Great Doctor Ling Ran Chapter 502
There were several people standing in the corridor of the operating theater where the freelance surgery was being carried out. Some observed curiously while some continued to make phone calls, reporting to doctors who could not come to observe on their own.
There was no doubt about it. There were definitely some doctors who were performing surgery while listening to the situation live handsfree.
When there was a problem in freelance surgery, there would always be a series of responsibilities that needed to be taken care of.
Therefore, doctors who could perform freelance surgery had to be doctors who were able to handle the surgery, and they were required to be very familiar with the surgical method. When such doctors made mistakes, everyone would know what transpired.
There were people coming in and out from three operating theaters located along the same corridor.
The circulating nurses had already paid their visits. The doctors who had been performing surgeries may not have stepped out of their operating theaters, but the other doctors who had gone there to observe were already exiting the place to take a stroll.
Many people found the operating theater in the hospital to be an enclosed space.
But in truth, the flow of personnel in the operating theaters in hospitals was more frequent than the workshops in a factory.
Only the areas near the operating table in the operating theater were considered highly sterile environment.The operating table aside, countless people moved about the operating theaters, including doctors who went there for observations, nurses who passed over consumables, or doctors who just went to take a look.
For a top local hospital like Yun Hua Hospital, there would be a few hundred doctors from junior hospitals arriving at its doorstep for training throughout the year. Among them, only a few got to practice their skills. For those who could not participate in the surgeries, they would go to the operating theater to observe surgeries very frequently.
Cholecystectomies, liver cyst removals, and finger replantations were surgeries that local hospitals often encountered. Hence, the doctors who were there to observe and learn would always attend such surgeries. Meanwhile, even more doctors would be there to observe surgeries that they did not usually encounter, such as hepatectomies. Perhaps when they encountered a difficult case one day, they could apply the techniques they had learned from the surgery they observed today.
In fact, the larger the hospital was, the more doctors who would wander around the operating theaters. Doctors from all around the world who wanted to observe and learn would need to queue up at America's Cleveland Clinic or Mayo Clinic's operating theatersOnce they were back in their hometowns, they would promote the surgeries that they had observed instead of those they performed on their own.
The development of surgery in China started this way in the beginning as well.
Ling Ran stepped open the door and entered the operating theater.
He saw a bulk of bloody gauze on the floor in the operating theater. There may have been around a dozen rolls of them on the floor. The recyclable bottles for autologous blood transfusion were all filled with blood too.
Guo Mingcheng was scowling. His hands were stained red by the blood while he held a pair of forceps and grumbled.
"Can't you make the light brighter?
"Clean the floor please, what if someone falls?
"Where is the blood? Why hasn't it been delivered yet? What are all of you doing?"
It was normal for a chief surgeon to scold people in the operating theater. Once the surgery did not progress smoothly, the chief surgeon would be even fiercer as he rebuked those in the room. Of course, some people were already very fierce in the first place.
Professor Feng Zhixiang who was by the side joined the resuscitation team as well. However, he was old now. When his hands entered the blood-filled abdominal cavity, he looked like he had stuck his hand into a swamp.
Meanwhile, He Yuanzheng picked up the phone and started to make a call.
In an operating theater, the more high-end a doctor was, the more calls he would receive.
Although most people would keep their conversations short, they were no match against the people who constantly called them. When doctors became department directors who were in charge of many tasks, if no one called them constantly, then they should probably start making calls.
At that moment, He Yuanzheng was panicking a little.
"Has he started to bleed?" Ling Ran had not washed his hands yet, so he could not rush to the operating table immediately. As such, he first asked Huo Congjun who was next to him instead.
Huo Congjun, who had been working in the Emergency Department for more than thirty years, was used to seeing blood. Hence, a hemorrhage was normal for him. He stood firmly and said to Ling Ran, "During the hepatectomy, Doctor Guo thought of avoiding the angiomas, but the blood pressure became too high and the blood vessels may have turned incredibly fragile, so it burst all of a sudden."
"Yes, the bleeding in the liver is also very serious."
"What's the rate of blood loss now?"
"At least 2,000 to 3,000cc."
"That's a lot." Ling Ran did not feel very nervous. He was no longer as he was when he initially joined the Emergency Department. Back then, he panicked when he saw massive bleeding in the patient.
However, even though there was massive bleeding, as long as it was under control, there were still chances to save the patient.
Of course, when the level of bleeding grew higher, it would be more difficult to control the situation, and the patient's prognosis would turn out worse too.
Ling Ran silently observed a few feet away from the operating table.
He observed the surgery intermittently, but he had analyzed the MRI scan before. Most importantly, Guo Mingcheng did not use any weird surgical methods. At most, he only used the improved version of hepatic portal superior approach hepatectomy.
As Ling Ran continued to periodically observe, he basically came to understand the intraoperative judgment and intraoperative decisions made by Guo Mingcheng...
Or rather, Guo Mingcheng did not do anything wrong, but he just had bad luck.
Besides, when he chose to perform hepatic portal superior approach hepatectomy on a patient with portal hypertension, he needed to bear the high risk that came with such a surgery.
Now, he had to face that risk.
Ling Ran made an assumption: if he had been the one to perform the surgery, he would have probably made different intraoperative judgments and choices.
He may not have even chosen to perform hepatic portal superior approach hepatectomy.
However, he had Master Level Hepatectomy, had analyzed the MRI scan beforehand, had experience in one hundred and seventy anatomical abdominal dissections, Perfect Level Hemostasis by Heat, and Perfect Level Barehanded Bleeding Control.
It could be said that Ling Ran, who was from the Emergency Department, possessed great advantages and specializations for bleeding control during hepatectomies.
For Guo Mingcheng who only had advanced Specialist Level skills, which was nowhere near the basic standards of Master Level, he had done his best.
It was just that the patient's condition was really complicated, and Guo Mingcheng did not make the best judgments.
Nonetheless, making a different decision was not an assignment of judgment based on numbers. Perhaps during the patient mortality discussion, doctors were able to make an assignment of judgment. But during the surgery, intraoperative judgment was always a comprehensive decision made in the moment. In simpler terms, under the situation where there was absolutely no choice, the chief surgeon could only operate based on their gut.
Making an intraoperative decision in a high-risk surgery was like walking in the forest. If there was a wild boar chasing a person and there was a crossroads ahead, how should the person choose when one path had wolf tracks, another had bear tracks, and the third had tiger tracks?
Sometimes, when the doctor's skills were not good, accidents in surgery would not be due to wrong intraoperative decision. Instead, no matter what decision the doctor made, it may not lead to good results anyway.
When the doctor's skills were good enough, it still did not necessarily mean that the doctor would be able to constantly make correct decisions. The wrong decisions were simply no match for a surgeon.
Doctors who were in between those two categories would usually require luck to guide them in making intraoperative decisions, just like Doctor Guo Mingcheng.
Ling Ran lifted his mask and stood closer to Guo Mingcheng while he craned his neck to observe the abdominal cavity.
"What is it?" Guo Mingcheng did not sound too pleasant. When surgery did not run smoothly, all surgeons would become aggressive.
Professor Feng Zhixiang seemed to be tired from standing, and his maneuvers had grown slower. But he still looked calm as he asked, "Any thoughts, Doctor Ling?"
Ling Ran hesitated for a second before he said, "My bleeding control is much better than my skills in hepatectomy."
If a person wanted to advance from Master Level to Perfect Level, that person would need to perform at least thousands of surgeries, and that upgrade might even include many preconditions. In the case of Ling Ran, who had Perfect Level Hemostasis by Heat and Perfect Level Barehanded Bleeding Control, his bleeding control skills would definitely be better than his hepatectomy's.
Feng Zhixiang had been a professor for many years, and he had seen many different talented people. When he recalled the condition of Elder Mei's hepatolithiasis and looked at Ling Ran's expression, he asked, "Do you have any suggestions?"
"I can help at the operating table after I wash my hands." Ling Ran paused for a moment. for visiting.
Huo Congjun pretended to cough.
Then, he pulled Ling Ran to the back from behind and said, "They are here as freelance surgeons, so if you're going to the operating table, are you willing to bear the responsibility?"
He Yuanzheng noticed that Ling Ran was also stunned, and he felt warmth blossom in his heart, as though someone had just decided to help him bite the bullet.
Ling Ran said, "It's okay if we can save the patient."
"What if you can't?" Huo Congjun retorted.
"I definitely can." Ling Ran's concern was totally different from Huo Congjun's.
"It'd be great if Doctor Ling could help. Sorry that we have to trouble you." Feng Zhixiang did not wait for them to discuss the matter further. That level of bleeding would lead to their announcement of the patient's death because all their efforts would be in vain if they made the slightest mistake. Feng Zhixiang did not have any better methods to handle it, and his disciple, Guo Mingcheng was struggling too
Ling Ran nodded. He did not waste his breath in saying any nonsense. He just turned around and said, "I'll go and wash my hands."
After a few minutes, Ling Ran returned again.
During that time, many doctors and nurses came over to observe once they heard the news. They were not allowed to enter the operating theater, thus they listened to the sounds outside and snuck peeks through the door.
Professor Feng Zhixiang, whose name was written in teaching materials, had made a mistake during a freelance surgery. It would be a topic of discussion for many people in the future.
Ling Ran did not say anything and entered. Then, he put on a surgical gown and gloves with the help of a nurse.
"Let me touch him," Ling Ran said as he put his hands into the slimy abdominal cavity that was filled with blood.