Chapter 225: Chapter 225
At lunchtime, the interns led by Liu Banxia could be described as "ravenous"; even Xu Yino and Liu Yiqing, the two girls, ate half a steamed bun more than usual.
As for Liang Xiaolin and Qing Kewa, it went without saying that under Liu Banxia's guidance, they typically ate more than those two girls.
"I just received a notification from Shi Lei. We need to add a laparoscopic appendectomy this afternoon. From the first group of four, who knows how to make the trocar incisions? Who dares to do it?" Liu Banxia asked after taking a sip of his egg drop soup.
The moment he finished speaking, Qing Kewa's small hand shot up high.
"You can rest this time. Let the other three choose first," Liu Banxia said.
Qing Kewa wasn't disappointed and continued eating.
This made Xu Yino, Su Wenhao, and Miao Rui extremely nervous. The original plan had been for a small-incision surgery.
"The patient was just admitted at noon. His appendix is somewhat purulent, and he's currently being prepared for surgery. We'll have to go straight to the operating room after lunch," Liu Banxia added.
"I'll do it," Xu Yino gritted her teeth.
"You? Are you sure?" Liu Banxia asked with a smile.
Xu Yino nodded forcefully, but the expression on her face betrayed her lack of confidence.
"Just teasing you," Liu Banxia chuckled.
Xu Yino was taken aback. This is giving me a headache, she thought. Teacher Liu is a good teacher, much bolder than the others, always letting us try things hands-on. But, just as Doctor Liang said, he can be a bit unpredictable and often enjoys teasing us.
"There are three ports, one for each of you," Liu Banxia added with a smirk.
This stunned the three of them again. They had felt a brief moment of relief, but now tension gripped them once more.
"Alright, you have ten minutes for a restroom break. Then meet at the entrance of Operating Room 6," Liu Banxia said, finishing the last of his meal.
Hearing his words, the four of them jogged off to return their meal trays and then hurried out.
"You four should also discuss it. There are many appendectomies scheduled, so everyone will get a chance to be first assistant. However, the first time you operate is very important; it will affect your confidence in future procedures," Liu Banxia said, turning to the remaining four.
"Anyway, with so many surgeries, choose carefully and don't try to be a hero. Whether it's laparoscopic or a small incision, both are techniques you need to master. Hmm... Secretary Liang's requirements can be appropriately lowered."
Liang Xiaolin felt a bit helpless; after all, she was from Cardiology. However, she had to admit that in the time she had spent with Liu Banxia, she had indeed learned many things, all of them fundamental.
The commotion their table made naturally attracted the attention of others. However, people were somewhat accustomed to it by now; under Liu Banxia's leadership, these eight were always a bit boisterous.
By the time Liu Banxia arrived at the entrance of the operating room, Xu Yino and the other three were standing there in perfect formation.
"Alright, you all look energized. Scrub in. Who's first assistant?" Liu Banxia asked with a smile.
"Teacher Liu, they've given me this opportunity," Xu Yino raised her hand.
"I'm next, Dr. Liu!" Qing Kewa also raised her hand eagerly.
Liu Banxia nodded, then led them to scrub in.
"Dr. Liu, Director Zhou personally assigned me to assist you," Wang Lei said seriously.
"Hehe, Old Wang, it looks like you won't be able to go home tonight either," Liu Banxia said with a grin.
"Ah... I've given up hope. Fortunately, Lily understands. She'll bring us some large bone stew tonight," Wang Lei sighed.
The surgeons in the General Surgery Department had been a bit moody lately, and things hadn't been easy for them in the Anesthesiology Department either. They constantly faced a shortage of personnel, and two had even been poached. Moreover, they had to coordinate surgeries with other departments. It was all very tough.
"Xu Yino, confirm the patient's information with Doctor Wang." Just then, the patient was wheeled in.
Xu Yino had an outgoing personality, but she was quite nervous about today's situation. It was a good thing Wang Lei and Liu Banxia were already well-acquainted; otherwise, Wang Lei might have offered a few words of criticism to her.
The four youngsters were overly excited, but they had all forgotten to ask Liu Banxia for the patient's case file beforehand, so they knew nothing about the case.
Seeing Liu Banxia's leisurely demeanor, they knew this was another one of his tests. Unfortunately, no one had passed.
Perhaps to accommodate them, Liu Banxia personally marked the trocar insertion sites and then also marked the lines for an emergency laparotomy, should unforeseen circumstances arise.
"Xu Yino, make the first incision, then explore," Liu Banxia said.
Xu Yino was still a little nervous, her hand hesitating slightly as she held the scalpel.
Liu Banxia didn't rush her; these were trials everyone had to go through. She wasn't like Liang Xiaolin, who had a slight psychological block, so there was no need to add more pressure.
After making the incision, Xu Yino inserted the Veress needle and insufflated the abdomen. Once the pressure reached 12mmHg, she carefully inserted the laparoscope.
"Hmm... Hmm... Puncture sites and abdominal organs appear intact, no active bleeding. The greater omentum is congregated in the right lower quadrant. The appendix shows significant swelling with surrounding exudate. Laparoscopic appendectomy is feasible," Xu Yino reported.
"Good. You observe, and you two make the remaining trocar incisions," Liu Banxia said.
Su Wenhao and Miao Rui were slightly calmer than Xu Yino, but only marginally. Liu Banxia could see the tension on their faces.
Perhaps only Qing Kewa wouldn't be nervous, he mused. After all, there seemed to be very little in this world that could make that girl anxious.
Once preparations were complete, Liu Banxia stood at the operating position. "Adjust the bed: head up, feet down, left lateral decubitus position. Xu Yino, don't be so nervous."
"The principles of laparoscopic appendectomy are actually quite similar to those of a conventional appendectomy; it's merely the method of operation that differs. The basic physiological structure of the human body doesn't change just because we opt for a laparoscopic approach."
"No matter what surgery we perform, the most fundamental and essential knowledge is anatomy. We can only proceed to the next step once we have isolated the appendix." Official source is novęlfire.net
While Liu Banxia was speaking, his hands never stopped moving, patiently performing blunt dissection with atraumatic forceps. He worked slowly deliberately, to allow the four of them to clearly observe his technique.
Just as he used the atraumatic forceps to clamp the mesoappendix and lift the appendix, the operating room doors opened, and Chen Zhenxing and Zhou Zhiyong walked in.
"You all continue; we're just here to observe," Chen Zhenxing said with a smile.
Liu Banxia felt somewhat helpless. He himself didn't mind, having been supervised by the higher-ups many times. However, the pressure on Xu Yino now was considerable.
"This patient's appendiceal base isn't very thick; only the distal end is somewhat purulent. So, we have several options for ligation: we can use sutures, or we can use titanium clips," Liu Banxia continued, drawing Xu Yino's attention back.
"I prefer using sutures, especially when you're first starting out. More hands-on practice will help you become more proficient. But regardless of the method, our hands need to be steady."
"Later, in your spare time, you can work on strengthening your hands and wrists. Now that I've completed the ligation, who wants the honor of transecting the appendix?"
"Me!" Qing Kewa was the quickest to respond.
Liu Banxia nodded at her. Qing Kewa happily approached, deftly snipped the appendix between the ligatures, placed it into a specimen bag, and performed an initial rinse of the site.
"The purpose of rinsing the specimen bag is to prevent contamination of the trocar sites during extraction, which could lead to infection," Liu Banxia continued.
"In every step of our operation, we must carefully consider the possibility of secondary contamination. Otherwise, even if the surgery itself is successful, neglecting these small details could lead to postoperative complications. Our conscience wouldn't allow that."
After removal, Liu Banxia took a scalpel and incised the appendix, revealing several fecaliths—the culprits that caused the appendicitis and suppuration.
"Alright, the next steps are quite simple: create a purse-string suture," Liu Banxia continued. "Don't make the suture too tight. Once it's placed, invaginate the appendiceal stump, and then gently tighten the suture."
"Suction... Irrigation... No active bleeding or significant oozing observed. However, because the tip of the patient's appendix was purulent with some exudate, we'll leave a drainage tube in for now."
After inserting the drainage tube, Liu Banxia quickly sutured the small incisions.
Daily Task Completed (20/20)
Experience Points +300, Glory Points +5
Incredible Challenge Completed (1/50)
Experience Points +200
Appendectomy Skill Proficiency +500
Dressing Change Skill Proficiency +100
Suturing Skill Proficiency +100
Diagnostic Science Skill Proficiency +400
This surgical procedure has been rated: Flawless
Experience Points +200
Appendectomy Skill Proficiency +500
Dressing Change Skill Proficiency +200
Suturing Skill Proficiency +200
Diagnostic Science Skill Proficiency +400
It was actually rated Flawless. Liu Banxia felt a slight twinge of regret, wondering if it could have yielded even more. However, the experience points awarded were substantial. This was likely because his explanations during the procedure had been very detailed—even his Diagnostic Science skill proficiency had increased significantly.
"Take him back to the ward, write up the post-operative orders, alright? Then, notify the other four to come over," Liu Banxia said.
"Are you going to teach them in rotation?" Chen Zhenxing asked.
"Chief Director, they're all from the Emergency Department. I just want them to gain more experience," Liu Banxia quickly replied.
Chen Zhenxing nodded with a smile. "Shuwen mentioned to me that you intend to help alleviate some of his workload. That's very good. The remaining surgeries will be moved to the teaching operating room. For today and tomorrow, the teaching operating room is exclusively yours."
Liu Banxia felt slightly troubled; this was escalating things quite a bit.
"Lacking confidence?" Zhou Zhiyong asked with a smile.
"I have confidence. It's just that my skills are quite ordinary. I'm afraid if too many people watch, I'll become a laughingstock," Liu Banxia said sheepishly.
"Don't worry. Six patients have already opted to switch from laparoscopic surgery to a small-incision procedure. Your teaching demonstration just now was excellent; there's much to learn from it," Chen Zhenxing said, nodding.
With that, the two senior leaders left cheerfully. Liu Banxia was also beaming. Praised again, huh? His mood was truly wonderful.
As for the pressure of operating in the teaching operating room? He couldn't care less.