The anterior tibial artery was one of the important vessels carrying blood from the calf to the instep.
It also served to distribute blood throughout the entire calf.
Among the calf vessels, it belonged to the thick axis along with the posterior tibial artery.
Squish, squeeze.
Taesu gently gripped the vessel with a Mixter and put the sensation into words.
"It feels kind of like a deflated balloon."
"I checked along that vessel down below the knee, and there were no major issues up to the calf."
"Then it means the problem is with the upper artery. Minsu."
Taesu called out immediately.
Jeong Minsu was already moving his hands inside the affected area, as if he had already sprung into action.
"Wait, 30 seconds."
Swish, swish.
Even from where they stood, the surgical instruments could be seen moving rapidly.
An unexpected, brief lull occurred.
But even this bit of spare time could be put to ample use.
"Mr. Hyeokgwon, replace the glucose with a new bag… No. Just connect two of them instead."
"Additional hemostatic?"
"No. Since it's a circulation issue, not a hemostatic—hang a small electrolyte pack alongside it, please."
"Anything else?"
When Gim Hyeokgwon asked briefly, Taesu rolled his eyes and shook his head.
"That's enough for now."
"Let's do that. And let's go replenish what we're short on."
"I'll go get that."
Swish.
Taesu moved first, not content with mere words.
Having stepped away from the operating table, Taesu immediately approached the shelf.
Supplies sufficient for at least two more surgeries were stocked there.
It was abundantly equipped in preparation for emergencies or should the surgery change course midway.
Taesu grabbed whatever caught his eye and cradled it in his arms.
"This, you, and you again… Ah, to hell with it. Whatever."
Clack, clack.
He literally swept them up.
Even in that rough handling, there was a calculation of his own.
Soon, Taesu returned with his arms full of supplies.
Thud.
He dumped them onto the medical cart first and quickly surveyed their surroundings.
While checking for any inadequately prepared items, Gim Hyeokgwon approached.
"All done."
"Good work."
"But it's been a while since you fetched supplies, and you brought quite a good haul."
As Gim Hyeokgwon spoke while glancing at the medical cart, Taesu replied simply.
"I was the one who taught you."
"It was so long ago, I thought I'd figured it out on my own."
"It's only been half a year."
"Time seems to fly by, yet at the same time, it crawls disgustingly slowly."
Gim Hyeokgwon forced a joke with a sullen expression.
He had said they would laugh when it was over, but even this brief respite showed his desire to catch his breath.
Taesu felt the same way.
After spending hours in a state of tension, he was beginning to feel the strain.
It was the very moment his tension began to ease slightly.
"Found it."
Jeong Minsu's sharp cry rang out.
It had taken roughly 40 seconds.
It was slightly later than expected, but not a situation that would cause major problems.
Before they knew it, Taesu and Gim Hyeokgwon were tense again.
Taesu asked immediately while changing his surgical gloves.
"So, the cause?"
"It's the femoral artery, just as I thought. The area where necrosis was progressing."
"With an abscess that deep, necrosis is bound to happen."
Taesu's expression turned bitter.
Even if theoretically entirely possible, it was unwelcome news.
Taesu immediately approached the opposite side of Jeong Minsu and asked.
"So, have you thought of a method?"
"How about an aortobifemoral bypass?"
"No way. If we occlude the femoral artery now, everything from the calf to the toes will rot."
Taesu blocked the suggestion, pointing out the problem.
The femoral artery was that vital a vessel.
Having grasped the situation, Jeong Minsu abruptly furrowed his brow.
"Then what do we do?"
"Shall we replace it with an artificial vessel?"
"How is that different from attaching it?"
When Jeong Minsu hit the core issue, Taesu flinched, having been in a hurry to answer.
"Th-that's right."
"More importantly, do we even have an artificial vessel?"
When Jeong Minsu asked, Gim Hyeokgwon answered immediately.
"We do."
"Oho. If we use that."
"Right. Let's say we somehow use it. But did you say we should continue administering a thrombolytic agent?"
Gim Hyeokgwon expressed doubt.
At those words, Jeong Minsu paused this time.
"Ah, damn."
"That's impossible."
Taesu also immediately erased that method from his mind.
The affected area was so extensive that one could say they were operating on the entire right leg.
The main part of the surgery going forward could not avoid bleeding.
But if they administered a thrombolytic agent?
They would have to worry about excessive bleeding more than the surgery's success.
Stymied by an unexpected problem, the operating room atmosphere grew even heavier.
"Let's look again. The femoral artery is the problem."
Taesu muttered, reviewing the current situation.
He wasn't the only one worrying.
Jeong Minsu and Gim Hyeokgwon also furrowed their brows and fell into deep thought.
It was then.
"That's it."
All eyes immediately focused on Taesu at his bright exclamation.
"Taesu, did you think of something?"
"Yeah. Connect the catheter directly to the femoral artery and the anterior tibial artery."
At those words, Jeong Minsu and Gim Hyeokgwon each showed doubt.
"A catheter instead of an artificial vessel?"
"Even with a direct connection, don't we need warfarin?"
As if he had thought that far ahead, Taesu answered the questions in sequence.
"Let's save the artificial vessel. Catheters can be reused after sterilization."
"Hmm. I'll give you that."
"Then that's settled. Mr. Hyeokgwon, we won't be using warfarin."
Gim Hyeokgwon could not easily understand Taesu's words.
"You said catheters absolutely require warfarin."
"We only need to redirect part of the blood flow."
"If blood leaves the body, won't the temperature drop and cause it to clot?"
"If we increase the blood volume, the circulating amount increases and covers it."
Taesu answered smoothly without a hitch.
Having perhaps pictured it in his mind, Gim Hyeokgwon made a strange expression.
"You're right. It might be possible, but who will punch a hole in that thin vessel and connect it?"
"Who else? Naturally, Minsu will do the suturing."
Taesu replied in a voice that suggested it was only natural.
At the same time, Jeong Minsu pointed at himself with a bewildered expression and asked.
"Me? How?"
"We have a guide wire. Pass the guide wire through the catheter and make a hole in the vessel."
"Ah, ahh. Like that. I understand that part."
"Isn't it strange that you, who found the vessels on Songhui's face so easily, can't thread these thick arteries?"
Taesu openly flattered him.
At times like this, Jeong Minsu innocently took it at face value.
"That's right. Who am I? Of course I can do it."
"Good."
"Okay, I'm on it. Mr. Hyeokgwon, the loupe, please."
As Jeong Minsu looked for the magnifying glass, Gim Hyeokgwon frowned and bent down in front of the medical cart.
Rattle.
"Here's the loupe, catheter, and guide wire."
Seeing that, Taesu gave a grave order.
"Minsu, focus on the vessel bridge."
"Put your worries away. It's suturing. There's no one more suitable than me."
Swish.
Jeong Minsu immediately moved just as Taesu had hinted.
In the meantime, Gim Hyeokgwon arrived beside Taesu.
Taesu glanced at him and spoke briefly and firmly.
"Assist me, please."
"Always have, haven't I?"
"These are tricky parts."
"When haven't I?"
As always, Gim Hyeokgwon's reaction was nonchalant.
But his hands were already holding the suction and hook, fully prepared.
Taesu also gripped the surgical instruments.
This time, it was a mosquito clamp and Metzenbaum baby.
"Stand by."
...
Taesu and Gim Hyeokgwon waited, maintaining their focus.
Because Jeong Minsu's procedure had to come first.
About 10 minutes?
Taesu expected as much.
But it hadn't even been 5 minutes.
Jeong Minsu's voice rang out.
"I've started suturing the femoral artery side. Wait just a little more."
"Don't rush. Don't be in such a hurry."
"It's fine. I cut it diagonally to widen the surface area."
"Hmm?"
Taesu tilted his head and looked over.
Just as Jeong Minsu said, the end of the catheter was cut diagonally. Thanks to that, the contact area with the femoral artery had more than doubled.
'The brat, quick-witted.'
Now Jeong Minsu was also applying and utilizing things quite formidably.
Taesu felt a fresh stimulus at that sight.
That stimulus strongly ignited a fire in Taesu's heart.
But he didn't move immediately.
A little more.
He had to wait.
Jeong Minsu was still in the middle of bridge-suturing the femoral artery.
Since the surgical sites overlapped, they couldn't move together until the procedure was finished.
But it was not a meaningless wait.
Taesu condensed his strength.
For the moment he would unleash it all at once.
The time of patience was not long.
Soon, Jeong Minsu spoke while stepping aside.
"The femoral artery is done. Starting the connection to the anterior tibial artery side."
Snip, snip.
Having declared boldly, Jeong Minsu carefully continued the vessel connection.
At that moment, Taesu's patience also ended.
Now, it begins again.
Immediately moving both hands, he gave detailed orders to Gim Hyeokgwon.
"Mr. Hyeokgwon, hold the hook in your left hand and pull this way."
"Pulling."
"Right hand with the C-retractor here, like this."
"Okay."
Gim Hyeokgwon's reactions were quick and precise.
It felt intensely focused.
On the other hand, Taesu's voice showed little inflection.
Strangely, Gim Hyeokgwon grew even more tense at Taesu's voice.
That was due to the unique atmosphere Taesu radiated.
The unique atmosphere that emerged at specific moments made Taesu feel like an immense wall.
Having settled down so completely, Taesu's actions changed as much as his atmosphere.
His hand movements became as weighty as his orders.
Chuk, swish.
They were never fast.
To that extent, he observed coolly and tried to judge as accurately as possible.
The more he did so, Taesu's senses grew sharper.
'First, this side.'
Swish.
Taesu moved the surgical instrument into the affected area that Gim Hyeokgwon had secured.
He traced the boundary of the blackened, necrotic muscle.
When searching, cautiously.
Flash.
'Here.'
When acting?
Swish, slice.
Swift yet precise.
It was completely different from his earlier appearance where he had focused solely on speed.
It was a touch aimed at minimizing muscle loss.
Taesu's careful movements continued ceaselessly, like flowing water.
The necrotic tissue that had gradually burrowed into the inner muscles was being removed.
At this moment, Taesu did not blink even once.
His concentration was at its peak.
...
To that degree of concentration, he was unaware of anything.
It was as if only Taesu and the affected area existed in this operating room.
To that extent, he was mobilizing all his concentration to accurately locate and treat the surgical site.