Da Ming: Father, step aside, I'll be the prime minister!

Chapter 372 The surgery was a success!
The most crucial aspect of this surgery is how to close the airway after the tracheotomy to ensure safe ventilation while preventing throat secretions from being inhaled into the lungs.

To achieve these goals, a suction tube and an air bag are essential instruments.

Yuan Zongdao was stunned for a moment. He suddenly understood why Zhang Yunxiu had come to him. He couldn't find other equipment, but things like trachea and air bags were more commonly found in biochemistry labs.

Realizing the importance of the matter, he quickly cupped his hands in greeting.

"Please rest assured, Master, I will do my utmost."

As they walked into the intensive care unit, they were greeted by Xia Shi and Zhang Yuanhao's group.

Supported by her, Xia Shi, looking ashen-faced, bowed and spoke to Zhang Yunxiu from afar.

"Please, my nephew, save my master's life."

Zhang Yunxiu sighed, his expression very solemn.

"Has the old lady made up her mind?"

Just now, on the way here, Zhang Yunxiu had already explained the advantages and disadvantages of this matter.

Xia's lips moved slightly: "Things have come to this point. If we hesitate any longer, the master will surely die soon. Bring me pen and ink. I will do this. The Duke of Ying's mansion is willing to bear all the consequences of the surgery."

Zhang Yunxiu nodded slightly; it was best if the Duke of Ying's mansion had someone in charge.

If no one is willing to sign, the clinic will have to report to the Wanli Emperor if it wants to treat the Duke of England. In the end, Zhang Rong will really be dragged to his death.

"mother"

Not far away, Zhang Yuangong looked hesitant to speak, but seeing Xia Shi's stern gaze, he finally gave up.

Xia rolled up her sleeves and signed the contract. The moment the words were written, Zhang Yunxiu and the others, dressed in protective suits, entered the "silkworm room".

After signing the document, Xia seemed to lose all her strength and collapsed into Zhang Yuanhao's arms.

"mother!"

With tears in his eyes, Zhang Yuanhao turned his gaze to the door of the silkworm rearing room.

As soon as I entered the silkworm room, I saw Zhang Rong lying in the center of the operating table, his face pale. The elderly Duke of England was naked from the waist up, and had already been disinfected. However, his rough, wrinkled skin and dull complexion made him look like a corpse to anyone who didn't know better.

Two people were standing in the silkworm rearing room, already ready to go.

Li Shizhen had already drawn lines on Zhang Rong's throat, picked up the gleaming scalpel, and kept gesturing on it, seemingly hesitant.

He spoke softly, "Your Highness, please help me locate the trachea. Once this knife is in place, there is no turning back."

A female voice replied, "Mr. Dongbi, please rest assured, this place should be completely safe."

Li Shizhen sighed and said, "I have read the description of the human body in Western medicine countless times, and I used to work as a coroner, but I am still a little terrified to actually do this to such a critical place."

Zhu Yaoying replied, "This is only natural. The Duke of Yingguo is a pillar of the nation. If he is not careful, it could lead to disaster. I think Commander Zhang will have a solution."

She had barely finished speaking when she heard a cough behind her. She turned around abruptly and saw Zhang Yunxiu wrapped up like a big white rice dumpling. Her face flushed instantly, but she quickly concealed her emotions.

Zhang Yunxiu recognized Zhu Yaoying at first glance, which was somewhat unexpected. An assistant was needed in the operating room, but he did not expect it to be Her Highness the Princess.

Li Shizhen noticed the other party's doubts and explained.

"In this clinic, if we're talking about boldness and meticulousness, there's no one more like Princess Yongning."

Zhang Yunxiu felt rather awkward, as he felt it was strange for the three of them to be in the same room, but Zhang Rong's situation was urgent.

Even in the intensive care unit, Zhang Rong was finding it increasingly difficult to breathe, and she kept making whimpering sounds in her throat.

Zhang Yunxiu instructed in a deep voice, "First, make an incision along the midline of the neck, between the Adam's apple and the suprasternal notch, then cut through the subcutaneous tissue."

Li Shizhen's pupils contracted slightly, and without saying a word, he had already raised his knife.

On the operating table, Zhang Rong's expression was extremely painful, but under the effect of anesthesia, she remained motionless. To prevent accidents, there were also special fixation straps on the operating table to help keep her still.

Due to the sensitive nature of the surgical location, a range of medications and instruments, including hemostatic powder and hemostatic forceps, were prepared on the side of the operating table in case of any unexpected events.

Of course, Li Shizhen knew in his heart that if there was a serious hemorrhage in the throat, even hemostatic forceps would be powerless to save the patient.

Li Shizhen took a deep breath, and after finding the correct location by relying on the markings and his memory, he finally made up his mind.

Just as he was about to apply force, he heard Zhang Rong let out a violent whimper. The sound was extremely faint and hoarse, as if something was choking him, and he couldn't even cough.

He was writhing in pain on the operating table, his hands seemingly trying to raise and cover his throat.

"This is not good," Zhu Yaoying said, frowning. "It seems the pus is stuck in his throat, and the Duke of Yingguo may suffocate and faint due to the obstruction in his throat!"

Sweat beaded on the foreheads of all three men. None of them had ever undergone similar surgery. Li Shizhen had performed some hemorrhoid removal surgeries and amputations, and Zhu Yaoying had removed tumors. But no matter how you look at it, surgery on the throat was still a matter of life and death.

"We can't wait any longer." Li Shizhen gritted his teeth, just about to make the incision, when he felt his wrist being firmly pressed down.

The sharp scalpel gleamed coldly under the shadowless lamps of the silkworm room, leaving a bloody mark on Zhang Rong's neck.

Zhang Yunxiu shook his head slightly and said, "Not here, it's too late. Move the position a little."

He gestured at Zhang Rong's neck.

"Below the Adam's apple in the neck, between the thyroid cartilage and cricoid cartilage, there is a thin membrane without important vascular structures. Originally, a puncture needle was to be used, but due to the urgency of the situation, we made a direct incision here to establish an airway."

Li Shizhen's eyes showed some surprise. Judging from Zhang Yunxiu's usual medical skills, he could be considered a master in various medical books and theories. No one knew how he had so much energy to know so much knowledge.

However, based on clinical medical experience, Zhang Yunxiu was definitely not as good as Li Shizhen and Zhu Yaoying.

Even in previous surgeries, Zhang Yunxiu always played a supporting and reminding role.

Surprisingly, he was so familiar with these anatomical parts.
Li Shizhen felt a chill run down his spine, and the image involuntarily flashed through his mind: Zhang Yunxiu leading the Imperial Guards to dissect prisoners in the imperial prison under the cover of darkness.

However, it was too late. He kept his questions to himself, and with a sense of confidence, he moved the scalpel down and found the exact location below his Adam's apple.

The cricothyroid membrane was clearly more distinct than the former. Li Shizhen carefully cut open the flesh first, and then Zhang Yunxiu reminded him in his ear.

"Remember not to cut too deep; a small opening is enough."

Li Shizhen immediately understood, and Zhu Yaoying steadily handed over an even more slender dagger from the side.

After receiving the dagger, Li Shizhen firmly gripped the handle with his right thumb and forefinger, blade facing down, and vertically and quickly stabbed it into the cricothyroid membrane at the position he had simulated countless times.

When the blade made contact, he could clearly feel a slight resistance in his hand.

He applied force slowly and steadily, and the extremely sharp blade took effect.

When he reached the critical point, Li Shizhen suddenly felt a "sudden decrease in resistance," which was the sensation of penetrating the fascia. He immediately stopped applying force with his hands.

Crimson blood seeped from the incision, and all three could hear a faint sound of gas escaping.

"Cough cough!"

Zhang Rong, lying on the operating table, let out a faint cough.

"It's done."

Li Shizhen's eyes widened, and he visibly breathed a sigh of relief. The fact that the patient could cough indicated that his breathing had become somewhat clearer. However, Zhang Yunxiu, standing to the side, showed no sign of letting up and continued to give instructions.

"Yongning, remove the catheter and use gauze to stop the bleeding."

Zhu Yaoying's hands were very steady. This princess, who usually kept a low profile, even showed a level of calmness on the operating table that surpassed that of men.

However, the step of inserting the breathing tube still had to be done by Li Shizhen.

Renmin Medical Clinic has nearly a year of experience in intravenous medical care, and is already very familiar with procedures such as injections.

This conduit has been temporarily modified, with a section in the middle being hardened.

Li Shizhen accurately aimed at the position, inserting the needle neither too deep nor too shallow.

Only after the sausage casing catheter was inserted did Zhang Rong's condition truly begin to improve. His complexion gradually returned to normal, and the three of them could hear his breathing through the catheter.

Zhu Yaoying worked quickly and efficiently, wrapping and securing the sterile gauze around the catheter.

This series of actions took no more than five minutes, but it seemed to have exhausted all the strength of the three of them.

Only when Li Shizhen and Zhu Yaoying worked together to secure the catheter in Zhang Rong's neck to prevent it from becoming blocked did the three of them finally breathe a sigh of relief.

After this, everyone was drenched in sweat.

Seeing Zhang Rong's complexion gradually return to normal, Zhu Yaoying was overjoyed and exclaimed from the bottom of her heart.

"It's done!"

From her perspective, it was an incredible feat of skill. Zhang Rong, who was already beyond saving and on the verge of suffocation, was saved in an instant by a small incision.

Although it was a small incision, only those present knew how difficult the process was.

This was the first cricothyrotomy in the history of the Ming Dynasty, and it may also be the first time in the world!
Zhu Yaoying had too many doubts in her heart, but she held back at this moment.

But Zhang Yunxiu continued to instruct the two, "The next three days are especially important. We need to check the catheter for blockages at all times. If there is phlegm or pus or blood, we need to clean it in time. Daily disinfection is also necessary."

Li Shizhen asked questions like a student.

“Shiyuan, this tracheotomy is indeed very effective, but does it have to be inserted like this indefinitely? I think the cricothyroid membrane here is narrow, which can protect the Duke’s life for a while, but if it continues for a long time, it will definitely have an impact on his health.”

He immediately grasped the key point, and Zhang Yunxiu nodded slightly as he spoke.

“Cricothyrotomy is an emergency procedure. Although the operation is quick and the trauma is minimal, the airway is extremely narrow, so it is not a long-term solution.”

"Now we need to observe the Duke of England's recovery. If the abscess in his throat subsides in three days, things will be much easier. If it doesn't, we'll likely need another surgery, either a tracheotomy or removal of the affected area from his throat."

Li Shizhen sighed and said, "It still seems we cannot let our guard down."

Cricothyrotomy is already considered a relatively simple surgery. If it really goes to the point of removing the tonsils, the difficulty level would probably be a level higher.

At this point, all we can do is hope that Zhang Rong can recover gradually within three days through treatment.

Zhang Yunxiu asked, "I heard that allicin injection has been successfully developed. Regular daily injections should be able to reduce inflammation. With the care of the intensive care unit, the probability of recovery is very high."

The intensive care unit is equipped with dedicated nursing staff and equipment, so the follow-up work can be handed over to others after the surgery.

Zhang Lanying is now the head of the intensive care unit at the clinic. She rushed over and saw Zhang Yunxiu, so she quickly bowed and greeted him.

"Commander Zhang."

Zhang Yunxiu looked at the woman. Just over half a year ago, she was a helpless mother among the refugees, but now she is a pillar of the medical community in the Ming Dynasty.

"give it to you."

Zhang Yunxiu nodded slightly, offering his reminder.

"If the patient is unable to eat, intravenous drip or enema can be used."

"Enema?"

Zhang Lanying was quite surprised.

That's Zhang Rong, the Duke of England! I wonder how he would react if he knew he was going to be given an enema.

"Is face more important or life?"

Zhang Yunxiu was worried about Zhang Rong's safety, but he also found it a little funny when he thought about Zhang Rong's reaction to the enema.

"Keep the news under wraps in the intensive care unit and don't let it get out."

Since Zhu Yinghuai tried the enema method, it has been widely used in Renmin Medical Clinic.

Although this method is somewhat unrefined, it can still save a life, especially in cases of serious illness.

Even though the Ming Dynasty had the concept of intravenous injections, the preparation of solutions such as glucose solution, fat emulsion, and nutrient solution for fat emulsion was still a very difficult process.

Therefore, the only way to survive is through an enema.

Although the high-ranking officials and nobles in the capital scoffed at this, when their lives were truly at stake, they would obediently have a tube inserted into their buttocks.

After finishing the surgery, Li Shizhen rushed to his study, clearly because the surgery was too important to be missed and needed to be recorded.

Zhu Yaoying, however, was somewhat inconvenienced. After completing the surgery, she gave Zhang Yunxiu a look and then went back to the palace in the backyard alone.

Zhang Yunxiu sighed helplessly. This was the downside of marrying a princess; one had to be careful and cautious in everything.

After leaving the intensive care unit area, they were greeted by Yang Jishi, accompanied by Xia and other members of the Duke of England's household.

Yang Jishi came up first and, seeing Zhang Yunxiu's tired face, couldn't help but ask.

"Master, how is the Duke of Ying?"

Zhang Yunxiu turned his gaze to Xia Shi behind him.

Madam Xia's face was deathly pale, as if she herself had just been on the operating table. When she saw Zhang Yunxiu, she forced herself to stay awake despite the pain.

"Mother, let me help you across." Zhang Yuanhao tried to support her, but she pushed him away with her cane.

"I can walk by myself!"

Xia stared wide-eyed.

She turned her head, took a few steps forward, and gazed intently at Zhang Yunxiu as she spoke.

“Commander Zhang, please tell me the truth about my husband. At this age, I can still manage.”

In the past, preparations for Zhang Rong's funeral would have already begun, but now, with the help of Renmin Medical Center and Zhang Yunxiu, a glimmer of hope has emerged.

Zhang Yunxiu took a deep breath and said with a genuine smile.

"Please rest assured, Madam, the surgery was a success, and Uncle's life has been saved."

Xia's eyes, which were originally full of tears, suddenly fell into a daze.

(End of this chapter)