The Returning Doctor Wanted to Live Quietly - Chapter 312



Only Noblemtl

Episode 312. Vice Resident (8)

Omentectomy.

It is a fatty tissue that fills the abdominal wall from top to bottom.

What should I say?

Should we say that the yellow folds covering the intestines spread out like an apron?

Well, anyway.

Now that I’ve taken out the liver.

It’s time to kick the lid off and reveal the top.

but.

‘What is it, why is it so noisy?’

An unwelcome voice is heard from the observation room.

Who is making such a loud noise?

Without any manners.

Jinhyuk immediately raised his voice.

“I will abate right away.”

After notifying the professor who came in as the first assistant.

I started moving my hands right away.

Dduk.

Dduk.

The omental blood vessel is resected using an ultrasonic cutter.

Of course, there was no certainty.

Although I was fully prepared, I lacked experience.

He just cut out the part he thought was the best.

It was a while before I noticed the professor’s expression as he came in.

He lifted the long pole as if he were lifting an apron.

The posterior wall (back of the upper body) is only visible then.

The light brown stomach contrasting with the yellow fat layer welcomed Jinhyeok, but he had no time to enjoy it.

‘I told you to make sure the apron was properly spread out.’

Check that the long-awaited plan is properly laid out.

The omental bursa (the posterior opening located behind the duodenal ligament) needed to be checked immediately.

“You shouldn’t touch the cyst. Just check its condition with your eyes.”

“Yes, Professor. There are no cysts or tumors. It’s clean.”

“Let’s keep going. It seems like it’s going to be quite noisy.”

Without even hearing an answer.

The professor, who had come in through the window, grabbed the upper rear wall with a grasper and pushed it up in the 11 o’clock direction.

Now it’s time to peel off the left omentum.

Jinhyuk hesitated for a moment, holding the grabber and ultrasonic cutter in his hands.

‘I told you not to touch the transverse mesentery (the peritoneum that connects the transverse colon to the posterior abdominal wall of the stomach). I told you to find the border and carefully dissect it.’

Soon, push the grasper in.

The long-awaited border.

So, I moved my hand along the surface where the transverse colon and the omentum meet.

Crunch.

Crunch.

He moves his hands carefully, again and again.

Of course, it wasn’t just carefully kicked out.

A branch vessel clearly arising from the right superior omental blood vessel.

Cut it boldly as if pruning.

Sometimes pulling.

Sometimes, we had to repeatedly push up and cut off the blood vessels to distinguish between those that could be cut off and those that could not.

The professor who came in also did not stay still.

He continued to help Jinhyeok by pulling the rope upward with the grabber.

Every time, from right to left.

Jinhyuk continued to move his hands as he came down diagonally.

* * *

At first, I was full of worries.

So I also vomited out the silence.

He watched with a worried expression, his whole body twisted.

but.

“Are you good at it?”

It was better than I thought.

A movement that cannot be called R3.

Even in his third year of residency, his hand movements were so simple that it could be said that there was absolutely no one here who could perform surgery to this degree.

Also, finding the physiological plane where the omentum and transverse mesentery fuse.

There is also a peeling movement.

Also playing around with laparoscopic tools.

They were all equally neat.

After standing there for a while with a worried expression on his face, Oh Ji-ho opened his eyes.

“Haha. Don’t worry about anything… … As expected, as expected! It’s our teacher Lee!”

That means there’s no need to worry.

Everyone nodded.

Every little movement makes me happy and sad.

Well, someone could ask why he’s so frivolous, even though he’s a professor at a general hospital.

This is what happens when you only hear stories of failure for a dozen years.

Only C-turns, which are called the lung-level ones, are applying to the surgical department one after another.

This is an era where all the A-turns who are quick-witted, sensible, and good with their hands are getting away with skin care.

Because I had experienced that, Jinhyuk’s presence was more precious to me than anyone else’s.

In the meantime, the observation room became noisy again.

Right omental resection has begun.

Of course, the order was the same as the left omental resection, but there was a difference.

The fish that had been pulling the upper back wall in the 11 o’clock direction was now pulling it in the direction of the spleen.

“You shouldn’t touch the pancreas… … .”

“You shouldn’t touch the parasplenic blood vessels either.”

“You also need to be careful of the Groove (pancreatic groove) and the Mound (small pancreatic mound).”

A voice mixed with concern and worry.

Everyone, stand close to the window.

Or, they would stare blankly at the monitor installed in the observation room and chatter away.

And at that moment.

“Me, me!!”

“Ugh.”

“Ugh.”

When Jinhyuk hesitated again, the atmosphere in the room changed.

Some people are even pulling out their hair!

The professors were like children, reacting to every little movement.

* * *

Jinhyuk furrowed his brow as he heard noise again from the observation room.

Why are you doing that?

Why on earth are you interfering?

It’s burdensome to even observe.

You’re talking nonsense.

Oh, right,

It’s so noisy I could die.

But I look at the piercing wound again and again.

A situation where a professor who came in as a fish lifted the subarachnoid lymph node vertically.

On the left is the pancreas.

In the center is the right superior omental vein.

On the right side, the anterior superior pancreatoduodenal vein and the omental artery were located.

I had to figure out the structure and simulate it in my head.

‘Take the circulatory blood vessel as a reference point and go down from here.’

Soon Jinhyuk’s hand moved.

Start teasing the disecto from the duodenum side.

They were removed one by one starting from the right superior omental artery.

One, two,

One by one again.

And tie it.

Kick it out.

Repeat peeling.

Of course, it wasn’t easy.

Branch blood vessels.

In terms of tree branches, the branch vessels that extend out from the main blood vessels are removed and removed again.

Fortunately,

‘I’m not obese, so I have less fat. And I also bleed less.’

That is, patients with abdominal obesity do not have a lot of fatty tissue around their blood vessels.

So there is very little bleeding.

Well, using an ultrasonic cutter may have had an effect.

Then soon.

“ah…….”

Jinhyuk let out a short sigh.

Lower cervical blood vessel.

This is because blood spurts from the blood vessels connecting the lower part of the pylorus (stomach exit) and the duodenum.

at last.

“Clip applicator.”

Jinhyuk changed his tools.

Ligate the bleeding site again and again.

As I continued like that, I started to laugh in vain.

It wasn’t because I liked doing surgery.

Because it was too big of a surgery for R3 to do.

‘Well, I did it because it was worth doing. Is this right? I skipped R2.’

He himself was the first assistant in both large and small surgeries until his second year.

You could say that I’ve been doing everything at a fast pace compared to others.

It was also true that it was burdensome.

And at that moment.

“uh?”

Jinhyuk let out a sigh again.

* * *

Jinhyuk stopped playing with his hands and spoke.

The target was a professor who had come in through fishing.

“professor.”

“why.”

“I wonder if you do this to other people too. When you’re performing a surgery, do you really not give them any advice or caution?”

“You don’t have any intelligence? Why all of a sudden?”

“I’ve never been in a surgery performed by a resident before.”

“hmm.”

“Well, there is also the purpose of training future generations. There are also cases where surgeries are performed that are suitable for R3. Everyone is different… … .”

Jinhyuk trailed off.

His colleagues who have different surgeries than him.

I just thought he was having a hard time like Jang Hyuk-jun, but I never thought to ask him directly.

“Well, it’s because you’re Jinhyuk. You’re staying quiet on purpose.”

“Are you saying that I’m the only one who’s different?”

“Yeah, but don’t worry too much. I’m doing well.”

“Then in other surgeries… … .”

“Well, shouting is part of everyday life. Even if you suddenly start talking nonsense like this, I’ll scold you. If it weren’t for you in front of me, I would’ve already thrown the knife.”

A look of wondering what nonsense this is.

Fortunately, he didn’t get angry.

An expression that says he’s letting it go because it’s Lee Jin-hyuk.

Jinhyuk continued speaking, his expression slightly hardened.

“You have to learn by breaking. If you keep doing it, there is no end to it. I know that too.”

“however.”

“But if you could send me a map, I think it would be easier to get there. A gastrointestinal anastomosis. It’s my first time doing it.”

“You’ve done it in mock surgeries, right? You’ve done it many times before.”

“Still, I beg you.”

A request to stop giving special treatment.

The point was to guide them rather than just occasionally giving them cautionary notes.

The professor turned his head and looked at the observation room and asked.

“Why all of a sudden?”

“yes?”

“It’s not just me who is different. The surgeon is different too. Other residents? They all talk a lot. They ask questions and ask again. But you. You don’t ask questions.”

“… … !”

“The idea of ​​doing it yourself. Wasn’t it strong? Why did it suddenly change?”

“that…….”

Jinhyuk stopped talking and clicked his tongue softly.

okay.

The professors were a problem, but he himself was a problem.

It was clear that he was driven by the thought that he had to do it himself, as he could not refuse the surgery.

Of course, I did mind control endlessly to overcome the things I hesitated to do because I was not sure.

I moved with the thought that I just had to do my best.

‘Do you still have pride in being a former thoracic surgeon?’

Jinhyuk smiled as he realized his situation.

“What should we do here? How deep should we go?”

* * *

Jinhyeok, who always looked around when performing a surgery.

I started asking questions for the first time.

I was fully prepared, but this was more helpful.

The professor, who had turned his head toward the observation room again, answered.

“Just peel along the incision line. It should go in just the right amount.”

“If you go into too much detail, please let me know right away.”

“Okay.”

Jinhyuk immediately moved the di-sector.

Anyway, the surgical process is already in my head.

What he needed was confidence.

so.

Crunch.

Crunch.

The duodenal artery located between the posterior wall of the duodenum and the pancreas is identified and dissected.

What followed was an 8a lymph node dissection.

Jinhyuk opened his mouth again.

“We will enter via the lower duodenal approach.”

“Push deep into the right superior vena cava.”

“Is it this deep?”

“No, more there.”

“Each professor has a different style… … so I was very confused. Thank you.”

“what?”

“I don’t know which one is correct.”

Jinhyuk waved his hands after giving a short answer.

A situation where a professor who came in through a fishing line grabbed the superior vena cava with a grasper.

He pulled the duodenum inward with his left hand.

I pushed in the grabber and the di-sector.

Ligation, and incision.

Move your hand quickly up the left aspect of the proper mesenteric artery.

At the same time, Jinhyuk reached out his hand.

“Ultrasonic cutter.”

“Here it is.”

After removing the die sector, insert the ultrasonic cutter and cut while confirming the origin of the superior vena cava.

Blind speed.

The hand movements were as delicate and precise as the conversation during the surgery.

Of course, perhaps it was natural.

Thoracic surgery deals with not only the heart but also blood vessels.

If only someone had guided me, this would have been easy.

* * *

“So… … . That’s why it’s like that!”

“Heh heh.”

“Well, it wasn’t a psychological factor or anything.”

The observation room has been renovated.

A situation where the person concerned has explained the reason for his or her hesitation.

There was nothing to worry about anymore.

Rather, it failed to standardize the surgical method.

So, they had to blame themselves for performing different surgeries depending on who they learned from after coming down through the apprenticeship system.

That makes sense.

Isn’t this Lee Jin-hyuk someone you can imitate just by looking at him once?

When everyone is just laughing in vain.

Oh Ji-ho raised a topic.

“It would be better to have a teacher… … . Who would be okay with that? Isn’t it confusing now because everyone is different?”

“Yes? Are you saying we should choose a master? Then I will… … . Hmm. Hmm. I will do it.”

“No, I have to do it.”

“I am the right person for the job!”

“Haha! What are you talking about! I told you about Sisyphus. You seemed very impressed.”

The observation room became noisy again.

The task of appointing a professor to be in charge of Lee Jin-hyeok.

They each raised their hands and said they would do it.

Let’s grumble for a while instead of organizing it.

Oh Ji-ho said.

“Hmm, big. Should I just teach you? I used to do it too when I was younger. Hmm, big.”

Oh Ji-ho mentions the time when tigers smoked cigarettes.

They all shook their heads and shouted.

“The hospital director, please get out of here!!”

“you’re right!!”

“The person in the field should teach!”

The professors are extremely blunt, as befitting surgeons.

Oh Ji-ho quietly lowered his head and let out a sigh.

“Huh… … .”

There is nothing more sad than growing old.

.