Perfect Surgeon 147
Perfect Surgeon chapter 147

Episode 146.

146.

When the spleen, the site of the most severe damage, was removed, internal bleeding was noticeably reduced.

After the spleen, Director Seok stopped the bleeding in the order of the severity of the wound.

Depending on the situation, the wound was sometimes treated with an electric cauterizer, and the necessary areas were quickly sutured.

Goosebumps appeared on Hyun-joon’s forearm, watching from the side of Manager Seok’s every move.

I thought that I had improved a lot through virtual surgery, but Manager Seok’s skills were more sophisticated and quicker than I had imagined.

‘You are a person who operates several Tista (severe trauma) patients a day… … .’

Beyond envy and surprise, Hyun-jun’s head was filled with thoughts that he should work harder.

‘I can do it if I practice more.’

Although he did not express his feelings at all, it was the same with Manager Seok Jin-woong who was admiring himself.

Professor Yoo Sang-wook, who has been working together for over ten years, has not been able to show this level of sum with himself.

Hyeon-jun’s sense of making the operation easier was quite surprising.

‘How can a resident develop such skills… … .’

Come to think of it, Hyunjun conducted DCS during his internship.

I had only heard from Son Wan-gyu, but now I can be sure.

Manager Seok Jin-woong also wanted to see Hyun-joon’s ability to perform, not just an assistant.

“Chief, guardians have arrived.”

This was what Suk Seok told the operating room staff after completing the spleen removal.

The guardians, who appear to be mothers and older brothers, could not even look directly at their daughter and brother lying on the operating table.

Hyunjun tilted his head at that sight.

‘Why did you bring the guardians into the operating room?’

After stopping the operation for a while, Manager Seok Jin-woong explained the condition of the patient to the guardian.

“The spleen was resected due to severe bleeding and severe damage. Other organs… … .”

It was an action that stemmed from his belief that it was the doctor’s job to not only save the patient, but also to accurately convey the patient’s condition to the guardian and to calm the heart.

“The patient is also struggling now.”

“Yeah… … .”

At first, the older brother, who had been ignoring the operating table, looked intently at the operating table on which his younger brother was lying and hugged his mother tightly.

“Please take good care of your son. We will do our best.”

“Yeah… … .”

“Teacher, please take good care of our Seohee. Whoops!”

“We will do our best.”

Manager Seok did not say anything to make the guardian hopeful.

He just kept repeating that he would do his best.

Jin Insa Daecheonmyeong.

Because he knew better than anyone from experience that if he did the best he could, the rest would depend on the sky.

When the damaged area and torn blood vessel were sutured and bleeding was caught, Manager Seok nodded.

“The ship will not close. Master Jang. egg plant.”

After the guardian left and ordered the temporary abdominal wall closure, he moved to the operating room where Professor Yoo Sang-wook was operating right next door.

Director Seok Jin-woong, who first checked the patient’s CT, approached the surgeon.

“Professor Yu, how are you?”

“I have severe liver damage, so hemostasis is stopped with a hemoclip and a drainage tube is being inserted.”

After examining the condition of the liver, Manager Seok nodded. The intra-abdominal hemorrhage was almost uncontrollable.

“Grade 4?”

“Yeah.”

Professor Yoo Sang-wook is the second-largest trauma surgeon, and if he was in another hospital, he would have been the head of the center.

Section Chief Seok Jin-woong also came to check the situation and did not appear to have any intention of getting involved in his operation.

“Then I will go see Mr. Son. hard work.”

“all right.”

Hyun-jun also bowed his head and followed Manager Seok.

Even in such an emergency, the two people who exchanged trusting glances without losing their composure were both great and envious.

‘Maybe I can have my own surgical team someday… … .’

Unlike the operating room he had entered a while ago, Hyunjun’s heart was pounding slightly.

It was the first time since the Gyeongju earthquake to enter the operating room with Son Wan-gyu.

I wondered how much his skill had improved.

Son Wan-gyu, who was performing the operation, naturally tried to change his seat when Director Seok Jin-woong appeared.

“Chief.”

“No, go ahead.”

“all right.”

“How is the patient?”

“After irrigation, the bleeding site showed that the spleen, liver, and retroperitoneal were injured.”

“Well. I think it was a pelvic fracture.”

When Manager Seok checked the bleeding condition of the organs, Hyun-jun looked down from behind their shoulders into the abdominal cavity and understood everything in an instant.

At first glance, Son Wan-gyu seemed to have cleaned the bleeding organ.

I felt it when we worked together in Gyeongju, but Son Wan-gyu had a great chance of developing his surgical skills by using both hands well.

It has been 3 years since I worked at the trauma center at Daehan University Hospital.

Hyeon-jun has also improved in many ways, but Son Wan-gyu has also been trained with uncountable practical experience.

‘Wan-gyu hyung.’

Hyun-jun smiled inside the mask with some sense of pride.

“But, Manager. The intra-abdominal bleeding seems to have been almost controlled, but my BP (blood pressure) is not recovering well.”

After checking the vitals, Manager Seok’s expression became serious.

That meant there was an organ somewhere that was wounded and needed a touch.

“What about blood vessels?”

“Central hematoma (hematoma) is confirmed, but the exact type of blood vessel is not confirmed.”

Hearing the conversation between the two, Hyun-jun also tried to find the bleeding site.

It was a pity that I couldn’t see it with my own eyes instead of right next to the patient.

‘If it was central, it was zone 1 or zone 3 of the retroperitoneum… … If it is a vessel in zone 1, is it the renal artery, the superior aorta, the vena cava, or the celiac artery? … .’

[Zone 3 contains the renal artery inferior aorta and vena cava.]

‘Ronnie, where do you think you are?’

[More information is needed.]

While everyone was concentrating on the patient, Hyun-jun, who moved gently, checked the CT image again.

“Son, first press your aorta.”

Son Wan-gyu took action according to Seok’s words, but the bleeding showed no sign of stopping.

“Then zone 3 is venous bleeding. First catch the bleeding with a pelvic cavity packing, then angiography.”

“all right.”

According to the order of Manager Seok, the staff moved in unison.

As he said, when the pelvic cavity packing was completed, blood pressure gradually stabilized.

The operating room staff wiped Son Wan-gyu’s sweat. He looked at Manager Seok with respectful eyes.

I’ve watched dozens or hundreds of surgical cases from my side, but every time I can’t help but admire the workmanship.

“Whew… … I feel a bit more stable now.”

“Well.”

“Secondary surgery for additional hemostasis… … .”

“Watch the status and implement it in two or three days.”

“Yeah.”

Three Tista patients were operated on at the same time, but all of them had passed the emergency situation.

belt belt belt.

Everyone breathed a sigh of relief when suddenly a warning sound rang through the operating room.

“Blood pressure drops sharply! Systolic blood pressure 90, 85!”

“Bring more blood!”

Director Seok Jin-woong immediately responded to the warning from the anesthesiologist that followed immediately.

Even in this situation, he did not lose his composure.

“What is your body temperature?”

“It’s 34 degrees. It is falling!”

At the same time, blood began to pool again in the abdominal cavity.

Even Manager Seok, who conducted numerous T-Star cases, could not easily analyze the cause.

“Umm… … .”

When the captain did not give instructions immediately, the movement of the crew stopped as well.

As everyone was waiting for his next words, another voice was heard first from the other side of the operating room.

“A ruptured abdominal aortic aneurysm… … .”

It was Hyunjun.

Director Seok asked him, who couldn’t take his eyes off the CT image.

“Master Jang, what did you say now?”

“… … Manager. It appears that the patient had an abdominal aortic aneurysm.”

“What?”

“If you look at the picture here, it’s not easy to tell because of the intra-abdominal hemorrhage, but it definitely looks like an enlarged aorta.”

Manager Seok, who approached Hyun-jun, also focused on the CT image without blinking a single eye.

As he said, if you look closely, you can see that the aorta has expanded to about 5 cm.

“Doctor Song, do you have a patient history?”

“that is… … . He is the first patient to come to our hospital.”

If the aortic aneurysm was about 5 cm, it could be asymptomatic. If he hadn’t gone to the hospital, the patient probably wouldn’t have known.

“then… … .”

“It appears that the aortic aneurysm has been impacted by trauma.”

“this… … .”

If it was an abdominal aortic aneurysm rupture, everything was right.

At the same time, his complexion darkened sharply.

The mortality rate of patients with ruptured abdominal aortic aneurysms is over 90% if surgery is not performed on time. Even with timely surgery, more than 50% of the patients died.

Besides, the trauma has damaged other blood vessels and organs.

The patient’s bleeding volume was also approaching 5 liters.

Everything was a hopeless situation, but that didn’t stop him from giving up on the patient.

If you don’t have surgery here, it’s like death.

“Call the aortic emergency surgery team and the thoracic surgeon!”

“all right!”

The problem was time.

No matter how much an emergency call was made, there was no choice but to delay at least a few dozen minutes for the surgical team to gather and complete disinfection.

“Did you contact me?”

“Professor Seongdo Kim is coming!”

The aortic aneurysm surgery team was in charge of the thoracic surgery aorta, so it was difficult for the trauma surgery team to come forward.

Director Seok Jin-woong was also specialized in trauma surgery, so it was the same.

Everyone in the operating room was the same.

Except for one person.

Hyun-Jun has performed several abdominal aortic aneurysm surgeries in a virtual operating room.

The time I wasted wasted on Hyun-jun was so precious.

Every second, every second was directly related to the patient’s life.

But this is the operating room of a severe trauma center.

He was an outsider who happened to be involved in the operation.

Conflicts arose in their minds, but, as always, the conclusion was the same.

The patient comes first!

“Chief, shouldn’t we do what we can before the thoracic surgeon arrives to save time for the operation?”

At Hyeon-jun’s words, not only Manager Seok, but also all the staff put on an absurd expression.

“… … Then who is it?”

“I do not know. I don’t think he’s affiliated with trauma surgery… … .”

Everyone was unaware of the situation, but Hyeonjun was the first to figure out the cause of the bleeding.

Meanwhile, Son Wan-gyu was thinking differently.

‘It might be possible if it’s Hyunjun.’

He was a person who witnessed Hyun-jun’s skills, or even a miracle, in Gyeongju.

Manager Seok also looked into Hyun-jun’s eyes.

His eyes were telling him that he could do it.

“Try it.”

“… … Yeah!”

“Chief! But… … .”

“it’s okay. I will take responsibility.”

Hyun-jun, who stood at the doctor’s seat, closed his eyes for a moment and then opened it.

As the neurotransmitter was properly released, his concentration slowly rose.

In order to expose the aorta and surrounding blood vessels, Hyunjun tilted the organ by hand using the left medial visceral rotation method.

The most important thing now was to hold the neck of the aortic aneurysm and stabilize the bleeding.

The problem was that the hematoma was filled with the aorta, making it difficult to find the neck.

Hyeonjun slowly put his finger between the hematoma, focusing his senses on the tip.

‘Where are you… … .’

The gaze of all the staff also followed Hyunjoo’s finger.

‘Ronnie.’

[Has confirmed.]

The hand that was moving slowly while digging the hematoma paused for a moment, and then Hyun-jun held out the rest of his hand.

“Give me vascular forceps, please.”

“… … uh. Yes.”

Son Wan-gyu swallowed his saliva and handed the device.

He was looking forward to it, but never expected that he would be this active.

Hyun-jun, who took the blood vessel forceps, without hesitation, put it directly into the place where the opposite finger was placed.

Perfect Surgeon chapter 147

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