Chapter 504: Bleeding Control
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Have you used the hemostatic drugs?” Ling Ran groped around the liver as he asked.
“Tranexamic acid and ethamsylate were applied,” Guo Mingcheng said. “I also used some medication before the surgery.”
“Okay,” Ling Ran replied, and he continued to feel around the liver.
Guo Mingcheng had performed the emergency suture, and the wound was coagulated using an ultrasonic knife, but the blood just kept flowing out.
It could be considered as a typical case of a surgeon’s bad luck. Plus, his skills were not good either.
There was nothing wrong with Guo Mingcheng’s operation. The preoperative preparation was not perfect, but it had reached beyond the standard. Yet, he could still do nothing when the patient suffered from hemorrhage.
In Ling Ran’s mind, he thought about the patient’s MRI scan and other X-ray details.
As a pure surgeon, Ling Ran paid very little attention to information from internal medicine, such as biochemical tests and so on. However, he remembered the details in the patient’s X-ray and other scans well.
Ling Ran thought while his left hand was groped about the liver region. His touch was very gentle, and his fingers were practically sliding through the liver. At the same time, Ling Ran placed his right hand inside as well.
*Shick.*
The airtight access door was opened.
Department Director Lei from the Medical Affairs Department came in a rush and stared at Huo Congjun before he looked Ling Ran. He said, “Doctor Ling, don’t go any further if you are not confident. For a case like this, we’ll need to take two months just to write the report on the cause of death.”
For doctors, any patient who died on the operating table would be treated as an accident. But the hospital’s grade would also come into play.
For a grade B or secondary hospital, a patient’s death during surgery was very serious. It was because if the doctors were not confident, they should have transferred the patient to a hospital with a higher grade.
But for tertiary hospitals, especially a strong tertiary hospital like Yun Hua Hospital, if any death happened during surgery, as long as it was not due to an error in the surgeon’s operation, the surgeon would not be directly sacked by the hospital, even though he would still receive limited punishment.
However, for Department Director Lei, this limited punishment was not necessary at all. It was not fun to be disqualified for the evaluation for excellence, to be forced to write a report with ten thousand words, being reviewed multiple times, getting bonuses reduced, and having benefits taken away, especially when life for the surgeon had been good previously.
Department Director Lei knew Ling Ran had been performing freelance surgeons, and he was not short of money. But most of the doctors did not like patient mortality discussions, and writing a report was even more frustrating…
“I can do it,” Ling Ran merely replied with these words. He then said to Guo Mingcheng, “I can perform barehanded bleeding control and reduce a certain amount of blood loss. Then, you’ll have to hurry up to aspirate the abdominal cavity, and maybe we’ll see how it goes from there?”
“Okay.” Guo Mingcheng agreed and cast Ling Ran a profound glance. He ordered. “Force in aspirator has been increased. When are we starting?”
“Already started. Two minutes.” Ling Ran was worried that he would damage the patient’s liver. Besides, the angle in which he could exert force was also limited. He could not interrupt the blood flow completely.
Blood kept flowing out in the patient’s abdominal cavity, but it was aspirated when it appeared. The blood gradually reduced.
He Yuanzheng did not understand what he was looking at. But in his mind, he thought about a question he answered when he was young. ‘When a discharge pipe and a water inlet is activated at the same time, you are given…
‘Who said the question that year was useless?
‘This question was so difficult that it used hydrodynamics.’
He Yuanzheng stared at the thick blood and had his thoughts run wild.
He had no choice but to have his thoughts run wild. He could not see what Ling Ran was doing now, because all his movements happened underneath the blood. The only variable was the reduction of collected blood in the abdominal cavity.
Huo Congjun took out his phone again. This time, he called the blood station.
Then, Huo Congjun called Hospital Director Zhou.
With such a great amount of blood loss, if there was no support from the blood station and hospital director, the surgery could not be performed.
Guo Mingcheng stared at the blood while he held he forceps. He basically did nothing else.
The liver was exposed slowly.
“Angiomas. Intercept,” Ling Ran spoke quickly, but his hands moved even faster. With a flip and a shake, the location of the angiomas was exposed a bit more.
Although it was just a little bit more, at least the border of the angiomas could be seen. Guo Mingcheng had been performing the operation for a long time, but he had still not been able to figure out the location of the angiomas after so long.
Of course, it was because Guo Mingcheng dared not flip the liver too much.
He did not have Ling Ran’s barehanded bleeding control skills. So, if he flipped the liver too much, he could cause unpredictable consequences.
“I need at least one and a half minute.” Guo Mingcheng no longer dared to hide his skills anymore.
If he were not careful, the patient’s bleeding would become uncontrollable, and the surgery would completely fail. If it were possible, he did not want to lose hope.
Ling Ran frowned. He was pinching the liver. It was excessive for him to continue pinching the liver for two minutes, and Guo Mingcheng actually needed one and a half minutes to intercept the angiomas…
“I’ll suture. Help me tear the suture line.” Ling Ran pinched the patient’s liver with his right hand, and he extended his left hand to the scrub nurse before he said, “Needle-holder, fine thread.”
At this moment, the surgeon was no longer particular about the type of thread used. The nurse passed the needle-holder with the finest thread to Ling Ran.
Ling Ran held the needle-holder tightly with his left hand and poked the center of the liver with the needle.
It was only then that Guo Mingcheng realized what Ling Ran was doing, and he immediately helped to trim the thread.
Ling Ran quickly performed a few stitches. Then, he began to perform a few meticulous sutures.
Within less than a minute, Ling Ran threw away the needle-holder and said, “Completed. I’m going to let go with my right hand.”
Guo Mingcheng opened his eyes wide to observe Ling Ran’s operation. At that moment, provided the people watching were not idiots, they likely knew just how well Ling Ran’s level and standards were.
“Continue to aspirate,” Ling Ran said again and slowly let go of the liver.
The liver still bled from time to time, but it no longer bled massively as it did previously.
“Let us finish the remaining hepatectomy.” Ling Ran sounded like he was giving an order. The person who could make the decisions could have that kind of tone during surgeries because this was influenced by the nature of the operating table.
Only one man was required to make decisions on the battlefield. Only one man was required to give instruction on the operating table.
Ling Ran could no longer completely let Guo Mingcheng handle the hepatectomy.
In fact, even if Ling Ran continued to let Guo Mingcheng perform hepatectomy, Guo Mingcheng could no longer do that.
Guo Mingcheng lowered his head and cooperated with Ling Ran while he silently carried out his duty as an assistant.
Professor Feng Zhixiang took two steps back and gave out the position. Then, he slowly took off his gloves and watched Ling Ran with a look of interest.
For him, today was quite embarrassing.
However, such an embarrassment was not comparable to a patient dying on the operating table.
His position was determined by one or two surgeries. Moreover, he was just a freelance surgeon for today’s surgery. He was not performing a surgery that would be observed by others in an international conference, and neither was he performing a demonstration surgery to his academic peers.
Professor Feng Zhixiang was more surprised that Ling Ran could save the patient.
He had also participated in the surgery just now. So, Feng Zhixiang knew clearly that he could not have saved the patient. Even when Feng Zhixiang was at his best, Feng Zhixiang was not confident that he could save the patient. However, Feng Zhixiang was confident that if he had been at his best, the surgery would not have progressed to such a state.
Therefore, Guo Mingcheng was still not skillful enough.
Meanwhile, this explained that Ling Ran was truly skillful.
“Doctor Ling, which university did you graduate from?” Feng Zhixiang asked when he saw that the surgery had been stabilized.
“A medical institute attached to Yun Hua University,” Ling Ran said.
“Yun Hua University, huh? I know Li Binnong from Yun Hua University,” Feng Zhixiang said.
“Professor Li Binnong retired last year,” Ling Ran said, “He taught us a basic class before.”
“Ah, that’s right. He has already reached the age of retirement.” Feng Zhixiang sighed and asked, “Doctor Ling, are you a PhD graduate?”
“Undergraduate.”
“Under… graduate?” Feng Zhixiang was surprised. “Which year did you enter the hospital?”
Ling Ran thought about it. “This year, I think.”
Feng Zhixiang gazed at Huo Congjun with a surprised look.
Huo Congjun chuckled and said, “It’s grace from heaven.”
Feng Zhixiang was speechless as he looked at Ling Ran’s face. He felt that the world was unfair. Some people still needed to beg for a living when they were in their sixties. Some people could perform hepatectomy for an old man whose health was poor when they were in their twenties…
*Shick.*
The door of the operating theater opened, and Associate Hospital Director Zhou came in with a somber look.
“It’s alright now.” Huo Congjun said without waiting for Associate Hospital Director Zhou to ask, “Ling Ran performed barehanded bleeding control and sutured the wound. The patient’s condition is now stable.”
“Oh…” Associate Hospital Director Zhou had come in an aggressive presence, but he instantly relaxed, and he seemed to have become shorter by three inches. He asked Ling Ran amiably, “Doctor Ling, how’s the situation now?”
“We should be able to go along the original plan and complete the hepatectomy.” Ling Ran paused for a moment before he said, “But we won’t be able to make it in time to the original estimated time of surgery.”
Guo Mingcheng was a bit depressed, and he smiled awkwardly, “I underestimated it.”
“You have bad luck. Ultrasonic knife.” Ling Ran did not attempt to perform the surgery in any other way. He just followed Guo Mingcheng’s plan and performed the hepatectomy bit by bit.
He would just be wasting away the patient’s life if he messed up the surgery while Guo Mingcheng was already halfway through the surgery, anyway.
However, it was precisely because Ling Ran performed the surgery according to Guo Mingcheng’s plan that Guo Mingcheng became more stunned.
Forget the other aspects, Ling Ran’s method of operating the ultrasonic knife alone had already far surpassed his skill level.
Ling Ran held the ultrasonic knife and sliced the tissue from high above. He finished the incision in one go, and only did he perform the incision accurately, the damage to the surrounding tissue was very minimal as well…
Most importantly, Ling Ran was more familiar with this surgical skill than Guo Mingcheng! And Guo Mingcheng had been using this surgical skill as his main surgical method for more than a year.
*Shick.*
The door of the operating theater was opened again. The one who entered was the secretary of another hospital director. She came over as the hospital director’s representative to take a look at the situation.
The secretary nodded at everyone and did not bother to introduce herself. She asked, “What happened?”
“We had trouble controlling the hemorrhage. Bleeding control has finally been completed now,” Huo Congjun said.
The secretary asked, “Can the patient be saved?”
“Almost. We can save him.” Huo Congjun still gave an affirmative answer.
As expected, the secretary relaxed.
*Shick.*
The door of the operating theater opened again.
A few resident doctors peered in.
Associate Hospital Director Zhou, the hospital director’s secretary, Department Director Lei from the Medical Affairs Department, Huo Congjun, He Yuanzheng, Feng Zhixiang, and the others turned around to look simultaneously.
“We…” The resident doctors stiffened up as though they saw Medusa. They were so stiff they looked as if they had experienced rigor mortis for a few hours. Their words were at the tips of their tongue, but they just could not say them.
Chapter 504: Bleeding Control
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Have you used the hemostatic drugs?” Ling Ran groped around the liver as he asked.
“Tranexamic acid and ethamsylate were applied,” Guo Mingcheng said. “I also used some medication before the surgery.”
“Okay,” Ling Ran replied, and he continued to feel around the liver.
Guo Mingcheng had performed the emergency suture, and the wound was coagulated using an ultrasonic knife, but the blood just kept flowing out.
It could be considered as a typical case of a surgeon’s bad luck. Plus, his skills were not good either.
There was nothing wrong with Guo Mingcheng’s operation. The preoperative preparation was not perfect, but it had reached beyond the standard. Yet, he could still do nothing when the patient suffered from hemorrhage.
In Ling Ran’s mind, he thought about the patient’s MRI scan and other X-ray details.
As a pure surgeon, Ling Ran paid very little attention to information from internal medicine, such as biochemical tests and so on. However, he remembered the details in the patient’s X-ray and other scans well.
Ling Ran thought while his left hand was groped about the liver region. His touch was very gentle, and his fingers were practically sliding through the liver. At the same time, Ling Ran placed his right hand inside as well.
*Shick.*
The airtight access door was opened.
Department Director Lei from the Medical Affairs Department came in a rush and stared at Huo Congjun before he looked Ling Ran. He said, “Doctor Ling, don’t go any further if you are not confident. For a case like this, we’ll need to take two months just to write the report on the cause of death.”
For doctors, any patient who died on the operating table would be treated as an accident. But the hospital’s grade would also come into play.
For a grade B or secondary hospital, a patient’s death during surgery was very serious. It was because if the doctors were not confident, they should have transferred the patient to a hospital with a higher grade.
But for tertiary hospitals, especially a strong tertiary hospital like Yun Hua Hospital, if any death happened during surgery, as long as it was not due to an error in the surgeon’s operation, the surgeon would not be directly sacked by the hospital, even though he would still receive limited punishment.
However, for Department Director Lei, this limited punishment was not necessary at all. It was not fun to be disqualified for the evaluation for excellence, to be forced to write a report with ten thousand words, being reviewed multiple times, getting bonuses reduced, and having benefits taken away, especially when life for the surgeon had been good previously.
Department Director Lei knew Ling Ran had been performing freelance surgeons, and he was not short of money. But most of the doctors did not like patient mortality discussions, and writing a report was even more frustrating…
“I can do it,” Ling Ran merely replied with these words. He then said to Guo Mingcheng, “I can perform barehanded bleeding control and reduce a certain amount of blood loss. Then, you’ll have to hurry up to aspirate the abdominal cavity, and maybe we’ll see how it goes from there?”
“Okay.” Guo Mingcheng agreed and cast Ling Ran a profound glance. He ordered. “Force in aspirator has been increased. When are we starting?”
“Already started. Two minutes.” Ling Ran was worried that he would damage the patient’s liver. Besides, the angle in which he could exert force was also limited. He could not interrupt the blood flow completely.
Blood kept flowing out in the patient’s abdominal cavity, but it was aspirated when it appeared. The blood gradually reduced.
He Yuanzheng did not understand what he was looking at. But in his mind, he thought about a question he answered when he was young. ‘When a discharge pipe and a water inlet is activated at the same time, you are given…
‘Who said the question that year was useless?
‘This question was so difficult that it used hydrodynamics.’
He Yuanzheng stared at the thick blood and had his thoughts run wild.
He had no choice but to have his thoughts run wild. He could not see what Ling Ran was doing now, because all his movements happened underneath the blood. The only variable was the reduction of collected blood in the abdominal cavity.
Huo Congjun took out his phone again. This time, he called the blood station.
Then, Huo Congjun called Hospital Director Zhou.
With such a great amount of blood loss, if there was no support from the blood station and hospital director, the surgery could not be performed.
Guo Mingcheng stared at the blood while he held he forceps. He basically did nothing else.
The liver was exposed slowly.
“Angiomas. Intercept,” Ling Ran spoke quickly, but his hands moved even faster. With a flip and a shake, the location of the angiomas was exposed a bit more.
Although it was just a little bit more, at least the border of the angiomas could be seen. Guo Mingcheng had been performing the operation for a long time, but he had still not been able to figure out the location of the angiomas after so long.
Of course, it was because Guo Mingcheng dared not flip the liver too much.
He did not have Ling Ran’s barehanded bleeding control skills. So, if he flipped the liver too much, he could cause unpredictable consequences.
“I need at least one and a half minute.” Guo Mingcheng no longer dared to hide his skills anymore.
If he were not careful, the patient’s bleeding would become uncontrollable, and the surgery would completely fail. If it were possible, he did not want to lose hope.
Ling Ran frowned. He was pinching the liver. It was excessive for him to continue pinching the liver for two minutes, and Guo Mingcheng actually needed one and a half minutes to intercept the angiomas…
“I’ll suture. Help me tear the suture line.” Ling Ran pinched the patient’s liver with his right hand, and he extended his left hand to the scrub nurse before he said, “Needle-holder, fine thread.”
At this moment, the surgeon was no longer particular about the type of thread used. The nurse passed the needle-holder with the finest thread to Ling Ran.
Ling Ran held the needle-holder tightly with his left hand and poked the center of the liver with the needle.
It was only then that Guo Mingcheng realized what Ling Ran was doing, and he immediately helped to trim the thread.
Ling Ran quickly performed a few stitches. Then, he began to perform a few meticulous sutures.
Within less than a minute, Ling Ran threw away the needle-holder and said, “Completed. I’m going to let go with my right hand.”
Guo Mingcheng opened his eyes wide to observe Ling Ran’s operation. At that moment, provided the people watching were not idiots, they likely knew just how well Ling Ran’s level and standards were.
“Continue to aspirate,” Ling Ran said again and slowly let go of the liver.
The liver still bled from time to time, but it no longer bled massively as it did previously.
“Let us finish the remaining hepatectomy.” Ling Ran sounded like he was giving an order. The person who could make the decisions could have that kind of tone during surgeries because this was influenced by the nature of the operating table.
Only one man was required to make decisions on the battlefield. Only one man was required to give instruction on the operating table.
Ling Ran could no longer completely let Guo Mingcheng handle the hepatectomy.
In fact, even if Ling Ran continued to let Guo Mingcheng perform hepatectomy, Guo Mingcheng could no longer do that.
Guo Mingcheng lowered his head and cooperated with Ling Ran while he silently carried out his duty as an assistant.
Professor Feng Zhixiang took two steps back and gave out the position. Then, he slowly took off his gloves and watched Ling Ran with a look of interest.
For him, today was quite embarrassing.
However, such an embarrassment was not comparable to a patient dying on the operating table.
His position was determined by one or two surgeries. Moreover, he was just a freelance surgeon for today’s surgery. He was not performing a surgery that would be observed by others in an international conference, and neither was he performing a demonstration surgery to his academic peers.
Professor Feng Zhixiang was more surprised that Ling Ran could save the patient.
He had also participated in the surgery just now. So, Feng Zhixiang knew clearly that he could not have saved the patient. Even when Feng Zhixiang was at his best, Feng Zhixiang was not confident that he could save the patient. However, Feng Zhixiang was confident that if he had been at his best, the surgery would not have progressed to such a state.
Therefore, Guo Mingcheng was still not skillful enough.
Meanwhile, this explained that Ling Ran was truly skillful.
“Doctor Ling, which university did you graduate from?” Feng Zhixiang asked when he saw that the surgery had been stabilized.
“A medical institute attached to Yun Hua University,” Ling Ran said.
“Yun Hua University, huh? I know Li Binnong from Yun Hua University,” Feng Zhixiang said.
“Professor Li Binnong retired last year,” Ling Ran said, “He taught us a basic class before.”
“Ah, that’s right. He has already reached the age of retirement.” Feng Zhixiang sighed and asked, “Doctor Ling, are you a PhD graduate?”
“Undergraduate.”
“Under… graduate?” Feng Zhixiang was surprised. “Which year did you enter the hospital?”
Ling Ran thought about it. “This year, I think.”
Feng Zhixiang gazed at Huo Congjun with a surprised look.
Huo Congjun chuckled and said, “It’s grace from heaven.”
Feng Zhixiang was speechless as he looked at Ling Ran’s face. He felt that the world was unfair. Some people still needed to beg for a living when they were in their sixties. Some people could perform hepatectomy for an old man whose health was poor when they were in their twenties…
*Shick.*
The door of the operating theater opened, and Associate Hospital Director Zhou came in with a somber look.
“It’s alright now.” Huo Congjun said without waiting for Associate Hospital Director Zhou to ask, “Ling Ran performed barehanded bleeding control and sutured the wound. The patient’s condition is now stable.”
“Oh…” Associate Hospital Director Zhou had come in an aggressive presence, but he instantly relaxed, and he seemed to have become shorter by three inches. He asked Ling Ran amiably, “Doctor Ling, how’s the situation now?”
“We should be able to go along the original plan and complete the hepatectomy.” Ling Ran paused for a moment before he said, “But we won’t be able to make it in time to the original estimated time of surgery.”
Guo Mingcheng was a bit depressed, and he smiled awkwardly, “I underestimated it.”
“You have bad luck. Ultrasonic knife.” Ling Ran did not attempt to perform the surgery in any other way. He just followed Guo Mingcheng’s plan and performed the hepatectomy bit by bit.
He would just be wasting away the patient’s life if he messed up the surgery while Guo Mingcheng was already halfway through the surgery, anyway.
However, it was precisely because Ling Ran performed the surgery according to Guo Mingcheng’s plan that Guo Mingcheng became more stunned.
Forget the other aspects, Ling Ran’s method of operating the ultrasonic knife alone had already far surpassed his skill level.
Ling Ran held the ultrasonic knife and sliced the tissue from high above. He finished the incision in one go, and only did he perform the incision accurately, the damage to the surrounding tissue was very minimal as well…
Most importantly, Ling Ran was more familiar with this surgical skill than Guo Mingcheng! And Guo Mingcheng had been using this surgical skill as his main surgical method for more than a year.
*Shick.*
The door of the operating theater was opened again. The one who entered was the secretary of another hospital director. She came over as the hospital director’s representative to take a look at the situation.
The secretary nodded at everyone and did not bother to introduce herself. She asked, “What happened?”
“We had trouble controlling the hemorrhage. Bleeding control has finally been completed now,” Huo Congjun said.
The secretary asked, “Can the patient be saved?”
“Almost. We can save him.” Huo Congjun still gave an affirmative answer.
As expected, the secretary relaxed.
*Shick.*
The door of the operating theater opened again.
A few resident doctors peered in.
Associate Hospital Director Zhou, the hospital director’s secretary, Department Director Lei from the Medical Affairs Department, Huo Congjun, He Yuanzheng, Feng Zhixiang, and the others turned around to look simultaneously.
“We…” The resident doctors stiffened up as though they saw Medusa. They were so stiff they looked as if they had experienced rigor mortis for a few hours. Their words were at the tips of their tongue, but they just could not say them.
