"Old Chen, why did you involve in this?"
The next morning, Liu Banxia muttered this while scrubbing in.
"What else could I do? I'm not confident enough to go up there alone. Besides, the angiogram shows that the patient's great saphenous vein was completely used up during the last bypass. Our options are very limited," Chen Xuehai said.
"I'm quite curious. Last night, when you heard the patient's family decide to take a chance on the surgery, what were your feelings and thoughts?"
"?" Liu Banxia shook his head. "I'm not sure. Maybe a little happy?"
Perhaps, deep down, I also leaned towards the patient having the surgery. Instead of living in constant fear, it's better to take a gamble. If it succeeds, he could have a good few years, maybe even ten or twenty.
"But that's looking at it from an outsider's perspective. For the family, who are so worried about the patient, making such a decision is incredibly difficult."
"Exactly. Are you familiar with the surgical procedure?" Chen Xuehai asked.
Liu Banxia smiled and nodded. "But I still think Linlin should be the first assistant. I'm just a backup. I only caught a glimpse of this type of surgery once, with that conscious patient."
"My role is mainly to provide ergency hemostasis if the vessels are too fragile and rupture. Other things, like vessel dissection, are just basic procedures."
"For Linlin, this surgery is also very educational. True participation will give her a lot of experience. Don't worry, she can handle it."
Although Liu Banxia had recomnded himself as first assistant, hearing his senior's sowhat patronizing tone irked Liang Xiaolin a bit.
But what could she do? Even though their age difference wasn't significant, Liu Banxia was on a higher level. Besides, in a few months, this guy would be a proper attending physician, and she would still be under his supervision.
"That works too. Linlin has been in many surgeries for a while now, so her experience should be adequate. Just don't panic if an ergency arises," Chen Xuehai said after a mont's thought.
"Since it's the anterior descending artery, our only option is a dian sternotomy. When splitting the sternum, be very careful of the innominate vein underneath. It's best not to nick it."
"Alright, those are the main points. Let's get started. The chances of success are still high, and we've prepared so thoroughly. There shouldn't be any problems."
It was hard to tell if that last sentence was ant to boost Liu Banxia and Liang Xiaolin's confidence or his own.
After entering the operating room and donning masks and gloves, the three of them stood by the operating table.
"I've already done the pre-op checks for you," Wang Lei said.
Chen Xuehai nodded. "Let's begin anesthesia. We need to finish this surgery as quickly as possible."
He saw his patient wave his good hand. Although the patient didn't fully understand his own condition, he had undergone bypass surgery before and naturally knew it was quite risky.
"Old Wang, the patient's vital signs are your responsibility. Keep a close watch on all indicators," Chen Xuehai said after the patient was anesthetized.
"Don't worry. I reviewed the patient's files thoroughly last night. It's challenging, but not insurmountable," Wang Lei nodded.
"Linlin, femoral arteriovenous cannulation. Advance the venous cannula to the inferior vena cava," Chen Xuehai continued.
Liang Xiaolin began the procedure without hesitation.
Watching her, Liu Banxia couldn't help but nod in approval. It had been a long ti since he'd seen Liang Xiaolin operate. Coming from a distinguished family and ticulously trained by Chen Xuehai, her movents were clean and precise.
Even with my current attribute bonuses, I could barely match Liang Xiaolin's current standard.
Everyone has their specialty. She's perford this kind of procedure many tis; for her, it's routine.
The purpose of such arteriovenous cannulation was to be prepared for any eventuality. If a crisis occurred and the patient started bleeding profusely, extracorporeal circulation could be established.
That might not happen, but such preparations were essential; trying to set it up at the last minute would be too late.
"Okay, Linlin, open the chest," Chen Xuehai said once Liang Xiaolin had finished the cannulation.
The preliminary preparations were complete. Now, the critical phase of the surgery—the most crucial steps—was about to begin.
Repeat coronary artery bypass grafting was inherently very risky, and this patient's situation was particularly complex. They had to minimize any chance of mishaps.
"Doctor Liang really has improved remarkably. Hasn't her growth been incredibly fast lately?" Liu Banxia asked.
"She's willing to apply herself and learn," Chen Xuehai said.
"But you deserve credit too. If you hadn't helped her overco her psychological block, she wouldn't have progressed so quickly. Neither her grandfather nor I could bring ourselves to train her so rigorously. You, however, had no problem."
"Hey, can we not? I'm working here," Liang Xiaolin interjected.
Liu Banxia, who had been about to praise her further, quickly shut up and just watched.
Wang Lei found it quite amusing. Liang Xiaolin was probably the only one in the entire ergency center who could make these two so compliant.
Don't think Liu Banxia is the only handful. Chen Xuehai, with all his skills and titles, has a temper too.
"Okay, very good. It's completely split. Dissect the posterior adhesions. A bit faster, and be more ticulous," Chen Xuehai instructed.
"Old Chen, everything looks stable so far, right?" Liu Banxia asked.
Chen Xuehai nodded. "So far, yes. But the most critical part is the bypass later. Be ready when we open the chest fully with the retractor."
"So vessels might have potential rupture points. It would be best if you could spot them in advance. That way, we can minimize the damage and avoid excessive danger."
Liu Banxia nodded, his expression growing serious.
As the retractor spread, the patient's thoracic cavity was exposed to everyone.
"My God! Good thing we operated today. The hematoma is a whole size larger than it was during yesterday's check," Chen Xuehai exclaid.
"See? There's scar tissue on these vessels. Though not extensive or very long, it indicates their condition is truly poor."
"You two, keep a close watch. I'm going to dissect slowly. I can't rush it, or the hematoma might rupture from the sudden release of tension."
Liu Banxia watched Chen Xuehai's every move intently. In a true sense, this was the first ti he had observed such a procedure so closely and with such focus.
Many people had gathered at the observation gallery—not just from the ergency center, but also colleagues who had rushed over from the inpatient departnt.
Everyone knew this surgery was highly difficult. However, they didn't quite understand why Liu Banxia was there, seemingly just watching the show.
"President Liu, help assess the right gastroepiploic artery, radial artery, and small saphenous vein. See which one is most suitable for the bypass graft. Once you've chosen, start harvesting it imdiately to save as much ti as possible," Chen Xuehai instructed.
"Alright." Liu Banxia comnted, "From what I can see, none of them look great. This old gentleman must have had quite a high standard of living. Why didn't he take better care of himself?"
Despite his words, he began the examination.
Now, the observers understood why Liu Banxia was in the OR.
During the full abdominal organ transplant, Liu Banxia had demonstrated exceptional skill in selecting blood vessels. If he could select and harvest the graft in advance, it would save a significant amount of ti for this operation.
"Let's use the right gastroepiploic artery. It's marginally better than the other two. Should I start harvesting it now?" Liu Banxia asked after a brief assessnt.
"Yes," Chen Xuehai affird.
Liu Banxia began the dissection without hesitation.
If anyone in the gallery had initially thought Liu Banxia was just a bystander, they certainly didn't think so now. Harvesting a graft wasn't easy unless one had a thorough understanding of the entire operation.
The fact that Liu Banxia started imdiately indicated they had ticulously discussed and planned the procedure beforehand.
Even so, for a general surgeon to have such a thorough grasp of a repeat bypass surgery wasn't simple. It wasn't sothing you could master just by watching once and morizing the steps.
BEEP BEEP BEEP... BEEP BEEP BEEP...
Just then, the monitor alarms blared frantically.
"The hematoma ruptured! Patient has massive blood loss and cardiac arrest! Start blood recovery and initiate extracorporeal circulation!" Chen Xuehai ordered, simultaneously beginning cardiac massage.
"President Liu, continue harvesting! Linlin, after you control the bleeding, continue your dissection and prepare for the bypass! We need to be fast! Even with extracorporeal circulation, we can't delay for too long!"
"Okay!" Liang Xiaolin responded, continuing her work.
The sudden turn of events had everyone in the observation gallery holding their breath. Their worst fear—the premature rupture of the pseudoaneurysm—had materialized.
However, their calm and thodical response to the ergency showcased the solid professionalism of all three surgeons.
Chen Xuehai was a well-known rising star throughout the Second Hospital. But the seamless cooperation and skillful execution by Liang Xiaolin, an intern, and Liu Banxia, a general surgeon, were enough to make many attending cardiac surgeons reflect.
If they were in the sa situation, even with forewarning, they might not have been able to react so swiftly and decisively when the crisis actually hit.
This ergency center was truly remarkable. Though relatively new, with many staff mbers trained only after its establishnt, their rate of growth was terrifyingly fast.
You wouldn't find another intern in cardiac surgery who could operate with the skill Liang Xiaolin had just displayed.
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