BXBX NOVEL Chapter 95: Teacher Shi, don’t be nervous!
Chen Cang thought about it and then called Qin Yue, his little brown-noser.
After all, it was a pleasant thing to have someone good-looking and boastfully cheering for oneself as “awesome” during surgery.
Of course, Qin Yue was a genuine Xiangya graduate student, so the level was somewhat there.
Having only Wang Yong-
Boring, dull!
Actually, could Chen Cang do it alone?
He could!
But thinking about how Wang Yong was an important clue to activate the mentor-student task, Chen Cang still wanted to give him a chance to train and guide him.
As for Qin Yue-
Chen Cang didn’t think it was merely boring, he wasn’t that idle and pain-stricken.
The main reason was that Qin Yue was currently engaged in surgical research work, and Chen Cang reckoned that communicating more with Qin Yue to summarize his surgical experience might yield a research paper.
The operating room was ready, the first patient wasn’t too troublesome, just a regular case of cholelithiasis, with the ultrasound showing an enlarged gallbladder!
Because she didn’t feel reassured, Shi Na decided to follow Chen Cang into surgery, while Qin Yue came early to take Shi Na’s duty.
Full of curiosity, Qin Yue arrived at the office to find that Shi Na had already followed Chen Cang into the operating room.
Qin Yue couldn’t help but ask the duty nurse, “What surgery is Chen Cang performing?”
The nurse was stunned for a moment, “It should be a cholecystectomy, 1 think
it was case number 12 just before.”
Upon hearing this, Qin Yue scampered to the office, logged onto the computer, and opened the medical record for bed 12.
Preoperative records, all set!
Laparoscopic cholecystectomy.
Preoperative diagnosis:
Cholelithiasis.
Significant enlargement of the gallbladder.
Chen Cang is performing a cholecystectomy?
What the?
For real?
At this moment, Wang Yong also rushed in hastily, seeing Qin Yue sitting in the office with a puzzled expression on his face.
“Where’s Chen Cang?” gasped Wang Yong.
Qin Yue: “He’s gone to surgery with Teacher Shi, why are you here?
Wang Yong sighed helplessly: “I am now Chen Big Boss’s little follower. When
Chen Big Boss calls, don’t 1 have to scurry over here?”
Upon hearing this, Qin Yue burst into giggles.
Wang Yong glared at Qin Yue, “You’re laughing at me, but aren’t you the same?
Also a follower of Chen Cang, mind you.”
That comment made Qin Yue so mad her chest puffed up a cup size!
Wang Yong chuckled, “See, 1 told you, you look much prettier when you’re
angry than when you’re laughing.”
Qin Yue was so infuriated, she wanted to hit someone!
Wang Yong couldn’t help but ask, “What surgery is Chen Cang doing? He didn’t make it clear on the phone.”
Qin Yue replied irritably, “Look for yourself!”
After Wang Yong read it, he was suddenly stunned, “Oh my dear, a cholecystectomy? Chen Cang can do that too? He must be doing it with Teacher Shi, right?”
Qin Yue shook her head, “Teacher Shi is an orthopedic doctor, for goodness’ sake! She never performs gallbladder surgeries. I’ve been following her for so long and have never seen her do one.”
Upon hearing this, Wang Yong’s eyes widened in shock, “Then you mean…
Teacher Shi is assisting Chen Cang? Chen Cang is the main surgeon?
Qin Yue also suddenly realized, and her already large eyes widened again like a cartoon character: “Is Chen Cang that amazing?”
Suddenly, both of their gossiping hearts were stirred.
Inside the operating room, the anesthetist had already administered general anesthesia to the patient.
The cholecystectomy was more troublesome, took a long time, and it was a laparoscopic cholecystectomy at that.
Truth be told, Shi Na was feeling a little panicky and short of breath, as she wasn’t very familiar with this surgery, and it naturally made her nervous!
After all, surgery wasn’t like slaughtering a pig, where you could just kill it and be done; surgery was about saving lives, and there was no room for negligence.
Standing inside the operating room, Shi Na looked at Chen Cang with some concern.
Why does the operating room feel so cramped today?
In short, Shi Na just felt uncomfortable!
Seeing this, Chen Cang smiled and said, “Teacher Shi, don’t be nervous.” Shi Na’s face immediately flushed red. Who said I’m nervous? Nonsense!
Besides, it’s my first time. Who wouldn’t be nervous? I, a distinguished orthopedic surgeon, am here to watch you perform a gallbladder surgery. It would be strange not to be nervous!
Shi Na adjusted her status and said softly, “Let’s start.” Conventional disinfection of the skin of the surgical field, sterile drapes were laid, the trocar sleeve…
Next up, time to inflate the abdomen!
Laparoscopic surgery requires insufflation to lift the abdominal wall for a better view of the surgical field and to facilitate the surgery. Everyone should still remember the insufflation anthem, so there’s no need to sing it here.
Chen Cang made a 1.5cm arcuate incision at the umbilicus and, through the incision, inserted the veress needle into the abdominal cavity to start insufflating with carbon dioxide.
Inflating requires the right amount of force. As the saying goes, “practice makes perfect.” When the indicated pressure reached 13 millimeters of water column, pneumoperitoneum was successfully established!
After removing the veress needle, he inserted a 10mm trocar at this puncture point to manipulate the internal organs through the auxiliary port. At this time, the surgical field was fully exposed, and the organs inside the abdomen began to appear on the monitor!
1 Liver) Green, no abnormalities detected.
(Peritoneum] Green, no signs of infection or exudate.
(Stomach] Green, normal.
When the red (Gallbladder] appeared, some information flashed through Chen Cang’s mind.
[Cholecystitis, level: lv28, size: 50x21x18mm, grey-white, wall thickness 4mm, congestive edema, high tension, gallbladder neck with an impacted stone, stone size…]
Chen Cang was surprised to find that this time there was much more information than before. Detailed data was directly fed into his mind, allowing for a more detailed and comprehensive grasp of the disease!
After the examination, Chen Cang said to Shi Na, “Teacher Shi, please provide support in this field of view.”
Shi Na nodded, and Chen Cang began the next step of the operation.
Chen Cang chose a three-port laparoscopic approach: one for observation, one for primary operation, and one for assisting.
Shi Na was indeed nervous because it was time to dissect the gallbladder triangle, also known as the triangle of Calot.
Fortunately, the gallbladder triangle was clear and easy to dissect. Chen Cang, with forceps in his left hand, retracted the bottom of the gallbladder towards the head side, and with the electrocautery hook, he approached the gallbladder infundibulum to separate the cystic duct.
This series of movements, although simple in appearance, required countless practice sessions to master proficiently because it’s easy to accidentally damage the sensitive area.
The dissection and separation of the gallbladder triangle were the most difficult; it’s also the toughest aspect of difficult cholecystectomy surgeries because adhesions in the triangle are severe and hard to separate. While operating, Chen Cang suddenly noticed something very exciting!
A red [Stone]!
Chen Cang discovered that while dissecting the gallbladder triangle, he could actually see the red-tagged [Stone]!
This was undoubtedly great news for Chen Cang.
Why are there so many instances of postcholecystectomy syndrome?
It’s because many tiny stones are left behind, or even stones remaining in the intrahepatic or extrahepatic bile ducts, leading to direct surgical failure!
If it’s something more serious, such as if a tumor is left behind instead of stones?
Remember, these things are not easily detected!
Yet here I am, able to discover those hidden diseases, which is undoubtedly a blessing for the patient.
Realizing this, Chen Cang discovered that his vision was a treasure, and perhaps there were many more uses for it that he had yet to uncover. But it’s undoubtedly a powerful tool for saving lives and treating diseases! Being able to detect diseases that are easily overlooked is critical for a surgeon! After the excitement, Chen Cang continued with the surgery.
After clamping the cystic duct and cystic artery, he handed over the electrocautery hook and the converter to proceed with the gallbladder removal! At this moment, Shi Na finally breathed a sigh of relief!
It’s good once cut!
Once it’s cut, all is well-
Next, it was time to extract the gallbladder. A medium-sized vascular clamp was used to grasp it, a small incision with a scalpel was made, and the bile was washed out.
At this point, the surgery was nearly at its end!
Now it was time to remove the stones and subsequently pull out the gallbladder!
The entire procedure went so smoothly that Shi Na felt it all seemed a bit surreal..