Chapter 747

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Protagonist:

Fang Ziye

Not a high-cold anesthesiologist whose voice cuts like a knife and stops the moment it's sent, Fang Ziye's hands began rapidly twisting the buttons on each pump.

"Beep beep beep beep... biubiubiubiu"

Machine noises rang out in a chaotic jumble! ~

The circulating nurse's eyes fixed on the operating table on one side, on the other phoning to urge the blood bank, tone low and cold: "Has the blood for Room 13 come up yet?"

"The patient's already in shock." She nodded at Tang Xiaoping on the operating table, indicating she knew to open things up.

Professor Wu Yong had already donned his sterile surgical gown, only managing to put on one glove before tossing the other on casually and taking three steps in two to reach the operating table.

Tang Xiaoping's hands were pressed deep into the patient's abdomen, eyeballs bloodshot, urgent but not flustered, looking at Wu Yong, voice hoarse and urgent: "Professor Wu, it burst! ~"

"Where did it burst! ~" Wu Yong asked.

Tang Xiaoping squeezed his eyes tight, carefully feeling through the glove for the direction of blood flow: "Possibly the descending thoracic aorta!"

"Got it pressed down...?"

Deng Haibo had no time to exchange pleasantries or explain with Fang Ziye, immediately went out to scrub again; with Professor Wu Yong at the operating table, no matter how inadequate, he could buy some time.

Fang Ziye threw away the paper and pen in his hand.

He could no longer afford to keep pushing a more detailed plan.

Emergency surgery isn't elective surgery, much less sanatorium boutique surgery; quality must be guaranteed first, quantity pursued second.

The only difference between emergency surgery and elective surgery is "gambling"!

Though gamblers deserve death, gamblers who wager lives deserve it even more.

But every emergency department doctor is a gambler, none knowing what the next emergency patient will have, whether they can be saved alive...

Fang Ziye stepped up behind Deng Haibo.

Like turning off a faucet, he shut off the valve of his thoughts.

No complete plan, currently only one line of thinking.

Fang Ziye came to Deng Haibo's side; Deng Haibo said: "Professor Fang, in a bit I'll swap Tang Xiaoping off the table, have him go talk to the family."

"We all know you've done your utmost."

Fang Ziye kept his head down scrubbing, simply no time to explain anything to Deng Haibo! ~

Called scrubbing, really just a cursory rub, then a quick rinse, simply fulfilling the sterile principle.

Then the two hurried back; Fang Ziye said: "Professor Deng, in a bit follow my thinking."

"Not necessarily right, but can try."

"I only have sixty percent confidence! ~ Time too tight, my problem."

As Fang Ziye spoke, he'd already strode to the sterile surgical gown, twisted the clothes and pulled them on.

Though only one circulating nurse, Tang Xiaoping had already had someone step down, so Wang Qiang and the Vascular Surgery Master's Student simultaneously came behind Fang Ziye and Deng Haibo to start gowning.

Just to save time!

Quickly getting Fang Ziye and Deng Haibo up on the table, swapping the others down, is the most urgent technical resource restructuring.

Deng Haibo froze a moment, said: "Good."

Deng Haibo didn't struggle over Fang Ziye saying it was his problem; though Tang Xiaoping hadn't explicitly said what happened with Fang Ziye, Tang Xiaoping called them, they all rushed over, yet Fang Ziye had only just arrived at the OR recently.

Something might have happened in between.

But none important; right now most important is whether we can save the life.

Deng Haibo replied: "Do your best is enough, Professor Fang."

"Sixty percent probability is already not low."

Compared to one percent or even five percent, sixty percent is a kind of redemption, even if Fang Ziye's assessment contains exaggeration.

Fang Ziye extended his hands out of the sterile surgical gown and began gloving.

At fastest speed gloving, no attention to sterile principle, after sleeves on rushed to operating table side.

Wang Qiang tying Fang Ziye's gown hadn't finished fixing the collar, could only be "dragged" by Fang Ziye toward the operating table.

"Blood pressure hit 55!" The anesthesiologist side again gave a freezing prompt, not a shred of emotional fluctuation.

As if chanting a send-off slogan for the patient.

Long in the OR, many lead surgeries, anesthesiologist reporting vital signs no longer stirred great inner ripples in Fang Ziye.

Fang Ziye still didn't circle around, just reached his hand inside!

"Professor Tang, you let go." Fang Ziye said.

Tang Xiaoping heard, froze two seconds, seeing Fang Ziye had made the preparatory move, decisively withdrew his hand.

This too is gambling, gambling on Fang Ziye's skill, gambling on the patient's life, gambling on the patient's luck! ~

The arterial breach Tang Xiaoping had been pinching, once released, immediately spurted arterial blood, in an instant drenching Fang Ziye's hand back.

However, Fang Ziye's hand had already probed inside.

Then both hands began separating!

This isn't modern medicine's surgical technique, but the most primitive, most violent, most direct fight for life.

No preoperative examination, no preoperative discussion, not even usable instruments available!

Modern medicine's definition is very broad, meaning only the last two to three hundred years of development.

Modern science, like physics, chemistry, biology's development, application of experiment and measurement in scientific activities, brought life sciences and medicine onto the track of scientific development: anatomy's development led to correct recognition of human organs; microscope's discovery and use led to recognition of cells;

The discovery of bacteria played a decisive role in humanity's eradication of smallpox, cholera, plague, tuberculosis, anthrax — these century-defining diseases;

The discovery of antibiotics played a role in treating various human diseases……

The use of auxiliary examination tools is critically important for precise diagnosis and treatment guidance before a patient's disease treatment.

But now, none of it exists.

Precision instruments can only monitor the patient's vital signs; they fundamentally don't know where the patient's fine damage points are.

All of this requires Fang Ziye to grope and search.

Not a broad groping, but truly to grope, to search!

He wasn't given the opportunity and time to formulate a complete rescue plan. Perhaps it was given, but Fang Ziye didn't come at the first time.

Fortunately, Fang Ziye's physical examination technique is strong enough, his level high enough; no spider-silk horse-track escapes his perception.

Therefore, Fang Ziye's single hand quickly found the position Tang Xiaoping's two hands had covered before, and after exploring more finely for two seconds, he chose — two hands clamping!

Professor Wu Yong, very familiar with Fang Ziye, handed over the hemostat; he chose unconditional trust in Fang Ziye!

Originally, Fang Ziye should have asked for the hemostat before it was given.

"You let go!" Fang Ziye wasn't willing to waste the time for three words "Professor Wu":

"Follow my left wrist inward, the hemostat's jaws about two centimeters above my fingers, roughly at a thirty to fifty degree angle, clamp shut!"

"Then don't let go; after one minute, release, then clamp shut again."

This patient didn't go on ECMO, not because they were unwilling, but because there was no machine.

Don't know why; perhaps resources are limited!

But this is reality; every hospital's every kind of medical resource is limited — others are using it, so it's impossible to take it down for this operating room, unless it's been used up and sits idle.

Therefore, Fang Ziye needs to manage the artery's output rhythm himself, so that blood completes circulation under bleeding conditions.

Wu Yong's right hand stiffened for roughly two seconds, no nonsense; following Fang Ziye's instructions he sent the hemostat in.

Of course, Wu Yong is very professional; after the blind operation, he even tapped Fang Ziye's hand, probing whether he had touched Fang Ziye's hand, so as not to harm Fang Ziye.

"Move upward, angle correct!" Fang Ziye finished speaking, looked toward Deng Haibo who had re-mounted the platform.

"Professor Deng, your other hemostat follow my right hand in, angle choice ninety degrees."

Fang Ziye called Deng Haibo by name because Tang Xiaoping's basic skills weren't enough.

If Deng Haibo hadn't come, only Tang Xiaoping could replace the role; but after all, Deng Haibo came.

Fang Ziye had even called Tang Xiaoping to say your capability isn't up to it; at this moment he doesn't fear "ignoring" him to his face again.

Tang Xiaoping's hands were trembling slightly right now, his mask flashing on and off under rapid breathing rhythm.

He had pressed on the patient's internal blood spray, so he knew how tense it would be to place his hand there.

Based on perception, he knew how large the patient's aortic rupture was.

Based on theoretical knowledge, he knew how much pressure Fang Ziye's current operation would face!

Tang Xiaoping's Adam's apple rolled up and down, constantly watching Fang Ziye's expression.

Fang Ziye's eyes finally showed a trace of panic that couldn't be concealed.

A person's nervous emotion and panic emotion are different; panic at a nervous moment is hard to conceal.

Yes, different from the unease of the past few days, what Fang Ziye now displays is panic.

He has finally encountered a disease type beyond his capability.

Tang Xiaoping thinks this way not out of schadenfreude, but from the angle of solving the problem, considering how things should be solved.

He had already been ordered off the platform by Deng Haibo; he was taking off his clothes, slowing his rhythm, considering whether to go outside and inform the patient's family of the patient's life and death!

If Fang Ziye hadn't spoken, he most likely would have reported to the patient's family a notification of extremely high death risk……

Unfortunately, no matter how Tang Xiaoping slowed his rhythm, Fang Ziye didn't have the attention to spare for him.

He stepped out of the operating room door; after turning the door corner, Tang Xiaoping once again squeezed his eyes shut hard.

Tang Xiaoping reopened his eyes, looked at his own hands, and in an instant felt a bit of suspecting life: "Man cannot fight heaven, even less fight fate."

Although this isn't his first time breaking down when facing a patient, this is his first time seeing everyone around him 'break down', all as if facing a great enemy……

"If I didn't work at Zhongnan Hospital it would be good; I could calmly accept the fact of relatively limited capability, that those who should die die……" Tang Xiaoping's mouth corners turned bitter.

He kept calling Fang Ziye, certainly because he didn't want someone to die this quickly during his tenure as director.

But as a doctor, not wanting one's own admitted patient to die — isn't that instinct?

……

On the operating table, Deng Haibo had just sent the surgical hemostat into a suitable position following Fang Ziye's orders, when a jet of blood suddenly sprayed onto the chest of Liu Faming standing on the opposite side!!

Part of the blood jet sprayed onto Liu Faming's chin.

Although Liu Faming was completely unprepared for this, even somewhat panic-stricken, he still forcibly closed his eyes, soles gripping the ground, fiercely using his weight to press down the instinct to retreat backward.

"Arterial blood flow diverted, small rupture turned large!" Professor Wu Yong instinctively uttered an explanation.

Fang Ziye naturally knows the situation Wu Yong speaks of.

The aorta is the main trunk artery; after the main trunk artery's flow is clamped shut, branch artery blood flow will skyrocket, because the heart's pumping hasn't stopped!

After local arterial blood pressure increases, the pressure difference grows larger, causing the original rupture to be forced open.

This is also the fundamental principle why in multiple arterial injuries, directly clamping the large artery is inadvisable.

Fang Ziye's brain rapidly deduced the branch blood flow changes after the thoracic aorta was clamped, then based on the already-smaller blood jet's direction, roughly inferred the arterial rupture's location.

Right renal artery!

Fang Ziye released his hand, extended his right hand over.

At this moment, having lost modern medicine's fine-grained examination, Fang Ziye could only transform all his own techniques into instinct, using the most primitive physical examination technique to probe——

"Found it." Fang Ziye said.

Sweat from his temples slid into his eye corners; the stinging pain made him awake.

"Give me the hemostat! ~" The renal artery is located behind the intestine, behind the peritoneum, not the large artery.

At this moment, letting Professor Deng Haibo follow his hand to clamp and stop the bleeding was too difficult, and it was not as good as doing it himself with ease.

The hemostat in Deng Haibo's hand was passed over.

Fang Ziye once again clamped it temporarily to stop the bleeding, then without hesitation said: "Prepare for aortic replacement, first restore aortic circulation! ~"

Wu Yong emphasized from the perspective of vascular surgery expertise: "In this situation, performing aortic replacement is not the optimal solution. The surgery process will take too much time."

"Use it as a temporary substitute! Start using it now." Fang Ziye said.

"Surgery time?" Wu Yong asked further, his tone not accusatory.

"I'll control it! ~"

By the time Fang Ziye said this, he had already probed again toward the connection of the thoracic aorta, intending to palpate the location and depth of the aortic rupture.

For emergency trauma patients, the first priority is to restore circulation.

The most basic principle of restoring circulation is only two: one is to replenish blood volume, the second is to first complete hemostasis.

In summary, it is input greater than output; the blood volume in the body must be higher than a certain threshold line, otherwise death is certain.

"Artificial blood vessel, open it on the table?" The circulating nurse had taken the instrument and asked.

Fang Ziye did not answer, Deng Haibo nodded at her.

However, just at this moment, Fang Ziye suddenly changed his mind: "Wait a moment, the patient's vena cava deformation seems to be no problem."

The circulating nurse had already opened the packaging; hearing this, she almost cursed out loud.

But the packaging was already opened, so it could only be sent onto the table; as for notifying the device business to take it back to the company for disinfection afterward, that was extra postoperative work.

"Professor Fang, how do you intend to proceed?" Wu Yong looked at Fang Ziye.

Wu Yong was clearly letting Fang Ziye have the permission to be the lead surgeon.

Fang Ziye said: "Directly remove the spleen, tie off the hepatic artery! ~"

"But the spleen is not directly ruptured! ~" There was a hepatobiliary surgery doctor in the operating room.

"Even if not ruptured, it must be removed; the abdominal cavity cannot be directly tied off; for hemostasis, we can only give up the spleen."

"Otherwise, when we deal with it later, the spleen will undergo delayed rupture during surgery, and the patient cannot withstand such a second blow."

"Save lives first! ~" Fang Ziye said firmly.

Saving lives first is a principle written into every doctor's bones, the first priority when receiving any patient!

Save lives first, then treat diseases!

Fang Ziye then looked at Wu Yong: "Professor Wu, for now, we can only treat him as a high-level amputation."

Wu Yong heard this, his scalp went numb, his eyes widened like a cow: "Perform this kind of surgery?"

"We can only do this for now; first use the concept of high-level limb amputation surgery to restore his circulation, ignore all 'ineffective life' organs below the abdominal aorta, and first save the liver, gallbladder, pancreas, stomach, intestines, and other organs."

"Then, if time permits, we will think of other solutions."

"Do this first, turn the fragmented into the whole." Fang Ziye's brain at this moment was spinning wildly.

This madness was not just the madness of spinning speed, but the ideology radiating had reached an extreme.

Honest people will go mad; when people are pushed into a corner, they will produce extreme mad thoughts.

If not a Buddha, then a demon! ~

Fang Ziye certainly could not become a Buddha, nor would he fall into demonhood.

Thinking of this, Fang Ziye without hesitation directly flipped the intestine out. Decisive and resolute, he turned his head and said: "Anesthesiologist, I intend to perform vena cava amputation surgery! ~"

The fundamental principle for the success of high-level limb amputation surgery lies in completing arteriovenous circulation between the aorta and the vena cava, making the blood in the circulation truly circulate.

This is a surgery with a very low success rate, but its theoretical core for allowing the patient to survive lies in forming a "short circuit" connection between the large artery and the large vein, thereby completing circulation.

The essence of circulation lies in circulating first!

During chest compressions, the reason the priority of compressions is higher than ventilation is because the meaning of circulation is greater than oxygen supply!

The patient currently has no indication for high-level limb amputation surgery!

But Fang Ziye still wanted to perform such a surgery; such thinking cannot be called anything but madness.

Although Deng Haibo is currently the director of vascular surgery, at this moment he was flustered, looking at Wu Yong, his mouth trembling: "This... really do it?"

However, Wu Yong had already given authorization, and Fang Ziye did not care about so much; after clamping the inferior vena cava with a large hemostat, he directly cut it.

Fang Ziye's previous movements when cutting arteries were crisp and decisive; when cutting veins, there was no dragging or hesitation.

"Give me the artificial blood vessel! ~" Fang Ziye turned his head and instructed one of the instrument nurses.

At the same time turning his head: "Circulating Teacher, get my mobile phone, boot password one-three-one-three-zero, find Lan Tianluo's phone number and Li Nuo's phone number, tell them to hurry over, handle the bilateral lower limbs!"

"Use microcirculation amputation surgery to disassemble the bilateral lower limbs."

"Call the blood bank again, tell them to prepare blood! ~"

Fang Ziye had already found a train of thought; even if he was mad enough, once a choice was made, he no longer hesitated.

Immediately turning his head, looking at Wu Yong: "Professor Wu, you cooperate with hepatobiliary surgery to perform splenectomy and hemostasis in the spleen-pancreas area."

"Professor Deng Haibo, you cooperate with hepatobiliary surgery to perform local hemostasis."

"After I complete the arteriovenous connection short circuit on my side, I will remove the steel plate! ~"

Xia Shuanglong of hepatobiliary surgery felt his scalp go a little numb; he, squeezed out of the surgical position, hurriedly advised: "This thing? Cannot be removed casually."

"The brittleness of liver tissue cannot be compared to the muscle and bone of orthopedics! ~"

Fang Ziye said: "I know; before removing it, we will first restore three minutes of circulation, then clamp for two minutes."

"Within these two minutes of mine, I will remove the steel plate on the liver side and complete hemostasis as much as possible."

Xia Shuanglong was not so easily misled: "How can you guarantee to try your best to complete hemostasis?"

Fang Ziye fell silent.

But he, with head down continuing to operate the aortic "variant replacement surgery," replied after ten seconds: "Then Professor Xia, you just directly remove the patient's liver on the affected side."

"Professor Xia can perform a partial hepatectomy, right?"

"After cutting it off, remove the steel plate directly."

"Otherwise, who would remove it?"

Fang Ziye has regressed!

"But?" Xia Shuanglong was still hesitating and vacillating; the reason he had previously rejected Fang Ziye's suggestion was that, in his comprehensive assessment, this patient already had one foot in the King of Hell's palace.

What awaited him was 'death' after the Vascular Surgery people had looked him over!

The kind that couldn't even be rushed into!

He just hadn't expected to encounter such a ruthless person as Fang Ziye, who, in such a short time, had completed hemostasis for an aortic injury and even straightforwardly proposed such a 'crazy procedure' as high-level limb amputation!

"No 'buts,' Professor Xia, you must make up your mind! ~"

"That is, there is no extracorporeal circulation instrument from Cardiac Surgery now; otherwise, I would want to open the heart and control the blood flow speed." Fang Ziye had already expressed his determination.

Once a decision is made, one must proceed without hesitation; hesitating too long over gains and losses, and the patient will bid farewell to this world.

Fang Ziye's suturing speed was fast, and steady.

In just a short minute, he had actually completed half of the aorta; this speed was not slow compared to suturing the surface of the incision.

The assistant standing opposite Fang Ziye responsible for cutting the thread was somewhat flustered and couldn't keep up.

"Then how about you take over the hemostasis, and I'll try my best to preserve the liver! ~" Xia Shuanglong said with gritted teeth.

Originally, the most fatal location for this patient was not this steel plate of Hepatobiliary Surgery; indeed, before it could take the patient's life here, injuries elsewhere had already sent him away.

There was no situation that would put Hepatobiliary Surgery in a difficult position.

Now, Fang Ziye directly removed the spleen first, and also directly removed the steel plate from the liver; this idea was too crazy.

Xia Shuanglong really wanted to say, you haven't seen a human liver, but you've eaten pork liver, right? That thing isn't the bone of your Orthopedics Department; it's very fragile!

Just as Xia Shuanglong decided to curse inwardly, Fang Ziye had seized the opportunity to add points to the common procedures of Hepatobiliary Surgery, bringing them to an average Level 4.

Specialty procedures are operational skills, with the core lying in basic skills; the skills of the specialty don't need to be too high.

At this moment, Fang Ziye only hated that his skill library wasn't deep enough.

The current situation of this patient was unprecedented, and whether there would be successors afterward was hard to say, but even a Level 6 hemostasis technique would feel strained when dealing with his situation, and even feel fearful.

But there was no way; Level 6 skills were merely the peak of the present world, the most awesome operational skill of the past ten to twenty years; it wasn't that they weren't awesome enough, but their awesomeness still couldn't catch up to the 'weirdness' of the patient's injuries!

Actually, various 'weird' injuries existed in clinical medicine originally; it's just that once these 'weird' injuries appeared, they became death cases, and the quantity was extremely small, belonging to the blind spots in textbooks.

There was no way to treat them.

Dead is dead.

Which hospital can still avoid deaths?

Which Emergency Department doesn't have a few deaths every day?

If Fang Ziye's hemostasis technique were Level 7, a redefined perfection, then there might still be a possibility to quickly calculate a relatively complete treatment plan based on the patient's actual situation within a short time.

Fang Ziye didn't have that many knowledge points to add.

Five minutes later, Fang Ziye completed the connection between the aorta and the vena cava.

Aortic replacement surgery is connecting the proximal and distal ends of the aorta using an artificial blood vessel; Fang Ziye modified this surgery, connecting it between the artery and the vena cava.

"The patient's blood oxygen level has risen somewhat, but the blood pressure is even lower."

"But it's probably because after the aorta was clamped, the circulating blood volume decreased, and the patient's heart rate is speeding up." The Anesthesiologist delivered news that was neither good nor bad.

"Anesthesia Teacher, pay attention to blood pressure! ~" Fang Ziye opened the clamped thoracic aorta.

Although Fang Ziye was confident in his suturing technique, he also had to wait for the circulation between the aorta and the vena cava to recover.

After opening the hemostat on the thoracic aorta, Fang Ziye discovered that, because the aorta and vena cava had formed a connection, the veins immediately filled up!

Moreover, because the dynamic potential energy inside the aorta was higher, after the blood of the vena cava entered the liver, the liver's bleeding volume was even greater.

But the bleeding volume on the liver's surface was far less than one-tenth of an arterial injury; plus, after Fang Ziye opened the hemostat, he covered the patient's wound with a sterile cotton pad moistened with normal saline.

The bleeding volume was very limited!

Thus, the simplest circulation was completed! ~

"After the splenic artery is ligated, no need to open it! ~"

"The abdominal aorta lost its blood-holding capacity; the bleeding volumes of the hepatic arterial system and the pancreatic arterial system are relatively limited! ~"

"After circulation is restored, at least intracranial blood flow can be guaranteed! ~" Fang Ziye said.

Wu Yong's voice trembled as he asked: "But, Professor Fang, what do we do next?"

"The location of the arterial transection is the thoracic aorta; the abdominal aorta is below the transected artery. No blood supply! ~"

Fang Ziye analyzed calmly: "The time window for renal ischemic necrosis is roughly four hours; the pancreas is even slower."

"The liver has two blood supply systems; no need to deal with it temporarily."

"Restore circulation first, then deal with them one by one slowly later." Fang Ziye said.

"Then what about this below?" Wu Yong pointed to the bilateral lower limbs and pelvis under Fang Ziye's responsibility.

"People from our department will come to deal with it later! ~" Fang Ziye was not worried about necrosis of the bilateral lower limbs.

Even, because of the special anatomical structure, Fang Ziye could adjust the parameters of the microcirculation instrument to parameters suitable for the kidneys and bilateral lower limbs.

The reason this thing couldn't be used together normally was because most patients wouldn't face this patient's extreme situation of directly cutting off the aorta!

The liver's microcirculation instrument was the most difficult to debug because the blood supply system was too complex.

Besides the liver, other organs were relatively better.

Except the spleen.

Splenectomy was already a very mature surgery; moreover, after splenectomy, the impact on human body function was not great, so Fang Ziye did not develop any circulation instrument for this organ.

Moreover, what mostly happens to the spleen is rupture; even if the microcirculation instrument came out, it would be useless for it!

The organ is already broken; restoring its circulation is useless.

Roughly three minutes later, Li Nuo came in from outside the door and said, "Tian Luo is performing emergency surgery; I've already called Wang Zongkai."

"Are we?"

Li Nuo, who was washing his hands, approached while seriously replying to Fang Ziye; halfway through, after seeing the surgical field clearly, he was stunned in shock.

Instinctively, he offered Fang Ziye two common Chinese exclamations.

"Stop saying 'Holy Crap'; just put on the circulator. Don't worry about the bleeding—the blood downstream of the aorta and inside the vena cava can all drain out, it doesn't matter."

"Put on the circulator first; after the circulator is on, then proceed with hemostasis," Fang Ziye said.

"Of course, it's best not to leak at all."

After seeing Li Nuo and giving his instructions, Fang Ziye said, "Clamp the thoracic aorta; reopen it after three minutes, and keep it open for three minutes."

"When you open it, you must notify us when clamping. Can you do that?" Fang Ziye handed the permission to clamp the aorta to a young person beside him.

He didn't dare reply, trembling as he glanced at his superior.

His eyes carried a plea—

"Teacher, my cultivation is shallow; can you not take me down there? I'm afraid I won't come back."

Letting a graduate student directly participate in this level of surgery on the stage actually gave him enormous psychological pressure.

"Listen to Professor Fang," Xu Haoyang of Hepatobiliary Surgery said, giving instructions.

The graduate student nodded.

"Then prepare to clamp; wait for my order and pay close attention to the time."

After speaking, Fang Ziye looked at Professor Xia Shuanglong: "Professor Xia, I need to retrieve the steel plate."

"The steel plate has four corners: one in the liver, one in the spleen, and the lower two corners at the femoral triangle position. The spleen will be removed!"

"The femoral triangle area doesn't need attention for now; I'll take it, you handle temporary hemostasis, okay?" Fang Ziye directly called out names and clarified each person's task.

"Fine! ~" Xia Shuanglong understood; Fang Ziye was trying to forcibly save a life.

Moreover, this wasn't because Fang Ziye himself actively wanted to join in; it was Tang Xiaoping of Vascular Surgery who pried Fang Ziye away.

Although this idea was crazy, once accomplished, the sense of achievement would naturally be extraordinary.

"We'll do our best to cooperate," Xia Shuanglong emphasized.

After speaking, Fang Ziye ordered the graduate student: "Clamp! Start timing."

Immediately afterward came a "Crack!" sound.

Fang Ziye's attention was fixed on the steel plate fragments embedded in the patient's liver.

Although irregular with a few corners, the curvature of those corners wasn't large, nor were they large reverse hooks; therefore, Fang Ziye very easily removed them from the liver.

Along with the liver came a large amount of blood, blood clots, and fresh venous blood, gushing forth like a spring.

At the same time, Professor Xia Shuanglong and Professor Deng Haibo immediately performed hemostasis on the local area.

Professor Xia Shuanglong's strength was still very strong; after Fang Ziye allocated skill points to the corresponding Hepatobiliary Surgery skills to Level 4, he could also tell that Professor Xia Shuanglong was thoroughly familiar with common hemostasis methods for liver injuries in Hepatobiliary Surgery.

For example, the Pringle maneuver, compression hemostasis, local clamping hemostasis, and other specific surgical operations were all quite exquisite...

The strength of Zhongnan Hospital's Hepatobiliary Surgery wasn't blown out by boasting.

Therefore, actually before the operation, Xia Shuanglong repeatedly stopped Fang Ziye, telling him not to act rashly; it wasn't that Xia Shuanglong couldn't handle the situation, but that he was "afraid," unwilling to take risks, and not willing to take risks.

Nowadays, clinical doctors show three parts of their skill to make a living, six parts to secure the bottom line, and the last part is always hidden, all left to fate.

Perhaps Professor Xia Shuanglong was also young once, but after suffering several "beatings" from patients' family members, he preferred fewer troubles and was unwilling to take on more.

Fang Ziye's planned skill point allocation was completely useless...

Since his own skills were useless and the liver's surgical field was only so large, Fang Ziye no longer interfered, but instead used his free time to temporarily handle the gastric-related arteries and pancreatic arteries in the abdominal cavity! ~

In Fang Ziye's heart, a countdown had been going on...

As expected, five seconds before the three minutes were up, Fang Ziye looked at the Hepatobiliary Surgery graduate student; he had already prepared himself, staring without blinking.

"Three minutes are almost up!" he said, timing it.

Hearing this, Professor Xia Shuanglong nodded: "It's fine; there's only the blood capacity of the vena cava, we can continue operating."

"This cut surface is mostly arterial injury; it's the blood supply of the portal system."

Before doing it, Xia Shuanglong had advised against it.

But once the surgery started, he entered his own rhythm; not only did he let go, but he completely let go, fully displaying his skills.

The liver has two systems; to laypeople, they are indistinguishable.

But in the eyes of Hepatobiliary Surgery professionals, these two systems are relatively independent; when treating liver injuries, there's no need to clamp the vena cava!

The reason for clamping before was fear that the depth of the steel plate cutting had reached the vena cava system, causing massive bleeding.

Now it's confirmed it's not that deep, so naturally there's no worry.

This is cognition.

"The spleen has been removed," Xu Haoyang of Hepatobiliary Surgery said.

Removing the spleen is simple; if the operation is fast enough, ten minutes is considered a long time. As an Associate Professor of Hepatobiliary Surgery who can independently lead a group, he naturally doesn't need that much time.

"Okay, Professor Xia, the liver side is handed over to you! ~"

"After you finish hemostasis and suturing, I will then perform vascular reconstruction."

"Professor Deng, Professor Wu, you two are responsible for handling the arterial blood supply of the stomach and pancreas areas."

"Professor Chen, trouble you to handle the pancreas; based on your experience, see how to cut or how to preserve, and how to drain is more suitable."

"Is Professor Tang Xiaoping back?" Fang Ziye began to look around.

Liu Faming shook his head: "Director Tang hasn't returned yet."

"Then you handle the hematoma in the abdominal cavity!"

"Gastrointestinal Surgery can start handling the intestinal anastomosis."

"Please note, the blood supply of the mesenteric artery may recover after ten minutes! ~" Fang Ziye watched Li Nuo's progress while speaking, and approached him at the same time.

The surgery had proceeded to this point, and after Fang Ziye's decomposition, it had finally become orderly.

Fang Ziye began performing microcirculation reconstruction surgery, but Fang Ziye's current microcirculation reconstruction involved two sets of circulation working together, with microcirculation interruption between the aorta and the inferior vena cava.

The other set connected the aorta and the vena cava directly to the heart.

And the two microcirculation instruments served as a second heart.

Divide and conquer!

Two systems, working independently.

Since there was no need to worry about bleeding, the system Fang Ziye and Li Nuo cooperated on could operate independently, without affecting the other systems!

Fang Ziye first helped Li Nuo finish connecting the microcirculation instrument, then reported the appropriate parameters to the circulating nurse.

After reporting, Fang Ziye added: "Circulating Teacher, call the Urology Department people, they should come over and handle the kidney artery damage!"

"Once I finish handling the pelvic hematoma on this side, we'll have to reconstruct the circulation anew."

When Fang Ziye instructed to this point, he glanced at Zhan Zhongyuan of Gastrointestinal Surgery: "Doctor Zhan, I told you to restore blood supply circulation within ten minutes, you completely didn't care?"

After the mesenteric artery's blood supply was restored, there were now quite a few bleeding points at the intestinal position.

However, Zhan Zhongyuan previously thought Fang Ziye was joking, so he didn't handle it, and was still managing the intestinal rupture openings.

Now seeing the numerous bleeding points, he became somewhat panicked.

Zhan Zhongyuan dared not raise his head, afraid he would be dissed by the many professors on the platform, because just now during this period, he had dissed Fang Ziye many times in his heart.

He felt Fang Ziye was meddling in idle matters.

Clearly a person who couldn't be saved, yet he had to create extra branches, and even came up with so many "vague and confusing" routines.

Of course, Fang Ziye spoke his piece, but with hands let loose, he was still helping with all his might!

After helping Zhan Zhongyuan handle five or six larger bleeding points, Fang Ziye's hemostat reached the arterial bleeding point in front of him a step faster than Zhan Zhongyuan.

Zhan Zhongyuan's movement paused, he swallowed two mouthfuls of saliva: "Tha, thank you!"

"No matter, you continue busy with yours!" Fang Ziye said.

"The patient's blood pressure has slightly risen a bit." The anesthesiologist's tone finally warmed somewhat, but he still looked at the patient's internal circulation separation situation with some worry.

He added: "But with this kind of situation, you're really putting pressure on me?"

"The circulation reconstruction later will be super reperfusion syndrome, can the patient survive this pass?"

On the operating table, everyone was attending to their own operations, no one replied.

Including Fang Ziye.

Although divide and conquer is a good thing, after dividing and conquering, whether the patient can pull through is not easy to say.

Before, even Fang Ziye had never been this crazy, directly cutting off the large artery and vena cava to form a short-circuit circulation.

But this trouble was stirred up by Fang Ziye, so Fang Ziye actively said: "Later push the patient to the interventional surgery room for follow-up."

"In case any sudden situation occurs, it'll be convenient to handle it too."

Vascular Surgery Professor Wu Yong and Deng Haibo, upon hearing Fang Ziye's words, both couldn't help but raise their heads instantly.

Others didn't know Fang Ziye's ability, but they had clearly seen it.

Fang Ziye had even clamped the carotid artery embolus!

That time, Liu Huanglong's patient encountered shock and embolism and was snatched back, entirely because Fang Ziye alone swaggered in and out of the gates of Yama's Palace.

Not only did he knock over Ox-Head Horse-Face, he might have even fought a few rounds of magic with the Ten Directions Yama!

"Mm, later go to the interventional surgery room."

"Things that haven't happened, we don't beautify, and we don't avoid, we avoid the risks in advance."

Deng Haibo spoke to here, suddenly asked: "How much money does this patient have on the account?"

The circulating nurse with a cold face, voice like a cold cicada: "Three thousand on the account, now already owes fifteen thousand in debt!"

"If he doesn't pay, two months of my salary will be deducted into it!" (Chapter End)