Saijô no Meii
-> RTS Page for Saijô no Meii 29
Reserved for Trinity BAKumA. Do not use without my permission.
Saijou Mikoto, this will be the final battle between you and I!
Chapter 29: Conventional Wisdom
Woman: Excuse me, Saijou-sensei.
Woman: The gentlemen up above would like you to wear headphones for the live surgery.
Ayame: Hey, are you fine with that, Mikoto?
Ayame: Usually it's used for the sake of the observers, who would ask questions to the surgeon when they don't understand something...
Ayame: But this time, it's those two.
Mikoto: But there must be people among them who really want to learn something from the operation.
Mikoto: If they want to ask something, I would have to answer.
Mikoto: I wouldn't be operating on people if I am easily swayed by words.
Mikoto: Aren't you the same, Ayame?
Ayame: Hmph, that's true enough.
Ayame(thought): I didn't need to worry after all.
Ayame(thought): It's just that...this time, bro brought a man here who is probably his trump card.
Ayame(thought): I have to think ahead of time if there are any special odds...
Mikoto: We shall now commence the diaphragm reconstruction procedure.
Mikoto: The patient is Takahashi Yuuma-kun, a five-year-old boy.
Mikoto: To have the minimum amount of cutting, we will begin at the scar left by the operation performed right after his birth.
Mikoto: Entry at the scar.
Mikoto: I will an incision on the latissimus dorsi muscle, which is the muscle on the back.
Mikoto: Ayame, use the hooks.
Ayame: Got it.
Mikoto: I am removing the Gore-Tex that was previously attached.
Mikoto: The surgeon and first assistant will be switching positions, and the patient will be turned to his side.
Diagram(clockwise): First assistant, Surgeon, first assistant, surgeon
Yourou: Hm, so fast...
Yourou: It's been only about 20 minutes?
Sadame: He is quite the monster.
Sadame: To cut the latissimus dorsi muscle his way...first, he needs to go around the rib cage and start cutting from the side, and then go inward to finish the job...
Sadame: But as we are talking like this, he probably would finish the incision on the side of the muscle.
Mikoto: The side of latissimus dorsi muscle has been cut.
Yourou: But the real challenge begins here...
Yourou: Is the preparation done?
Sadame: Saijou-sensei, I have one question.
Mikoto: What is it?
Sadame: It's true that people have used latissimus dorsi muscle for the diaphragm before...
Sadame: But it's common sense to make the incision on the muscle from the top.
Conventional Way: Cut from the top to make the diaphragm
Mikoto's Way: Cut from the bottom to make the diaphragm
Sadame: But why are you making the incision from the bottom?
Ayame: I see, so that's their angle of attack.
Maria: Wh-what is it?
Ayame: To be honest, there have been procedures in the past where the upper latissimus dorsi muscle is used as the diaphragm, but this is the first time the world has seen...
Ayame: Mikoto's original technique.
Mikoto: The reason is that I do not want to damage the nerves in the muscle.
Mikoto: The nerves are located in the upper area, so if I cut off that portion, the nerves will be severed and it will simply become a piece of flesh.
Sadame: I see.
Diagram: The nerves
Sadame: But there is a problem with that.
Sadame: Isn't that right, chancellor?
Yourou: Yes, that's right.
Yourou: Nice to meet you, Saijou Mikoto-kun. I am the chancellor of Teiou University, Yourou Shigetoshi.
Yourou: This is going away from the topic a little bit, but I used to be a plastic surgeon, so I know more about muscles than anyone else.
Yourou: And coming from experience, I would have to say that...
Yourou: This operation is extremely dangerous, and you are being irresponsible.
Yourou: Just now, you said that having the nerves severed in the latissimus dorsi muscle would make it simply a piece of flesh...
Yourou: And what exactly is wrong with that!?
Yourou: Other than having it become part of the diaphragm, there's no need for it to be anything more than just a piece of normal flesh...
Yourou: If you must cut from the bottom, then don't do it at all. You will end up severing several blood vessels.
Diagram(clockwise): Nerves in the muscle, Incision, Several blood vessels, Lower portion, Upper portion
Yourou: Isn't that just conventional wisdom?
Mikoto: Oh, is that so?
Mikoto: Then to overturn what you said...
Mikoto: From today, this will become the common procedure!
Yourou: H-how impertinent...!
Yourou: I'll chew you to bits, you insignificant brat!!
TN: He probably means literally, lol.
Sadame: C-chancellor, your mike is still on.
Sadame: Not only the surgeon, but the observers all around can hear you as well, so please be careful.
Yourou: I was trying to say, you are a bit cheeky.
Yourou: It's true that it would be better to not sever the nerves, but in a procedure where you just need to make a diaphragm, it's more advantageous to save the blood vessels than the nerves.
Diagram: Nerves in the muscle, Preferable, Several blood vessels
Yourou: When you make the incision on the lower portion, there is the possibility of not having enough bloodflow...
Mikoto: That will not happen.
Mikoto: It's true that I will have to sever several blood vessels in the process...
Mikoto: Because the dorsal thoracic artery in the upper portion will remain connected, having enough blood flow will not be a problem.
Diagram(clockwise): Nerves in the muscle, Dorsal thoracic artery, Incision, Several blood vessels, There will be enough blood flow with just dorsal thoracic artery.
Yourou: That is just your own theory.
Yourou: And since you have never done it before, how do you know it will work?
Yourou: You're just using him as a human experiment!!
Mikoto: Incision on the latissimus dorsi muscle is complete.
Mikoto: Um, and now,
What were you saying?
Mikoto: I wasn't listening because the part just now was the most difficult...
Yourou: T-that brat...
Guy: Woah, did you see that just now!?
Guy: Yeah, I did!
Guy: The hardest part was just now...when he was cutting near the rib cage, right?
Guy: Of course.
Guy: It's in the deepest part of the back, so no matter how much you try to pull the opening, you can't really see much inside.
Guy: But he didn't even use the endoscope...
Guy: Yeah, his skills rival those of a god.
Maria: Ayame-sensei, the most difficult part you mentioned before the operation...
Ayame: Yeah, it was that.
Ayame: But in reality, it's not that easy you know. Mikoto correctly grasped the size of the muscle, so that's why he doesn't need to be able to see.
Maria: Saijou-sensei is really amazing!
Sadame(thought): ...Th...this is bad.
Sadame(thought): Even the observers around us up here on the second floor are all speaking out in excitement...
Sadame(thought): At this rate, it'll turn out to be like always.
Yourou: Listen up, if you didn't hear it before, I'll say it again...
Yourou: When you cut the lower portion, the bloodflow...
Mikoto: Oh yeah, you were talking about that before.
Yourou: So...so you were listening after all!!
Mikoto: But there is no need to worry about the blood vessels.
Diagram: The muscle will go through the rib cage.
Mikoto: I will make the muscle go through the ribs...
Mikoto: And supercharge it!
Yourou: Sa-Sadame-chan, what is it?
Some kind of nutrient?
Sadame: Probably not.
Sadame(thought): Supercharge...I have heard before that it's a new technique of some kind...
Mikoto: Please start preparing the microscope.
Woman: Yes sir.
Sadame: Oh no, that's right! The microscope...!!
Yourou: Wh, what is it?
Sadame: To be honest, I didn't pay attention to the fact that the microscope was placed in this room.
Sadame: Like you already know, microscopes like that will not be placed in operating rooms unless the surgeon is planning to sew up blood vessels thinner than 1mm.
Sadame: In other words, from the very beginning, Saijou already predicted our objections...
Sadame: In addition to saving the nerves, he is planning to connect the tiny vessels surrounding the cut, in order to increase the bloodflow that was slightly weakened!
Yourou: Wh-what did you say!?
Sadame(thought): That's right...this is the so-called supercharge!
Sadame(thought): Heh, how ironic.
Sadame: To lose so completely actually feels good.
Sadame: This is my utter defeat!