Challenge (7)
Snap!
The suture broke with the sound of scissors.
With this, all three major blood vessel anastomoses of the liver were completed.
“Head Chief. Shall we begin reperfusion?”
Smith nodded in response to Todd’s question.
Reperfusion is the process of releasing temporarily blocked blood vessels and allowing blood to flow.
When the clip holding the blood vessel was released, the blood vessel wriggled.
The liver, which had previously been dark, gradually regained its original color.
“Respiration decreases and blood pressure decreases: 80 mmHg systolic and 40 mmHg diastolic.”
“Let’s wait and see.”
Smith answered calmly.
Reperfusion is an unavoidable challenge in liver transplant surgery.
When blood suddenly flows through the veins, various side effects are bound to occur.
Among them, lowering blood pressure was the most representative and mild side effect.
“Head Chief. It’s VF (ventricular fibrillation).”
“VF? Already?”
“Yes. If you look at the electrocardiogram, the waveforms of the P wave, QRS wave and T wave are not visible properly and the baseline is trembling.”
Bleep. Bleep.
As soon as Choi Ki-seok finished speaking, an ominous electronic sound spread through the rosette.
“Your heart rate goes up to 200 beats per minute and your blood pressure continues to drop.”
“Damn it. Why VF at the time of reperfusion? Liver transplant is all-stop. Todd prepares the defibrillator, Mr. Choi prepares chest compressions, Rahul prepares epinephrine.”
“yes!”
The assistants were busy following Smith’s instructions.
[You used “must be saved.” All stats temporarily increase by one level.
[You have used the awakening CPR buff. The patient’s improvement level increases depending on the type of treatment.]
Okay. puck. puck. puck.
Ki-Seok Choi pressed Jace’s chest hard.
Every time he applied pressure, Jace’s body bounced like a spring.
It may seem a bit excessive to others, but as long as you have the alert CPR buff, there is no need to worry about breaking your ribs.
‘please. Jace.’
Choi Ki-seok looked down at Jace, breathing heavily.
“I guess I’m out of luck when it comes to ventricular fibrillation.”
“I think the problem was that the surgery time was long. If the donor surgery and recipient surgery had been done at the same time, this wouldn’t have happened…” “I think the same thing. If I had done that, I would have had at least two hours to spare
.”
“My opinion is different. I think it’s because of the patient’s chronic illness or age.”
The conversation between the surgeons continued in the surgical observation room.
Although our approaches to emergency situations were different, one thing was consistent. The fact that now is the most dangerous moment in surgery.
“I mixed an epinephrine IV.”
“I have the defibrillator ready.”
“Give it to me.”
Smith stood next to Jace, defibrillator paddles in his hands.
“Head Chief. I want to use the defibrillator.”
“The reason is?”
“Shouldn’t the Head Chief check on the patient and give instructions? I want to do the treatment.”
“…Okay. Do whatever you want.”
As Smith retreated, Ki-Seok Choi began preliminary work to use the defibrillator.
“Everyone get out of the way. 200j!”
“Charge!”
“Clear!”
thud!
Smith’s body wriggled with electrical stimulation.
“One more time. 200j!”
“Charge!”
“Clear!”
thud!
Choi Ki-seok used the defibrillator and started chest compressions again.
Even then, Jace showed no improvement.
“Give me another dose of epinephrine and administer amiodarone as well.”
“All right.”
On Smith’s instructions, Rahul began administering the injection.
Chest compressions and defibrillation injections continued continuously. The staff members’ bodies suddenly became wet with sweat and their eyes lost their vitality.
The patient was already dead and the surgery was a failure.
Although most people felt defeated, Choi Ki-seok and Smithman enthusiastically pursued treatment.
The actions and voices of the two people conveyed the desperation that they could not give up on the patient.
“Head Chief, it’s been over 30 minutes since I did CPR. I’m sorry, but I’m done…”
Todd spoke to Smith cautiously.
The end of his words were blurry, but everyone could tell what he was trying to say.
“The surgery isn’t over yet.”
“I understand your feelings, but…”
“Shut up and quickly charge the defibrillator. Can’t you do it? Then I’ll do it myself.”
Smith pushed Todd and took a seat behind Ki-Seok Choi.
“Keep going. 200j!”
“Charge!”
“Clear!”
thud!
Choi Ki-seok used a defibrillator, checked the circulation, and began chest compressions.
Pop. Pop. Pop.
Sweat poured down my face like rain.
Because I was in charge of chest compressions alone, my physical strength was very high. But I couldn’t give this position to someone else.
Because we need to take advantage of the effects of awakening CPR.
‘cheer up. Jace.’
Ki-Seok Choi took a deep breath and looked down at Jace.
I wanted to see his smile that I saw right before the surgery one more time.
I wanted to restore the joy of life I had lost after my daughter passed away.
Still, I wanted to let people know that the world is still worth living in and that it is not a complete hell.
‘You idiot! wake up. Wake up. Why are you doing this after taking William’s liver? Do you want your son’s sacrifice to be in vain? Do you want your wife to cry for the rest of her life? If that’s not what you want to see in the sky, come back now. ‘Get back to normal!’
The words I spit out in rapid fire came to an end.
Ki-seok Choi, who had finished performing chest compressions, suddenly stood in his place. CPR, which had continued for a long time, was cut off for the first time.
Thick tears and sweat drops tangled together and flowed down my cheeks.
So so so so so.
Frozen Heart passive broken.
At the same time, the blue energy surrounding his body disappeared.
The fear, sadness and frustration I felt during CPR.
As various emotions surged to the extreme, the Frozen Heart passive stopped working for the first time.
“What… what do we do now?”
“You’ve worked hard, Mr. Choi. This is something we can’t help. It’s not our fault.”
Todd consoled Choi Ki-seok.
So far, everyone has done their best, especially Choi Ki-seok, who has done his job 200 percent.
Showing off incredible skills as a new resident.
“Why are you standing there like an idiot? Keep killing them.”
“But…”
“If we give up on the patient, no one will be on the patient’s side.
Smith took care of the treatment alone.
No one could say anything to his pitiful appearance.
Choi Ki-seok watched Smith blankly and belatedly approached him to provide treatment. “Mr. Choi ,
can’t you open your eyes straight? Your eyes are acknowledging that the patient is dead. You can’t save a patient with those eyes. Just like before, you have to do it desperately.”
“….”
“Knock! If you’re going to do something like that, get out of there. Korean Monkey! There is also a patient who survived after two hours of CPR. I can’t believe I gave up like this. I looked at you wrong.”
Smith’s curse penetrated his heart.
At this, Choi Ki-seok’s blurry eyes slowly regained life.
“I was a fool. We will continue to treat you.”
Ki-Seok Choi and Smith continued CPR, followed by Todd and Rahul.
“Mr. Choi. “You said you majored in thoracic surgery in Korea, right?”
“Yes. That’s right.”
“Can you do thoracocardial heart massage?”
“You can.”
“Then go for thoracocardial heart massage instead of chest compressions. If things continue like this, there will be no improvement.”
“Head Chief. It’s a thoracotomy heart massage. That’s too reckless.”
Todd, who had been quiet, raised his voice.
“Are you pouting at my words?”
“I understand your desire to save the patient, but if you do it wrong, the patient will be in more danger. It is true that Mr. Choi is superior to his classmates, but you must not forget that he is a new resident.” ”
Age and experience are not necessary when a patient is dying. I’m just doing everything I can as a doctor.”
“B… But…”
“You idiot! I take responsibility. You two switch places.”
Under Smith’s instructions, Choi Ki-seok moved up to the first assistant and Todd went down to the second assistant.
Sigh. Ki-seok
Choi disinfected the patient’s chest with povidone solution and then covered it again with a cloth. So Smith used the scalpel. He cut the skin from the bottom of the patient’s neck to the solar plexus.
Jeeeeee.
Ki-Seok Choi cut open the sternum with a chainsaw and slightly pushed out the lungs.
The heart finally revealed itself.
Jace’s heart was motionless, as if it was asleep.
” “Start the thoracotomy heart massage.”
He held Jace’s heart in one hand and massaged it with moderate force.
‘You can do it. Don’t give up.’
Choi Ki-seok continued the massage, repeating the same words to himself.
Whiiiiing.
As he got his emotions together, the effect of the frozen heart began to kick in again.
“One massage is over. Please use the defibrillator.”
Choi Ki-seok stepped back to the second line and Todd used the defibrillator.
Boom!
Jace’s body shook.
After checking the condition with the patient monitoring device, Choi Ki-seok started massaging the heart again.
But that was the moment.
The white light emitted from his hand enveloped Jace’s heart.
At the same time, his heart, which had stopped as if dead, showed a slight beat.
‘This… this!’
Choi Ki-seok flinched in surprise.
In the past, Choi Mi-soon had received the title of lifesaver. That title had the effect of resurrecting patients at 20 percent, and the resurrection effect had appeared. “I think my heart just moved
? ”
“I saw it too,”
Rahul added to Smith’s words.
I found hope for the first time in the first aid treatment that lasted for nearly 40 minutes.
Heart massage and defibrillation medication followed.
Thump, thump, thump, thump.
The staff’s efforts . With effort and persistence, the heart regained its beat.
“We did it!”
“Spontaneous circulation has returned!”
The staff’s shouts echoed throughout the rosette.
If it weren’t for the contamination issue, they would have hugged each other and shared their joy.
“Thank you, Jace.” .’
Choi Ki-seok looked down at Jace and shed tears with a different meaning than before.
“Everyone must not forget. In Rosette, the doctor is god. “If a doctor gives up on a patient, it’s like God giving up on the patient.”
“I’m sorry. My thoughts were too short.”
“I’ll keep that in mind.”
Smith nodded in response to Todd and Ki-Seok Choi’s response.
“Now that his vitals have returned to normal, the liver transplant surgery will resume. “Keep your wits about you until the end.”
Smith connected the patient’s bile duct to the intestines.
Bleeding occurred in the middle, but he wisely went over it.
The laparoscopic bleeding control device he brought from Korea played a vital role. This
is the final step after biliary anastomosis . The liver suture was unfolded.
The process of suturing the front of the liver with 12 stitches and the back with 24 stitches.
Although he was probably exhausted due to the long surgery time and emergency situation, Smith completed the suturing with neat workmanship.
“Phew… I’ve been through the whole war.” “It’s the same.”
Ethan breathed a sigh of relief while placing his hand on his chest.
The first laparoscopic living liver transplant surgery performed at Meijo.
The nearly ten-hour journey was coming to an end. There were many twists and turns along the way, but I believed that it would be a success as the staff put in their blood and sweat.
‘Mr Choi. What are you…’
Ethan’s gaze was fixed on Choi Ki-seok.
An aspiring cardiothoracic surgeon from Korea.
He always stood at the center of various issues and showed brilliant performance.
Just today, he impressed others with his presence by providing the surgeon with a perfect surgical field of view and performing a thoracotomy heart massage.
Once you are finished as a fellow, you will become a warrior that no one can approach.
While I was lost in thought for a moment, the surgery was completed.
The eyes of staff and observers were simultaneously focused on the patient monitoring device.
* * *
Jiiiing.
The operating room door opened and Smith and the staff came out.
Julie, who was shaking nervously in the waiting room, found them late.
“Dr. Choi. How was the surgery?”
Julie ran to her doctor, Ki-Seok Choi.
“The surgery… was successful. However, we need to wait a little longer as there may be transplant rejection.”
“Thank you. Hehehehehe.”
Choi Ki-seok hugged Julie, who was sobbing, and patted her back.
However, as he was comforting her, he soon began to cry with his whole body.
The doctor, who was supposed to care for Jace more than anyone else, ended up giving up on Jace even for a moment.
“I’m sorry, Julie. I’m so sorry. I….”
