Chapter 421: Laparotomy

Ling Ran scrubbed his hands seriously.

Scrubbing hands required time for thorough disinfection and sanitization. Although the patient in the operating theater was in critical condition, Ling Ran did not feel nervous with his assistants behind him.

The doctors in the same group with Huo Congjun still wandered around the patients with crush injuries, hence Lu Wenbin, Yu Yuan, and Zuo Cidian in Ling Treatment Group obtained a chance to operate on this patient, but they were slightly lost in the operating theater.

In other treatment groups, there would be one or two senior attending physician or associate chief physicians beneath the chief physicians or associate chief physicians who shouldered great responsibilities. The junior resident doctors like Lu Wenbin would not be able to be the chief surgeons unless it was a job that involved the removal of foreign objects or fish bones.

Naturally, Lu Wenbin was not considered a chief surgeon now as well. He was just standing at the position of the chief surgeon.

“What should I do?” Lu Wenbin asked Yu Yuan who stood at his side.

Yu Yuan did not get to stand at the chief surgeon’s position, so she pursed her lips unhappily and said, “If you don’t know what to do, why did you run so quickly to the place?”

“I saw you turn around to the back!” Lu Wenbin felt wronged.

Yu Yuan’s face became livid with rage. “I went to take the stepping stool!”

Lu Wenbin twitched his mouth. He felt that it was not appropriate for him to laugh, so he forced himself to say, “You need to get this kind of thing ready beforehand. Besides, you shouldn’t move it on your own, you should ask people for help.”

Yu Yuan stared at Lu Wenbin with a face that said, “Are you serious?” Then, she said, “If I put two stepping stools at the chief surgeon’s position beforehand, what will happen if Doctor Ling comes? If I don’t find the stepping stools on my own, how can I ask people to move them over for me?”

“Yu Yuan, you really gave this a lot of thought,” Zuo Cidian could not stand the conversation anymore. If he continued listening to them, he might end up laughing.

Lu Wenbin chuckled before he lowered his head and said, “Let us talk about the surgery first…”

Yu Yuan obviously did not want to talk about this topic too. She snorted and said, “It’s not our turn to perform surgery yet. Right now, we need to check all our preoperative preparations. Firstly, we need to check all the equipment for CPR. Defibrillator, ventilator, tracheotomy pack…”

After Yu Yuan had been working as the chief resident for more than a month, her presence became totally different. Most importantly, her confidence became much stronger.

This was just like how a student would stay in school for more than ten hours every day to prepare for the college entrance examination when it was around the corner and only went back home for a shower in one or two weeks. Two months later, the student would surely have a surprising change. At least, the student knew his or her limitations, like which questions he or she could challenge, which questions he or she could not answer…

Yu Yuan was also the same.

In the beginning, she was not good at surgery. Before she became a chief resident, she always felt that it was because she had no chance to perform surgeries, and it led to her being incompetent…

After becoming a chief resident, Yu Yuan slowly understood that she was really not good at practical surgery!

However, being bad in surgery did not mean that Yu Yuan was not good at surgical medicine, and it absolutely did not mean that she could not grow in the field of medicine. The long period of being a chief resident had made Yu Yuan understand this problem clearly.

When she worked as the chief resident in the Emergency Department, most patients she encountered did not need surgery. It was even rarer for her to encounter patients who needed to enter the operating theater.

Yu Yuan could always pass these patients to doctors who were good at surgery, or she could always call the doctors from other departments for consultation…

Therefore, Yu Yuan saw her limitations, at the same time, she knew her specialty…

She earnestly completed her preoperative preparation. Meanwhile, she paid attention to the patient’s vital signs all the time and frequently gave instructions in medicine prescription.

Yu Yuan did everything she could do except for the opening of the abdominal cavity…

Ling Ran walked into the operating theater.

He first looked at the monitor before he asked Su Jiafu, who was next to him. “How’s the patient’s condition?”

“He is still stable, but his blood loss is a little concerning. Look at the drainage bag at the bottom, it’s almost full.” Su Jiafu was slightly bogged down on this. For an anesthetist, it was very difficult to maintain the stability of such a patient.

“This means that there is still active bleeding in the abdominal cavity.” Ling Ran turned around and asked, “Has the patient’s family signed the informed consent form?”

“I’ll make the call.” The circulating nurse immediately went to make a phone call.

It was at this moment that Huo Congjun finally received the Volkswagen Jetta where the patients’ parents were.

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Ling Ran nodded silently. He put on the surgical gown and gloves with the help of the circulating nurse.

When he turned around, Ling Ran looked at the display monitor and patient again. He fell into deep thought.

Ling Ran could now perform all the tasks in the Emergency Department easily now.

It was true that Ling Ran could not perform some surgical skills and carry out certain treatment plans very well. However, after working in the Emergency Department for almost a year, the skills he had mastered were more than enough. Not only had he obtained the gifts from the system, he also learned a lot after performing surgeries for a long time.

Nonetheless, the patient in front of them was already considered to be at death’s door.

*Ring.*

The phone in the operating theater rang.

The circulating nurse immediately picked up the phone before she shouted a few seconds later, “The patient’s family has just signed the forms.”

“Laparotomy.” Without hesitation, Ling Ran extended his hand for the instrument.

The scrub nurse in this surgery was still Nurse Wang Jia, whom he was the most familiar with. There was no need for Ling Ran to shout the name of the particular instrument, Wang Jia just passed it to Ling Ran.

Ling Ran took only a few seconds to open the patient’s abdominal cavity.

At the moment the abdominal cavity was opened, he found that this readmitted patient had his blood mixed with blood clots, and that blood and blood clots covered the operating table very quickly.

“This… too much hemorrhaging.” Lu Wenbin was slightly stunned at that moment.

Yu Yuan’s experience as a chief resident worked slightly at this moment. “Doctor Ling, aspiration?”

Ling Ran shook his head slightly before he said, “We’ll get the gauze out first. Then, request blood.”

“Yes.” The circulating nurse heard her task. She immediately went to make a phone call.

“Forceps.” Ling Ran bent over to pull out the gauze.

One piece, two pieces, three pieces…

“The abdominal cavity is full of gauze…” Zuo Cidian was performing retraction. He could see the situation clearly, and he clicked his tongue nonstop.

“We can stuff the gauze into the cavity to stop bleeding. But the liver has ruptured. It’s useless to put more gauze into the cavity.” While Ling Ran explained the situation of the situation, he also did an on-the-spot training for his assistants.

When all the gauze had been taken out, the blood loss of the patient naturally increased exponentially.

Su Jiafu was terrified. He used his legs to move the chair toward the pressure infusion cuff, blood warmer, and transfusion device to quickly adjust the parameters.

The blood bags that had just been sent over were all fixed on the device.

In some small hospitals that did not have good facilities, the photos of the medical staff carrying the blood bags or using their hands to pump the blood bags could always be seen. However, blood products were always kept at low temperatures, and the patient’s temperature was always a major issue when it came to them surviving. When the moment came for emergency blood transfusion, the medical staff could only choose to warm the blood bags using their body temperature and used their hands to exert pressure in order to pump the blood so that they could transfuse the blood at a suitable temperature to the patient.

Such photos would always be paired with some heart-warming captions and shared by groups of people who did not know the truth.

In truth, heating up the blood bags using body temperature was very slow. It could only temporarily alleviate the crisis. Most of the blood transfused into the patient’s body, in the end, would be blood that had a temperature that was too low. Furthermore, using hands to shake or press the blood bags was not only slow, the blood cells and blood platelets would also encounter high damage, thus reducing the blood quality greatly [1].

Local top-grade hospitals like Yun Hua Hospital had used pressure infusion cuffs, blood warmers, and transfusion devices since the last decade. It could ensure blood quality and reduce the doctors’ workload.

Most importantly, different surgical plans affected patients greatly.

On the operating table, these different plans can allow the chief surgeon to save more energy and put their focus on other more important matters.

Ling Ran paid close attention to the bleeding point. He slowly extended his left hand and gently pressed the hepatic artery. Then, he used hemostatic forceps to clamp down on the artery gently.

At the same time, Huo Congjun reached the area outside the operating theater and shouted outside the door, “I’m washing my hands now, how’s the situation?

“I’m going to cut the right lobe of the patient’s liver,” Ling Ran replied with equal volume.

Huo Congjun could not see the situation in the operating theater. He could only lower his head and keep scrubbing his hands.