The Returning Doctor Wanted to Live Quietly - Chapter 311



Only Noblemtl

Episode 311. Vice Resident (7)

Although it was my first time performing a laparoscopic surgery, the professor who came in was there to look after me like any other surgery.

So there shouldn’t have been any spectators.

but.

– That’s what Professor Lee Jin-hyeok said. Isn’t it similar to patient Park Seon-jeong? They say that when you play a musical instrument, your left index finger gets stiff, but when Lee Jin-hyeok performs a surgery, he also hesitates.

– what?

– He’s fine when he’s standing, but he hesitates when he’s performing the surgery.

– that…….

– Look. The environment is the same. Excessive attention. The perfectionist personality. The spotlight. The expectations of a genius. Even the sense of responsibility. Well, it’s all the same.

Word spread later that the patient looked exactly like Park Seon-jeong.

The professors who had casually entrusted Jinhyeok with the task had to harden their faces.

Of course, it’s not like I had nothing to say.

Park Seon-jeong’s problem is caused by the brain nerves.

So, it was a suspected finding of localized dystonia.

However, Asin Hospital, like Seoundae and Catholic Hospital, gave a different diagnosis.

As a result, everyone had no choice but to gather in the observation room.

“Patient Park Seon-jeong, are you saying that this is not focal dystonia (localized muscle tension disorder)?”

“What, it’s closer to autonomic dysfunction?”

“Stress-induced autonomic nervous system disorder? Hmm. Could it be focal dystonia?”

“Well, there’s no clear diagnostic method. It might not be true. It might be true.”

“Heh heh.”

“If every doctor’s diagnosis was the same, cancer patients wouldn’t have to move between hospitals.”

In the end, it was diagnosed as a psychological problem.

I also did an EEG while playing the violin.

Psychiatry and orthopedics. The conclusion reached by examining the hands and feet and nerves was different.

The problem is the hope of the surgical department.

The same was true for Lee Jin-hyeok.

“Our teacher is also showing the same symptoms as patient Park Seon-jeong… … This is a big problem. This is a big problem.”

“You can’t be perfect. I think you’re pushing yourself too hard.”

“I thought you were hesitating for a moment because you had a lot on your mind. Ha, right.”

“Haha. You didn’t even sleep. You just watched the surgery videos. I guess you put too much pressure on me.”

Those who show a different attitude than a week ago.

Because she was unsure, she was concerned about Jinhyeok’s behavior, which she was watching closely, and linked it to the symptoms that Park Seonjeong was showing.

When everyone was making such a fuss about Jinhyuk.

Park Woon-hyeok, a leading expert in psychology, asked.

“The upper exit is blocked. Why do you do a gastrojejunostomy? Isn’t it a surgery done when the vital signs are unstable or when there is cancer (stomach cancer) or when the condition is severe?”

“… … .”

“If it’s GOO (Gastric outlet obstruction), I think it can be treated with pyloroplasty.”

“That’s because it’s not a situation that can be resolved by just touching the pylorus (the tissue connecting the stomach and duodenum).”

“Is the degree of closure severe? It’s not like I’m that skinny.”

“Patient Park Seon-jeong, you already had the news, right? That’s why it didn’t show that the food wasn’t going down to the small intestine, and now… … .”

The explanation went on for a long time.

At that moment, Jinhyuk, holding the scalpel in his hand, began to cut.

Just below the belly button.

The skin incision has begun.

“Oh, I started! But I think I put it too close. I should have done it from a little lower… … .”

“Haha, that’s right.”

“This is my first time performing laparoscopic surgery. Hmm.”

Once you start to worry.

A situation where everything is concerning.

Everyone’s faces hardened, showing the reaction that other hospital professors would show.

Professor Sangsoo Seo, who brought up the myth of Sisyphus, came forward.

“Linea alba (Linea alba, white line). So, it seems like they were aiming for white line.”

“There is no reason to go through all that trouble… … .”

“Isn’t she a female patient? Her scars are sensitive… … Well, whiteheads don’t have muscle layers, they only have fibrous tissue, so they recover quickly. Well. I guess you have an idea.”

“That may be true, but… … .”

These people talk a lot about intentions.

There was only one thing that was clear.

Everyone was looking at Lee Jin-hyeok with eyes of worry and concern.

* * *

It wasn’t intentionally difficult.

Laparoscopic surgery.

I’ve done this a lot in thoracic surgery.

The reason he hesitated was because he wasn’t sure whether ‘this was enough’.

The basics were thorough.

That’s why Jinhyuk, who finished cutting the skin, immediately reached out his hand.

“Mosquito.”

Mosquito forceps handed out immediately.

Use this to hold the edges of the cut skin surface.

I repeated the process of gently pulling and peeling.

It is to separate the fat layer.

“Bovie (electric cauterizer).”

What followed was fasciotomy.

I held the electric cautery like a pencil and moved my hand up and down.

Because you can’t kick it out deeply all at once.

The fascia was removed little by little, as if removing fluff with an electric cautery.

Of course, since I deliberately avoided the muscle layer, the speed was fast.

As the dark red peritoneum became visible, Jinhyeok reached out his hand again.

“Kelly Forceps. Please cut me.”

“I will make the incision.”

“Yes, I will push it in right after I make the incision.”

Soon, blunt-tipped, grooved forceps are handed out for vascular hemostasis.

Intended to be used to secure a passage for inserting a trocar.

As soon as the first assistant moved his hand, the peritoneum opened.

Although he hesitated, Jinhyuk quickly pushed Kelly Forcep inside.

I felt resistance, but I didn’t hesitate.

Rather, it was good.

They say that inserting a catheter actually makes it safer.

“11mm Troca.”

A thick trocar needle is immediately inserted.

Since the peritoneum was opened through an umbilical incision, organ damage was confirmed using a Veress Needle.

So the catheter was inserted without even having to check whether the abdominal wall was properly perforated.

What followed was an incision in another area.

One on the outer border of the rectus abdominis.

One more beyond that boundary.

The opposite side is the upper right side of the belly button.

So, for the distal incision, diagonally. Two trocars were inserted, slightly distant from the umbilicus.

The gap is 5cm.

It was a movement that was almost orthodox, but no one responded with surprise or exclamation.

This is because everyone was just watching to see if Lee Jin-hyeok would hesitate again or not.

* * *

Preparing for basic surgery.

Create space by injecting gas into the abdominal cavity.

The camera mount for the field of view is also complete.

That’s not all.

The laparoscopic tools that Jinhyeok and his assistant would use were pushed in through the trocar, and the patient’s position was also changed.

I even adjusted the bed slightly to avoid my organs being pressed down by gravity.

Now it’s time to get into the actual surgery.

At that time, Seo Sang-soo, who was in the observation room, tilted his head.

“The left hand position is a little… … .”

“What are you talking about?”

“I’m talking about the position of the surgeon’s left hand. It seems too close to the outer border of the rectus abdominis muscle. What do you think, Professor Chang?”

“Well, everyone does whatever they want. I put the full amount on the line, because that’s convenient.”

“I will also lower the amount to the full amount.”

“Well, it’s different for everyone. So, ah… … .”

At that moment, the professor who had been asked a question by Seo Sang-soo let out a sigh.

A habit that all surgeons have.

In baseball terms, there are bound to be things like quirks.

But Lee Jin-hyuk also has a crush.

It was a little strange.

I’ve done a lot of laparotomy surgeries, but today is my first time doing a laparoscopic procedure.

It was a little strange that Jinhyeok, who had only ever performed laparoscopic surgery, had a Kuse.

“… … .”

“… … .”

“… … .”

“… … .”

When there is only quiet silence and everyone is puzzled.

Liver retraction has begun.

* * *

Laparoscopy has distinct advantages and disadvantages.

Recovery is quick as it does not require surgery.

There are also fewer scars.

But it is a situation where the view can be said to be completely blocked.

The liver covering the stomach, that is, the left lobe, had to be removed first.

Jinhyuk looked at the monitor and gave instructions in a dry tone.

“Down.”

“four.”

“Back up again.”

“… … .”

“No, down there again.”

“yes.”

The one in charge of the camera was his junior.

It was possible to use informal language because it was R1.

Of course, I didn’t like moving that much, but I just had to guide it.

Jinhyuk looked at the monitor and repeated his instructions, the avascular area.

So, we focused on finding the liver ligament, which does not have many blood vessels passing through it.

The moment I thought it was over.

The professor who was teaching opened his mouth.

“I’m going to lift the left lobe of the liver. Not too high. Just enough to secure the field of vision. Can you do it?”

“Yes. First, I will remove all the ligaments that are holding the liver together.”

“Minimize bleeding. Remove appropriate amount.”

“All right.”

But again, that damn word ‘moderate’ came up.

Jinhyuk thought so.

Just as the diagnosis varied from doctor to doctor, the surgical method also varied from doctor to doctor.

A view that allows you to see upwards.

So, I wanted someone to definitely lift the left lobe of the liver.

Someone else thought that it would be okay to just show off a little bit.

How do you know?

This was the conclusion I reached after watching dozens, if not hundreds, of videos of gastrointestinal anastomosis over the past week.

‘There is no right answer anyway. The right answer is to just do your best.’

Jinhyeok Akmun immediately moved the harmonic (laparoscopic ultrasonic cutting machine).

First, the left triangular ligament.

The ligaments that attach the left lobe to the diaphragm were resected.

The ligaments attached to the anterior abdominal wall are then cut one by one.

Soon, as the left leaf began to shake to the point where it could rattle, Jinhyuk looked at the monitor and gave instructions.

“Please give me a Penrose drain (rubber tube) and 2-0 Prolene (non-absorbable suture).”

“I’m ready.”

Everyone was busy moving their hands at Jinhyeok’s announcement.

Ligaments coagulated and excised simultaneously using ultrasonic energy.

Open it again and insert the suture.

Since I had to drain the Penrose drain and also fix it, I changed tools quickly.

And from then on, Jinhyuk’s movements became faster.

Secure the suture using a hemorlock (surgical clip).

Again, work was done to install a Penrose drain so that the left lobe could be pulled to the right of the humerus ligament.

The sight was so fast that a sigh of relief escaped the observation room.

“Haha, as expected, it’s our teacher Lee.”

“Genius is genius.”

“Haha. As expected! As expected! You’re a genius!”

The professors smile with satisfaction.

They started making noise when they started the left partial omentectomy.

* * *

Clearly, he was doing well.

And that too, very quickly and accurately.

R3 was showing off his dexterity that he couldn’t show off.

But, I hesitate again.

In fact, it was closer to a momentary hesitation that could not be called hesitation.

Jinhyuk also has his own shortcomings.

So, I knew that I was hesitant when it came to making value judgments, and I was working to fix that.

So, it shouldn’t be called hesitation.

But where is the person like that?

A situation that was already being viewed through colored glasses.

The professors who thought that Jinhyeok, like Park Seonjeong, would suffer from psychological pressure immediately started talking nonsense.

“No, I… … Heh heh. If you lift the lower anterior wall of the upper body with forceps, wouldn’t it be possible to just do it?”

“I could see all the blood vessels leading to the temple. Why? Hehe. I hesitated for a moment. I hesitated.”

“Aren’t you worried about whether you should stick close and restrain yourself or distance yourself a little and restrain yourself? That much… … .”

“No, no. Just let the transverse colon fall naturally due to gravity. Just cut it off while being careful of the superior reticularis oculi.”

The observation room was quite messy.

Someone claimed that he hesitated.

Anyone would have thought it was a time to worry.

It was just a moment compared to the hesitation I showed during the past week.

But right now.

“Ugh.”

Hospital director Oh Ji-ho, who entered the observation room late, was the first to say this.

It all happened because everyone mistook Lee Jin-hyeok for a genius.

.