Surgery Godfather
Chapter 1300 - 989: Major Bleeding

Chapter 1300: Chapter 989: Major Bleeding

Director Zhang’s skills were indeed commendable, especially considering the conditions of a grassroots hospital. His ability to independently carry out major surgeries, such as radical surgery for liver cancer and other digestive tract tumors, was of great significance in remote county cities like Nanqiao. The inconvenient transportation in the mountain areas meant that transferring patients to a tier-three hospital in the city took at least two to three hours, so solving problems locally could alleviate a lot of the economic pressure for patients. This was also why the Shipo County People’s Hospital managed to develop.

The patient was a 50-year-old male with late-stage colon cancer, who had developed an obvious intestinal obstruction and thus required surgery. Due to economic conditions and the high reimbursement rate for the new rural cooperative medical care in township-level hospitals, the family decided to ask the elderly director for help in having the surgery at Guandu Hospital.

Once the abdominal cavity was opened, Director Zhang’s hands were swift, exhibiting the skill level one would expect from Zhang Yidao. He quickly located the tumor, using his fingers as a miraculous separator to begin blunt separation. Amid the commotion in the abdominal cavity and after several separations, Director Zhang quickly found the breakthrough for separating the tumor.

"Surgery is all about practice makes perfect, the more you do, the more skillful you become. There aren’t any special tricks. How old were we when we graduated from secondary specialized school, 18! Started holding a scalpel at 18, imagine that. Nowadays, doctors are in their thirties before they start operating, how can their experience compare to ours?"

As Director Zhang performed the surgery, he also taught Li Min. Old Zhang was very confident in his surgical skills and he deeply trusted experience. In his view, all the talk about papers, new techniques, and evidence-based medicine was bullshit. The real essence of surgery lay in hands-on skills, and traditional methods were the most reliable. Decades of clinical experience were worth more than anything.

"I’ve also been to the provincial city for advanced training before and seen young doctors perform surgeries. Their hands holding the scalpel were like chicken claws, it was agonizing to watch."

"Starting practice in their thirties, how could they ever get good?"

Director Zhang continued lecturing regardless of whether Li Min responded or not.

"Director Zhang! Let’s have dinner here today, how about a local chicken fried with tea oil?" The elderly director suggested, seeing Director Zhang’s relaxed demeanor.

Director Zhang directly refused, "After I finish this surgery, I have a thyroid surgery to attend to at Crossroads Hospital. It’s a relative of our hospital’s logistics staff, so we’ll have dinner another time."

Director Zhang was easy-going and straightforward, so when he declined like this, the elderly director didn’t bring it up again.

As the first assistant, Li Min appeared quite relaxed, tying knots and cutting sutures with ease. Such a surgery would have been beyond Li Min’s capability as an assistant in the past, as he had never even seen it, let alone assisted. But now, Li Min had grown beyond recognition; such surgeries were nothing more than routine for him, considered within the batch of surgeries that Professor Yang had classified him as proficient.

The proficiency demanded by Professor Yang was not ordinary. Although the training time was short, Li Min was, after all, a direct disciple of Professor Yang.

About ten to fifteen minutes into the surgery, Director Zhang’s hands began to slow down. He touched the pulsating aorta in the abdomen, then felt the tumor, "My goodness, the tumor is adhered to the aorta. Let’s see how the inferior vena cava is."

The inferior vena cava in the abdomen was also adhered to the tumor. Now what? The walls of the inferior vena cava were thin, and if the separation was careless, it could cause massive bleeding with no rescue measures available.

Director Zhang might have looked rough on the outside, but he was meticulous at heart. He stopped the separation and began looking for a new breakthrough. His hands were still very agile, and he quickly found a thick, cord-like structure and gave it a squeeze.

"This can’t be a blood vessel, right? Why is there such a thick blood vessel!" Director Zhang muttered to himself.

Li Min looked at the location of Director Zhang’s hands, which was right where a bundle of blood vessels supplying the tumor were located. They were adherent to each other and to the surrounding areas. From the tactile feedback, it was undoubtedly a bundle of blood vessels. If faced with this difficulty and retreating, it would clearly not fit Zhang Yidao’s style. The reputation of Zhang Yidao was built surgery by surgery, not out of random claims.

Since this was the pedicle of the blood vessels, Director Zhang decided to breakthrough from here; otherwise, they couldn’t proceed with the surgery. He also had his own methods, which involved trusting his own tactile sense. Using fingers in coordination with tissue scissors, he touched repeatedly and then cut with the scissors. Bit by bit, he advanced, forging a path through mountains and building bridges over water – this was Director Zhang’s strategy.

"How much blood do we have on reserve?" asked Director Zhang.

The elderly director brought a stool over to sit in a corner, "Six units; it’s inconvenient to get blood in a grassroots hospital, so we could only prepare this much."

Six units might suffice for an ordinary surgery, which very likely wouldn’t require blood at all, but for this sort of surgery involving major blood vessels, six units might be inadequate in case of hemorrhage.

Director Zhang paused briefly to think about the next step; with complex surgeries, he always took it one step at a time. He had gone through other dangerous surgeries before but had always managed to turn peril into safety.

If the tumor was to be completely removed at present, it was necessary to separate the adhesions with the aorta and the inferior vena cava. Such a risk was too great, so it was better to step back. The parts of the tumor close to the blood vessels would be left in place, removing most of the other parts to resolve the symptoms of compression, thereby achieving the goal.

"Let’s do it this way," Director Zhang continued the separation, fingers working in concert with the tissue scissors, skilled and experienced. After great effort, Director Zhang managed to separate the cord-like structure entirely, by then already beginning to sweat from the forehead, "Damn, it’s quite tricky, but let’s reduce the resection range. We’ll remove most of the tumor to alleviate the compression symptoms and leave the rest for now, how does that sound?"

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