Chapter 69: Overstepping One's Authority

"Doctor Xiao Ji, the operation for minimally invasive surgery is a bit difficult, especially the step of guiding the guide wire from the bladder into the ureteral orifice; it's different from a surgical operation. Just watch for two days, don't be in a hurry to start."

While Ji Xiang was changing his clothes, Wu Zong stood to one side to give him a preemptive warning.

Wu Zong was genuinely afraid that once they were on the operating table, Ji Xiang would turn into a different person, staring straight at him with those eyes...

He couldn't think about it; the moment he dwelled on it, Wu Zong felt an itch in all his bones.

"Mm, okay, Wu Zong." Ji Xiang did not refute Wu Zong's words.

Having undergone surgical training in the System Operating Room, his overall level had already surpassed that of a clinical Attending Professor and Department Director, reaching a top-tier level within the province.

The surgical skill of a Resident Chief like Wu Zong was just so-so; Ji Xiang could have crushed him early on.

But Ji Xiang only smiled, standing honestly in the assistant's position.

"Oh my, the positioning was set up quickly today." The Circulating Nurse returned in a flurry, carrying a pile of things, and seeing the patient in a standard lithotomy position, she praised them.

"Chu Jie, hurry up and open the pack." Wu Zong urged.

"It's ready, so I'm opening the pack."

"What are you all doing?!" the patient asked suspiciously.

The anesthesia was a combined continuous epidural and saddle block, so the patient could hear the conversation between the doctor and the nurse.

He was quite confused as to why they needed to "open his pack."

Everyone in the operating room froze for a moment, but the Circulating Nurse quickly reacted.

Everyone had long been accustomed to this kind of thing; as long as the speed of the "vehicle" was fast enough, everything else was stationary.

But the patient was not used to it.

The speed of the vehicle was enough to jolt him right off.

"The sterile surgical pack, it's been sterilized." The Circulating Nurse didn't take it to heart and explained simply.

"It's the first time I've realized there could be another ambiguity; Chu Jie, you open packs every day, it's so enviable," Wu Zong said with a grin.

"Cut the crap, we have three surgeries to do, hurry up," the Circulating Nurse scolded. "I don't know why you couldn't come after lunch; you just had to do them back-to-back."

"Chu Jie, we are serving the people wholeheartedly to relieve the patient's pain. If the patient is uncomfortable, how could I have the heart to eat? You're right, aren't you?"

"If you say any more nonsense, believe it or not, I'll grind the stone into a 'power pill' and stuff it in your mouth later."

Wu Zong shrugged and began the surgery.

The ureteroscope was inserted, advancing bit by bit, passing through the urethra into the bladder.

Wu Zong moved the lens, first taking a look around the situation inside the bladder.

The bladder was slightly red, the color was normal, and there were no stones or polyps. Wu Zong then compared the two ureters and chose the affected side to enter.

Before entering, Wu Zong checked with the Anesthesiologist again to confirm he hadn't mixed up left and right.

Although Wu Zong's act of checking was overly cautious, Ji Xiang didn't feel there was any problem.

In the System Operating Room, the System NPC would check repeatedly; even when facing a Simulated Human, he was afraid of getting the direction wrong.

A Non-vascular Lumen Guidewire is composed of a guide wire rod, a soft spring tip, and a plastic-coated layer.

Depending on the different soft spring tips and whether they are plastic-coated, they are divided into Large-head Rigid Guidewires, Flat-head Rigid Guidewires, and Plastic-coated Guidewires.

The Zebra Guidewire Wu Zong chose was a Flat-head Rigid Guidewire.

After finding the ureteral orifice, Wu Zong loosened his wrists and said to Ji Xiang, "The operation here is the most difficult. The guide wire is too thin, there is urine in the bladder, and coupled with factors like bladder muscle spasms, it is somewhat difficult to successfully insert it."

"That's called 'placement'," the Circulating Nurse corrected.

"Same thing, same thing. Talking all bookish is pointless; isn't placement just sticking it in? What's the difference?"

After saying this, Wu Zong stopped bantering with the Circulating Nurse and focused intently on maneuvering the Zebra Guidewire to aim at the right ureteral orifice.

It was off...

As soon as Ji Xiang saw the shape of Wu Zong's hand, he knew that this time it would definitely... fail to be successfully placed.

Wu Zong was right; this step was indeed the most difficult, otherwise the System NPC wouldn't have taught him both the Rotation Method and the Lifting Method to solve the problem.

In the System Operating Room, it took Ji Xiang a long time to even get a glimpse of the threshold for this step.

Unfortunately, let alone the threshold, Wu Zong didn't even know where the front door was.

The ureteral orifice is hidden in the folds of the bladder; it's not like a hole on a piece of white paper where you just have to send the Zebra Guidewire in.

Moreover, the ureteral orifice moves with the peristalsis of the bladder, so successful catheterization is quite difficult.

The first time, failure.

Wu Zong didn't expect to succeed on the first try either; he pulled the Zebra Guidewire back a little, preparing to try again.

Mo Chenggui stood behind, and seeing that Wu Zong had no intention of suppressing Ji Xiang, he felt relieved.

Ji Xiang was his student, at least that was what Mo Chenggui believed.

Everyone has a protective instinct for their own, and Mo Chenggui was the same.

He prepared to leave once he saw Wu Zong succeed in the catheterization.

Failing once didn't count for much; Mo Chenggui thought the same.

Even when Mo Chenggui operated himself, it was very common for him not to succeed in eight or ten attempts.

If it really didn't work, one would need to dilate the ureteral opening with a Perfusion Hydraulic Pump and perform direct-vision scope placement guided by a safety guide wire.

The greatest difficulty in Stone Crushing and Stone Removal Surgery was not the stone, but this.

The second time, Wu Zong's operation failed again.

Wu Zong's sterile cap began to get a little damp, and his flattened hair could be vaguely seen.

This is ridiculous!

He had intended to teach Ji Xiang how to perform surgery to return a favor, but who knew the patient's ureteral orifice would be so hard to find.

Wu Zong focused his mind, cast all distractions to the back of his head, and concentrated on trying one more time.

Failure!

Failure!!

Failure!!!

Successive failures made the Resident Chief a bit disheartened.

"Prepare the irrigation fluid." The Resident Chief sighed.

Afterward, he comforted the Patient, "We need to put some water into the bladder and then apply pressure; it makes it easier to operate."

The Patient did not understand, but hearing the Resident Chief say this, could only nod blankly.

The Resident Chief handed the Zebra Guidewire to Ji Xiang, told him to hold it, and then prepared the irrigation fluid.

This was the only way; Mo Chenggui, standing behind, also felt quite helpless.

The Patient's ureteral orifice was indeed hidden quite deep, no wonder... wait!

The next second, Mo Chenggui saw Ji Xiang's eyes fixed on the Endoscope, his right hand slightly twisting the Zebra Guidewire.

!!!

Mo Chenggui was stunned all of a sudden.

Ji Xiang's movements were standard, a hundred times more standard than the Resident Chief's!

Holmium Laser Lithotripsy was a technique that had only been developed in the last ten years or so; as Mo Chenggui grew older, he found it difficult to precisely insert the Guide Wire.

The Resident Chief was young, and his skill level was even above his own.

But Mo Chenggui had a solid foundation; he could at least distinguish between high and low skill levels.

The Lifting Method!

A standard, textbook-like Lifting Method!

Mo Chenggui's pupils constricted, his eyes narrowed into slits, staring fixedly at the Zebra Guidewire between Ji Xiang's fingers.

Meanwhile, the Resident Chief was preparing the irrigation fluid and did not see this scene.

Ji Xiang could actually perform Ureteroscopic Surgery!

A shocking thought appeared in Mo Chenggui's mind.

If his skill in performing circumcisions was high, Mo Chenggui could understand.

Medical students all have internship periods; perhaps Ji Xiang had exceptional talent and had completely mastered this procedure after following a teacher for a few circumcisions.

However, Ureteroscopic Surgery is a Level 3 surgery!

Although it is minimally invasive, its Surgery Level is high; a Resident Chief like the Resident Chief was only just able to reach that Surgery Level.

If one were to be very strict, even the Resident Chief of the Second Affiliated Hospital would not be qualified to perform it.

Normally, it would be impossible for Ji Xiang to even come into contact with such a high-level surgery.

Yet!

The Zebra Guidewire seemed alive between Ji Xiang's fingers, moving forward bit by bit, slowly and firmly.

How the hell is this something a novice could do?

Compared to Ji Xiang, the Resident Chief looked like a greenhorn, sweating profusely on his wedding night and still unable to do anything, having no idea what he should do to insert it successfully.

Mo Chenggui saw Ji Xiang's wrist lower slightly, and his eyelids twitched wildly.

Indeed, it wasn't just luck; this was the most standard Lifting Method technique!

Within a few breaths, the Zebra Guidewire finally stopped.

Did it go in?

Mo Chenggui looked at Ji Xiang in doubt.

Either he was just parroting, imitating it so well that he had created an illusion for himself.

Or, in the span of a few breaths, Ji Xiang had successfully inserted the Zebra Guidewire into the affected ureter.

"Irrigation pump ready," the Resident Chief said in a low voice.

After preparing the irrigation fluid, the Resident Chief leaned toward the Endoscope, preparing to take another look.

When his field of vision landed on the surgical site, his hand suddenly froze.

The Guide Wire!

The Zebra Guidewire!!

It had run into the ureter by itself!!!

What is going on!

Countless exclamation marks appeared in the Resident Chief's mind, and he was suddenly dumbfounded.

"Resident Chief Wu, hurry up." The Circulating Nurse had already prepared to connect the pressure pump; seeing the Resident Chief not speaking and standing there like a statue, she urged him.

"..."

The Resident Chief stared blankly at the Endoscope; he couldn't understand how the Zebra Guidewire had gotten in.

"First... no need... no need anymore," the Resident Chief stammered.

"What are you doing?" the Circulating Nurse scolded unhappily, "One minute you want it, the next you don't; did you not sleep well last night?"

"It's already in," the Resident Chief said helplessly.

"Huh? It's in and you still want to apply pressure? Are you sick?" The Circulating Nurse did not indulge the Resident Chief at all, especially seeing his wooden expression made her even more irritable.

The Resident Chief didn't talk back; he observed it carefully once more.

The Zebra Guidewire had indeed been successfully inserted.

Countless questions flooded his mind, but regardless, as long as the Guide Wire was in, it was a good thing.

The Resident Chief continued the operation, slowly advancing the Ureteroscope until it reached the location of the stone. Fortunately, the stone wasn't giving him any more trouble and was sitting there in plain sight.

He first used the Stone Extraction Forceps to clamp the stone, tested it, and confirmed that the stone was too large to be successfully removed from the ureter in one piece.

He started the Holmium Laser Lithotripter to perform Stone Crushing, and the Resident Chief broke the Shuniuguan Jieshi into pieces about 1~2mm in size, then removed the larger fragments into the bladder using the Stone Extraction Forceps.

The surgical procedure went smoothly, with no symptoms such as ureteral mucosal rupture or small ureteral perforation.

Even so, General Manager Wu cautiously placed a Double-J Stent inside the ureter for internal drainage and retained the Urinary Catheter.

Although the subsequent surgery was very smooth, General Manager Wu was operating based on muscle memory, and he remained somewhat dazed throughout.

The surgery ended, and Ji Xiang escorted the Patient back.

General Manager Wu closed his eyes, and his vision was filled with that Zebra Guidewire, the Zebra Guidewire that had inexplicably entered the right ureteral orifice.

Turning back, he saw Mo Jiaoshou watching the surgery, and General Manager Wu subconsciously asked, "Mo Jiaoshou, have you been watching the surgery the whole time?"

"Yes." Mo Chenggui nodded, then turned around, "Xiao Wu, come with me."

General Manager Wu took off his surgical gown, tossed it aside, and followed Mo Chenggui out of the operating room.

"Xiao Wu, were you startled when the Zebra Guidewire suddenly inserted itself?" Mo Chenggui didn't walk far, instead standing in the hallway and asking in a low voice.

General Manager Wu nodded.

"I saw it; it was Doctor Xiao Ji operating, using the Lifting Method."

"!!!"

"About ten seconds, I'd say. It was done very steadily, succeeding on the first try."

"!!!"

General Manager Wu was unable to speak.

Tears flowed down like frothy apple juice.

(End of this chapter)