Chapter 170: Kasai Op [3]
Chapter 170: Kasai Op [3]
Because Kanghyeok’s tone had been so firm, both Dolseok and Yeoni kept their mouths tightly shut.
They merely stuck out their lips with sullen expressions.
How exactly is he going to make it again?
They had definitely learned about the tube through which bile flowed, the bile duct, during those hellish anatomy lab sessions.
It had been extremely thin and had an incredibly complex structure.
And yet he was saying he would remake it.
In a child this small, no less.
They had mountains of questions, but they could not rashly open their mouths.
Because a deep crease had formed between Kanghyeok’s brows.
If we keep asking, he’ll probably thunder at us.
In any case, if they just endured a little longer, they would be able to see it for themselves.
So Yeoni forcibly swallowed the words she wanted to say.
But unexpectedly, someone else called out to Kanghyeok.
“U-um, Young Master?”
“What.”
Kanghyeok had just been about to cut away the nonfunctional bile duct with the scalpel.
He lifted his head with eyes full of irritation.
With things so urgent, it was only natural that he would react that way when someone kept calling him.
He’s turned into a goblin.
The instant Makbong saw the fierce look in Kanghyeok’s eyes, he shrank back.
Perhaps because Kanghyeok was holding a scalpel, it felt especially terrifying.
“Well…”
“What is it.”
It might have been just his imagination, but it seemed like more strength had gone into Kanghyeok’s hand.
Makbong even had the premonition that the scalpel might come flying straight at his forehead.
But Makbong had a reason he had to take the risk.
“He’s moving.”
“What… what is?”
“Him. Tsu… whatever-his-name-is.”
Makbong smiled awkwardly and pointed at Tsurumatsu’s hand.
Just as he said, Tsurumatsu’s hand was clenching and unclenching.
It was a sign that consciousness was gradually returning.
“Ah, is it because I got scared and lowered the dose…?”
“Uh… more than that, Young Master. He also looks like he’s about to retch a little.”
“That won’t do.”
Kanghyeok checked Tsurumatsu’s throat as it bobbed.
Then he looked at the metal airway tube still firmly inserted in the child’s throat.
With Makbong’s grip strength, it would not come out easily.
But it would be too much to continue the surgery like this.
The irritation from that tube will probably be even worse than the surgery itself.
It was plainly true that Kanghyeok had no intention of fully curing Tsurumatsu.
But he also had not the slightest intention of putting a child with whom he had no personal grudge through raw torture during surgery.
“First, Makbong, keep things as they are. Dolseok, irrigate the inside of the abdomen. Yeoni, come with me to the neck.”
“Ah, yes.”
Whatever else they were, they were a trained surgical team.
At a single word from Kanghyeok, each of them moved swiftly to their positions.
In the middle of that, Yeoni even measured out the local anesthetic injection and handed it to Kanghyeok.
“Here it is.”
“Good. We’re in a hurry, so I’m going to do this fast. You need to keep up.”
“Yes.”
Yeoni answered with a stiff face.
As Kanghyeok quickly inserted the injection below Tsurumatsu’s throat, he kept speaking.
This time it was toward Makbong.
“Makbong, hold on as long as you can. He doesn’t have any teeth anyway, so don’t worry and just keep it in there.”
“There’s a little bleeding…”
“There aren’t any major vessels there anyway. And if we insert the airway here, there’s no risk of blockage.”
“Yes, then I’ll hold out as long as I can.”
“Okay. I’m counting on you.”
“Yes, sir.”
Kanghyeok’s instructions were clear and fast.
There was also something reassuring about them.
“All right, I’m cutting now.”
Kanghyeok made a horizontal incision in Tsurumatsu’s neck with the scalpel.
The moment the incision went in, Yeoni spread the muscles hidden beneath the skin to either side.
Then the white trachea deeper inside came into view.
“Yeon-ah, there’s going to be phlegm, so be ready. Makbong, when I signal you, pull that tube out right away.”
“Yes.”
“Yes, Young Master.”
Working on the airway was always nerve-racking, especially the airway of a child this small.
Even for a doctor as experienced as Kanghyeok, it was the same.
Gulp.
Kanghyeok swallowed once, then spoke in a hurried tone.
“Makbong, now!”
At the same time, he sliced through the protruding trachea with the scalpel.
In one stroke, the membrane connecting cartilage to cartilage was cut, and the blood-tinged phlegm pooled inside gushed out.
But there was not much of it.
Yeoni quickly wiped it away with gauze.
“Here it is!”
“Okay. Yeon-ah, spread it!”
“Yes!”
With the hand not holding the gauze, Yeoni used a hook to pull the opening slightly wider.
It was only a tiny gap, but Kanghyeok did not miss it.
Pop.
The metal airway tube that had just been inside the throat a moment ago instantly slid into the opening in the trachea.
At that point, they were safe.
At the very least, even if something happened, breathing itself would now remain stable.
O-no-dono and Hideyoshi probably won’t like this…
But once they saw Tsurumatsu improved, that would probably vanish at once.
“Whew. I was a little tense because he’s so small, but I haven’t lost my touch.”
Looking at the securely seated tube, Kanghyeok let out a sigh of relief.
Makbong, on the other hand, still looked anxious.
The child’s arm was still moving, and his blood pressure and heart rate were still elevated.
“Then we have to put him back to sleep now, right?”
Makbong was stuck, not knowing what to do.
If it had been a full-grown man, he could have just smacked him on the head or at the nape.
But this was far too small a child.
If he struck wrong, the child might lose consciousness forever.
“Over there. O-no-dono left it behind, didn’t she? The feeding bottle.”
“The feeding bottle…?”
Makbong looked puzzled, then spotted the feeding bottle placed on the platform.
It was an extremely precious feeding bottle made of imported Portuguese glass.
Inside it was milk O-no-dono had personally expressed, mixed with the medicine Kanghyeok had given.
That gave it a very peculiar color and smell.
“This…?”
“Yeah. Feed him that.”
“Feed him? Me?”
“Who else here has a hand free besides you?”
“That’s true, but… ah, I’ve never fed a baby…”
“Stop talking and feed him. We’ve still got a long way to go.”
After snapping that out, Kanghyeok returned to the abdomen.
Then he nodded with satisfaction.
“Oh, Dolseok. You cleaned the abdomen up nicely?”
“Of course.”
“Good. Then…”
It was as though he had already completely forgotten that putting Tsurumatsu back to sleep was even an issue.
So that matter was left entirely to Makbong.
Ah… wow, and you dump this on a bachelor…
Makbong looked at Kanghyeok resentfully, but it was useless.
Those three were already completely absorbed in the surgery again.
So when he looked down, he saw Tsurumatsu’s face with eyes wide open.
Holy shit… you scared me.
As befitted a child who had been sick for so long, he had no strength at all.
So even when he saw the huge, unfamiliar brute named Makbong, he could not really react much.
He merely flailed his arms and legs a bit more than before, and even that was weak.
But Makbong could not just leave him like that.
It was not for any special reason.
It was because Kanghyeok had shouted, “You’re not feeding him?”
“Yes, yes.”
What else could he do?
He was a servant.
If he was told to do it, he had to do it.
“Uh… here, drink this… there, there…”
Makbong did his best to rely on memory and held the bottle out.
Fortunately, Tsurumatsu obediently latched onto the bottle.
Because of the ascites that had always filled his abdomen, he had never been able to take enough in, but now that it had been relieved, his stomach was in much better condition.
Of course, the fact that they were about to cut that abdomen open again was a bit of a problem.
After confirming that Tsurumatsu’s throat had begun to move slightly, Kanghyeok lowered his head again.
“Now that he’s taking the medicine… it’ll come down soon enough. But no matter how much it’s medicine, if you pour it into the abdominal cavity instead of the gut, it becomes poison. So… let’s clamp this here for now.”
Kanghyeok clamped the middle part of the duodenum, the very first section of the small intestine connected to the stomach.
It was possible only because he had no intention of operating above that point anyway.
The drug would be absorbed roughly through the duodenum.
“Makbong, hold onto the child until the medicine takes effect.”
“Yes… he keeps smiling, though.”
A baby smiling with his abdomen open.
That was something that would almost belong in a horror film.
But medically speaking, it was not impossible at all.
“That’s a good thing. Babies’ abdominal organs are duller than ours. Still, put him to sleep.”
“Yes, Young Master.”
Kanghyeok again grasped the shriveled, dried-up bile duct.
Just in case, he cut the middle open, and as expected, it was completely blocked.
There’s no lumen. If the bile ducts deeper inside the liver are all like this too, that’ll be bad…
But that could not be the case.
He could be sure even without ultrasound or a CT scan.
If that were the case, he would already be dead.
A form of biliary atresia that severe would never have allowed the child to survive to this age.
Because Kanghyeok knew that well, he had been able to proceed with the surgery confidently.
Still, until he saw it with his own eyes, it had bothered him a little.
So he quickly brought the scalpel to the bile duct closest to the liver.
“Dolseok, hold some kind of basin under here.”
“This one?”
“Hey, that… will that even fit into his abdomen? A smaller one!”
“You said any basin…”
“You want to die?”
“No. I’ll use this one.”
Dolseok quickly brought over another basin.
The moment it was in position, Kanghyeok swung the scalpel.
Slice.
With a chilling sound, the bile duct split open.
Then the bile that had been trapped inside began pouring out in torrents.
It had been stagnant for so long that not a single drop of proper bile remained.
All of it had gone foul, and some of it even came out mixed with pus.
As a result, the room filled with a harsh, vile stench.
“Urk.”
Because he had to hold the basin close, Dolseok had his nose right near it, and he let out a groan.
Even someone like him, hardened by countless surgeries and anatomy labs, was affected that badly by the smell.
“Good, good.”
But Kanghyeok was smiling instead.
The state of the liver was better than he had expected.
Looks like about ten percent of it is still functioning. In that case… after the surgery, he’ll really seem fine for about a year.
After that, he would gradually worsen and eventually die.
But at any rate, while the diplomatic mission remained here, he would show the sort of improvement that made him seem almost like a different person.
Still smiling with satisfaction, Kanghyeok murmured, “Dolseok, don’t let your hand shake. Keep holding it there. If that spills into the abdominal cavity, it’ll be a disaster.”
“Yes, yes.”
“Yeoni, bend the syringe needle, fill it with saline, and give it to me.”
“Yes, Young Master.”
Kanghyeok inserted the tip of the syringe Yeoni had prepared into the bile duct.
Then he flushed saline through it.
More bile that had still been trapped inside flowed out.
“This way, we can irrigate it and get it cleaner.”
“Oh…”
“For now, Dolseok, keep collecting it like that. Yeon-ah, now you and I are going to make that bile duct anew.”
“With what… are you going to make it?”
At Yeoni’s question, Kanghyeok burst into laughter.
Unlike before, it was full of kindness.
That was because he had much more room to breathe now.
“Where is bile supposed to go in the first place?”
“Uh… the intestines?”
“That’s right. Then if we just get it into the intestines somehow, that solves it.”
“Yes, that’s true.”
“The small intestine is, as you can see, long. There’s plenty of it to spare. And since he’s a child, it’s very thin too.”
“That… is true?”
“I’m going to cut a piece of it and make a tube. Hand me the scissors.”