Chapter 36: Lu Cheng’s Advance!
“Xiao Lu, are you tired?”
“Not really.”
“Xiao Lu, you look full of energy. How about you be the chief surgeon for this liver protection surgery?” While scrubbing in at the sink, Professor Chen Song tilted his chin arrogantly, trying to match Lu Cheng’s eye level.
Lu Cheng’s smile froze: “Teacher Chen, aren’t you just mocking me…”
“Let alone liver protection surgery? I wouldn’t dare attempt a liver lobectomy!”
“I still have to rely on you, Teacher Chen, to show your mighty power.” Lu Cheng’s eyes were flattering, as if he had just undergone cosmetic surgery.
Professor Chen’s current situation was akin to asking a butcher at a slaughterhouse if he wanted to perform an appendectomy at the People’s Hospital.
If Master Hu could do this, why would he still be at the slaughterhouse butchering pigs?
“Are you sure you don’t want to do it? If not, I’ll do it. Don’t say Teacher Chen didn’t give you a chance.” Professor Chen Song’s tone was as amiable as could be.
“When your Teacher Chen gets so tired that he dies, you’ll have to go it alone.” Professor Chen Song’s voice was serious, making him seem like a mischievous rascal.
It was 3:30 AM. Lu Cheng had forgotten the specific date in July. Ever since he stopped having regular shifts and was always on call, Lu Cheng truly couldn’t keep track of what day it was.
“Teacher Chen, after this surgery, I’ll immediately call Director Lin. We’ll take a break for a day and suspend emergency surgeries.” Lu Cheng’s tone was decisive, and he understood Professor Chen Song’s implied meaning.
Professor Chen Song’s eyes narrowed, and he clasped his hands together in front of his chest as he entered the operating room, his tone laced with sarcasm: “Oh my goodness! Xiao Lu, you still remember that your Teacher Chen is a person, not a machine, right? How nice!”
Lu Cheng felt a slight blush.
Lu Cheng also understood that the reason Professor Chen Song agreed to the “beast of burden shifts” requested by Director Lin Qianlong and others was primarily to teach him.
Otherwise, how could Professor Chen, who was a visiting professor, always be on call for emergency shifts?
As Lu Cheng entered, he asked, “Brother Liang, what’s today’s date?”
Brother Liang, an anesthesiologist, looked surprised: “July 28th? You don’t even remember the date, what kind of shift are you working?”
Professor Chen Song said, “He wants to court death and drag someone else down with him. It’s all about not taking a loss.”
Professor Chen Song had come to understand that if he didn’t tease Lu Cheng, Lu Cheng would never know what normal human sleep schedules were.
What’s more, Lu Cheng was still full of fighting spirit…
Doctor Liang was stunned: “Professor Chen, you guys haven’t 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, after which he had two days off.
Professor Chen Song said nothing.
Lu Cheng lowered his head and followed Professor Chen Song to put on a sterile surgical gown.
This emergency patient, whom no one else could handle, was already anesthetized, and the surgery had to proceed. There was no turning back.
Liang Guihong winked at Lu Cheng: “Xiao Lu, take it easy. If Professor Chen hasn’t rested well, you won’t be able to bear that responsibility.”
If a visiting doctor died of exhaustion while on a training program abroad, the host unit would be troubled. If a doctor providing rural aid died suddenly at Long County People’s Hospital, a whole string of people would be in trouble.
Lu Cheng lowered his head, thinking that his actions were not meticulous enough. After this surgery, he had to add a reminder to record the start and end times of Professor Chen Song’s surgeries to ensure Professor Chen Song’s rest time.
In his spare time, he would just do appendectomies and tendon suturing by himself…
He was the one who wanted to learn surgery, not Professor Chen Song.
“Teacher Chen, I’m sorry…” Lu Cheng apologized sincerely.
Once the surgery officially began, Professor Chen Song stopped joking and said, “If the liver injury is within grade 3, hemodynamically stable, with no signs of peritoneal irritation, and CT shows no active bleeding, non-surgical treatment can be chosen.”
“But this patient is AAST grade 3. A debridement liver resection must be performed.”
“Precise liver resection with ultrasonic scalpel and fibrin glue sealant for the wound. Since it hasn’t reached the stage of destructive parenchymal rupture, a liver segment resection is not necessary. This is the choice of treatment procedure.”
Lu Cheng nodded: “Yes, Teacher Chen.”
“The best hemostasis strategy is interventional surgery, but your hospital doesn’t have it, so you can’t use interventional embolization for hemostasis. We’ll have to open it up and stop the bleeding slowly.”
“What we will use today is the selective liver blood flow occlusion, the Takasaki method. This method is actually very easy to understand; it’s simply a selective liver blood flow occlusion technique.”
“But the process is quite complex. We first need to dissect the Glisson’s sheath, precisely separate the target liver segment’s Glisson’s pedicle, and then precisely occlude it with a vascular clamp.”
“This process, while seemingly hemostasis, is actually a precise application of incision techniques. Watch carefully…” After patiently explaining to Lu Cheng, Professor Chen Song made an incision on the liver lobe.
The ultrasonic scalpel moved fluidly in Professor Chen Song’s hand, like a swimming dragon. After a while, it exposed the Glisson’s pedicle of the target liver segment.
“You place the vascular clamp and experience the liver segment blood flow occlusion technique…”
Lu Cheng mechanically followed instructions. After he placed the vascular clamp, the bleeding points in the area completely disappeared.
The small amount of oozing blood was residual and slowly disappeared.
This clamp seemed to root out the problem entirely…
“This kind of AAST grade 3 liver protection surgery is exactly the best material for you to learn. If you want to perform liver protection surgery, this is the surgical technique you need to learn.”
“However, you can’t do it alone. You’ll have to bring your Director Lin along, and then it will be fine…”
“For grade 3 liver injuries, a liver lobectomy is not necessary; only debridement resection is needed. But how to perform the resection is a very detailed matter.”
“What’s required is the flexible application of debridement techniques. However, your basic skills in debridement are not yet up to par, so you still need to practice slowly.”
“The most basic principle remains the same: remove all necrotic tissue and suspicious necrotic tissue…”
“But there are techniques for handling the resected surface. If the surface has grade 1 oozing, bipolar cautery will suffice. For grade 2 oozing like this, argon plasma coagulation is needed for superficial spraying. Your hospital doesn’t have this, so you’ll have to use hemostatic gauze compression for about two minutes, similar to grade 3 oozing.”
“You must pay attention to ruling out bile leakage. A stricter standard is that the bilirubin content of the wound exudate is less than 17 umol/L. This is not easy to quantify, so you can only practice your basic skills very rigorously.”
“There are also considerations for the ratio of fibrin glue. You can read about this in books later…” With each step, Professor Chen meticulously explained the key points of the operation to Lu Cheng.
Lu Cheng nodded repeatedly. This was not something taught in instructional videos; it was the personal experience and understanding of each chief surgeon, considered empirical knowledge points…
【Master’s careful and long-term guidance on the liver protection surgery process leads to improved liver protection surgery skills.】
【Liver Protection Surgery （Beginner 4/5）（+2）……】
This guidance from Professor Chen Song directly earned Lu Cheng two experience points, a truly bountiful harvest.
The rewards of skill points also followed.
【Assisted in the specific operations of hemostasis, debridement, and suturing for the liver protection surgery, ensuring the smooth progress of the surgery and gaining 0.4 skill points.】
【Current Skill Point Balance: 42.3 points】
In 4 days, 30 skill points were enough to make Lu Cheng grin from ear to ear.
After stepping down from the surgery, Professor Chen Song poked Lu Cheng’s temple with his index finger: “Stop grinning like an idiot. Go back and catch up on sleep. Surgeries are never-ending!”
“Just stay alive… You’re acting possessed,” Professor Chen Song said, walking out with his hands behind his back, pushing open the automatic sensing air-tight door of the operating room.
Professor Chen Song had realized that if he didn’t directly point out how tired he was, Lu Cheng would eventually wear him out to death.
However, Professor Chen Song didn’t blame Lu Cheng. If Lu Cheng wasn’t so passionate about surgery and learning so quickly, it would be a miracle.
