Level Up Doctor - Chapter 140
What to do (5)
“I think… it won’t be easy.”
“Are you trying to keep another team in check?”
“That is absolutely not the case. As you know, the Norwood surgery is very difficult. Not only that, but we also took into account that an interval would be needed afterward and additional surgery would be necessary.”
Hyukpil Jang answered calmly.
Norwood surgery is the primary surgery for left ventricular dysfunction in children.
After Norwood, the superior vena cava-pulmonary artery shunt is performed six months later, with a slight delay, and the Fontan operation is performed.
There was no guarantee that the subsequent second and third surgeries would be successful.
“Norwood is difficult, but I think it is possible with Professor Kwon.”
“I have hope in that too.”
While the two were talking, two employees of the Korean Association of Pediatric Thoracic Surgery entered the observation room.
Association members are Lee Man-sik and Ko Jong-hyeon.
“You had a hard time coming here in the morning.”
“Oh my, Chief. What kind of trouble are you going through? If I can observe the Norwood surgery, I have to go to the farthest village in the world.”
Lee Man-sik joked at Jo Ji-hwan’s greeting.
“I recently heard that you successfully performed Saber surgery and signed a cooperation agreement with Changjin University Hospital in China. Congratulations.”
“It looks like things are going well this year. Please have a seat.”
Jo Ji-hwan made the two people sit in the empty seats next to him.
‘Are you going to start soon?’
Choi Ki-seok’s eyes turned to the large monitor.
Today, I had no schedule this morning, so I was able to observe the Norwood surgery.
Even though I can’t go into the operating room, I plan to upload a video at least to the monitor.
Jiyiing.
The rosette door opened and the Norwood staff entered.
Choi Ki-seok frowned as he looked at the staff.
Seo Ji-hoon came in as third assistant in place of Min-hyuk Min.
The fact that Seo Ji-hoon joined the Norwood team and the fact that Min-hyuk Min was pushed out were both surprising.
How on earth did this happen?
Choi Ki-seok put aside his embarrassment and used the Eye of Hippocrates on Kwon Il-soo.
[Affiliation: Team Norwood]
[Team level: 2.4/5]
[Cohesion: 2/5]
[Skill level: 3/5]
I rubbed my chin while looking at the team stats of the Norwood team.
The Norwood team was slightly ahead of the Saber team in terms of team level and kill level. The reason the Saber team is higher than the Norwood team is because of unity.
I thought it was because the Norwood staff’s overall experience was higher than that of the Saber team.
‘It’ll be okay.’
Choi Ki-seok consoled himself.
I thought a lot about whether I should use the buff I got from rescuing a falling patient on Kwon Il-soo.
The conclusion is no.
In the end, I decided to have a buff.
The fact that I was worried about Kwon Il-su’s surgery was tantamount to putting a wrinkle in front of the chrysalis. So, when an emergency came, I decided to write it to myself.
While I was thinking about this and that, the staff settled in.
Choi Ki-seok stared at the monitor using his dragon eyes.
“Just do what you prepared. There’s no need for you to be nervous, okay?”
“yes!”
The staff responded in unison to Kwon Il-soo’s words.
Preparation for surgery was completed with smooth movements.
“We will now begin Norwood surgery for left ventricular dysfunction.”
At the glance of Kwon Il-soo, third assistant Seo Ji-hoon disinfected the patient’s chest widely and covered it with a cloth. Afterwards, second assistant Jaewon Woo cut the patient’s chest with a scalpel and picked up a chainsaw.
Weeeeeee. Drumming. Weeeeeee. Drumming.
The sound of chainsaws and bones breaking formed an ensemble.
After the median sternum incision was completed, Seo Ji-hoon and Woo Jae-won opened the patient’s chest with a retractor.
“Inject cardioplegia and run the heart-lung machine.”
“yes!”
When Min Byung-seok inserted the arterial cannula and the venous cannula, the heart-lung machine started.
‘I will definitely do it!’
Kwon Il-soo stared at the surgical observation room for a moment and made up his mind.
I have been constantly whipping myself and my staff for this very moment.
For patients and guardians.
For your own glory.
In order to break Jang Hyuk-pil’s nose, this surgery must be successful.
Click!
Min Byeong-seok grabbed the ascending aorta with vascular forceps.
This is to prevent bleeding.
“Meth.”
Kwon Il-soo’s blade was aimed at the ascending aorta.
In Norwood’s case, the left ventricle was not properly formed.
Therefore, the ascending aorta extending upward from the left ventricle is also thin.
The first stage of Norwood surgery.
It creates a new abnormal ascending aorta.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu.
The blade split the side of the ascending aorta.
As the blood remaining in the veins began to flow, Seo Ji-hoon, who was next to him, began to administer suction.
‘You just need to stay calm.’
Kwon Il-soo split the side of the main pulmonary artery located next to the ascending aorta. The incisions in both blood vessels were of equal length and did not affect other nerves.
“The two of us will hold it.”
“okay.”
In response to Kwon Il-soo’s answer, Min Byeong-seok and Woo Jae-won grabbed the two blood vessels with forceps and held them together.
“5-0 prolene.”
Let’s go together.
After tightening the suture needle with the needle holder, suturing began.
What we need to do from now on is to repair the defective ascending aorta by suturing the ascending aorta and pulmonary artery.
As the full-scale suturing began, the operating room became quiet.
All the staff’s attention was focused on Kwon Il-su’s hands. Kwon Il-su’s every knot and stitch determines the success or failure of the surgery.
“Jaewon, my hands are shaking so much.”
“S-sorry.”
“Just concentrate a little longer. It’s almost over.”
Kwon Il-soo held his breath and continued to delicately suture.
click!
The suture was cut by Seo Ji-hoon’s cutting.
The first stage of the Norwood surgery, ascending aorta remodeling, was completed successfully.
While Min Byung-seok was wiping the bloody spot with gauze, Kwon Il-soo turned his head and took a moment to relax.
The real surgery starts now.
Since the existing pulmonary artery was attached to the ascending aorta, a new pulmonary artery path must be created.
“Meth.”
The sharp blade moved.
Kwon Il-soo placed a scalpel at the beginning of the bifurcated pulmonary artery and cut straight down.
Half pulmonary artery.
The pulmonary artery on one side was attached to the ascending aorta and separated on the other side.
“dakron (artificial blood vessel).”
Under Kwon Il-soo’s instructions, Min Byeong-seok aligned the artificial blood vessel with the lone pulmonary artery.
“You’ve done well so far, and you just have to keep doing the same from now on. Okay?”
“yes!”
Kwon Il-soo calmly began suturing the artificial blood vessel.
But as time passed, my eyes became blurry and my hands lost feeling. For some reason, I felt like my body was floating. I felt like I used up too much mental power during the first stage of the surgery.
‘What are you doing you idiot? Wake!’
Kwon Il-soo pushed himself.
In the past, surgeries lasting over twelve hours were performed with ease. It is impossible to be distracted to this degree.
widely!
I put down the surgical tools and looked into the observation room.
I came to my senses when I saw Jo Ji-hwan and Jang Hyuk-pil, members of the Pediatric Thoracic Surgery Association, in the front row.
Continued Blalock-Taussig shunt.
There was silence not only in the operating room but also in the observation room.
‘Are you tired?’
Hyukpil Jang looked at the monitor and frowned.
The Norwood team has changed.
In the previous surgery, the Norwood team focused entirely on Kwon Il-soo. Kwon Il-soo provided key measures and other staff members thoroughly supported him.
But today, the entire staff moved flexibly.
Seo Ji-hoon, the third assistant, performed suction, and the second assistant fixed the surgical site. Min Byeong-seok, the first assistant, also showed more active movements than before.
Kwon Il-soo was reborn as a true team rather than a one-man system.
‘Has something happened in the meantime?’
Hyukpil Jang folded his arms in frustration.
The weakness of the Norwood team he thought had disappeared.
That means the Norwood team has risen to a level that threatens the Saber team. As I glanced at Jo Ji-hwan, a gentle smile appeared on his lips.
It seems like Kwon Il-su liked the surgery.
If this is the case, a fierce battle will be inevitable when the heart clinic opens.
click!
The sound of scissors rang out clearly.
The ascending aorta and pulmonary artery surgeries, which can be considered the backbone of Norwood’s surgery, have been completed.
“Shall we try it?”
“yes.”
Second assistant Jaewon Woo poured saline solution into the pulmonary artery.
Saline flowed from the pulmonary artery, but did not flow into the sutured area.
Paragraph formation is successful.
Cheeeeeeeek.
After sucking up the saline solution with a suction device, I began the final surgery.
With atrial septum surgery, the thick tissue formed in the septum is slightly cut.
Empty!
Norwood’s surgery ended when the tissue fell off.
There was pride in the staff’s eyes as they looked at each other.
“Jaewon should close the surgical area.”
“I… do you mean me? This is normally the manager’s job…”
“It’s okay. I’m in my second year as a fellow, so can’t you entrust me with this level of responsibility?”
“All right.”
Jaewon Woo closed the surgical site and soon the heart-lung machine was turned off.
“The patient’s vitals are normal.”
“There is nothing wrong with the suture gauze curtain ball counting.”
The words of the anesthetist and disinfection nurse sent a thrill down my spine.
Kwon Il-soo barely suppressed his crying heart and opened his mouth.
“Thank you. Everyone worked hard.”
* * *
That afternoon.
Choi Ki-seok, who was working in the ward, received a call and went down to the first floor.
When we arrived at the cafe, a familiar face stood up and waved happily.
“It’s been a while, Teacher Choi.”
“Hello. You must be busy, but thank you for stopping by.”
“I’m not busy at all, so please call me often.”
Reporter Park Kwang-soo said with a smile.
“We have to order something first, right?”
Ki-Seok Choi returned to his seat after ordering coffee.
“Still, it’s definitely unexpected. I didn’t expect Mr. Choi to call first.”
“Hahaha… me too.”
“Anyway, Uijin University has become a hot topic in many ways these days.”
Park Kwang-soo changed the topic.
Lung cancer symposium held, cooperation agreement with Changjin University Hospital in China, success of Saber surgery and Norwood surgery, large-scale remodeling of the heart clinic, etc.
If you look at the news on large portal sites, you will only see news about Uijin University.
“Because that’s what the manager wants.”
“Well, the hospital would probably prefer that. Seeing how this is happening, I think I will serve as the manager for about two years and then run for the vice hospital director election.”
“Maybe so?”
“I agree too.”
Weeeeeee.
A vibrating bell rings at the right time.
Choi Ki-seok went to the cash register with a vibrating bell and got coffee.
“I’ll tell you straight. The reason I visited Reporter Park is because I wanted you to publish a large-scale article about Elita.”
“If it’s Elita… it’s a lung cancer treatment that was recently released.”
“Yes. That drug can be problematic. An acquaintance of mine suffered an acute myocardial infarction after taking Elita.”
“Hmm… Even so, stories of side effects are coming out every now and then.”
Park Kwang-soo took a sip of coffee and continued.
“As Dr. Choi said, the main symptoms of side effects are redness of the skin and acute myocardial infarction.” ”
I’m sorry to hear you already know . This is comfortable. If I hand over the side effect case data, can you make it louder?”
“You can’t do that, right? But I don’t know if it will be effective.”
“Why?”
“Elita is a new drug that Yangcheon Pharmaceutical is pushing hard. It has already received official approval from the Ministry of Food and Drug Safety. It is questionable whether a few cases of side effects can lead to the suspension of sales.”
Park Kwang-soo expressed skepticism.
“But if we leave it like this, the number of victims will increase. We have to take action first.”
“That’s right, but…”
“Reporter, please just publish the article. I’ll take care of the rest.”
Choi Ki-seok took out a ringing cell phone from inside his robe and made a call.
Soon, a man dressed in a suit appeared. I came into the cafe.
“Shall we now listen to the story of the reinforcements?”