Chapter 44: Intraoperative Unexpected Engorgement

Entering the operating room, the System NPC anesthetist had already administered anesthesia to the Simulated Human.

Ji Xiang actually felt this was unnecessary; after all, it was a Simulated Human and had no sense of pain.

But the System NPC insisted, so he didn't say anything.

Better to be formal, better to be formal, Ji Xiang told himself, so as to avoid getting too used to the rhythm in the system and having any oversights when returning to reality.

Disinfection, laying out sterile drapes, the surgery began.

The System NPC did not perform the surgery simply as usual, but instead interspersed some of Gu Lao's surgical movements to explain the pros and cons to Ji Xiang.

The main point was to adapt to local conditions and use different surgical methods according to the Patient's different circumstances.

This surgery was performed extremely slowly, at least twice as slow as the surgery where Ji Xiang and the System NPC had previously learned the Extension Surgery.

Yet Ji Xiang gained a great deal.

Throughout the entire surgery, he constantly had realizations of "so that's how it is."

And the Experience Points were also climbing rapidly; a single teaching surgery brought Ji Xiang nearly 5000 Experience Points.

The surgery ended, and Ji Xiang looked at the harvest with pleasant surprise.

"Teacher, will you do another one?" Ji Xiang felt it wasn't enough, so he asked.

The System NPC's surgery was truly as beautiful as a painting.

Ji Xiang didn't have this feeling before; after his Circumcision reached Level 7, the surgical visuals had undergone a qualitative change.

Ji Xiang knew this was growth.

"You do one yourself." The System NPC rejected Ji Xiang's idea, "Only by performing surgery can you make progress."

Ji Xiang didn't argue; after assisting the System Operating Room's anesthetist and Nurse in lifting the Patient onto a flat cart to be sent away, he received the next Patient.

The anesthetist administered anesthesia, and Ji Xiang and the System NPC went to scrub and put on gowns again.

Ji Xiang already had his own understanding of Extension Surgery in his heart; to say he was innovating was impossible, but if it came to the depth of understanding of the surgery, he was definitely top-tier within the province.

Coupled with the Level 9 Circumcision that caused a qualitative change in his technique, Ji Xiang had the confidence to pull off the surgery.

Actually, he was also very worried; what if he botched the surgery and the System NPC took a sudden interest in making him experience Empathy?

Ji Xiang performed this surgery with extreme patience, from skin incision to Blunt Dissection, following every step by the book.

Ji Xiang's hand speed was very slow; he deliberately suppressed the effect of his speed bonus, letting the surgery be slow, even slower, striving for a one-time success.

The early stages of the surgery went very smoothly; although Ji Xiang didn't look at the System NPC, he could feel the expectant and appreciative gaze cast upon him.

This was an unnecessary psychological activity; although Ji Xiang understood this, he still felt a little bit proud inside.

When cutting the Y-incision, Ji Xiang suddenly felt the surgical area move, nearly touching the tip of the scalpel.

This gave Ji Xiang a fright.

At the first moment, Ji Xiang thought there was a problem with his Endurance Value, causing him to have blurred vision.

Otherwise, why would there be an abnormal movement in the surgical area?

But the Endurance Value on the System Panel in the top right corner of his field of vision still had 8 points; there was no problem at all.

The next second, Ji Xiang saw in astonishment... saw... the Simulated Human's Corpus Cavernosum began to engorge with blood, and the surgical area changed its appearance in an instant.

"Teacher..."

Ji Xiang hadn't expected this situation to occur; wasn't it anesthetized? How could such an anomaly happen?

He had no choice but to ask the System NPC for help.

"This is a rare, but not uncommon situation," the System NPC said calmly, "Sterile ice pack."

The System Nurse immediately went to fetch a sterile ice pack; before this, Ji Xiang didn't even know that the operating room was equipped with such high-end things as sterile ice packs.

"Nothing to be surprised about," the System NPC seemed to read the surprise in Ji Xiang's heart, "There is a certain probability of this happening during surgery; the operating room has spare sterile ice packs. Did you think they were just there for nothing?"

Ji Xiang nodded; he didn't intervene, but instead watched the System NPC's operation.

This belonged to an intraoperative emergency; it seemed the System NPC hadn't anticipated it either. It must be said that the System Operating Room was set up well; all these accidents were included.

The Circulating Nurse took the ice pack and handed it to the System NPC.

The System NPC applied the ice pack to the base; Ji Xiang looked closely at the surgical area, but there was absolutely no reaction.

The Corpus Cavernosum was still engorging with blood, and the color also looked somewhat abnormal.

But the System NPC acted as if he were accustomed to it, not nervous at all, and explained calmly to Ji Xiang, "Although this condition is not common, the consequences are serious. It requires early and effective diagnosis and treatment. If handled improperly, it often leads to erectile dysfunction or even ischemia and necrosis."

Necrosis...

Ji Xiang had already made up his mind; if the System NPC made him experience Empathy, he would definitely refuse.

"Teacher, how does this abnormal situation come about?" Ji Xiang asked.

"Reflexive engorgement refers to stimulation from the outside to the surgical area and other sexually sensitive areas, or stimulation from visceral receptors, which is transmitted through a portion of nerves to the sacral spinal cord center, mainly Sacral 2-4, and causes engorgement through parasympathetic nerve impulses."

The System NPC explained the ins and outs of this abnormal situation to Ji Xiang.

Ji Xiang listened... absent-mindedly.

The Simulated Human's engorgement seemed a bit abnormal; the surgical area was turning black and purple, and it looked like it would suffer necrosis if not treated in time.

Absolutely cannot let it necrose!

Unknowingly, a part of Ji Xiang's consciousness had entered the system of Empathy; he was afraid from the bottom of his heart that necrosis would occur and require amputation.

"Don't worry, apply the ice pack for 15 minutes, and 60% of abnormal cases can be relieved," the System NPC said gently, "Just wait."

"When the epidural anesthesia block is incomplete, the Patient's psychological activity, or reflexive stimulation from disinfection, draping, and placing relevant instruments in the surgical area, triggers psychological or reflexive engorgement.

The nerve innervation of the surgical area includes autonomic nerves and somatic nerves; the former is divided into sympathetic and parasympathetic nerves. The parasympathetic nerve is the main nerve for engorgement, coming from the Sacral 2-4 parasympathetic center. During neuraxial anesthesia, one must block Sacral 2-4 to block the engorgement nerve."

The System NPC continued to explain to Ji Xiang.

But 15 minutes passed in a flash, and the surgical area still hadn't returned to normal.

"Lidocaine." The System NPC reached out, and the Instrument Nurse immediately slapped the Syringe, already diluted and drawn, into his hand.

Ji Xiang felt a bit envious, but he knew this should be a system program.

In reality, how could there possibly be such tacit coordination.

Perform a dorsal nerve block by injecting 10ml of 2% Lidocaine layer by layer subcutaneously on both sides of the midline at the root.

However, after the block, the surgical area of the Simulated Human remained persistently congested; it was of no use at all.

The System NPC still did not rush; after waiting for 30 minutes, he stepped down to assist the Anesthesia doctor in injecting 10ml of 2% Lidocaine via sacral canal puncture.

Another 30 minutes passed, and the congestion of the Simulated Human still had not improved.

"Truly stubborn," the System NPC scrubbed in and stepped up to the table, "Prepare Phenylephrine."

Soon, a Syringe was placed in his hand.

Inject 1ml of 0.2% Phenylephrine into the Corpus Cavernosum; this time was the moment to witness a miracle.

1 minute, it only took 1 minute for the drug to take effect; it could almost be said to be immediate.

But Ji Xiang soon noticed that the System NPC's gaze did not linger on the surgical area; he kept staring at the Cardiac Monitor.

Ji Xiang immediately swallowed all the questions in his heart.

The blood pressure of the Simulated Human rose by 15mmhg, and the System NPC said, "Give 5mg of Urapidil."

The drug was pushed, and the blood pressure of the Simulated Human soon returned to normal.

After a delay of more than an hour, the surgical area, which had been stimulated to congestion for unknown reasons, was finally restored to normal, and Ji Xiang let out a long breath.

If it were a few days ago, when he had just arrived at the System Operating Room, he would have thought this was just a Simulated Human, and at worst, he could just swap for another one.

But after experiencing Empathy several times, Ji Xiang had changed without realizing it.

"Continue the surgery," the System NPC stood in the assistant's position and said to Ji Xiang.

Ji Xiang nodded and continued the surgery.

The surgery was relatively smooth, and Ji Xiang looked up at the Cardiac Monitor from time to time.

He guessed that the reason the System NPC gave Phenylephrine at the end was because this drug could affect blood pressure and cause more unpredictable consequences.

As for the specific reason why, the System NPC did not say, and Ji Xiang did not ask; he prepared to look it up himself when he went back.

Although it was very useful to have the System NPC, what if one day the system left him?

Do it yourself, and you shall have plenty of food and clothing.

……

……

While Ji Xiang was training hard in the system, Zhou Jiaoshou Tianbo and Dean Li were accompanying Gu Lao for a meal.

"Boss, you always say you are old, but look, your surgery is so masterful; your craft has improved even more than it was half a year ago," Zhou Jiaoshou said sincerely.

"Not at all," Gu Lao shook his head, "I know my own limits in my heart; I've done surgery for a lifetime, and it's just like this, there's no way to make any more progress. However, this is enough."

"More than enough, it's simply more than enough!" Dean Li said with a smile from the side, his smile overflowing.

Gu Lao's surgery was extremely impressive, and the post-operative results were also very obvious; several patients who were on the fence were persuaded and decided to have the surgery.

Those young masters were not short of money at home, and birds of a feather flock together; upon learning that a top national Expert had been invited to the Provincial Hospital to perform surgery, they were all paying attention.

These people were Dean Li's target customers; even if an ordinary person shaved off all the flesh on their body, how much money could they have? To put it bluntly, that bit of mosquito meat couldn't even keep up with a target customer's one-day hospitalization fee.

Therefore, even though Gu Lao always made Dean Li unhappy, either openly or secretly, he still rushed to flatter him and did his best to please Gu Lao to leave a good impression.

"Xiao Zhou, what do you think of the level of that young man today?" Gu Lao suddenly asked.

"Ji Xiang?" Zhou Jiaoshou frowned slightly, "I think it's a purely talent-driven surgery; after all, his Practicing Physician Qualification hasn't been obtained yet, and theoretically, not many surgeons would be willing to let him perform surgery."

This was said very bluntly, but Zhou Jiaoshou saw his own boss shake his head slightly.

"I don't think so," Gu Lao said.

(End of this chapter)