Suturing blood vessels was a very familiar task for Ling Ran.
When he first arrived at Yun Hua Hospital, the Medical Affairs Department used the suturing of a rat's tail as a show of strength.
Now that he thought about it, it was equivalent to letting a recruit compete with a special forces soldier in a sniper shooting competition. The difficulty was already at the top of the industry.
However, suturing the vascular network was still a challenge that exceeded the normal level of difficulty.
The blood vessels in the feet were thicker than those in the hands. That referred to the main arteries and veins. The perforating arteries from the posterior tibial artery or the peroneal artery were not as wild. Many of them were thinner than the arteries in the fingers.
Meanwhile, finger suturing only required the suturing of two or three or four blood vessels.
Of course, the actual difficulty of suturing severed fingers was still higher. This was because finger amputation sutures had a very high requirement for the quality of the suturing of blood vessels, and the tolerance for low-quality sutures was very low. If it was not done well, the patient would suffer from thrombosis and necrosis.
The vascular network around the Achilles tendon did not have such high requirements. Academician Zhu Tongyi's plan A only required the reconstruction of the vascular network. There were three or four perforating arteries on the medial side of the Achilles tendon, and there were three or four perforating arteries on the lateral side of the Achilles tendon. Academician Zhu Tongyi hoped to have two perforating arteries on each side of the Achilles tendon, and at least one perforating artery. He also needed to ensure the existence of a certain number of small blood vessels.
Most importantly, even if Ling Ran failed to suture one or two blood vessels, it would not cause too serious of an impact. At the very least, it would not cause the suturing of the Achilles tendon to fail.
As for the failure of the original plan, for such an experimental surgery, there would be many explanations if it succeeded, but if it failed, there was no way to explain it.
Zhu Tongyi stared at Ling Ran's movements quietly. He seemed to be even more nervous than Ling Ran.
But Ling Ran's movements became more relaxed.
His wrist was gentle, and his fingers slid lightly across the microscope. With just a few movements, he sutured a blood vessel. Then, he pulled out another blood vessel, brushed it a few times, and sutured it again.
Ji Tianlu hurriedly cooperated with him. Even the second assistant, Lu Wenbin, was also circling around the operating table. At one moment, he was pouring saline water to moisten the blood vessels, at another moment, he was fixing the gauze, and at another moment, he was aspirating, and at another moment, he was operating the retractor. The degree of difficulty was comparable to that of a barbecue buffet.
Everyone's eyebrows were tightly furrowed, as if they had just fought a bloody battle on the battlefield and stayed up all night to catch up on homework.
Only Ling Ran's expression did not change, but his heart was filled with joy.
He was suturing the blood vessels of a living person, and he could even stitch a net. How cool was that?
If it were a finger replantation, Ling Ran would first need to carefully debride the wound, then fix the bone, and suture the tendon. Only then would he have the chance to play with the two or three blood vessels that were the most crucial. When they were done playing, they would suture the nerves and throw the suturing of the skin to the other animals.
To Ling Ran, debridement was no longer that interesting. Internal fixation of bones was more like carpentry work. When it came to tendon sutures, flexor tendons were still fun, but normal tendons were not worth mentioning. The remaining blood vessels and nerves were the most interesting parts of finger replantation.
What kind of situation did Ling Ran encounter today?
There was a large vascular network, and it was difficult to suture the small and thin blood vessels.
In other words, he was giving Ling Ran the best part of finger replantation surgery.
Needless to say, Ling Ran was very happy.
This was not the rat tail in the training room. Perhaps for a newbie, being able to suture a rat tail once was already something to be happy about. However, Ling Ran had long since passed that stage of being a newbie.
There was a living person to suture, and he had the cooperation of the first and second assistants. There was also a scrub nurse to hand him things, and there was a circulating nurse to help him suture. It was much more comfortable than sitting alone in the training room.
"Change to a thinner suture thread." Ling Ran was having fun. He sutured three perforating arteries in one go. When he faced the fourth artery, which was even thinner, he decided to change the thread.
Academician Zhu Tongyi had to remind him, "The key is to pay attention to the dynamic balance."
In other words, it was impossible for him to suture the entire vascular network again. He could only select the important blood vessels to form a barely usable vascular network.
It was like after a war, where most of the originally detailed and orderly logistics routes were destroyed. The task of the general in charge of reconstruction was not to restore every original logistics route bit by bit, but to focus on restoring one supply chain to ensure that the most important supplies were supplied. The restoration of the remaining supply chain could be handed over to other people, and it could be done slowly over a longer period of time.
Ling Ran understood Zhu Tongyi's order very well. He nodded and explained, "I want to make an extra backup route."
Unlike ordinary "generals", Ling Ran, who was in a good condition, not only wanted to restore one supply chain, but he also wanted to make another one.
"Can we make it in time?" Zhu Tongyi raised his head and looked at his watch. His expression relaxed a little.
A normal Achilles tendon surgery would take about one to two hours. The time spent on the operating table could be as long as two hours, or as short as thirty to forty minutes.
Zhu Tongyi's Plan A was much more complicated. He planned to give the chief surgeon four hours of surgery time. This time was not given randomly. It was a "dynamic balance" based on the degree of exposure of the Achilles tendon and other factors.
If the time was too short, the chief surgeon would not be able to complete the surgery. If the time was too long, the effect of the surgery might be reduced.
Now, seeing that the surgery was progressing smoothly, Zhu Tongyi hoped that the surgery could end within three hours to ensure a more efficient recovery.
Looking at Ling Ran's progress, Zhu Tongyi felt that there was a lot of hope. Even if he made another backup route, if he could maintain the current speed, it was still possible.
Considering that there would be no benefits if the surgery ended too early, Zhu Tongyi might as well agree to Ling Ran suturing a few more blood vessels.
Ling Ran was also very familiar with Zhu Tongyi's plan. He stared at the microscope, and he was so happy that he did not want to leave. He said, "We did not sever many small blood vessels. There is hope to restore thirty to forty percent of the vascular network. It's good to restore more, right?"
"Of course, but we have to try our best to ensure the quality." Zhu Tongyi reminded him, "The risk of spasms still exists. Only the blood vessels that are cleared are useful blood vessels."
The more blood vessels that were restored, the more nourishment the Achilles tendon would receive during the recovery process.
The reason why patients who received minimally invasive Achilles tendon surgery could be discharged from the hospital quickly and undergo rehabilitation was because the vascular network around the Achilles tendon was still there. As long as the Achilles tendon was sutured and the adhesion was dealt with, it could recover to its original state.
Open surgeries performed to ensure the strength of the Achilles tendon did not have such an advantage, especially for some special approaches. For example, Achilles tendon repair surgeries that used a posterior median incision of the Achilles tendon would obviously have more complications than incisions in the median of the Achilles tendon. The reason was that the latter had less blood supply, and fewer blood vessels were damaged during the incision.
In Zhu Tongyi's plan, the sutured blood vessels needed to have a certain quality before they could be used.
They did not need to be as high quality as the blood vessels used in finger replantation surgeries, but they still needed to have a certain quality.
In fact, Zhu Tongyi's Plan A basically made Liu Weichen's Achilles tendon suture into an Achilles tendon suture combined with blood vessel replantation, which increased the difficulty by more than ten times. It was even more difficult to ensure the quality and quantity.
Zhu Tongyi looked at the young Ling Ran, afraid that he would not be able to control his temper or lose his focus.
This was the most common problem for young people.
Once words like roughness and impulsiveness appeared in the suturing of blood vessels, problems would appear.
Ling Ran did not care about Zhu Tongyi's advice at all. He steadily sutured the blood vessels and said, "Ensure the quality."
At this time, Ji Tianlu could not help but raise his head and said, "Doctor Ling, there will be no problem."
Zhu Tongyi came to a realization and quickly said, "Being too concerned makes one confused. I'm a little too concerned about our plan. "
In the demonstration room.
When they heard Academician Zhu Tongyi, the leader of the research center and the absolute flag, say such words, the doctors were already in an uproar.
Doctor Qu could no longer suppress the emotions in his heart. He said angrily, "The monk from outside is really good at chanting, and the department director is too easy to talk to."
"In other words, even his tone is wrong."
"Hey, hey, hey, don't make it sound so serious. Academician Zhu didn't say anything, right?"
"What do you want Academician Zhu to say? What he said is enough. You have to understand that the plan is Academician Zhu's, and this is a guided surgery. Ling Ran is just the chief surgeon. "
The 220-pound resident doctor held a bottle of mineral water and smiled foolishly. "Ling Ran is just the chief surgeon? Just? "
The few doctors who had been very impassioned just now wisely shut their mouths.
It was very difficult to show off among peers, and it was even more so when it came to doctors from the same department.
If they were facing outsiders, they might still have something to say. But when they were facing their own people, everyone was relatively clear about their own positions.
Ling Ran's position as the chief surgeon could be said to be given to him by the research center, but it could also be said that the research center really could not provide anyone, so they were sent to support him.
But no matter how they looked at it, Ling Ran currently occupied the strongest position.
The 220-pound resident doctor was not willing to belittle his opponent.
He was also afraid of his opponent's strength, but he was willing to face the gap between him and Ling Ran. Ling Ran's skills were strong, he was talented, and he might be a first-class surgeon in the country, but … doctors would continue to grow!
The 220-pound resident doctor had already set a detailed goal for himself. Once this matter was over, he would go into isolated training and catch up to Ling Ran's skills in the shortest time possible.
At that time, he would definitely find another chance to defeat Ling Ran and bring a pair of purebred French lop-eared rabbits to Xiao Yun.
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