Chapter 318: 312 Problematic Operation (4/4, 4500-subs bonus chapter)

Zheng Renyi reached out, and the suction device without a cover was slapped into his hand.

At the blind spot, verdigris-colored pus appeared in the field of view.

"Give me a scraper first." Zheng Ren hesitated slightly, slapped the suction device onto the patient's leg, and said.

"Hmm." Xie Yiren flashed her big eyes, slapped the scraper into Zheng Ren's hand, then took a piece of sterile gauze and held it in her hand.

Zheng Ren did not suction the pus, but used the scraper to scrape it two or three times, placing the scraped pus onto the sterile gauze in Xie Yiren's hand.

This is a specimen for bacterial culture; needless to say, Xie Yiren also knows.

Although the pus at the patient's blind spot looks like a Pseudomonas aeruginosa infection, without testing, who would know?

After taking the sample, Zheng Ren began to suction out the pus with the suction device.

On her side, Xie Yiren carefully placed the contaminated instruments aside, and organized the uncontaminated ones for later use when closing the abdomen.

Everything was in orderly fashion.

【Wow, green!】

【That's called verdigris; just from the pus you can see the color—how severe is the infection? Even with postoperative Tai Neng and Wan Gu combined application, the infection might not be suppressed.】

【The practitioner took a sample; this surgery is truly flawless.】

After Zheng Ren suctioned the pus clean, he continued to dissect the surrounding connective tissue and edematous adhesions.

The patient's gallbladder had been removed 24 years ago; Zheng Ren carefully located the bile duct and dissected it free from the pancreas.

Actually, this is the most difficult step; Zheng Ren could sense that Su Yun was fully focused, each step following his train of thought. Yang Lei, however, was unaware of this, feeling somewhat lost.

Zheng Ren felt somewhat emotional; talent varies among people, and this cannot be forced.

The pancreas showed slight signs of edema, but not severe. Postoperatively, a period of growth inhibitor can be given to prevent uncontrollable acute pancreatitis.

"Yang Lei, note this: after the operation, tell Director Xia to administer growth inhibitor at normal dosage for 3-5 days." Zheng Ren reminded Yang Lei to pay attention to the key points of his surgery.

Yang Lei acknowledged.

Zheng Ren continued to separate the hepatoduodenal ligament, free the duodenum, and locate the blind spot near the duodenum where the fluid pus had already been suctioned away.

On the wall of the blind spot, there was a coating of pus moss.

At this angle, Xie Yiren probably couldn't see it; Zheng Renyi reached out and rarely said, "Small scraper."

As his words fell, a light scraper dropped into his hand.

Zheng Renyi was slightly surprised, turned his head to look. With brows curved, Xie Yiren was smiling at him.

【Seeing this pus moss makes me worried; last time I encountered a similar situation, the patient ran a fever for twelve days post-op.】

【Yeah, the practitioner probably doesn't intend to peel off the pus moss.】

【Don't…… the pus moss is heavily adhered to the nearby intestinal tissue; don't tear the intestine. The intestine is edematous and very fragile.】

【Mortal, don't use your shallow and vulgar gaze to speculate about the practitioner's next step.】

【I have a feeling the practitioner is really going to peel off the pus moss… he moved, he really moved! He's actually peeling off the pus moss!】

Zheng Ren used the scraper to clean the superficial pus moss, then requested tweezers and a fine forceps, found a spot where the pus moss was thicker, and began separating the pus moss from the intestinal wall.

Su Yun tightly gripped the retractor with care, her breathing becoming much lighter.

He dared not move; even the slightest abnormal movement would make him worry that Zheng Ren would tear the edematous intestinal wall.

If that happened, not only would tissue spill from the intestine, but suturing the intestine during the edematous phase could lead to poor healing, even requiring a second laparotomy and re-anastomosis.

Zheng Ren is also quite bold for his skill, having performed many similar dissections in the System Operating Room.

Nevertheless, he remained cautious, found a slit, inserted the fine forceps, and patiently peeled.

This part of the surgery was extremely slow, starkly different from the lightning-fast laparotomy.

Whether in the operating room or the live-stream room, everyone watching the procedure couldn't help but hold their breath, extremely tense.

Five minutes……

Ten minutes……

Fifteen minutes……

At the twenty-second minute, Zheng Ren finally pulled out the fine forceps and small scraper from the patient's abdominal cavity, with the forceps still clamping a large irregular piece of pus moss about 20 square centimeters in area.

【Damn, this is the most impressive operation I've ever seen.】

【It's completely like microsurgery; it's hard to believe the practitioner accomplished this with the naked eye.】

【Nonsense, the difficulty of this operation lies not in the field of view but in the hands. The manipulation is delicate; the intestine suffered hardly anything, and the pus moss was completely peeled off.】

Across from Zheng Ren, Su Yun, as the assistant, exhaled.

"Your operation has a problem," Su Yun said.

"Hmm, I know." Zheng Ren replied: "But the patient has septicemia; reducing the chance of infection here also increases the possibility of survival post-op."

"How can you be so confident?" Su Yun's words seemed off-topic, but Zheng Ren understood he was referring to himself taking great risk to peel off the pus moss.

Perhaps to others the risk seems great, but in his own eyes it's just that—just a bit more effort.

If the patient recovers faster post-op, any hardship is nothing.

After peeling off the pus moss from the blind spot, Zheng Ren completely separated the duodenum, then reached out and the scalpel was slapped into his hand.

At the same time, Su Yun also reached out.

The uncovered contaminated suction device was slapped into his hand.

While cutting the common bile duct, Su Yun inserted the suction device into it.

Purulent, foul-smelling food residue and purulent matter, along with discolored digestive fluid, were sucked out along the walls of the suction device.

Su Yun's hand moved slightly, trying not to miss anything.

The bile duct contents were large; the uncovered suction device clogged in less than twenty seconds.

The suction device's hissing sound grew softer and softer.

Zheng Ren held a wet gauze in his hand; as soon as Su Yun's suction device withdrew, he immediately covered it with the wet gauze.

Xie Yiren had already prepared the warm saline; Su Yun placed the suction device into the basin, repeatedly aspirated several times, after the tube wall became clear, aspirated again the object blocking the bile duct.

After repeating this five times, the bile duct finally became clear.

【Does this count as half the surgery completed?】

【It's about more than half done; the next step should be performing an Oddi sphincteroplasty. The foreign matter remaining in the bile duct has been suctioned out, the pus membrane has also been stripped away, and what remains is relatively simple.】

【This surgery is really done finely. However, how should the patient's postoperative infection be recovered?】

【That's an ICU issue; if we don't do the surgery, all this dirty stuff will inevitably lead to uncontrollable infection in the patient.】

【Before the operation I examined the diagnosis and saw the diagnosis of septicemia. The patient's surgery is already not early; I hope that through the surgeon's technique, I can pull her back from the brink of hell.】

As the aspiration of the foreign object ended, Zheng Renye breathed a sigh of relief. What he feared most was that severe edema of the remaining bile duct might truly harbor a large foreign object, requiring him to further expand the surgical approach, opening the bile duct to remove the object.

Fortunately, there wasn't.