Chapter 86

“Is the [laparoscopy set] ready?”
(T/N: [Laparoscopy] is a surgical procedure using a camera to examine the abdominal cavity.)

“What? [Laparoscopy]?”

Kang Hyuk requested a [laparoscopy set] at the most unexpected time.

Both the main and assistant nurses in the operating room looked at him with bewildered expressions.

Why would anyone request [laparoscopy] during trauma surgery?

[Laparoscopy] is a technique that should only be performed when both the patient and the medical staff are perfectly prepared.

“Why are you suddenly talking about [laparoscopy]?” Han Yoo-rim immediately questioned Kang Hyuk’s request.

He also seemed unable to understand Kang Hyuk’s demand.

He was already struggling to control the bleeding, and here Kang Hyuk was making what sounded like a pointless request.

The sooner something was done, the sooner he could get his hands free.

A wound made slippery by oil and blood seeping from destroyed fat cells.

How long was he supposed to keep pressing down on this?

It was agony.

“If the [surgeon] needs it, you should bring it quickly. Hang in there just a bit longer, Chief. I’ll make sure you can take your hands off soon.”

“R-Really?”

“Yes, really. Just bring the [laparoscopy set] quickly.”

“Then what are you waiting for? Go get it.”

With both Kang Hyuk and Han Yoo-rim insisting, the nurse couldn’t hold out any longer.

Whatever the circumstances, Han Yoo-rim was still the head of a department.

And not just any department—surgery, a major department.

Even the head nurse overseeing all the main building operating rooms couldn’t ignore Han Yoo-rim’s orders.

“Yes, I’ll prepare it right away.”

“How long will it take?”

“Um…”

The assistant nurse, taking off her gloves, stopped on her way out and looked around the operating room.

The rooms in the main building’s operating suite were really small.

When they were built, there hadn’t been much need for equipment.

Most departments just brought a single scalpel to surgery back then.

Because of this, unlike the emergency operating room or the cancer center, there was no camera system set up in the rooms.

It would have definitely gotten in the way during other surgeries.

So, the nurse had to go get a camera to look inside the abdominal cavity.

“It’ll take about 10 minutes…”

“10 minutes?”

“Yes.”

“That’s too long. Anyway, just be as quick as you can.”

“Yes, Professor.”

The assistant nurse quickly left the operating room.

Kang Hyuk watched her go for a moment before turning to Han Yoo-rim.

Han Yoo-rim, the chief of general surgery and a surgeon with decades of experience, was pressing down on the wound with all his might.

‘It’s a waste to use someone with over 20 years on the scalpel like this, even if he’s just an intern.’

It might be odd to call someone a ‘resource,’ but still—

It seemed like a waste of a great resource.

“Chief.”

“Huh? Why, is it bleeding?”

The person in question didn’t seem to think so, though.

Judging by his expression, he was truly giving it his all.

“Just hold still for a second. Stay like that.”

“Oh? Okay, sure.”

Kang Hyuk secured Han Yoo-rim in place and picked up the suturing tools again.

Then, right by Han Yoo-rim’s left hand on the lower abdomen, he quickly stitched a messy suture.

Ziiip.

As soon as he pulled tight on the suture, Yoo-rim immediately felt something change.

It was as if the pressure on his left hand had suddenly lessened.

“Hmm?”

“Now, gently lift your hand there.”

“All right.”

Although it had been some time since he’d worked on the frontlines saving lives—

Han Yoo-rim had once been a remarkable figure.

Hanguk University Hospital’s surgery department wasn’t an easy place to become chief.

Even if he wasn’t as sharp as in his prime, his hands were still plenty sensitive as he slowly lifted them away.

Drip.

Blood seeped from the torn wound in the lower abdomen.

But at least it wasn’t gushing out anymore.

Most of the bleeding here seemed to have come from the [skin].

‘That’s a relief. The internal wound must be… at worst, an injury to the [colon] or [small intestine].’

Han Yoo-rim looked relieved as he turned to Kang Hyuk.

Kang Hyuk wore a similar expression.

It seemed Kang Hyuk would handle the upper abdominal injury and leave the lower one to Yoo-rim.

Calling the part he gave away easier felt like a stroke of luck.

At least for him.

“All right, now with your left hand, lift the area you’re pressing with your right hand.”

Kang Hyuk handed Yoo-rim the [army–navy retractor] as he spoke.
(T/N: [Army–navy retractor] is a surgical instrument for holding back tissue.)

Yoo-rim hesitated briefly, holding the retractor, then moved as Kang Hyuk instructed.

‘So, he wants me to use the retractor where I was pressing with my right hand.’

A wound will stop bleeding whether you press from above or below.

So by switching from pressing down with his hand to lifting up with the retractor, the bleeding would stop—at least as long as the lower field was clearly visible.

With his right hand still applying pressure, Yoo-rim slipped the retractor through the torn gap and lifted the wound.

Drip.

At that moment, blood began to flow from somewhere in the area that had been held down so well.

Kang Hyuk tried to look inside but couldn’t quite manage it.

The wound was too deep and too narrow.

Not even Kang Hyuk could see in total darkness.

“Give me the [headlight].”

He asked for a [headlight], and another nurse quickly fitted it to his head.

Suddenly, the inside that had appeared pitch-black before became visible.

He’d need to insert a camera to perform detailed procedures, but at least now he could see inside the abdominal cavity.

“All right. Where is it? Hmm… The [spleen] and… [adrenal gland]. This is going to be a headache. Is the patient’s blood pressure stable?”

“It’s stable for now! But if it’s the [adrenal gland]… I’ll prepare an [antihypertensive] just in case.”
(T/N: [Adrenal gland] is a small organ above the kidney that secretes steroid hormones. [Antihypertensive] is a medication used to lower blood pressure.)

“Get ready with [beta-blockers]. You need to control the heart rate, not just relax the blood vessels.”

“Understood.”

At the mention of the [adrenal gland] injury, anesthesiologist Park Gyeongwon’s expression turned grave.

The [adrenal gland] is a small organ above the kidney that secretes glucocorticoids, a hormone well known for responding to stress.

‘It’s a miracle the blood pressure has been stable so far.’

Kang Hyuk’s face also darkened considerably.

Like other organs in the body, the [adrenal gland] does not produce steroid hormones as needed in real-time. Instead, it produces and stores them in advance, releasing them when necessary.

Damage to the [adrenal gland] means the steroid reservoir has been destroyed.

‘If all that gets released into the bloodstream…’

The patient would be swept up in a massive steroid storm.

That would inevitably accelerate the heart rate and increase the contractile force, regardless of the actual physical state.

“We can’t touch this yet. When’s the [laparoscopy] arriving?!”

At Kang Hyuk’s shout, the nurses flinched even though they hadn’t done anything wrong.

They looked at the operating room door with expressions of helpless frustration.

Screee—

Miraculously, the door opened right on cue.

“You’ve been waiting! I’ll set it up right away.”

The new nurse, realizing that everyone was watching as she brought the device in, quickly bowed her head.

“Never mind that. How long will it take to set up?”

At Kang Hyuk’s words, the new nurse hurriedly plugged in the power and replied.

“Five minutes. It’ll be ready in five minutes.”

“Five minutes. Okay. Got it.”

Kang Hyuk nodded and looked at Han Yoo-rim.

“Chief, let’s get some [hemostasis] at the site where the camera will go in.”
(T/N: The process of stopping bleeding or keeping blood within a damaged blood vessel.)

“Okay. Uh, how? Can you see anything?”

With the [headlight] on, it did seem a bit brighter inside.

But it was still mostly darkness.

In fact, knowing the [adrenal gland] was injured came from what he’d heard, not what he’d seen.

The wound in the patient’s abdomen was extremely irregular, narrow, and deep.

The more he looked at it, the more it felt like a wound handed down by fate.

“It’s a little better from here. You know how important the angle is.”

“Yeah, that’s true…”

“And you’re actually holding it quite perfectly, Chief.”

“Really? I’m doing well?”

“Yeah. Hold it right there. Don’t move.”

“I-I will.”

Han Yoo-rim, almost like a first-year resident, wavered at Kang Hyuk’s words.

Fortunately, he had solid fundamentals and kept the tool firmly in place.

Thanks to that, Kang Hyuk could finally control the bleeding from the skin that he’d missed with the earlier, rough suture.

‘This way, blood won’t get on the camera lens.’

What’s the most important thing to secure in any surgery?

The answer is always the [field of view].

If you can’t see, you can’t do anything.

In surgeries using [laparoscopy] or [endoscopy], the importance of the [field of view] multiplies.

You only have a single camera lens to see into tight spaces.

So, it’s best to eliminate anything that could obstruct the view in advance.

“Are we good now?”

“Yes, the camera is connected. The [insufflator] isn’t hooked up yet—”
(T/N: A medical device used to pump gas (usually carbon dioxide) into a body cavity, commonly during laparoscopic surgery, to create space for better visibility and access.)

“Don’t bother! The wounds are all open anyway. Just hand me the camera.”

In regular [laparoscopic] surgery, gas insufflation is essential.

Injecting gas into the abdominal cavity creates the space needed for surgery.

But in this case?

Any gas injected would just leak right out.

There were holes everywhere.

Swoosh.

Kang Hyuk inserted the camera through one of the holes.

Thanks to all the diligent hemostasis, there was no blood at all on the lens.

Now, even Han Yoo-rim and the other staff could finally see inside the abdominal cavity.

“Oh man…”

Han Yoo-rim let out an involuntary sigh at the wounds displayed on the monitor.

Just as Kang Hyuk had said, the [spleen] and [adrenal gland] were badly injured.

The [spleen], famous for breaking down damaged blood cells, was drenched in bright red, and blood continuously flowed from the damaged area.

“This… Wouldn’t it be better to just open it up wide?”

So Yoo-rim suggested ditching the [laparoscope] and opening the wound for better access.

Better to open it wide and operate with a clear field of view, rather than risk an accident due to poor visibility.

But Kang Hyuk thought differently.

‘If this were the only surgery, maybe…’

He wasn’t just any doctor.

He was the head of the Severe Trauma Center and chief of trauma surgery.

To quickly join the two other surgeries happening without him right now, he had to finish this one in the shortest time possible.

“No, I’m going ahead as is. I… can do this.”