The Enhanced Doctor

"Is the bleeding that severe?"

Qi Wentai asked after they wheeled the patient out.

"It was already an aortic dissection when sent in, and it just ruptured after the examination." Liu Banxia said.

"The bleeding couldn’t be controlled, so we have to do it on the spot. Are those his colleagues or friends? We need to get them to contact the family quickly."

"I’ve already arranged it." Qi Wentai said.

"Then I don’t need to worry. I’ll go in too. If the director is busy, I’ll do it." Liu Banxia nodded.

"Who doesn’t have anything to do right now? Follow this case of artificial blood vessel replacement. The director is operating, not many chances, make the most of it."

After he shouted, several people looked towards Qi Wentai.

He’s the chief resident, so these people still have to follow his arrangements.

Qi Wentai helplessly waved his hand, "Liu Yiqing, Xu Yino, Huang Bo stay, the rest of you, whoever wants to watch, go ahead. Be quick, the director won’t take long."

"Causing me trouble, three are fine, at least we won’t be that busy. You too, be quick, don’t cause unnecessary commotion."

"Haha, no problem." Liu Banxia responded cheerfully.

It does seem like causing trouble, but this type of surgery involves many knowledge points, it’s very necessary for them to see more.

And today is New Year’s Day, after all, for them it also means giving some small gifts.

He happily led the group over and scrubbed carefully. When entering the operating room, he saw Zhou Shuwen hadn’t started yet.

"Haven’t you already controlled the situation? Why have me here? You could do it yourself." Zhou Shuwen said.

"Director, many haven’t seen your skills, and you haven’t officially guided me on artificial vessel replacement either." Liu Banxia said.

Zhou Shuwen gave him a helpless look, "Day in and day out, you’re too much trouble."

Su Wenhao and his group held back their laughter, the comment was spot on.

"I just checked, Su Wenhao handled it quite well, although time was tight and he couldn’t fully isolate it, under the circumstances it was still okay." Zhou Shuwen said.

"Director, actually my mind went blank at the time, so I didn’t have a chance to deal with the intestine." Su Wenhao said, embarrassed.

"For emergency room cases, getting this far is quite good. After all, some organs are in an ischemic state, and that’s also a consideration." Zhou Shuwen said.

"Speaking of Teacher Liu’s compression hemostasis, it’s indeed the method with the least bleeding and fastest control. We’ve used it frequently in our rescues, with good prognosis."

"Director, although my mind didn’t go blank at the time, the first method that came to mind was this." Liu Banxia said.

"What? Waiting for me to praise you? Without these skills, how could you be a deputy director?" Zhou Shuwen glanced at him.

Liu Banxia didn’t dare speak up, he was indeed waiting for some praise.

This emergency rescue today, although not as perilous as usual manual hemostasis, tested surgical speed and effect.

"What are you waiting for?" Zhou Shuwen asked again.

"Um... waiting for you to perform the surgery." Liu Banxia said.

Zhou Shuwen didn’t speak, just gestured with his chin toward the patient.

Liu Banxia understood immediately, the preliminary dissection was assigned to him.

Being in such a position, how could he be so vengeful?

"Su Wenhao, assist me, let’s quickly isolate it, then we can watch the director’s abdominal aortic exchange, and still make it in time for lunch." Liu Banxia said.

"Briefly, during normal operations we need to expose a sufficiently good field. These small intestines should be properly managed, wrapped and pushed to the upper right, or placed outside the abdomen."

This was the issue mentioned before, which Liu Banxia provided as additional explanation.

It’s all routine operation, maintaining a sufficiently good field facilitates the surgery.

"Pay more attention when he’s isolating, he’s faster than me." Zhou Shuwen said again.

Liu Banxia felt helpless, still waiting for praise. But now it’s not needed, yet more praise came.

But the work still has to be done, also to save Zhou Shuwen some time, he started speeding up.

His assistant, Su Wenhao, struggled to keep up, barely managing to follow.

Of course, everyone could see this struggle. It felt like Teacher Liu hadn’t reached his top speed yet.

Many people felt truly amazed in their hearts—Teacher Liu’s hands are just incredibly fast.

"Liu Banxia, during an artificial blood vessel replacement surgery, what should one be cautious about?"

Liu Banxia was in the process of freeing the left renal vein when Zhou Shuwen suddenly asked.

"What needs attention is that the inferior mesenteric arteries arising from the aneurysm are mostly severely stenosed or occluded. Our normal operation is to cut and ligate them at the root," Liu Banxia said while operating.

"However, some situations are quite special. For example, if the inferior mesenteric artery is significantly dilated, or if the superior mesenteric artery has insufficient blood supply, we need to do a reconstruction."

"Our patient didn’t have time for angiography, so we’ll have to do a Doppler ultrasound later to check the blood flow. But I personally think that his condition is likely due to an abdominal aortic dissection from a car accident."

"Another thing is the trimming of the artificial blood vessel. Since the artificial vessel will stretch after blood flow is restored, we should trim it in its extended state."

"In terms of medication, we must use heparin cautiously. The patient’s current condition, along with factors like the artificial blood vessel, may cause coagulation abnormalities."

After speaking, Liu Banxia paused and sneaked a glance at Zhou Shuwen.

Zhou Shuwen did not respond, leaving it unknown how he felt about the answer.

"Oh, and one more thing, the patient’s body temperature," Liu Banxia continued.

"Actually, this is something we need to pay attention to in many surgeries with high blood loss. With significant blood loss, the body temperature will definitely drop."

"The temperature of the fluids and blood we provide is also very low, so we must preheat them to prevent hypothermia from affecting cardiac function and coagulation mechanisms."

Zhou Shuwen nodded, "That’s more like it. Everyone knows how it is. Artificial blood vessel replacement isn’t that difficult. You just need to pay attention to proper anastomosis after freeing."

"At the same time, when we perform an artificial blood vessel replacement, we’re rebuilding the patient’s blood flow, so we must consider the overall blood circulation as well."

"You obviously know everything, and can do it yourself, yet you want to drag me into it. Whether we can have lunch on time depends on the speed of your freeing and closing the abdomen."

The people in the operating room stifled their laughter, feeling entertained.

Usually, Liu Banxia would make others suffer during surgery, but today someone finally made him suffer. Especially Su Wenhao and the others felt very pleased in their hearts.

However, Su Wenhao still felt somewhat fatigued, as Liu Banxia’s speed was truly unmatched.

If not for frequently assisting Liu Banxia and gaining enough surgical experience, he wouldn’t have had the confidence to handle this surgery.

And he wasn’t even the lead surgeon, just the first assistant for now.

Everyone else was also meticulously observing Liu Banxia’s operation, envious of his speed and precision.

"OK, freeing is complete. Let the director show his skills next."

After a while, Liu Banxia stepped back and stood aside.

"Looks like lunch shouldn’t be a problem," Zhou Shuwen said.

"He’s not only quick at freeing; he’s also very fast at closing the abdomen. But you all shouldn’t just learn his speed without considering his steadiness and accuracy."

"We evaluate a surgery by many factors, aiming for precision in every operation. You’ve seen Shi Lei’s surgeries, right? Shi Lei’s operations couldn’t be called fast, but he doesn’t take too long either."

Everyone nodded in unison. Liu Banxia had explained this during earlier surgeries too.

But the admiration for Liu Banxia’s recent operational speed remained in their hearts, unsure of how many years it would take to reach his level.

"Liu Banxia, what should you pay attention to when anastomosing the distal end?" Zhou Shuwen suddenly asked another small question.

"Could you not ask that now? Just before tying the last stitch, release the clamps at the proximal and distal ends to expel air and clots from the artificial blood vessel," Liu Banxia replied.

"See, I just said it. He could handle it entirely by himself, yet insists I suffer with him," Zhou Shuwen teased.

"I’ve just been busy for the past few months and haven’t had the chance to do surgery with you. It’s been a while," Liu Banxia said with a smile.

"The last time at the inpatient department, we did surgery in the operating room where I first assisted you in doing surgery for Wang Mingxing. I instantly got a feeling when I entered."

"Back then, I already felt you were a bit jumpy. So what else needs attention at the distal end?" Zhou Shuwen prompted with another small question.

"To avoid an arterial-enteric fistula, the anastomosis must be covered and isolated from the duodenum and intestines. If the sac wall allows, overlapping sutures can be done," Liu Banxia replied offhandedly.

"That’s about right. The rest are common-sense issues. For instance, when opening the clamps, we need to prevent a sudden drop in blood pressure by gradually releasing them," Zhou Shuwen instructed.

"Also, in proximal sutures, as you have seen, the back wall must be sewn deep enough, encompassing all layers. Otherwise, it could peel off the inner membrane, leading to bleeding."

"When stitching from the back wall to the front, pay attention to the corner. It requires tight suturing, or it could also easily lead to bleeding."

Everyone nodded in agreement, realizing that many hadn’t noticed these details before.