84: Chapter 84: A spleen resection completed in thirty-eight minutes?
Lu Chen stood in the correct position at the Operating Room table.
The shadowless lamp was turned on.
The white light shone down, illuminating the entire surgical area.
"Start."
Lu Chen picked up the scalpel.
Midline abdominal incision.
From below the xiphoid process to three centimeters below the umbilicus.
With one stroke, he cut through the skin, subcutaneous tissue, and the anterior rectus sheath.
Separated the rectus abdominis.
The moment the peritoneum was cut...
A large amount of dark red blood gushed out.
As expected.
The abdominal cavity was full of blood.
"Suction!"
Shen Xiaoning immediately handed over the suction tube.
Lu Chen quickly explored while suctioning the accumulated blood in the abdominal cavity.
The Eye of Truth was running simultaneously, precisely marking the situation inside the abdominal cavity.
The spleen, found.
Comminuted rupture.
The entire spleen had shattered into three large pieces, the surface covered with irregular lacerations, and the vessels of the splenic hilum were still spraying blood.
"Splenic comminuted rupture confirmed, Splenectomy required."
Director Li Sen looked over from the opposite side.
"Seen it. Control the bleeding at the splenic hilum first."
Lu Chen nodded.
His left hand reached into the abdominal cavity and pinched the splenic hilum with his fingers.
The pressure of his fingertips was precisely controlled to just block the blood flow without damaging the surrounding tissue.
The bleeding immediately decreased by more than half.
"Splenic hilum clamp controlled, starting to mobilize the spleen."
He began to separate the connections between the spleen and the surrounding tissues step by step.
Splenocolic ligament, cut.
Splenorenal ligament, cut.
Gastrosplenic ligament, ligated and then cut.
Every step was steady, every cut was precise.
Director Li Sen watched silently from the opposite side, saying nothing.
It wasn't that he didn't want to speak.
It was that there was no need to speak.
Every move Lu Chen made was above standard.
His technique didn't look like that of a Resident Physician.
It didn't even look like a young attending physician.
It was more like a veteran who had done hundreds of Splenectomies.
The final handling of the splenic hilum was the key.
Lu Chen used a double ligation method to handle the splenic artery and splenic vein. After confirming there was no oozing, he removed the shattered spleen in its entirety.
"Splenectomy complete."
He handed the curved tray containing the spleen to the Nurse beside him.
"Next step, check the abdominal cavity for other injuries."
Lu Chen once again used the Eye of Truth to scan the abdominal cavity comprehensively.
Left kidney contusion, but no rupture, capsule intact, no surgical treatment needed.
No obvious damage to other organs.
"No other active bleeding points in the abdominal cavity, a small amount of oozing in the splenic bed area, I will perform electrocoagulation hemostasis."
Electrocoagulation hemostasis.
Handling one oozing point after another.
Three minutes later, the splenic bed area was dry.
"Check the wound, no active bleeding, abdominal irrigation."
Warm normal saline was injected into the abdominal cavity, and after irrigation, it was suctioned clean.
The abdominal cavity was clear.
"Place the drainage tube, close the abdomen."
The drainage tube was placed in the splenic fossa position.
Lu Chen began to close the abdomen layer by layer.
Peritoneum, continuous suture.
Anterior rectus sheath, Interrupted suture.
Subcutaneous tissue, absorbable suture.
Skin, Interrupted suture.
Every stitch was neat, and the spacing of every stitch was consistent.
From skin incision to completion of abdominal closure.
Total time, thirty-eight minutes.
Zhao Ming glanced at the clock on the wall of the Operating Room.
"Thirty-eight minutes to complete a Splenectomy?"
His voice carried obvious disbelief.
"How many Splenectomies have you done before?"
Lu Chen was tying the knot for the last stitch.
"The first one."
Zhao Ming was silent for a long time.
Then he turned his face to Director Li Sen.
"Director Li, how do you train the Resident Physicians in your Emergency Department? Can you share the methodology with our Department of Anesthesiology?"
Director Li Sen took off his gloves.
His expression was calm, but there was something deep in his eyes.
"There is no methodology; some people are born to do this job."
He patted Lu Chen on the shoulder.
He didn't say much else.
But the force of this pat was heavier than any praise.
A system prompt popped up.
"Ding! Emergency Operating Room task progress: 2/5"
"Calculating surgical experience for this operation"
"Surgical difficulty rating: A+ grade"
"Triggered five-fold experience critical hit!"
"Task additional bonus 30% has taken effect"
"Emergency Surgery Skill Enhancement Card 50% bonus has taken effect"
"Comprehensive experience multiplier: 9 times!"
9 times.
Lu Chen took a deep breath in his heart.
A+ grade, five-fold critical hit, plus the stacked multipliers, it shot straight to 9 times.
He didn't have time to look at the detailed settlement yet, because there were injured people waiting outside.
He didn't have time to look at the data in detail.
He pushed open the door of the Operating Room and returned to the Red Zone.
...
3:45 PM.
The Red Zone was still operating at high speed.
Rescue operations under the mine were still ongoing, and injured people were still being sent in continuously.
Wu Fan and Sun Ji were each in charge of a resuscitation bay, having already treated seven or eight injured people.
Since Zhou Ze came over from the Yellow Zone, he had been coordinating consultations with various departments, having made no fewer than twenty phone calls.
Zhao Yaqin had been standing in front of the Triage Desk for nearly two hours, and her voice was a bit hoarse.
After Lu Chen came out of the Operating Room, he immediately threw himself into the reception work outside.
In the next hour, he treated six injured people in a row.
Two Debridement and Suturing for head and facial injuries.
One temporary fixation for a forearm fracture.
One observation and treatment for chest wall contusion complicated by subcutaneous emphysema.
Two Debridement and Suturing for lower limb soft tissue lacerations.
The Eye of Truth helped him accurately judge the severity of each injured person's condition, allowing him to quickly prioritize them.
Shen Xiaoning was always by his side, handing instruments, recording data, and preparing supplies, her movements becoming more and more proficient.
Although there was always tension on her face, she hadn't made a single mistake.
4:50 PM.
Another ambulance arrived.
This time, they brought a miner who had been trapped the longest.
"This person has been crushed for nearly four hours!"
The emergency personnel shouted.
Zhao Yaqin ran over to take a look.
"What is the blood pressure?"
"Systolic pressure of 62!"
"What about consciousness?"
"It comes and goes!"
"Red tag! Send to the resuscitation bay!"
Lu Chen rushed over.
Eye of Truth locked on.
"Eye of Truth scan complete"
"Patient information: Male, 41 years old"
"Chief complaint: Crushed by a giant rock on the left thigh for about 4 hours during the mine collapse, rescued 20 minutes ago"
"Eye of Truth diagnosis: Left femoral open comminuted fracture, left thigh compartment syndrome (extremely high pressure), rhabdomyolysis (myoglobin seriously exceeding the standard), early stage of acute kidney injury, crush syndrome"
"Danger level: S grade (extremely critical)"
"Current symptoms: Severe swelling of the left thigh, skin cyanosis, dorsalis pedis artery pulse disappeared, blood pressure 62/40 mmHg, heart rate 141 beats/min, oliguria, blurred consciousness"
"Recommendation: Perform left thigh fasciotomy decompression immediately, while simultaneously massive fluid resuscitation and urine alkalization to prevent myoglobin from blocking renal tubules, emergency surgery required"
"Warning: Compartment pressure is extremely high; if not decompressed immediately, amputation risk will be faced within 6 hours; if crush syndrome is not treated in time, acute renal failure will occur within a few hours, with risk of death"
Lu Chen's expression became grave.
Crush syndrome.
This is one of the most dangerous conditions among mine disaster casualties.
Having been crushed for four hours, a large amount of substances like myoglobin and potassium ions released by muscle necrosis entered the blood circulation, which could lead to acute renal failure and fatal arrhythmia at any time.
Moreover, the compartment syndrome in the left thigh was already very serious.
Skin cyanosis, dorsalis pedis artery disappeared.
If fasciotomy decompression was not performed immediately, the leg would not be saved.