"Change her utensils later. Replace the open ones with narrow ones." Unexpectedly, Ling Ran did not scold anyone. Although Ling Ran rarely scolded people in the operating theater, in everyone's stereotype, chief surgeons always scolded people.
The circulating nurse agreed, feeling wronged. If it were any other young chief surgeon, the nurse might have started scolding them. When it came to scolding in the operating theater, young doctors could only win against patients who were under general anesthesia.
Fortunately, it was Ling Ran's order, so the circulating nurse did not think much about it. However, her gaze when she looked at Yu Yuan was not as friendly.
Yu Yuan apologized again in fear, and she looked a little dejected.
She originally hoped that she could have a good start when she was in a new group.
However, nothing seemed to have changed much.
She could not even hide the fact that she was in the first few days.
Ling Ran's expression did not change much. He continued to let Yu Yuan operate the retractor. After a while, he said, "Yu Yuan, change gloves."
"Huh? Change gloves? "Yu Yuan, who was retracting the retractor while feeling sorry for herself, did not understand.
"Your gloves are stained with blood," Ma Yanlin kindly explained.
Yu Yuan turned her hand over to take a look. In the end, she found a few spots of blood at the joints on the back of her hand, and she felt even more embarrassed.
Microsurgeries required a lot of details. It was a basic requirement for gloves and instruments to be bloodless, because blood would easily adhere to the sutures.
Yu Yuan could not remember when she came into contact with blood. When she thought about it, she could not help but feel nervous.
She left the operating theater in a slight panic and took off her gloves. With the help of the circulating nurse, she put on a new pair of gloves and came back. She looked very dispirited.
"Yu Yuan, you want a pair of Durbecker forceps." Ling Ran's order was immediately released.
"Oh … okay, um, give me Durbecker forceps." Yu Yuan was so flustered that she could not even speak clearly, just like an intern.
The circulating nurse had already held the Durbecker forceps in her hand. When Yu Yuan said it, she immediately slapped it into her hand.
The Durbecker forceps, also known as non-invasive forceps, felt cold in her hand, but it made Yu Yuan calm down a little.
Her mind instantly recalled the Durbeck teeth in her previous life and most importantly, its use. The Durbeck teeth were specially made forceps for clamping blood vessels, and the labial teeth were specially concave and convex teeth, round and small. This ensured that when blood vessels and other fragile tissues were clamped, they suffered very little damage from the compression.
There was no doubt that Ling Ran asked Yu Yuan to pick up the Durbeck teeth so that she could clamp the blood vessels.
Yu Yuan could not help but take a light breath, and she felt nervous again.
"Do you know how to use Durbeck teeth?" Ling Ran asked Yu Yuan as if he was asking an intern.
And this was exactly what Yu Yuan needed the most.
Back then, in order to write her thesis, she basically did not come into contact with clinical work during her postgraduate studies. She came to Yun Hua Hospital with the terrifying task of writing a Division I thesis, and there were no clinicians to teach her step-by-step.
Of course, Yu Yuan never worried about theoretical knowledge. She thought about it for a while and said, "Never use forceps to clamp the intima of blood vessels. Clamp the intima only when necessary, and you must be gentle …"
"Yes, the Durbeck teeth you have now were chosen after many surgeries. The pressure won't be too great. You don't need to exert more force, and you don't need to worry about it loosening." Ling Ran continued to do his own thing while he explained to Yu Yuan.
His Perfect Level Finger Replantation Surgery also included guidance for his assistants.
Surgery was never a matter of one person. The bigger the surgery, the more doctors needed to cooperate with it. Therefore, if he wanted to push for perfection, he must have the ability to coordinate and manage.
Based on Ling Ran's personality, coordination and management were not his forte.
If he were an engineer or a product manager, Ling Ran would most likely die of exhaustion.
However, as the chief surgeon of the operating theater, issuing orders with confidence was a coordination and management method that met the expectations of surgeons.
Ling Ran did not discuss Yu Yuan's handicapped hands, nor did he criticize or suggest her surgical skills. He just treated her like an intern and explained step by step.
After all, Yu Yuan had some foundation. She only needed to familiarize herself a little before she reached Ling Ran's standard. The standard of a second assistant at the operating table could usually be reached by any individual. Under the circumstances of paying extra attention and giving special instructions, even a handicapped person could reach the standard.
Ling Ran sutured a blood vessel with incredible speed, and he sutured the next one.
Yu Yuan held the forceps and followed him all the way.
When she sutured the first vein, Yu Yuan's movements were still a little rusty. Slowly, after suturing a few veins, her rudderliness slowly disappeared.
"Rinse," Ling Ran ordered again.
Yu Yuan picked up the narrow-mouthed bottle confidently.
* Splash … *
Water splashed again.
Ling Ran said without even frowning, "Next, we'll perform perineurium anastomosis."
Yu Yuan breathed a sigh of relief, and she became nervous again.
Ling Ran's rhythm was too fast.
A few seconds later, Yu Yuan suddenly widened her eyes and asked, "Why is it perineurium, not epineurium?"
"I'm better at perineurium," Ling Ran said matter-of-factly.
"But perineurium is much more difficult, and it takes a lot more time …" Yu Yuan's voice became softer as she spoke, because Ling Ran was clearly doing it faster and faster.
At this time, there was no need for a second assistant.
Yu Yuan threw away the forceps in her hand and asked the nurse to put on a pair of surgical magnifying glasses for her. She tried her best to adapt to the surgical field under the lens.
Ling Ran used a microscopic instrument to gently separate the epineurium of the broken end of the ulnar nerve. When normal nerve fibers appeared, he made a circular excision of the epineurium at the broken end. Then, he began to differentiate the nerve bundles.
When Yu Yuan saw this, she widened her eyes.
A nerve could be seen as a bundle of nerve bundles, just like a rope that was twisted by many threads.
It was obviously not an easy task to distinguish the different functions of different threads.
However, Yu Yuan did not see any difficulty on Ling Ran's face.
In fact, when Ling Ran connected the perineurium one by one, it was as if there were words written on it.
Yu Yuan could not help but say, "The anatomical structure of the nerves looks similar. How did you distinguish them?"
Ling Ran said without thinking, "Anatomical dissection experience."
"This … How much anatomical dissection experience does it take?"
Ling Ran did not answer Yu Yuan.
The experience of performing three thousand dissections allowed Ling Ran to be at ease when it came to surgeries in the Hand Surgery Department.
Everyone's hands were slightly different, but the probability of growing a pair of hands that were different from those of three thousand randomly selected people was extremely low. Besides, there were all sorts of theoretical articles now.
Yu Yuan was stunned. She mumbled to herself, "Usually, perineurium anastomosis is better than epineurium anastomosis, but it also takes more time. It's usually not used in finger replantation … However, it's very easy to choose the wrong perineurium during perineurium anastomosis. If the wrong perineurium is chosen, it's better to use epineurium anastomosis. Besides, perineurium suture is more troublesome, and it takes more time. It takes at least half an hour more than epineurium anastomosis. For finger replantation surgeries, it's not cost-effective to spend so much time on perineurium anastomosis … "
The nurses, anesthetist, and Ma Yanlin in the operating theater looked at Yu Yuan strangely.
Yu Yuan shook her head vigorously. "powerD has published an article about the treatment effects of epineurium anastomosis and perineurium anastomosis. Although the results of comparison showed that perineurium anastomosis has a higher nerve conduction speed, the amplitude of compound muscle action potential is significantly higher than epineurium anastomosis, and the excellent rate is also higher, the subject of comparison is the ulnar nerve."
Yu Yuan paused for a moment and mumbled again, "The ulnar nerve is easier to suture than the nerves at the severed finger. It takes less time, and the difficulty is lower. It's impossible to suture the nerves at the severed finger in the same amount of time. So, we can't simply think that perineurium anastomosis is better …"
"Okay, I'm done." Ling Ran's eyes left the microscope, and he took off his gloves.
Yu Yuan, who was talking excitedly, was stunned again.
Before she could ask, Ling Ran grabbed his neck and said, "Young Ma, can you do the rest of the suture?"
"No problem. You can rest now." Ma Yanlin was a little excited. After enduring for so long, even though he only had to suture the skin, he was still very happy.
Ling Ran took off his surgical gown and threw it into the cylinder. He stepped open the door of the operating theater and left.
Now, every time he finished a surgery, he would take a short nap, and no one thought that there was anything wrong with it.
Ma Yanlin waited until the door of the operating theater was closed again before he sized up Yu Yuan from head to toe. He said, "I didn't expect that even though you look like an honest person, you're such a good flatterer."
Yu Yuan was still in extreme shock. When she heard Ma Yanlin's words, she did not have much of a reaction. She asked, "What do you mean?"
"You know that Doctor Ling is most famous for his excellent hand anatomy and perineurium anastomosis, but you deliberately said that it's difficult. You're good, aren't you?" Ma Yanlin laughed as he spoke.
Yu Yuan then realized that he was teasing her. She could not help but lower her head and say, "I didn't know that I would be assigned to Doctor Ling."
"You'll get to know him slowly in the future." Ma Yanlin slowly sutured the skin and said, "When Doctor Ling performs surgeries, he doesn't like to talk, and his rhythm is a little tense. He's more relaxed than when he follows other doctors, but there's only one problem …"
Yu Yuan naturally asked, "What's the problem?"
"Doctor Ling is always performing surgeries."
"Always … performing surgeries?" When Yu Yuan thought of her terrible surgical skills, she immediately felt that something was wrong. In a flash, she recalled a few direct orders from Ling Ran. Under Ling Ran's command, she did play some role …
Yu Yuan stood in the operating theater in a daze for a few seconds. A burning desire for knowledge and a strong desire to perform surgeries burned in her round eyes again …
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