CHAPTER 192: 192 TEMPORARY ASSESSMENT OF ZHOU SHUWEN

"Why are you only just getting back? Hurry up, the director’s looking for you." The moment Liu Banxia walked into the Emergency Department, Shi Lei started waving at him frantically.

That scared the life out of him. Even though he had taken leave, he had indeed returned beyond the stipulated time. He was worried that Zhou Shuwen might label him as a slacker. After all, Zhou Shuwen was his mentor now.

Knocking and entering Zhou Shuwen’s office, he was taken aback to see Wang Chao and Qi Wentai there too. By the looks on their faces, they seemed somewhat confused as well.

"Director, I ran into a heart attack patient on the way back and had to send them to the city hospital. That’s why I’m late." Without thinking further, Liu Banxia quickly explained his situation.

Zhou Shuwen nodded. "Have you done a laparoscopic cholecystectomy before?"

Hearing Zhou Shuwen’s question, Qi Wentai, who was sitting to the side, had a darkened look in his eyes. Sure enough, the director was favoring Liu Banxia. The meaning behind that question was too clear—he wanted to give Liu Banxia a laparoscopic cholecystectomy to perform.

"Director, I’ve not done it before. But I’ve seen Dr. Shi do it twice," Liu Banxia replied.

Upon hearing Liu Banxia’s honest answer, Qi Wentai’s hopes were reignited.

Even if Director Zhou is playing favorites, he would still have to consider the patient’s interest, right? So the next question should be directed towards him and Wang Chao. While he wasn’t sure about Wang Chao’s situation, he had indeed specifically trained for laparoscopic cholecystectomy.

"Are you willing to do it? Are you capable of doing it?" However, Zhou Shuwen directed his question straight at Liu Banxia.

Liu Banxia nodded with a smile. "Yes, I am. It’s merely a different approach. The standards for gallbladder dissection and separation are the same."

He felt happy inwardly. This was the advantage of having a mentor; Director Zhou always kept him in mind.

"Wang Chao, how about you?" Zhou Shuwen asked Wang Chao next.

Wang Chao was a bit timid. "Director, I’ve done it once."

Zhou Shuwen nodded. "Alright, go to operating rooms 4, 5, and 6. At eleven, there will be three patients who need cholecystectomies sent over. Because Liu Banxia came back late, you don’t have time to review the cases."

"Okay," responded Qi Wentai and immediately ran out, glancing at Liu Banxia with a challenging look on his face.

Finally, it was his opportunity to shine. The money he’d spent recently was not wasted. Liu Banxia had never performed a laparoscopic surgery, so if he successfully completed it this time, he’d count it as a win.

"Director, who will be my first assistant?" Liu Banxia asked.

"Me," Zhou Shuwen replied with a grin.

Wang Chao, who had just risen to leave, almost sat back down in surprise. He glanced at Liu Banxia, his eyes full of sympathy. How much pressure would there be during the surgery? It must be immense.

Liu Banxia indeed felt the pressure. He could joke around with Shi Lei, but he wouldn’t dare with Zhou Shuwen. A single glance from the director felt like it could take half his life.

"What are you waiting for? Hurry up," said Shi Lei with a laugh once Liu Banxia left the room.

"You’re so mean. You already knew about this, didn’t you? Why didn’t you tell me earlier?" Liu Banxia asked.

"This is an evaluation prepared by Director Zhou. How could I tell you? There’s not much time to prepare. Good luck," Shi Lei shrugged.

Liu Banxia was helpless. This was obviously a set-up. Shi Lei must have known about it several days earlier. Next time, he would have to make Shi Lei buy him dinner.

"Doctor Liang, Qing Kewa, stop watching from the sidelines. Come and learn something," Liu Banxia called out.

"Learn what?" Liang Xiaolin asked curiously.

"A laparoscopic cholecystectomy. Even though it doesn’t directly relate to your cardiac surgeries, you can still learn the steps of a laparoscopic procedure," Liu Banxia replied.

The two of them had no idea what was going on. But when they heard there was a surgery, they decided to follow and watch.

Before scrubbing in, Liu Banxia quickly reviewed the patient’s basic information. The patient had suffered from chronic cholecystitis for many years. They had previously relied on conservative treatment, but now surgery could no longer be postponed.

Luckily, the patient only had a history of high blood pressure and not diabetes, which was a relief.

After scrubbing in, the patient was being prepared for surgery. Seeing Zhou Shuwen in the operating room gave Liang Xiaolin a bit of a scare. She had assumed Liu Banxia would be operating with a standard assistant, not with Director Zhou scrubbed in too.

"How are you feeling? Want to sit this one out? Both Wang Chao and Qi Wentai are experienced," Zhou Shuwen asked.

"Director, there’s no need. Even though it’s my first time performing the surgery, it’s fine," Liu Banxia said with a smile.

"That’s good." Zhou Shuwen nodded.

"It’s not just you all. All doctors on rotation in the Emergency Department will undergo unscheduled assessments. Especially those of you who have just finished your residency—you’re considered the first batch."

"The method and content of the assessment are uncertain. To improve the Emergency Department’s service capability and efficiency, we will conduct random evaluations. It could be a group evaluation like today, or it could be an individual one."

"In the future, experienced attending doctors might also become examiners. Their job in the workplace is to oversee you all and point out mistakes in your work."

Liu Banxia nodded. This was very much Zhou Shuwen’s style. No wonder there had been no major events in the Emergency Department for the past few days; things were truly starting now.

After confirming the patient’s information, today’s anesthesiologist, Zhao Feng, began to administer anesthesia.

Although Zhou Shuwen was the first assistant, could Liu Banxia really expect a director like him to do all the routine tasks of an assistant surgeon? That would be a joke.

After the anesthesia took effect, Liu Banxia bounced in place twice, stretching his wrists, fingers, and shoulders.

Laparoscopic surgery significantly tests finger dexterity and brain-hand coordination. Unlike holding a scalpel directly, which offers more immediate control and sensory feedback, laparoscopy adds a layer of instrumentation.

Now, between the surgical instrument and his hand was an additional set of tools. Had he not trained in the dream space, he might not have dared to step up today.

The traditional puncture method for laparoscopy involves making a one-centimeter incision along the upper rim of the navel. Next, a pneumoperitoneum needle puncture is performed. Once completed, it’s connected to the pneumoperitoneum machine for insufflation. The purpose is to increase the distance between the abdominal wall and the internal organs, expanding the field of vision and operational space.

After insufflation, Liu Banxia removed the pneumoperitoneum needle, inserted the laparoscope, adjusted the angle slightly, and began to explore.

"Exploration results: there is significant adhesion around the gallbladder. The gallbladder is slightly congested, approximately 9 cm x 4.5 cm in size. Laparoscopic cholecystectomy can be performed," Liu Banxia stated.

"You might lose today; the adhesion is quite extensive. You have to be extremely cautious when dissecting it. Are you sure about this? I could find another surgery for you," Zhou Shuwen advised.

He hadn’t expected this surgery to become this complicated. Excessive adhesions would require many additional steps and also introduce significant uncertainty to the procedure.

"Director, it’s okay. Doctor Zhang Yun once said that after stripping away the superficial layers of any surgery, what remains is actually basic anatomy. Let me give it a try," Liu Banxia said with a smile.

Zhou Shuwen nodded.

Liu Banxia started making the second and third incisions. One incision was positioned below the xiphoid process, serving as the main operating port. The other was on the right anterior axillary line at the rib margin, which was the auxiliary port for Zhou Shuwen, the first assistant.

After inserting the dissector and grasping forceps, Liu Banxia started the operation.

Operating for the first time with Zhou Shuwen scrutinizing him from the side brought Liu Banxia immense pressure. He was grateful that he had embedded a Strength Stone yesterday; it was a stroke of luck.

Laparoscopy is purely instrument-based, and the Strength attribute included instrument proficiency. Even though he was a bit nervous at first and operated somewhat slowly, his speed gradually increased.

Performing such an operation was incredibly easy for Zhou Shuwen. As the "supervisor," besides observing the display, he could even spare some time to observe Liu Banxia’s expression.

This was also a form of assessment. Even with a mask, facial expressions could reveal the surgeon’s mental state.

He was quite satisfied with Liu Banxia’s confidence. When confident, a surgeon wouldn’t hesitate and would be decisive in their actions.

Then he had no time to observe Liu Banxia. Despite the extensive adhesions, Liu Banxia’s dissection speed steadily increased. Liu Banxia managed to quickly clear all those adhesions, completely exposing the gallbladder.

Zhou Shuwen lifted the gallbladder with a pair of forceps, and Liu Banxia quickly stripped away the fat. Seeing the cystic duct, cystic artery, common bile duct, and common hepatic duct clearly displayed on the screen, Zhou Shuwen was filled with pleasant surprise.

The assessment was not only about Liu Banxia’s laparoscopic operative skills but also tested his understanding of human anatomy.

Throughout the dissection, Liu Banxia was not only fast but also gentle.

This proved he had no problem with instrument operation. For someone performing their first actual surgery, this was beyond excellent. It also demonstrated Liu Banxia’s thorough understanding of the Calot’s triangle anatomy.

At this moment, Liu Banxia inserted an absorbable clip applicator through the operating port. He clamped the cystic duct as close as possible to the neck of the gallbladder. Then, he clamped the common bile duct and the cystic artery, each clamp placed cleanly and precisely.

After cutting, Liu Banxia cautiously began to detach the gallbladder from the posterior aspect of the liver.

Watching his maneuvers, both Liang Xiaolin and Qing Kewa held their breath. This was the liver; any slightly aggressive move could cause damage.

Although bleeding could be controlled, today was different. With Director Zhou, the big boss, observing on-site, any insignificant misstep would be infinitely magnified.

After completely detaching the gallbladder, placing it into a disposable retrieval bag, and pulling it out through the operating port, Liu Banxia let out a long sigh of relief.

He initially wanted to gloat a bit out of habit, but when he accidentally caught Zhou Shuwen’s gaze, he hurriedly proceeded with the final cleanup and spray coagulation to stop any bleeding.

"Doctor Liang, you can do the suturing," Liu Banxia said after completing all procedures.

The incisions, which were not that large to begin with, were quickly sutured by Liang Xiaolin.

DING! Daily mission complete (20/20)

Experience points gained: 300 points, Glory Points: 5 points

Gallbladder removal surgery completed. Experience points gained: 200 points. Skill proficiency in gallbladder removal: 500 points. Diagnostic skill proficiency: 100 points.

This surgery is rated as perfect. Experience points gained: 500 points. Skill proficiency in gallbladder removal: 1,000 points. Diagnostic skill proficiency: 100 points. Glory Points: 7 points.

Liu Banxia glanced at the operating room timer: 35 minutes had passed since the start of the surgery.