Surgery Godfather

Although there is no X-ray monitoring from the interventional room, having ultrasound monitoring now is better than going past the narrow part blindly. Yang Ping told the ultrasound doctor, “Keep this position, don’t move it, I am going to insert the tube.”

The hand of the ultrasound doctor was very steady, freezing at the position Yang Ping thought was good. He was sitting at the edge of the bed, with his hand suspended in the air because he couldn’t press against the abdomen, which was very taxing. To maintain stability, he propped up the hand holding the probe with his other hand.

“Miss Ning, could you please step out for a moment?” Yang Ping said.

Family members are generally not allowed in the room while the doctor is performing the procedure, because sometimes they may interfere with the operation. Especially at critical junctures, if the family members do not understand the principles of the operation, they may easily misinterpret the situation. And once they interfere, things could go wrong.

Miss Ning hesitated and then reluctantly left the ward. As she left, she said to Yang Ping, “Please take care of him!”

Yang Ping nodded at her definitively.

“Be careful, Xiao Yang! The blood vessel wall is very thin right now, a slight prick could rupture it.” The associate chief physician of the vascular surgery department reminded him, purely out of concern for his colleague.

Director Jiang suggested, “Shouldn’t we withdraw the catheter and use interventional tools to send in a vascular stent, use it to prop open the narrow part, and then re-catheterize?”

This method seemed good, but it was infeasible at the moment. The catheter could not be withdrawn. Once it was withdrawn, the entire human circulation would be interrupted. Mr. Ning’s lungs hardly functioned on their own, so the direct consequence would be a domino effect, leading to the failure of multiple organ functions, which would be beyond saving.

“The catheter can just pass through the narrow part. As long as the direction is adjusted correctly, it should be able to go through. The catheter cannot be withdrawn. If it is, the blood oxygen level will drop straight down!” Yang Ping stared at the ultrasound screen and said.

Director Jiang stopped talking. Yang Ping was right. Once the catheter was withdrawn and the new catheter had not been inserted, the patient’s blood oxygen level would drop drastically, causing cerebral tissue hypoxia and triggering multiple organ failures.

Ultrasound cannot replace touch, especially as the ultrasound image shown is two-dimensional and distorted.

Yang Ping judged the depth and state of the catheter based on the length and state of the exposed part. He held the catheter with the thumb, index finger, and middle finger of one hand and gently rotated it.

He withdrew about one centimeter first, the image in his mind was blurry. Yang Ping enhanced it in his brain, causing it to be clearer, but due to the mental strain, sweat appeared on his forehead. He had to try several times before the image was clear.

Just like when ordinary people try to remember an object, its image stays clear in their minds at first, but after a while it gets blurry. Especially the details, they can’t recall them at all.

“Xiao Yang! If you can’t, don’t force it–”

Director Jiang was on tenterhooks, fearing that rookie bravado might lead to extreme bleeding and immediate death. Even if the family didn’t pursue the matter, it wouldn’t be a good thing.

“Don’t worry, I’ve got this.” Yang Ping responded.

He gently moved the catheter upward until it hit the narrow part. The slight contact between the catheter and the narrowed area sent a delicate sensation through the catheter to his hand. His hand made fine adjustments depending on this indirect tactile feedback, as if threading a needle.

Bit by bit, they all stared at the ultrasound screen as he managed to adjust and move past the narrowing.

“I can’t hold it steady anymore.” The ultrasound doctor’s suspended hand started to shake.

Yang Ping immediately, gently pulled the tube back: “You can relax your hand, rest for a bit, I’ll wait for you!”

After a short break, the ultrasound doctor’s probe was pressed down again.

Yang Ping’s hand that was guiding the catheter didn’t move at all, he waited till the ultrasound image of the blood vessel and catheter reappeared, his hand began to adjust the catheter again, and began to slowly pass it through the narrow area.

The blood oxygen level fluctuated severely and suddenly dropped, Mr. Ning became agitated, Yang Ping’s hand withdrew the catheter once again, with precision ensuring it didn’t hit the blood vessel wall.

“Give him more sedatives!”

An anesthetist, who had been silent all along, only spoke up when necessary.

The narrow part was just big enough for the catheter to pass. If the direction deviated slightly, it would be impossible to pass. If the patient became agitated while passing, there was a high probability that the catheter would puncture the blood vessel.

The risk was too high passing it slowly, Yang Ping decided to seize the opportunity to pass it quickly.

At this time, Director Han, who had been notified by Director Kong, came in. After all, it wouldn’t be right not to inform him when it involves high risk operations being performed by a member of his team.

Upon hearing the news, Director Han immediately rushed over from home. No matter how capable Yang Ping was, he was still human. Having Han around could help provide additional advice.

“Director!” Yang Ping greeted Director Han.

Director Han nodded slightly, indicating for him to continue his work without distraction.

After greeting Yang Ping, Director Han went over to the viewing lamp to examine the films. After studying for a while, he spoke:

“Xiao Yang, in this situation, it’s best to proceed quickly, although the risk is extremely high, but it’s still better than proceeding slowly.”

The idea coincided with Yang Ping’s.

“Call Miss Ning in!” Yang Ping wanted to discuss the risks with her; this was a gamble. If successful, Mr. Ning could hold on for a few more days, even several tens of days; but if not, his heartbeat and respiration could stop at this very moment.

Director Kong understood Yang Ping’s intentions and said, “We’ve already had a careful discussion before the surgery; the risk is extremely high, he might stop breathing and his heartbeat may stop immediately”.

But Yang Ping still insisted on the necessity of discussion: “Let me talk to her again”.

Director Kong summoned Miss Ning. Just earlier, Miss Ning had been pacing anxiously in the hallway. Although she had mentally prepared herself for this, at this critical moment, she still found it hard to accept.

“Miss Ning, this catheter must pass through the narrow portions now; otherwise, Mr. Ning will not survive today. However, passing through these narrow parts carries a very high risk. I have to seize this opportunity to quickly insert the catheter; success or failure would be a split-second difference. We only have this one chance for success. If we succeed, Mr. Ning could hold on for a few days, even tens of days. If not, his heartbeat and respiration could stop immediately. I’d like to hear your opinion and whether you’re willing to take this risk–”

Now, the anesthesiologist had administered a sedative, leaving Mr. Ning unable to express himself, even a simple nod was out of the question. Miss Ning was caught between a rock and a hard place. Her facial muscles trembling, her lips attempting to speak but only resulted in small movements without any sound coming out.

“We don’t have much time. The current oxygen pressure is extremely high, we can’t maintain this pressure for too long!” Yang Ping said calmly.

If they didn’t take this risk, Mr. Ning wasn’t likely to survive the day. This would be no different from his heart stopping on the spot. Miss Ning analyzed that her father was stalling because he wanted to see his younger brother one more time.

Although she was young, her years of experience in the business world had made her calmer and more rational than most people.

“What are the chances of success?” Miss Ning asked.

Yang Ping shook his head: “It’s hard to say!”.

Biting her lip, Miss Ning said decisively: “Doctor Yang, I trust you. You do everything you can, I’m willing to take this risk, whatever the consequences, I’m ready to accept them.”

“Alright, I understand, you wait outside!” Since the family member was willing to take the risk, he might as well gamble.

Yang Ping had some level of confidence, however, he knew that it was crucial to clarify the situation with family members specifically and not to make things appear more certain than they actually were.

Miss Ning went out, and the door to the intensive-care ward was closed by a doctor.

“Can you still continue with the ultrasound? If no, take your hands off for a rest.” Yang Ping said to his colleague operating the surface ultrasound machine.

“I can keep going!” The technician replied.

“Just hold the position steady for 30 seconds and I can finish inserting the catheter. Make sure to hold completely still, it’s best if you rest a bit.” Yang Ping noticed the ultrasound technician had been holding the position for quite some time.

“Alright!” The technician retreated the probe, started to stretch a bit, weak and numb.

After some rest, he picked up the probe again and pressed it firmly onto the right side of the abdomen. When the image captured was at its best, he froze in position.

“Alright, don’t move!”

Yang Ping and the ultrasound technician exchanged confirmative looks.

“Hold steady, look for the right opportunity and pass through in one go!” Director Han encouraged.

Everyone held their breath, falling silent, eyes glued to the ultrasound screen.

The ultrasound technician gritted his teeth, his hand held perfectly still, like a statue.

The screen was extremely stable with no tremors, the red and blue colors representing blood flow flickered.

Yang Ping adjusted his breathing, holding on to the catheter, releasing and tightening his grip to adjust it to just the right direction, before he made his move!

In an instant, it was as if a sniper who had been aiming for a long time finally pulled the trigger.

Perfect! The catheter successfully passed through the narrow segment without touching the vessel walls, moving on a further twenty centimeters before Yang finally loosened his grip.

Everyone let the breath they’d held in their throats out, relieved.

On the monitor, the oxygen saturation, which had been dangerously low, gradually rose….90, 92, 95, 99–

“It’s a success!” Director Han said, barely managing to suppress the excitement in his voice.Nôv(el)B\\\\jnn

With the support of this ECMO machine, Mr. Ning could survive for a few days. If they were lucky, even a few tens of days.