Chapter 49

“The femoral artery is severed, with three large pieces of glass nearby.” Song Zimo turned to look at the CT scan on the light box.

Yang Ping was looking for the second piece, saying, “You’re pretty smart, being able to see all three.”

Song Zimo said, “Don’t be smug. I’m getting much faster at vascular anastomosis on newborn mice with fragile blood vessels. I’m catching up with you.”

As Song Zimo spoke, he constantly adjusted the retractor in his hand. He was indeed smart, anticipating where Yang Ping would look next, making adjustments in advance so that Yang Ping always had the best field of vision.

Actually, handling the retractor well is a skill. If done correctly, the surgeon can maintain the best surgical view without noticing the retractor.

“Should I shine the light in?” the circulating nurse asked.

Song Zimo said, “No need.”

At this moment, what matters is one’s ability to position accurately, spatial imagination, the feel of forceps in hand, preoperative precision spatial positioning based on imaging, and identifying different tactile sensations when the metal touches glass and soft tissue during surgery.>

At this point, the surgical instruments act as extensions of the surgeon’s fingers.

“You have acne all over your face, standing so close, when the blood sprays–” Little Five handed over a face shield.

Scared, Zhang Lin immediately moved away from the operating table, involuntary remembering a story from his internship. During an internship, a classmate was sprayed with a trauma patient’s blood in the emergency department. The classmate had a face full of acne and only discovered the patient had AIDS after saving his life.

Immediately reporting occupational exposure, he then went for blood tests and took AIDS blocking medicine for four consecutive weeks. Blood tests were performed periodically for half a year. During those six months, his weight plummeted from over 80 kilograms to barely 80 pounds. A return to normal life only happened after confirmation he was fine.

With such thoughts, Zhang Lin retreated a few more steps, putting on the face shield from Little Five.

The second piece was detected but could not be removed, as it was adjacent to blood vessels and nerves. Any abrupt removal could damage these.

“Light!” Song Zimo, as an assistant, was absolutely perfect.

Without Yang Ping’s reminder, he held a retractor in one hand and the sterile handle of the surgical lamp in the other, precisely directing the light.

The suction device extended in, drawing blood away. As Yang Ping moved to adjust the retractor, Song Zimo gently let go, allowing Yang Ping to reposition the retractor.

Suddenly, a pair of scissors was already in his hand. He used them to sharply dissect the tissue surrounding the glass, fully exposing it.

Indeed, an artery branch was right next to the glass. Yang Ping carefully removed the glass, a fragment of green beer bottle.

“How deep was their hatred? The groin was pierced badly, with shards of beer bottle left inside,” Zhang Lin exclaimed.

Little Five said, “Fighting over a woman in a nightclub, two groups of men got out of hand.”

Zhang Lin corrected, “Not two groups of men. I heard he fought ten men by himself.”

What exactly happened was a matter for the police. Doctors only need to treat and save people.

Su Yixuan stopped their chatter: “Quiet.”

The other nurses might argue sometimes, but they wouldn’t dare with Su Yixuan. Little Five made a gesture to keep quiet and Zhang Lin didn’t dare to speak again either.

“There’s one piece left, and it’s gone into the pelvic cavity.” Song Zimo adjusted the light again.

With the local anatomy of this area etched in his mind, he could build a 3D image even with his eyes closed. After hundreds of attempts to save patients with ruptured external iliac arteries, he had a clear understanding of the anatomy and its variations.

He dissected along the vessels and nerves upward, into the retro-peritoneal space of the pelvic cavity, and the third piece appeared. It was easily removed, and the surrounding area was examined. The peritoneum was not ruptured.

Large quantities of saline flushed the surgical area. A detailed investigation again revealed both the femoral artery and vein were severed. The femoral nerve was thankfully intact, the outer layer only exposed through a small incision, with the nerve bundles inside unaffected.

“Needle and thread!”

Su Yixuan placed the needle and thread on the dish, passing it over. This way, by transferring items via the dish, the chances of inadvertent injury were minimized. Yang Ping picked up the needle and thread, holding a needle holder in his right hand while his left hand held a long-toothed tweezer.

This type of vascular anastomosis was incredibly simple for him.

In just over a minute, he had trimmed the blood vessels, completed the anastomosis of the artery, and ligated the vein.

After releasing the clamps on the external iliac artery and vein, there was no bleeding.

Then, another rinse, layers of suturing, insertion of a drain.

Last, applying a dressing neatly.

In the right corner of Yang Ping’s vision, a window and caption appeared: “Task complete, gained 6000 points.”

The entire process went incredibly smoothly, especially the extraction of the glass shards, which totally impressed Song Zimo.

Speaking of foreign object retrieval, it’s a minor task, but it’s not easy to handle this minor task exceptionally well.

Many doctors become frustrated as they use a C-arm X-ray machine for a tiny foreign object, they may find the object on the screen, but not able to retrieve it, and they can’t help it.

Dr. Jin in our department once locked himself away to study the X-rays, surface ultrasounds, CT scans, and MRIs of all foreign objects in the hospital because he failed to extract one. He drew hundreds of diagrams. Years later, whenever there was a foreign object that couldn’t be removed, they turned to old Jin who always removed it with ease.

No joke, a senior director may well perform a cervical spine surgery easily, but sometimes fails to take out a tiny foreign object. Many even make a long incision and rummage through it, only to close it in vain.

Foreign objects can be quite tricky sometimes. Song Zimo spent a great deal of time asking old Jin and studying the space localization of medical imaging to remove foreign objects. He finally outperformed old Jin.

Now these pieces of glass, Yang Ping took them out in a breeze.

Song Zimo admired Yang Ping even more and couldn’t figure out the limit of Yang Ping’s capability.

The patient was sent to the ICU, all the sterile sheets and clothes had to be disposed of through a special channel, and the surgical instruments went through a special sterilization process.

“How’s everything going for Director Tian?” Yang Ping wanted to see if there were any ways he could help.

Little Five and Zhang Lin didn’t know, because this was an infectious surgery, they couldn’t freely visit other operating rooms. They would be kicked out if discovered by the patrol nurse from another operating room.

Since no one had been called over to ask for help, Director Tian probably didn’t need any. Tian was a well-rounded surgeon who could easily handle any kind of surgery, and it was unnecessary for Yang Ping to check on him especially after just performing a surgery on an AIDS patient.

Song Zimo led Little Five and Zhang Lin to send the patient to the trauma ICU, having already advised the ICU to prepare an isolation ward in accordance with the standards for isolating body fluids and blood.

Yang Ping had a shower in the changing room and sat down to rest for a while.

He was very familiar with the anatomy of the part he operated on today. His recent practice with wire and needle techniques had further improved his spatial localization skills, which made the surgery so easy. It might not be this smooth if the location of the procedure was different.

He must take every opportunity to train his skills of removing foreign objects and spatial positioning in the system.

He opened the window and checked he had accumulated 14,000 points, bringing him one step closer to purchasing the pelvis fracture training.

Once he nailed the pelvis fracture, his trauma orthopedic techniques would be considered comprehensive.

He closed the system window when Little Five called.

“Boss, the hot pot is still waiting for us. We’ve just showered in the department, let’s meet at the front gate of the Surgical Building.”

His stomach was growling, he was starving. Yang Ping thought, if only reality was like the system, where he didn’t need to eat, drink, or sleep, life would be so much easier.

But that was impossible.

They went back to the mutton hot pot shop which was still bustling with activity. The table had been saved for them.

The fire had been put out, but the food was still there.

Seeing them coming, the waiter quickly helped relight the fire.

The waiter said, “I told the boss that you guys are doctors from Sanbo Hospital. The boss said he’d keep this table reserved for you until dawn.”

Such a magnanimous boss, if this was ancient times, he would be a great hero like Chai Jin.

Everyone sat down and started adding ingredients into the pot before the soup even started boiling.

Zhang Lin directly stuffed raw cabbage into his mouth, chewing it with great enjoyment.

This is what hunger truly means.

“Tell your boss, we all appreciate his hour. If he ever strains his waist, he doesn’t need to book an appointment, just come look for me directly,” said Zhang Lin.

At that moment, the boss came over. He was in his forties, skinny, and spoke with a Chaoshan accent. “This meal is on the house, thank you for reattaching my son’s hand.”

“Your son?” Yang Ping asked. He had reattached so many hands, he had no idea who the boss’s son was.

The boss pointed to his hair. “That blonde kid, he got mad at me and went to work at Hongda Factory. He crushed his hand.”

It was him, he should have said so earlier.