances, as the hematoma and blood gradually decreased, Lu Cheng turned, "Vascular clamp."
The instrument nurse handed over the vascular clamp, which Lu Cheng accurately applied to the posterior branch of the patient’s left renal artery, then released his hand.
Silence returned!
The operating room, originally silent as a crow, grew even quieter. While recording data, Hu Yaya shut her mouth entirely.
What Lu Cheng had speculated earlier had now been confirmed.
It at least demonstrated that Lu Cheng’s film-reading skills were superior to those of the other two deputy chief physicians.
After checking several times, Lu Cheng saw no new fresh bleeding emerging, then covered the abdomen and intestines.
Withdrawing his hands, he returned the operating space to Song Daoneng.
Because Lu Cheng was not proficient in pancreatic surgery!
Song Daoneng took a deep breath, the turbulence of air in his nasal passages making a harsh sound, as if his throat had been squeezed, his voice slightly distorted, "This technique is amazing."
Song Daoneng knew nothing about Lu Cheng’s film-reading ability, but Lu Cheng’s hemostatic technique aroused his envy as a specialized surgeon.
Surgery relies on skilled technique for survival.
Naturally, Lu Cheng did not respond verbally, continuing his role as an assistant.
His personal mission was to leave once the patient’s blood pressure stabilized and transfusion began.
Before then, he might still be able to help with hemostasis on the operating table.
Meanwhile, Zhang Zhong had finally dealt with the last bleeding point in the superior mesenteric artery.
After putting down his instruments, he glanced at Lu Cheng with a complex look but remained silent, yet his gaze conveyed an intricate array of feelings.
Previously, during hospital and State Health and Health Commission mortality rate inspections, many were discontent.
Why, when Lu Cheng was on duty, was the patient’s mortality rate lower?
Why claim patient deaths on Lu Cheng’s watch occurred because Lu Cheng wasn’t in the operating room?
Everyone has a pair of hands—are Lu Cheng’s hands really that remarkable?
Surgeons like to debate techniques and are hard to convince, without ocular proof.
Being a surgeon himself, Zhang Zhong understood the disparity in operational skills among surgeons because he’d seen great performances.
Therefore, he recognized that Lu Cheng’s skills couldn’t be honed merely through time; they required pure talent.
Blind hemostasis is unrelated to experience or effort.
"The blood type is out, O type," the circulating nurse announced.
"Call the blood bank for a blood release," Hu Yaya finally found a point to vent, speaking rapidly, as if her lack of speech earlier had bottled her up.
"Got it," the circulating nurse immediately used the operating room’s phone to make the call.
Lu Cheng reminded, "Circulating nurse, call for a urology consult to handle the left renal artery."
"Director Song, Director Zhang, if there’s nothing else here, I’ll step off; I need to go write the emergency record," Lu Cheng said.
"Alright," with Lu Cheng’s suggestion, Song Daoneng and Zhang Zhong had no room for refusal.
Emergency records had to be written, and surgical operation records need to be by Lu Cheng.
Only, Lu Cheng suddenly saying he’d leave left them feeling somewhat uneasy.
Did he just show off and leave?
...
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