Towards the end (3)
Seuuuuuu.
A scalpel emitting sharp light reflecting the light of a surgical lamp cut open the organ donor’s chest.
As median sternotomy was performed and the surgical field was expanded, the donor lung was finally revealed.
‘It’s clean.’
Jeremy nodded as he scanned the donor’s heart and lungs.
We have already determined that it is an organ with no problems through examination. However, just in case, we went through the verification process one more time.
Although it is very rare, there have been cases where the lungs of a donor with lung cancer could not be removed and were transplanted into the recipient, causing lung cancer to spread.
Jeremy then cut into the patient’s abdomen.
The purpose was to obtain a donor liver.
The liver transplant will be used for a young patient in his 30s whose heart tumor has spread to the liver.
Click.
After tying off major arteries and veins with vascular forceps, work began to obtain the liver.
“Doctor, how are you able to perform hepatobiliary pancreatic surgery?”
One of the staff members asked a question.
It’s amazing.
A thoracic surgeon is doing the job of a hepatobiliary pancreatic surgeon.
“Actually, when I was training at Meijo, I was planning to major in hepatobiliary and pancreatic surgery. So my superiors taught me a lot of different surgeries.”
“I… I see.”
“If you learn anything, there will be a time when you can use it. ruler.”
Jeremy removed the liver in an instant and handed it over to the sterilizing nurse. Then, the disinfection nurse wrapped the liver in plastic and stored it in an icebox.
“Administer 100 percent oxygen and cleanse the lungs with lung lavage solution.”
The staff moved quickly according to his instructions.
After completing a series of procedures, Jeremy began work on a lung transplant. The lower lung ligaments on both sides were cut, and blood vessels near the esophagus were also removed.
“The ascending aorta was ligated and heparin was administered.”
“Good. Inject cardioplegia solution and contact the beneficiary team to find out the progress.”
“All right.”
The youngest staff member left his position. But when he returned a while later, he told me something surprising. The beneficiary team said they were on the verge of completing total pneumococcal surgery.
‘Are you saying it’s still far away?’
A smile appeared on Jeremy’s lips.
After Ki-Seok Choi left MHC, he developed a reputation for completing surgeries quickly. I wonder why people even gave him the nickname Sonic.
So I was secretly looking forward to today.
It is expected that Choi Ki-seok will be able to send the cut lung to the recipient team before completing the surgery.
I wanted to show off how I grew while Choi Ki-seok was away.
Now, it looks like the plan went awry.
“Continuing the work.”
Suddenly. Suddenly. Suddenly.
Processes such as aortic cutting, left atrium transection, and tracheal dissection proceeded smoothly. By removing the blood vessels and other connecting parts around the lung, the lung could be easily obtained.
“teacher. “I have a question. Can I ask you one thing?”
“anything.”
“What kind of person was Manager Choi at MHC?”
“It’s Kiseok Choi’s appearance in MHC…”
Jeremy paused before continuing.
“I’ve never seen it in Korea, so an exact comparison would be impossible. It’s not much different from what you guys know. “He only thought about the patient, looked only at the patient, and did not hesitate to do things that seemed reckless, like today’s surgery.”
“….”
“Would you perform a lung transplant on a patient with stage 4 lung cancer?”
“Uh… um… no. “Honestly, I think it’s meaningless.”
“what. That’s it. But what’s interesting is that Ki-seok rarely fails because of his stubbornness.”
Jeremy’s eyes formed half moons above his surgical mask.
“You can trust Kiseok. “He’s a guy who always exceeds your expectations.”
Jeremy stored the left and right lungs in an icebox and handed them to the youngest staff member.
The donor’s lung left his hand.
Now the patient’s life depends on Choi Ki-seok, who holds the lungs and the card in both hands.
* * *
J Rosette.
Choi Ki-seok was in the middle of the housework.
Before removing the heart tumor, they were removing some of the metastatic lymph nodes and organs, but because the scope was large, it took longer than expected.
Empty! Empty! Empty!
With a metallic sound, the cancerous tissue fell onto the bench.
‘As expected, it’s Charles.’
Ki-Seok Choi, who was placing the cancer tissue on the bench, glanced at Charles. A skilled person who had no problems performing this surgery was assisting in the second role.
Thanks to this, the entire process proceeded smoothly and smoothly.
The fact that I got to work with him after a long time was also one of my small joys.
“Should we start pneumonectomy?”
“good. “Let’s go.”
While stretching with both hands toward the ceiling, Ki-Seok Choi’s eyes turned to the operating room for observation. At that very moment, my eyes met with Kim Han-cheol, who was staring at me with his arms crossed.
Kim Han-cheol’s eyes had a fierce light as if he was watching his enemy.
Do you want to catch the pod somehow?
Choi Ki-seok read Kim Han-cheol’s thoughts and smiled bitterly.
Followed by pneumonectomy.
The process of cutting the lower lung ligament and ligation of the pulmonary artery was completed in an instant, so only the main game of lung transplant remained.
“I heard the donor team is still far away from obtaining lungs?”
“yes. “They say they might need about ten more minutes.”
Ki-Seok Choi nodded slightly at Daniel Lee’s words.
“Chief of department. “Patient vitals are dropping.”
The staff’s attention was simultaneously focused on the patient monitoring device when the anesthesiologist announced the news.
“My heart rate dropped to 34 beats per minute. Blood pressure soared to less than 40 mmHg/20 mmHg and central venous pressure.”
Bleep. Bleep.
The patient monitoring device let out an ominous electronic sound.
“Give me one ampoule of epinephrine IV and Charles do CPR with me.”
“okay.”
Choi Ki-seok gently grabbed the patient’s heart and massaged it with appropriate force. Meanwhile, Daniel Lee administered epinephrine to the patient, and Charles began charging the defibrillator.
“Everyone step back. 200J!”
Charles handed the spatula-shaped defibrillator paddles to Ki-Seok Choi. Just then, the lamp came on and an electronic beep sounded.
“Charge!”
“Clear!”
thud!
As the current flowed, the patient’s body jumped.
“200J!”
“Charge!”
“Clear!”
thud!
With rapid CPR, the patient’s vitals gradually returned to normal range. However, that was only for a short period of time. The patient’s blood pressure decreased again to 50/30 mmHg and 30 beats per minute, and even with the addition of epinephrine, it was not expected that his vitals would recover.
“under. “What is the reason?”
Charles looked down at the patient with a puzzled expression.
Ki-Seok Choi, a triple board thoracic surgeon and MHC pulmonary and esophageal surgery fellow, performed the surgery. I couldn’t believe that a situation like this had happened even though there wasn’t a single mistake during the surgery.
“What should we do, Chief? If this continues, the patient will die before the lung transplant surgery…”
Daniel Lee asked, stamping his feet, but Ki-Seok Choi remained silent as if he had a lock on his mouth.
Meanwhile, the patient’s vitals were falling to the bottom of the abyss.
“Lay the patient on his right side, Daniel.”
“Is there any meaning in changing positions?”
Charles frowned at Choi Ki-seok’s words.
“There’s something I want to check.”
“All right.
Daniel Lee and the disinfection nurse laid the patient, who had been lying on his back, on his right side. As I was examining the surgical area again, Charles was the first to shake his head.
“Is this really it?”
“that’s right. “My heart was herniated.”
Choi Ki-seok nodded slightly.
In this surgery, he attempted a pneumonectomy by incising the pericardium.
The cause of the problem is pericardial suturing.
The sutures were loosened somewhat to prevent cardiac tamponade, but the heart fell out through the gap.
Changing position during surgery could also be considered one of the causes.
“Now that I know the cause, it’s okay.”
Ki-Seok Choi returned the heart that had prolapsed outside the pericardium and then sutured the pericardium more tightly. After checking for any possible risk of blood vessel damage or bleeding, we looked at the patient monitoring device.
The patient’s vitals were slowly rising.
“I thought I was going to die.”
Charles continued speaking with a sigh of relief.
“Kiseok. Is it possible for cardiac hernia to occur during pneumonectomy? “I’ve never experienced it before.”
“Today is my first time too.”
“The analysis was too calm for something like that?”
“If the surgeon is embarrassed, who will take responsibility for the patient and who will the staff rely on?”
“You still have a long way to go to catch up.”
The two people looked at each other and exchanged smiles on their lips.
Jiiiing.
“I brought you a donor lung.”
The rosette door opened and a staff member carrying an icebox approached.
“Is there any problem with the donor?”
“yes. “We even got all the organs needed for the next surgery.”
“What about Jeremy?”
“Professor Jeremy is taking a short break in the break room.”
“Good job. “Go.”
After sending the staff away, the full-scale lung transplant surgery began.
Ki-Seok Choi, assisted by Charles, went to work like a fish in water.
“4-0 Vicryl (absorbable suture).”
Geek.
After tightening the suture needle with the needle holder, we started with the bronchial anastomosis.
A simple interrupted suture was spread in the front part of the bronchus, and a continuous anastomosis was spread in the back part.
There were times when the size of the bronchi did not match, but the crisis was safely overcome using the overlapping suture method.
Click!
“The left atrium was ligated.”
“thank you.”
Choi Ki-seok cut open the left atrium with a scalpel and connected the left atrium of the pulmonary vein and the patient’s left atrium. The remaining treatment was to connect the pulmonary artery.
Should we say that the final chapter of lung transplant surgery has arrived?
But that’s the moment.
Bleep. Bleep.
Daniel Lee was away when the phone suddenly rang, and upon his return, he urgently delivered the news.
“Chief. “This is patient Lee Tae-hyun, who is scheduled for heart tumor surgery.”
“why?”
“They say the condition has worsened now. “The patient’s vitals are normal, but he is complaining of severe chest pain and comes to see the director.”
Choi Ki-seok’s hand stopped for a moment at Daniel Lee’s report.
After thinking for a while, he put down the surgical tool he was holding.
“Tell them to raise it to a rosette. Have surgery right away. “We called back Jeremy and the staff who operated with him.”
“Then, patient Park Gwang-jin….”
“Charles will finish it. right?”
“what. “This is the extent to which you can swim while holding on to the ground.”
Charles smiled brightly as if telling him not to worry, and Ki-Seok Choi left Rosette with a request.
‘It shouldn’t be a big deal.’
Lee Tae-hyun, a terminally ill heart tumor patient, recently underwent emergency surgery due to a ruptured right atrium caused by a heart tumor. That he survived until now was, in a word, a miracle.
And all Choi Ki-seok had to do now was to repay the patient for the miracle he had shown.
“sorry. “I didn’t know I’d be asking for it again.”
Ki-Seok Choi, who was standing in front of K Rosette, checked Jeremy approaching and spoke to him first.
“I’m even sorry. This is our job. “How was the lung transplant surgery?”
“There doesn’t seem to be any problem so far, but we will know only when the progress is made.”
“It’ll turn out okay.”
While the two were talking, the staff to be used for the surgery arrived at Rosette.
Buck. Buck. Buck. Buck.
After finishing disinfection, the staff entered the rosette all at once.
[You used the Soul Tear item. The super awakening effect is applied.]
[Super awakening effect: The surgical treatment level temporarily increases by 3 levels. The duration is half a day, and when the hyper-awakening effect ends, you will temporarily fall into exhaustion.]
[Surgical treatment: 15 (12+3)]
After using the item, he stood at the surgeon’s chair with a solemn expression.
I will pour everything into this surgery.
