Once Ling Ran started the surgery, he was extremely focused.
The average time for an Achilles tendon repair surgery was very short. For example, the five surgeries he performed last night and the two surgeries he performed in the early hours of this morning were a total of seven surgeries, and the time he spent on each surgery was less than seven hours.
Of course, the time for each surgery was slightly longer. After all, there were preoperative preparations and postoperative sutures, but Ling Ran did not have to participate in them. Ling Ran only appeared in the operating theater when it was time to feed the medicine.
And his work mainly started from the moment the incision was made.
"Pull it open." Ling Ran threw away the scalpel, and together with Ji Tianlu, they pulled open the outer skin of Liu Weichen.
"It's the same when we slaughter sheep in my hometown," Ji Tianlu suddenly said, and it could be considered as a joke in the operating theater.
Ling Ran operated without saying a word, just like what he did before.
Lu Wenbin quickly joined in and asked curiously, "How long is the Achilles tendon of a sheep?"
"I don't know, but it's not delicious." Ji Tianlu pursed his lips and said, "Sheep's trotters taste the worst. Oh, the Achilles tendon is quite long. "
Ling Ran used forceps to clamp the exposed Achilles tendon.
"The broken end is in the shape of a ponytail." Zhu Tongyi frowned as expected.
This was one of the worse types of tendon ruptures.
"Cut it." Ling Ran propped up the part of the broken tendon that had become a ponytail. He turned it around and used a pair of scissors to cut it flat.
"Cut it." Zhu Tongyi still crossed his arms in front of his chest and watched Ling Ran operate.
If it was a normal person's tendon suture, there was no need to cut the broken ponytail tendon. Some surgeons were used to using it as a material to strengthen the suture.
However, athletes had different requirements for tendons. A scattered tendon like this was not enough to support high-intensity training. It was not beneficial for competitive sports, so it could only be cut.
"Dalang's tendon is missing by about three centimeters." The anesthetist finished his task and craned his neck to take a look. He was also a little curious.
Lu Wenbin turned the tray and said, "It's about the same, maybe even more."
"Can he continue to run like this?"
"If the suture is good, it won't be a problem." Zhu Tongyi's answer was very certain, but the content was full of uncertainty.
Regarding the final question and answer session, the people in the operating theater were very concerned, and the audience in the demonstration room was even more concerned.
Zhu Tongyi's plan was not a secret in the Orthopedic and Sports Medicine Center. Many senior resident doctors had come into contact with it before. Therefore, when Zhu Tongyi mentioned that the patient was sutured well, many people's expressions did not look too good.
"Looks like we have to use Plan A."
"He's a little perverted."
"Will it work?"
A few doctors could not help but discuss in whispers.
"What's wrong with Plan A?" A young nurse sat on the table in the demonstration room and asked the attending doctor next to her worriedly.
A young and lively girl's request was something a 30-year-old man could not refuse. The attending physician flashed the smile of someone who had been single for thirty years and said, "Academician Zhu's Plan A is to ensure blood supply. This can ensure the strength of the tendon after stretching. "
"And then?"
"Then?" The attending physician chuckled and said, "Then, I'll have my hands tied."
"Why?"
"Because …" The attending physician did not know what to say. He thought about it and said, "Let's put it this way. The blood supply of the medial side of the Achilles tendon comes from the posterior tibial artery, and it's divided into three to four perforating arteries, which are almost invisible to the naked eye. The vascular area on the lateral side of the Achilles tendon is similar, but it comes from the peroneal artery. You have to bypass all of them."
"I have to bypass a total of eight small blood vessels?"
"There are also countless small branches of small arteries. Academician Zhu also hopes to bypass them to protect the vascular network around the Achilles tendon. The blood vessels supply nutrients to the Achilles tendon. If the vascular network is protected, the Achilles tendon will have a greater supply of nutrients, and it will recover faster. It's a little like an open surgery to achieve the effect of a minimally invasive surgery. The idea is quite good, but it's basically impossible to achieve. "The attending physician chuckled.
"It's not just a good idea, it's practically idealistic." Another resident doctor felt the same way.
The 222-pound resident doctor gulped down mineral water and said with a sad expression, "It's always good to have ideals. When Academician Zhu came up with the plan, he also knew how difficult it would be. That's why he delayed it until now."
"It's useless even if he delayed it for ten years. Can you believe that he can avoid all the vascular network? It's impossible. Even if the current machines like da Vinci mark all the vascular network, the ones that need to be cut will still be cut. The position of each person's blood vessel is different, and it's not that easy to avoid. "
"So, in Plan A, I remember that the vascular network will be restored in the end. If too many small blood vessels are accidentally cut, blood vessel sutures will be performed?"
"Crazy!" The attending physician snorted. It was not that he had any opinion on the plan itself. On the contrary, the attending physician had a considerable understanding of how terrifying and effective the plan was.
The so-called vascular network was really a fine and dense net-like structure.
In theory, the small blood vessels had the ability to compensate. Even if they were cut, after some time, the body would reconfigure the blood vessels and reconnect them.
However, Academician Zhu believed that this compensation was too slow, and it would affect the athlete's recovery speed and quality of recovery.
The position of the Achilles' heel was precisely the position with the worst blood supply in the human body. If a destructive open surgery was carried out there, it would be like asking for fish from a tree if the athlete wanted to recover quickly and recover with high quality.
It could be seen from the effect of minimally invasive Achilles tendon surgery that ordinary people often performed. Because minimally invasive surgery preserved the tissues around the Achilles tendon as much as possible, not only was the recovery fast, but the quality of recovery was also very good.
However, minimally invasive surgery could not achieve the effect of high-intensity suturing of the Achilles tendon. Therefore, Academician Zhu Tongyi's plan was basically equivalent to an open minimally invasive surgery.
In a situation where the theoretical foundation and equipment were not complete, the surgeon's own skill level could be relied on to achieve the goal.
Zhu Tongyi had also tried this way of thinking many years ago. Sometimes he failed, and sometimes he succeeded.
But regardless of whether he succeeded or failed, the difficulty of the plan was obvious.
The attending physicians and the others snorted because they had a great understanding of the difficulty of the plan.
The surgeons in the research center were like students with good grades who confidently participated in an Olympiad Math test. After they were beaten to a pulp, they discovered that there was a transfer student hiding at the back of the classroom, trying to solve the Olympiad Math problem.
Even if they were not professionals in performing Achilles tendon repairs, even if they did not intend to rely on Olympiad math to make a living in the future, for the doctors in the Orthopedic and Sports Medicine Center, the basic sense of shame and competitiveness were essential.
Even a resident doctor who weighed 222 pounds was a man who had both strength and perseverance. He had no weaknesses other than the fact that he would gain weight even when he drank water.
The experience of being beaten to a pulp was something that many of the surgeons in the research center had never experienced.
It could be said that none of the doctors in the Orthopedic and Sports Medicine Center were weak, but none of them were surgeons who could create miracles.
There were not many surgeons who could do that in the world.
And most of the doctors did not even think about this kind of thing.
"Microscope." Ling Ran strictly followed the plan and began to separate the Achilles tendon more carefully so that he would not break more blood vessels during the suture.
This was a serious and meticulous job, and he did not know whether it would be effective.
However, since Ling Ran believed in Zhu Tongyi's plan, he tried his best to complete it perfectly.
The trivial work seemed endless, and it made people feel bored just by looking at it.
But Ling Ran did not say anything and operated quietly.
A little at a time, a little at a time. Slowly, the workload accumulated.
When Ling Ran really began to suture the Achilles tendon, many of the doctors who were watching did not even realize what was going on.
"Achilles tendon strengthening suture completed." Ling Ran's movements were extremely skilled. He only used a few minutes to reattach the Achilles tendon that other people had to play with for a long time.
However, for this surgery, although the core of the surgery was the suture of the Achilles tendon, the difficulty of the surgery was the reconstruction of the vascular network.
"It's really complicated now." Ji Tianlu looked at the broken vascular network in the microscope, and he could not see it clearly. He was very confused.
The blood vessels that were injured due to the Achilles tendon rupture, the blood vessels that were cut open due to the open wound, the blood vessels that were torn due to the pulling of the Achilles tendon, and so on were filled with a bloody red surgical field. It was like a set of complicated dominoes that were destroyed by accident.
The hope of restoring the vascular network was to reconstruct a set of usable dominoes with the least amount of work.
This work was even more difficult than finger replantation surgeries, and it was still uncertain whether it would be successful.
"It's starting." Ling Ran still did not say a word. He adjusted the microscope and started to get busy.
Ji Tianlu raised his head to look at the time and quietly lowered his head. He decided to cooperate with Ling Ran and do a good job as the first assistant.
In the demonstration room, some of the doctors who had been watching for more than an hour could not help but yawn. However, when they looked at Ling Ran, their expressions changed unexpectedly. Forget about actually suturing the vascular network, just looking at the complicated scene was enough to make them dizzy. Besides, Ling Ran was not just simply restoring the vascular network.
He had to rebuild it. He had to let it unleash its immediate combat power, and he also had to give it space to heal and extend itself.
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