The Enhanced Doctor
Chapter 856: Low Anterior Resection with Sphincter Preservation (Part 1)
The next morning, Liu Banxia got up early and headed straight to the emergency center of the second hospital.
Today was going to be a tough battle; whether or not the surgery would succeed depended not just on the patient's luck, but also on Liu Banxia's skills. The same went for Wu Zhen, where both luck and skill were crucial.
Liu Banxia didn't bother thinking about anything else; the focus today was on these two patients. If he started thinking about unnecessary things, it would be irresponsible towards the patients.
At the cafeteria, Zhou Qiang, yawning, saw him and his eyes lit up.
"What's going on? Just the sight of you gives me chills," Liu Banxia said.
"What a rare sight, it's really hard to see you in the morning. No need to say more, breakfast is on me today," Zhou Qiang said.
"No need to treat me, just get me a couple of tea eggs. Today's surgery is quite difficult, so I had to come earlier," Liu Banxia said.
"If everything goes smoothly, by around 9:30 in the morning, we can come back and have lunch. Then we'll be stuck in the operating room, who knows when we'll get out."
"Oh my, what kind of surgery is it, so complicated?" Zhou Qiang asked while serving food.
"Liver cancer, plus a hepatic artery aneurysm, it's tough," Liu Banxia said.
"Oh my god, Teacher Liu, why did you come so early? I thought I was early enough," Xu Yino said as she led the interns over.
"Wow, you even gather a group for meals?" Liu Banxia joked.
"They're attending such a long surgery for the first time, it's a chance to gain some experience. At least their attitude is commendable," Xu Yino said.
"Manager Zhou, put all our meals on this guy," Wang Lei's voice came over.
"All on me, all on me, haha, sorry for making everyone get up early. It's not just this meal, even lunch after the surgery is all on me," Liu Banxia quickly said.
"I've already talked to Manager Zhou, order whatever you want in advance. Getting things done early helps us clock out on time in the evening. Dandan, be more alert, we're here."
Xu Dan glanced, "I haven't known what sleeping in feels like for ages. My biggest dream now is to sleep until I naturally wake up."
"Don't worry, that's definitely doable. Eat well first, so you can sleep soundly during the break," Liu Banxia coaxed like talking to a child.
Xu Dan, still somewhat groggy from sleep, nodded at Liu Banxia's words.
This amused everyone, boosting their spirits a little.
Though they weren't the primary surgeons today, the second surgery was indeed a major one. They all needed to hang in there; if everyone performed well, it could minimize errors during surgery.
After a hearty meal, the group returned to the emergency center, changed their clothes, and marched off valiantly to the operating room.
Of course, Liu Banxia also brought some fruit for the nurses who were on night duty. The morning's pre-surgery preparations were all thanks to their help.
One mustn't recklessly boss others around during such busy times, merely assisting the doctors in patient care. To make it easier, he came on duty early, which did cause quite the stir.
"Chao, cooperate well today, we need to save time for the following surgeries," Liu Banxia said while scrubbing in.
"Don't worry, no problem at all," Wang Chao responded energetically.
Xu Yino found it amusing watching them, but she was happy too. Learning from Liu Banxia really saved her from a lot of detours.
Even though many people were more senior than Liu Banxia, many times they would just observe his surgeries from the observation room, reluctant to help as an assistant in the OR.
But for the entire emergency center, in many surgeries, the skill level of Liu Banxia and director Zhou Shuwen was the same.
If they didn't have such high standards to support him, neither Zhou Shuwen nor Chen Zhenxing would dare to make him step up. In places that emphasize seniority, strength is also very important.
This is what breaking the norm for promotion is about, considering all aspects like Qiao Xuezhi mentioned.
And for them? They had no such worries.
They could freely choose what surgeries to join, allowing them more options naturally.
They didn't have to stick to Zhou Shuwen; following Liu Banxia achieved the same effect.
Of course, being occasionally tormented was normal too, that's an "additional harm" they had to endure.
"Xu Yino, check the patient's information," Liu Banxia said as they entered the operating room.
Xu Yino quickly got to work.
Now there can't be any random thoughts, it's like being on the battlefield.
Checking patient information and starting anesthesia went smoothly.
"OK, today's operation actually involves two surgeries: one is a radical resection for rectal cancer via the abdomen, and the other is a double instrument low anterior resection with sphincter preservation," Liu Banxia said after the patient was anesthetized.
"Zhang Hongfei, tell us why we chose open surgery over laparoscopy. You must answer carefully; we're now in the evaluation stage."
"Hmm... Is it because there might be some adhesions in the patient's abdominal cavity?" Zhang Hongfei nervously replied.
Liu Banxia nodded with a smile, "Congratulations, you got it wrong. The main reason is that the patient wants to save some money. Personally, I prefer laparoscopy, as the prognosis is better."
Zhang Hongfei's eyes filled with resentment; he hadn't expected such a situation.
"Wang Chao, perform the laparotomy; Xu Yino, assist," Liu Banxia instructed.
"Don't think I'm torturing you. While there's an element of testing, I also want to remind you to consider the patient's financial capacity."
"Sometimes what's convenient for us isn't convenient for the patient's wallet. What to do? It all needs to be weighed carefully. So, here's the second question: What are the drawbacks of the double instrument anastomosis? Chen Hongmei."
"There might be anastomotic leaks, anastomotic strictures, and local recurrence," Chen Hongmei responded.
"Exactly, although, to be honest, one drawback is that it's costly," Liu Banxia stated.
"But for the sake of preserving an anus that will accompany us for life, many people think it's worth the risk. However, anastomotic leaks are indeed a potential complication, so extra care should be taken post-operatively."
"The actual operation is pretty routine; in the past, dual-instrument anastomosis was typically controlled within a five to eight-centimeter range to avoid complications associated with anastomotic leaks."
"However, as doctors, while assisting the patient, we still need to listen to the patient's requests as much as possible. Remember, I said as much as possible, don't agree to everything later on."
"In low or ultralow sphincter-preserving surgeries, this technique is now frequently used. Sometimes the occurrence of anastomotic leaks is a matter of luck, but we should do our utmost to prevent local recurrence."
"So during the operation, I will also perform pelvic side lymph node dissection. Here's the new question: If our surgery is successful, will there be some impact on the patient's anal function? Xu Zhenkai."
"There is a high probability of impact, but some effects can be effectively improved through post-operative anal lifting exercises," Xu Zhenkai replied.
"Oh, nice, you actually prepared! Come on, confess, who did you consult?" Liu Banxia inquired.
"I consulted Teacher Huang Bo," Xu Zhenkai admitted a bit sheepishly.
"No need to be shy. For us doctors, no amount of preparation is too much. The more you prepare for consultations, communicating with the patient's family, and explaining, the better," Liu Banxia advised.
"The more thorough your preparation, the more information you can provide to the patient's family, which can reduce risks. That's why our surgical consent forms list so many items. Even if the patient's family doesn't care, we still need to explain."
"This help us remember that while treating patients, we should also protect ourselves. I won't demand that you be self-sacrificing; that's nonsense."
"We are doing a job now, and by doing this job well, we can help more people. In the future, you will also encounter tense doctor-patient relationships, so protect yourselves at that time."
"Inspection reveals no ascites, no nodules in the abdominal cavity. The liver shows no abnormal masses, and no enlarged lymph nodes are palpable in front of the abdominal aorta," Wang Chao reported.
"No abnormal enlarged lymph nodes palpable within the rectal mesentery, and the pelvic side wall shows no enlarged lymph nodes. The tumor is located on the anterior rectal wall below the peritoneal reflection, about five centimeters from the anus, penetrating the full thickness. Suitable for radical resection of rectal cancer via abdomen and double instrument low anterior resection with sphincter preservation."
"OK, the next part is my turn. I might not have much time to chat with you, so if there's anything you don't understand, ask Xu Yino and Teacher Wang," Liu Banxia said.
"What I'm going to do now is actually the dissection. Since Teacher Wang has already prepared us well for the preliminary work, this showcases the importance of a good first assistant."
After Liu Banxia finished speaking, he began to operate.
Under different circumstances, he might have let Xu Yino or Wang Chao perform more, but dissection is crucial now, and he has to follow his transfer task, so he must do his best.
The interns couldn't focus on asking questions, their eyes were glued to his actions.
The more they watched, the more beautiful it seemed. Liu Banxia's dissections were not just fast but also pleasing to the eye.
Even though they were not experienced experts yet, they knew it would be a long time before they could match Liu Banxia's level.