"It's too tight and the remaining part is too short, so there's no way to remove it," Chief Sun said helplessly as he touched the gangrenous gallbladder with a pair of hemostatic forceps.
"Don't untie it," Zheng Ren said seriously. "Gangrene lasts for a long time. If the necrotic tissue in the gallbladder retrograde into the hepatic duct, it might be very troublesome after the surgery."
"But …" Chief Sun glanced at the twisted cystic duct, arteriovenous vein, and hepatic duct, feeling very helpless.
There was no room for resection and suture. If it was too short, there was a high chance that the ligation thread would fall off and other problems. However, if the various tissues were not untied due to the twisted gallbladder, there was no way to perform a cholecystectomy.
"Can I try?" Zheng Ren asked politely.
Chief Sun was overjoyed and nodded repeatedly.
Why did he ask you to come? Wasn't it just surgery? However, Chief Sun did not dare to say it out loud.
In the hospital, it was one thing to consult on stage.
If he did not ask for the surgeon's opinion and rashly performed the surgery, the meaning of contempt would be too strong and the hatred would not rest until he died.
After asking, Zheng Ren went to wash his hands and change his clothes.
"Little Zheng, come over here," Chief Sun called after Zheng Ren changed his clothes.
Zheng Ren hesitated for a moment but still chose to go to Chief Sun's position.
The surgeon's angle was undoubtedly the best. Only in some special circumstances where the surgeon's angle was limited could the position of the first assistant be used as a supplement.
Chief Sun moved to the side and Zheng Ren did not stand on ceremony. He directly stood in the surgeon's position and focused on examining the gallbladder.
Originally, Chief Sun was performing a laparoscopic cholecystectomy but found that the situation was special during the surgery and changed to an open surgery.
After opening the abdominal cavity, the problem could not be solved. It was the first time that Director Sun had encountered a gallbladder that was twisted like an 18th street fried dough twist.
If it had been a few hours earlier and the gangrene had not appeared, the surgery would have been relatively simple. It would have been easier to untie the gallbladder root tissue.
However, after a few hours of evolution, a large amount of exudate had become entangled with the gangrenous cystic duct and hepatic duct. It was likely that the tissue would tear at the slightest movement.
If that was the case, the consequences would be unimaginable.
No one drove in the entire operating theater, not because of Director Xiao but because the patient's condition was very troublesome.
Usually, when faced with such a problem, the surgeon would not be in a good mood. At this time, they were still driving and joking. The overbearing chief director threw a pair of hemostatic forceps at them.
Zheng Ren reached out and paused for a moment. He realized something and whispered, "Hemostatic forceps."
The pliers were slapped on Zheng Ren's hand. The force was a little strong, and Zheng Ren did not feel good.
The blunt dissection of the surrounding edematous and adherent tissues made Chief Sun tremble in fear. Little Zheng was really bold. This kind of edematous tissue was very fragile. If he didn't use force, he wouldn't be able to break it down. If he used too much force, it was very likely that it would cause irreversible tears.
"Scissors," Zheng Ren said after a few minutes.
A pair of scissors landed on his hand.
After a quick glance, he placed the scissors on the patient's leg and said, "Blunt scissors."
The scrub nurse was stunned for a moment. Then, she picked up the blunt scissors and slapped it.
'It's really not easy to use someone who's not my scrub nurse,' Zheng Ren lamented in his heart.
But to replace Xie Yiren? It seemed to be too much. It was better for him to bear with it.
"Retract the hook a little higher."
"Apply force with the appendix retractor."
"Here, help me clamp it with hemostatic forceps. Pay attention to the strength."
Zheng Ren kept talking to the first assistant. The time it took for the first assistant to change the retractor seemed to be longer than the surgery.
Director Xiao shook his head. Chief Sun and his subordinates were really embarrassing in front of a foreign expert.
However, he could not say anything at the moment. Everything had to wait for the surgery to be completed.
Only Zheng Ren's voice kept ringing in the operating theater. His voice was not loud and emotionless, but the constant reminders made the first assistant feel more and more embarrassed.
Anger burned in his heart.
In his opinion, as long as there was enough vision, the surgeon would be able to use the retractor. Zheng Ren was nitpicking!
If there was a problem in the surgery, he could simply say that the assistant's skills were poor and the responsibility would be reduced by 30%.
"Prepare the 3 # 0 non-invasive suture. Use the smallest needle," Zheng Ren said again. "Expose the liver with the small retractor."
The little monster in the chief resident's heart was about to go berserk.
"Don't shake. Yes, hold on if you're tired."
The little monster continued to grow and could vaguely breathe fire.
"I want blunt dissection of the liver capsule. Help me expose the field of vision.
"Fix the retractor position. Don't move."
A long retractor was a huge test for the assistant's stamina.
The chief resident could not understand what Zheng Ren was trying to do, so he could not predict the next step to the surgeon's satisfaction.
Zheng Ren lowered his head and performed the surgery. He talked to the first assistant and the scrub nurse more and more.
The atmosphere in the operating theater was strange and a little awkward.
The little monster in the first assistant's heart had grown into a Godzilla. If he had not been patient and wanted to publicly expose Zheng Ren's inability to perform the surgery and push the blame onto himself, he would have left a long time ago.
"Boss, should I do it?" Su Yun's voice came from behind the crowd.
"The patient has been sent to the ICU?"
"Yes, his condition is stable, but there are many fractures and a lot of blood loss. Let's replenish the blood first and deal with any complications. It's just that fibrinogen is more difficult to find. I've asked Chief Qian to contact him, but it's hard to say if he can find it, "Su Yun said calmly.
"Chief Sun?" Zheng Ren asked softly. His voice was so soft that only Chief Sun and the first assistant could hear him.
The first assistant understood Zheng Ren's meaning. The veins on his forehead were popping.
"Little Lei, rest for a while. Su Yun, come and help." Chief Sun gave the chief resident a way out.
Su Yun immediately went to wash his hands and put on his clothes.
"How do we do it?" After going on stage, Su Yun was stunned when he saw the patient's organs.
"Liver split." Zheng Ren's answer was simple.
However, this word was like a thunderclap. It did not hit the liver, but the heads of the doctors present.
Liver split surgery was mostly used to remove liver cancer that was three to five centimeters long. Moreover, most doctors had not mastered this technique.
After all, the liver was fragile and rich in blood vessels. After a wedge-shaped resection, suturing the liver tissue to stop the bleeding was a huge problem.
After Su Yun asked for the surgical method, he turned to the operating theater nurse and smiled. He asked for a large number of instruments and placed them on the side of the patient's leg.
The operating theater was finally quiet.
Su Yun was prepared for Zheng Ren's every move in advance. Whether it was retraction, exposing the field of vision, hepatectomy, hemostasis, or suturing.
The surgery was smooth and pleasing to the eye.
The degree of tacit understanding between them and the previous chief resident of the second general surgery department … could not be compared at all.
One was in the sky, and the other was on the ground.
A section of liver tissue was cut, the bleeding was stopped, the cystic duct, hepatic duct, arteries and veins were blocked, and the gallbladder was removed. Once again, the bleeding was stopped, and the liver split was continuously sutured …
The little monster in the heart of the second general surgery department's chief resident was immediately crushed.
It was not that Zheng Ren was too troublesome, but that he was indeed not skilled enough.
Looking at the cooperation between the two, and then thinking about his previous cooperation, the chief resident covered his face and left.
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