Iryu Team Medical Dragon 4
The negotiations went smoothly.
India Government is also extremely cooperative.
I think we can open the business next year.
Ha. We've hold the best box.
Next one is the artist.
Superstar is needed, to make the audience be enthusiastic.
Director !
The next automobiles appliance are Japan's Medical Care, isn't it?
Japan's Medical Care has the highest standard in the world.
For the start let's make India success first.
After India, Russia, China, Vietnam.
Have to make India success no matter what it takes.
Thank you doctor.
Doctor ! Doctor !
Welcome back. Welcome back.
Chad !
Doctor Please ! Help ! Doctor Help !
Medical equipment here is the world highest level.
It's not rare to have patients who come from overseas to receive
our L&P Hospital's advanced medical treatment here.
The number of patients is soaring rapidly.
I will guide you to Japan's leading hospital both in names and substance.
Lithotripter Machine. The safe and reliable medical treatment which has been made possible.
A Linac that shoots cancer cells with an accurate high radiation.
Of course, a hybrid operating room.
3D Vision and High level joints, Enabling delicate operation to be done,
Surgical Assistant Robot. Amazing ! Amazing !
Today's medical Intern are blessed.
They can choose this hospital which has a forefront equipment like this
As their intern location for their own purpose. Furthermore, there's me in this hospital.
The Head of Surgical Department Kihara Takehiko.
To be able to learn under the guidance of an excellent instructor like me,
the Head of Surgical Department, you guys are really lucky.
When I was an intern before, I couldn't choose my intern place.
Because there's no shortage of doctors like now, the treatment is harsh.
There's no more time to go to bed at all... been overworked at the medical office.
Aaa? Huh?
Doctor Kihara was in a University Hospital? Yes, a former flower.
Then, a God Hand has been bought by this L & P Hospital
and become a headhunt.
It hurts. Shoulder pain. Hurts.
Listen you guys ! There's no such thing like this in here !
Let's show the best thing ! Hahaha...
"All examination are done by automation"
Whoa..! Amazing !
Amazing, isn't it? This CT is about 2 Billion !
Hey, 2 Billion.. Hahaha?
Do you guys surprised hearing the amount?
However, they prepared well just for this facility only.
They have Japan's largest leasing company
behind this hospital.
Being involve in Hospital Management,
corporate values will rise with status of social contributions. Indeed.
They will prepare the latest equipment one after another,
because the management foundation is stable.
In addition, salary in here is higher than the other hospital.
It's right to choose this hospital as your intern location.
Looks like, there's no Medical Intern coming here, isn't it?
Seems like a lot of them are coming to L & P.
They are not even a University Hospital,
it's because they are prepared with the latest medical equipments.
Not only the doctors, apparently
Patients are flowing over there. while ours...
The collapsing may also be a matter of time.
There are still hopes.
But there's no medical intern coming, also dr. Ono from Surgical Department,
dr. Satou from Internal Medicine quited last month. The doctor is only Director.
It will be ok. There's a negotiation about business partnership with L & P.
But, Director... Director certainly opposes it.
However, our only way to survive,
is to obtain L & P's help.
Don't have to worry. Okay...Okay.. Back to work..Okay.
Mr. Morimoto. What's the matter?
Aa...Ms. Inohara.
I've decided. Yes?
After all, I won't undergo the surgery.
I don't want to die in pain in the middle of surgery at this age.
Mr. Morimoto. Pulmonary aspergillosis,
is a frightening disease. There are also people who lose their lives,
because of bleeding and vomitting blood. But, it may be saved by doing the surgery.
The success rate is 50% even if you do the surgery.
I was told in that L & P,
to be honest even no doctor
who can do such difficult surgery, Is it possible in this hospital?
There's no way to survive.
Then don't save him. Director..
If the patient is giving up,
The doctors can't save him even though they tried with all possibilities.
But, If the patient fight for his life,
I will also fight for his life.
Can you believe such fine words?
Subtitle by: penk_88 | This is a free subtitle Get it free at d-addicts.com
There was a contact from L & P Hospital.
They want to settle our bussiness partnership negotiation even in next week.
I heard that not only loan, but they will also assign some doctors for us.
with this, we won't be colapsed.
Director. Even if Director works hard alone in this situation...
Where is he now? Huh?
3-0. Yes.
You have taken part in the reconstruction for more than 300 hospitals in America, right?
MBA. Having a International Lawyer Qualification,
A businessman who moves the world, 1 of the 100 people elected as well.
Why did that Okamura is entrusted with the management of L & P Hospital?
The collapsing of local medical crisis has calling for a long time,
It seems that there hasn't been found an effective breaktrough.
But, If we make a hospital which is funded by with a company who understands the social contributions,
and prepared with the latest medical equipment like ours,
Young and excellent doctors will come together.
It means that we can provide advanced medical treatment, which are demanded by the patients even they are in local area.
From now on, It's the changing era of Japan Medical Treatment that start from the local area.
We will move. Please.
How's the condition? Nakahara Shinichi. 37 years old. Male.
Level 1. Sudden attack, severe abdominal and lower back pain. Respiration rate 22.
Saturation 94?. Turn the Automated Inspection !
It's the end.
On CT of the abdominal contrast image,
Confirmed, Abdominal aortic aneurysm with diameter 7 cm under the Renal Artery.
It's Abdominal Aortic Aneurysm Impending Rupture, since false lumen has also been enhanced.
Interns, Let's show it ! My Godhand !
Ooo !
Please. Please.
It's Operation room. dr. Kihara.
Huh?
Yes. What ?? Aa, I understand.
Please call back the ambulance crew ! Call back ?
This patient cannot be accepted here.
37 years old. Male. Patient with Abdominal Aortic Aneurysm Impending Rupture.
In the examination taken at L & P Hospital, Diabetes. High blood pressure.
Impaired renal and liver function. Decreasing of cardiac function.
Added to those, has doing abdominal surgery in the gastric ulcer.
that means, the adhesions in the abdominal cavity are also bad.
L & P refused to accept.
Thought that he need an emergency surgery,
is it possible to accept ?
L & P is giving a hopeless patient to us ? It's impossible to be able to operate.
Patient is hoping with your hospital.
We will accept. Bring him here.
Though it's impossible even in L & P, with our equipment, then...
Patient is hoping with our hospital.
He's desperately trying to live.
And yet us doctors and nurses,
will abandon that patient ?
Prepare the operating room immediately. Yes.
Are you ready to operate ? Yes, we are ready.
Ms. Inohara is preparing. Ok.
Patient is going in. OK.
Slashing back. OK.
Hurry up, He's unconscious. OK.
Moving. 1 , 2 , 3.
Applying the infusion. OK.
Monitor, Hurry ! OK.
Please. Yes.
Disinfecting. OK.
Defense ? It's rapturing already.
The lump is bursting ?
If it left like this, his heart will stop due to the excessive bleeding.
Let's operate. but...
It's assumed with a severe adhesions of the intestine.
If he's having a adhesiolysis, it won't wait until we reaches the aortic aneurysm.
We can't do any procedures eventually.
Director.
Ryuutarou. Who is he?
A surgeon who will get to work here starting from now.
Asada Ryuutarou.
I've heard the condition. Patien with a laparotomy history.
To do the abdominal approach, we have 30 minutes even in a hurry because of the adhesions.
But, Patient certainly won't have 5 minutes after we start the operation.
What to do, Asada ?
I won't separate the adhesions. What ??
Patient in the lateral position. The body position sideways ?
And then ? I'll do the abdominal aorta replacement surgery,
with retro approach. From the flank part ?
If it's midline incision, to separate the severe adhesion in the abdominal cavity,
will take some time even though it has reached the main aortic aneurysm.
However, since the aneurysm is bursting already, 5 minutes is unbearable in the operation.
But, If it's from the flank part, regardless the adhesion in abdominal cavity,
We can approach to aortic aneurysm.
Correct. But, the surgical field is narrow,
also aorta in the hematoma will be confusing, difficulty level will jump high.
and those all in 5 minutes ? Impossible. It's possible.
If it's me and dr. Sakurai.
Put the patient sideways. I'll be 1st assistant.
The surgeon will be Asada.
What are you doing ? I won't let this patient die.
Do it. We will put the patient sideways.
OK.
From this, I will do aorta replacement surgery according to retro approach.
scalpel. Here.
Tweezers. Here.
Gauze.
Electric scalpel. Here.
??
Secured the neck. Put in the heparin.
Aorta clamp. Here.
Reverse. Here.
Blood pressure control. OK.
Aortic cross clamping.
Blood pressure ?
Restored to 100.
What is this speed. Not even 5 minutes.
It's still early to relief, after this is the crucial part.
Cutting through the lump. Scissors. Here.
Spoon. Here.
Sucker-up. OK.
Add Echibondo with felt !
OK.
I'll do the haemostatis of the lumbar arteries. Tweezers. 4-0 Proline.
Bring the 18mm graft. OK.
3-0
??
Scissors. Here.
OK. Next, I will close it up with distal anastomosis.
OK.
Blood pressure decrease ! It's VT.
DC ! OK !
Xylocaine. OK.
Charge ! OK !
ON !
It's a heart attack. What?!
Heart attack ? In this kind of timing?
Aorta replacement is still not done yet.
We can't go back after we cut the aneurysm.
But, the heart will stop if it left like this.
Let's do an open chest heart massage ! I'll do the heart massage.
Asada. Take the vein. I'll start from 5th intercostal.
Cooper. Here.
How is it? Is the pressure out? 45 of 73.
OK. Come back.
Done taking the veins. So fast.
How's the injured part ? Calcification at 6th.
I'll do bypass surgery at the same time. Doctor please go back to the aorta.
Wait ! Bypass is not possible.
If you start to set the heart-lung machine now, no matter how fast it is
it will take 30 minutes.
Ryuutarou. Asada.
Don't need the heart-lung machine. I'll go with on-beat.
On-beat? You don't say.. Bypass without the heart-lung machine ?
On-beat over a simultaneous surgery..
Considering the quality of cardiac function and postoperative of this patient,
That's the best.
Inflow in the subclavian artery, Let's do bypass on the LAD.
Stabilizer. Here.
We'll go also. 4-0.
Here.
??
There's no waste at all in the movement of these 2 people.
As expected, the strongest teacher-student combination.
??
Excuse me, about the acceptance of that patient earlier,
Thank you for your accurate instruction.
Yes. It's Okamura.
I've seen the result of the automatic examination.
Please call back the ambulance crew as soon as possible.
We can't accept that patient.
I'm sorry for interrupting an opinion as an amateur.
No, it's not. I think the operation will be succeed,
If it's dr. Kihara who does it. Aa, of course.
But for example, even though it's successful,
Based on the condition of the patient, long-term hospitalization is inevitable.
Right. Here, a lot of patient are in need of bed.
We have to avoid occupying bed for long-terms, just only for 1 patient.
Ah, OK. Thank for the hardworks.
Going home already? Yes. It's 5 o'clock.
Aa, No no. Excuse me. Hey ! Wait !
Ah, speaking of it, I've heard from the ambulance crew,
It seems the patient that was taken to Sakurai Hospital was saved.
Is it a lie?
Patient full with adhesion like that...
It seems they have tried a retroperitoneal approach.
Moreover, apparently a heart attack occurred during the operation,
they did bypass surgery on heart beating.
An old man like that alone, doing that kind of surgery ?
It seems a new doctor who did it.
New doctor ?
I guess it's Asada, a doctor for all people who came to do it.
Well then, thank you for the hardworks today.
Anyhow, glad the patient has been saved.
Why is Asada ?!
Ryuutarou.
Such an impressive operation. Your skills has improved again, hasn't it?
My skill as an operating nurse is also not rusting, isn't it?
Yes.
Anyway, you've come back really well.
Because this hospital is my starting point as a doctor.
Damn. Where is the bleeding location?
13 years ago...
Epinephrine ! IV !
Cardiac arrest...
Asada, Don't give up !
Doctor. It's not over yet !
Heart massage. Do a white blood transfusion ! OK.
Asada. You are a doctor, aren't you?
If there remains even 1% of possibilities,
Give your best for the patient until the end !
Back. Come back. Come back.
Asada, you'll do this surgery until the end.
OK.
Listen up, Asada !
In order to give your best for this patient,
Experience a lot of surgeries, for example you should be able to handle even in cases which are outside of your expertise,
What we doctors are examining, is not just a single disease.
It's the patients entirely.
Yes.
??
When L & P is built,
I thought that I might close here.
Building a big hospital fully equipped with the latest equipment,
is a good news for the people in this town.
My role are also done.
But, while listening to the story of patients who received medical treatment at L & P,
I changed my mind, here should not be closed.
The patient earlier is also the same.
With the symptom of lower back pain,
He seems to be asked to meet orthopedic in L & P,
The abdominal aorta aneurysm should be visible in the examination.
But, to the people with non-expertise of aneurysm,
They wouldn't aware of it.
Elders and patients that suffer more than one disease,
Medical treatment can't be decided with just a result that spat out from a machine.
Often hear patient's story,
We must think about the best treatment they want.
What we doctors are examining, is not just a single disease.
It's patient entirely.
I still remember. because it was imprinted thoroughly.
There are patients who will loose their live if this hospital is closed.
That's why I came back here.
Asada, I want to entrust you my hospital.
I'll leave it all to you.
I understand.
Director. Wait a minute.
What will you do for the partnership with L & P ?
It's a reality that if we do a fair clinic, management will be tight.
Burden of works will increase,
Even there's no doctors who agree with our objectives.
How you, Director and Ryuutarou, 2 people will do it ?
If it's doctors, we have them. Huh?
I will gather them.
Doctors who will agree with dr. Sakurai's ideal.
The best team.
I will reject the partnership offer.
Like what have been told before, it's not just because of the loan,
but also we don't have any intentions to take over the hospital at all.
Big hospital and small-medium hospital will both have advantages.
We should co-exist by using of our characteristic respectively for the sake of patients is what I'm thinking about.
However, we should closed down our Pediatric also Obstetrics and Gynecology Departments as your requirement.
Refering to the streamline of the management, this hopital itself are collapsing.
Wouldn't that be troubling for the patients as a result?
A good doctor who committed to my hospital has come back.
I've heard that.
Heard that he's dr. Sakurai former student.
Asada Ryuutarou. I've entrusted this hospital to him.
However, no matter how excellence he is, but if he's alone...
Not just alone..
Doctors who have strong wills on saving patients life will gather to him. Is that so ?
But please tell me anytime if there's a problem.
Not only sending staffs, Lending our equipments are also not a problem.
Because this area needs Sakurai Hospital.
??
Excuse me.
Are you a doctor of this hospital ? Yes.
Does he really can't be saved ?
My grandfather. Morimoto from Room 401.
They say it's Pulmonary Aspergillosis disease.
Grandfather, he said that he won't undergo the surgery because he can't be saved even if he does it.
Even in L & P the big hospital, they told him it's impossible.
L & P and here are different. Huh ?
It's a difficult disease but there are enough possibilities to be saved.
Then, if grandfather says that he will undergo the surgery, Would you save him for me?
Yes. Really?
We won't abandon lives that has been entrusted to us.
No matter what will happen, we won't give up in order to save patients until the end.
That's this Sakurai Hospital.
Oh ! Hooray ! Success ! Only 120gr.
World's smallest artificial heart ! We can use this for children.
Moreover, we can use it permanently.
Even in large anime experiments, there was no problem at all.
We can move forward to the clinical trial stage with this.
We've done it, Professor.
4 years.
I will show that it can be put for practical uses in 4 years.
Meishin University Affiliated Hospital - Professor of Thoracic Cardiac Surgical Department
Katou Akira
With this, we could save life of those children who had given up the implantations.
First, the press release.
Yes. Report to the Society of Transplantation.
Contact the public relations department ! Bad news ! Bad news !
??
President, Please wait ! Do you believe such an article ?
It's completely nonsense.
Even you say it, the media report is flooding.
I will explain to the media.
If you do something like that, it will amused those guys.
Furthermore, I think it will make a fuss.
We have no choice but to kick you out from the development team.
What? dr. Katou.
For Meishin, we must avoid damage caused by an uninteresting scandal like this.
About my research, what will it be ?
We can't do the implant without appearing the organ donor, many children....
The successor, I'll leave it to him.
Please leave it to me, President.
As a dean, I will continue to develop.
Perhaps, you... ?
After this is the press conference.
I will explain in details about the world's smallest artificial heart.
??
Asada.
The Dean is aiming for the upcoming president.
That's why he took my research, leaking those nonsense informations,
and fabricate such article in order to make appeal of himself.
Research which are used to save patients,
has been replaced by honor and interest before I knew it.
University Hospital is still doing such thing.
Although I just only want to save patients.
Either it's honor or interest, they are irrelevant. What ?
Would you like to try to make a hospital which are only concentrating in saving patients life at all cost together ?
Is it true that the treatment plan will be chosen by patients ?
Meishin University Affiliated Hospital - Circulatory Organ Center
Depends on the condition of the patients,
There are cases which are better with abdominal surgery not with less invasive catheter, aren't they ?
Therefore, discuss it well....
I will be the one who decide the treatment plan.
Do you know that we are selling the less invasive right?
In order to increase the number of patients according to our policies. But...
But I think that is not related to the patients.
Besides, Doctors should.. the way of thinking against diseases and how to fight...
Meishin University Affiliated Hospital - Chief of Circulatory Organ Center
Ijyuuin Noboru
Chief, if you say such things it won't be practical here.
We are limited in times and number of doctors.
Please stop saying immature things.
dr. Ijyuuin, a guest for you.
Ah, ok.
dr. Asada ! Yo !
When I was about to deal with a patient properly,
Been told that it was not necessary from my superior.
When i thought of teaching the interns comprehensively
so that they can examine patients at ER, They said it's an unnecessary thing.
Ah ! I'm sorry..
I keep complaining though it's been a while since we met.
Ijyuuin. Yes..
You're not wrong.
Which hospital where are you in now dr. Asada ?
Properly facing the patients one by one,
Describing the treatment plan until they are convinced.
Huh ? Not only specialities,
Handling every patients upon the diagnosis which has been taken.
That's the hospital where I am now.
Ijyuuin.
We need doctors like you there.
Ah !
Excuse me.
Yes. You've got the preview of the wedding hall Got it. I will call you back.
Ah, to be honest, I will get married next year.
Blood pressure decrease. There's no time. VPC has come out.
Head down and Volume Load.
Perfusion Pressure. I will raise it.
It's bad. ST went up. I will widen the coronary artery. Nitrates.
Damn. It's VF?
Lidocaine IV. Do DC 20 joules charges !
Fire ! Prepare the catheter's lab !
??
Good Morning. Head of Anesthesiology Department, Arase.
Very well. The vital has also been stable.
Start the bypass. 2 cases for today's surgeries.
Damn. Wait. I caused a spasm.
Milrinone Injection. dr. Arase.
Something worth doing is definitely over here.
Oushuu Hopistal - Head of Anesthesiology Department
Arase Monji
The surgeries of every surgeons here are always exactly as the manual.
Not even 1/100 of my real abilities are used.
It will be a trouble if you pull it out.
If dr. Arase pull out all of your abilities, Any of the surgeons won't match with it.
If so, it will be fine even if it's not me right ?
No, no. It will be a trouble if it's not dr. Arase.
Patients can be gathered because of the brand called "The Legend of Anesthetist".
Ah, Please let me talk about your annual salary for the next term later.
Ah, of course, with a satisfying amount..
Yo ! Still alive ? 75kg.
What's with that hair ?
Ha, from now I will do 2 operations in a row.
Ah, It's all the same, not worthed to visit.
I'll be free at 4 o'clock.
Sorry, took 5 hours in the dental surgery.
Geez, all of them are nothing but coward surgeons.
Other than that, when did you come back ? Last week.
Which hospital are you in now ? Meishin ?
No. Wrong.
If they hired you in, it would be a substantial hospital right ?
In most advanced surgical navigations,
I guess they provide surgical robots, don't they ?
Those hirer only talk about money and equipments.
How much is the annual salary ? It's surely high, isn't it?
at 1/10 of yours. What ?
Regarding the most advanced equipments, there's not even one.
Also there's not enough doctors, it's a small-medium local hospital.
Arase, I want to recruit you.
Wait a minute. no decent equipment, a local hospital,
Moreover, isn't that the annual salary is at same level as interns ?
Why should I be in such a place ? There's me in that hospital.
I will make you to pull out 100% of your capabilities.
??
Grandpa. Oh !
I've become a regular. Next time, please come to see my match .
Is that so ? It's nice !
But, how to do... ?
Could I be healthy by that time ?
Please undergo the surgery.
Cure the disease, then definately come to see my match.
It's a promise.
Excuse me.
Oh ! Mr. Morimoto, your grandchild ?
My grandfather always troubling you.
Does he speak selfishly ? Oi !
Geez.. Go home early and practice..
Keep your promise..
Ah, please for your help.
What a good grandchild.. hahaha...
When Shunsuke was 6 years old,
My daugther got divorced, then she came back home bringing him along.
After that, I raised him in a father figure.
OK, Shunsuke, Here we go !
Wait a minute ! when you throw, face your grab here towards grandpa. Try it...
Yes ! OK !
Then, let's see. OK.
2 of us often did catch ball.
Then, he becomes to like baseball.
At the time he just come, he was a shyfull and harsh kid.
But, entering the baseball team, he made some friends and become cheerful.
He wasn't very good at first.
Ball fetchers substitute.
He said that he has become a regular,
but I know that he's lying.
A lie to encourage me.
It will take much more time to come..
For my grandson to truly play as a regular.
But I want to see...
Want to see him play in his match..
Doctor, though L & P has given up,
If I decided to undergo the surgery, will I be saved ?
It's definitely difficult. The success rate of a general operation is 50%.
However, if it's me and Asada, we can raise it up until 70%.
If you seriously fight the disease,
I will let you play catch ball with your grandson one more time.
I'll show you his figure playing as the regular.
Can I received Shunsuke's ball ? because he's growing in a poor way....
I want to live...
I want to live longer...
Doctor, Yes ?
Please do the surgery.
??
The man who has created Asada ?
When I was an intern, I was expelled from the medical office because of striking back at a professor.
Demanded to serve the stupid professor other than the patients.
Medical office is the most imbalance place for you, right ?
Suruga Medical Center - Cardiologists
Fujiyoshi Keisuke
There's no hospital that accept me who don't belong to any medical office. At that time,
I got to know with dr. Sakurai at the tunnel cave-in accident site.
It was great. dr. Sakurai's Emergency Medical Care.
Then he told to me while laughing, "Come to my hospital".
If there's no dr. Sakurai, there's no me right now.
So it means that you've been entrusted with the hospital by your former teacher ?
Yes..
I want to make a hospital that brought me back to my starting point as a doctor.
I'm anticipating. A hospital that Asada made.
I also would like to meet dr. Sakurai.
However, It's impossible for me to leave this now.
I'm in charge of a girl who suffers Dilated Cardiomyopathy. Heart transplant is needed.
Based on the revised law, children under 15 years old
now can accept heart transplant.
In the reality, Donors haven't really come out yet.
My late daugther is also like that.
However, A research in this hospital which is developing the myocardial sheet made from Somatic Stem Cell,
is entering the final stage of clinical trials.
If the approval from clinical trials is granted,
The possibility to be saved without taking a heart transplant will come.
Until that, I want to keep doing the medical treatment.
It's once in a lifetime opportunity. Should we go with the flashy church ?
Ah, Where should we do it ? Wedding hall.
What is it ?
Nothing. Never thought even in a dream,
That a day when I talk about wedding reception with that Ijyuuin is come... Huh ?
I just said it now, I forgot about it until we met at the reunion last year....
I don't remember it. Sorry...
But I was surprised when I heard that you've become a doctor.
Other than becoming a doctor, it's harder after you become one.
becoming itself... It's incredible.
Moreover, being able to be an associate professor at Meishin after 2 years,
That said it all, right ? Yes.
My parent somehow,
They always say like "It's ok to be sick anytime",
"If having a great pain, let's bring our family all together to the hospital where Ijyuuin works,
and have him examine us" They are in glee.
Huh ? Is it troubling ?
No. There's no such thing like that.
I've put the plan that should be done for the improvement in this.
Many children who are not transplanted,
are waiting for the practical use of this artificial heart.
Please.
Please use this as reference for the development hereafter.
??
Ah, that's right.
And also this, this, this, this, this,
You bring it home, because throwing those away is bothersome.
Your prototype is not needed anymore. It's just only a trash.
dr. Arase, Thank you for the hardworks.
By the way, Your contract of the annual salary for the next term,
I'm thinking to double it from this year....
Ah, No, That 3, How about 3 times ?
Well.... dr. Arase ? If you aren't satisfied with 3 times,
I'll do it. You don't need anything in me anymore.
Ah,
Sorry, lend me some coin..
Mr. Morimoto's condition is growing worser than I thought.
The surgery this time, we'll do it not with on-beat but with on-pump.
Will you use the heart-lung machine ? Yes.
Based on today's condition of Mr. Morimoto,
Using the heart-lung machine is the best way.
Aspergillus, the bacterium which are spreading in the air,
become molds inside the body. Settling down object.
Mr. Morimoto's Aspergillus are not directly to the lung but to the brain.
Invading until the Proximal Aortic Arch.
Using the heart-lung machine and control the blood stream,
Just a simple removal, no treatment.
If we don't use the heart-lung machine, it will be a bleeding to death during the surgery.
Otherwise, brain death due to Ischemia. The risks are extremely high.
I've never heard a case like this before.
That's the reaseon why L & P gave up.
How is the maintenance of the heart-lung machine ?
It's fine. No trouble.
The surgery is 3 days ahead. Yes.
??
First snow in Kanto Region.
Under the influence of low pressure of south marine in Kanto Region,
It has been snowing in a wide range such in the Southern Kanto, Shizuoka Perfecture, etc.
Japan Meteorogycal Agency, has warned earlier for a heavy snow in the Eastern Shizuoka Perfecture, the mountenous area of Izu Region.
Then, they issued a heavy snow warning in Tokyo, Chiba, Kanagawa, Ibaraki, etc. Calling for a precaution.
??
We'll lie you down. Slowly please. OK. OK. OK.
Folded down the bed. OK.
Do you understand ? Mr. Morimoto. It's fine.
Preparing the Epinephrine.
Mr. Morimoto, Ok..ok... Please face to the side.
OK.. Properly..Properly...
The Pulmonary aspergillosis has caused Artery Perforation.
There's no time ! We have no choice but to take it off in surgery immediately.
But, Today's Thursday. There's no Anesthetist.
Then cooperation request at L & P.... It won't be in time for that.
It's crumbling more than I've expected.
Is it really fine, here ?
If it's being recruited, It's better in that huge hospital over there after all...
Who is he? The best Anesthetist.
Pull out 100% of my capabilities as promised!
If it's him, he can keep up with my and dr. Sakurai's speed.
OK ! Let's do the surgery immediately !
OK !
OK. Standing platform !
Huh ? What ?
Ah, OK.
1...... 2.....
Why is the number? Slowly counting, 7.
That's the ideal speed to be anesthetized.
But the anesthetic doses are different for each patients, so it's not always possible to fall down on 7.
6....... 7.......
Ok, fell down. Fell down ?!
Listen from Asada for who am I...
Doctor..
Please save grandfather. Please for your help. Please save him.
Mr. Morimoto said that he want to cure the disease,
then see you play as a regular in your match.
He's fighting for his life.. We will also fight with all of our strenght.
??
Preparation is done.
From now, we'll do Artificial blood vessel replacement and right upper lobe resection,
towards the proximal aortic arch perforation.
Scalpel. Here.
Tweezers. Gauze. Here.
Electric scalpel. Ok.
Muscle hook. OK.
Lung Ventilation Separation Endotracheal suctioning, are OK at anytime.
Done already? So fast.
Sternal saw. OK.
Blood pressure is decreasing. Don't panic.
Plasma fully open. Bed down.
Rib spreader OK.
Separation of lung ventilation start. Ready at anytime.
Opening the pleura. Scissors. Ok.
Intrathoraric is not bleeding.
Continuous bleeding from the bronchial tube. Asada.
Ensure the upper lobe of lung.
OK. Pump on as it is now.
Place on a heart-lung machine while controlling the bleeding with a finger?
Right rotation. Putting in Heparin.
Electric scalpel. Ok.
Tweezers. Here.
Here is the infiltrating point.
Partial clamp. OK.
Bleeding from right upper lobe of lung has stopped.
Amazing. What are they ?
Tube clamp. Ok.
Switching into a full bypass according to the heart-lung machine.
Pump on. Pump on.
Tie up. Right angle. Ok.
Tweezers. 2-0. Ok. Ok.
Right angle, tweezers, 2-0. Ok. Ok. Ok
Scissors.
It's going pretty good, isn't it?
Followed by vein, let's do it. Harmonic.
Ok. Yes, it's Operation room. What?!
What happened? It's emergency request.
42 years, female. Fall down while riding a bicycle on the frozen road.
Hit the precordial. Complaining of breathing difficulty.
Consciousness level is pure and clear.... Seeing this condition, you could understand right ?
It's impossible to accept. They said she has our patient registration card.
I understand this patient's condition well,
she wonders if she could have even just a first response at our hospital?
We can't do this surgery if there's no Ryuutarou and Director.
There's no other way. There's no more doctors in our hospital.
Have her sent to L & P..
I will send the patient's information immediately.
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If it's a doctor, there it is.. Even there's 2 doctors.
I will giving all of my strength just for saving patient's life.
I came here to make such hospital together with Asada.
In this hospital where dr. Asada is,
I came here to really face each patients one by one properly.
They are Team Dragon ? Yes.
What's with those appearance ? Isn't it extremely well prepared ?
I was thinking to observe dr. Asada's surgery after a long time....
Unfortunately, the observation has to be postponed.
We'll deal with the emergency case.
But, what to you do if there's an operation needed condition ?
Who will be Anesthetic in charged there ?
Looks like you still haven't yet understand my skill, haven't you ? Huh?!
I'll watch the progress of both operations simultaneously.
We're teamed up in the previous hospital. Different with those slow surgeons.
It should be you who will be alright or not if I'm missing.
Who are you talking to?
Is it okay to leave it all to you ? Yes.
Show the medical record immediately !
??
Entering. Ms. Yagi. It's OK.
1,2,3. Turning on the monitor.
Ms. Yagi, I will cut your clothes.
Putting on the saturation.
There are bruise marks in left anterior chest.
Can you do a deep breath? Heart rate 110.
Saturation 72%.
Raise the Oxygen up to 10 L. Ok.
The air entering of the left lung is bad. Is it Pneumothorax? Gloves.
What ?!
Saturation 85. 88. 91. 95.
The Oxygen has improved.
How is it? It's a traumatic pneumothorax.
Now, we're doing a deaeration, vital has also been stable.
It's fine here.
Then, let me concentrate on the surgery over there.
Blood pressure 48/70. Heart rate 126.
Prepare the echo. OK.
Low voltage.
Cardiac tamponade. Putting the volume in.
I'll do intubation. Ok.
Inserting trocar complete. It's ok to intubate.
OK. Rapid sequence intubation?
Rapid introduction of tracheal intubation. Amazing.
There's a space in the right fronter part.
Pig Tail Catheter please. Ok.
Pulsatility of the arterial blood.
We have to do a fenestration. Let's start the surgery immediately.
Hurry ! Yes !
Stapler. Ok.
Separating the bronchial tubes.
Cut off the right upper lobe.
Accepting. Please.
Patient over there is having a surgery because of cardiac tamponade.
Bring the cell saver and thoracotomy set over there ! OK !
Increase the pressure for me !
OK !
No leaks.
Continuing, we will move to the replacement of artificial blood vessel of the proximal aortic arch.
4-0. Ok.
Tourniquet. Ok.
??
Ok ! It's ready at anytime.
I'll leave the surgery to you, Ijyuuin.
Ok.
From now, we will perform the fenestration drainage surgery
towards the cardiac tamponade. Scalpel. Ok.
Electric scalpel. Ok.
Tweezers. Ok.
Weight Liner. Starting the Catecholamine.
Hook. Ok.
Cutting the pericardium.
Cell saver. Ok.
Scalpel. Ok.
Large amount of bleeding. Could it be ?
Heart rupture of the left ventricular. If it's left like this, it wouldn't wait until 30 minutes.
Open the chest immediately, use the heart-lung machine then do left ventricular reparation.
Prepare the heart-lung machine ! It's impossible !
There's just only 1 machine which are in Operation Room 1.
What to do? With this condition,
the heart-lung machine are surely needed, to repair the left ventricular.
If it remains like this, it will be bleeding to death.
Aorta Clamp. Ok.
Flow down. Flow down.
Aortic cross clamping. Backup. Backup.
It can't be?! Blackout? Black out at time like this!?
Is there any nurse? It's a blackout !
How about the emergency power source?
Freddie Stop. Stopped.
I will check the hospital ward's situations. Please.
Ok. Aorta Declamp.
Emergency power source has been operating.
Perhaps, the wire is cut due to the heavy snow...
Maybe snow isn't the cause...
We use the heaters in the whole hospital because of the sudden snow,
Adding to those, we usually don't do simultaneous surgeries in here.
It's over more than the Ampere amount contract, then used the emergency power source.
There's no way for us with our equipment,
to do a simultaneous surgeries like big hospitals do.
How long do we have for the emergency power source?
If it's only this operation room, 45 minutes.
Because we are using 2 rooms, 20 minutes less.
This operation really won't be finished in 20 minutes.
Also the people in 2nd operation room, has just started the surgery now.
All equipment is shut down, they can't do the surgery in the midway.
Anyhow, among all hospitalized patients, switch those who are relying on the respirator,
and those who can't take off any medical equipment into batteries.
Moreover, cut hospital's heater,
save the power as much as possible ! Ok !
and then provide the flashlights. Ok.
and because of the power saving, we have 30 minutes at most.
We have to do a simultaneous surgeries.
We can't do this surgery if there's no heart-lung machine.
Bring my carry case here.
Huh ?! Hurry !
Separate from the heart-lung machine then switch into on beat.
What? Continuing the surgery while Mr. Morimoto's heart is moving.
Don't use the heart-lung machine at this state?! It's absurd !
We don't know when will the power be recovered.
If we use the heart-lung machine as it is and continue the surgery,
It will give trouble to Katou and the others.
That's why you are switching into on beat?
And in the dark right now. Although it's a surgery with high difficulty,
We can't even look directly into the surgical field.
It's reckless no matter how you look at it.
We've been entrusted with patients' life.
??
I won't abandon those entrusted life in any situations.
I won't give up until the end in order to save patients no matter what happen.
That's what Sakurai Hospital should be.
Doing an on beat in the darkness is certainly dangerous.
But, to make these simultaneous surgeries in emergency succeed,
That's the only way.
There's no time to stand still.
Make it finished within 30 minutes with on beat. Counter start.
30 minutes until all power source shut down.
Pump off. Resuming the artificial respiration.
Ok.
Separating the heart-lung machine. Scalpel. Ok.
I've brought the flashlights. Lighten the surgical field.
Ok.
I will perform the Reconstruction of Aorta and Bronchiocephalic Artery at the same time.
Lighten the surgical field. Partial clamp.
Ok. Muscle hook.
Ok.
Katou, What the heck are you thinking?
That is... This is a heart-lung machine.
You've thought it, Katou.
Using an artificial heart as a heart-lung machine?
Theoretically it's indeed possible.
After the srugery,
the heart-lung machine leads blood to the outside of the body, a temporary circulation system.
Heart-lung machine is a pumping device which send bloods to the whole body of the patients whose cardiac function is down in everyday life.
The intended use and size are very different,
but regarding the ability to pump the blood, they are not much different.
But the power source... This heart-lung machine is battery-powered.
It doesn't need power source since it's fully charged.
So that means we won't bother Asada's surgery?
Asada is also thinking about the same thing.
Thinking about the others mutually even if we're separated is a team.
I'll cannulate.
Prepare Thoracotomy. Ok.
I will use my research for the patients. Pump on.
Ok. It's resuming.
Proceed the surgery at the fastest. Repairing the left ventricular laceration.
Lighten it up with the flashlight. Ok.
Electric scalpel. Ok.
??
Please bear with it.. it's a bit more...
Thank you. Let me help you.
dr. Arase, What is it?
It's alright now over here..
Please concentrate to dr. Asada's surgery.
I'll follow the whole-body control.
Go. Arase.
Got it.
Artificial heart as the replacement of the heart-lung machine?
It's a prototype that Katou has developed for a long time.
That way is good under this circumstances.
And then, seems like it's ok for me to concentrate in this surgery.
On beat surgery of Pulmonary Aspergillosis Proximal Arch Aortic Perforation.
This darkness in addition.
I intend to let you put your whole heart into this.
Whole heartedly? Ryuutarou is doing with all of his strength.
I will concentrate to this surgery, giving all my might to the whole-body control.
Well then let me do it, with 100% of my capabilities.
Satin ski. Cooling the head.
Ok. Aorta Re-clamp.
Pressure of the right hand is gone. Hurry. Scalpel.
Ok. Systemic blood pressure returned.
I will continuously stitch the central side.
??
The speed is increased even more.
Because he concurrently didn't pull out 100% of his capabilities until now,
it means that he intentionally suppress the speed.
Entrusting the whole-body control entirely, and be able to focus on cutting.
Asada pull out all of his best because he trusts him.
Scalpel. Ok.
Neofirin. Ok.
Team dragon is this far...
Ok. Let me also join you.
Cooper. Ok.
Side clamp.
Left Piece of Pulmonary Ventilation goes well.
No anastomic bleeding.
Next, Let's do distal. Electric scalpel. Ok.
The power will be shut in 5 more minutes.
Felt Strip. Ok.
Close to the Coronary Artery.
Mattress stitch the deep part.
2-0 Proline. Ok.
Next. Ok.
The Mosquito. Ok.
3 minutes has passed.
Head down. Tape up.
Prepare the drain. Ok.
5-0 Castro back.
??
Everyone, are you alright?
Artificial heart weaning.
Saline dropper. Ok.
Scalpel. Ok.
1 minute left.
Scalpel. Ok.
De-clamp.
Resuming both lung ventilations.
Sternal wire. Ok.
Scalpel. Ok.
Surgery is done.
No Anisocoria.
Scalpel. Ok.
Surgery is done.
??
Grandpa ! So glad...
It's all because of you. I can fight the disease without giving up
because you're here. Thank you.
Grandpa...
Next time, it's grandpa's turn.
Huh? Like the old time,
2 of us do a catch ball together again, to train you.
If you're not giving up until the end, dream will be come true.
dr. Asada has done a difficult surgery for us.
I'm really glad that I go to see the doctors in this hospital.
You didn't give up. That's the reason why the surgery is succeed.
Thank you doctor.
Really thank you so much for saving me.
Thank you very much.
They said that if the treatment was a little late, it would be dangerous.
Trully.. Thank you very much.
Excuse us.
You look extremely happy...
I'm thinking that it's been a while since a word "Thank you" was said to me by a patient...
Me too.
But, I haven't said anything about coming here to my girlfriend.
I talked to my wife and my child then I got an OK.
Huh?
Even so, it's impossible that,
we decided to gather in a collapsing hospital like this...
I will make this collapsing hospital revived.
Our team, will make an ideal hospital.
??
It's all exactly like what you've said.
They don't bend to money and honor.
They only move with their sense of responsibility as a doctor.
Because superstar is a noble.
That's why, first you assumed Management's Rationalization in Sakurai Hospital, then propose a partnership and hunt it down.
The director asks for a help to his favorite disciple, Asada.
That Asada gathered his friends, and the best team was made.
It's all exactly as our calculation.
Because I'm the one know them well more than anyone.
The one who bring up that team,
is me after all...
Anyway, patients who can't do treatment
with that hospital's equipments, appear in front of them right?
At that time, please give them cooperation.
Using the most advanced equipment in here.
I guess that means exchanging conditions. Have them go to India.
Delhi Shanti Hospital.
I love this kind of model.
The expected earnings for the first year is 1.5 billion.
I suppose, we have to have them earn money substantially in India, for me, the benefactor.
??
Nevertheless, you are also cruel, aren't you?
You've tried using a patient, haven't you?
Is it the one with Abdominal Aortic Aneurysm?
It's not likely be sent to Sakurai Hospita.
Our hospital is an institution which adopts a comprehensive health care system.
If you put on the unnecessary treatments and times, it's not only become a burden to the hospital,
but there were also risks of litigations.
In that case, it's efficient to make sure of Asada Ryuutaro's skill.
As expected from a well known economic consultant in the world.
Mr. Okamura.
It's been a while.
I guess it's the arrival of a reassuring ally.
Becoming an ally,
because I want you to keep your promise.
I understand. Anyway I will give,
team dragon to you.
Yakusha is assembled, huh ?
It's been a long time,
Team Dragon !
Go home, and get lots of sleep.
If I sleep more, I'll become a mummy.
??
Doctor. I'll be saved if I fight a little more right?
It will be alright. I'll definitely save you.
dr. Fujiyoshi, Ok.
It's Kana's test result.
??
dr. Asada !
It's emergency !