The Returning Doctor Wanted to Live Quietly - Chapter 361
Only Noblemtl
Episode 361. The Poison Miner (5)
Between the 5th and 6th intercostal space.
Kim Hyun-soo played with the scalpel 11 times, avoiding the ribs.
Crunch.
Crunch.
Blood gushing out.
An incision was made 5 cm in size, with occasional hemostasis.
Of course, the shape is circular.
The incision was easy because the patient was lying on his side, as is done for a lateral thoracotomy.
After a while, the main incision was completely made.
Before Kim Hyun-soo could say anything, Jin-hyeok moved.
Jinhyuk lifts the skin from both sides using towel clamps.
This is to maintain tension.
The purpose was to assist the attending physician in inserting the Beres needle.
“Veress needle.”
“Here it is.”
“Let’s get right into it.”
Dduk.
Dduk.
As usual, two disconnects.
Kim Hyun-soo sensed this with his hand and moved.
A situation where there is absolutely no view inside the body.
If you push too hard, you could puncture an organ.
It could also damage blood vessels, which could lead to unwanted consequences.
So, it is a task that requires careful work, trusting the feel of your hands.
Kim Hyun-soo, who had been pushing his hand in for a while, took his hand away at some point.
“Let’s go and check.”
“Yeah.”
This time, the first assistant moved.
A syringe filled with saline solution.
Attach it to the Beres needle and open the valve.
If the saline solution flows properly, it is a success.
If not, you would have to change the location.
“It looks like it went in well. Should I put in some gas?”
“Please watch a little longer.”
“Hmm.”
“I want to proceed cautiously. Didn’t you hear the patient’s story earlier?”
What Jinhyuk said after the anesthesia ended.
Kim Hyun-soo also had tears in his eyes for a while, and the German professor was also able to hear the story belatedly.
Because Jinhyuk explained it in German so he could understand.
soon.
“Let’s start injecting gas.”
“I will adjust it to 15 mmHg.”
“Let’s proceed cautiously. Let’s go down by 10 mmHg.”
“four!”
A nurse opening a valve.
The abdomen gradually swells.
This was also done to create ups and downs.
Not long after that.
“It’s stable!”
“Remove the Beres Needle!”
“four!”
“Please give me the syringe!”
“Here it is!”
Everyone was busy waving their hands.
The Veres needle that had been inserted for gas injection was removed, and then the work of inserting the trocar began immediately.
Of course, I didn’t just shove it in blindly.
Originally, the trocar was a passage for inserting laparoscopic tools.
The incision was carefully advanced by turning the needle left and right through the already incised area.
Of course, it goes without saying that Jinhyeok helped maintain the tension.
Subcutaneous fat.
fascia.
Even to adipose tissue.
Knock knock.
Knock knock.
The piercing needle penetrated with a loud thud.
As soon as Kim Hyun-soo reached out, a needle and suture were placed in his hand.
So-called anchoring sutures.
It was a fixed suture.
One sweat, two sweats, three sweats, four sweats.
As soon as Kim Hyun-soo, who had quickly finished his work, took his hand off, Jin-hyeok pushed the camera inside the syringe.
A situation where the main incision has already been secured.
Now, an auxiliary incision had to be made, and before that, the first step was to clear the field of vision.
“It’s clean.”
“Let’s go right away.”
After a short conversation, Kim Hyun-soo moves his hands again.
The camera confirmed that there was no damage to other organs or blood vessels.
Another incision was made between the 7th and 8th ribs with a scalpel number 11.
Crunch.
Crunch.
This time it’s circular.
Its size is 3cm.
The act of making a small incision for the camera port was over in an instant. Then, Kim Hyun-soo’s hand went to the tip of his shoulder blade.
A location very close to the back.
Re-incision was attempted for traction or stapling.
It was possible to complete the catheter intubation and fixation suture in an instant.
“Let’s change the camera position.”
“yes.”
“Ring clamp.”
“Here it is.”
“I’ll grab the lungs right away.”
“yes.”
Those who start to speed up their conversation by speaking in English.
First, the first assistant used a ring clamp to grab the lung lobe.
A circular shaped ring end.
Bite the lung lobe tightly and pull it out.
An act of exposing the closed part of the front.
Jinhyuk also did not stay still.
At the same time, the camera was moved to secure a view of the closed area.
Superior pulmonary vein.
Inferior pulmonary vein.
Pulmonary artery.
To the bronchial tubes.
Kim Hyun-soo’s dry voice rang out as he confirmed this.
“Mezenbaum Caesar. Grasper.”
In the left hand, a grasper for holding the tissue.
He continued to move his hands, holding a Mezenbaum Caesar in his right hand, a pair of bladed scissors.
The act of opening the pleura around the hilum.
It was never easy.
Arteries and veins inside the thin membrane.
And the bronchi and lymph nodes.
You shouldn’t touch it.
All I had to do was peel off a thin layer.
Crunch.
Crunch.
The curtain is peeled off again and again for a long time.
The inside, now fully revealed.
Unlike the German doctor who was impressed by the quick and precise surgery, Jinhyeok and Kim Hyunsu sighed.
Seriously… … .
It’s really dark.
I’ve seen smokers’ lungs countless times, but this is the first time I’ve seen a miner’s lungs.
Both of them were silent for a while.
Kim Hyun-soo opened his mouth late.
“You said you received 700 marks, right? That’s only 40,000 won of our money. You worked like a dog for an entire month without being treated like shit.”
“It was a lot of money at the time.”
“They didn’t even give me a mask. They just made me wear underwear and then… … That’s why this happened. Damn it.”
“Mr. Kim… … .”
“under…….”
Kim Hyun-soo, who had been expressing his emotions, let out a deep sigh.
The work of erecting an iron pillar called a stumpel inside a coal mine.
60 per person.
Or there was a quota of 80 each.
I couldn’t even rest properly.
That’s not all.
These were people who didn’t even receive their wages properly unless they mined a certain amount.
Just as Southeast Asians working in Korea face discrimination and neglect, they also suffered terrible neglect and worked hard.
The results are right before your eyes.
Kim Hyun-soo, who came to his senses late, gritted his teeth. Then he changed the surgical tools again.
This time, a blunt C-type clamp.
He started the pulmonary vein dissection without saying a word.
Crunch.
Crunch.
Jieeeeing.
Jiiing.
Peeling, hemostasis, and suction.
Only mechanical movements are visible.
Nothing special happened.
When you continue working like that for a long time.
Pfft!
Blood spurted out strongly, dyeing the monitor red.
Suddenly, a third of the camera lens was submerged in blood.
Without any time to say anything.
“Your blood pressure is dropping little by little!”
The anesthesiologist who was monitoring the vitals shouted.
Sudden massive bleeding.
He looked very embarrassed for a while.
But both Jinhyeok and Kim Hyunsu had calm expressions.
Unexpected massive bleeding.
It was a regular occurrence.
While Kim Hyun-soo was moving around trying to find the bleeding point.
Jinhyeok, who was doing suction, pushed in an endoscopic vascular stapler.
And then.
“Mr. Kim!”
I called out to Kim Hyun-soo in a slightly raised voice, and he silently pulled back the C-clamp.
All this happened in a split second.
The anesthesiologist shouted as he watched Jinhyeok attempting to stop the bleeding instead of the attending physician.
“Your blood pressure is dropping even further, Professor!”
“Wait a minute, wait a minute.”
“No, I need to clean the lenses right now… … .”
“It will only take a moment.”
After Jinhyeok covered the anesthesiologist’s mouth.
He just closed the stapler.
And then the suction started.
Only after wiping the camera lens did the recovered area become clean.
Even in a situation where blood was splattered and a mess, the bleeding was stopped precisely.
* * *
I should have made sure I had bitten the vein before I fired the stapler and then closed it.
A situation overcome through intuition or experience.
Hospital director Max, who was watching the surgery from the observation room, burst into laughter.
“Heh heh… … .”
“Why are you doing that?”
“Those guys. They’re just fellows. Fellows. Oh, and Dr. Lee isn’t even a fellow. He’s on the double board.”
“I already knew you were very dexterous.”
“But this isn’t your first time seeing a real fight. Especially that guy. Dr. Lee has never worked in thoracic surgery.”
Everyone looked surprised at the words of Max, the hospital director.
Unlike other thoracic surgeons who all specialize in surgery, these doctors have different specialties.
Out of curiosity, out of interest, or because I had time on my hands, or because of Dr. Max.
I just observed and later remembered what they had forgotten.
Come to think of it, Jinhyuk Lee, like them, specialized in general surgery.
But they move without any specific instructions.
It was truly amazing how he was able to calmly stop the bleeding in a yard with limited visibility.
The gossip was short-lived.
As soon as the surgery resumed, they looked into the operating room again.
In the meantime, the pulmonary vein treatment has been completed.
Now the pulmonary artery branches were being dissected and treated one by one.
The pulmonary arteries spread out everywhere like leafless branches before the spring cherry blossoms come into full bloom.
It took a long time to bluntly cut and stop the bleeding so that it could be reattached.
Next is bronchial dissection.
Kim Hyun-soo was heard shouting while holding the trachea with forceps.
“Increase the ventilation speed!”
“Speed up!”
“Movement is normal!”
“There is no expansion abnormality!”
“Back to normal speed!”
“four!”
After completing the task of confirming that the lower lung lobe is normally expanded even while clamped,
The nurse turned the lever back into place.
Meanwhile, Jinhyuk also did not stay still.
Interlobar fissure.
The so-called interleaf fissures between the lobes were targeted.
Chook.
Chook.
To prevent bleeding and air leakage.
Or preliminary work to separate the lung lobes.
I can’t stop playing with the stapler.
Not long after that.
“It’s all over.”
“Shall we go in?”
“I think it’s okay to go in.”
“Come on in.”
Kim Hyun-soo and First Ashi work in place of Jin-hyeok.
The work of removing the upper leaves with an electric cautery machine while holding the tissue with a grasper continued for a long time.
Cheeeeek.
Cheeeeek.
Spicy smoke.
And the noise.
The camera kept fading and brightening, but no one stopped.
How could you not know that dust was accumulating in your lungs?
Who would have wanted to stay in Germany, where there wasn’t even kimchi, after a three-year contract ended?
Just because of my family, or because of my mom and dad who are at home.
Or maybe because of the belated independence and the destruction of the homeland due to the Korean War.
He kept waving his hands like a miner who worked in a mine, knowing that when he coughed and spit out phlegm, black iron dust would come out.
Crunch.
Crunch.
The hand movements continued for a long time.
Kim Hyun-soo spoke in an even drier voice.
“Only the final separation remains. Endoback.”
“I will do the endo pack.”
“yes.”
The first assistant removed the surgical instruments and then inserted the endotracheal bag.
A plastic bag that looks like a fishing net at first glance.
It was a tool for removing tumors and organs during surgery.
soon.
The heavy, black-dotted upper leaf, which seemed to make a thud sound, fell straight into the endobag.
Now all that’s left to do is dissect the tracheal lymph nodes and finish the rest.
Jinhyeok and Kim Hyunsu started to increase their speed without saying a word.
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