Training (4)
Choi Ki-seok stands in front of J Rosette where surgery is scheduled.
Perhaps because there were about twenty minutes left until the meeting time, no other staff members were visible.
So, I spent the remaining time picturing today’s surgical procedure in my head.
Although it is the first time that video assisted thoracoscopic surgery has been performed, the principle is no different from laparoscopic surgery in general surgery.
First, a small incision is made in the chest and a port is inserted into it.
This is a method of treatment by inserting a thoracoscope and tools specifically for thoracoscopy surgery into the port.
“You came first.”
Jinpyeong Wang and a resident approached him.
Jinpyeong Wang is a Chinese doctor and is currently completing his second year of residency in thoracic surgery.
“hello.”
“Aren’t you surprised? The Head Chief suddenly changed the surgical assistant.”
“I think it’s because I have a lot of scrubs.”
“Well, I’m glad you think so. Isn’t this your first time assisting with Head Chief Yasada?”
“Yes. This is my first time having VATS surgery.”
“Pay attention. Chief Yasada is usually picky, but he’s even more picky in the operating room. He doesn’t show any respect just because you’re his first assistant.”
“I’m already nervous.”
Camille, the resident nearby, trembled.
“Now that I think about it, today’s surgery is very unusual.”
“In what way?”
“Three Asian doctors got together. Oh my god, Korea, China, and Japan
are
doing joint surgery. In that sense, politicians need to reflect hard on themselves. Instead of hitting and fighting each other, they should achieve great integration like we do. Don’t you think?”
“Yes.
Choi Ki-seok burst out laughing at Wang Jin-pyeong’s flashy speaking skills.
But just then.
Even the tiger said that he would come if I told him, and Yasada joined in during the conversation.
“Were you talking about me by any chance? “Your ears were itching?”
“Yes. “I was doing it.”
“What?”
“I was talking with my juniors about what I could learn from the head chief today.”
“Isn’t it time to stop flattering him?”
“I’m flattering you. I’m always sincere.”
“That’s it. Mr. Choi. Brief the patient.”
“I understand.”
Choi Ki-seok continued his explanation.
“The patient was diagnosed with stage 2 lung cancer through a health checkup conducted by MHC. The cancerous tissue was located in the left lower lobe of the lung and was 6 centimeters in size. The surgical process…”
“That’s enough. Scrub and go into the rosette.”
The staff members scrubbed their forearms side by side with brushes.
Jiiiing.
The rosette opens when the scrub is over.
The surgeon for today’s surgery is Yasada, the first assistant is Wang Jin-pyeong, the second assistant is Choi Ki-seok, and the third assistant is Camille
. While everyone was settling down, the anesthesiologist began administering general anesthesia.
“Damien. Quickly turn the patient to the side.”
Choi Ki-seok approached the intern and whispered in a low voice.
“Huh? Why?”
“Don’t you know that the surgery is performed in the lateral position?”
“Ah… I thought it was in the supine position. Thank you, Mr. Choi.”
After the intern whispered to Camille, the patient’s position changed.
Yasada’s unpleasant command was once avoided.
“General anesthesia is over.”
“From now on, we will perform video thoracoscopic lung cancer resection for a patient with stage 2 lung cancer. Let’s start.”
“Yes!”
Camille answered bravely and began disinfecting the surgical area.
His hand rubbing the povidone cotton trembled slightly.
“Camille. “Are you kidding me?”
“Oh no.”
“Why are you dropping your hands when you’re just doing things like disinfecting? So, are you going to suture properly later?”
“I’m sorry.”
“Are you afraid that I might scold you?”
Camille hesitated at Yasada’s sharp question.
“If you want to be a good surgeon, don’t look at the surgeon or your colleagues, but look at the patient. You have to know how to see. Do you understand what I mean?”
“…I’ll keep that in mind.”
Rosette froze coldly at Yasada’s harsh criticism.
The reason other sergeants fear and avoid scrubbing with Yasada.
Choi Ki-seok realized it sooner than expected.
“Mess. .”
Yasada cut the patient’s skin with the scalpel given to him by the sterilizing nurse.
Sssssssssssssssssssssssssssing
. 10 millimeters in the mid-axillary line of the eighth intercostal space.
4 centimeters in the posterior axillary line of the fifth intercostal space.
10 centimeters in the anterior fossa of the fifth intercostal space. A sized incision was made.
Choi Ki-seok inserted the thoracoscope into the first incision and installed ports in the remaining incisions.
Surgical tools were inserted into the place where the ports were inserted.
“The preparation is good. I heard that this is definitely my first time with VATS.”
“I have experience performing laparoscopic surgery in a general surgery department. I thought the principle wasn’t much different.”
“That’s right.”
Yasada nodded.
With the preliminary preparations completed, the thoracoscope illuminated the lungs.
Ki-Seok Choi moved the camera port to control the view, even though no one asked him to.
Meanwhile . I have performed countless surgeries in the training room.
He knew the surgeon’s mind better than anyone else, and with his dragon’s eye, he was well-versed in finding the optimal surgical field of view. I was confident that I could secure the field of
view better than anyone else.
“N1 N2 lymph node abnormalities . doesn’t exist. Let’s take a look at the left lower lobe, where the cancerous tissue is located.”
Choi Ki-seok naturally led the surgical process by moving the surgical field of view, and Yasada smiled after seeing his skill.
“The full-scale resection will begin now. Scalpel.”
Yasada inserted a thoracoscope-specific surgical tool into the port.
Chiiik.
The ultrasonic cutter began to cut away the tissue around the pulmonary veins.
All the while, Yasada did not take his eyes off the monitor or even blink. Close observation. Inside, some tissue in the lower left lobe began to fall off.
“Suction.”
“Yes.”
At Yasada’s instructions, Jinpyeong Wang sucked in the blood flowing out.
“Head Chief. Now I can’t reach the surgical tools. How should I do the dissection in the remaining area…”
“Mr. Choi, please answer for me.”
“I think I can do the dissection using a Penrose drain.”
“That’s the correct answer.”
Yasada used a Penrose drain and an automatic suture machine to remove the cancerous tissue. The area around the closely attached pulmonary veins was cut out.
The lymph nodes around the pulmonary artery and bronchial tubes were dissected.
Yasada’s outstanding skill.
In addition, Wang Jin-pyeong and Choi Ki-seok’s thorough assistance added, and the surgery proceeded smoothly.
“Finally, the mediastinal lymph node was removed. Since it is an area where metastases easily occur, complete dissection is necessary.”
“Yes!”
“Cutter.”
Yasada started to remove the mediastinal lymph nodes.
However, while the treatment was proceeding smoothly, Yasada’s hand suddenly stopped.
“Now. Do your homework here. How can I remove the remaining lymph node number 7 on the right side?”
There was a heavy silence in response to Yasada’s question.
The remaining lymph nodes were located in a place where the surgical port and assist port could not reach.
It was not even possible to use the Penrose drain like before.
” Does anyone know? I’ll give you exactly 30 seconds. Think of a way to do it.”
Yasada leaned back and glanced at the staff.
His eyes were as if
‘you guys get it.’
There was a hint of disdain.
‘Let’s think about it. Think about it.’
Choi Ki-seok stared at the monitor and the port alternately and racked his brain.
One of the important virtues a surgeon must have is creativity. With
the slightest change in idea, impossible surgery becomes possible, and a 10-hour surgery can be reduced to a few hours. He thought this
was an important opportunity to test his creativity.
“Time over! Actually, it would be impossible to come up with such an idea at your level.”
“Now, give me a chance.”
“Do you have something to say? Do you need more time?”
“No. I came up with a way to remove the lymph nodes that the Head Chief pointed out.”
“Really?”
Yasada continued, raising his eyes.
“Then try it yourself.”
“Okay.”
Choi Ki-seok first cleaned the area around the port and the surgical tools. was sterilized. Then, he quickly began to change the location.
A surgical tool was inserted into the port where the thoracoscope was inserted, and a thoracoscope was inserted into the port where the surgical tool was inserted. By
changing the location of the existing port, the treatment site was secured.
“Head Chief. Is this okay? How dare you change the port location? This is the first time I have seen such a ridiculous case.”
“This is not the only way to go. This is the correct answer.”
Yasada calmly answered Wang Jin-pyeong’s words.
“It would be a mistake to think that the port location is absolutely unchangeable. Isn’t it?”
“That’s right.”
“Good job Mr. Choi. Dr. Song didn’t bring me to America for nothing. We continue the treatment.”
Eventually, the lymphectomy performed with the port changed was successfully completed.
The surgery, which usually takes close to two hours, was completed in one hour under Yasada’s hands.
Of course, the completion of the surgery was flawless.
[First task: You have successfully completed VATS assistance.]
[You have formed a rapport with Yasada.]
NEW [Rapor level 2 – Faith]
[You have achieved the special achievement How to deal with a tough sergeant. As a reward, you will receive 500
A.P. 200 P.P.
]
[Special item Legend Gem has been released. Legend Gem will be paid if you succeed in completing special missions and achievements.]
[Dragon’s Eye has been raised to level 3. Special video mode three-dimensionalization has been opened. ]
The notification rang incessantly.
Choi Ki-seok enjoyed the joy as he checked the status window.
Jeeeeee.
The staff came out as the rosette door opened.
Choi Ki-seok’s eyes were fixed on Camille.
“Camille. “You know how to insert a chest tube into a patient who has had a lobectomy, right?”
“I know that much. After surgery, there is a temporary air leak and the pleural fluid increases.”
“I’m just saying this out of old age. Good work.”
He left the operating room and headed to the cafe on the first basement floor with Yasada.
Unlike the two, the other staff members had separate work to do.
“I heard about your performance so that Dr. Song wouldn’t get a scab in his ear, but I never thought it would be like this.”
Yasada said . “Is this really your
first time having VATS surgery?”
“Yes. That’s right.”
“Sigh… I can’t believe it.”
Yasada rubbed his chin as he thought about the surgery.
He felt something unusual from the moment he gained visibility. However, the assisting ability he showed during the surgery exceeded even his expectations. Choi Ki-seok can only be described as a monster.
“Thank you for the compliment.”
“Okay. It’s good to be proud, but you shouldn’t be arrogant. The moment you lose your original intention, the war will collapse.”
“I’ll keep
that in mind.” Choi Ki-seok paused before continuing.
“Head Chief, I have a question.”
“Tell me.”
“I’m curious about the relationship between James Hopkins Heart Clinic and MHC. .”
“Why is that suddenly? Did something happen?”
“Actually, I had a problem during the outpatient treatment…”
As Choi Ki-seok explained what happened in the treatment room, Yasada wrinkled his face.
“You dirty bastards. You’re still doing that.”
“….”
“As MHC became famous, James Hopkins’ position naturally narrowed. From what I heard, after the establishment of MHC, the proportion of outpatients and inpatients dropped by 30%. Maybe that’s why I’ve been so passionate about nonsense these days. They published articles disparaging our clinic and even took away the doctors’ money.”
“When you say take away the doctors’
money, do you mean scouts?”
Yasada continued speaking with an uncomfortable expression.
“Especially that Head Chief, he is the most evil of evils. Have you ever heard of the name Clara?”
“No, I haven’t heard of it.”
“Be careful because you never know when or how the devil will strike. If you get caught wrongly, your career as a doctor may be ruined.”
Yasada’s advice actually deepened my curiosity about her.
What kind of person is Clara?
