Dr. Xiao took over the arterial clamp to clamp the iliac artery base, the iliac internal artery opening is about the same size as the renal artery opening, using 5-0, 6-0 smooth threads for two-point or interrupted suturing.

The stitch distance is about 1mm from the edge of the tube, about 0.5-1mm. Using a two-point continuous suture method to sew until the last stitch, Heparin saline with a fine flat needle at a right angle is injected with 5-6ml, the suture is tightened, and checked for leaks. Li Jingyi, after checking, quickly tied the suture with 7-8 knots to prevent it from coming loose.

In the same manner, use a Kocher clamp on the renal artery, loosen the root clamp of the iliac internal artery, check if there is any bleeding at the anastomosis, and Dr. Xiao said in a deep voice: "No problem."

"Dr. Xiao, look at the artery here, it has atherosclerosis, which doesn't align with Dan Qing's age-related aging state." Li Jingyi pointed to an artery to express her doubt to Dr. Xiao. Generally, iliac internal arteries have atherosclerosis which is more evident in older individuals, the vessel is brittle, prone to rupture, requiring particular care and attention during suturing.

"Dan Qing's living conditions led to her nutritional deficiencies in various aspects, combined with her long-term fatigue and suffering from illness, her internal organs are under a heavy burden, which causes premature aging phenomena." Dr. Xiao was not too surprised by this condition. Instead, the fact that no major incidents have occurred so far in the surgery is beyond his expectation, besides some minor issues, her internal organs are still well-protected, possibly due to the training of the Profound Lady Heart Scripture. "Suturing can be done in full layers from the renal artery to the iliac internal artery. If the iliac internal artery tears longitudinally during suturing, it should be sutured transversely or in a figure-eight formation if necessary."

Perhaps due to living conditions, Dan Qing had little subcutaneous fat, making it easy to separate the external iliac artery. Dr. Xiao used a heart iron clamp to clamp the external iliac artery at the corresponding location of the renal vein, cut it with a sharp knife to match the aperture of the renal artery, and trimmed a small amount of artery wall to form an oval opening.

Suture one stitch each on the upper and lower parts of the artery, similar to venous suturing, but different from Li Jingyi's stitch intervals; his every stitch interval does not exceed 1mm, and the thread is 0.5mm from the incision edge. Upon reaching the last stitch, Li Jingyi administered heparin saline.

After clamping the renal artery with a Kocher clamp, he released the heart iron clamp and observed the anastomosis for leakage. The two cooperated with each other with a high degree of tacit understanding.

"When performing arterial anastomosis, it's crucial to pay attention to whether the renal artery is twisted or rotated. In cases with multiple renal arteries or abnormal vessels, it's preferable to utilize the aortic flap to join the multiple vessels together, making it more favorable for anastomosis with the external iliac artery."

Li Jingyi found it difficult to describe her mood at the moment. As a fellow doctor, she certainly wouldn't normally inform a colleague in such detail about potential situations and remedies during surgery. It's common knowledge that technical skills should not be disclosed easily for fear of others mastering them. Was this person in front of her selfless because of overwhelming confidence that no one can match his medical skills? Or because...

"In performing anastomosis to the external iliac artery, it is important to minimize suture time to prevent prolonged ischemia of the lower limb. Arterial anastomosis can also use a continuous point method, making an all-layer suturing with intima to intima contact. When suturing the end, one should start with the medial surface and then rotate the fixing wire to suture the rest." Dr. Xiao took a deep breath, noticing that the clock on the wall was pointing to 6:30 AM.

"Sister Jing, now we need to initiate blood flow. In this process, I hope you can concentrate, as this is a critical step." Compared to the first time, Dr. Xiao's tone was obviously heavier this time, clearly expressing his dissatisfaction with her distraction. As a doctor, indeed she had no reason to rebut; her distraction could lead to a crisis in such a significant surgery, a responsibility she found hard to bear.

"I'm sorry!"

After completing the static and arterial anastomosis, Dr. Xiao used a Kocher clamp to clamp the static and arterial vessels respectively and checked the anastomosis for bleeding and oozing at the incision.

"Input 600ml of A-type plasma, 30g protein." According to Dr. Xiao's instructions, Li Jingyi simultaneously administered immunosuppressant drugs and 20% mannitol 250ml.

Dr. Xiao first released the venous clamp, then the arterial clamp, the kidney turned from white to red, with a rosy color, and became turgid and swollen.

"Administer 70mg of Lasix again."

The artery was pulsating, and the renal elbow had elasticity. Dr. Xiao observed the changes in the kidney, while Li Jingyi held a Halsted clamp in her hand, quickly clamping and ligating the bleeding point at the renal hilum. When small blood vessels on the surface of the renal capsule showed blood traces, she immediately applied gauze to stop the bleeding. "There is seepage at the ureter stump, the ureteral artery blood supply is good, some turbid liquid flows out."

Listening to Li Jingyi's report, Dr. Xiao nodded his head, but still furrowed his brows. From the start of the surgery until now, it can be said to be quite successful, only the arterial pulse was somewhat weak. He re-examined the renal artery, checking for any twisting, angulation, or issues at the iliac blood vessel site.

"Is there a problem?"

Li Jingyi inquired upon noticing Dr. Xiao's actions, but he shook his head as he checked Dan Qing's blood pressure.

The weak pulse of the artery might be due to her symptoms of low blood pressure. From the color of the kidney, the possibility of deterioration is not high. After hesitating for a moment, he gathered a force in his palm and slowly infused it into Dan Qing's body. Perhaps the effect was not very potent, but it was enough for Dan Qing to sustain herself for a while.

"Done!"

"Congratulations, Dr. Xiao!" Li Jingyi also exhaled deeply. Her legs felt weak, and she just wanted to find a chair to sit down. The strain on her nerves had nearly driven her to collapse.

"Sister Jing, you should go and rest first. There are still some wrap-up tasks to be done." Xiao Lin, thoughtfully, signaled with his mouth to Li Jingyi.

Although the ureteral anastomosis was completed and the kidney transplant surgery was concluded, Dan Qing's clotting mechanism was relatively poor, with low platelet count and poor functionality, leading to diluted blood and a tendency to bleed. Xiao Lin did not dare to slack off and meticulously checked the incision, the wound bleeding, and the overall bleeding situation.

"I'll take care of the rest myself."

Li Jingyi took over the instruments from Xiao Lin. The physical exertion required to complete the entire surgical procedure was far more than she had imagined. Although Dan Qing's condition was stabilizing, a poor clotting degree could still affect post-operative bleeding issues. Only after ensuring no seepage and related hazards can a drainage tube be placed outside the bladder and led out from the incision beside the iliac vessels for layer-by-layer closure.

Xiao Lin nodded and sat down on a cabinet nearby. Only then did he feel the cold, his surgical gown soaked with sweat. The habitual drowsiness began creeping into him slowly. He leaned against the wall, closing his eyes, but he didn't dare to sleep. Until everything was completely done, there was still potential for crises. Ruffling his hair, he walked over to the operating table, watching Li Jingyi meticulously check each anastomosis point and platelet appearances, repeatedly ensuring there were no problems, before Li Jingyi began the final epidermal suturing.

"Transfer to the intensive care unit. These three days are a very critical period. If the urinary tract operates normally without any sign of rejection, only then can it be considered a true success." Xiao Lin supported himself against the wall, his exhaustion making his voice weak.

"Are you alright?" Li Jingyi asked with concern, understanding his current state: "Let me take you back to rest first."

"No need!" Xiao Lin waved a hand at Li Jingyi. During these crucial three days, he needed to stay at the hospital.

"Dr. Xiao!" Watching Xiao Lin open the door of the operating room and walk out, Li Jingyi didn't pursue further. She couldn't quite describe her feeling, like spices being spilled—it was a mix of all sorts of emotions, but she couldn't pinpoint a single one.

"Mom, is it done?" Niu Niu, holding onto the teddy bear given by Xiao Lin, stood outside the operating room door, tears still hanging on her cheeks. She had woken up in the middle of the night and couldn't find her mother, crying alone in the ward. Fortunately, Yu Zhengbo was passing by and informed her about her mother's situation. She then fearfully made her way to the operating room door, sitting silently on the long bench as she watched the red light above the door.

"How did you end up here all by yourself?" Xiao Lin squatted and patted Niu Niu's hair, gently wiping away her tears with his thumb. "Have you been crying?"

"Where's mom?"

"Mom has to go to the intensive care unit. Niu Niu, don't worry."

"Brother Xiao, will mom get better?"

"Be good, Niu Niu. Brother will take you to see mom!" A big hand took Niu Niu as they turned to head toward the intensive care unit on the third floor.

"Brother Xiao!" Halfway there, Niu Niu suddenly stopped. Her round eyes stared unblinkingly at Xiao Lin: "Thank you, Dr. Xiao." Suddenly, she bent her knees as if to kneel down, but Xiao Lin quickly gripped her arms and lifted her up.

"What are you doing?" Xiao Lin picked up Niu Niu to stop her from making any further actions.

Frightened by Xiao Lin's stern voice, Niu Niu's eyes brimmed with tears, her mouth pouting. She dug her small hand into her pocket, taking out a piece of fruit candy, and placed it in Xiao Lin's large hand: "This is the candy Sister Xiao Yuan gave me. I'm giving it to you now." (To be continued. If you enjoy this work, please visit Qidian (qidian.com) to cast your recommendation votes and monthly votes. Your support is my greatest motivation.)

If you find any errors ( broken links, non-standard content, etc.. ), Please let us know < report chapter > so we can fix it as soon as possible.