“Burn my calories!” Zheng Ren, who had changed his attire, heard a childish yell before he walked into the operating theater.
That must be Chu Yanzhi. She only had calories to burn right now, having not slept all night.
When he entered the operating theater, Xie Yiren had already changed and was counting the instruments in front of the instrument table.
Zheng Ren went to perform a surgical scrub and asked during disinfection, “How much did they drink?”
“Eleven boxes each, and that was all the restaurant had.” Chu Yanzhi exaggeratedly extended her arms in an attempt to describe the height of the piled-up boxes, which failed.
“They really had a death wish,” Zheng Ren cursed as he disinfected.
“It’s thanks to Su Yun.” Chu Yanzhi was one of the few people who remained insensitive to Su Yun’s charm and immediately put the blame on him. “I tried to persuade them many times, but he insisted on continuing.”
Zheng Ren sighed heavily.
He really hoped that Su Yun would learn his lesson this time and stop assuming that all women were lightweight. If he continued, he could end up having incontinence in the future.
The surgical site was disinfected, the surgical drapes applied, surgical gowns worn, and the last layer of surgical drapes reapplied… Zheng Ren stood under the surgical lighthead, fully prepared for the operation.
The scalpel in his hand gleamed.
Instead of the standard incision for ordinary appendectomy or a small incision similar to those made during the crazy night of appendectomies, Zheng Ren made a roughly ten-centimeter incision lateral to the right rectus abdominis muscle.
Since the patient was emaciated, he reached the peritoneum shortly after a simple dissection of subcutaneous and fascial layers.
He frowned: the patient’s peritoneum had obviously turned black, which meant that the infection had been going on for at least three days.
Damn, this patient was really tough if he could endure the pain building up from simple appendicitis to acute peritonitis. Barely anyone could withstand the agony of a perforated appendix, to begin with.
Zheng Ren extended his hand and an aspirator with a suction tube attached was gently placed on his palm.
The livestream in Xinglin Garden started at the same time.
It was late at night, so there were only a few hundred viewers watching the livestream.
It was only relatively a small viewer count; normally, at least a few thousand viewers would swarm into the live broadcast room as soon as the anonymous account began livestreaming.
[The peritoneum is black. Is treatment even possible for this sort of severe infection?]
[The god will also handle feces? I thought he was a hepatobiliary and pancreatic surgeon.]
[Young man, are you new to this livestream? Have you begun worshipping the god for his miraculous overnight performance of forty-nine appendectomies?]
There was no doubt that the aspirator had to be plunged in immediately after opening the peritoneum. The pus, digestive fluid, and food debris residing in the peritoneal cavity had to be removed to prevent leakage that could lead to secondary infection.
[That’s strange. Why isn’t there any food residue?]
[Oh, yeah… I treated a gastric perforation case a few days ago and even aspirated a few pieces of meat.]
[The host surgeon is really lucky. He made it clear that he wanted to dig out some feces, but the insides looked so clean when the peritoneum was opened.]
Lots of pus and exudate were aspirated, but food residue and excrement were nowhere to be seen.
This sight made Zheng Ren feel uneasy. Even though this made the surgery somewhat easier, it also meant that this patient had fasted for three to five days.
No wonder he was big-boned but appeared physically wasted.
After ensuring that all pus and exudate had been fully aspirated, Zheng Ren put protective measures on the peritoneal membranes and carefully exposed the peritoneal cavity.
A large, black appendix emerged in the operative field.
The base of the appendix had perforated and its surrounding areas had become gangrenous.
Zheng Ren cautiously dissected the tissue around the appendix twice as slowly compared to his previous operations.
The gangrenous tissue was particularly brittle and had adhered to the surrounding organs for a few days. Therefore, any accident during dissection could cause irreversible damage to the surrounding tissue.
Although the tissue looked light-colored and unhealthy, gangrene had at least not taken hold, which meant that there was still hope for recovery.
[This is nerve-racking… That must be the appendicular artery. Arterial blood won’t gush out, right?]
[Are you a doctor or not? In a gangrenous setting, the appendicular artery will contract and partially close up. Bleeding won’t occur as long as the ligation is secure. However, this is the difficult part as there is severe edema on the non-gangrenous base. If it isn’t tightly sutured, the thread will automatically fall off once edema subsides.]
[You can put in two sutures, but it’s no easy task and any slight overuse of strength will definitely rupture the artery.]
Soon, the doctors in the live broadcast room started discussing the condition animatedly. Exchanging views could widen their horizons, and they had already discussed the challenges of this surgery before Zheng Ren even had even begun ligating the appendicular artery.
Even though it was basic knowledge, this manner of gangrenous appendicitis was rare to actually see in the medical field.
As development expanded, the medical and health sectors had grown by leaps and bounds each year. There were hospitals all over the country, and even in the absence of Class Three Grade A Hospitals and community hospitals, there were still “barefoot doctors”.
Even in the most remote of villages, “barefoot doctors” still knew how to perform simple appendectomies.
Enduring the intense pain of appendicitis, followed by tearing and further complications from septic shock…
Zheng Ren and the doctors in the live broadcast room had never encountered such a case in all of their careers.
What kind of man was this?!
Zheng Ren used a tiny pair of forceps to gradually lyse the adhesions between the gangrenous and normal tissue with extreme caution.
“Wipe my sweat,” he instructed.
Chu Yanzhi obediently took a piece of gauze and approached him.
Zheng Ren turned his head aside and allowed her to wipe the sweat that had drenched his sterile surgical cap.
“Do you need an assistant? I’ve assisted in surgeries in West China Hospital,” said Chu Yanran out of the blue.
“No,” Zheng Ren refused bluntly.
Pooh! A bachelor who could not get a girlfriend.
How could he possibly start a relationship when he was so direct in his approach?
Zheng Ren did not even take her suggestion into consideration. He was incredibly nervous, not because of inexperience, but due to the need for extremely gentle manipulation that was necessary to prevent large-scale torsion that would greatly impact the patient’s postoperative recovery.
Under present circumstances, there was nothing Chu Yanran could do to assist him.
The problem lay in his frank and direct attitude. Sigh… Poor bachelor.
[Ligation! He is ligating the artery now!]
[Shut the f*ck up! Your comment blocked my view.]
[A taper-point needle? My guess was correct. A taper-point needle can easily penetrate the tissue and cause minimal trauma, hence reducing the risk of torsion.]
[Don’t bullsh*t me. If you’d been the surgeon in charge, the operative field would be a bloody mess of torn tissue. You’d be in the process of resuscitation.]
[That’s right. You might as well cut the diaphragm and perform direct compression on the failing heart.]
Zheng Ren held the needle holder firmly and with a dexterous flick, plunged the suture needle deeply into the tissue under the appendicular artery.
He inched the needle forward while being aware of the texture of the tissue until it reached the edematous area. Then, he applied gentle pressure on his wrist and the needle came out of the other side of the appendicular artery.
After passing the needle holder back to Xie Yiren, he made a complicated surgical knot using both hands.
[My heart is about to pop out of my chest.]
[God, please be careful. It’ll tear if you’re not careful.]
[I’m not worried at all. He is a god; how can he make such a simple mistake?]
[666! The pressure he applied was just perfect! How did he even acquire such experience?]
[Damn, Xinglin Garden doesn’t have a reward system. Otherwise, I definitely would’ve sent a wave of positive energy to the god.]
After complete ligation of the appendicular artery, Zheng Ren let it rest for a few seconds before reinitiating adhesiolysis between the gangrenous appendix and the peritoneum, the greater omentum, and the surrounding intestines.
