"The damage to the patient's index finger is quite serious. It's not considered serious in finger transplantation, but it's much more serious than the standard of finger replantation. In this case, we must first consider using the skin flap to repair the finger. "Wang Haiyang stood at the chief surgeon's position, and he was in high spirits.
Ectopic transplantation could be said to be the ultimate operation in microsurgery.
But from this point of view, ectopic transplantation could also be considered as the current ultimate operation in human medicine.
One of the reasons why Yun Hua Hospital's Hand Surgery Department was famous was that it had the ultimate operation in this field.
Of course, the ultimate operation was still palm and arm ectopic transplantation. The difficulty of fingers was lower, but overall, it still represented a very high level of skill.
The operation difficulty of ectopic transplantation and the various problems during the nursing period were basically similar, but there was a slight difference in magnitude.
Most hospitals in the country would first be stuck in nursing and other aspects, not to mention the surgical skills of the doctors. Even hospitals in Beijing and Shanghai would not be able to perform this kind of surgery if they did not have a professional team in the Hand Surgery Department or the Orthopedics Department.
Wang Haiyang, who mastered ectopic transplantation, had the right to express his pride.
Twenty years ago, he was one of the main doctors in Yun Hua Hospital who tackled ectopic transplantation.
Wang Haiyang looked at Ling Ran and said,
"Once we understand this foundation, we will understand the first key problem. How to choose a suitable skin flap is the first problem.
"Usually, when it comes to finger transplantation, it's easier to design and use radial artery flap, dorsal foot flap, and ulnar artery flap that are close to the finger or the wound surface to achieve satisfactory results. Today, we will choose dorsal foot flap.
"The three main elements of ectopic transplantation replantation are the reconstruction of blood circulation, the repair of tissue defects, and the reconstruction of function in the later stage. Usually, the first stage of the surgery basically determines the upper limit of the entire surgery. "
Wang Haiyang could be said to be addicted to teaching Doctor Ling.
At this time, Guan Fei had already disinfected the patient's foot.
Looking at the patient's small foot, Guan Fei had a strange expression and said, "Grow fingers on the instep of a child's foot?"
Wang Haiyang, who had just said a long sentence, was thinking about the next part of the content. Being interrupted, he immediately glanced at Guan Fei unhappily and asked, "Do you want to listen?"
Wang Haiyang was more patient with pretty girls. Otherwise, if it had been an idiotic male intern, he wouldn't have asked a question at all. He would have just said "get out" to solve the problem. He didn't add the word "Scram" because he was old. His testosterone levels had changed, and his temper had become better.
Guan Fei, who had always spoken casually, had met Chief Physician Wang Haiyang several times. She felt that he was a good-tempered chief physician. She did not expect that she would suddenly be scolded.
Guan Fei could not help but lower her head. A year of internship was obviously not enough for her to completely adapt to the hospital environment.
Wang Haiyang turned around after cursing.
He couldn't be bothered to look at the pretty girl right now.
At this moment, Wang Haiyang was immersed in the most mysterious, happiest, and most elusive emotion of the Chinese — being a good teacher.
Wang Haiyang raised his head happily and asked Ling Ran, "Doctor Ling, you shouldn't have any problem with making skin flaps, right?"
"Cut open the muscle tissue to form a skin flap? Sure. "
"If you had to choose, which position would you choose?"
Ling Ran recalled and said, "It should be connected to the dorsal artery of the foot."
"Yes, yes … not bad. Did you think of it yourself, or did you read it?"
"I read it when I was studying." This time, Ling Ran's answer was the result of studying hard.
Not only could Energy Serums help him perform surgeries, but the effect of reading books was also very good.
As a newbie in the hospital, Ling Ran had quite a lot of books to read.
It was very common for a mature doctor to read a stack of professional books that corresponded to his height every time he leveled up.
* Slap. *
Wang Haiyang stomped his feet hard. "That's right. 'Doctor Ling is prepared.' Alright, let's continue … The second stage of replantation is the main and difficult part of ectopic transplantation. Usually, based on the need, the skin flap of the dorsal artery of the foot will be cut. This is mainly to maintain the continuity of the vascular graft and the dorsal artery of the foot … "
Wang Haiyang was very detailed, even more so than when he was in the Hand Surgery Department.
From Ling Ran. Everyone listened very seriously, from Lu Wenbin to the interns.
However, Ling Ran was the only one who was qualified to carry out ectopic transplantation.
Among the others, Lu Wenbin, who was the best at finger replantation, had never carried out this surgery independently. For him, ectopic transplantation, which was of a higher standard, was even more difficult.
Wang Haiyang spoke for more than half an hour before he started.
Of course, he did not stop talking during the surgery, so much so that the nurse had to give him water to moisten his throat.
Wang Haiyang was so excited that he could not stop.
After the skin flap was done, Wang Haiyang was so happy that he wanted to take off his clothes and dance.
"Not bad. Today's ectopic transplantation is not bad." Wang Haiyang was the chief surgeon who was in charge today. Under the influence of Ling Ran's silent feeding technique, the results of the surgery almost shocked himself.
After all, skills were interchangeable. Ling Ran did not know how to carry out ectopic transplantation, but he had one hundred foot anatomical dissections and three thousand upper limb anatomical dissections. With this kind of anatomical dissection experience, he could tell the shape of the tissue around a blood vessel just by looking at it. He could even tell the strength of the tissue he pulled just by looking at the state of other muscle tissues and tendons.
With this kind of foundation and Wang Haiyang's detailed explanation, Ling Ran was not very clear about the specific steps of the surgical method. Now that he knew the general direction, he acted as an assistant and continued to feed Wang Haiyang.
Theoretically, unless Wang Haiyang had eighty percent of Ling Ran's skills, focused on performing the surgery quickly, and gave a lot of supporting work to the assistant, Ling Ran might not be able to use the Great Feeding Technique. However, if Ling Ran was given a few more chances to familiarize himself with the surgical method, even if Wang Haiyang had ninety percent of Ling Ran's skills, he would still be fed.
The pressure on an assistant during the surgery was much less than that of a chief surgeon.
A chief surgeon had to consider all kinds of problems, such as the patient's condition, the endurance of the tissue, the sequence of the surgery, and so on. The assistant only needed to cooperate well with the chief surgeon.
If it were a normal junior attending physician or resident doctor, they might not be able to cooperate well. Senior attending physicians who had a few years of experience would rarely have this kind of situation.
Wang Haiyang performed the surgery for a while. He felt so good that he was about to fly. He looked around, pointed at someone he knew, and said, "Doctor Zuo, go to the Hand Surgery Department and ask the doctors in my group to come and watch the surgery."
Zuo Cidian was free after he debrided a finger. He quickly agreed and said, "Should I inform the doctors in your group?"
"The doctors from other groups can come and watch if they want. By the way, ask the specialists and interns to come too. Ectopic transplantation is quite rare." Wang Haiyang decided to increase his coolness.
The best thing about being a surgeon was having other doctors come and watch the surgery when it was done well.
Correspondingly, if the surgery was not done well and there were many people watching, the surgeon would scold them.
Zuo Cidian reluctantly walked backward out of the operating theater.
He really wanted to finish watching the surgery. Just as Haiyang Wang had said, ectopic transplantation was indeed rare. Moreover, chief physicians like Haiyang Wang would not explain the details of other surgeries in detail during other surgeries.
Most surgeons liked to chat when they were at the operating table.
When it came to lecturing, it definitely depended on the mood.
If Ling Ran was not listening today, Wang Haiyang would not have bothered to talk.
After a while, the doctors from the Hand Surgery Department came in one after another.
The circulating nurse anxiously drew the line and controlled the number of people. In the end, Xiang Xueming and the other interns were chased out.
Wang Haiyang was satisfied as long as there were people who came to worship him. He felt even better when he kept changing people. He even raised his voice.
"It's not easy to suture a child's blood vessels. This young patient is only ten years old. It's rare to see ectopic transplantation at such a young age. "
"The youngest ectopic transplantation in our hospital should be seven years old. How should I put it? It's quite average. The surgical conditions back then can't be compared to now. The microscopes now are much better than before. It's just that my eyes are getting old … "
"This surgery is estimated to take three hours. Those who need to urinate, do it. Don't pee in my operating theater. I'm just kidding. Pee in your diapers is allowed. Don't pee in too much. Lick it clean when it drips on the floor. "
Ling Ran listened to Wang Haiyang and thought as he operated.
As the surgery progressed, he became more familiar with the surgery, so he could do it with more ease.
As the pressure of the surgery decreased, he had more time to think.
Ling Ran did not expect the system to give him the skill of ectopic transplantation, so he had to learn it seriously. In fact, most doctors who performed ectopic transplantation were forced to do it beyond their abilities.
The volume of this surgery was too small. If they performed three to five cases, they could call themselves experts in the country.
Of course, there were also doctors who performed more. However, ectopic transplantation was a surgery of the Hand Surgery Department, and it was more suitable for emergency cases. Even if they performed it well, there might be a long period of time when there were no similar surgeries.
Ling Ran's current level was already better than most doctors who had performed this kind of surgery. He just lacked experience compared to those who were familiar with it.
"The blood vessels in the ectopic region should match the blood vessels in the fingers. It's easy to show, and it's beneficial for the surgery later.
"The thickness and color of the skin flap should also be taken into consideration.
"You don't have to think too much about the donor area. We're only cutting a small piece, and it won't affect the donor area much."
Wang Haiyang was extremely excited as he spoke. His hands moved faster.
The doctors around them also stared at the surgery and Ling Ran, who was performing the surgery.
A few young interns who were hiding at the back could not see the operating area clearly. They looked at Ling Ran and whispered in his ear.
"Doctor Ling is really handsome when he performs the surgery."
"Look at the way Doctor Ling holds the forceps. Ah, look, it's so cool."
"Look at his standing posture. If it were up to me, we should broadcast the scene of Doctor Ling performing the surgery. There won't be any doctor-patient disputes."
"There will only be more doctor-patient disputes. There will definitely be a bitch who curses her husband to death and sues Doctor Ling for marriage. I've even thought of the plot …"
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