When the Doctor Uses A Hack - Chapter 204:
Chapter 204: Chapter 205: Saliva is Poisonous! (Please Vote for Monthly Ticket haha)
“Give me the scalpel!”
Yuan Yuan, watching Chen Cang’s outstretched hands, couldn’t help but blush and quickly nodded her head.
Indeed, as they had said, such large, slender hands—what size of gloves would he need?
And… was he really that fast?
Thinking this, Kong Yuanyuan was filled with immense anticipation for the surgery.
Although it was her first time in surgery with Chen Cang, the legend of this master had already spread far and wide.
You see, the operating room is where gossip and news spread fastest, and Chen Cang has been a hot topic there lately.
He’s even become the object of daydreams for the numerous young and middle-aged female staff in the operating room.
Especially during the night shifts, when it’s deep into the quiet night with no surgeries, to drive away the gloomy fear from the operation rooms, these women like to talk about men with masculine energy to boost their spirits.
Any nurse who had witnessed Chen Cang’s surgeries would always come back to gossip, providing conversation topics for others at bedtime.
“Chen Cang is incredible. One time, Zhou Xiaodong couldn’t proceed with the surgery after starting, but when Chen Cang stepped in, he neatly solved the problem in no time at all. He’s really impressive!”
“That’s nothing. You didn’t hear about the time in Operating Room 3 when we had a crucial surgery that required rapid suturing of blood vessels. You have no idea about Doctor Chen’s hand speed. He has to have been single for at least a hundred and eighty years to develop such speed!”
“That night, Chen Cang turned the tide and saved Dean Fang. Honestly, it was so impressive…!”
Kong Yuanyuan looked at Chen Cang. Was he really that impressive?
…
…
Following layer by layer of incisions.
Chen Cang entered the chest cavity, and the real surgery began.
Although it was only just five or six hours in, there was already a slight accumulation of pleural effusion.
“Suction!”
Wang Yong nodded, took the suction device, and began the operation carefully.
Chen Cang’s fingers were very slender and his movements were light.
The esophagus was exposed in front of everyone, and Liu Jian, who was in the distance, felt worried and did not leave the operating room.
Ever since Liu Jian had come in, he had been fretting internally.
How long had Chen Cang been performing thoracic surgeries?
In the Emergency Department, let alone Chen Cang, even Director Li Baoshan had never engaged in thoracic surgery.
Being the protégé of Old Chen, Liu Jian had some understanding of Chen Cang.
And it was because of this understanding that he was even more concerned about potential complications.
Once the esophagus was exposed, Xiao He stood there: “Chen, it’s in the fourth intercostal space on the chest, toward the back at about the 2 o’clock position.”
Liu Jian couldn’t help but remind him, “Be careful, Chen. The vagus nerve is quite complex.”
Chen Cang nodded without a word, carefully dissecting the esophagus.
The process went smoothly, with no complications.
After flipping it over, the wound was exposed.
“Micro tweezers”
“Scissors”
“Hemostatic gauze”
“Saline”
Kong Yuanyuan quickly nodded and passed them over one by one.
Chen Cang received the tweezers and scissors.
He extended the slit in the muscular layer of the esophagus upward and downward until he exposed the area where the mucosa was ruptured.
This operation made Xiao He involuntarily swallow.
A bit nervous…
He was just about to question why Chen Cang was enlarging the wound when he realized the reason!
“Number four silk thread”
The time for suturing had arrived.
Because the esophagus had mucosal damage already, it wouldn’t be wise to merely suture the muscular layer without paying attention.
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Simply put, after suturing, it will not be stable!
Even later on, the mucosa that was already ulcerated can continue to be damaged, leading to secondary destruction of the esophagus, and by then, treatment will become troublesome!
Others may not understand this, but Xiao He himself works with endoscopes and is very familiar with the physiological and anatomical structures of the esophagus.
The set of maneuvers Chen Cang just used to clip the wound was really eye-catching!
In this way, the ulcerated esophagus can be sutured without causing narrowing due to the wound area being too small.
Thinking of this, Xiao He suddenly became excited.
At this moment, although the surgery had just started, he already felt it was half-successful.
Now came the suturing.
The success rate of suturing is directly related to the esophageal function in the later stages.
Chen Cang carefully picked up the 4-0 suture, and this kind of suturing actually has a similar ingenuity to that used in the anastomosis of intestinal fistulas.
Amidst threading the needle, it was like a butterfly playing chess, incredibly delicate yet punctuated with touches here and there.
Chen Cang’s suturing was very clever; he chose the technique of anastomosing the ends without occupying too much of the esophagus.
As a result, it would be convenient for the restoration of esophageal function later on.
Liu Jian may not understand other things, but he understands suturing!
The way Chen Cang sutured truly enlarged the usable space of the esophagus, ensuring a better outcome after recovery.
Don’t other people know to suture like this?
Of course not!
Do they all know that suturing this way is good?
But how many have the confidence to suture well in this manner.
The esophagus is different from other organs; it’s a passage that must be kept clear at all times.
For patients with esophageal stricture, eating is a troublesome matter.
If you’ve ever choked, you can understand it like this: when the esophagus is narrowed, you would choke even on rice!
The patency of the esophagus is extremely important.
Why do patients with esophageal cancer first feel the obstruction of the esophagus, and many don’t even feel pain, but the sheer obstruction can drive one to distraction.
Therefore, the suturing skills and ability Chen Cang demonstrated, Liu Jian would bet, are stronger than those of the expert who initially came to help with thoracic surgery at the Second Provincial Hospital!
Many things are obvious at a glance.
As we are all in the medical field, some things do not need to be spelled out.
Upon seeing this, Liu Jian couldn’t help but say to Wang Yong, “Xiao Wang, pay close attention to how your teacher Chen Cang sutures. That esophageal suturing technique… it’s really amazing!”
Wang Yong nodded, his eyes firmly fixed on every detail of Chen Cang’s movements.
Chen Cang didn’t speak, because it was after all the first time he was undertaking such a surgery, and he still needed to do his best to complete it.
It took seven or eight minutes for Chen Cang to finish the suturing.
This might seem laughable to others, taking seven or eight minutes to suture an esophagus; indeed, it was somewhat slow.
But now was not the time to measure expertise with speed.
When Chen Cang got going, he didn’t even know how fast he could be!
Similarly, when he needed to be steady… steady as a rock!
The slowness of the suturing did not mean it was not tight. On the contrary, the reason for Chen Cang’s slowness was that he sutured the mucosal layer and muscle layer separately.
At this time, Chen Cang said to Wang Yong, “Esophageal suturing doesn’t need to be too tight or too loose; knots should also be tied with appropriate tension.”
Wang Yong, not understanding the rationale, could only look it up in books later but needed to remember it for now.
Next, after suturing was completed, the repaired tear needed to be covered with a pedicled pleural flap, just like patching a tire, essentially as a precaution!
The surgery had now come to an end.
Placing a closed thoracic drainage tube for drainage, the rest would wait for recovery.
Chen Cang handed the suturing over to Wang Yong and was the first to take off his gloves, saying to Xiao He, “Director Xiao, have the patient admitted to the hospital, and for now, don’t insert a nasogastric tube; continue with decompression. I’m still worried about mediastinal infection later on, so use broad-spectrum antibiotics during this period.”
“He can’t eat for ten days, no food at all, and after ten days, do an esophagogram before starting on a liquid diet.”
“After all, saliva is poisonous!”
ps: Saliva really is poisonous. Many patients with esophageal perforations have been poisoned by their own saliva due to lack of care. So from a medical standpoint, saliva can indeed be deadly! So… the next time you want to spit at me, rinse your mouth before you do.
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