(Thanks to friends 08a and Captain Ou for their warm encouragement.)
"Relax, we’ll be using minimally invasive surgery. Even if you stitch slowly, they won’t be able to tell," Liu Banxia consoled as they walked towards the station exit.
"Will you stop it? You didn’t stop talking about it on the train. Even if I wasn’t nervous before, I am now because of you!" Liang Xiaolin said in annoyance.
Liu Banxia grimaced. Actually, he was the one who was a bit nervous.
Even though he had thoroughly mastered the minimally invasive appendectomy and had come to practice once with Shi Lei, this time was different since he was leading the surgeries.
"Dr. Liu, it must have been a tiring journey," Chief Director Xu Chengjun greeted them as soon as they walked out of the station exit.
"You’re too kind, Chief Director Xu. This is Dr. Liang. I was worried I might be too tired to make it through all three surgeries alone," Liu Banxia said.
Xu Chengjun nodded at Liang Xiaolin and then gestured for the two of them to get into the car, heading towards Jinshui District Hospital.
"Chief Director Xu, are these three all routine procedures?" Liu Banxia asked.
Xu Chengjun nodded. "They are all routine procedures, but it’s not three anymore; it’s four. Last night, a patient was admitted with acute abdominal pain—acute appendicitis. The medication hasn’t been very effective."
Liu Banxia frowned. "Let’s move this case up. We don’t want it to become purulent or perforated. Also, I can’t guarantee this patient can be treated with minimally invasive surgery; I need to see the films."
"Understood, understood. I’ve already communicated with the patient. They were doing the final checks when I left," Xu Chengjun said hurriedly.
As fellow doctors, they understood this; it wasn’t Liu Banxia being nitpicky.
The minimally invasive appendectomy indeed has many advantages, but it’s not suitable for all conditions. If the appendix is severely purulent, it’s very likely to perforate and can easily rupture during removal.
In that case, a safer option like conventional removal would be chosen. Otherwise, the incision would have to be enlarged mid-operation, as there would be no other way to handle the exudate and pus in the abdominal cavity.
The reception they received at the hospital today could only be described as grand. Not only were doctors from the Department of General Surgery waiting for them in the courtyard, timed to their arrival, but a banner had also been hung upstairs.
Liu Banxia, despite being quite thick-skinned, felt a bit awkward about such a high-profile reception.
"Dr. Liu, to preserve this valuable learning opportunity, could we set up a camera in the operating room?" Chief Director Xu Chengjun asked as they got out of the car.
Liu Banxia smiled and nodded. "No problem, it’s not like it’s anything secretive. As long as the patient consents, I’m completely fine with it. And, as we discussed earlier, please provide me with a copy of the patient’s relevant information and prognosis later."
Xu Chengjun was thrilled; he had been worried Liu Banxia wouldn’t agree.
Their plan was to meticulously study the techniques of minimally invasive appendectomy from the recording; it was a significant challenge their hospital aimed to overcome this year.
Before entering the operating room, Liu Banxia carefully reviewed the patient’s relevant examination data.
"This patient can also undergo minimally invasive surgery. I’ll just need to be careful when extracting the appendix," Liu Banxia said after reviewing the data.
"Alright, let’s get started then. Can we finish all four surgeries this morning? We need to free up the afternoon to have a proper discussion," Xu Chengjun asked.
Liu Banxia nodded with a smile.
After scrubbing in and approaching the operating table, he personally palpated the patient again to confirm the location. This air of ease and confidence seemed somewhat curious to Liang Xiaolin.
She had often seen Liu Banxia perform in the operating room at the Second Hospital. Back then, her impression was that he was somewhat unprofessional, even during surgery.
Yet today, though he still had that somewhat unprofessional demeanor, the feeling was different. Whether chatting with patients or with the other doctors from Jinshui District Hospital, he exuded an air of calm competence.
This time, Liu Banxia chose a 2-centimeter incision. He didn’t dare to be too bold. He was also concerned about encountering conditions he hadn’t fully mastered, and a 2-centimeter incision would still be manageable.
Despite not having performed surgery in a while, Liu Banxia’s speed wasn’t slow. It was just that this time, extracting the appendix took a little longer.
The last time he had operated here, it had taken him about five to six seconds to extract the appendix. This time, it took a full thirteen seconds, more than twice as long.
It wasn’t surprising he was so cautious; this appendix was somewhat swollen and showed signs of an abscess. Any excessive force could indeed cause it to tear, which would be a difficult situation to manage.
"PHEW... That made me sweat. Just in time. If we’d been two hours later, the patient might have been in danger," Liu Banxia said with a smile after transecting it.
"Dr. Liu, tell me honestly, had you already made that assessment before making the incision? I noticed your percussion was very gentle," Xu Chengjun asked.
Liu Banxia nodded. "It was an educated guess, combined with the ultrasound report."
"Ah... Truly a case of high skill and bold execution. If it were me, I would definitely have enlarged the incision. Otherwise, I wouldn’t have dared to extract it," Xu Chengjun said with deep admiration.
This wasn’t mere flattery but genuine admiration.
Any skill looks easy but is difficult in practice. Liu Banxia had made an assessment based on the imaging and then confirmed the appendix’s actual condition by palpating it with his fingers; that was true expertise.
After the appendiceal stump was managed, he carefully inspected the area through the incision again to ensure there was no exudate or bleeding points, then handed the suturing over to Liang Xiaolin.
DING! Appendectomy completed. Experience points +200, Appendectomy skill proficiency +300, Diagnostics skill proficiency +200.
Rating: Perfect. Experience points +800, Appendectomy skill proficiency +700, Diagnostics skill proficiency +600, Glory Points +5.
Liang Xiaolin’s suturing technique also had its merits; it was very meticulous, with each stitch placed with great care. The only drawback was her somewhat slow speed.
However, Xu Chengjun and the others weren’t aware of this. They just assumed Liu Banxia wanted to train a junior, so they deferred to him and praised the suturing afterward.
Time was tight, so they had to hurry to the next operating room for the subsequent surgery.
Liu Banxia habitually reviewed the patient’s preoperative examination report first. Even with the system’s support, he believed in following protocol. At the very least, he had to confirm there was no ectopic appendix; otherwise, it would lead to an embarrassing mistake.
After scrubbing in and approaching the operating table, Liu Banxia frowned upon seeing the patient. He had focused only on the imaging section of the examination report and hadn’t anticipated the patient being so thin.
He recalled the patient was 56 years old but couldn’t remember their weight.
DING! Task issued: The Emaciated Patient.
Open Task: Host has observed the patient’s emaciation and suspects an underlying condition. Further examinations are required. Task rewards will be issued based on the examination results.
"Besides the pain here, do you normally experience any other symptoms?" Liu Banxia asked while performing percussion.
"Nothing else, except I can’t eat cold food anymore. Every time I eat something cold, I get diarrhea," the patient replied.
"When did you first start to feel pain here?" Liu Banxia continued questioning.
"It’s been over twenty days, less than a month," the patient said.
Liu Banxia turned to Xu Chengjun. "Chief Director Xu, I personally recommend a colonoscopy for this patient. Let’s schedule this surgery for last; the indications are somewhat unclear."
Hearing Liu Banxia say this, Xu Chengjun’s heart tightened. There might have been a missed diagnosis, but Liu Banxia hadn’t stated it directly.