Chapter 915: 896 No Urine

How great is the surgical difficulty for this patient? Zheng Ren has made a preliminary judgment.

Hydatid disease, a patient with autologous liver transplant, the big pig trotter gave no mission grade; yet this patient actually received an S-rank judgment.

Is the surgery S-rank?

Zheng Ren froze for a moment, where is the difficulty? Preserve the kidneys?!

He recalled the kidney images shown in the scans, beginning to reconstruct them in his mind. Bilateral kidney rupture was extremely severe, hard to preserve. At the very least, from Zheng Ren's level, it was indeed difficult to preserve.

He has a grandmaster-level skill book in hand; if needed, he can try to use it. Moreover, he still has some surgical training time left, which should be enough to support completing this surgery.

However, the S-rank surgery, like an inescapable shadow, loomed over Zheng Ren's mind.

From the big pig trotter's judgment, he knew that what Director Miao said was just a try, with a success probability less than 20%. But it's still better than him looking at the scans and thinking there's no way to do surgery, just waiting to die.

"Let's go together, squeeze in, we must seize the time, cannot delay." Director Miao said.

Scrub up, go onto the operating table.

Fang Lin didn't even have a position; the thoracic department chief probably heard from emergency that the chest trauma wasn't serious, so he'd come later. Let Fang Lin come, the next thoracic bottle will be enough.

Hepatobiliary, urology, and interventional radiology—three departments opened their tables simultaneously.

Warmed plasma was poured in bag after bag, yet blood pressure remained especially low. Time is life; no one spoke in the operating room, only the sound of hurried footsteps echoed.

Laying out the sheets is a difficult task, but everyone just makes do.

Zheng Ren pressed Director Kong into a chair, indicating that he alone would be enough. Then he went to put on lead clothing and scrub up.

Professor Yang and Director Miao also put on lead clothing and scrubbed up; they were not used to it, wearing ten-something jin on their bodies was too awkward.

But the interventional embolization surgery for a severe pelvic fracture takes about two hours—how much wire would that consume?!

It's possible that the abdominal surgeries are finished, but the interventional surgery cannot yet be completed in a super-selective manner.

So the lead clothing must be worn; even if it's awkward, we still have to be awkward.

The inpatient chiefs knew time was pressing, acting especially quickly; Yu Zong and Director Dong swiftly laid out the sheets. After Professor Yang and Director Miao came up, they stood on the patient's right side, while the two inpatient chiefs stood in the assistant's position.

Zheng Ren stood at the leg side, greeted Su Yun to uncover a corner of the sterile sheet, and immediately began femoral artery puncture.

The posture was especially awkward, but this posed no problem for Zheng Ren. Director Miao and Professor Yang briefly communicated, selecting an incision both could accept; by then Zheng Ren had already completed the femoral artery puncture, and the guidewire went in smoothly.

"Prepare to step on the line." Zheng Ren felt the guidewire was in position and said in a low voice.

The airtight lead door closed; Director Miao was somewhat surprised, how could it be so fast? But he had no time to think about it, cutting from below upward, opening the patient's abdomen and connecting it to Professor Yang's incision.

Quickly separating skin and subcutaneous tissue, entering the abdominal cavity.

After a glance, Director Miao wanted to turn and step down.

A massive hematoma near the kidneys, although wrapped in yellow fat, the naked eye could see both kidneys were shattered.

It's estimated that arriving at the hospital early gave a slim chance of rescue; if they were three to five minutes later, there would really be no chance at all.

Even so, Director Miao felt it was already hopeless.

Meanwhile, the injuries to the liver and spleen were relatively minor, and Professor Yang had already begun suturing.

Director Miao carefully separated and continuously ligated; he wanted to at least preserve one kidney.

But five minutes later, he found the left kidney could not be saved.

Almost completely shattered, it couldn't be sutured.

Making a decisive decision, he blocked the renal artery and began left nephrectomy. All that remained was to pray that the patient's right kidney still had a slim chance of preservation.

"How much urine output?"

"No urine." The anesthesiologist immediately replied.

No urine! This is the manifestation of complete loss of kidney function.

To completely remove the kidney, Director Miao doesn't need to be too skilled; for him it's just a matter of a few minutes.

But making this choice is extremely difficult.

Removing the left kidney makes the surgery simple and allows immediate hemostasis; but if the right kidney fails, what then?

However, the suction device was drawing arterial blood, its hissing sound reminding Director Miao that he could no longer hesitate.

The renal pedicle clamp directly clamped, cutting the ligament, preparing for total left kidney removal.

Because there were many people around the operating table, the upper and lower instrument nurses passed instruments, but Director Miao standing in the middle was very inconvenient.

He clamped the renal pedicle, just about to get something, when a blunt scissors slapped into his hand. A gloved hand took the renal pedicle clamp from his hand.

Uh……

Director Miao froze for a moment.

This is…… Zheng Lao Ban?

"Is the surgery done?" Director Miao asked in surprise.

"Yeah, embolization is complete." Zheng Ren took the clamp, didn't step down, but stood on the operating table to act as Director Miao's assistant.

Su Yun then crouched under the operating table, squeezing through the gaps between people, hiding under the sterile sheet, and with an extremely awkward posture applied pressure to the puncture site.

Although the patient is currently in hemorrhagic shock, if the bleeding could be stopped, blood pressure would definitely rise. Otherwise, after the upper surgery is finished, looking down at the blood would soak the pants.

That amount of bleeding is at least around 1000 ml. The patient is already in hemorrhagic shock, so saving any blood is a point.

Director Miao lifted his head to glance at the time; the table had been open for only a few minutes, had Zheng Ren's side already finished surgery?

"How severe is the retroperitoneal injury?" Director Miao asked seemingly offhand while cutting the kidney.

"Five blood vessels are bleeding, all embolized, no problem." Zheng Ren knew his concern, but answered irrelevantly.

Director Miao lifted his head to glance at the opposite screen; the image froze on the embolization interface, with no postoperative angiography.

"Why no angiography to confirm?"

"The patient has no urine; taking less contrast agent will be beneficial for postoperative recovery." Zheng Ren said matter-of-factly: "Can the right kidney be preserved?"

"It depends." Director Miao cleanly removed the left kidney, then examined the right kidney, handing the left kidney fragments to Zheng Ren to pick up bit by bit and place them in the nearby pathology basin.

The left kidney was shattered like a ragdoll that couldn't be sewn; the right kidney… was slightly better, but not much.

Zheng Ren watched Director Miao suture as best he could, straining with all his might to preserve the right kidney, knowing in his heart that this was merely a death struggle.

No wonder the system rated it an S-rank mission; this damn thing is basically impossible to complete.

"Su Yun, how much urine output?" Zheng Ren helped Director Miao with the suturing, and began to worry about the urine volume.

If there were even a few milliliters of urine, it could prove that the injured person's right kidney still had residual function.

But Su Yun's words made Zheng Ren feel as if he had fallen into an ice cellar.

"There's no urine, not even any left in the catheter." Su Yun said calmly.

Director Miao's hand paused for a moment upon hearing Su Yun's words.