Chapter 276 - Difficult surgery (1/2)

Chapter 276: Difficult surgery

Zhang Fan finished putting on his surgical attire with the help of the operating room nurse and anesthesiologist.

“Doctor Zhang, is it too tight? Is this alright?” the operating room nurse gently asked him.

“This is fine, thank you,” Zhang Fan answered as he directly went up to the operating table.

As Zhang Fan was putting on his surgical attire, Director Zhao automatically moved over to the primary surgical assistant’s position. Vice Director Song, who was the primary surgical assistant, moved over to the secondary surgical assistant’s position. The secondary surgical assistant became the third surgical assistant. There was no need for anyone to say anything. Everyone knew their own position. Zhang Fan’s skill level was far too well known in Chasu City Hospital by now!

Old Yang’s intestines had many small holes poked into them by the metal bars, so they had been like a sieve. However, the teenaged girl’s intestines were filled with much larger holes. Zhang Fan furrowed his eyebrows when he stood at the primary surgeon’s position and saw the patient’s abdomen.

The other doctors had already prepared an excellent field of vision for the surgery. Since the girl was still young, her intestines were pink and tender! However, such tender intestines were now filled with holes everywhere. Zhang Fan did a swift count and found six major visible holes. There was also a portion of the small intestine that had almost been completely severed!

The intestines’ blood supply was shaped like a fan. The fan’s handle was located at the liver. Although blood vessels here were really abundant, damage which was too severe would still cause organ failure due to inability to receive blood.

Outside the operating room, the contractor boss had a blank expression which was similar to the teenaged girl’s mother’s. Both of them appeared expressionless and tense, although they were different types of tense. Still, both of them similarly hoped that the patients in the operating room could be saved successfully.

Chasu City’s traffic police started going crazy. City Leader Zhao became so angry that he even spat up blood. He ordered for roadblocks to be set up everywhere. The traffic police weren’t checking for driving under the influence of alcohol or expired driver’s licenses. Instead, the traffic police only checked motorcycles and electric scooters. The police then confiscated every single motorcycle and electric scooter that didn’t have proper licensing and registration!

Chasu City was a relatively small city in China. Like other small cities, families with cars were in the minority. Most people would get around using motorcycles or electric scooters. Originally, the traffic police simply turned a blind eye to this, but they no longer dared to ignore things now that City Leader Zhao had gotten angry to the point of spitting up blood.

The ordinary citizens received quite a blow from this incident. No matter if their motorcycles and electric scooters were used for street races or not, they were all confiscated if they lacked proper licensing and registration!

Meanwhile, Zhang Fan directly began the surgery even as he furrowed his eyebrows. Quite a while had already passed before the teenaged girl’s surgery began. The longer that things took, the greater the chance that she would be infected.

Due to modern antibiotics being prevalent everywhere, maybe ordinary people would think that infections weren’t a big deal. However, infections after surgery were truly a major complication. A less serious infection would delay the patient’s recovery after the surgery, while a more serious infection might cause other problems in the patient’s body or even be fatal.

“Director Zhao, we won’t be able to do regular surgical repairing for this patient!” Zhang Fan said as he continued to investigate the girl’s intestinal injuries. Just the visible injuries alone were already too severe for standard surgery to deal with.

“Okay, what’s your plan then?” Director Zhao could already guess.

“Directly sew the greater omentum onto the intestines, and use enteroanastomosis to fix the most important parts of the intestine,” Zhang Fan answered.

“With such large holes, even if we use the greater omentum to cover them, the intestine still might die!”

The problem had been identified as intestinal damage in this situation. The foundational principle of surgery was to treat the problem. However, surgery plans also needed to adapt to the specific situation. Since this surgery was taking place in the intestines, where the blood cycle was poor and germs were abundant, and also since intestinal pressure was rather high, performing intestinal repair or enteroanastomosis would easily result in an enterovesical fistula or abnormal abdominal cavity residue that would easily become infected and lead to other problems.

Not to mention, far too many portions of the patient’s intestines had serious damage. Of course Director Zhao would be afraid. If standard surgical methods were used to repair the patient’s intestines, it would still be likely that she would suddenly have an intestinal obstruction any time after the surgery.

“It’s fine!” Zhang Fan already established his surgery plan in his mind. This was why general surgery was so difficult. Many times, a surgery plan that had been discussed before the surgery began would become unusable. The surgeon would need to rapidly establish a new surgery plan after seeing what the situation was really like inside the patient!

In orthopedic surgery, it was much simpler to establish a surgery plan just from seeing the patient’s X-rays and CT scans. More skilled doctors wouldn’t even bring any unnecessary medical equipment. Orthopedic surgery was rather straightforward as the blood vessels and nerves usually weren’t involved. The bones were rather similar to pieces of wood. It would be fine to simply install metal plates along the broken portion of bone!

However, general surgery was far more difficult. There were organs on top of other organs. Some gases and liquids couldn’t be seen from outside the body even with detailed examinations. Maybe before a surgery began, the doctor would think that the appendix had a problem, but then the patient was opened up and the appendix was fine! What to do then? Hahaha.

Zhang Fan didn’t explain his surgery plan. There was no need to, as he was the primary surgeon, which meant that he had the right to decide. He had the skill level necessary to make Director Zhao willing to listen to him. Zhang Fan immediately began the surgery.

He started on the jejunum and began to perform enteroanastomosis. There was no need to cut off any portion of the intestine here. He began to gently sew up the intestine.

Zhang Fan’s movements were precise and accurate. He was also sewing with a tiny absorbable needle. He gently passed his needle through the patient’s intestines and gradually filled up the holes. His movements were really swift and beautiful. He connected the damaged portions as if they were two lovers kissing each other. Zhang Fan then sewed up the intestine so that the holes would be closed forever!

“Whoa!” Director Zhao inhaled a cold breath in surprise. “Doctor Zhang, will this really be alright? What will happen to your sutures when intestinal peristalsis occurs? What about gastric food retention? There will be an infection! If any digestive juice gathers here, the sutures will definitely fall apart!” Director Zhao had never even witnessed such a surgical technique before.

“There’s a chance that there will be gastric food retention, but intestinal obstruction definitely won’t occur. Enteroanastomosis will also cause less damage than cutting out the portions of the intestine that might die. She’s just a teenager. How will she have a normal life after this if she loses too much of her intestine?”