System Came When the Doctor was Thirty-Chapter 36: Lu Cheng on the Offensive!

"Xiao Lu, are you tired?"

"It’s okay."

"Xiao Lu, seeing you so full of energy, how about you take charge of this Liver Preservation Surgery?" At the scrub sink, Chen Song brushed his hands while raising his chin proudly, trying to level it with Lu Cheng’s chin.

Lu Cheng’s smile suddenly froze: "Teacher Chen, aren’t you teasing me..."

"Not to mention Liver Preservation Surgery? I don’t even dare to take on liver lobe resection?"

"Still, we have to rely on Teacher Chen for showcasing your prowess." Lu Cheng’s eyes were ingratiating, as if he had just undergone cosmetic surgery.

Chen Song’s current dilemma was similar to asking a butcher at a slaughterhouse if he wanted to pop over to Renmin Hospital to do a fracture surgery...

If Master Hu could handle this, why would he be at the slaughterhouse killing pigs?

"Are you sure you don’t want to do it? If you don’t, I’ll go ahead. Don’t say Teacher Chen didn’t give you a chance." Chen Song’s tone was warm and friendly.

"When the day comes that Teacher Chen is exhausted, you’ll have to fight alone." Chen Song’s voice was earnest, yet mischievous.

It’s now three-thirty in the morning; Lu Cheng has forgotten which day it is in July. Ever since he hasn’t had regular shifts and is on call anytime, he really can’t keep track of the date.

"Teacher Chen, after this surgery, I’ll call Director Lin immediately. Let’s take a break for a day, pause urgent surgical operations." Lu Cheng’s tone was decisive, having understood the implication in Chen Song’s words.

Chen Song squinted, clasped his hands to his chest, and entered the operating room, speaking with a sardonic tone: "Good heavens! Xiao Lu, you remembered Teacher Chen is a human, not a machine? Wonderful!"

Lu Cheng felt slightly embarrassed.

Lu Cheng also understood that Chen Song agreed to Director Lin Qianlong and others’ ’workhorse shifts’ mainly to teach him things.

Otherwise, as a visiting professor, how could Chen Song be on call for emergency shifts anytime?

Lu Cheng followed and asked, "Brother Liang, what day is it today?"

Brother Liang, the anesthesiologist, looked surprised: "It’s July 28th? You don’t even remember the date; how do you even manage your shifts?"

Chen Song said: "He’s looking to wear himself out and drag someone along as backup. It’s all about not losing out."

Chen Song seemed to understand: if he didn’t jab Lu Cheng now and then, Lu Cheng wouldn’t even know what a normal person’s schedule is.

The key point is, Lu Cheng is still so spirited...

Dr. Liang was stunned: "Professor Chen, have you not gone back to rest since you started surgery on the 25th?"

The last time Liang Guihong was on duty was the night shift on July 25th, then he took a two-day break.

Chen Song said nothing.

Lu Cheng lowered his head, and followed Chen Song to don the sterile surgical gown.

This emergency patient that no one else could handle had been anesthetized, the surgery must proceed, there’s no turning back.

Liang Guihong gave Lu Cheng a signal: "Xiao Lu, take it easy. If Professor Chen doesn’t rest well, you won’t be able to shoulder the responsibility."

If an intern dies from exhaustion at an internship, the institution will be in trouble. If a visiting doctor suddenly dies at Long County People’s Hospital, it would be catastrophic for a string of people.

Lu Cheng lowered his head, thinking he wasn’t meticulous enough. Once this surgery ends, he must add a new memo, recording Professor Chen Song’s surgical start and end times, ensuring Chen Song gets adequate rest.

During spare time, he could perform appendectomies and tendon suturing solo...

It’s me who wants to learn surgery, not Professor Chen Song who needs to learn.

"Teacher Chen, I’m sorry..." Lu Cheng apologized sincerely.

Once the surgery officially began, Chen Song switched to a professional tone: "Liver injuries classified as Grade 3 and below, with hemodynamic stability, no peritoneal irritation signs, and CT showing no active bleeding, can opt for non-operative treatment."

"But this patient isn’t suitable; he’s AAST Grade 3 and requires debridement liver resection."

"Ultrasonic knife for precise liver cutting + fibrin glue for wound closure, since it’s not yet at the level of destructive parenchymal rupture, liver segment removal isn’t needed. This is the surgical technique choice."

Lu Cheng nodded: "Yes, Teacher Chen."

"The best hemostatic strategy is interventional surgery, but your hospital doesn’t have it, so we can’t use interventional embolization for bleeding control; we’ll have to enter and slowly stop the bleeding."

"Today, we’ll use the liver segment blood flow occlusion (Takasaki method). This method is actually quite understandable, just selective liver blood flow occlusion surgery."

"But the process is relatively complex; we first need to anatomize the Glisson’s sheath, precisely separate the target liver segment’s Glisson’s pedicle, and accurately seal it with a vascular clamp."

"This process may seem to be a bleeding control technique, but it’s actually a precise application of incision skills, watch carefully..." Chen Song patiently explained to Lu Cheng, then began incising the liver lobe.

In Chen Song’s hand, the ultrasonic knife moved like a nimble dragon, darting in and out for a while, exposing the target liver segment’s Glisson’s pedicle.

"You place the vascular clamp, experience the liver segment blood flow occlusion technique..."

Lu Cheng dazedly complied, placing the vascular clamp, and the bleeding points in the area completely hid away.

There was still a small amount of residual bleeding, all surface bleeding, gradually disappearing.

With this clamp, it’s like eradicating from the root...

"Such AAST Grade 3 liver preservation surgery is the best material for you to learn; if you want to develop liver preservation surgery, you’ll need to learn these surgical techniques as well."

"However, you can’t undertake it alone, you’ll need to bring Director Lin with you, then it will work..."

"Grade 3 damaged liver injury doesn’t require liver lobe resection, just debridement resection is sufficient, but how to resect is detailed and intricate."

"It requires mastering the flexible application of wound cleaning skills, although your basic skills in wound cleaning are not yet up to standard, so you need to practice slowly."

"The basic principles remain those, removing all necrotic tissue, suspicious necrotic tissue..."

"But there are techniques for dealing with the resection wound. If it’s grade 1 oozing, bipolar coagulation suffices. For grade 2 oozing, it requires argon knife superficial coating, but your hospital lacks it, so for grade 3 oozing, you’ll use hemostatic gauze compression for about two minutes."

"One major aspect is to avoid bile leakage, the strict benchmark is having bilirubin less than 17umol/L in wound exudate, which can’t be easily quantified, so you must rigorously hone your fundamental skills."

"The ratio for fibrin glue is a skill in itself, which you can study through books later..." Chen Song elaborated each operational point to Lu Cheng step by step.

Lu Cheng nodded frequently; these things weren’t in educational videos, being each primary surgeon’s personal insights and comprehension, a learning of experiential knowledge...

[A distinguished teacher continually guides the Liver Preservation Surgery procedure, improving liver preservation skills.]

[Liver Preservation Surgery (Beginner 4/5)(+2)...]

This guidance from Chen Song directly added two points to Lu Cheng’s experience points, a fruitful outcome indeed.

Skills point rewards also followed.

[Collaborating to complete the Liver Preservation Surgery, Hemostasis Technique, Wound Cleaning Skill, Suturing Skill operations, leading to a successful surgery, earning 0.4 Skill Points]

[Current skill point balance: 42.3 points]

In 4 days, 30 skill points, enough to make Lu Cheng’s smile crooked—

After Chen Song stepped down from the table, he tapped Lu Cheng’s temple with his index finger: "Stop silly grinning, hurry back to catch some sleep, surgeries never end!"

"First, stay alive... You’re acting possessed." Chen Song opened the automatic induction air-tight door of the operating room with his hands behind him, and walked out arrogantly.

Chen Song understood that if he didn’t directly point out his fatigue, sooner or later Lu Cheng would wear him down completely.

Though Chen Song didn’t blame Lu Cheng, if Lu Cheng didn’t have a passion for surgery, learning this fast would be unimaginable.