Auto-brewery syndro is a very interesting disease, but also a very dangerous one.
It was said that an instance of it had been diagnosed by Liu Banxia in the ergency center, intriguing hospital staff enough that even people from the inpatient departnt would co over for a look when they had ti.
However, the necessary fungal cultures and tests required ti, as did observing the patient’s body brew alcohol under natural conditions.
At this point, it was rely Liu Banxia’s speculation. Only when the actual results ca out and were verified would it confirm that the patient hadn’t been driving under the influence. Then, they could research how to treat his condition.
Presently, Liu Banxia didn’t have ti to concern himself further with this patient. After checking that there wasn’t much else to do in the ergency center and giving so instructions, he rushed towards the operating room.
He needed to observe Xu Peichen’s total hip replacent surgery. This was a procedure only orthopedic surgeons could perform; general surgeons, no matter how urgent the situation, wouldn’t encounter such a case.
"Our President Liu has finally arrived. If you hadn’t shown up any sooner, we would have had to call you," Xu Peichen said with a smile.
Liu Banxia was a bit puzzled because the patient on the operating table hadn’t been anesthetized yet. According to the surgical schedule, this step should have been completed ten minutes ago.
"As soon as he heard you were coming to participate in the surgery, he insisted on waiting for you," Wu Mingyu said with a laugh.
Liu Banxia approached the patient. "That made a bit nervous," he said to the patient. "But don’t worry. Director Xu is one of the top experts in the country. Besides, a total hip replacent is our last resort. We still need to see the results of the intraoperative frozen section."
The patient nodded with a smile. "To be honest, I’m really scared. I can’t tell my friends or family. You’re all I can count on. Please, I’m entrusting myself to you."
"Rest assured," Liu Banxia said. "Although the surgery is scheduled a bit late, it won’t affect anything. Director Xu specifically squeezed out ti for this."
"I’ve also arranged everything in the ward. We always prepare for the worst and hope for the best. Even if you do need a hip replacent, we’ll oversee your entire rehabilitation process."
The patient nodded.
"Alright," Liu Banxia said. "We’ll intubate you shortly and then administer the anesthesia."
Upon hearing this, the patient imdiately opened his mouth.
Wu Mingyu had already explained the detailed surgical procedure to him. The patient had also looked up Xu Peichen’s standing in the field of orthopedics online.
Moreover, he hadn’t waited too long. Being diagnosed yesterday and having the surgery today was, in itself, quite fortunate.
Intubation, anesthesia, and positioning the patient in the left lateral decubitus position were completed. The surgery officially began.
As Wu Mingyu perford the initial dissection, Xu Peichen comnted, "Liu, you’re very patient with your patients. You need to maintain that patience."
"I just offered so comforting words. Undergoing such a major surgery alone, without being able to tell his family, must be agonizing for him," Liu Banxia replied.
"A good mood can help with a faster, better recovery. He has to bear all of this alone. Director Xu, do you think the chances of it being malignant are high?"
Xu Peichen nodded. "It developed very quickly. It’s fortunate he didn’t delay. I’d dare say if he had waited another month, there probably would have been no saving him."
"Malignant bone tumors progress very rapidly, and they tastasize even faster. We have three such patients in our inpatient departnt for whom surgery is no longer an option."
"One patient started feeling leg pain when the weather turned cold but dismissed it, thinking it was just the cold. He only ca for an examination recently when the pain beca unbearable. How long has it been? Just over two months."
"Ming Yu, pause for a mont," Xu Peichen said. "Let Banxia experience the next part. In general surgery, you also perform basic dissections, but you probably haven’t tried to open up such a large surgical field, have you?"
Liu Banxia was startled, looking at Xu Peichen with a helpless expression.
He indeed hadn’t perford such a dissection before. If it were a leg fasciotomy for compartnt syndro, that would be no problem. He was now very experienced in that area and no longer needed anyone’s guidance.
Exploring intra-abdominal organs also wouldn’t be an issue, as most of his training in the dream space focused on that.
Only with a complete understanding of intra-abdominal anatomy could one handle various unexpected surgical situations more easily.
But a total hip replacent? That involved dissecting out the entire hip joint. Where would he have encountered such a large surgical field? This was a proper level-four orthopedic surgery.
Xu Peichen’s suggestion startled not only Liu Banxia but also those watching the surgery on the screen. After all, it was a level-four orthopedic surgery with Xu Peichen himself as the chief surgeon, making it highly educational.
No one had expected Xu Peichen to trust Liu Banxia so much, especially since this involved dissecting different types of tissue, with differing technical points.
"Director Xu, let ask first," Liu Banxia said. "Now that Doctor Wu has opened the subcutaneous tissue and fascia, should I incise along the fibers of the gluteus maximus, transecting the iliotibial band down to below the greater trochanter?"
Xu Peichen nodded with a smile. "It seems you’ve studied this procedure. Go ahead, give it a try."
Liu Banxia nodded and took the chief surgeon’s position.
Just as Xu Peichen had said, the basic anatomy was similar. Liu Banxia had just stated the key technical points, or rather, the path; he just needed to follow it.
His hands remained as steady and swift as ever. Even though this was his first ti dissecting this specific area, countless days and nights of training had given his hands a solid foundation.
Although it was just a simple dissection, those watching on the screen couldn’t help but praise his skill with a "Nice!" Watching Liu Banxia make his incisions was sohow very satisfying.
When Liu Banxia made an incision, his movents were not only fast but also steady and precise. Judging by this current performance, he didn’t seem like soone attempting this for the first ti at all. This required strong fundantal skills; the scalpel followed his eyes.
"Director Xu, the rest is up to you. I’m out of my depth now," Liu Banxia said, stepping aside.
"See? I told you, you should co to our Orthopedics Departnt. Ming Yu, show him how it’s done. Next ti you encounter a similar surgery over in your departnt, you two can manage it together," Xu Peichen said.
Wu Mingyu didn’t hesitate, taking over skillfully.
He was also one of Xu Peichen’s prized pupils; otherwise, he wouldn’t have been sent to the ergency center. If he didn’t have considerable skill, he couldn’t have single-handedly supported orthopedics there.
"Exploration reveals an irregular tumor, approximately 0.5 by 0.3 centiters. Proceeding with excision and sending for intraoperative frozen section," Wu Mingyu stated.
Xu Peichen nodded. "Excise it. There’s very little chance of it being benign."
Liu Banxia sighed inwardly. If the tumor’s edges were smooth, there might have been so hope. But with a tumor like this, the chances of it being benign were practically zero. Irregular margins are, in fact, a hallmark of malignant tumors.
After a short wait, the phone rang. The nurse answered and then shook her head.
"Proceed with the replacent," Xu Peichen said.
Wu Mingyu nodded and resud operating.
This ti, Xu Peichen didn’t let Liu Banxia assist. The basic dissection he’d done earlier was acceptable, but what followed was critical to the entire surgery’s success or failure.
The surgery itself wasn’t overly complex for Xu Peichen; he had perford it countless tis and knew it inside out. He would only intervene at crucial steps, with Wu Mingyu handling many of the basic procedures.
To Liu Banxia, who was observing, orthopedic surgery seed sowhat "brutal": breaking bones, sawing bones, grinding them down...
He was a surgeon too, but witnessing a joint replacent today was still hard for him to quite accept. It truly validated the saying, "Different fields are like different mountains." Though both were surgical disciplines, orthopedics involved a distinctly different approach.
This wasn’t as simple as replacing parts in a machine; these were human bones, and each individual’s anatomy was different.
Therefore, one needed to test and adjust ticulously. After reducing the hip joint, one had to ensure that flexion, abduction, and external rotation of the hip were unrestricted. When internally rotated to 45 degrees, the knee also had to be pushed posteriorly to check if the joint would dislocate.
The entire process was intricate, not as straightforward as general surgery where a damaged part was simply repaired or removed, prioritizing speed and decisiveness. Joint replacent demanded imnse observational skills and patience, as it would affect the patient’s mobility for the rest of their life.
After the drainage tube was placed and the gauze and instrunts were checked, the wound was sutured layer by layer.
"Well, what did you think?" Xu Peichen asked Liu Banxia.
Liu Banxia thought for a mont before replying, "It’s certainly changed my perception of orthopedic surgery. It’s very different from our general surgery—a kind of beauty that’s both rough and delicate."
"Especially the joint adjustnt. I believe that’s the most critical part of this procedure. Only when the prosthesis achieves a perfect fit after reduction can the surgery be called a success."
Xu Peichen nodded. "Though you’re exaggerating a bit, you’re not far off. Anatomically, orthopedic surgery isn’t overly complex; these approaches are also commonly used in internal fixation procedures."
"However, the reason joint replacent is classified as a level-four surgery is precisely because the adjustnt process is so critical. After all, this is a joint the patient will use frequently. We remove the damaged bone to treat the disease."
"And after treating the disease, ensuring the patient has a better prognosis is equally a requirent of the surgery. A surgery’s success isn’t just determined on the operating table, but also by the patient’s outco afterward."
"Director Zhou must have told you, right? There’s no such thing as a perfect surgery, only the most suitable one. Often, constrained by the location of the lesion, we can only make the most difficult, sotis seemingly helpless, choices. After making that choice, we then need to consider how to give the patient the best possible prognosis."
"Thank you, Director Xu, for this valuable lesson," Liu Banxia said sincerely.
Those watching the surgery on the screen shared this sentint. They had all witnessed the ticulous adjustnts. There were no one-step solutions, only gradual refinents and shaping until a perfect fit was achieved.
User Comments
0 comments from readers