Surgery Godfather

Chapter 206: Chapter 0194: The Rescue That Silences Everyone

The mini-lecture on open-chest surgery was over, but everyone still couldn’t get enough. They asked to replay the surgical images more slowly.

The chest cavity, split open from the sternum in the middle, opened to both sides, the exploration went from the front to the back, all the way to the spine on the rear side, leaving no blind spots, no omissions; Likewise, the abdomen, also with a vertical incision, fully opened to both sides, fully revealing the injured areas.

In this case, there were two short nails on the wooden stake, which had punctured the abdominal aorta. Looking at the images, when the injured aorta was revealed, the nails were still hooked in the abdominal aorta.

When the images of the injured abdominal aorta were magnified, everyone was terrified, sighing deeply. If the wooden stake had been pulled out directly, the nails would have torn the aorta further, and the patient still breathing would have died instantly from massive blood loss, without any chance of undergoing surgery.

“Time is life! In such surgeries, one second can decide life and death!” Yang Ping added from the podium.

Speed up, speed more, and even more! This is the rhythm of such rescue surgeries.

There are countless places bleeding, like numerous broken faucets that are all gushing water, it is impossible to shut them all off at the same time. This requires a judgment to be made about which one to shut off first.

First turn off the faucet that is gushing out the fastest, then shut off the others one after the other in sequence. That’s the thought process – this is a matter of surgical priority.

With the order of things now resolved, the next step is hemostasis. For instance, in the event of a ruptured spleen, perform splenectomy. But before it is removed, it will still bleed. In order to reduce bleeding and minimize the risk, a vascular occlusion procedure is employed to resolve this contradiction.

It’s like all these faucets are spewing water, and I know which one to turn off first and which one to turn off later. But I can’t, because there’s water everywhere, I can’t even see clearly where these faucets are. Even if I manage to notice them, I’m too busy trying to stop the water to attend to them all.

In such a situation, turn off the main switch first, stopping all the faucets under its jurisdiction. This way, it’s clear which ones are the biggest and which ones are the smallest. Then, calmly close these faucets in sequence, fix what needs fixing, and directly shut off what needs shutting off.

The main switch can’t be off for too long, because other people still need water. Therefore, try to complete the operation within the allowed time, and then turn the main switch back on. The faucets won’t spew water anymore.

Tan Boyun was watching the screen intently. His area of expertise is trauma orthopedics, and he has lots of accomplishments in this field. These types of surgeries indeed involve high difficulty and high risks. Surgeons must not only operate very quickly but also have a thorough understanding of anatomy. For this case, the aorta is blocked quite high up, after the division into the head/trunk branches, and the blockage can only last about twenty minutes.

According to the introduction, this surgery was completed within twenty minutes. These short twenty minutes involved complex explorations, repairs to the aorta, liver, pancreas, duodenum, and diaphragm, as well as ligation and hemostasis at multiple locations.

This level of familiarity with anatomy is unimaginable. I can’t fathom the level of skill required to complete such a series of procedures within twenty minutes. If I were the lead surgeon, I definitely couldn’t finish within twenty minutes.

Temporary vascular bridging techniques or artificial vascular implantation must be used to stop the bleeding from the abdominal aorta. Only then is there time to slowly carry out the subsequent steps.

If it weren’t for this meeting discussing this case, Director Tan wouldn’t have known that Yang Ping was this capable. To be able to perform such surgery with such apparent ease is impressive.

Fatty raised his hand and scratched his head, saying “Dr. Yang, you’re incredibly skilled, but not everyone is as skilled as you. Even after you explain this surgery, if I encountered the same case, I still wouldn’t be able to do it in the same way. Is there a simplified method for such trauma surgery? For example, photography—professional cameras have focal length, light settings, and are so complicated. By comparison, point-and-shoot cameras, although they don’t capture photos as well as professional cameras, do produce satisfactory photos with a simple press of the shutter.”

True, Fatty hit the nail on the head, bringing up the issue everyone was pondering. Everyone was waiting for Yang Ping to answer. Fatty narrowed his eyes into a thin line, awaiting the answer as well.

Director Bai, sitting next to him, said: “That’s right, Xiao Yang, for a surgical procedure to be suitable for mass replication, it has to be replicable. If it can’t be replicated, it can’t be promoted, and you need to figure out how to make this operation more accessible. Only in this way can we save more lives.”

Director Han said with a smile, “That’s the subject of Xiao Yang’s upcoming talk, and part of our ongoing effort to improve the entire trauma emergency response protocol. Xiao Yang has put a lot of effort into creating a modular surgical process, which we’ll discuss shortly. Everyone, please be patient, and let’s watch a video on large-scale trauma rescue at Tokyo University Hospital first.”

Yang Ping returned to his seat to rest, and Dr. Zhong went up to the stage and retrieved a video from his computer. “This is a large-scale rescue operation following a serious traffic accident. The whole video, starting from the emergency department to the end of the surgery, is a live recording of the full process. Please watch it carefully, and don’t film it or disseminate it, as this was privately provided by a friend who was training there. They filmed it to assess areas for improvement in the process and strive for excellence.”

The doctors who had been using their phones to take pictures and record videos put them away. Everyone started to pay close attention to the video, because it represented the international pinnacle of trauma rescue standards.

“Let’s play the video at normal speed first. Then replay it in slow motion. When we slow it down, Director Tan can explain it to everyone.” Director Han instructed Director Tan.

Director Tan replied, “Okay, Director! Everyone should watch it carefully. That way, my explanation will be more accurate and meaningful.”

The video started playing. The emergency transport beds, one after another, brought the casualties to the emergency center hall. The patients’ clothes were all cut off, with only specialized blankets left covering them.

The doctors and nurses of the emergency department, already divided into teams, are waiting in the hall. As soon as the injured appear, they immediately take charge of their patients. The doctors make preliminary judgments on the injuries and arrange the next treatment steps; nurses measure vital signs and administer blood transfusions. Nearly without pause, everything seems well-prepared in advance, all done during the transport of patients on the stretcher.

The stretchers start to branch off in the hall, being pushed towards different areas. Those needing emergency surgery are sent to the surgical area; those not requiring emergency surgery are taken to another area.

The camera follows one patient needing emergency surgery, entering the surgical area. The doors have been opened in advance. The first stop seems to be the CT room for an emergency CT scan.

The height of the stretcher matches the CT platform, having been adjusted in advance. The stretcher docks with the CT platform, and the patient is swiftly and smoothly pulled onto the platform. The patient’s stretcher doesn’t need to be dismantled as it’s X-ray transparent and can pass through the CT.

The patient undergoes a high-speed CT scan. Once the scan is done, they are immediately transferred to the connecting stretcher on the other side of the CT platform. Pulled onto the stretcher, they are taken to the next station – the operating room.

The hallway connecting the operating room and CT room is a straight line. The patient enters from the CT room side, and once the check is completed, they exit from the other side, are taken down the hall, and directly pushed into the operating room where doctors and nurses are ready to receive them. Once the stretcher is pushed to the entrance, they take over.

The connection between both stations is fully open and straight-line, with no obstacles, no unnecessary turns or detours, offering straight and clear access. Upon entering the operation room, the stretcher aligns perfectly with the bed, and the patient is pulled onto the operation bed. Only then is the detachable stretcher dismantled from both sides.

The doctors participating in the surgery have already prepared themselves in surgical gowns and are waiting. Assistants start disinfecting and laying out the sterile sheets, while the chief surgeon reviews the patient’s CT scan report and images.

The efficiency is very high. As soon as the disinfection is done, the CT room has already transmitted images and reports. The patient’s CT images and reports appear on the LCD screen, the control panel of which is covered with a sterile membrane.

The chief surgeon directly controls and reviews the emergency case files and CT data, first reading the report to quickly gather information, then studying the 3D reconstructed images. Simultaneously, a reference opinion on the surgical method is given, providing guidance on what injuries there are, which should be treated first, which later, including specific surgical methods.

The patient has an aortic rupture, splenic rupture, and multiple duodenal ruptures. The chief surgeon first stops the aortic blood flow, then repairs the aorta, then carries out a splenectomy, releases the aortic obstruction, and finally treats the liver rupture, duodenal rupture, and other injuries. The surgical procedure is highly scientific, and the surgery is successfully completed in the end.

From the moment the emergency stretcher appears in the emergency department, the entire process, with the doctors and nurses working together like precise gears, seems like a well-rehearsed routine. No matter how you look at it, you can’t find any flaws, connection errors, or wasted time.

The whole process takes just over an hour, with most of the time spent on the operation table, primarily following the completion of the aortic obstruction. Thus, for the majority of time, the patient is in a controllable state. That is, after being handed over to the doctor, the patient’s condition is stabilized.

From the emergency hall to the operating table, including the intermediate CT scan, it takes less than ten minutes – merely a few minutes to get onto the operation table, undergoing an examination and having a clear understanding of the injuries and a mature surgical plan.

This is just a rescue surgery for one patient. The rescue procedures for other patients are also shown one by one. The speed at which each patient is rescued is practically the fastest, with no delays, as if it were intentionally filmed. The entire process and the scene are smooth and tidy, with not a single hint of chaos. Even after completing a surgery, all waste in the operating rooms is thrown into bins, leaving no mess.

One patient, upon arrival at the emergency department, immediately underwent aortic balloon occlusion surgery for temporary hemostasis; another patient with multiple rib fractures, tension pneumothorax, and cardiac arrest had thoracotomy directly in the ambulance and was subjected to intrathoracic compression.

When the video finished playing, everyone drew a breath. The entire venue was silent. The doctor who had been joking earlier and impatiently whispered, “Why watch a video of the Japanese…” also fell silent.

Some doubted, guessing it was fake, intentionally filmed to show off to everyone, right? How could it be so fast and perfectly coordinated? Rescues would at least create a bit of chaos and waste some time, wouldn’t they?

“This is a video of their regular trauma emergency surgery!”

Director Tan’s words broke the silence and dispelled everyone’s doubts.

“The participating doctors are ordinary doctors. There’s a scene where a lecturer, equivalent to our attending physician, operates on a liver and spleen rupture in twelve minutes. The one who operated earlier had an aortic rupture, liver and spleen rupture, and duodenum rupture. The surgery took an hour, and the surgeon was also a lecturer.”

“Each physician at this level possesses such skills. For a top-level professor like Fujiwara Masao, he hasn’t even performed such surgeries. He simply repairs the aorta and never takes more than two minutes!”

“Without comparison, there’s no recognition of the gap. It’s not scary to have a gap. What’s scary is to turn a blind eye, to not admit the gap. I just heard someone say, ‘I’m busy with surgeries, why watch a Japanese surgical video, where are they better than us?’ Now you see? Do you know where their superiority lies?”

Director Han stood up, stating each word solemnly.

“To surpass others and to become stronger, you have to do it with your hands, not your mouth. Do you understand?”