Free Web NovelChapter 551: Chapter 252: Finally Open for Business; This Patient Is Not Acceptable (2)
Li Jingsheng performed an ultrasound examination on him and felt confident in performing the surgery.
He started to persuade the patient earnestly.
"What you said makes sense, so go ahead and do it for me!"
The man agreed on the spot.
"Can you find a family member to come and sign?"
"I lost my parents when I was very young, lived in a welfare institution for two years, and then was taken in by a kind elderly couple. Unfortunately, they died in a car accident during my sophomore year in college. Alas, if they were still alive, I could have given them a prosperous old age."
At this point, the patient’s eyes slightly reddened.
Everyone has a tender spot within their heart.
"Alright then! You can sign by yourself later on, right? Did you bring your ID card?"
"How can I not bring it when seeing a doctor?"
Li Jingsheng discussed the price with the patient, charging twenty-five hundred, including all fees.
Li Jingsheng also handles the pathology examination.
The patient very readily agreed to the surgery price.
As per protocol, let the patient sign the surgical risk consent form, pay the fee, and then arrange the surgery.
"Meng Luo, Siying, prepare for surgery in the operating room. The patient needs a tumor removed from the left upper arm."
They immediately started preparing.
Meng Luo is a senior surgical nurse, experienced.
Packing instruments, setting up the drapes, and disinfecting were all handled by her. Han Siying helped out and learned alongside.
Li Jingsheng personally conducted the preoperative preparations for the patient.
Including cleansing and sanitizing the surgical area.
This patient had long hairs on his arm that needed shaving preoperatively, otherwise, it would affect the surgical effect.
Fortunately, shaving was relatively easy.
Li Jingsheng most feared shaving the patient’s head or perineal area, as sometimes it hurt, resulting in verbal complaints.
...
Inside the operating room, the procedure started with an allergy test for the anesthesia.
After no allergic reaction occurred, the patient received a brachial plexus block injection.
This procedure was executed by Meng Luo.
It was evident she had extensive experience with dosage, injection sites, and depths.
The purpose of brachial plexus block anesthesia is to interrupt the conduction of the brachial plexus.
To make the patient’s left arm lose sensations, and relax the muscles.
Li Jingsheng donned gloves, wearing surgical attire, standing in the main surgeon position, with Meng Luo opposite him.
The position of the instrument nurse is generally flexible, often standing on the same side as the main surgeon, but many surgeries have them positioned opposite the surgeon. There’s no strict rule.
A good instrument nurse is not only observant but also thoroughly prepared preoperatively, and meticulously counts the instruments, sutures, gauze, etc., postoperatively with the circulating nurse to ensure everything is correct.
Because a small surgical needle, if left inside the patient, could cause catastrophic consequences.
Li Jingsheng and Meng Luo previously teamed up for a small surgical procedure to suture wounds on an injured patient.
It was a very minor surgery.
Not even requiring completion in the operating room.
This time, even though removing such a large tumor is considered a superficial tumor on the arm, it barely qualifies as a secondary-level surgery.
The technical difficulty is much higher than imagined.
Including major blood vessels and critical nerves in the arm, requiring utmost caution.
Preoperatively, Li Jingsheng repeatedly reviewed the anatomical structure of the left upper arm in his mind.
This tumor should tightly adhere to the biceps.
It might even extend to the triceps area.
Its end likely reaches the patient’s elbow artery and radial recurrent artery, as the patient’s left arm flexion is significantly impaired.
The nerve supply here is also relatively abundant.
The posterior cutaneous nerve of the forearm is positioned where the tumor is, necessitating careful separation.
Also, the tumor should be closely attached to the ulnar nerve underneath.
If this nerve is severed, it would constitute a major medical error.
Luckily, his skin incision technique has reached the Great Success Realm, excising a superficial tumor with carefulness shouldn’t lead to any incidents.
With his current skill level, he can competently perform tertiary surgeries without issue.
Li Jingsheng began by cutting through the patient’s skin layer by layer.
Moving at considerable speed.
The incision was smooth and clean, with minimal bleeding.
Meng Luo, having witnessed her boss’s suturing and debridement skills before, saw him making such a smooth incision on the patient’s left upper arm with remarkably little bleeding, felt extraordinarily shocked.
Only now did she realize the boss she was following was a prodigy.
With such impressive diagnostic skills and now showcasing such powerful surgical abilities, this genius-level presence would be hard to find even in People’s Hospital or Qiaobang Hospital!
Who would’ve thought a doctor with such strength would choose to stay in a clinic?
After the incision, the tumor was already visible.
Its color appeared normal, its surface reasonably smooth, without any noticeable irregular mutations.
Indicating a high likelihood of being benign.
Li Jingsheng first probed for a while before starting the separation process.
"Siying, when separating the tumor for the patient, pay special attention to the soft tissues and ligaments. Under no circumstances should you act roughly or crudely. Remember, surgery is a technical endeavor; the only time brute force is justified is when cutting bone."
With his present level, he is fully capable of instructing Han Siying.
He deftly utilized combined sharp and blunt separation techniques, gradually isolating the tumor.
He found the tumor boundaries were indistinct.
