"No." Zheng Ren passed the aspirator to Su Yun and opened the peritoneum for peritoneal protection.
The chief of thoracic surgery was a short, plump man with a sterile mask and a wretched look on his face.
He was notorious for being petty and vindictive. Few people interacted with him unless it was an important matter.
Chief Zhang felt awkward and hesitated in front of the operating table.
Seeing that there was no response from the other side, Old Chief Physician Pan, who had just returned from urging the blood transfusion department, heard the conversation and glared at him.
The thoracic surgery department was not to blame. Yang Lili's blood pressure was still undetectable and the possibility of surviving a thoracotomy and laparotomy at the same time was slim.
"Exploratory thoracotomy," Old Chief Physician Pan said when he noticed Chief Zhang's hesitation.
Chief Zhang would have rejected the surgery if not for the hospital leaders in the operating theater.
He wanted to say, 'What's the point of struggling when she's already dead?'
The blood pressure on the ECG monitor was still undetectable and her heart rate was extremely fast. Atrial fibrillation had already started.
However, the emergency general surgery was done quickly. He had only been standing there for a few minutes and they had already found the damaged mesenteric artery and started ligating it.
Director Zhang sighed and said, "I'll try my best."
"Su Yun, go help Chief Zhang." Zheng Ren did not even look up. He reached out and a warm saline gauze landed on his hand. He covered the intestines to see which sections showed signs of necrosis and looked for stab wounds.
Huh? Chief Zhang was stunned. He glanced at Old Chief Physician Pan out of the corner of his eye. Old Chief Physician Pan did not object to Zheng Ren's words.
Chief Zhang knew that the emergency department had 'snatched' the emergency general surgery. Was it going to snatch the thoracic surgery this time?
The emergency department did not have many guns, but their appetite was huge.
Su Yun did not look at Chief Zhang and turned to leave the operating theater to disinfect the incision. He then scrubbed in and put on a surgical gown.
Chief Zhang was helpless. What the f * ck was going on?
However, he could not afford to lose his temper in front of so many hospital leaders. It was mainly because Old Chief Physician Pan was a mountain that he did not dare provoke.
If it happened … Liu Tianxing was still hospitalized. Rumor had it that he was suffering from liver disease.
Chief Physician Zhang began to communicate with the head nurse of the emergency operating theater. He wanted to go to the operating theater to retrieve the sterile bag from the Thoracic Department.
Su Yun ignored Chief Zhang. After disinfection, he began to lay out the sheet and scrub in. Standing beside Zheng Ren, the two surgeries began at the same time.
Xie Yiren became even busier.
Because it was an unconventional tactic, the tacit understanding without words became an extravagant hope.
Zheng Ren and Su Yun kept asking for equipment in low voices. Xie Yiren was barely able to keep up.
Chief Surgeon Zhang instructed the matron of the operating theater about the sterile bag and sent his chief resident to retrieve it. When he turned around and saw that Su Yun's chest had been cut open, he was furious.
"Are you kidding me? You're going to operate blindly without equipment?! This is a thoracic surgery, not an emergency surgery! "
What he said made sense. There were ribs in the chest, so special instruments were needed to open the chest wall and expose the surgical field. The general surgery department could use a few retractors, but the thoracic surgery department could not.
If it had been twenty years earlier, a rib would have been amputated to widen the surgical field.
It made sense, but in the emergency department, every minute and second was more precious than gold.
Su Yun was focused on the thoracic surgery. The rising star of the cardiothoracic department had his own confidence and pride. Why would he care about the clamor of a chief physician in Sea City General Hospital?
No one paid attention to him. Zheng Ren and Su Yun were busy. Director Xiao and Old Chief Physician Pan stood behind Zheng Ren, focused on the surgery and did not seem to hear Chief Physician Zhang's words.
Chief Physician Zhang was helpless and did not dare to complain too much, so he could only scrub in.
Two surgeries at the same time could not accommodate so many people. Usually, a thoracic surgery required at least three people to perform. However, at this moment, only Chief Physician Zhang and Su Yun were doing it.
Yang Lei, who was the first assistant, was the busiest person in the room.
He had to retract the retractor and pass the equipment at the same time.
Zheng Ren was multitasking, his eyes on Su Yun.
Su Yun's skillful technique showed that he was indeed a doctor from the thoracic department. He was much better than the general surgery department.
In fact, Zheng Ren had asked Su Yun to assist Chief Physician Zhang because he had seen Su Yun's heart transplant surgery in Imperial Capital.
How could an emergency surgery not be able to handle a top-notch thoracic surgery?
What a joke!
To better coordinate with Su Yun, Zheng Ren did not hesitate and added a Master-level skill book to the cardiothoracic surgery skill tree.
Yang Lili was stabbed twice in the chest. She struggled with all her might to hold on to the attacker's arm and was stabbed several times in the abdomen.
Her liver and spleen were unharmed, but there were seven or eight lacerations in her intestines, some of which had even been penetrated.
The peritoneal cavity was severely contaminated.
After rinsing and aspirating with warm saline repeatedly and ligating part of the injured mesenteric artery, the surgical field became much clearer.
Repairing the damaged intestines was a small problem. Zheng Ren moved the needle and thread quickly and quickly repaired every part.
The main problem was that the patient's mesenteric artery had been punctured, resulting in mesenteric ischemia and necrosis. After ligating part of the mesenteric artery, the part of the intestine that supplied blood to the ligated artery would inevitably suffer necrosis.
The main task of abdominal surgery was to remove and anastomose the intestines.
However, it was best for Zheng Ren to have an assistant. If not, he could do it alone.
Gradually, Yang Lei helped Su Yun more. On Zheng Ren's side, he only pulled the retractor to help expose the skill field.
Even the knotting and thread cutting were all done by Zheng Ren himself. Holding the scissors in his palm, it appeared and disappeared like magic. It did not delay his hand movements at all.
The necrotic part of Yang Lili's intestines was about 60 centimeters long, which was acceptable. Any longer and Zheng Ren would have to be careful of postoperative complications such as jejunal syndrome.
Fifteen minutes after the laparotomy, Zheng Ren had removed the necrotic intestines and anastomosed the normal intestines.
Fresh frozen red blood cells and plasma had just been retrieved.
"One bag each." Old Chief Physician Pan picked up a bag of red blood cells and warmed it with both hands.
Director Xiao frowned as he watched the surgery.
However, when he saw the blood being delivered, he asked Chief Physician Ding to bring him a bag of red blood cells as well.
With the director's example, none of the hospital leaders dared to say no.
"The blood transfusion department is out of blood," said the matron of the emergency operating theater after picking up the phone.
"Chief Physician Ding, contact the blood bank in the city center," Director Xiao said. "Prepare at least 20 units of red blood cells."
"Platelets and fibrinogen, too." Su Yun continued the surgery but kept an eye on the situation behind him.
Director Xiao had a clinical background and knew that even if the patient could be removed from the operating table, she would still have to deal with multiple organ ischemia-reperfusion injuries and DIC complications after a large amount of blood transfusion.
He nodded.
Chief Physician Ding immediately ran out to make a call to the central blood bank.
Soon, he ran back and whispered to Director Xiao, "Director, the central blood bank is running out of B-type RH-positive blood."
The city's blood supply came from the blood bank in the city center. Some rare blood types, or blood types that have been used more recently, may not have enough blood.
"Contact the blood bank and the hospital and find someone with the corresponding blood type to donate. Hurry! "Director Xiao's face was ashen as he watched the surgery.
"Okay." Chief Physician Ding left the operating theater to deal with these matters.
Under normal circumstances, even if someone donated blood, the central blood bank had its own set of cumbersome procedures that would take at least a day to transfuse.
At this time, the words of the director of the city's largest hospital carried a certain amount of weight.
Zheng Ren felt more at ease as he listened to the rest of the conversation.
The hospital's presence meant that there would be no shortage of platelets or fibrinogen.
These two things were necessary for the patient to survive the surgery, but they were rare nowadays, especially fibrinogen.
Due to the lack of fibrinogen, many portal-azygos disconnection surgeries could not be performed.
After the intestinal anastomosis was completed, the wound was covered with warm saline gauze for five minutes. Zheng Ren checked the peritoneal cavity to make sure there were no untreated injuries. He removed the gauze and saw that there was blood on both ends of the intestinal anastomosis.
This proved that there was no necrotic tissue left and postoperative intestinal anastomosis should not be a problem.
He rinsed the peritoneal cavity and began to close it.
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