Surgery Godfather-Chapter 578 - 526: One Man Equals A Team

In the makeshift operating room of the Emergency Department, Chen Dashun was transferred to the operating table.

During the transfer process, everyone was extremely careful to minimize disturbances and maintain the stability of the patient’s blood oxygen level.

However, the blood oxygen level still showed violent fluctuations due to systemic hypoperfusion. The limited oxygen could only maintain the minimum requirement of the cells, hence even a slight disturbance would cause the cells to consume more oxygen, leading to an oxygen deficiency.

It took several minutes to stabilize the blood oxygen levels.

After anesthesia, Yang Ping quickly scrubbed his hands and personally disinfected and draped the operation area.

All of Chen Dashun’s wounds were concentrated on the front of his body; presumably, he saw the explosion about to happen and immediately used his body to shield his younger brother. His brother was unhurt, but he was wounded by the blast, which scattered shrapnel that pierced through his body, cutting and tearing his internal organs.

Yang Ping put on his surgical gown, with Dr. Zhou and two doctors from Yemen assisting.

The circulating nurse was an emergency department nurse, who usually helps doctors perform simple trauma surgeries. The scrub nurse was temporarily reassigned from the operating room.

Chen Ershun was waiting at the door. The management of this makeshift operating room was rather lax; it didn’t have dedicated security, and passers-by could walk in at any time, possibly disrupting the surgery, and increasing the chance of infection.

Yang Ping received the scalpel from the nurse and started the surgery.

While performing the surgery, he informed the scrub nurse in advance about the preparations for the next steps in order to save time; otherwise, if the scrub-nurse cannot keep up, the transition between stages of the surgery would waste a lot of time.

The first issue to address was the shrapnel in the chest, especially the small piece on the heart.

This was a time bomb waiting to explode. The small hole pierced by the shrapnel on the heart, if it continued to tear, blood inside the heart would spray out from this hole. And the sprayed blood could tear the wound even larger.

A midline sternotomy was performed, the chest cavity was opened, and a chest retractor was inserted.

The mediastinum was cut open, and the pericardium opened.

During the process of exposing and opening it, the shrapnel pathway was cleaned, and a piece of shrapnel on the mediastinum was removed.

The heart was contracting and relaxing. During diastole, a small tear was visible on the outer edge of the right atrium.

The tiny piece of shrapnel had already penetrated into the myocardium and was not exposed. Now it had to be found and removed through this wound.

Currently, the wound was not entirely torn. The heart was still closed; once the shrapnel was removed, the tear could potentially evolve into a full-thickness laceration during contraction and expansion, leading to an immediate leak in the heart, resulting in high-speed blood ejection.

"There’s a piece of deadly shrapnel here, don’t move, vascular clamp!"

Yang Ping asked Dr. Zhou to keep the suction device a little further from the tear on the heart because sometimes the suction power of the device could also pose a certain risk.

"You’re saying there’s a piece of shrapnel here?" Dr. Zhou recalled the CT and X-ray images, and there was no shrapnel at this location.

"The CT scan is sectional, and this scan is not thin-layered. It’s 10 millimeters per layer and just missed this piece of shrapnel. It’s on the chest x-ray film, but unfortunately, it’s blocked by that piece we just removed from the mediastinum, so it’s not visible."

As Yang Ping was explaining this to Dr. Zhou, his mosquito hemostat has already gently extended into the tear, accurately clamping the shrapnel. He gently tried to pull it out to confirm the shrapnel had not hooked onto the myocardium. Only then did Yang Ping slowly remove it along the insertion direction.

With a crisp sound, the shrapnel was thrown into the kidney dish, and the blood smeared on it immediately spread out in the dish.

"Syringe with saline!"

Yang Ping used a syringe to gently inject physiological saline to irrigate the tear on the heart. After a few rounds of irrigation, he started suturing.

Every step was performed with extreme care to minimize the force applied. An aggressive move could cause a full-thickness tear.

After suturing the tear on the heart, Yang Ping checked for any blood leakage.

After confirming there was no leakage, he moved on to the next step: further wound cleaning, removing the other fragments in the chest cavity, and ligating or repairing the damaged vessels.

Non-essential vessels were ligated, while the major blood-supplying vessels were repaired by vascular anastomosis. The damaged organs and tissues underwent meticulous repair.

After exploration, wound cleaning, and repairing the damages in the chest cavity, a large amount of physiological saline was used for irrigation.

For open wounds, irrigation is vital. Repeatedly doing so can continuously dilute the concentration of bacteria, minimizing the chance of infection.

After irrigation, Yang Ping checked the chest cavity once again to ensure complete hemostasis before closing the chest cavity.

Overall, the treatment for the chest cavity took only about ten minutes.

The speed and proficiency of the operation left Dr. Zhou in awe. He felt like a mere intern in front of Yang Ping.

He didn’t know there were people in the world who could operate with such precision and speed.

After treating the chest cavity, the surgical focus shifted to the head.

The entrance of the shrapnel in the head was on the forehead, with the thin and long shrapnel sticking slightly out.

Yang Ping made an incision around the puncture on the skull, stopped the bleeding, lifted the skin, then used a bone saw to directly open the skull, drawing a circle on the skull centered around the tail of the shrapnel.

This action startled Dr. Zhou. This kind of bone saw was a normal orthopedic tool, with no safety depth control. A slight mishandling could cause the saw to penetrate the skull and damage the brain tissue within.

Yang Ping was solely focusing on saving time. He would use whatever method was quickest without considering the feelings of the others.

The skull was lifted. The depth of the bone saw’s cut was just right, neither too shallow nor too deep, sufficient to just cut through the skull without damaging the dura mater, not to mention the brain tissue.

Tracking the pathway the shrapnel entered the wound, Yang Ping cut open the dura mater and brain tissue, removed the shrapnel within and the hematoma around the shrapnel, then irrigated the wound, and finally used bipolar coagulation for hemostasis.

Yang Ping couldn’t help but gloat inwardly. This Chen Dashun was indeed lucky.

The sharp bullet fragments had lodged in the folds of brain tissue, causing minimal damage to the functional areas of the brain.

Yet, Yang Ping was still worried that the trauma would lead to some complications. Apart from damage to functional areas, scars left after the healing of brain tissue could disrupt the brain’s electrical activity, leading to epilepsy.

He rinsed the wound, stopped the bleeding, repaired the brain tissue and meninges, then closed up the cranium.

He managed that with relative ease.

Dealing with each of these injuries required a high level of surgical skill. All of them combined made for an exceptionally challenging procedure.

Any other doctor would have needed a team of neurosurgeons, cardiothoracic surgeons, general surgeons, urological surgeons, and orthopedists. Over a dozen surgeons would have to perform the operation in rotation.

On the other hand, Yang Ping managed the operation on his own, with apparent ease.

One man, but so efficient it felt like a team was at work!

No, perhaps not even a top trauma surgery team would match his surgical speed.

Dr. Zhou finally understood why Professor Yang dared perform surgery in such basic conditions – his surgical skills had reached points of finesse where they seemed to obey his will.

With the cranium taken care of, Yang Ping began abdominal surgery.

Upon opening the abdominal cavity, he conducted a thorough examination of the liver, gallbladder, pancreas, spleen, stomach, and intestines, removed all the bullet fragments lodged within, and repaired each injured organ.

Quickly, he concluded the abdominal surgery and proceeded to operate on the limbs.

Whether it was investigating and repairing the axillary nerve or blood vessels, or grafting skin onto the area where skin was missing.

With an artery clamp in his left hand and tissue scissors in his right, he removed all contaminated tissues, dead tissues, or foreign objects, layer by layer, every step of the way.

An exhaustive examination, high-quality repair, each bullet fragment seemed to be located without need for guidance, every time they could be found and removed directly.

Such a complex surgery looked as simple as stitching up a small clean wound under his hands. Dr. Zhou finally understood just how formidable this trauma surgeon was.

Such speed, such proficiency, as if he knew the anatomy of the human body without needing to look.

As the first assistant, Dr. Zhou could hardly keep up with Yang Ping’s speed – often, Yang Ping had to finish much of the assistant’s work himself.

Slowly, the bullet fragments were removed, the bleeding stopped, blood transfusion continued, and the patient’s blood pressure began to rise slowly.

Finally, the last wound was taken care of, and all the bullet fragments removed.

Yang Ping looked at Chen Dashun, who was almost entirely wrapped in gauze and bandages, and said:

"Send him to the observation room, continue the blood transfusion and rehydration, and use antibiotics for a week to prevent infection."

Today, Dr Zhou felt like he had witnessed a world-class procedure, as if what he had seen was surreal.

He had dealt with such complex multi-trauma in just two hours and concluded the operation.

Dr. Zhou calmed his mind, called in the emergency department director, and arranged for postoperative care.

The director from Yemen rushed in, thinking the patient had failed on the operating table, but then looked at the healthy EKG wave on the monitor.

He asked Dr. Zhou: "What’s going on?"

"The surgery is over. Please arrange a hospital room for him and assign two nurses to watch over him," said Dr. Zhou wearily.

Two hours? The surgery is over?

The director of Yemen looked around, hoping for a different answer.

That’s when Manager Qiu and Chen Ershun came in. Seeing everyone taking off their surgical gowns, they thought Chen Dashun was beyond saving.

Chen Ershun’s mind went blank, and he shouted like a fool: "Brother! Brother——what’s wrong with you?"

His voice was as piercing as a thunderbolt, filled with unspeakable sorrow.

"What are you yelling for? If you’ve got the energy, help us move the bed and take him to the observation room," Yang Ping scolded him.

Everyone was in good spirits after the surgery, but his sudden yell startled them.

"Professor Yang, how is it?" Manager Qiu asked, looking at the Dashun on the operating table.

Yang Ping said calmly, "The surgery has been successful. As long as there are no complications after surgery, there shouldn’t be any problems."

This youngster’s physique was truly robust. Anyone else, with injuries like these and loss of so much blood, wouldn’t have held on for so long.

"Help to move the bed, what are you staring at?"

Yang Ping gave Chen Ershun a little push.

Chen Ershun snapped back to his senses, realizing his brother was alive.

Looking at the steadily rising blood pressure, Yang Ping felt a weight lift from his shoulders.

After surgery, as long as he could be transferred to Saudi Arabia for careful post-operative care, this Chen Dashun should be able to survive.