CHAPTER 205: 205 SEEING BAREHANDED HEMOSTASIS AGAIN

(Thanks to good friends Zhen Jia Zhen, Bai Yun Tai Qing Dan, and Wu Cong Lu for their encouragement tickets.)

Liu Banxia had experienced such a tense moment once before, during a case that had left him with a psychological scar. Although a cesarean section had been successfully performed at that time, it had also impacted him.

Today’s situation was similar to that day, but even more critical. This was because they were psychologically prepared for the potential difficulties they might face after the surgery began.

The area outside the operating room was also filled with people; not just surgeons from the general surgery department, but doctors from other departments were there too.

Everyone knew that today’s operation was of extraordinary significance, and the difficulty was exceedingly high.

"Alright, let’s begin the operation. I’ll first saw off this rear section," Zhou Shuwen said, picking up the electric saw.

As Zhou Shuwen’s electric saw started its work, all eyes were on the monitor. The patient’s blood pressure had already started to drop, and the heart rate was accelerating.

Wang Lei also timely administered some vasopressors.

"We should be able to saw it off completely in about twenty seconds. Increase the fluid replacement," Zhou Shuwen said.

This was Zhou Shuwen’s estimated time, but in those short twenty seconds, the patient could easily cross the line between life and death and back again.

"Alright, patient in supine position, prepare for laparotomy." After finally sawing off that section, Zhou Shuwen’s voice was tinged with excitement.

Zhou Shuwen picked up the scalpel. This time, he didn’t make an initial skin incision and then use an electrosurgical knife to dissect through the layers as usual. Instead, he made a single, long incision that directly opened the abdomen.

Liu Banxia and Wei Yuan quickly retracted the skin and tissues on both sides of the incision.

All they could see was blood. The monitor alarms blared frantically as the patient’s blood pressure plummeted rapidly.

"Multiple colonic perforations, splenic rupture, right kidney shattered. Visible hemorrhage from the splenic artery, suspected mesenteric arterial bleeding," Liu Banxia called out, even as he clamped the splenic artery with a hemostat.

"Suction. Wei Yuan, ligate the renal artery. I’ll find the mesenteric artery and then perform a splenectomy," Zhou Shuwen said.

There were indeed too many bleeding points. The tree branches inside the patient’s abdomen had already caused massive damage. As soon as the abdomen was opened, two small branches poked out from the incision.

The bleeding Liu Banxia had just reported constituted only the major bleeding points he could see. The other, smaller bleeding points were insignificant compared to the arterial hemorrhages.

Gritting his teeth, even though he couldn’t yet determine if the patient could be saved, Liu Banxia added 5 agility points to himself.

DING! You have gained 5 agility points, and now you have 70 in total, improving your stability, speed, and tactile sense by 29.63%.

None of the three slowed down, especially Liu Banxia, who began dealing with the splenic artery immediately after speaking. However, even after Zhou Shuwen found and clamped the mesenteric bleeding point, the patient’s blood pressure continued to drop.

Though the suction machine was working non-stop, the volume of blood in the abdominal cavity did not decrease much. Moreover, the branch stuck in the abdominal cavity also obscured a large area of the surgical field.

Liu Banxia had no choice but to insert both his hands into the patient’s abdominal cavity, feeling around the branch, carefully sensing the direction from which the blood flow was surging.

Zhou Shuwen had initially planned to continue searching as well, but with limited operating space in the abdominal cavity—now obstructed by both the branch and Liu Banxia’s hands—all he could do was join Wei Yuan in dealing with the minor bleeding points at the periphery.

Even under the current circumstances, treating these minor bleeding points was significantly beneficial for the patient.

Before the abdomen was opened, the pressure from the internal blood had temporarily stemmed the bleeding from these points. But now, with the abdomen open, these bleeding points were like unleashed floodgates, blood gushing madly outward.

The fact that Liu Banxia could report so much information in such a short time was commendable. But it wasn’t enough. There were still bleeding points obscured from view; judging by the current blood loss, these were likely arterial as well.

"Found it! The external iliac artery! A sharp piece from the branch, where it split, pierced it!" Liu Banxia cried out.

"That’s about right. The blood pressure has finally stopped dropping," Wang Lei said.

"Continue suction. Hold it," Zhou Shuwen glanced at him and said in a deep voice.

This was an unexpected boon for the day. He had heard about Liu Banxia manually compressing blood vessels to stop bleeding but had thought it was just luck. Yet, today, he had done it again.

The surprise among the onlookers outside was no less than Zhou Shuwen’s. For many doctors in the Second Affiliated Hospital, Liu Banxia was just a name associated with some noteworthy incidents.

No matter how much of a stir Liu Banxia had caused before, it wouldn’t have garnered the attention of all the doctors in the hospital; at most, they would only hear about it in passing. But today, this maneuver of his—manually stopping bleeding, and from the external iliac artery no less—truly shocked everyone.

The surgical field in the abdominal cavity was so poor, with numerous leaves obstructing their vision. He actually found it purely by touch? How could that be possible?

"Director, we need to hurry. I’m pressing it with my fingers right now," Liu Banxia called out urgently, while the onlookers were still marveling.

"Bear with it. Wei Yuan, deal with the colon," Zhou Shuwen, who had already started handling the spleen, said without raising his head.

Liu Banxia didn’t dare say another word. He could only maintain his grip around the branch, acting as a human hemostat.

Zhou Shuwen wasn’t deliberately making things difficult for him. Although suction had begun, the branches were greatly interfering with the view of the surgical field. A lot could be accomplished while waiting for the surgical field to clear.

Watching Zhou Shuwen, Liu Banxia’s jaw dropped beneath his mask. Director Zhou was unbelievably skilled! In what seemed like less than half a minute, he had already removed the shattered spleen.

Although this was an emergency surgery, with different requirements than a regular operation, allowing for a somewhat rougher approach, wasn’t this speed still too fast?

Just how profound was Director Zhou’s understanding of human anatomy?

This was the first time he had truly grasped how formidable Zhou Shuwen was.

"Why are you staring at my hands? Keep pressure on that artery," Zhou Shuwen said, having placed the removed spleen aside.

"Director, you’ll have to be quicker; my fingers are getting numb. Moreover, I’m worried that pressing too long could damage the patient’s tissues," Liu Banxia said.

"Wei Yuan, you continue dealing with the colon. I’ll go over to his side; I can’t see from here," Zhou Shuwen said.

Liu Banxia knew the current situation, so he could only persist.

"Hang in there for a few more seconds. I’ll dissect the upstream vessel first. Don’t rush; I need approximately six more seconds." Zhou Shuwen, having moved around, reached his hand into the patient’s abdomen from under Liu Banxia’s armpit and began operating.

Before six seconds had passed, after dissecting a small portion, Zhou Shuwen directly inserted the hemostat.

"Okay, try releasing your hand," Zhou Shuwen said after clamping the vessel.

Liu Banxia slowly released his pressing fingers; the patient’s blood pressure did not drop. However, even with the ongoing transfusion, it wasn’t very high, indicating there were other points of oozing.

The first stage of the task was complete. Wei Yuan had also resected nearly sixty centimeters of the colon.

"Director, my fingers are very numb; I need some time to recover," Liu Banxia said after testing them.

Zhou Shuwen nodded. "There are still some oozing bleeders; we’ll handle them directly. I’m dealing with the kidney now. You two figure out how to manage the remaining smaller branches and how to extract this large one."

Liu Banxia glanced at the suctioned blood—no less than 2,000 ml. He then carefully inspected the abdominal cavity. "Prepare more blood bags. A branch has pierced the liver; I don’t know if it has damaged any major blood vessels."

"There are scratches on the stomach wall, but it’s not severe, just some oozing," Wei Yuan said.

"Is that particular branch the most dangerous one?" Zhou Shuwen asked while working on the right kidney.

"Director, it appears so for now. But there’s oozing along that branch, and the blood is bright red. I’m afraid it has indeed injured the hepatic artery," Liu Banxia said.

"Wei Yuan, how well do you know your liver anatomy?" Zhou Shuwen asked.

"Director, I am competent," Wei Yuan said.

"Very good. Once Liu Banxia’s fingers have recovered, you’ll take the lead on this, and he will assist you. I’ll handle the remaining oozing points," Zhou Shuwen said, looking at them both.

"Brother Wei, go ahead with confidence. My fingers have recovered," Liu Banxia also spoke up.

Opportunities for hands-on liver surgery were scarce. Liu Banxia had already been the lead surgeon for one that morning. Now, Zhou Shuwen’s decision was clearly made from a training perspective.

In this respect, Zhou Shuwen was leagues ahead of Qin Hai; Liu Banxia was his true disciple, after all.

"Director, the other patient has been sent to the operating room. Do you need help here?" Shi Lei came in from outside at this moment.

"Come and help me," Zhou Shuwen said.

Wei Yuan wasted no time and began carefully dissecting around the liver, bit by bit.

It was currently unclear if there were other injuries to the liver. If the branch had simply pierced it straight through, it would have been somewhat easier. However, this branch also had some springiness to it. Liu Banxia assisted Wei Yuan with his right hand while steadying the branch with his left.

The observing surgeons were envious because this single operation truly encompassed a vast amount of knowledge and numerous surgical skills: liver, colon, spleen, right kidney, and various vascular ligations within the abdominal cavity, among others.

Such an incredibly difficult surgery was truly a battle to snatch the patient from the jaws of death. To have reached this stage meant they had already reclaimed more than half of the patient’s life.

Time ticked by. Wei Yuan was still meticulously dissecting. Zhou Shuwen, with Shi Lei assisting, had finished dealing with the right kidney. After a thorough re-examination, they addressed newly discovered oozing points and also repaired the ruptured external iliac artery.

At this moment, everyone’s focus was on Wei Yuan and Liu Banxia. This thin branch, though not very thick, could be causing immense harm to the patient. Whether it could be managed successfully depended on them.

Only then did someone notice the duration of the surgery: it had already lasted nearly two hours.

For such a complicated operation, two hours wasn’t actually very long. Because for this patient, they weren’t even halfway through the surgery yet.