Healing Doctor

Chapter 69 Overstepping One's bounds

"Dr. Ji, minimally invasive surgery is a bit difficult, especially the step of inserting the guide wire from the bladder into the ureter, which is different from surgical procedures. Please observe for a couple of days before proceeding."

While Ji Xiang was changing clothes, General Manager Wu stood to the side and gave him a heads-up.

Mr. Wu was genuinely afraid that once he stepped onto the stage, Ji Xiang would transform into a different person, staring intently at him...

He couldn't bear to think about it; just thinking about it made Mr. Wu's whole body itch.

"Yes, Mr. Wu." Ji Xiang did not refute Mr. Wu's words.

After undergoing systematic surgical training in the operating room, his overall skill level has surpassed that of clinical professors and department heads, reaching the top level in the province.

Dr. Wu's surgical skills as a resident are just so-so; Ji Xiang could have easily surpassed him long ago.

But Ji Xiang just smiled and stood obediently in his assistant's position.

"Wow, you got the patient into position really fast today." The circulating nurse came back in a hurry, carrying a bunch of things. She praised the patient for being in the lithotomy position so well.

"Sister Chu, hurry up and open the package," Mr. Wu urged.

"Ready? I'm opening the package."

"What are you going to do?!" the patient asked in confusion.

The anesthesia is a combination of continuous epidural and sellar region anesthesia, and the patient can hear the conversation between the doctor and the nurse.

He couldn't understand why he had to open a package for himself.

Everyone in the operating room was stunned for a moment, but the circulating nurse quickly reacted.

Everyone is used to this kind of thing; as long as the car is going fast enough, everything is stationary.

However, the patient was not used to it.

The car was going so fast it was going to throw him off.

"The surgical sterile pack is disinfected," the circulating nurse explained simply, not taking it seriously.

"This is the first time I've heard of any other ambiguity. Sister Chu, you open bags every day, it's so enviable," Mr. Wu said with a grin.

"Stop talking nonsense, we have three surgeries to perform, hurry up!" the circulating nurse scolded. "Why didn't you come back after lunch? You have to do them back to back."

"Sister Chu, we serve the people wholeheartedly and relieve patients' pain. How can I eat if the patients are not feeling well? You agree, right?"

"If you keep talking nonsense, believe me, I'll crush your kidney stones into a giant pill and stuff it into your mouth."

Mr. Wu shrugged and began the surgery.

The ureteroscope is inserted and moved little by little through the urethra into the bladder.

Mr. Wu moved the camera around and first looked at the condition inside the bladder.

The bladder was slightly red, but the color was normal, and there were no stones or polyps. Mr. Wu then compared the two ureters and chose to enter the affected side.

Before entering, Mr. Wu checked with the anesthesiologist again to confirm that the left and right sides were correct.

Although Mr. Wu was being overly cautious in his checks, Ji Xiang didn't sense anything was wrong.

In the system's operating room, the system NPCs would double-check everything, even when facing simulated humans, for fear of getting the direction wrong.

Non-vascular lumen guidewires consist of a guidewire rod, a spring tip, and a plastic coating.

Based on the different spring tips and whether they are plastic-coated, guidewires are classified into large-tip rigid guidewires, flat-tip rigid guidewires, and plastic-coated guidewires.

Mr. Wu chose the Zebra guidewire, which is a flat-tipped rigid guidewire.

After locating the ureteral orifice, Mr. Wu flexed his wrist and said to Ji Xiang, "This is the most difficult part. The guidewire is too thin, there is urine in the bladder, and there are also factors such as bladder muscle spasms, making it quite difficult to insert it successfully."

"That's called insertion," the circulating nurse corrected.

"Same, same. Speaking in such flowery language is meaningless. 'Insertion' is just inserting, what's the difference?"

After saying that, Mr. Wu stopped joking with the circulating nurse and focused on operating the zebra guidewire to align with the right ureteral orifice.

It's off-center...

Ji Xiang could tell from the shape of General Manager Wu's hand that this time the insertion would definitely fail...

Mr. Wu is right, this step is indeed the most difficult, otherwise the system NPC would not have taught me the two methods of solving the problem: the rotation method and the upward slash method.

In the operating room, Ji Xiang spent a long time learning this step before he could even begin to grasp its basics.

Unfortunately, Mr. Wu didn't even know where the front door was, let alone the threshold.

The ureteral orifice is hidden in the folds of the bladder; it's not like a piece of paper with a hole where you can just insert a zebra guidewire.

Furthermore, the ureteral orifice moves with the peristalsis of the bladder, making successful catheter placement quite difficult.

The first attempt failed.

Mr. Wu didn't expect to succeed on the first try. He stepped the zebra guide wire back a little, preparing to try again.

Mo Chenggui, standing behind, was relieved to see that President Wu had no intention of suppressing Ji Xiang.

Ji Xiang was his student, at least that's what Mo Chenggui thought.

Everyone has a protective instinct, and Mo Chenggui is no exception.

He planned to leave once he saw that Mr. Wu had successfully placed the tube.

One failure is nothing, and that's what Mo Chenggui thought too.

Even when Mo Chenggui tries it himself, it's common for him to fail eight or ten times.

If all else fails, the ureteral opening needs to be dilated using an infusion hydraulic pump, and the endoscope can be placed directly under direct vision guided by a safety guidewire.

The greatest difficulty in lithotripsy and stone removal surgery lies not in the stone itself, but in this area.

Mr. Wu's second attempt also failed.

Mr. Wu's sterile cap began to get a little damp, and you could vaguely see his flattened hair.

It’s just that!

I originally intended to teach Ji Xiang how to perform surgery as a way of repaying a favor, but who knew that the patient's ureteral orifice would be so difficult to find.

Mr. Wu focused his mind, putting all distractions aside, and concentrated on doing it again.

failure!

fail!!

fail!!!

The series of failures left Mr. Wu somewhat disheartened.

"Prepare the infusion fluid." Mr. Wu sighed.

He then reassured the patient, "We just need to put some water into the bladder and then pressurize it; it's that easy to do."

The patient didn't understand, and could only nod blankly after hearing what Mr. Wu said.

Mr. Wu handed the zebra guidewire to Ji Xiang and asked him to hold it before preparing to inject the fluid.

There was nothing that could be done about it; Mo Chenggui, standing at the back, was also quite helpless.

The patient's ureteral orifice is indeed quite deeply hidden, no wonder... wait!

The next second, Mo Chenggui saw Ji Xiang looking into the mirror and gently twisting the zebra guidewire with his right hand.

!!!

Mo Chenggui was stunned.

Ji Xiang's technique is a hundred times better than General Manager Wu's!

Laser lithotripsy is a technology that has only been developed in the last ten years or so. As Mo Chenggui gets older, it becomes more difficult for him to insert the guidewire precisely.

Mr. Wu is young, and his abilities are even superior to his.

But Mo Chenggui has a solid foundation, so he can at least distinguish between high and low skill levels.

The upward flick technique!

A standard, textbook-perfect upward flick!

Mo Chenggui's pupils contracted, his eyes narrowed into slits, and he stared intently at the zebra guide wire between Ji Xiang's fingers.

At that moment, Mr. Wu was preparing the infusion fluid and did not see this scene.

Ji Xiang can actually perform ureteroscopy!

A horrifying thought popped into Mo Chenggui's mind.

If his skill in cutting leather bags is very high, Mo Chenggui can understand it.

Medical students all have internships. Perhaps Ji Xiang was exceptionally talented and mastered the procedure after performing a few circumcisions with his teacher.

However, ureteroscopy is classified as a level 3 surgery!

Although it is minimally invasive, it is a very high level of surgery. Even a resident like Mr. Wu is only at the level of surgery.

If the requirements are really strict, even the chief resident of the Second Affiliated Hospital wouldn't be qualified to do it.

Normally, Ji Xiang would never have been able to access such advanced surgery.

however!

The zebra guidewire seemed to come alive between Ji Xiang's fingers, moving forward little by little, slowly and steadily.

This is something no novice could do!

Compared to Ji Xiang, General Manager Wu seemed like a greenhorn. On their wedding night, he was sweating profusely but still couldn't do anything, having no idea what he should do to successfully insert the implant.

Mo Chenggui noticed that Jixiang's wrist was slightly lowered, and his eyelids twitched.

Indeed, it wasn't a fluke; this is the most standard upward flick technique!

After a few breaths, the zebra guidewire finally stopped.

Did you get in?

Mo Chenggui looked at Ji Xiang with a puzzled expression.

Either he copied the cat so well that he developed a misconception.

Alternatively, Ji Xiang had already successfully inserted the zebra guidewire into the ureter on the affected side while breathing.

"Prepare the injection pump," General Manager Wu said in a deep voice.

With the infusion solution ready, Mr. Wu approached the mirror, preparing to take one last look.

When his gaze fell on the surgical area, his hand froze.

Guide wire!

Zebra guidewire!!

It ran into the ureter by itself!!!

What's going on?!

Countless exclamation marks appeared in Mr. Wu's mind, leaving him completely stunned.

"Mr. Wu, hurry up." The circulating nurse had already prepared to connect the pressure pump. Seeing that Mr. Wu was standing there like a statue without saying a word, she urged him.

"..."

Mr. Wu stared blankly at the mirror, unable to understand how the zebra guide wire had been inserted.

"No...no need...no need," Wu stammered.

"What's going on?" the circulating nurse scolded unhappily. "Using it one minute and not using it the next, did you not sleep well last night?"

"They're already inside," Mr. Wu said helplessly.

"Huh? You're already inside and you're still pressurizing him? Are you crazy?" The circulating nurse wasn't going to put up with Mr. Wu at all, especially seeing his blank expression made her even more annoyed.

Mr. Wu didn't retort; he took another careful look.

The zebra guidewire was indeed successfully implanted.

Countless questions flooded my mind, but no matter what, as long as the guidewire goes in, it's all good.

Mr. Wu continued the procedure, slowly inserting the ureteroscope until it reached the stone. Fortunately, the stone didn't cause any further problems and was clearly visible there.

He first used pliers to clamp the stone, tried it, and determined that the stone was too large to be completely removed from the ureter.

The laser lithotripter was started to break up the stones. Mr. Wu broke the ureteral stones into pieces about 1-2 mm in size. Larger stones were removed into the bladder using stone retrieval forceps.

The surgery went smoothly, and no symptoms such as ureteral mucosal rupture or ureteral perforation occurred.

Nevertheless, Mr. Wu cautiously placed a double-J stent for internal drainage in the ureter and retained the urinary catheter.

Although the subsequent surgery went smoothly, Mr. Wu relied on his muscle instincts to operate, and he remained somewhat dazed throughout.

After the surgery, Ji Xiang took the patient home.

Mr. Wu closed his eyes, all he could see was that zebra guide wire, which had inexplicably entered the opening of his right ureter.

Turning around, he saw Professor Mo watching a surgery and instinctively asked, "Professor Mo, have you been watching the surgery?"

"Okay." Mo Chenggui nodded, then turned around. "Xiao Wu, come with me."

Mr. Wu took off his surgical gown, tossed it aside, and left the operating room with Mo Chenggui.

"Xiao Wu, were you startled when the zebra guide wire was suddenly inserted?" Mo Chenggui didn't go far, but stood in the corridor and asked in a low voice.

Mr. Wu nodded.

"I saw it. It was Dr. Ji who performed the procedure, using the upward lifting technique."

"!!!"

"It took about ten seconds, I did it very steadily, and it was done in one take."

"!!!"

Mr. Wu was speechless.

Tears streamed down my face like frothy apple juice.

(End of this chapter)