The Surgeon's Studio c1-799

by Black Ursa Prime

Her fair-skinned hands were clean and unpolished, natural like a beautifully carved jade.

  Zheng Ren could even detect her infinite love for delicious food as she opened the bags of food one after another.

  There was a gleam in her eyes as she elaborated on their taste and texture.

  'She is a typical foodie,' Zheng Ren thought.

  He did not have much love for food and considered it a means to fill his stomach. If there was no hunger and food was not required for his survival, he would probably choose not to eat at all.

  Eating was simply a waste of time.

  "Try this, it's very delicious. Unlike ordinary rib fingers, you can actually savor the depths of flavor in your mouth.

  "Try this. It'll stimulate all your taste buds without giving you a greasy feeling and make your heart explode with joy."

  "..."

  Zheng Ren tasted each dish while listening to Xie Yiren's enthusiastic descriptions. He failed to detect the depths of flavor, nor did he experience explosive sensations on his taste buds.

  "How are they?" asked Xie Yiren with her big, round eyes full of excitement.

  "Delicious," answered Zheng Ren against his conscience.

  In his opinion, this was merely food, and the only differences lay in their content—protein suppressed appetite for a longer period of time.

  However, his strong instinct for survival prevented him from blurting out the truth. No matter how insensible he was, he had to show some respect for his precious life.

  "My bestie, the one hospitalized in the gastroenterology department for acute pancreatitis a few days ago and discharged recently, also went for a barbeque today." Xie Yiren smiled, her crinkled eyes like crescent moons. "She liked it and ate a lot as well."

  "She had acute pancreatitis, it's best not to binge-eat." Zheng Ren was a killjoy.

  "She had recovered anyway. Besides, she wasn't really binge-eating because her stomach could only expand so much." Xie Yiren argued.

  "Have they gone home?" asked Zheng Ren.

  "They wanted to play mahjong after dinner, but it's alien to me, so I sent them back to my house first before delivering food to you. I think they're still in the middle of their game."

  'They're really indulging themselves,' Zheng Ren grumbled internally about their luxurious lifestyle.

  "I'm afraid to stay alone in a house, anyway. The more the merrier, right?" continued Xie Yiren as she stared at Zheng Ren happily, anticipating compliments whenever food entered his mouth as if she was savoring the taste herself.

  In order not to disappoint Xie Yiren, Zheng Ren ate very slowly while racking his brain for numerous compliments every time he took a bite of the barbecued meat.

  This was more… agonizing than when he had faced the young robber just now.

  The thought popped up naturally without him actually realizing it.

  Suddenly, his phone rang while he was halfway through the meal.

  His heart rate that had normalized once again accelerated to more than 110 beats per minute. When a chief resident's cell phone rang, especially for doctors like Zheng Ren, it usually meant the arrival of an emergency case.

  "Chief Zheng, there is a patient with a stab wound in the emergency department. Please come down and take a look at him."

  Chapter 142 - Don't Use Knife In A Quarrel (Part I)

  After telling Xie Yiren to summon the group of p.l.e.a.s.u.r.e-seeking doctors for overtime, Zheng Ren stuffed the rest of the meat into his mouth.

  In the emergency department located on the first floor, a woman helplessly stood in the resuscitation room, covered in blood with fear written all over her face.

  Zheng Ren quickly reentered the emergency department and glanced at the patient on the bed. On the upper right corner of his vision floated the System panel with a diagnosis painted in light red—splenic rupture complicated with hemorrhagic shock.

  "A forty-five-year-old man was stabbed on the left upper quadrant of his abdomen an hour ago. His blood pressure was at 80/60mmHg upon arrival at the hospital," the emergency doctor on duty in the general surgery division reported, "An emergency B-scan ultrasonography revealed a 3.5-centimeter deep effusion that did not reach the thoracic cavity."

  The spleen was located below to the left diaphragm, so it was necessary to rule out a thoracoabdominal injury when managing a trauma patient.

  If the patient had a collapsed lung and required artificial ventilation in the operating theater… Death would be imminent.

  Even though the System did not report a punctured lung or traumatic pneumothorax, Zheng Ren remained vigilant and examined the man's respiratory system with a stethoscope. Air entry was equal on both sides of the lungs without any crackles or rales.

  This should be an uncomplicated trauma case.

  "Where are his family members?" asked Zheng Ren.

  "There she is." The doctor furtively pointed at the stunned woman in the resuscitation room. "I heard she stabbed her lover in an argument."

  "..."

  What a tough woman!

  However, Zheng Ren had no d.e.s.i.r.e to resolve a lovers' quarrel. He called out to the woman and brought the patient to a thoracoabdominal CT scan to ensure the absence of pneumothorax before pushing him to the emergency operating theater.

  Su Yun, who was already waiting at the entrance, wheeled the patient into the operating theater along with one of the Chu sisters while Zheng Ren proceeded to change out of his attire.

  Judging from the patient's blood pressure, his condition was actually not serious.

  'Perhaps I don't have to remove his spleen,' Zheng Ren thought after judging the situation.

  He changed, performed a surgical scrub and put on a gown.

  The Chu sisters had anesthetized the patient and Su Yun had performed all necessary preparations such as disinfection and application of surgical dr.a.p.es on the operative site. All of them were solemnly standing by beneath the surgical lighthead and waiting for Zheng Ren to march into the battlefield.

  Zheng Ren had a feeling that he was now a professor, something that he still had not gotten used to. After all, Su Yun's current tasks had been his responsibility during his time in the first general surgery department, and the chief surgeon had occasionally disallowed his participation after surgical dr.a.p.es had been applied.

  He had decided on a course of action after thinking about it along the way.

  A surgical scalpel was placed on his outstretched hand.

  Zheng Ren then made a 20-centimeter incision along the left costal margin.

  The surgery was broadcast live in Xinglin Garden at the same time.

  [The god hasn't broadcast his surgery in a while.]

  [What's this case about? Huh? It's a rare case of splenic rupture.]

  [It's an uncomplicated case of splenic rupture and the blood pressure isn't dangerously low either. Just perform a splenectomy and the patient can be discharged in a week, not a big deal at all.]

  The first batch of viewers chatted leisurely before the surgery officially began.

  A simple splenectomy posed no difficulty for all general surgeons.

  After all, destruction was always easier than construction.

  [That's a big and wide incision. I think this host surgeon is different.]

  [Who knows? You can actually see some similarities in their techniques.]

  [Fast, isn't it? It's just a splenectomy, how slow can you go?]

  In the livestream, an aspirator with suction tube was plunged into the peritoneal cavity once an opening was created on the peritoneum. Viscous, dark red blood gurgled up the tube.

  The blood around the incision was soon extracted. Pushing the aspirator deeper into the cavity, the host surgeon opened the peritoneum and put protective measures on the peritoneal membranes.

  [A surgical assistant really makes the operation much easier.]

  [Of course, that's why there is a saying, "you can't perform a surgery alone."]

  [Watch the host surgeon's past surger
ies; most of them had been completed single-handedly. A surgical assistant would shorten the surgery by a few minutes at most.]

  The doctors watching the livestream had an inexplicable confidence in the host surgeon, developed after observing hundreds of amazing surgeries.

  When the peritoneal membrane was protected, it was time to expose the peritoneal cavity.

  Su Yun aspirated the remaining blood in the cavity while Zheng Ren inspected the spleen and found a two-centimeter wound with blood constantly oozing out of it.

  The wound was compressed with a sterile gauze to minimize blood loss before Zheng Ren quickly examined other abdominal organs such as the liver, pancreas, stomach, retroperitoneal blood vessels, surrounding intestines and duodenum.

  Fortunately, it was just a simple splenic rupture; the same diagnosis given by the System.

  Massive hemorrhaging had caused the ruptured spleen to shrink without adhering to the surrounding tissue. Zheng Ren took it out of the wound and carefully passed it to Su Yun.

  [Wow, what is the host surgeon going to do? Repair the spleen?]

  [Sure looks like it. This patient's injured spleen can be surgically repaired.]

  [Unless the spleen is severely ruptured, we would normally proceed with repair. A splenectomy is simply too easy.]

  [Can you stop bullsh*tting? If something goes wrong during a splenic repair surgery, the patient would most likely have to go for reoperation.]

  Many doctors watching the livestream had their own opinion on whether to proceed with surgical repair or the more violent method—direct removal of the ruptured spleen.

  Doctors with slightly inferior skills rarely had the courage to repair a ruptured spleen.

  The post-segmental nephrectomy hemorrhaging that Zheng Ren had treated a few days ago posed the same risks that now plagued this spleen.

  Both the kidney and spleen were fragile organs. During repair, suture knots would not hold in mild injuries, and any unnecessary increase in strength would cause a secondary rupture in severely traumatized organs.

  After passing the ruptured spleen to Su Yun, Zheng Ren used several pieces of large sterile gauze to fill the splenic fossa.

  The entire procedure was done speedily and cautiously without causing any secondary damage to other organs.

  Su Yun had already examined the direction and depth of the wound while Zheng Ren was busy compressing the splenic fossa.

  The wound was located on the superior border of the spleen with a depth of approximately three centimeters.

  After Zheng Ren filled the splenic fossa with gauze, he reached out again for a needle holder along with a suture thread.

  A standard 3# suture needle was used, along with an absorbable suture thread size 1-0.

  Su Yun held the ruptured spleen firmly for Zheng Ren to close the wound using the vertical mattress suture technique.

  [Er… Why is the host surgeon moving so fast? Are they not worried about secondary tears?]

  [They know what they are doing. After all, they have performed this procedure multiple times, so they can't slow down even if they want to.]

  [That's still so scary. One time I repaired a ruptured spleen and accidentally tore it due to excessive strength.]

  This was not a standardized surgical procedure. Some surgeons from lower-ranked hospitals had never performed surgical repair of a ruptured spleen in their entire career. They would usually proceed with a splenectomy to prevent secondary injuries that could require reoperation.

  Following closure of the wound, Zheng Ren placed the needle holder beside the patient's t.h.i.g.h. Xie Yiren then picked it up, wiped the blood off and placed it onto the instrument table while stealing a peek at Zheng Ren's movements from time to time.

  After a surgical knot was made, Xie Yiren gently placed a pair of scissors on Zheng Ren's outstretched palm.

  Excessive suture thread was cut and thrown away, and the wound was irrigated with warm normal saline.

  Everything was done according to protocol.

  Chapter 143 - Don't Use Knife In A Quarrel (Part II)

  Warm normal saline was used to irrigate the peritoneal cavity. Even though the surgery completion rate on the System panel was high and would reach 100 percent following the closure of the abdominal surgical wound, Zheng Ren still cautiously examined the peritoneal cavity for any active bleeding spots.

  This was probably a type of obsessive-compulsive disorder that every surgeon suffered.

  A detailed examination was absolutely necessary as reoperation due to postoperative hemorrhaging would be more damaging to the patient than simply undergoing one surgery.

  A reoperation had a higher risk of complications.

  Two thousand milliliters of warm normal saline was poured into the peritoneal cavity and aspirated until the fluid gurgling along the tube became light-colored and less turbid. Then, Zheng Ren and Su Yun closed the abdomen together.

  Chu Yanran had been observing the patient's vital signs and progression throughout the surgery.

  At the beginning of abdominal wound closure, she made a note on the intraoperative anesthesia record and prepared medication for the patient's anesthesia recovery.

  On the other hand, Chu Yanzhi chatted leisurely with Xie Yiren for a while and stood behind Zheng Ren and Su Yun to observe the surgery's progress from a different angle.

  Each abdominal wall layer was sutured accordingly. As the last layer was being sutured, the patient gradually began to regain consciousness.

  Since he had been admitted just in time, blood loss remained minimal and he merely suffered mild hemorrhagic shock. Thus, he did not need to be intubated or ventilated post-surgery.

  However, due to a lack of nurses in the emergency department, Zheng Ren decided to transfer the patient to the ICU for one night.

  The cost of treatment in the ICU would not exceed ten thousand yuan a day. If the patient's postoperative blood tests revealed a hemoglobin count over 80, blood transfusions would be unnecessary.

  He could get through the recovery phase with his hematopoiesis alone.

  Following the completion of surgery, Zheng Ren remained onsite to assist with the patient transfer to a stretcher trolley, which was then escorted to the ICU by Su Yun and Chu Yanran. After that, he took a shower and changed his clothes before returning to the emergency ward.

  Su Yun was nowhere to be seen as he was adhering to standard procedure.

  Since it was a postoperative emergency surgical case, Su Yun would normally stay in the ICU and monitor the patient for one to two hours. When the patient's condition had stabilized and no additional treatment plan was required, only then would he return to the emergency department.

  An hour later, Zheng Ren informed the nurses on duty of his temporary absence before putting on a white coat and heading to the ICU to check on the postoperative patient's condition.

  Unless the surgery was very simple, every surgeon would do this as long as conditions permitted.

  In the ICU, the patient had regained consciousness and his condition had stabilized.

  However, analgesia had been administered for the pain at the incision site, so he was currently asleep at the moment.

  Monitors revealed that the patient's vital signs were stable as well. However, Su Yun was not making calculations with pen and paper by the ventilator and various monitors as he did the other critically ill patients.

  Instead, he was chatting leisurely with the nurses.

  Zheng Ren had no idea what they were talking about, but he could clearly see the euphoric smiles on the nurses' faces as they spoke softly.

  Apart from the slight discomfort of the ventilator tube, the old man with a ruptured hemangioma had basically stabilized and his blood pressure had normalized as well. Zheng Ren then explained the situation outside to him and calmed him down.

  He was recovering well, which was a good sign.

  Zheng Ren smiled and left.

  All the chairs in the corridor were fully occupied with multiple sl
eeping bags laid all across the floor, but he had no idea if the patient's lover was among them.

  That was usually the case in the ICU. Family members were restricted from entering at all times, which was a necessity to prevent transmission of bacteria to patients' exposed airways which could lead to secondary bacterial infection. Thus, they had no choice but to sleep outside, even on the floor as the hospital did not have a lounge.

  The patient who had undergone surgery today was considered a minor case and could be transferred out of the ICU the next day, so his family had to suffer for only one night. However, for patients who were critically ill and relied on ventilators for life support, their families would be forced to wait outside indefinitely.

  Zheng Ren called out the family member's name several times. His voice was loud but not deafening.

  A sound could be heard from the fire escape, so he pushed open the door to have a look.

  Tang Xiu and the middle-aged woman were smoking in the fire escape.

  Upon seeing Zheng Ren, Tang Xiu was momentarily stunned and subconsciously offered him her fashionable cigarettes.

  Zheng Ren waved his hand in response.

  "The patient is recovering well, so you can expect a transfer out of the ICU if everything goes well," said Zheng Ren.

  The news exhilarated both Tang Xiu and the middle-aged woman, but they were soon in doubt. Which patient was Doctor Zheng referring to?

  Zheng Ren also smiled. "Both are fine."

  This put their weight off their minds.

  "Lovers' quarrel?" Zheng Ren pretended to be relaxed and asked tentatively.

  Embarrassed, the middle-aged woman bit her lip and nodded.

  "Why did you use a knife?"

  "He is an honest man, but there are lots of wedding ceremonies this month and he asked for money to be gifted as a wedding present," the middle-aged woman said in defense, "You also know that high school tuition fees are very expensive and each make-up class costs a few hundred yuan. Both of us are ordinary employees who earn just enough money to live on. The money he requested was basically all of our savings."

  "You don't have to use a knife either." Zheng Ren smiled kindly. "Now you have to pay more for the treatment fee."