Chapter 911: [(911)] Try hard to keep it safe Chapter 911: [(911)] Try hard to keep it safe The spleen had shattered like tofu in water. Xie Wanying recalled the exam question Senior Tao had set for the surgical students. The reality of the operating room was much more severe than Senior Tao’s exam question; this spleen was beyond repair with just a few stitches.

A Level Three or Four spleen rupture could only mean splenectomy.

If the entire spleen, including the hilum, was removed, one had to consider the young age of the child and the space for future growth, demanding a more careful consideration by the doctors.

Xie Wanying remembered what she had said to Wengui. Although she spoke rationally to the family members, emotionally, she found it just as difficult to bear.

“Teacher Nie. The child’s risk of OPSI is quite high, higher than in adults, possibly due to complete removal of the spleen. If we could preserve the spleen, it would be more significant for the child. The spleen isn’t just for blood storage; for children, it also has a period of hematopoietic function and irreplaceable immune function, as well as future anti-tumor capabilities,” Xie Wanying said, knowing she only had this brief time to influence Teacher Nie’s decision. Now it all depended on how Teacher Nie would decide. With more experience than her, she believed he would make the best choice for the patient.

A complete removal would solve everything once and for all, but if saving the spleen was the goal, then the only option was autologous spleen tissue transplantation. The biggest issue with autotransplantation lay in the postoperative care.

Children require close monitoring for OPSI, just like adults, but autologous spleen tissue transplantation also carries the risk of necrotic infection. Moreover, it necessitates long-term dynamic observation post-surgery to ensure the recovery of spleen function; professional doctors needed to oversee this process.

If the surgery was performed in their own hospital, the follow-up would be straightforward. But now the situation was different; one couldn’t guarantee that the child would have professional medical care postoperatively. The conditions he had witnessed at the county hospital that evening spoke for themselves.

Considering these factors, Nie Jiamin had already made a decision before the operation: if this issue couldn’t be resolved, splenectomy was the only route.

Unexpectedly, the student across from him brought up this concern.

“Haven’t you considered other problems?” Nie Jiamin deliberately questioned her. He recognized her skills and hoped to guide her towards more thorough consideration as a future doctor.

“Teacher Nie,” Xie Wanying continued without stopping her assisting hand movements. Whichever procedure it might be, isolating the splenic pedicle was necessary. Meanwhile, she said, “If the problem is postoperative, I personally think there’s no need to worry too much. We’re not far from the Capital, and it’s feasible to continue postoperative care at Guoxie.”

It seemed she knew what he was concerned about. He wasn’t quite sure about how patient transfers worked domestically and asked, “Do you think she can be transferred to Guoxie?”

“She’s a car accident victim. The medical expenses should be covered by the driver at fault.”

The primary criterion for domestic patient transfer was financial sufficiency. Nie Jiamin understood her point and told her, “Abroad, it depends on insurance.”

Perhaps the mention of money struck a chord with Teacher Nie, prompting him to discuss the situation abroad with her.

With the hurdle of funding resolved, they proceeded to perform autologous spleen tissue transplantation on the child. Three hemostatic forceps clamped tightly around the splenic hilum, and she cut the splenic pedicle between the two forceps closest to the spleen, placing the detached spleen still clamped by the vessel forceps into a cooled balanced solution at 4 degrees Celsius.

First, she doubly ligated the vessels of the splenic pedicle, achieving adequate hemostasis, and finally, the blood stopped flowing like a fountain. They inspected the abdominal cavity for other organ ruptures and bleeding. The child’s blood pressure stabilized.