Chapter 50: Canine Thoracotomy
The spacious operating room was hushed. The three operating tables, where the surgeries were ongoing, were illuminated by their respective shadowless lights.
On one of the tables, Gu Jun made a 15cm skin incision on the jinmenken and said, "Curved scissors." He took the curved surgical scissors which Cai Zixuan, who was standing to his right, quickly handed over, and slowly sliced open each layer of subcutaneous tissue, skin muscle, and ventral pectoral muscle. Wang Ruoxiang, who was standing on his opposite end, was silent and focused on hemostasis.
All three of them were fully immersed in the operation. Occasionally, they would notice the terrifying human countenance, but they merely treated it as part of the background.
Gu Jun had to be extremely meticulous in order to minimise the damage to the tissues. The scissors need to be as close as possible to the leading edge of the ribs to avoid the blood vessels and nerves between the intercostals. If a blood vessel was accidentally cut off, that would be a real nightmare for the primary surgeon.
However, he was still brimming with spirit. His mental energy, eyesight, and the strength exerted in his hands were all accurately controlled and steadily cut down down layer by layer. There was no horrifying scene of blood suddenly spewing out.
"Turn on the ventilator," Gu Jun said again. As he was entirely absorbed in operation, his face remained expressionless and his words were spoken rather quietly. Cai Zixuan knew his duties and shouted, "Circulating nurse, come over and turn on the ventilator!"
Each operating table had conventional instruments such as a ventilator and electrocardiogram monitor. Some of them were put into use when the circulating nurses brought in the jinmenkens before. Upon hearing Cai Zixuan's call, a circulating nurse came over immediately and helped activate the animal ventilator to provide oxygen via positive airway pressure.
The moment when the jinmenken exhaled, Gu Jun opened its intercostal muscles and pleura.
There was a slight layer of sweat matting his forehead, but his hands remained steady. "Towel." He placed the wet sterilised towel on the edge of the incision of the surgery. "Retainer." He then put on the retainers. "Retractor." He then took the retractor and expanded the incision evenly, widening the area for operation, and affixed the retainer on the retractor to make sure that it stayed on.
At this point of the surgery, the surgical access to the heart and hilar area had been completely opened even though the operation area looks like a pile of cutaneous and pericardial blood.
At the same time, a group of spectators standing nearby whispered to Zhou Jiaqiang.
"The primary surgeon is Gu Jun." Team Leader Qiu wore the smile of a proud mother, but his blatant satisfaction was unsurprising. "The next generation is indeed talented." Even in this situation, there were still some things that left one gratified. The discovery of this stunning young man was one of them.
The five new primary surgeons were all pleasantly surprised. This was akin to striking gold while digging for silver. They were here to find a third assistant but got a second assistant instead.
The jinmenken retained the dog's physical characteristics; the chest wall having a large curvature, and the costal margin of the diaphragm situated lower. There were technical difficulties in cutting it, which was different from ordinary experimental animals. However, Gu Jun's handiwork was truly phenomenal. His hands were steady and fast. They thought several times that he had to cut the blood vessel to proceed further, but the result was that he didn't do so.
Many people will have a so-called professional ‘sense of smell'. This applied to surgeons as well. They were able to ‘sniff out' where the problematic areas and what kind of force needed to be used to deal with the problem, but this ‘sense of smell' and skills from expertise required years of experience to develop.
Gu Jun's exemplary performance seemed like he already had developed such a sense, but they heard that this was his very first operation.
This kind of talent was truly born to perform surgery.
"Team leader Qiu, I thought your words were over-exaggerated to some degree, but now I realised that they were actually less exaggerated."
"He already reached this degree of expertise. What else is there to cultivate? Give me Gu Jun. He can come to my side to become my third assistant."
They spoke very softly, afraid of disturbing the surgeons. At this time, Zhu Ruiwen, one of the new primary surgeons, couldn't help but scoff loudly. "Third assistant? Why are you giving such cold treatment? With his skills, there is no problem with him being the second assistant. I will let him be my second assistant."
"We still have to take a look at his ligation techniques!"
Team Leader Qiu watched his subordinates practically reenact the scene of robbing people, and found it a little funny. He then stopped their petty argument, acting somewhat like Elder Qin and said: "Stop being so noisy. We're in the operating room. Let's take a look at his ligation first. Ah Qiang, it's enough for them to do this much, there's no need to proceed further. Start the ligation."
"Yes." Zhou Jiaqiang was about to step forward and relay the message. His expression was extremely self-satisfied.
Gu Jun was about to carry out further pericardial examination. At this time, the electrocardiogram monitor next to him suddenly issued a drip alarm. Wang Ruoxiang called. Her face scrunched up into a frown. "The animal has a cardiac arrest." Gu Jun weighed the values on the monitor. He determined that it was a typical case and said, "Intravenous injection of epinephrine, 0.2ml per kilogram of body weight."
This human face dog weighs 16.3 kilograms, which is 3.26 ml.
"3.26 ml…" Cai Zixuan murmured and carefully counted. "Is this the amount?" Gu Jun and Wang Ruoxiang cried out in unison, "Yes!" Gu Jun urged again, "It's fine to use any amount between 3-4ml. Hurry!"
Cai Zixuan quickly used a disposable trumpet syringe to dispense the medicine, and called for the circulating nurse to proceed to the hind leg of the jinmenken for intravenous injection.
After injecting the dose of epinephrine, the jinmenken's heartbeat stabilised again after a while and required no further treatment.
Over at Team leader Qiu's side, the group of spectators watched as Gu Jun dealt with the situation calmly without any hassle. They added another point to compliment!
Sudden cardiac arrest during the operation was a scary thing. Everyone knew to apply epinephrine, but some people just couldn't think of it at that point, especially novice rookies who would become flustered and blank out. It was thus really rare for an intern to perform like Gu Jun.
They are also paying attention to the other two operations, which was less meaningful in comparison. Both were the same thoracotomy method. However, the other two primary surgeons were still busy trying to stem blood flow. Because of problems such as overly deep cuts and severed blood vessels, they had to use an electrocoagulation knife. Fortunately, this was just an experimental animal.
"Ah Jun, don't proceed further and begin ligation," Zhou Jiaqiang went up and relayed Team Leader Qiu's message.
"Understood," Gu Jun nodded and let himself remain calm and focused. He began to close the incision and brought out the techniques he had worked hard refining over the past half a month.
He first used a rib spreader to reduce the proximity between the ribs on both sides of the incision and ensure the area of incision was close, but not overlapping. He then used a single strand of absorbable suture and stitched 6 times to tighten and affix the ribs on both sides. He then swapped the absorbable suture and sutured the intercostal muscles first. For other muscle layers, he used a double intermittent suture method.
The spectators watched as Gu Jun sewed layer after layer, clearly separating the primary muscles and the component muscles of each layer. The technique was crisp, and the ligation was smooth.
It was simply like running clouds and flowing water; there was not even the slightest vibration or extra movement in his actions.
Those hands were simply the practised hands of surgery veterans.
"Team Leader Qiu," Zhu Ruiwen scrambled to look at the leader, "there's no issue with him being the second assistant."
The other four newly appointed primary surgeons also knew that there was no problem, and they all begged to have Gu Jun on their teams.
"My ligature skills are not even as good as his!"
"This kid must have practised extensively."
Zhou Jiaqiang knew that they were deliberately saying these self-effacing sentences. No matter how formidable his skills were, Gu Jun was an intern after all. He couldn't match up with this group of old fritters.
However, the main job of the second assistant was to stitch and ligature the superficial layers. After these primary surgeons and first assistants were done with work on the deeper layers, the work was handed over to the second assistant. As the surgery will be done one after another, they need to save their energy for the next operation. If the second assistant was as capable as Gu Jun, the primary surgeon can be rest assured when handing over the task.
Brother Qiang also nodded and agreed to let Gu Jun leap through the ranks and be the second assistant. "Team Leader Qiu, that kid is improving every day and is a meticulous and diligent person."
"Well…" Team Leader Qiu was still pondering. The primary purpose this time was to select the third assistants. The reason why the second assistant was being brought up was because of Gu Jun. "He's indeed incredibly skilled. This is his advantage. However, he does not have any experience with human surgery. If faced with patients with the Malformation Banyan Disease…"
Team Leader Qiu felt that he had become Elder Qin. The goggled-eyes faces that Zhu Ruiwen and the others were revealing were really similar to his and Elder Zheng's that day.