(Thanks to my good friend 08a for the reward and encouragent)
After scrubbing in and setting up, today’s partner from the anesthesiology departnt was still Wang Lei.
"Mascot, verify the patient’s information."
Standing by the operating table, Liu Banxia blurted out a sentence that no one understood.
Well, he had no choice. This was the surgery he had been longing for. Ever since starting his internship at the Second Hospital, he had always wanted to properly remove an appendix.
Unfortunately, luck was not on his side. When an opportunity finally arose, Qin Hai had claid it for Qi Wentai.
Today’s surgery was not only his short-term life goal but also related to his career specialization task. So, he was a bit nervous and directly called out Liang Xiaolin’s "nickna."
He knew this comnt was out of the blue and felt incredibly awkward under everyone’s gaze.
"Um, Doctor Liang, could you do the verification?" Liu Banxia said after a few seconds of silence.
The patient on the bed, though still enduring the pain, almost chuckled when he heard this.
Liang Xiaolin felt helpless but had no choice. As the Second Assist, she had to follow the lead surgeon’s instructions.
"Don’t be nervous. You won’t feel anything once the anesthesia takes effect," Liu Banxia said with a smile after the verification.
"Today, you’re definitely receiving VIP treatnt. My first assistant here," he gestured to Shi Lei, "will soon beco an associate chief physician. If he weren’t so lazy about pushing himself, he would have been promoted long ago."
Hearing his words, the patient looked at Shi Lei, which made Shi Lei feel a bit annoyed, his eyebrows knitting together.
"And this one here," Liu Banxia said, gesturing to Liang Xiaolin, "is also a future renowned cardiothoracic surgeon in our Second Hospital. Plus , the one in charge of the looks, your money spent today is truly worth it."
.c(o)(m)
"But didn’t you say she’s the mascot?" the patient blurted out, stating the obvious with curiosity.
Wang Lei couldn’t stop laughing, making no effort to conceal his amusent.
Liu Banxia wasn’t rely blabbering. Anyone lying on the operating table would be nervous, and joking around like this could help alleviate the patient’s anxiety.
"Considering the patient’s appendicitis might rupture, I’ve decided to make an incision at McBurney’s point, Five Centiters." Upon getting the cue from Wang Lei, Liu Banxia picked up the scalpel.
Watching Liu Banxia make the first incision, Shi Lei nodded approvingly. This kid has indeed been working hard in private.
This cut shouldn’t be underestimated; the precision was just right.
"Electrosurgical knife."
Following Liu Banxia’s command, the scrub nurse, Liu i, handed him the electrosurgical knife.
This incision went directly to the external oblique aponeurosis. Liu Banxia then sequentially opened the external oblique aponeurosis and the external oblique muscle. Just before opening the peritoneum, Liu Banxia separated the space between the peritoneum and the abdominal muscle, simultaneously placing a corner of gauze outside the peritoneum.
After incising the peritoneum, he quickly packed gauze into the incision, then cut open the remaining peritoneum outside the gauze, exposing the abdominal cavity.
Watching his technique, Shi Lei almost felt like giving him a thumbs-up.
An appendectomy is considered a simple operation, but for many, it’s not as easy as imagined.
So surgeons, trying to show off their skills, deliberately make the incision too small. Then it becos awkward when they have to enlarge it mid-procedure. The choice of 5 centiters was standard, but it was also decided considering the patient’s appendix was already suppurating.
The gauze used earlier was to prevent contamination of the incision when collecting pus; otherwise, cleaning up would be very troubleso.
Moreover, Liu Banxia’s entire incision was larger on the outside and smaller on the inside, which was not only conducive to the procedure but also to the patient’s postoperative healing.
Observing Liu Banxia’s entire procedure up to this point, every move was clean and efficient, with no wasted actions. However, the crucial part was next: in an appendectomy, one first had to locate the appendix.
"Buddy, you’re doing great. We haven’t detected any exudate," Liu Banxia said with a smile.
"However, you’ll feel a bit of a tugging sensation from here on out. I need to lift your appendix to cut out this troublemaker."
"The quicker, the better, because it’s caused enough suffering," the patient said gloomily.
Liu Banxia lifted the patient’s small intestine, inserted his other hand, and prodded gently a couple of tis. The tip of the appendix imdiately appeared at the incision site.
Liang Xiaolin was taken aback. He found it so quickly? Was it even four seconds? I’m still trying to distinguish the small intestine from the cecum, how did he find it so fast?
Shi Lei also looked at Liu Banxia in surprise. Even as a veteran, he probably couldn’t have located it as quickly.
It hadn’t been easy for Liu Banxia. During his basic training at ho, he’d always secretly practiced locating the appendix. He had gone through so much to master this. What others might think was his first attempt, he had actually practiced hundreds of tis.
"Alright, brace yourselves! I’m about to extract this plump little fellow," Liu Banxia announced, then directly used forceps to grip the tip of the appendiceal sentery and lift out the appendix.
Seeing that the patient was still tolerating the procedure well, Liu Banxia didn’t administer a local anesthetic block.
He then began to ligate and cut the appendiceal sentery and the appendiceal artery within it. During this process, he also deliberately checked for an accessory appendiceal artery and dealt with it appropriately.
This is a common oversight for beginners. Not all patients have this accessory artery, but if you don’t consider it, there could be trouble.
"Doctor Liang, this next step is also important. We’ll be doing our usual purse-string suture. However, we won’t tighten the thread while suturing. The suture needs to go deep, into the muscle layer, but it mustn’t penetrate the intestinal lun. Heh, my suturing is just perfect," Liu Banxia said with satisfaction.
"Truth be told, his suturing technique is really excellent now. Not only are his stitches accurate, but his hands are also quite fast," Wang Lei couldn’t help but complint.
Liu Banxia gave Wang Lei a satisfied look and took the hemostatic forceps Liu i handed him. He clamped 0.5 centiters from the base of the appendix to prevent the suture from slipping during ligation.
The rest was quite simple, just standard procedure. However, Liu Banxia’s technique was sowhat different from others’; his movents were slightly faster. This was why Shi Lei, with his extensive experience, could keep up as first assistant; otherwise, the first assistant today might have been in for a scolding.
After cleaning the appendiceal stump, Shi Lei used his left hand to pick up the toothless forceps and lift the cecal wall opposite the purse-string suture ends. With his right hand holding the hemostatic forceps that clamped the suture knot, he pushed the appendiceal stump into the cecum.
Liu Banxia nodded. "Good job, young man. The first assistant is perfectly competent."
As he spoke, he tightened the purse-string suture, then ligated and cut the ends. After covering it with the sentery, he added a reinforcing suture. At this point, all the crucial steps of the surgery were complete.
With such a small wound, closing the abdon was very easy. However, to get a perfect rating, Liu Banxia didn’t let anyone else do it, opting to handle it all himself.
After checking the abdominal cavity and confirming no exudate, pus, or bleeding points from ligations, he leisurely began to suture.
DING! Appendectomy completed. Received 300 experience points, 500 skill proficiency points for Appendectomy.
Assessnt: Perfect. Received 1,000 experience points, 1,000 skill proficiency points for Appendectomy, 200 skill proficiency points for Diagnostics, and five Glory Points.
Qualified Surgeon task progress (1/3).
CLAP, CLAP, CLAP...
Led by Shi Lei, everyone in the operating room applauded.
This was a sign of affirmation for Liu Banxia. After all, this was the first appendectomy of his dical career, and he had done an excellent job.
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