Chapter 83: 083 Special Teaching by Liu Banxia
Liu Banxia ripped open the thoracotomy pack, poured povidone-iodine onto the area between the patient's sixth and seventh ribs, and picked up a scalpel. Taking a deep breath, he glanced at Qin Hai, who was watching from outside the resuscitation room with a blank expression, then made a decisive incision.
If the patient simply had a hemothorax, a small opening for closed-chest drainage would have sufficed. But this patient's situation was too unique, requiring an immediate thoracotomy.
He had never performed a thoracotomy. The only thoracic surgeon present was Liang Xiaolin—she, however, was in no state to assist, leaving Liu Banxia as the sole operator. His only support was the two hours of focused operating time he had just redeemed using some Glory Points as he took that deep breath.
As the scalpel cut across, streams of blood flowed from the incision.
"Rib spreader," Liu Banxia said, putting down the scalpel.
Chen Jianxin handed it to him.
Upon inserting the spreader and opening the chest cavity, Liu Banxia saw that the patient's left lung had completely collapsed. This was because air had entered the chest cavity due to the trauma, causing the intrathoracic pressure to exceed the alveolar pressure.
Liu Banxia raised his hand, and Chen Jianxin promptly handed him a pair of scissors.
He needed to make a small incision in the collapsed lung to allow air to enter, maintain pressure, and provide temporary ventilation.
He carefully selected a spot, avoiding any vasculature. As the scissors cut in, the patient's left lung inflated like a balloon. Liu Banxia showed no hesitation. Putting down the scissors, he took the sutures from Chen Jianxin and sewed three stitches.
The next crucial step was to find the source of bleeding in the patient's thoracic cavity.
"Right ventricle rupture! Need a surgical stapler!"
As soon as Liu Banxia reached inside, his heart skipped a beat. This patient is truly in critical condition.
Upon hearing Liu Banxia's words, even Chen Jianxin froze momentarily. But it was only for a moment; he quickly handed over a skin stapler.
Liu Banxia carefully adjusted the heart's position. Blood pumped from the tear in the right ventricle, spraying directly onto his surgical gown.
Accepting the skin stapler from Chen Jianxin, Liu Banxia felt for the rupture with his hand. CLICK! CLICK! CLICK! He pressed the stapler three times in quick succession.
On his side of the room, all eyes were fixed on the patient's heart. Once Liu Banxia removed the stapler, the heart resumed its beat.
"Blood pressure is rising steadily, vital signs are recovering," Liang Xiaolin said, her voice trembling slightly.
"Send him straight to the operating room. Notify the cardiothoracic surgeons to prepare to receive a thoracotomy patient. Call a general surgeon for the abdominal puncture wound," Liu Banxia stated.
"Dr. Liu, you and Doctor Liang will take the patient," Chen Jianxin instructed seriously.
Liu Banxia paused for a moment, then nodded.
This wasn't Chen Jianxin shirking responsibility or being timid. Rather, it was because if this patient could be saved in the operating room, Liu Banxia would be the one most credited for it. After all, it was Liu Banxia who performed the life-saving emergency thoracotomy in the ER, addressing the patient's critical lung and heart conditions. This honor should belong to Liu Banxia alone.
"Oh, Banxia, it's you?!" Wang Lei exclaimed in surprise as they entered the operating room.
"Old Wang, quickly get the patient under anesthesia. Who's coming from general surgery and cardiothoracic surgery?" Liu Banxia responded with a wry smile.
Wang Lei shook his head. "I really don't know. I just came over when I got the notification."
Just as Wang Lei finished speaking, Shi Lei entered, raising his hand. Seeing Liu Banxia, he also paused in surprise.
"You two, scrub in and get to the table," Shi Lei said directly.
Liu Banxia grinned, immediately grabbing Liang Xiaolin's hand and hurrying out.
"Banxia is incredible! Look at him, performing an emergency thoracotomy. My God, suturing the heart with a skin stapler? Banxia's skills are truly exceptional!" Wang Lei, having finished with the anesthesia, exclaimed in shock.
Shi Lei also looked astonished. He had seen the rib spreader, but he hadn't anticipated such a maneuver.
As the anesthesia took effect, Shi Lei had no time for anything else; he had to perform an exploratory laparotomy. The patient was relatively lucky; the abdominal trauma hadn't damaged other organs, only creating a small tear in the small intestine, which caused some fecal matter to leak into the abdominal cavity.
"Dr. Shi, Liu Banxia and Liang Xiaolin are scrubbed and ready. Your orders?" Liu Banxia ran in from outside.
"You, come over here. Handle this," Shi Lei glanced at him.
Liu Banxia put on his gloves and went directly to the operating table.
After assessing the situation, he chuckled. "Looks like I'm getting the full attending surgeon treatment here, Director Zhou level stuff! The abdominal cavity's cleaned, clamped with sponge forceps—all that's left is to suture it up, right?"
"So much chatter. You think I can't manage you anymore?" Shi Lei glared at him.
"Heh," Liu Banxia chuckled. "Of course not, Chief. This is like a reward for my permanent position. Mascot," he said, looking at Liang Xiaolin, "watch carefully. Even though you're a cardiothoracic surgeon, you never know what you might encounter in an emergency. Get closer and take a good look."
Liang Xiaolin felt a bit deflated. She didn't want to take his orders, but she also didn't want to miss this opportunity.
The tear was small. Liu Banxia didn't hesitate. He performed a purse-string suture 0.5 centimeters from the edge of the wound and then tightened it. After invaginating the perforated site into the intestinal lumen, he added a transverse interrupted seromuscular suture, using only two stitches.
Shi Lei genuinely didn't want to praise Liu Banxia, fearing he'd get cocky. But the suturing just performed was truly impeccable.
"Close the abdomen," Shi Lei grumbled.
His awkward, sulky expression made everyone in the operating room chuckle. This was part of Shi Lei's charm; an honest person could be endearing.
However, this time Liu Banxia didn't act immediately. Instead, he looked at Liang Xiaolin.
Liang Xiaolin froze. Closing the abdomen is such a critical task. How can he let me do it?
"Come on," Liu Banxia said with a smile. "You'll be working with me in the Emergency Department, so you need to improve your skills. Otherwise, you won't be able to keep up with me."
"This patient has been stabilized. The cardiothoracic surgeons will be here soon, and you can learn some heart suturing techniques from them then. Don't waste time, go ahead."
Liang Xiaolin gritted her teeth and took Liu Banxia's place.
Because the abdominal cavity was contaminated, a drainage tube had to be placed. Liang Xiaolin performed this procedure smoothly, without any hesitation.
However, once she began suturing, her speed made even Wang Lei frown; it seemed she had to carefully consider each pass of the needle.
Taking your time to close in the operating room is one thing, but what if you need to suture in an emergency? You won't have so much time to think then, Wang Lei thought.
Liang Xiaolin sensed the others' uneasy glances. Feeling aggrieved and helpless, tears welled up in her eyes again.
"Don't move. Feel my hand movements, then watch where I place the needle."
At that moment, Liu Banxia's voice sounded beside her ear, and he gently took her right hand.
Liu Banxia's idea was simple: he wanted Liang Xiaolin to feel the motion of his wrist. Suturing was all about wrist movement. He intended to give her a special, hands-on lesson right now, one far more memorable than any practice in the treatment room.
But for Liang Xiaolin? The intimate posture, Liu Banxia holding her hand... she blushed and froze, completely flustered.
By the time she regained her senses, Liu Banxia had already sutured more than half of the incision.