Is there no limit to this doctor's skills?

Chapter 155 'Experiencing' Surgery!

The emergency department of Yilan Central Hospital consists of several large sections, including surgical clinics, wards, resuscitation rooms, EICU, and operating rooms.

Both internal medicine and surgery operate on a shift system.

For example, today, the surgical team was led by Associate Chief Physician Zheng Chongyue, with attending physicians Tan Wenyuan and Ma Xiaocheng on duty.

There is another resident trainee named Huang Zhuoan assisting him.

The internal medicine and surgery departments are separate and have their own duty teams, so there seems to be a good number of staff.

In reality, if the manpower were evenly distributed among the wards, observation wards, EICU, and emergency room, it would still be far from sufficient.

Compared to emergency surgery, the on-call team in internal medicine is much larger...

It's 10 a.m.!

Ning Sanlong and Zheng Chongyue successfully performed a laryngoscopic "foreign body removal" procedure on a patient with airway obstruction.

Ning Sanlong took off his gloves and walked towards Guo Ziyuan.

"Xiao Guo, what are you doing holding your phone?"

"Not interested in such a small trick?"

Guo Ziyuan is a trauma surgeon, not an emergency surgeon.

In his previous life, Guo Ziyuan was not responsible for retrieving light bulbs from above or below, or for golf balls.

Guo Ziyuan slowly put away his phone and answered truthfully, "Professor Ning, Teacher Tan encouraged me to try an appendectomy later."

"Let me first look at the basic surgical procedure."

Ning Sanlong took off his mask and opened and closed his mouth twice.

He hadn't heard of needing to study appendectomy in a long time.

However, considering Guo Ziyuan's original major and age, all of this is quite natural.

"In return for their kindness, Director Zheng and the others called you from the control room to the emergency room so that you wouldn't miss your chance to operate."

"Appendectomy is generally only performed by interns, so even if it breaks open, it's not a big deal." Ning Sanlong didn't take it seriously at all.

"Hmm." In both his past and present lives, Guo Ziyuan had only ever seen an appendectomy, but had never performed one himself.

Therefore, his first appendectomy made him slightly nervous.

After Guo Ziyuan put away his phone, Tan Wenyuan came over.

"Dr. Guo, come on, the operating room just called, we can go over now."

After seeing Guo Ziyuan stand up, Tan Wenyuan briefly provided some background information for Guo Ziyuan: "Our hospital's emergency surgery department has taken over some minor surgeries from general surgery and orthopedics."

"So...in county hospitals, appendectomy and cholecystectomy are probably the surgical services offered by the general surgery department."

"We picked them up, just to earn a little extra money."

Yilan Central Hospital is the best tertiary hospital in Yilan, and it has a considerable number of patients.

When there is no shortage of patients in the general surgery department, it is normal to send simple surgeries out of the department.

For example, in the orthopedics department of the Provincial People's Hospital, if a patient has a fracture emergency, they won't be admitted to the department and occupy a bed.

Patients are usually referred to smaller hospitals for open reduction and internal fixation of fractures.

In Guo Ziyuan's past life memories, a few years later, the hospital's emergency department would take over the simple muscle debridement of the lower limbs from the trauma surgery department.

These are all normal surgical handover procedures.

Guo Ziyuan suddenly became mischievous and asked, "Professor Tan, aren't you worried that I can only perform external surgeries and won't be able to handle the main procedures?"

There are rumors circulating in the department.

The reason why Guo Ziyuan only stayed in the operating room and was unwilling to enter the operating room was because dog meat is not fit for the main course.

Most of the wound cleaning and suturing procedures that can be performed in the operating room are superficial injuries.

No surgeon doesn't look forward to going into the operating room to perform a real operation.

Even a first-level surgery like cyst removal is considered more advanced than debridement and suturing.

"Ah... well, wasn't that a joke?"

Tan Wenyuan put his arm around Guo Ziyuan's shoulder: "Xiao Guo, you don't look like the kind of person who can't take a joke."

"You still care about this?"

Guo Ziyuan smiled and countered, "Teacher Tan? What if I really care?"

Tan Wenyuan rubbed his nose: "Where are you going to spend money tonight? Which floor?"

"How about that one by the river?"

Guo Ziyuan knew what the so-called "house by the river" was.

It's a relatively high-end KTV, with floors up to the sixth or even seventh.

In his previous life, Guo Ziyuan had also tried it, but he found it uninteresting.

For some things, experiencing the emotional value they bring is enough.

What Guo Ziyuan truly finds "rare" is the emotional connection, not the physical one.

"Then forget it," Guo Ziyuan politely declined.

……

"Yes, that's the disinfection area!"

"The area for disinfection of the abdomen is slightly different from the orthopedic surgeries you often handle, Dr. Guo, but it is actually simpler."

"Once the patient lies down, one person can do the work."

While Guo Ziyuan was disinfecting, Tan Wenyuan was pointing with his fingers behind his back, and he looked quite pleased with himself.

There seems to be a thrill and a sense of 'immorality' in guiding geniuses!

After the disinfection and draping were completed, Tan Wenyuan handed the curved tray with the scalpel to Guo Ziyuan.

"Come on, let's make the incision. The incision for an appendectomy is made by finding McBurney's point, and then along..."

Before Tan Wenyuan could finish speaking, Guo Ziyuan picked up the knife and plunged it into the patient's skin.

His effortless demeanor was definitely not that of a first-timer or a novice who had handled a knife before.

Tan Wenyuan even felt that Guo Ziyuan had probably undergone surgery several times more often than he had.

Only with such experience can Guo Ziyuan operate on patients without any hesitation!

Before Tan Wenyuan could catch up, Guo Ziyuan put down the round knife and switched to an electrocautery knife, setting it to electrocoagulation mode to begin cutting open the soft tissue.

"Teacher Tan... lend a hand and hold the incision open." Guo Ziyuan instructed as the chief surgeon.

Tan Wenyuan belatedly realized that he had become a supporting tool, and nodded blankly.

This Guo Ziyuan?

Is he pretending to be weak to take advantage of others?

He's actually had a lot of surgeries?

How could Tan Wenyuan possibly know that Guo Ziyuan's body contained the soul of Zhong Deng, a 36-year-old chief surgeon?

Moreover, this Zhong Deng's basic cutting skills have already reached the level of a "national player".

Then, the situation became very difficult to control.

After Guo Ziyuan used an electrocautery knife to cut open the subcutaneous fat tissue and expose the muscle layer, he did not choose the conventional appendectomy method to cut open the muscle layer.

Guo Ziyuan put down the electrosurgical unit and began blunt dissection of the muscle layer using the blunt tip of the hemostat!

This is not the manual blunt separation method described in the text!

There is no such thing as blunt dissection by hand; blunt dissection is blunt dissection.

The blunt dissection performed by hand can never compare to the blunt dissection performed by instruments, the fundamental reason being that the volume of a finger is always larger than that of a hemostat!

It could be five seconds, or it could be eight or nine seconds.

Tan Wenyuan even felt that his brain couldn't keep up before Guo Ziyuan's hemostat went straight into the parietal layer of the abdominal cavity.

Guo Ziyuan then used the hemostat in his hand to bluntly cut and separate the muscle layer, and then inserted the small curved retractor.

He handed it to Tan Wenyuan and made him hold it down.

He was pressed down on the abdomen by Guo Ziyuan.

Then, Guo Ziyuan picked up the scalpel again, made a small incision in the abdominal wall membrane, and continued to bluntly rub with the hemostat in his hand.

The forceps in Guo Ziyuan's hand were not blunt; they were more like a saw!

Tan Wenyuan's eyelids were twitching wildly.

At that moment, he glanced at the timer panel in the operating room and was so shocked he couldn't close his legs.

00:00:46:34!

What does that mean?

It took only 46 seconds and 34 milliseconds from when Guo Ziyuan cut open the skin to when the abdominal cavity was exposed.

This is surgery, are you in a hurry to be reborn?

However, if we carefully calculate the time it took for Guo Ziyuan to undergo surgery?

It's the kind of knife that can be called a sharp weapon, and it only takes about seven or eight seconds.

Cutting the skin is one cut, using an electrocautery knife to reach the adipose tissue layer, and using a sharp knife to puncture the peritoneum is another cut.

Others?

Has Guo Ziyuan ever had surgery?

Guo Ziyuan has never had surgery!

So what exactly is vascular nerve injury?

At what level did Guo Ziyuan perform the surgery?

The outer layer of skin, the subcutaneous fat layer, and the peritoneum.

What important blood vessels and nerves could be located in this location?

Of course, after doing all that, Guo Ziyuan's operation slowed down, probably because he was still not familiar with the surgical procedure for appendectomy.

Therefore, it took Guo Ziyuan a full minute to locate the root of the appendix based on the taenia coli.

After removing the appendix by hand, Guo Ziyuan carefully examined the base of the appendix.

Tan Wenyuan, whose brain had been rested for almost a minute, finally had time to go and examine it with Guo Ziyuan.

The appendix is ​​swollen, discolored, and has abscesses!

The pus was localized and had not ruptured.

Otherwise, the procedure for this appendicitis surgery might have to be changed.

Only after confirming the integrity of the appendix and the nature of the lesion did Guo Ziyuan begin to take further action.

Guo Ziyuan was still using hemostats, but the blunt tip of those hemostats seemed to disappear in Guo Ziyuan's hands.

Guo Ziyuan punctured the mesentery at the base of the appendix in one go!

The reason for puncturing the base of the appendiceal mesentery is to expose the appendiceal mesentery artery, which is then clamped and ligated...

It seems that these are the kinds of operations that Guo Ziyuan excels at.

Guo Ziyuan completed the procedure of exposing and ligating the blood vessel in less than thirty seconds...

This series of operations can only be described as smooth and effortless.

It has a unique aesthetic appeal.

It doesn't involve the violent beauty of blades or electrocutions!

"Dr. Guo, you can slow down..." Tan Wenyuan tried to persuade Guo Ziyuan after regaining his senses.

But it was still too slow in the end.

Guo Ziyuan had not only completed the purse-string suture, but also clamped the base of the appendix with tissue forceps and then cut off the appendix with one incision.

Guo Ziyuan interrupted Tan Wenyuan, saying, "Teacher Tan, could you help tie the knot?"

An assistant is usually needed for an appendectomy.

Although one person can sew a purse, it doesn't look as natural as if someone is helping.

Tan Wenyuan's hands mechanically picked up the two ends of the sewn-on purse.

As Guo Ziyuan spoke, he picked up an alcohol swab with his right hand and wiped the stump of the appendix for disinfection.

"I'm going to put the remnant back in." Guo Ziyuan removed the tissue forceps with his left hand.

While assisting Tan Wenyuan in sewing the purse, the remaining end was pushed into the inside of the purse sewing!

Operation.

This can actually be considered the end!

Tan Wenyuan glanced at the operating room's timer panel again.

I rely on?

"00:04:23:36!"

Four minutes, twenty-three seconds, thirty-six milliseconds.

Tan Wenyuan specified the time down to the millisecond because Guo Ziyuan's surgical speed was calculated in milliseconds.

Guo Ziyuan released the appendix clamp from his hand!

Seeing that Tan Wenyuan was still in a daze and had not continued tying the knot, he took the end of the thread from Tan Wenyuan's hand.

After I started quickly tying a knot, I took the thread cutters and snipped it.

Then she looked up and said, "Teacher Tan, I think we don't need to rinse it. What do you think?"

Tan Wenyuan never imagined that he would be so overwhelmed by an appendectomy.

As his consciousness gradually cleared, Tan Wenyuan squeezed his upper and lower lips together forcefully.

His lips pursed involuntarily, making the mask resemble a monkey's mouth: "What are you doing?"

"Is he pretending to be weak to catch a tiger?" Tan Wenyuan felt a dryness in his mouth, just like the dry mouth and tongue of a diabetic patient.

Guo Ziyuan smiled and said, "Teacher Tan, I think we don't need to rinse it."

Actually, if it were faster, Guo Ziyuan could have finished even faster.

The current speed is indeed what Guo Ziyuan considers a normal speed.

Guo Ziyuan had a feeling that if he wanted to, he could even do it in three minutes!

Complete the incision from the anterior abdominal wall to the skin exit on the back of a patient!

Three minutes is enough.

This is the instinctive confidence that Guo Ziyuan developed after his incision technique reached the level of a national champion.

It's not just about being fast, it's also about being accurate!

Tan Wenyuan then turned his attention back to the surgery itself: "The appendicitis abscess hasn't ruptured, and there's no local inflammation, so there's no need to flush it."

"Just wipe it dry."

Tan Wenyuan looked at the appendix stump, but he didn't even see a drop of blood.

This is enough to prove that Guo Ziyuan has truly mastered every operational detail.

This pursuit of excellence does not come at the cost of "delaying time".

There's no such thing as slow and meticulous work; only speed and finesse!

Guo Ziyuan then began suturing the abdominal wall membrane.

After suturing the abdominal wall membrane, he realized that Tan Wenyuan had no intention of suturing the skin!

Then I picked up a cheaper cosmetic suture and used it to finish the cosmetic suturing of the outer layer of the abdominal opening.

Once Tan Wenyuan was on the operating table, he naturally became the surgeon.

With everything in place, the surgery was finally declared over.

Wrap it in gauze and cover it with tape.

When preparing to transfer the patient to the bed,

Guo Ziyuan then realized that the patient was under general anesthesia: "Anesthesiologist, you can wake the patient now."

The anesthesiologist is of course waking the patient up.

In fact, the amount of medication he prescribed was far excessive.

At that moment, the young anesthesiologist looked at Tan Wenyuan with a strange expression: "Good morning, Dr. Tan."

"Thank you for the gift..." He pointed to a pile of anesthetic pills on the tray.

"I'll give them all to you tonight."

Tan Wenyuan hesitated, as if he wanted to say something but then stopped.

Can he talk to Guo Ziyuan now?

Before he went to see Guo Ziyuan, did he come to his anesthesiology department buddy to make a deal?

Tan Wenyuan was able to tell Guo Ziyuan that he had considered that this was Guo Ziyuan's first time undergoing an appendectomy, so he had Lan Youqi from the anesthesiology department choose general anesthesia.

And they even told him that the surgery might take a long time.

Tan Wenyuan checked the surgery time—

00:10:23:33!

It was as if even the operating room timer panel was mocking him for being a clown.

If the anesthesiologist draws up the medication but doesn't administer it to the patient, it cannot be returned.

If I can't keep accounts for the patients, I'll have to keep accounts myself.

More importantly, they are anesthetics, not other drugs.

Even if Lan Youqi wanted to record it in his own account, he still had to submit reports to his superiors, the department head, and the head of the pharmacy department.

We need to confirm that you wasted or lost it.

Instead of you taking it back for yourself.

If you can't explain it clearly, that can be very serious.

Tan Wenyuan's lips twitched: "Brother Lan, can we talk about this another day?"

Lan Youqi raised an eyebrow: "Who slept with whom?"

"You fuck me!" Tan Wenyuan said sincerely.

"You're more like it." Lan Youqi's mood calmed down a little.

He was to prepare for a scolding from the director and a barrage of criticism from the pharmacy department...