Chapter 81 - 0079: Surgery Show

Prof. Tan’s parachuted arrival to the Trauma Orthopedics department was akin to a stone being thrown into a placid lake; it was bound to cause ripples.

Naturally, the most significant reactions came from Directors Ouyang, Bai, and Ding. On the surface, they remained calm, but they were certainly feeling all kinds of dissatisfaction and discontent inside. After over ten years of hard work developing the Trauma Orthopedics department into a strong entity, they were now expected to hand it over to an outsider. It was a hard pill to swallow.

Fortunately, Director Han possessed a strong commanding presence. Given his position as the department head, no one dared to start any conflicts or create any significant disturbances.

The tranquil weekend then passed.

On Monday morning, Deans Xia and Sun, as well as Director Zhao of the medical department, made their appearance at the Trauma Orthopedics department.

After the shift was handed over, Dean Xia whispered something to Director Han. Afterward, with a stern face, he made an announcement: the Trauma Orthopedics department was being renamed the Micro Trauma Orthopedics department, and Prof. Tan and Dr. Zhong were joining. Although no one was officially appointed as the new director, it was understood who it was.

Normally, Director Zhao would make the announcement. But this time, Dean Xia did it as a show of strong support. Following the proclamation, there was a round of applause, and Dean Xia made a short speech, then shook hands with Prof. Tan.

Everyone knew that the new director was going to showcase a surgery, so they all scheduled their surgeries for the afternoon, leaving the morning free to observe this exhibition.

There was a tale of how Prof. Tan had previously showcased an emergency surgery of the pelvic acetabulum at an academic conference. The success of that surgery had catapulted his fame.

The new director! Everyone was curious to see his skills firsthand. After all, rumours about how incredible he was were just that, rumors. There were numerous cases where such reputations proved hollow.n/o/vel/b//in dot c//om

There were a few directors who had never participated in clinical procedures and mainly conducted research overseas. Upon returning, they were directly appointed as heads of departments. This was less common in surgery and more so in internal medicine.

After visiting the wards, Director Han led Prof. Tan and Dr. Zhong to the operating room, introducing them to the situation there.

Once inside the operating room, Prof. Tan checked the operating table, the C-arm x-ray machine, then called for two assistants.

Tian Yuan volunteered himself, saying, “I’ll go!”

Prof. Tan refused: “No, no need. We can watch from down here. For this surgery, let young people handle it. Let Dr. Zhong do it. You can arrange two other people to assist him. He’s already very skilled at this surgery.”

Everyone wondered what Director Han must be thinking. At least Tian Yuan was dissatisfied. What did he mean by such arrangements? Sending an inferior surgeon to the stage, was it to show that his subordinate could outdo them all?

Director Han instructed Tian Yuan to assign two others to go up.

Tian Yuan considered for a moment and then said, “Let Song Zimo lead with Little Five as his assistant. Song Zimo will be the primary assistant, and Little Five will be the secondary assistant.”

“What about Yang Ping?” Director Han asked.

Tian Yuan laughed, “Yang Ping is the backup.”

This arrangement seemed reasonable, and Director Han had no objections.

“Prof. Tan, what do you think if we have Dr. Song as the primary assistant and Doctor Lu as the secondary assistant?” Tian Yuan softly queried Prof. Tan.

Prof. Tan casually dismissed the concern: “That’s fine, any two people should suffice. They just have to assist.”

Everyone moved next door where the video was set up.

Director Han and Director Tian sat in the front row with Prof. Tan. Tian Yuan waved to Yang Ping, “You can sit behind me. Don’t wander off.”

Yang Ping understood Director Tian’s intentions. He was ready to be called to the stage at any moment.

Directors Ouyang, Bai and Ding sat in the second row. Director Ouyang kept his emotions hidden, Director Bai looked troubled, and Director Ding was as indifferent as usual.

Director Ding rarely attended these surgical observations, so his presence today was unusual.

In the operating room, several individuals were busily preparing. The anesthesia had been administered, and Dr. Zhong was directing Song Zimo and Little Five to position the patient. He seemed unsatisfied and adjusted them several times.

The nursing manager personally prepared the instrument table below, and Su Yixuan was suddenly asked to step in as the surgical nurse.

Finally satisfied with the patient’s position, the three who were going up on stage washed their hands, got dressed, prepared the surgical drapes, and sterilized the equipment.

Once the preparations were complete, the sacred ceremony of beginning the operation took place. After pre-operative checks, the surgery began!

For the groin entry route, Dr. Zhong was indeed quite skilled. His credibility in the Nandu Affiliated Hospital was significant. His grip on the scalpel was standard, and he made a standard anterior incision. He planned to perform the anterior surgery first since it was more challenging, allowing everyone to relish his performance when their energy was at its peak.

To be honest, in G City, hospitals like Nandu Affiliated Hospital One and Two looked down upon Sanbo, an institution that had only been established for over a decade. Even if Han Jiangong individually was incredibly talented, he couldn’t make up for the hospital’s lack of reputation.

Dr. Zhong’s surgical cuts were impressive, definitely deserving of a showcase.

He made incisions through the skin, subcutaneous tissue, and deep into the fascia, systematically dissecting the muscles, nerves, blood vessels, and spermatic cord.

The spaces between these structures formed three classical windows, which became safe paths for visualizing the surgery. Through these paths, they could successfully reach the fracture site.

The muscles in the area were a bit hard, but it didn’t hinder the surgical operation.

The first window was easily created as the abdominal muscles and iliac muscles were peeled off the iliac bone and lifted upward. The electrosurgical unit was quickly used to stop bleeding, and the iliac fossa and the anterior part of the sacroiliac joint were easily exposed; the operator’s technique was remarkably adept.

The piece of gauze handed over only had a few small blood stains on it.

Prof. Tan was quite pleased: “Young people need to practice. Director Han will have to teach them more.”

Director Han said, “Dr. Zhong performs beautiful surgeries. Look at the basics of his dissections, they are excellent. Prof. Tan, you’ve tutored him well.”

When Dr. Zhong began to separate the spermatic cord, the surrounding tissue didn’t appear to be normal. It was a bit hard, and Dr. Zhong had to palpate it a few times to define the cord. The blunt dissection with a hemostat seemed inefficient.

There seemed to be some adhesions, and the tissue planes weren’t very clear. At such times, sharp dissection was favored.

“Scissors!” A pair was handed over.

“Be quick about it!” Dr. Zhong sternly admonished in a low voice; the authority of the chief surgeon was apparent.

Although Su Yixuan was quick, she was still regarded as slow. It appeared that the chief surgeon had quite the temperament.

The sharp scissors opened and maneuvered, suddenly, blood gushed out; a small artery underneath had been cut.

“Hemostatic forceps! Quickly!”

He was once again frustrated with the slow instruments.

Dr. Zhong received the forceps, immediately clamped it shut, and used the electric knife to cauterize and stop the bleeding. Her movements were swift and well-practiced.

They continued to advance, isolating the spermatic cord. The progress was not as quick as anticipated, and a few times small arteries were cut, but they quickly stopped the bleeding.

A sizable region on the surgical sponge was already dyed red.

“Lift it up and maintain tension!” Dr. Zhong lightly tapped Song Zimo’s back of the hand with the handle of the scissors.

Song Zimo looked up. His cold gaze returned to adjusting the tension in his hand.

“That’s too large, make it smaller.”

Song Zimo lowered the hemostatic forceps in his hand, reducing the tension on the spermatic cord lifted by the forceps.

“Don’t you perform many of these surgeries normally?” Dr. Zhong was not satisfied.

Song Zimo remained silent.

Upon the successful isolation of the spermatic cord, a rubber strip was placed inside to spread and protect it.

Next, they began the isolation of the external iliac vein and lymphatic vessels.

The surgical approach for pelvic surgery involves many blood vessels and nerves, most of which are vital. The surgical approach is a precondition for the success of the surgery.

Dr. Zhong frowned, carefully feeling for the blood vessels underneath. The hard and brittle tissues were increasing, and the structural layers were becoming more and more blurred. Just a moment ago, he was barely able to discern the spermatic cord from experience.

Now, the external iliac vessels were completely unrecognizable, and the sticky tissues were everywhere. He couldn’t sense anything beneath.

This patient had extensive scar adhesions. Had surgery been previously performed in this area?

A CT scan couldn’t reveal this type of soft tissue adhesion. Even an MRI needs an experienced person to make a judgment.

Before the surgery, he had carefully questioned Professor Tan, and there was no previous surgical history. There were also no small scars in this region during the physical examination.

So how could there be adhesions? However, exploring the cause was useless at this point. The only option was to keep pushing forward.

“Scalpel!”

The scalpel was handed over.

Using the scalpel to make a sharp dissection, he gently and progressively cut open the site. A stream of blood sprayed out, reaching over ten centimeters away. Dr. Zhong immediately pressed down with surgical sponges.

“Fasten the retractor properly!”

Song Zimo didn’t know where he’d gone wrong, but he still adjusted the position of the retractor.

“You! Get your strength together!”

The instrument hit Little Five’s hand.

“Hemostatic forceps!”

The hemostatic forceps were handed over.

“The smaller one!” Dr. Zhong’s tone was a bit unfriendly.

The smaller hemostatic forceps were handed over.

Releasing the surgical sponge, Dr. Zhong clamped to stem the bleeding, and cauterized with the electrosurgical knife.

Continue!

Another stream of blood spurted out, this time it was promptly covered with a surgical sponge.

“Hemostatic forceps!”

Dr. Zhong’s voice shrank, sweat began to dampen his forehead. The adhesions were too severe. There was no way to continue pushing forward.

The smile on Professor Tan’s face gradually faded and he became serious. He looked at the screen and said, “This patient could have experienced infection before, possibly pelvic tuberculosis. It self-healed but it caused extensive adhesions. The anatomical structure is not clear. Young people still lack experience, I will scrub in.”

Adhesions. Extensive adhesions are a great threat to the surgical approach, especially for the pelvis. Numerous blood vessels and nerves need to be avoided. Even the slightest injury could be a great embarrassment.

This patient was a bit unexpected.

Professor Tan expected to let Dr. Zhong showcase his skills. However, this is okay too. For this kind of extensive adhesion surgery, probably in Sanbo hospital only Director Han could carry it out. This can be counted on one hand among other hospitals in G City. So it wouldn’t be a loss of face for him to go on the stage this time.

The safety of the patient is the most important, Professor Tan stands up, “I will scrub in!”

Tian Yuan said, “Professor Tan, there’s no rush. Let’s sit down and let the younger ones do this kind of surgery. As long as we watch, there won’t be any problems. Yang Ping! Scrub in, you will assist Dr. Zhong.”

Director Han didn’t know much about Yang Ping’s pelvic surgeries. He only let him be the assistant and never let him carry out the surgery alone. Therefore, he can’t make any judgment on him.

However, seeing Tian Yuan’s confidence, he felt assured. He knew very well of Tian Yuan’s cautious and steady character. He would never allow anyone on stage if he didn’t have confidence in them. At some point, Tian Yuan must have let him perform pelvic surgery, so he felt confident.

“Xiao Yang, go!” Director Han gave the order.

Yang Ping stood up.