Chapter 896: No Urine
Zheng Ren had a preliminary a.s.sessment of the difficulty of this patient’s surgery.
Liver hydatid disease, a patient with an autogenous liver transplant, and the System did not even give him a task rating. But this patient actually gave him an S rating.
Was the surgery Grade S?
Zheng Ren was stunned. What was the difficulty? To preserve the kidney?!
He recalled the image of the kidney that appeared on the radiographic films and began to reconstruct it in his mind. Both of the kidneys were severely damaged, and it was very difficult to preserve them. Even with Zheng Ren’s own standards, it was indeed very difficult to preserve them.
He had a grandmaster-level skill book in his hands. Once he needed it, he could try to use it. Then, if there was still some time left for the surgical training, and he should be able to complete this surgery.
However, the S-rank surgery was like a lingering shadow that shrouded Zheng Ren’s heart.
Judging from the System’s judgment, he knew that Chief Miao was just trying. The probability of success was less than 20%. However, it was still better than looking at the radiographic films and thinking that there was no way to perform the surgery and that he had to wait for death.
“Let’s do it together. We have to hurry. We can’t be delayed,” Chief Miao said.
He scrubbed his hands and went on stage.
Fang Lin did not have a seat. The chief of the Chest Department must have heard from the Emergency Department that the chest injury was not serious, so he had to come up later. Fang Lin would be able to come up with a chest bottle.
The Hepatobiliary Department, the Urology Department, and the Interventional Department would open the stage at the same time.
Bags of warm plasma were poured in, but the blood pressure was still extremely low. Time was of the essence. No one spoke in the operating theater. Only the sound of hurried footsteps echoed in the air.
It was difficult to even lay down a single sheet, but it was enough for everyone to deal with it.
Zheng Ren pressed Chief Kong toward the chair, indicating that he alone would be enough. Then, he went to put on lead clothing and wash his hands.
Professor Yang and Chief Miao also wore lead clothing to wash their hands. They were not used to it. It was too awkward wearing something that weighed more than ten kilograms.
However, the interventional embolization surgery for severe pelvic fractures would take about two hours. How many threads would they need to use?!
It was possible that the surgery in the stomach had already been completed, and the interventional surgery could not be completed yet.
Therefore, the lead jacket had to be worn. It had to be awkward.
The chief resident knew that time was pressing, and they moved very quickly. Chief Yu and Chief Dong quickly laid out the list. After Professor Yang and Chief Miao came up, they stood on the right side of the patient, while the two chief resident stood in the first a.s.sistant’s position.
Zheng Ren stood on the side of his leg and asked Su Yun to lift the sterile surgical drapes to a corner. He immediately began to perform the femoral artery cannulation.
The posture was particularly awkward, but was not difficult for Zheng Ren. Chief Miao and Professor Yang had a simple exchange. When they chose an incision that both of them could accept, Zheng Ren had already completed the femoral artery cannulation and the guide wire went in.
“Prepare to step on the line,” Zheng Ren said in a deep voice when he felt that the guide wire had reached its position.
The airtight lead door was closed. Chief Miao was a little surprised. How could it be so fast? However, he did not have time to think. He cut open the patient’s abdomen from the bottom up and connected it to Professor Yang’s incision.
The skin and subcutaneous tissue were quickly separated and entered the abdominal cavity.
After taking a look, Chief Miao wanted to turn around and leave the stage.
There was a huge hematoma near the kidney. Although it was wrapped in yellow fat, it was visible to the naked eye that both sides of the kidney were shattered.
It was probably because they had come to the hospital early that they had a chance to save it. If they had come three to five minutes later, they really would not have had a chance at all.
Even so, Chief Miao felt that he could not take it anymore.
On the other hand, the injuries to the liver and spleen were relatively light. Professor Yang had already started to suture them.
Chief Miao carefully separated them and kept on ligating. He wanted to preserve at least one kidney.
However, five minutes later, he realized that he could no longer take the left kidney.
Almost all of it was shattered, and there was no way to suture it.
He made a prompt decision to block the renal artery and begin the left kidney resection. The rest could only pray that the patient’s right kidney still had a chance to be preserved…
“How much urine is there?”
“No urine,” the anesthesiologist answered immediately.
No urine! This was a sign that the kidney has completely stopped functioning.
Chief Miao was not very skilled at removing the entire kidney. To him, it would only take a few minutes.
However, making this choice was extremely difficult.
If he removed the left kidney, the surgery would be simple, and the bleeding could be stopped immediately. However, if the right kidney could not do it, what would he do?
However, the aspirator was sucking the blood from the artery. The hissing sound reminded Chief Miao that he could not hesitate anymore.
The kidney-stem forceps clamped directly, cutting off the ligaments and preparing to cut off the entire left kidney.
Because there were many people at the operating table, the scrub nurses were delivering the equipment. However, it was very inconvenient for Chief Miao to stand in the middle.
He clamped the kidney-stem and was about to ask for something when a pair of blunt scissors were slapped into his hand. The hand wearing a sterile glove took the kidney-stem forceps from his hand.
Uh…
Chief Miao was stunned.
Boss… Zheng?
“Is the surgery done?” Chief Miao asked in surprise.
“Yes, the embolization is done.” Zheng Ren took the forceps. He did not step down from the stage. Instead, he stood on the operating table and acted as Chief Miao’s a.s.sistant.
Su Yun crawled under the operating table and squeezed his way through the gaps between the people. He hid under the sterile surgical drapes and used an extremely awkward posture to apply pressure on the puncture site.
Although the patient was currently in a state of hemorrhagic shock, if the bleeding could be stopped, their blood pressure would definitely rise again. Even if the surgery was completed on the top, the blood on the bottom wet his pants.
The amount of blood loss would at least be around 1,000 ml. The patient was already in hemorrhagic shock. It would be better if they could save some blood.
Chief Miao raised his head and looked at the time. The surgery had only started for less than ten minutes, and Zheng Ren’s surgery was already completed?
“Is the retroperitoneal injury serious?” Chief Miao asked casually as he cut the kidney.
“Five blood vessels are bleeding. They are all embolized. There is no problem.” Zheng Ren knew his doubts, so he did not answer his question.
Chief Miao raised his head and looked at the screen opposite him. The screen stopped at the embolized screen. There was no post-operative contrast.
“Why isn’t there a contrast to confirm it?”
“The patient hasn’t urinated. Eating less contrast agent will be beneficial for the postoperative recovery,” Zheng Ren said matter-of-factly. “Can the right kidney be saved?”
“It depends on the situation.” Chief Miao neatly cut off the left kidney. Then, he checked the right kidney. Zheng Ren picked up the remnants of the left kidney bit by bit and placed it in the pathological basin beside him.
The left kidney was broken like a rag doll that could not be sewn up. The right kidney was slightly better, but it not by much.
Zheng Ren looked at Chief Miao trying his best to sew it up and did his best to protect the right kidney. In his heart, he knew that this was just a desperate struggle.
No wonder the System determined that it was an S-rank mission. This was simply impossible to complete.
“Su Yun, how much urine did you collect?” Zheng Ren helped Chief Miao repair it and began to ask about the urine volume.
If there were a few milliliters of urine, it could also prove that the injured person’s right kidney still had residual functions.
However, Su Yun’s words made Zheng Ren feel as if he had fallen into an ice cave.
“There’s no urine. There’s no residue in the urethra,” Su Yun said calmly.
After Chief Miao heard Su Yun’s words, his hand paused for a moment.