"Comrade Shi Lei, have you communicated with the patient about the surgical process?" After lunch, Liu Banxia slipped into Shi Lei's office, speaking earnestly with his hands behind his back.
There was still some time before his scheduled lead surgery, even after finishing the inguinal hernia repair. However, he was taking the prospect of being chief surgeon so seriously that his anxiety was palpable, making him somewhat agitated.
"Given your current mental state, are you fit to be the chief surgeon?" Shi Lei glanced at him, his expression unreadable and his eyebrows tightly furrowed.
"Boss, Boss, don't be mad! I'll go to the Colorectal Department and report to Director Jiang right now." Liu Banxia quickly put on a smile, snatched the patient's case file from Shi Lei's desk, and bolted.
As Liu Banxia hurried away, Shi Lei's brow furrowed slightly.
From the feedback he'd received, Liu Banxia hadn't gone to check on Wang Mingxing or Liu Liyou, which was unlike him. The patient who had passed away yesterday had clearly affected him.
The Colorectal Department was on the Fifth Floor. As soon as Liu Banxia stepped out of the elevator, he felt a wave of "resentment." Several patients were shuffling along the wall, their expressions nearly numb.
Even though his rotation in the Colorectal Department had been short, he knew a well-known saying that circulated there.
Someone once said they'd rather go to the Laoshang front lines than to a colorectal hospital. It just went to show that even though the patients here underwent low-risk surgeries, the suffering they endured was utterly dreadful.
Anal fistula surgery, involving an open wound often contaminated by feces, required daily dressing changes. Only those who experienced it truly knew the feeling.
Anyway, during Liu Banxia's rotation there, he had often seen strapping men walk out of the dressing room in tears, bent at the waist, and clutching the wall. It was almost like watching someone being tortured.
"Director Jiang, Liu Banxia reporting for duty. Awaiting your instructions!" Arriving at Director Jiang Tao's desk in the Colorectal Department, Liu Banxia stood at attention.
Jiang Tao nodded with a smile. "Liu, give it your all today. It's not easy to get Shi Lei to agree. Your surgery today will also be a teaching operation; we already have the patient's consent."
"Rest assured, Director Jiang. I guarantee I'll complete the task," Liu Banxia said earnestly.
"I also heard about what happened in the ER yesterday. You reacted quickly and handled it very well," Jiang Tao continued.
"Hehe, thank you for the compliment, Director Jiang. I'll go prepare now," Liu Banxia said with a laugh.
"Alright, go on then," Jiang Tao nodded.
The preoperative preparations were naturally handled by the Colorectal Department. He, on the other hand, headed straight to the operating room. Although he had technically completed the requirement for performing a surgery as chief surgeon, this operation would be his first *true* one in every sense of the word.
He was incredibly excited. For a surgeon, the operating table was the main battlefield. In the past, he'd mostly handled logistics and supplies on this battlefield. But today, he was truly leading the charge, ready to seize the flag.
"So nervous? Maybe you should just be the first assistant then," Shi Lei teased, walking in while Liu Banxia was still psyching himself up.
"Boss, can't you be serious? This is my first time, after all!" Liu Banxia rolled his eyes.
"Surgical precautions," Shi Lei stated.
"The internal opening must be located accurately, or a false tract will form. The rubber band ligation must be just right; too loose, and it won't work; too tight, and it will cause fecal incontinence and increase the patient's suffering. The surgery itself must be performed carefully to avoid significant bleeding," Liu Banxia recited without hesitation.
Was this a joke? After being cooped up studying for so long last night, this was no laughing matter to him.
Shi Lei nodded in satisfaction. "Work hard. If you do well, I'll treat you to dinner tonight."
"Hehe, thanks, Boss! But I can't let you treat. I'll make the arrangements," Liu Banxia said with a grin.
Without further delay, they both washed their hands and went straight into the operating room.
It was the same group from the morning, minus Qi Wentao. If the patient had been under general anesthesia, the team might have teased Liu Banxia. But not today; the patient was awake under caudal anesthesia.
After a final round of checks, Liu Banxia nodded to Jiang Tao, who had escorted the patient in, and began the surgery.
Taking the scalpel, Liu Banxia first made a radial incision at the site of the right posterior ulcer. Then, very carefully and meticulously, he excised the fistulous tract tissue. During this process, he took a sample of the excised tissue and sent it to pathology.
After all, this was his first *real* surgery. Unlike the simulated operations in the Dream Space, he wasn't as chatty as usual today.
Jiang Tao, observing the operation, nodded in surprised acknowledgment. "The incision was handled very well, and the fistulous tract tissue was excised perfectly. Even I couldn't have done it much better."
Hearing Director Jiang's words, the patient, Xu Qiang, who had been initially quite nervous, felt somewhat reassured. He didn't have much trust in the young Liu Banxia, but he trusted Director Jiang Tao.
However, these initial steps were routine for surgeons; the crucial part, the seton placement, was next.
Liu Banxia took a deep breath, picked up the ball-tipped probe, and inserted it along the incision, guiding it with his index finger, which he inserted into the anus.
As soon as he began, Liu Banxia knew he had this.
His index finger could feel the path of the ball-tipped probe through the fistulous tract. With each touch, the shape of that short segment of the tract materialized in his mind.
The patient's internal opening was at an anal crypt. Once the ball-tipped probe emerged through it, he deftly incised the skin between the internal and external openings and threaded a rubber band seton. He carefully assessed the tension of the secured rubber band before fixing it in place.
Jiang Tao stared at Liu Banxia in surprise. He himself was an expert, yet he had never seen anyone place a seton so quickly.
"You also have two small hemorrhoids," Liu Banxia said to the patient, Xu Qiang. "Normally, they wouldn't be an issue. However, given their current location, they'll interfere with dressing changes. This will not only increase your pain but also reduce the effectiveness of the dressings. I'll take care of them for you now."
"Alright, please do what you think is best. As long as it means less suffering for me. When I was being admitted yesterday, I saw them changing dressings for other patients. It looked excruciatingly painful," Xu Qiang said.
"Sickness always involves some suffering, but once you're through this part, you'll feel much better," Liu Banxia said while treating the two small hemorrhoids.
First Assistant Shi Lei clamped the base of the left posterior internal hemorrhoid. Liu Banxia then placed a figure-of-eight transfixing suture with 7-0 silk thread beneath the clamp. He treated the right posterior internal hemorrhoid using the same method.
If Liu Banxia's speed in placing the seton had already stunned Jiang Tao and the observing intern doctors, his speed in ligating and suturing the hemorrhoids was now utterly astounding.
The operative field was very restricted. Even Jiang Tao had to admit he couldn't have performed with such dexterity.
Liu Banxia carefully inspected the surgical site again. There were no signs of active bleeding. He disinfected the area once more. Then, he inserted a polyvinyl alcohol sponge into the anal canal, packed it with tower-shaped gauze for compression, and finally, secured everything with a T-bandage.
"CLAP! CLAP! CLAP! Excellent! Absolutely perfect!" Jiang Tao led the applause.
DING!
Daily Task Completed (20/20)
Obtained: 300 Experience Points, 5 Glory Points.
Anal Fistula Seton Ligation Surgery Completed
Obtained: 500 Experience Points
Suture Skill Proficiency +50
Dressing Change Skill Proficiency +30
Diagnostics Skill Proficiency +20
Anal Fistula Seton Ligation Skill Proficiency +300
Surgery Assessment: Perfect
Obtained: 200 Experience Points
Anal Fistula Seton Ligation Skill Proficiency +1,000
Suture Skill Proficiency +100
Dressing Change Skill Proficiency +100
Diagnostics Skill Proficiency +100
Glory Points +5
Looking at the system prompts, Liu Banxia breathed a sigh of relief. All his hard work hadn't been in vain; he had finally achieved a perfect "first kill" for this surgery!