Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 215

Whew-

Everyone breathes a sigh of relief like a deflated balloon.

He was so immersed that he forgot to explain the surgery he was demonstrating.

Only then does Shin Sang-mi relax, sliding down the back of her chair.

“Wow~ Our Professor Baek Yi-shin really knows how to keep the audience on their toes.”

“I was worried something had happened.”

Ryoo Myung-in also grumbles.

On the other hand, Ma Dong-seop tries not to miss a single word from Professor Baek Yi-shin.

I also listened intently to the lecture.

Because this part is the core of Korea’s first PRT [Pulmonary Root Translocation] surgery.

<…You can make an incision like this and proceed. It's very easy.>

Easy?

Is he joking or serious?

Everyone in the lecture hall chuckled.

It reminded me of an old painter who created the catchphrase ‘It’s very easy, right?’

In reality, it looks very easy at first glance.

But that’s because the surgeon is Baek Yi-shin.

Among the people in this lecture hall, no one thought it was easy.

“Ma Dong-seop, that’s not easy, is it?”

“Would it be easy?”

“But why does it look so easy when Professor Baek does it?”

“I wonder about that too.”

The aortic valve area and the mitral valve.

Important parts that are responsible for the flow of blood within the heart.

To avoid damaging these parts, Baek Yi-shin carefully dissected the pulmonary artery root as if he were sculpting it.

Snip, snip-

He resects the remaining tissues under the valves and part of the myocardium [heart muscle tissue], and finally completely separates the pulmonary artery root.

“Ma Dong-seop, what do you do with the hole you removed it from?”

“Wait and see. You’ll be surprised.”

Ma Dong-seop smiles slightly.

Soon, Professor Baek Yi-shin’s hand moves.

He covers the area where the pulmonary artery root was removed with the pericardium [the membrane enclosing the heart] that he had removed at the beginning of the surgery.

It fits perfectly, like a lid that’s the right size.

Shin Sang-mi’s eyes widened.

“Ah, that pericardium you cut out at the beginning of the surgery?”

“That’s right, everything was done according to plan.”

“Ugh, goosebumps…!”

Shin Sang-mi rubs her arms.

It is much more advantageous to use one’s own biological tissue than to use other external materials.

That’s why he cuts the pericardium in advance and uses it.

It’s like watching a movie where the foreshadowing in the beginning perfectly explains the ending, a moment of exhilaration.

‘Heart surgery is so cool after all.’

I felt my heart pounding.

Surgery that takes several hours.

Even that surgery has a set path and order.

The puzzle pieces of the PRT surgery were being put together one by one, completing the big picture.

Baek Yi-shin picks up the scalpel again.

This time, he began to incise the right ventricle of the heart.

Swoosh-

Baek Yi-shin’s scalpel cuts through the right ventricle.

Then, the VSD (ventricular septal defect) [a hole between the heart’s ventricles], a hole between the ventricles, began to appear inside.

For Seul-gi, this VSD had been playing a role in mixing blood.

But in fact, it is a hole that should not exist in a normal heart.

<…….>

Baek Yi-shin calmly examines the hole between the ventricles.

Then, he grabs the surgical scissors and begins to sculpt the inside of the heart once again.

Swoosh, swoosh-

The heart muscle and septum are gradually shaved away.

The surgical instruments held by Baek Yi-shin were creating a path inside the heart.

Ma Dong-seop’s explanation continues.

“In the end, what’s important in TGA [Transposition of the Great Arteries] surgery is creating a good path for the blood to flow out of the heart. He’s creating that path right now.”

Left ventricle → Aorta.

Right ventricle → Pulmonary artery.

This is the correct direction. Like the providence of the universe.

The time has come to correct the phenomenon of the sun rising in the west.

Baek Yi-shin quickly created a path (LVOT, left ventricular outflow tract) [pathway for blood to exit the left ventricle], and now he was trying to finish the construction process by blocking the ventricular septal defect.

This time, he picked up a needle holder and began to sew with continuous sutures.

Swoosh- Click-

Only the sound of the needle passing through the heart tissue and the sound of the needle holder biting again are heard regularly.

His hands were fast.

While continuing to move his hands like a sewing machine, Baek Yi-shin speaks into the microphone.

Conduction system.

The force of electricity within our heart is what makes it beat regularly.

What if the electrical flow is damaged?

Arrhythmia will occur.

Therefore, during heart surgery, you must know in advance and avoid the main paths through which electricity passes.

Baek Yi-shin was even telling them the main paths.

Like a navigation system that knows all the roads.

Almost the final stage.

The pulmonary artery root that was removed earlier is attached to the right ventricle.

The completion of a heart sculpture.

The shape is amazing and even beautiful.

Finally, the surgery is almost complete as he closes the atrial septal defect [a hole between the heart’s atria] that was created three months ago.

At that time, Professor Wang Seong-han, who was watching in the lecture hall, let out a low exclamation.

“…Less than two hours to finish the main procedure? That’s too fast?”

Only then do people look at their watches and stir.

Is it good if the surgery is fast?

Of course, it is.

During heart surgery, the heart does not beat while using a cardiopulmonary bypass machine [a machine that temporarily takes over the function of the heart and lungs during surgery].

The longer this time, the higher the probability of complications, and the harder it may be for the heart to recover after surgery.

Therefore, fast and accurate surgery is the way to improve the completeness of the surgery.

“Heeya…….”

“He’s amazing as expected.”

“Who said Professor Baek wouldn’t be able to do heart surgery anymore?”

“Ahem, ahem. I know, right. Who spread such nonsense…….”

The atmosphere changed completely in two hours.

Even those who had been skeptical with their arms crossed now had no choice but to admit it.

Professor Baek Yi-shin showed and proved it.

His surgical skills are still top class.

“Kuh, barkeep!”

“This is the class of Yonsei University Hospital’s Department of Thoracic Surgery!”

“Everyone calm down, it’s not over yet.”

At Ma Dong-seop’s words, the intern colleagues who had been excited for a while calmed down.

What if you fixed the engine of a car?

You have to start it.

Likewise, if the internal heart procedure is over?

Now it was time to get off the cardiopulmonary bypass machine and return to Seul-gi’s heart.

Professor Baek Yi-shin looks outside the field for the first time since the surgery began and says.

The timing to reduce the pump (cardiopulmonary bypass machine) after the surgery is over.

As the body temperature rises, work is underway to remove air bubbles remaining in the heart.

As the body temperature rises sufficiently and the effect of the cardioplegic solution [solution used to stop the heart during surgery] disappears, Seul-gi’s heart begins to beat little by little again.

“…….”

Flutter- Flutter-

Very slowly, a little faster.

The heart begins to beat.

It was a miraculous moment.

It was like watching Seul-gi’s soul, which had left for a while, return.

“Wow, the heart is starting to beat again! It’s amazing!”

Shin Sang-mi was already deeply immersed in the charm of heart surgery.

“Yes, now we can say that the main surgery is over. But there is one last step left.”

“What’s left?”

“Pump weaning. It’s time to evaluate whether the surgery was successful. If the surgery was successful, blood pressure and oxygen saturation must be sufficient even without the help of a cardiopulmonary bypass machine.”

It was as Ma Dong-seop said.

The evaluation of heart surgery can be done immediately in the operating room.

‘Can the heart generate enough power without a cardiopulmonary bypass machine?’

If this test is not passed, something is wrong with the surgery.

Whether it’s myocardial protection or the paths created within the heart are wrong.

Gulp-

Everyone held their breath and watched the process.

50%, 30%…….

As Baek Yi-shin says in turn, the pump dependency decreases.

But.

The sound that echoes from the monitoring device according to the heart rate begins to decrease.

Beep, beep-

Saturation (oxygen saturation) begins to drop.

The camera zooms in on the decreasing numbers.

“……?”

Was myocardial protection wrong?

Or was the surgery wrong?

Everyone’s anxious gaze turned to the vital signs monitor.

“…Could it be that he sped up too much because it was a live surgery?”

Professor Wang Seong-han frowned and muttered to himself.

The people in the lecture hall buzz.

Everyone fell into a state of confusion, unable to be sure of the outcome of this surgery.

Whirr-

Soon the saturation recovers.

But it’s only a temporary measure.

The people in the operating room looked at Baek Yi-shin with heavy expressions.

If the heart function does not return as it is, everything that has been done so far will be useless.

The people watching in the lecture hall were also thirsty.

“Ugh, it’s making me nervous… what’s going on?”

“It looks like there’s a problem during the surgery.”

“Well… I don’t know either, what’s going on.”

Shin Sang-mi and Ryoo Myung-in anxiously examine the screen.

Ma Dong-seop also looks uneasy.

But I thought.

‘No, it’s not a failure yet.’

Professor Baek Yi-shin.

He doesn’t panic.

If the surgical field is a stadium, the position of the surgeon is the coach and ace.

If he panics, the game is over.

So, even at this moment, he does not lose his composure and is lost in thought.

‘If I were Professor Baek Yi-shin…….’

I imagined.

Operating Room 17, patient’s right side.

If I were there, what decision would I have made?

While thinking about various possibilities, something suddenly popped into my head.

“It might not be the heart; it might be the lungs that are the problem.”

At my words, Ma Dong-seop looked at me with surprised eyes.

And then.

Professor Baek Yi-shin reaches out to the side and says.

Baek Yi-shin’s words are nervously sharp.

The operating room nurse hands over the surgical scissors, flustered for the first time.

Snip-

As soon as Baek Yi-shin hands over the scissors, he moves his hand.

Right next to the heart.

He splits and opens the pleura [membrane surrounding the lungs] surrounding the lungs and shouts.