I, Tomoya Aki, am not a bootlicker

At 7:50, the patient who had obtained the consent of his family members staying in the hospital for surgery was pushed into the operating room, and all the manpower that could be mobilized was ready.

"I already understand the situation. You two did a great job."

Yoshida Aoba, who had already started washing his hands outside, looked serious and praised the two of them at the same time.

The anesthesiologist from the anesthesiology department seemed a little hesitant at this time.

"I'm not sure, maybe we need Dr. Aoki to come over!"

This operation not only requires strict skills from the surgeon, but the anesthesiologist must also not make any mistakes.

The patient who had a sudden condition at six o'clock was sent to the operating room for emergency surgery. His condition was critical and required emergency treatment. If any link went wrong, the patient's life could be lost.

The patient's condition was acute, serious, heart function was poor, surgery was difficult and mortality was high. The operation to replace the artificial heart valve was not something that the anesthesiologist, who happened to be on duty at night, was confident of taking on.

They should replace them with someone who is more experienced and confident to cooperate with the cardiac surgeons to perform the operation, which would be safer.

"At this time, do we still have to wait for Dr. Aoki to arrive?"

An Yilun also frowned. He didn't expect that when he got outside the operating room, the people from the anesthesiology department actually started to get scared.

He could understand the other party's concerns after learning that the patient was in critical condition and that this was an extremely difficult operation, which would place higher demands on the anesthesiologist.

After all, once in the operating room, the patient's life is in their hands.

Moreover, this was an emergency operation, and there was no complete surgical plan in advance, so we had to adapt to the situation.

Perhaps because Tomoya Aki's words made him feel ashamed, the anesthesiologist had no choice but to bite the bullet and get ready.

"Follow our instructions then."

He also understood that it was not possible to deal with a difficult operation with that kind of mood. At this time, Aki Tomoya said something that gave Yoshida Aoba a headache.

"Doctor Aki, please trust your partner regarding anesthesia."

Yoshida Aoba was afraid that Aki Tomoya would say this and put all the blame on them. If something really happened then, it would be troublesome.

Although during the operation, the anesthesiologist will follow the surgeon's judgment because the surgeon is in charge, it is not the case that Tomoya Aki would say something that might put all the responsibility on himself just to encourage his colleague whose confidence is a little low to go into battle.

However, Aki Tomoya didn't think so much. Now they are the only people in the cardiac surgery and anesthesiology departments. If they don't go, who else can save the critically ill patient who has been pushed into the operating room and is waiting for help?

"Time is running out, so everyone should prepare early. Doctor Aki will be the first assistant, and Doctor Majima will be the second assistant. I'll leave the anesthesia to Doctor Otani."

Yoshida Aoba made all the arrangements in an instant.

Although all the treatments before entering the operating room were done by Tomoya Aki and Majima, he still had to be the chief surgeon.

For such a critical operation, it is impossible to give the opportunity to perform the surgery to two newcomers.

One is for the success rate of the operation, and the other is that if there is any accident during the operation, it would be much easier for him as the surgeon to take responsibility than for two newcomers to do so.

Of course, Yoshida Aoba also has confidence that he can save the patient.

At nearly eight o'clock, the patient was receiving mechanical ventilation using an anesthesia machine in the operating room, and a large amount of pink foamy sputum also flowed out of his trachea.

Therefore, intermittent high-frequency nebulization inhalation of defoaming agent is used.

Afterwards, invasive arterial puncture pressure measurement, venous pressure measurement, ECG monitoring, and urine volume monitoring were completed under rapid local anesthesia.

Anesthesia induction was performed under direct arterial pressure monitoring.

"Maintain the depth of anesthesia..."

The anesthesiologist named Otani was probably the least experienced anesthesiologist at Kanto General Hospital. Aki Tomoya could see it from his initial hesitation when he arrived outside the operating room and the obvious nervousness in his eyes in the operating room.

I had been performing surgeries with Yoshida Aoba, and the anesthesia was always performed by Yoshida Aoba's personal anesthesiologist, who was Dr. Aoki that Dr. Otani mentioned not long ago.

It was obviously his job to provide anesthesia, but Aki Tomoya reminded him with some difficulty in watching.

Otani, who was also on duty tonight, now didn't know whether he should be thankful for having had such a rare experience.

The surgeon in charge, Yoshida Aoba, performed a thoracotomy and used extracorporeal circulation to perform the mitral valve replacement.

"Refill!"

After the heart stopped beating, while cooperating with Yoshida Aoba's instructions and reminding Dr. Otani to perform the perfusion every thirty minutes when the other party was too busy, Aki Tomoya, who was very good at calculating time, reminded Otani to perform the perfusion.

The right femoral artery and femoral vein were carefully cut, and the femoral artery and femoral vein were cannulated after heparinization and partial blood flow diversion.

“The adhesion is severe!”

Looking at the severely adhered heart and pericardium, Yoshida Aoba frowned slightly, but did not stop, and slowly separated the superior and inferior vena cava.

Time passed little by little, and no one dared to blink.

The entire operating room suddenly became quiet and nothing could be heard.

The surgeon in charge, Yoshida Aoba, kept frowning.

In the operating room, you are not afraid of hearing the doctors laughing, but you are afraid of hearing nothing and everyone being silent.

Chapter 478 Next time you come

During the operation, it was found that the aortic valve opened and closed normally, the mitral valve opening was limited, there was a thrombus attached to the ventricular surface, and the tricuspid valve ring was relaxed and enlarged.

"Prepare to remove the original mitral valve prosthesis..."

Yoshida Aoba finally said something after a long time, but his brows were still furrowed.

No one dares to take it lightly until the patient's life is completely guaranteed.

After removing the patient's original artificial valve, he quickly instructed, "Artificial valve."

The original artificial valve was removed in order to replace it with a new one. Following Yoshida Aoba's instructions, the artificial valve was transferred over.

"Wipe sweat..."

After the artificial valve was replaced, Yoshida Aoba's brows relaxed a little.

Two hours and fifty-three minutes after the aorta was blocked, Yoshida Aoba ordered the aorta to be opened and the heart automatically recovered.

"No arrhythmia."

At this time, Aki Tomoya breathed a sigh of relief when looking at the surveillance.

"Doctor Aki, you come and close the chest."

Yoshida Aoba breathed a sigh of relief and handed the final chest closing task to Aki Tomoya.

Yoshida Aoba was the surgeon for most of the operation and was responsible for the important parts. After suturing and opening the aorta, the heart successfully resumed beating and no other problems occurred. The rest of the work of closing the chest was left to them.

Without hesitation, Aki Tomoya exchanged positions with Yoshida Aoba and let Majima cooperate with him to close the patient's chest.

But halfway through the procedure, the patient's body began to move, and his eyes seemed to be able to open.

No one expected the sudden situation.

Anesthesiologist Otani was stunned, and Majima and Yoshida Aoba both looked at Aki Tomoya, who paused for a moment.

Aki Tomoya's hand paused for less than a second. He raised his eyes and glanced casually, then said quickly, "5mg of Valium, 0.1mg of Fentanyl."

This is just a minor case and only requires tranquilizer, sedation and analgesia.

Originally, there was no need for him to remind the anesthesiologist.

However, perhaps because it was the first time such an operation was performed, Dr. Otani from the anesthesiology department made a wrong judgment.

During the operation, Otani, who was mostly listening to Tomoya Aki performing anesthesia, did not suspect anything and quickly followed Tomoya Aki's instructions.

Tomoya Aki's movements were neither fast nor slow, and his hands were steady. It was just a chest-locking job and was not challenging at all.

He had thought about what would happen if he were the lead surgeon for this rescue operation, but unfortunately, Yoshida Aoba did not entrust such an important matter to him for safety reasons.

However, as the first assistant, it was enough for this emergency operation.

After several hours of surgery, when the patient became critically ill, the sky outside had already brightened.

In the observation room above, there appeared several figures at some point.

Aki Tomoya and the others did not notice this, as all their attention was still on the operating table.

After completing the chest closing operation and receiving instructions from Yoshida Aoba, everyone breathed a sigh of relief when he announced the end of the operation.

After walking out of the operating room, Yoshida Aoba looked at him and thought for a while before asking, "Did you think about various possibilities at night?"

An Yilun didn't think much about it and just nodded.

After Majima went to the emergency room and cooperated with the initial treatment and examination, Akitomo received the report from him and knew that the surgery must be performed as soon as possible.

If nothing unexpected had happened, the surgery would have been arranged immediately in the morning after discussing with Yoshida Aoba and other people in the department.

However, an emergency operation was performed here, using the existing team.

Thinking about the huge gap between the anesthesiologist on duty in the Anesthesiology Department tonight and Dr. Aoki, who was employed by Yoshida Aoba, the first thing that Aki Tomoya thought about after the operation was to establish a good relationship with the excellent anesthesiologist.

There is a huge gap between an experienced anesthesiologist and an inexperienced anesthesiologist.

If Yoshida Aoba's personal anesthesiologist is here to cooperate, there is no need to intervene. He will know how to handle the situation and there is no need to worry too much.

But in today's operation, Akitomo also reminded many aspects of anesthesia.

This is also thanks to the fact that in the second half of the night, Akitomo considered all aspects.

As a surgeon, he must be able to control the overall situation in the operating room. This is what Yoshida Aoba has always told him.

"Next time there is an operation, you can be the lead surgeon and I can be your assistant, how about that?"

Yoshida Aoba looked at the expressionless Aki Tomoya and said something that made Aki Tomoya very excited.

He thought that he would have to wait at least half a year to become a chief surgeon, but looking at Yoshida Aoba's expression, it was obvious that he was ready to give him such an opportunity.

"Really? Dr. Yoshida?!"

Aki Tomoya looked at him in surprise.

This was like a huge surprise that hit him on the head, and he still couldn't believe it.

It's only been one year since I finished my training as a medical trainee, and I already have the opportunity to perform surgery in a large hospital, or to be the chief surgeon?

"I am very satisfied with your performance tonight."

Yoshida Aoba patted Aki Tomoya on the shoulder, signaling him not to doubt it.

From the time the patient became ill to the time he was sent to the operating room, Tomoya Aki's judgment did not make any mistakes, and he was able to cooperate with him perfectly, including during the operation.

This is thanks to the fact that Tomoya Aki had been his assistant before, accompanying him in and out of the operating room, while also not forgetting to develop into the main surgeon and take charge of the overall situation.

To be honest, the anesthesiologist today made him sweat.

There is a fixed anesthesiologist who cooperates with them in cardiac surgery. Just like him, every time he performs an operation, he will ask Dr. Aoki from the anesthesiology department to cooperate with him.

As for Otani, if there is someone there and the situation is urgent, it would be best to let Aoki from the anesthesiology department rush to the hospital.

But time is urgent and there is no time to lose. The patient's life is in danger at any time, so there is no time to hesitate.

Even during the operation, Akitomo did not devote half of his attention to anesthesia matters, and he would always speak and give instructions.

But Tomoya Aki's proper handling was as if he had been prepared, allowing him to concentrate on the operation and deal with the situation that appeared in his field of vision.

Yoshida Aoba believes in one thing——

As the surgeon in charge, you must be able to control all situations in the operating room.

Excluding such emergency surgeries that require flexibility, a normal operation should include preoperative examinations, discussion of surgical plans, consideration of specific intraoperative conditions, complications, postoperative care, and flexibility during the operation. As the core of an operation, the surgeon has a heavy responsibility.

"Are you touched to have me as your personal assistant?"

Yoshida Aoba felt that with him as his assistant, even if Aki Tomoya had problems during the operation, he would be able to save the situation, so it would be better to give him a chance and train him well.

"Please advise!"

Chapter 479 Watertight

"Doctor An Yi, what were your considerations for intervening as the first assistant to the anesthesiologist who was involved in the rescue operation the night before?"

The patient who underwent emergency surgery was sent to the ICU for care after the surgery ended the morning before yesterday. The surgery was successful and the family members also thanked them.

However, after a short rest for a day, when he returned to the hospital again, Sasaki Kazuru specifically called him in for a talk.

Sasaki Ichiru deliberately used a slightly harsh tone, especially emphasizing the word "interference".

At that time, there were four people in the operating room, including the anesthesiologist, in addition to the assisting nurses.

The chief surgeon is Yoshida Aoba, the first assistant is Aki Tomoya, the second assistant is Majima, and the anesthesiologist is Otani.