Chapter 21 (2/2)

The comment section started to overflow.

[Why does he pause after each injection? What’s the reasoning behind this?]

[My guess is that it allows the local anesthetic to take effect and avoid agitating the patient. Infiltrative 0.5% lidocaine will take effect around 12 seconds post-administration, though, so why is he s.p.a.cing out the injections at three-second intervals?]

[Don’t tell me that’s the use of propofol?]

[I’m kneeling. Please accept my reverence.]

[Oh please, stop commenting. Watch the surgery! Watch!]

The last call for silence was futile and was quickly lost in a sea of incoming comments.

[I remember the textbook incision for an appendectomy in pregnancy starts at the McBurney’s point¹ on the right side of the rectus abdominis. Isn’t the G.o.d’s incision point a bit high? Or am I remembering it wrong?]

[It’s possible that the position has been confirmed through palpation.]

[A five-centimeter incision on a pregnant woman for an appendectomy. How gutsy he must be!]

Although it was just an appendectomy, everyone watched hungrily. The live comments dwindled as the first layer of skin was peeled open.

…

…

Zheng Ren drew the scalpel across the skin and proceeded to perform a blunt dissection on the tissue and muscles underneath. The peritoneum was the last layer.

Every move required the administration of local anesthesia. The surgery was not a quick one but his movements were steady.

The anesthesiologist looked at the surgery, then at the patient’s vital signs, and then back at the surgery. They were at the peritoneum now, and the patient’s blood pressure, heart rate and breathing remained stable.

This indicated that Zheng Ren’s local anesthesia technique was effective and the patient did not feel any pain.

‘This man is a daredevil,’ the anesthesiologist thought.

Zheng Ren’s performance was of the highest caliber. Even a professional anesthesiologist would not have done as well. Was this the effect of the propofol? Could it perhaps be tested in the next surgery?

The anesthesiologist shook his head to clear the outrageous thoughts from his mind. He should keep to standard protocols for anesthesia. If something were to go wrong, he would not be able to shoulder the responsibility.

After cutting through the peritoneum, Zheng Ren looked inside and promptly located the appendix with the curved surgical forceps.

The swollen appendix was gently clamped between the forceps. There was not an ounce of unnecessary force in Zheng Ren’s grip.

With one hand on the scissors, Zheng Ren motioned for Xie Yiren.

A smaller pair of curved forceps was placed in his hands.

“Not this.” Zheng Ren rejected the instrument. “The syringe.”

With a start, Xie Yiren realized her mistake. This was not the standard appendectomy she was used to, but a local anesthesia appendectomy. The clamping of the ligaments and arteries surrounding the appendix had to be prefaced with administration of anesthetic.

Xie Yiren’s eyes twinkled as if a new toy was before her—Zheng Ren’s procedure had her full attention. All the routine appendectomies she a.s.sisted in had bored her to tears.

A quick round of local anesthesia later, Zheng Ren continued separating the ligaments.

Zheng Ren considered himself unlucky to be saddled with a case of appendicitis in pregnancy at such a precarious moment, and to operate with only local anesthesia.

Although he had practiced local anesthesia appendectomy in the System, he still prefered to avoid such outrageous practices as the risk of accidents was high.

However, there was some luck on his side as this case was not as complicated.

Due to the pregnancy, the patient’s uterus was enlarged and the greater omentum which usually covered the appendix had been pushed away. If the appendix ruptured without the greater omentum’s protection, the patient would suffer severe complications and the surgery would have been even more troublesome.

It was unclear to him how the swollen appendix was still intact. He chalked it up to a quick and timely diagnosis. The patient’s youth and general good health also likely contributed to the cause.

The inflammation around the appendix was also mild.

Zheng Ren thanked his lucky stars.

He removed the appendix and tied up the appendicular artery, then closed up the residual stump with a purse string suture, adding an extra st.i.tch at the end.

The whole process was clean and beautiful.

It was a success that stunned everyone into silence—from the surgical demonstration cla.s.sroom to Xinglin Garden.

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