Healing Doctor

Chapter 287 Synchronization Caution

Ji Xiang dissected the peritoneal reflection at the top of the bladder, opened the bladder, and used a small retractor to pull the bladder open, exposing the fistula.

Lu Gang stood behind, his eyes fixed intently on the surgical area.

Director Liu stood opposite him, obediently acting as his assistant, which Lu Gang found very puzzling. Director Liu wasn't usually like this; although he didn't oversee the surgeries and was quite hands-off, he was definitely not the kind of director who was easy to talk to or lacked principles.

Even if it's about letting go and trusting, this is still unfair. Lu Gang had mixed feelings.

After opening the abdomen and seeing the fistula, Ji Xiang asked for a regular urinary catheter. Lu Gang's vision was restricted, so he turned around and moved a footstool to the ground.

With the added height of the footrest, Lu Gang could see the surgical area just above Ji Xiang's shoulder.

He saw Ji Xiang insert a regular catheter into his vagina through the fistula, while Zhao Zhe waited below and pulled the catheter out of his vagina.

Even after seeing this, Lu Gang still didn't understand the purpose of billiards.

After inserting the catheter, Ji Xiang punched a hole in the top of the sterilized billiard ball and handed it to Zhao Zhe.

Zhao Zhe securely tied the catheter to the tip with a traction wire.

After doing all this, Zhao Zhe looked up at Ji Xiang.

"Brother Zhao, let's begin." Ji Xiang nodded in acknowledgment.

"Okay." Zhao Zhe pulled back the catheter and the upper traction line.

Zhao Zhe pushed the billiard ball up with his right hand, and the billiard ball easily went into the fistula.

This is……

Lu Gang was puzzled.

Ji Xiang tightened the upper traction line of the billiard ball inside the fistula, lifting the anterior wall of YD to fully expose the fistula.

The last surgery failed mainly because the fistula was not well exposed due to the many folds in the bladder wall.

This is similar to how Mr. Wu used a zebra guidewire to locate the ureteral opening in the bladder.

But this time, with the support of the billiard ball, the force pressed against the soft wall, and the fistula was exposed quite well.

Lu Gang was stunned.

He knew the surgery would definitely be completed once it reached this stage, and that it was indeed possible to complete it.

It would be the same if I were to do it myself; the subsequent surgery would be no problem at all.

Lu Gang was a little dazed; so this is what it means to perform surgery using a billiard ball!

Ji Xiang fully exposed the fistula, then cut away the scar tissue at the edge of the fistula wound, and appropriately separated the bladder and vaginal walls.

"Sheep gut sutures." Ji Xiang held out his hand. "2-0."

Tang Yan deftly threaded the needle, using a very fine catgut thread, and hit the target perfectly. She then placed the needle holder in Ji Xiang's palm.

Ji Xiang used 2-0 catgut to perform longitudinal interrupted full-thickness sutures on the YD wall, and then used No. 4 silk sutures to perform transverse interrupted mattress sutures on the bladder wall muscle layer.

Lu Gang quickly noticed a detail: the sutures Ji Xiang used did not penetrate the entire layer.

The sutures do not penetrate the entire thickness; instead, the needle and thread pass between the seromuscular layer and the mucosal layer, causing the tissue at the wound edge to invert, keeping the outer surface smooth, ensuring good apposition, and reducing adhesions. This technique is commonly used for anastomoses of the gastrointestinal tract and bladder.

After suturing, the serosal layers fit together tightly, which is beneficial for wound adhesion and healing.

It sounds simple, but Lu Gang has never met anyone who can do it as quickly and well as Ji Xiang.

Moreover, he knew very well that, setting aside the incredible table tennis skills, he couldn't achieve the same level of perfection as Ji Xiang in just the stitching process.

Are all those established experts and professors at the Second Affiliated Hospital really inferior to a resident trainee?

Gradually, a sense of loss and gloom settled over Lu Gang's heart.

Ji Xiang finally used 3-0 catgut sutures to intermittently suture the bladder mucosa, and then pulled out the traction suture left outside the vagina to remove the table tennis ball from inside the vagina.

An adult size 18 balloon catheter was inserted into the urethra, and Ji Xiang injected 15 ml of saline into the balloon using a syringe.

The mucosal layer of the bladder incision was continuously sutured with 2-0 catgut, and the outer layer was intermittently sutured with 6 silk suture, with the sutures still not penetrating the mucosa.

Ji Xiang's hands were very steady, and he performed difficult maneuvers with ease, as if they were not difficult at all.

After the suturing was completed, Ji Xiang injected methylene blue solution into the bladder through the catheter.

Lu Gang's eyes widened in disbelief; he knew this step was the only standard to verify the results of the recent surgery.

If there is no leakage, it proves that the suture was done well.

During the last surgery, after Dr. Liu finished suturing and injected methylene blue, there was always seepage. In the end, he couldn't suture anymore. Although there was seepage, it wasn't much. He could only comfort himself and hope that it would heal on its own.

Unfortunately, the fistula did not heal...

What about this time?

Ji Xiang waited 5 minutes after injecting Meilan.

After surgery, the atmosphere in the operating room is usually very relaxed while waiting for certain examinations; everyone is chatting and laughing.

However, this patient was involved in a medical dispute, and the surgery was the second or third time the patient had undergone the procedure. It looked like the stitches were very tight, but who knows what would happen?

The atmosphere in the operating room was oppressive; no one spoke.

Especially Director Bai, who stood directly behind Zhao Zhe, watching him intently without blinking.

Time passed by, second by second.

No seepage

No leakage!

No seepage!

"Brother Zhao, are you alright?"

"fine."

"Prepare to shut down."

"Wait a minute!" Director Bai and Director Liu said in unison.

"Hmm?" Ji Xiang asked, puzzled. "What's wrong?"

"Wait a little longer," the two said in unison once again.

There were hundreds of patients' family members outside the government building, and both veterans displayed extreme caution.

"..." Ji Xiang said helplessly.

The two were being overly cautious. They guessed that Director Liu was like someone who had been bitten by a snake once and was now afraid of ropes for ten years. After stepping down, Director Bai would have to face a hundred or so patients' families downstairs, so he needed to confirm things repeatedly.

After waiting another ten minutes, he wiped the area with a clean gauze and repeatedly confirmed that there was no more methylene blue seepage. Then, Director Bai breathed a sigh of relief and turned to leave.

Director Liu looked up at Ji Xiang and said, "Little Ji, you did a good job."

Ji Xiang smiled, inserted a balloon catheter, and then began to close the abdomen layer by layer.

"Xiao Ji, this is the first time I've heard of this method." Director Liu said with a relaxed mood and a happy expression. "You have no idea how many ways I tried to cope with the last surgery. I even tried using my fingers and other things, and I almost got pricked by the needle. I never thought that a table tennis ball could solve the old problem."

Ji Xiang smiled but didn't say anything.

Director Liu knew that whatever Ji Xiang said at this moment would be wrong, but he had witnessed a surgery that solved the problem with a table tennis ball, which was like a miracle from heaven. He felt relieved but also a little excited.

Mr. Wu chuckled and walked from behind Director Liu to Lu Gang's side.

"Director Lu, you see, I told you the surgery could fix it."

Lu Gang looked somewhat bewildered, staring blankly at the surgical area, seemingly oblivious to Mr. Wu's subtle sarcasm.

It wasn't until Ji Xiang turned around and nearly knocked Lu Gang over that he came to his senses.

"I'm sorry, Director Lu," Ji Xiang apologized.

Lu Gang's face was obscured by his mask, and he stood blankly in the corner, like a student being punished.

Ji Xiang's surgery was clean and neat, unlike some doctors whose surgical areas are messy and incomprehensible to others.

Clean, simple, and anyone can tell what Ji Xiang is going to do next.

Lu Gang really didn't expect that billiards could be so useful.

(End of this chapter)