Surgery Godfather

Chapter 253: 0237 Twin Heroes

“Professor Tan, you should have realized the complexity of this case long ago, you should not be hastily changing personnel at this point, it’s irresponsible to the patient. You trained at the affiliated hospital of Tokyo University, you should possess some basic professionalism.”

On the way to the operating room, Takahashi was dissatisfied, the arrogance and contempt ingrained in him would surface at any point.

Director Tan let him say whatever he wanted, offering no rebuttals, only leading the way.

It couldn’t be helped, they had research on these types of cases, accumulated experience, competition comes down to ability, everything else is irrelevant.

Song Zimo paused in his movements, operating nurse Zhou Can was reorganizing the tools on the operating table, the patrolling nurse hung a few more bags of blood, Liang Fatty was staring intensely at the data on the monitoring screen, Little Five and Zhang Lin were feeling frustrated on the operating table.

Yang Ping was already in surgical attire, gloves on, ready to replace Song Zimo at any moment, Xiao Su was also in surgical attire, sitting next to the instrument table, ready to replace Zhou Can whenever necessary.

The autologous blood transfusion equipment was collecting blood from the thoracic cavity, after filtration treatment, blood transfusion back into the patient’s body had started, the red blood mixed with saline solution, flowing via transparent tubes into the patient’s body.

The abdominal cavity had not yet been opened, the closed abdomen could temporarily stop the bleeding, the capacity of the abdominal cavity is limited, when the blood fills to a certain level, a balance is formed between the hydrostatic pressure of the blood in the abdomen and the pressure from the bleeding vessels, thus stopping the bleeding from the vessels temporarily.

Song Zimo glanced over at Yang Ping who was sitting, considering who to replace as Chief Surgeon; if not Yang Ping, could it be that Director Han was planning to go up himself?

He knew this surgery was difficult, over a hundred blood vessels scattered like spider webs, many even dangerously located. But he had confidence, he wanted to push forward.

Besides, with Yang Ping as his backup, he had even more confidence. Unfortunately, it seemed like Director Han was planning to take part himself.

“Elder brother, is Director Han planning to go up himself?”

The orders of the superiors are absolute, medical rules can’t be broken.

“Are the vital signs still stable?” Yang Ping asked, turning his head to look at the screen.

Liang Fatty, who sat by the patient’s head, replied, “Temporarily stable, but we can’t rely on blood transfusion to maintain this condition indefinitely.”

The automatic door to the operating room opened, and Director Han’s team filed in.

“Director Han!” Yang Ping got up.

Director Han waved his hand, “Yang Ping, Xiao Song, you guys take a break, let Mr. Takahashi be the Chief Surgeon, Director Tan and I will assist. Oh, and don’t take off your surgical gowns, and don’t contaminate yourselves, stand by.”

“Yang Ping!” Director Han called Yang Ping back.

“Director?” Yang Ping understood Director Han’s decision.

“Nothing, just pay attention to Takahashi’s surgery and learn.” Director Han hesitated before saying.

“I will, sir.” Yang Ping reassured Director Han.

After hastily giving instructions, the group immediately left to scrub in.

It turns out that Takahashi would be the Chief Surgeon instead of Director Han, Song Zimo didn’t even have a chance to ask before Director Han hurriedly took Takahashi to wash their hands.

Fujiwara Miyuki stayed in the operating room, Takahashi hadn’t invited her to the platform, and she looked around at the doctors and nurses in the operating room.

The surgeons in the room were surprisingly young, Fujiwara Miyuki hadn’t paid much attention when she watched the video, but now that she saw Song Zimo and Yang Ping up close, their spirited eyes, upright posture, and overall confidence left her impressed.

When she watched the video earlier, their exceptional thoracoscope skills were far from the “rag-tag band” that Takahashi had described.

If it hadn’t been for this rare case, they would have performed even better.

“Hi, everyone, I’m Miyuki Fujiwara, pleased to meet you!”

Even wearing a large surgical gown, Fujiwara Miyuki couldn’t conceal her figure. She graciously greeted everyone.

At this moment, who had the mood to be looking at a supermodel? Fatty didn’t even lift his head, Song Zimo merely nodded as a token of acknowledgement, Yang Ping didn’t hear her, he was entirely focused on the 3D reconstruction image of the blood vessels on the screen.

Right now, Yang Ping’s strong mental visualization had already constructed a complete 3D image.

According to the CT scans, the image constructed in the brain showed all 124 malformed vessels, each one posing a potentially fatal risk if not properly handled.

Yang Ping even simulated the surgery in his mind, using the constructed imagery, deciding which vessel to handle first, and which next, how to expose each vessel, where the risks were, and how to avoid dangerous structures.

The many vessels coming from multiple three-dimensional directions were a headache just to expose, let alone the pseudomorph distortions in the CT images, which couldn’t reproduce the true and meticulous anatomy relationships, increasing the difficulty of the surgery.

Takahashi finished washing his hands, held them up in front of him, chest out, walking into the OR with an air of confidence, wishing to exude the qualities and stride of a world-class surgeon.

If he wasn’t arrogant and ostentatious, he wouldn’t be Takahashi. When he entered, Zhou Can offered him his surgical gown.

He didn’t reach out to it immediately: “Can you hold it with both hands, please?”

Tang Fei translated, after a moment’s hesitation.

Zhou Can’s face turned a bit red, she held up the gown with both hands. Takahashi accepted it, “You’re standing in front of a world-class surgeon, you should show some respect.”

Takahashi flicked his hands, put his hand into the sleeve of the gown, put on his gloves, and walked towards the position of the Chief Surgeon.

Song Zimo reluctantly gave up his position as Chief Surgeon. Takahashi stood in the Chief Surgeon’s spot, “You can go down–”

Director Han gave a signal to Yang Ping and Song Zimo, “You guys take a break for now, don’t remove your surgical gowns and don’t contaminate yourselves, be ready to go on the platform to help anytime.”

Director Han had planned for this, even a world-renowned trauma surgery expert can’t be fully trusted. After all, the patient is their responsibility, if he can’t handle it and just leaves, they’ll have to clean up the mess.

“Assistants, take your positions!” Takahashi spoke authoritatively.

“Han, first assistant; Tan, second assistant; you, instrument nurse, are there any objections? If not, prepare to start. Anesthetist, report the vital signs, raise the operating table!”

Takahashi began speaking in Japanese, and Tang Fei had to help translate.

“Blood pressure is at 84/45mmHg, heart rate is 116 beats/minute, blood oxygen saturation under low flow oxygen is at 90%.” Fatty reported the vital signs.

“Speak up, the vital signs are already unstable, and yet you guys are so listless, scalpel!”

Fatty had no choice but to repeat his question loudly: he wasn’t paying much attention before, so how did this Japanese man suddenly take the stage? What happened?

“Should we pause the video?” Director Han suggested. @@novelbin@@

“No need!” Takahashi confidently replied.

“Let’s open the abdomen now, scalpel!”

Living up to his reputation as a top-notch Japanese surgeon, Takahashi took the scalpel and made a neat vertical incision in the center of the abdomen, cutting just deep enough to reach the subcutaneous tissue, not a bit more or less.

Subcutaneous fat the size of corn kernels rolled out. Electric knife stopped the bleeding, and layer by layer he cut. The anatomical layers were clearly defined and the surgical field was almost bloodless.

“This scalpel isn’t sharp enough. Do you all typically perform surgeries with this kind of blade? Change to a new one! Next time, I’ll bring you a set of surgical blades made in Japan.”

Takahashi threw the surgical scalpel into the instrument tray, and Xiao Su swiftly swapped it for a new one.

After cutting through the skin and superficial fascia, the deep fascia was revealed. Takahashi’s scalpel began to slice through several layers of muscles.

“Monitor the blood pressure, apply full pressure, and start transfusing blood. I’m about to open up the peritoneal cavity. I need the damage-free aortic clamp!”

The scalpel sliced through the last layer of muscles and opened the peritoneum. Blood instantly surged out from the abdominal cavity and was sucked away by Director Han’s suction device.

Takahashi used his fingers to gently and rapidly push aside the intestines floating in the blood. He placed a clamp on the upper section of the abdominal aorta, blocking it off.

Based on the CT angiogram, he identified the highest origin of the tumour’s blood vessels and clamped the aorta just above it.

“Time check!”

He needed to complete the operation within forty-five minutes, which meant he had less than half a minute on average to deal with each blood vessel.

The massive sprawling vascular tumour was a web of thick arteries and veins entwining and twisting around each other.

Takahashi’s fingers were exceedingly nimble. He gently palpated for a moment with his fingers, used a vascular clamp to isolate a vessel, and handed the clamp to Director Han to expose the vessel.

Takahashi used his right hand to clamp the isolated vessel and his left hand was already seeking the next one.

Each hand was doing something different, a difficult skill to master in surgical operations.

It took him more than ten years of training to acquire such sophisticated surgical skills.

Two vascular clamps grasped the distal and proximal ends of a blood vessel, and his right hand used a pair of scissors to sever the vessel in the middle.

His left hand then identified another vessel and handed it to Director Han.

Then, freeing both hands, he began suturing the vessel. Usually, this task was performed by an assistant.

But Takahashi preferred doing it himself to ensure its done right. He proceeded to neatly suture the vessel, successfully dealing with the first blood vessel.

This procedure took approximately one minute, which was a satisfactory pace.

“Keep up with my rhythm. I’m the Chief Surgeon. Keep up with my rhythm, understand?”

Takahashi was quite dissatisfied with the coordination between the assistant and the scrub nurse.

“Miss Miyuki, could you please transmit all the CT scan images to Teacher Fujihara in Tokyo?” Takahashi looked at the three-dimensional reconstruction image of the vessels on the screen. The precision was not adequate, some complex areas were too blurry.

“Little Five, please escort Dr. Fujihara to the operating room’s teaching room to assist her with transmitting the images.” Director Han asked Little Five to temporarily leave the stage to perform this task.

—

“The operation is really being led by Takahashi; he’s indeed a top surgeon!”

Exclamations of surprise filled the room. People tend to judge based on expectations. Now that Takahashi was operating, each of his movements was regarded as a masterstroke.

Everyone watched the master’s surgery in awe-stricken admiration.

The complex, blurred anatomy would have left an ordinary person at a loss, but Takahashi, a world-class surgeon, was calm and composed.

A surgeon’s hand and his instruments are like a special forces team. They have now entered the ruins of a city, advancing cautiously, relying on their training, making keen judgments, attacking decisively in an unknown world.

This is the complexity of surgery – a hundred blood vessels were like a hundred ambushed enemies, not one could be overlooked.

Now, each display in both the main conference room and the sub-conference rooms was split into two halves.

On the left side were the surgeries conducted by Sasaki, and on the right side were Takahashi’s procedures.

A feast of surgical demonstrations was unfolding – performed by the two titans of Japanese trauma surgery simultaneously.

Sasaki was struggling to reconstruct the hepato-biliary-pancreatic duct system.

The duct system was just beginning to show. This was a very dangerous area. If a general surgeon could perform a pancreaticoduodenectomy, it would signify reaching the peak in this field.

But Sasaki’s surgery was a total reconstruction of the hepato-biliary-pancreatic duct system, which was several times more difficult. In addition, it was being performed on a five-month-old infant under a microscope – the crown jewel of operations.

While over at Takahashi’s end, he had to successfully remove a huge tangled vascular tumour within forty-five minutes. This tumour was comprised of more than a hundred robust blood vessels.

In fact, Takahashi’s surgery was more challenging. Sasaki’s operation tested his micro-surgery and abdominal surgery skills, while Takahashi’s operation was a test of every single skill a surgeon could possess.

One was facing a formidable enemy but with ample intelligence; the other was facing a strong enemy with very limited information – an entirely new foe.

The live broadcasts, which were originally from two different hospitals, had now turned into a showcase of Tokyo University Hospital’s surgical prowess.

It was a surgical showcase by the two titans of Japanese trauma surgery!

“Operating independently with both hands?”

Someone had noticed Takahashi’s technique. He was actually capable of operating independently with both hands!