Surgery Godfather
Chapter 1043 - 858: Remote Hemostasis_2

Chapter 1043: Chapter 858: Remote Hemostasis_2

After clamping the aorta, Director Xu checked the blood vessel, fortunately, there was a tear that was previously overlooked, initially small, but perhaps due to the high pressure of the blood vessel, it suddenly ripped into a larger longitudinal tear. Major vascular surgeons thought it could be repaired after inspection.

However, they must deal with the two short steel rods before proceeding with the repair, otherwise, it would be difficult to even stitch up, with the tear right behind one of the rods, blocked from view by it.

Director Xu hadn’t yet caught his breath when another major bleeding site sprang up, gushing blood like a fountain.

"Suction device, here, quick, give me some visibility."

Director Xu estimated that the bleeding blood vessel originated from the liver or pancreas, but the vessels of the liver and pancreas are somewhat posterior, and if it’s one of the posterior vessels, it’s very tricky. For now, Director Xu could only pinpoint the general location of the bleeding.

Being an experienced emergency surgery expert, he remained calm and composed. With the assistance of the assistant’s suction device, he finally identified the source as likely being the vessel at the back of the liver, near the third hepatic portal.

He reached behind the liver to feel around and seemed to find something, then he pinched it, and remarkably, the bleeding decreased, which indicated his judgment was correct.

A short steel rod happened to pass through the liver. Since the liver needed to be opened anyway, he decided to do it now.

"Vascular clamps!"

Using vascular clamps, Director Xu achieved hemostasis with the dexterity of his hands, a skill hard-won from years of emergency surgical experience, something not easily replicated by less seasoned individuals.

But after handling that vessel, the bleeding only decreased, it didn’t stop.

From the direction of the bleeding, the remaining source seemed to be on the side of the pancreas. Director Xu tried to feel behind the pancreas; the pancreas is often more complicated because its vessels frequently vary, making anatomy unstable.

Moreover, the steel rod was pressing down firmly on the pancreas, not allowing much depth to probe, and after several attempts from above and below, Director Xu couldn’t find anything.

The situation was frustratingly passive, but Director Xu had no choice. This was Xiehe Hospital’s emergency surgical team in action. In an ordinary hospital, a case like this would have been lost by now.

Several groups of doctors worked swiftly, but futilely, as the bleeding was profuse and frequent, as were the steel rods.

With so many sites needing attention, and the abdominal cavity being limited in space, they had to deal with them sequentially.

Blood pressure had begun to show signs of instability, declining.

While the pancreas was still being dealt with, the major vascular team was waiting to attend to the major vessels, but it was impossible to address those while bleeding was gushing from the pancreas. If two people were to work at the same time, there wouldn’t be enough space.

The anesthesiologist was highly attentive to the patient’s blood pressure, plainly observing that it was on a downward trend. He intended to increase the transfusion pressure, but found it was already at maximum, not allowing for further increase.

"The blood pressure is a bit unstable!"

The anesthesiologist immediately reported the observed vital signs to the chief surgeon.

Despite the instability, there wasn’t much that could be done as the bleeding was extensive, like a fire out of control, with firefighters exhausted from the chaos.

The neurosurgery team was methodical, having cleared the intracranial hematoma, they were slowly starting to separate the tissue around the steel rod, creating a safe passage for its removal. Their surgery couldn’t be rushed; they had to proceed with steady hands.

"The vessels of the pancreas are variant; look, this one is the current major bleeding vessel from the pancreas, bleeding intensely. It’s a vessel that must be controlled immediately, not just these several vessels, but here too, you see, all these vessels must be quickly controlled."

Yang Ping pointed out several key vessels on the films, deemed imperative for immediate control, yet they were all still uncontained.

Based on the severity of the injury and the rate of blood pressure decline, Yang Ping could make a rough prediction. This was part of his published trauma theory, which estimates the rate of blood loss by assessing the injured vessels and then incorporates the rate of blood transfusion, allowing for a circulatory prediction of how long the patient can hold on. With the addition of factors like age, the accuracy increases even more.

According to his theory, the patient wouldn’t last much longer at this rate.

"We need to speed up, or the patient won’t last much longer," Yang Ping was seriously concerned.

Director Long also began to feel anxious about the situation unfolding on the operating table.

"The blood pressure is still dropping!" the anesthesiologist’s concern was now more evident.

"Continue increasing the pressure!"

Director Xu ordered.

But they were already at the limit, with no more pressure to add.

"It’s already at the maximum pressure."

The anesthesiologist said.

Director Xu looked up at the several bags of blood hanging on the intravenous stand, "No good, the bleeding is too rapid, the injuries too complicated. Not to mention the reinforcement bar has damaged so many blood vessels, there is also bleeding from numerous fractures—a tremendous amount of blood loss."

It was only now that Director Xu began to feel a lack of confidence; this case truly exceeded his previous experience and was incredibly difficult to manage.

Somehow, a blood vessel might have burst through the blood clot formed by the body’s natural coagulation process, and blood was gushing out again.

"Where is this new bleeding coming from?"

We haven’t even dealt with the current enemy, and now a new one has emerged.

Director Xu started to feel a bit overwhelmed, but this was just on the technical side. Emotionally, he remained as calm as ever; he was an experienced emergency surgeon, not a greenhorn holding the scalpel for the first time.

Not every patient can be saved; we can only do our best.

The anatomy here was complicated to begin with; otherwise, a Whipple procedure wouldn’t be considered a major surgery.

The short reinforcement bars hadn’t been removed yet, and now they had to dissect the pancreas. They were simply too busy, and even if you had three heads and six arms it would be in vain.

We can only do our best treating a dead horse as if it were alive.

"Director Xu! The most vigorous bleeding is behind the pancreatic head!"

"Give me a large curve, open the clamps a bit, insert them from the lower side of the pancreatic head, angle the bend towards the right, the clamps should enter straight up, extend the clamps to the pivot position to clamp."

"Hand me the large curve, I’ll demonstrate for you."

Yang Ping shouted loudly, and Director Xu immediately stopped, turned his head to look at Yang Ping, Qiu Nuo handed Yang Ping a clean large curved vascular clamp, and he immediately used his own hand to represent the pancreas, demonstrating to Director Xu.

After the demonstration, Yang Ping approached the operating table, ready to guide Director Xu in stopping the bleeding.

Director Xu hesitated briefly, then immediately followed suit, but even with the demonstration, he couldn’t be as precise; he carefully inserted the vascular clamps.

Everyone made space, and Yang Ping, disregarding sterility principles, leaned as close to the operating table as possible, peering inside before speaking:

"Slightly to the right, yes, go in a bit more, a bit more, don’t be afraid."

"The opening of the clamps is too small, make it larger."

"Rotate the clamps clockwise a bit, yes, stop!"

"Maintain this position, move forward a bit, don’t move!"

"Clamp!"

Under Yang Ping’s remote guidance, Director Xu finally completed the action. He could clearly feel that he had clamped onto some tissue. After the suction device cleared the bleeding in this area, something miraculous happened—there was truly no more bleeding.

"First clamp onto it with the tooth!"

Yang Ping could only instruct Director Xu in this way because the subsequent steps of ligating the blood vessels by feel were impossible for Director Xu to do.

Director Xu executed as instructed, attaching the tooth to the vascular clamps, and then releasing the clamps, his heart feeling relieved.

If it were someone else, even with Yang Ping’s remote guidance, they wouldn’t have been able to complete the hemostasis because it required a wealth of experience.

Afterwards, under Yang Ping’s distant guidance, Director Xu managed to stop the bleeding in several blood vessels, and these were the ones that were just troublesome.

After stopping the bleeding in several major vessels, the condition in the surgical field noticeably improved, and Director Xu breathed a sigh of relief.

It’s not possible to always have someone directing your surgery like this, right?

Director Xu said to Yang Ping, "How about you scrub in and help on the table?"

Yang Ping didn’t hesitate, there wasn’t time for fuss when saving lives, so he immediately went to scrub in.

As he left, he didn’t forget to say, "Qiu Nuo! Scrub in!"

The subsequent surgery progressed very quickly. The instrumental nurse couldn’t keep up. He needed a nurse who could adapt to his pace.