Surgery Godfather-Chapter 362 - 0343: The Man on the Peak

Chapter 362: Chapter 0343: The Man on the Peak

Just three days after the preoperative discussion, Yu Shuilian’s surgery officially began.

For the surgery, Yu Shuilian underwent thorough intestinal cleansing three days ago and was put on a diet, all her nutrition being supplied intravenously.

The aim is to ensure there is no food residue in the intestines during the operation, thereby minimizing the risk of infection.

The urine bag and feces bag were temporarily removed. Urine will be expelled via a sterile urinary catheter attached to a urine bag installed during surgery.

As Shuilian was on a diet, there were no feces temporarily, thus no worries of fecal contamination during surgery.

However, after this surgery, a fistula in the bladder and colon needs to be maintained for a while, so that urine can be drained directly from the kidneys through a drain tube, without affecting the survival of the rebuilt urethra.

For at least one week after surgery, intravenous nutrition will supply Shuilian’s nutritional needs to prevent the surgical site from being contaminated by feces – not even the slightest bit is allowed.

Just like a newly constructed road, traffic is not allowed before completion.

Sometimes, women can be more resilient than men. Shuilian had mentally accepted her disabled identity, understanding that she’d live the rest of her life in this state.

To her, this was going to be the norm for her future life, akin to a paralyzed person on a wheelchair, a blind person using a cane, or a mute person communicating with sign language. This was to be her special state of life.

Having experienced a life-and-death surgery, Shuilian was very composed about her second surgery, without any hesitation or worries.

In the face of such adversity, some people fall, while others obtain a new understanding of life.

Her husband and son held her hand the entire time journeying with her on her gurney, not releasing their grip until they reached the operating room doors. Her son obediently kissed her on the cheek, clutching his small fist, “Fight on!”

Her husband let go of her hand only after a while:” We’ll be waiting outside, don’t be afraid —”

Anesthesia, patient positioning, scrubbing hands, sterilization — they were daily procedures repeated over a dozen times so familiar that it’d be impossible to make a mistake even in one’s dreams.

Song Zimo assisted first, followed by Takahashi, with Xu Zhiliang observing from the side of the operating table.

The knife moved like a paintbrush, making incisions on the remaining part of Shuilian’s body.

Due to the adhesive tissues caused by the trauma and previous surgery, the anatomy in the second surgery was no longer in its normal state. However, the chief surgeon remained adept.

Whether it was the same plane direction of the scalpel or the layer-by-layer penetration across the plane, the altered anatomy did not affect either.

The combination and direction of the incisions were initially puzzling. Some were straight lines, some were diagonal, others were curves, and a few even resembled wavy lines.

Regardless of the direction or length, it seemed as if he already had precise measurements in mind. The ease of use and control of the scalpel’s weight were surprisingly accurate.

But why was it done this way?

It was not until the various incisions had begun to penetrate into the abdominal cavity that Takahashi, along with the long-following Song Zimo, could glean some clues, whilst others remained utterly baffled.

Why did the operation begin in this way, and where was it ultimately leading to?

Being unable to understand the beginning nor guessing the end was quite frustrating.

Only when the planned tunnels for placing the urethra, vagina, and anus had been opened did Takahashi finally get a sense of what was happening.

The colon was not cut open but turned inside out from the end, just like one would with a sock. After a certain length, it was stopped; following that, the remaining opening of the bladder neck was opened and turned inside out in a similar manner.

The lower part of the descending colon, with its inner surface exposed.

Under the microscope, the colonic mucosa was peeled off bit by bit using a snake-brand micro-scissors. The nerves leading to the mucosa, each one thinner than a baby’s finger, started to unravel, yet maintained their connections with the mucosa.

The colonic mucosa, along with all its nerves, was completely peeled off without any breakages. They then started excising the mucosa along with the surrounding nerves.

With the recipient area ready, they began to excise the bladder mucosa in the donor area.

Using the same sophisticated techniques, they removed the mucosa along with multiple nerves. To maintain the integrity of each portion of the mucosa, an exchange was performed.

The bladder mucosa, replete with pressure sensors, was transplanted to the lower segment of the colon, precisely filling the defect that was cut just now. The nerves from the bladder mucosa were sutured to the nerves in the recipient area, one by one. Even with the use of 12-0 micro-sutures, each nerve could only take two to four stitches.

Colonic mucosa was used to fill the loss in the bladder mucosa, with nerves being connected as well. Although the colonic mucosa did not possess pressure receptors, the pressure receptors in other parts of the bladder continued to trigger urinary sensation.

The content of the East wall was moved to fix the West wall, yet the East wall still remained solid, continuing to shelter against the wind and rain.

The two fresh pieces of mucosa were cut and exchanged without any pause, thereby completing the most delicate part of the surgery.

Under the microscope, even Takahashi, who dared not blink, realized that a operation that no one could achieve before had just been realized within his field of vision.

The entire process was as smooth as water, just like performing a routine operation.

Also under the microscope, the removed veins from the abdominal cavity were slowly peeled layer by layer with the snake-brand micro-scissors. Thin layers of the vascular wall were stripped off without any damage, down to the required thickness.

It was like cutting several layers from a thin sheet of A4 paper. Each layer was a complete A4 paper sheet, remaining intact even when thin enough to be transparent.

The eligible vein was led to connect with the remaining part of the urethra at the neck of the bladder. It then followed a predetermined route to be buried into the opened tunnel.

No wonder so many people have failed and finally had to give up the research on this kind of surgery, aside from him, who else would have such exquisite surgical skills?

With the completion of the two most difficult steps, the subsequent colonic reconstruction of YD and the pectoralis minor reconstruction of the sphincter will pose no difficulty.

The preoperative 3D printed mold is implanted into the reconstructed anus, urethra, and YD to prevent postoperative adhesions.

The suturing of the external orifices of the three reconstructed structures is highly meticulous, with beautiful round eversions sewn to the surrounding skin, resembling naturally formed transitional parts.

The scalpel never paused, flowing through various strengthening techniques and combinations of lines on the incisions, making the skin and tissue flaps flip up in pieces for recombination-some turned over, some buried, others folded.

Damage-free cosmetic sutures flowed like a divine brush, used in conjunction with surgical techniques such as cutting, suturing, grafting, and transposing.

Astoundingly, the anus, urethra, and YD are arranged in a natural order, with the reshaped skin and tissue flaps of WaiYinj indistinguishably real, even an artificial buttock crease is molded.

The residual bilateral iliac bones, which were smoothed during the first surgery, replace the original ischial tuberosity, and the remaining muscles are moved to the bilateral artificial ischial tuberosity as much as possible.

Thus, the half body is able to stand vertically, just as if it still had hips, by means of two supports with muscle padding and the help of hands.

During the first surgery, Yang Ping had already considered the second one, preparing many steps perfectly for it, such as the muscle padding around various reconstruction ducts.

Only then did Takahashi realize that Yang Ping’s surgical design capabilities greatly exceeded his imagination. He viewed Yang’s chaotic sequencing of surgical steps as an insurmountable obstacle.

But now, while racing against the clock, Dr. Yang had linked the two surgeries together, planning the sequence of surgical steps beyond the scope of the first operation and connecting to the second one.

Insurmountable upon insurmountable!

Beyond the insurmountable mountain, stands an even taller mountain.

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If there isn’t any infection or accident, Yu Shuilian will gain a nearly normal anus, urethra, and YD, preserving the basic functions of the half body.

Only her ability to walk is lost. If one day power-assisted devices become available, she may be able to walk upright like any normal person.

Trauma surgery, urological surgery, general surgery, reconstructive surgery, and plastic surgery, a combination of the top operations from various departments, completed this piece of art-like medical feat.

Each one of these surgeries, when placed in their respective departments, would be unassailable.

But who would know that these mesmerizing techniques were acquired by Yang Ping in the system space, enduring one devilish training after another.

A space that belongs only to him, a space filled with endless case analyses, surgical training, and anatomy learning, requires an indomitable will to overcome loneliness and solitude.

Only those who have the heart to become divine can be so persevering.

“The man standing at the summit!”

Fujiwara Miyuki admired Yang Ping who was focused on his surgery from the bottom of her heart.

At the end of the surgery, not to mention anything else, the perfect symmetry of Yu Shuilian’s remaining truncation could only be achieved by Yang Ping.

To achieve symmetry, everything from the grinding of the residual iliac bone, the padding of the muscles, and the adjustment of skin suturing needs to be taken into account.

This isn’t a requirement for surgery, but a reflection of the Chief Surgeon’s precision, precise to an impeccable extent.

“The surgery is over, the three of you, starting tomorrow, practice peeling grapes under the microscope. Dissect the grape skin into three intact layers to pass.”

Yang Ping was referring to Song Zimo, Takahashi, and Xu Zhiliang.

“Do you have any questions?” Yang Ping asked Xu Zhiliang.

As his foundation in microscopic surgery should be the weakest, Xu Zhiliang nodded, “No problem.”

“What about us?” Zhang Lin asked.

“Peel out two layers, as long as there are no major holes, you are qualified.”

“Also, you have to practice suturing, suturing with one hand continuously for an hour without trembling to qualify.”

Yang Ping stepped away from his position as Chief Surgeon, and Song Zimo, Takahashi, and Xu Zhiliang began bandaging Yu Shuilian’s truncation. This was no casual task; it required advanced bandaging skills.

Vaseline gauze was used as a base, followed by a layer of dry sterile gauze. Areas that needed to be loosened or tightened were treated accordingly, as were places that needed to be separated or compactly filled.

Finally, cotton padding and bandages were used to secure the wrapping of the truncation, ensuring it was neither too tight nor too loose and that the gauze bandages would not easily fall off.

“What about me, Dr. Yang? You haven’t assigned me any homework,” Fujiwara Miyuki proactively asked.

Yang Ping almost forgot about her, as she was here for further study, and she was in sports medicine, so she couldn’t be as multifaceted as Takahashi.