Level Up Doctor Chapter 263

Majo Heart Center (2)

Ssssssssssssssssssssss.

A scalpel cut into brain tissue.

Choi Ki-seok watched this with a painful expression.

The task of splitting one brain in half.

Because of this, some functions in the brain are bound to not work properly. But in order to save both children, it has to be done.

Cheeeeeeeek.

Ki-Seok Choi suctioned blood with a suction device with one hand and secured the surgical field with forceps with the other hand.

This is a multiplayer game that can be played thanks to the ambidextrous skill.

As the work continued, the brain tissue became increasingly divided diagonally.

“The pulse rose slightly. paco2 (arterial blood carbon dioxide partial pressure) also increased, po2 (oxygen partial pressure) decreased, and cerebral pressure was somewhat high at 20mmHg.”

Lucas showed no response to the anesthesiologist’s interim report.

Because a simple nod or a simple nod could have an impact on treatment.

‘what?’

Choi Ki-seok, who was helping Lucas, tilted his head.

Even though I was suctioning, blood continued to flow from the incision site.

It means there is something wrong.

On the other hand, Lucas and first assistant Henry, who were working hard to separate, seemed to view this as just simple bleeding.

Seeing as there has been no instructions so far.

[Use zoom-in mode for the Dragon’s Eye skill. The surgical area is magnified and examined.]

Choi Ki-seok examined the surgical area with a magnification that surpasses that of a microscopic microscope.

As a result, it was realized that the place where the bleeding occurred was not the surgical site.

In other words, blood from other areas was flowing into the surgical site.

The problem is that it is not easy to find that part.

“Professor. I think we need to stop separating for a moment.”

“what?”

Lucas frowned as he took away the scalpel.

“The bleeding hasn’t stopped yet.”

“The brain tissue is being separated. It’s natural for bleeding to occur.”

“This is not bleeding from the area being treated. So we need to find the actual bleeding point.”

“A real bleeding spot?”

Henri asked back with a surprised face.

“Then Mr. Choi should find it. I have no idea.”

“Yes. Please give me a moment.”

Choi Ki-seok carefully scanned the twins’ brains using zoom-in mode. Then, it was seen that the superior cerebral artery was connected to a vein without passing through the capillaries.

It is a cerebral arteriovenous malformation.

If you suffer from a cerebral arteriovenous malformation, high blood pressure from the arteries is transmitted directly to the veins, putting you at risk of rupturing the venous blood vessels.

The twins’ deformity was so small and narrow that it was impossible to confirm with the eyes of an examiner or Hippocrates.

It seems that the peeling operation probably caused bleeding.

“Head Chief. This way.”

In response to Choi Ki-seok’s point, Lucas and Henri moved the position of the microscopic microscope.

“Oh my god. He has a cerebral arteriovenous malformation.”

“There was a reason why my brain pressure was high.”

Lucas and Henry said something each time.

If Choi Ki-seok had not revealed the cause of the bleeding, the cerebral pressure would have continued to rise and an emergency situation would have occurred.

Unlike during practice, additional treatment was added and it was clear that it would have had a negative impact on the patient’s progress.

“Good job Mr. Choi. I overlooked the bleeding because I was working on separating it.”

“No. I was lucky too.”

“Stop the separation for a while and address the cerebral arteriovenous malformation first.

Lucas left the arteriovenous artery where the bleeding occurred for the time being and cut the surrounding veins that were tangled like threads with an electric cautery. If the surrounding veins

with the malformation were not treated, bleeding could occur again. .

“I think the blood vessel treatment is over.”

“Okay. Now, we will cut out the inflow arteriovenous vein where the bleeding occurred.”

Lucas nodded.

The reason for leaving the inflow arteriovenous vein until the end

is to prevent unexpected massive hemorrhage and cerebral edema. The inflow arteriovenous artery is a kind of large water stream, so it must be blocked first. If you throw it away, it will put a strain on the fine arteriovenous vessels.

After a while, the brain arteriovenous malformation surgery was successfully completed by identifying the key bleeding point.

“Shall I administer a vasopressor?”

“That’s a good point. “Try using a small amount of epinephrine.”

When Choi Ki-seok administered epinephrine, the twins’ blood pressure gradually rose.

Nevertheless, there was no problem in the area where the cerebral arteriovenous surgery was performed.

This is a sign that blood vessel flow is normal.

If there was a problem with the surgery, the treated blood vessel It must have exploded again.

After a while, the separation surgery resumed.

Because it was the most dangerous section of this surgery, the speed of treatment slowed down even more.

How much time had passed?

Lucas placed the scalpel in his hand on the table.

“We have now passed the critical juncture. ”

“Let me wipe off the sweat.”

The sterilizing nurse wiped the sweat from Lucas’ nape and forehead with gauze. Other staff members also moved their bodies and enjoyed a moment of relaxation. “The surgery took ten hours, but it’s only half

. “

Lucas sighed and looked at the staff.

“It’s team 1’s shift time now. Everyone worked hard.”

“I’m sorry for not being able to help you more.”

“Even though I’m not an assistant, I’ll watch from the observation room until the end.”

“It’s okay. are you okay. Just working hard so far is enough. Doesn’t Mr. Choi work shifts?”

“I want to be with the head chief until the end.”

“Don’t be stubborn for no reason. If something unexpected happens, the surgery may take more than a day. Do you think your physical and mental strength can hold out until then?”

A look of worry appeared on Lucas’ face.

Choi Ki-seok, whom he watched, was like a sharp awl throughout his assistance.

The surgeon’s and First’s support was flawless and the brain was in good condition. He achieved the great feat of discovering an arteriovenous malformation.

He showed the exact opposite of Nikolai, who was slow and slow to react as time went by.

But isn’t there a limit to a person’s concentration?

Lucas and his family have a lot of experience, so they can distribute their mental power, but Choi Ki-seok was different.

He is still a trainee in surgical rotation.

But he showed this level of concentration…

“I am Adam and Brian’s doctor. I have a responsibility to watch the surgery until the end.”

“Still, I’ll watch.”

“I don’t want to. “I can’t go anywhere without my patient.”

“True. I can’t stop his stubbornness. Instead, I will replace it at any time if the treatment is disturbed. Did you understand?”

“Yes!”

Lucas smiled at Choi Ki-seok’s courageous answer.

Choi Ki-seok’s presence was so heavy that it felt like he was leaning on the surgeon.

I would be grateful if he stayed.

While the two were talking, he looked at Henri and Nicolai. Instead, Leon and Justin took turns.

“Mr. Choi. Your performance is great today, isn’t it? In that situation, a cerebral arteriovenous malformation was detected. “Everyone outside flipped over.”

“I was lucky. what. By the way, now that Leon is here, I won’t have to play an active role anymore.”

“Another thing I don’t like.”

Leon and Choi Ki-seok shared a short joke.

It is a natural way to solve the gap created by the staff change.

“The progress and the remaining You’re familiar with the entire process, right?”

“Of course.”

“Yes!”

Leon and Justin answered Lucas’ question.

“Okay. Continue with surgery. The middle part of the parietal lobe is dissected, and then part of the occipital lobe is separated diagonally. The last one is skull reconstruction and scalp expansion surgery. “Mezzem.”

Lucas’ hand held a metzum.

The surgery to separate conjoined twins reached a turning point.

With some staff changes, the treatment continued smoothly. Because

the replaced staff was stronger than the previous staff in terms of physical and mental aspects.

‘I can’t believe it.’ ‘No. What’s the limit?’

Lucas’s gaze suddenly became fixed on Choi Ki-seok.

The surgery time had already passed half a day.

Nevertheless, Choi Ki-seok still showed his consistent appearance. The treatment was fast and accurate, and when there was nothing to do, he watched the surgical area closely to make sure

there were no problems with the treatment . I was taking a look.

I couldn’t help but click my tongue at the improvement compared to when I was receiving support for moyamoya disease. Bleep.

Bleep.

With an ominous electronic sound, the anesthesiologist delivered the sad news.

“The twins’ pulse and blood pressure are Falling at the same time. Adam’s levels are 90mmHg and 60mmHg, and Brian’s levels are 80mmHg and 50mmHg. sp02 (oxygen saturation) is 80. Both are below the normal range.”

“Stop the separation process and install a respirator. One ampoule of vasopressin intravenously.”

Following Lucas’ instructions, Ki-Seok Choi began treatment.

However, even after treatment, the twins’ vitals did not seem to return to normal.

“It appears that the cranial nerves were stimulated during the separation process.”

“What should we do? If it continues like this…”

Leon and Choi Ki-seok’s eyes were fixed on Lucas.

While Lucas was silent, the electrocardiogram graph began to fluctuate irregularly.

“Damn it. It’s VF (ventricular fibrillation)! Let’s do CPR first.”

“Yes!”

Lucas, Justin Leon, and Choi Ki-seok formed a team and each started CPR.

[You have used the Must Save skill. All stats will temporarily increase by one level.]

[You will receive the Awakening CPR buff. [He used it on his colleagues.]

The staff members who received the buff fought for about 30 minutes.

As VF developed into cardiac arrest, the twins were on the verge of life and death, but they barely survived cardiac arrest with proper chest compressions and a defibrillator. Their

vitals were still not up to normal. …

“Head Chief. If things continue like this, surgery is impossible.”

“I know. We have to find a way somehow.”

Lucas bit his lip.

As the surgery was paused, a heavy silence weighed on Rosette.

The surgeons watching the surgery in the observation room and the people watching it live couldn’t even swallow their saliva easily. I couldn’t.

How will Team Twins overcome this crisis?

“Head Chief. How about using hypothermia therapy?”

“Hypothermia therapy… is that okay?”

Lucas’ forehead wrinkled.

Hypothermia therapy is a method of lowering body temperature and reducing the body’s metabolic rate. Through this, it can prevent secondary brain damage and It was able to reduce the aftereffects of organ damage.

“Hypothermia therapy is mainly used in adults. It may be poisonous to the twins.”

“There is no other way now. If a problem arises, you can stop treatment immediately.”

“What do you think, Leon?”

“I’m the same as Mr. Choi. “If there is something that can be done, I think it is right to do it.”

“Yes. “For now…”

Lucas nodded slightly.

Soon, the Team Twins staff and anesthesiologist began hypothermia therapy. First,

a cooling mat was placed under the twins’ bodies, and then a special cooling tube was injected into the blood vessels.

Slowly . The twins’ body temperature dropped.

After a while, the body temperature reached 33 degrees, and the staff looked at the patient monitoring device in silence.

“Chief and Leon, please go out and rest for a moment. I will watch over Adam and Brian.”

“You can’t do that. Have you ever seen a ship without a captain?”

“I’m fine too.”

Lucas and Leon rejected Choi Ki-seok’s suggestion.

Since there was nothing to do right now, the staff brought special chairs and looked at the twins and the patient monitoring device in turn.

That’s how time passed . After this, the hypothermia therapy that lasted for nearly 12 hours was completed. As

the body temperature was slowly raised, the twins’ vitals returned to the normal range. After examining it with a portable imaging device, there were no signs of brain damage or organ damage.

Hypothermia therapy was successful.

Hope appeared in the staff’s eyes as they stared at each other.

“Let’s continue with the surgery. There is too much delay. It will be a huge burden on the children.”

“yes!”

Separation surgery finally resumed.

Brain tissue detachment and separation proceeded as if with a tailwind.

“I’ll bring the skull.”

Choi Ki-seok left his seat and moved to the freezer.

When I opened the freezer door, a pre-made skull was revealed. Normally, skull reconstruction uses artificial bone made of bone cement, but this was not necessary this time.

Because the finished product has already been produced through 3D printing.

“Good. It fits perfectly!”

Lucas smiled with satisfaction as he placed the skull Choi Ki-seok had brought on the twins.

The end of the long journey was in sight.

“Head Chief. I would like to perform scalp reconstruction surgery.”

“Mr. Choi?”

“Yes. I am confident. Just leave it to me.”

Choi Ki-seok said with his eyes shining.

As a result of looking at it through the eyes of Hippocrates, Lucas’ physical strength was reduced by 4 levels after surgical treatment, which was level 1 to level 9, and was now level 5.

Leon was no different.

Physical strength decreased by 2 levels for surgical treatment, which was level 3 and level 7, and became level 5.

Choi Ki-seok was the best in all statistics.

“Trust me just this once. Are you going to be okay, Leon?”

“I would be grateful if Mr. Choi would do it.”

“Thank you both.”

Ki-seok Choi switched places with Leon and began scalp reconstruction surgery.

Surgical procedures that have recently risen to level 8 and the ambidextrous skills that have been practiced so far.

These two things made my hands dance as if they had wings.

The treatment, which would have normally taken over an hour, was completed in twenty minutes by his hands.

The surgery is finally over.

The twins’ heads, which had been attached since birth, were now completely separated.

Choi Ki-seok wrapped the twins’ heads with bandages and muttered softly.

“Thank you. For sticking with me until the end.”