Great Doctor Ling Ran Chapter 155
155 One Operation After Another
The debridement and suturing related to a finger replantation was much more high-end compared to a normal debriding and suturing surgery.
Lu Wenbin handled the severed fingers on one side, while Ling Ran handled the other end with Ma Yanlin's help.
All three of them wore surgical magnifying glasses. Their heads were bent while they meticulously treated the wound.
Compared to an ordinary debridement and suturing surgery, the debridement and suturing of a finger replantation not only needed to be clean, but the surgeons also had to ensure minimal tissue loss, and the latter part was the most troublesome. If they cut up too much skin, they needed to perform a skin graft. The same situation would be applied if they removed too much muscle or blood vessels.
Lu Wenbin was only qualified to perform debridement on a severed finger alone since he helped Ling Ran in many surgeries using the M-Tang technique. This was also the easiest step in a finger replantation surgery.
Upon debriding, Ling Ran performed an artificial induction on the bones and joints. He then used the interlocking nails provided by Changxi Medical Company to lock down on the bone after anastomosis was achieved. Once this procedure was complete, forty minutes had passed.
Ling Ran raised his neck and rested for a few seconds before he pulled over the high power microscope.
The high power microscope of Yun Hua Hospital was like a huge table lamp. There were four wheels underneath. The lamp head was the main part of the microscope. The body was very heavy, and the magnification was sufficient for surgeons to see the small blood vessels and nerve fibers in the brain.
Finger replantation surgeries could also be performed with a regular surgical magnifying glass, but it would only make the task harder. In fact, the surgeons during the earlier days of finger replantation surgeries often did not use microscopes to perform the surgeries. In the twenty-first century, there were still small hospitals in some places that would do finger replantation surgeries with just the naked eye. Whether it was successful or not mattered little. Their methods were very primitive.
Ling Ran could not bear the crude nature of performing vascular anastomosis using the naked eye.
If the conditions were not favorable, he would still bear with it. But when the conditions allowed him to perform his surgeries with microscopes, then Ling Ran would not feel good if the twenty-four stitches were not aligned.
Ling Ran would be even more troubled if the sutures were uneven under the microscope when he had Master Level suture techniques in his possession.
Therefore, although Ling Ran had just begun performing finger replantations, he requested for a high power microscope. Such an equipment cost around ten thousand RMB, and in a private hospital, it would be regarded as the treasure of the hospital. In Yun Hua Hospital, it was considered as an ordinary piece of equipment. Huo Congjun just had to order it, and one was moved to their department.
Of course, only Ling Ran needed to use it, and he was indeed capable of using it. If it was requested by another attending physician, he or she might not have received the microscope so easily.
Ling Ran kicked over a stool with his foot and sat on it. He operated on the patient's broken finger through the table lamp-like microscope.
He first sutured the tendon, which was the most familiar organ to him. Compared with the M-Tang technique, the tendon suturing of a severed finger was much simpler. After all, the tendon sheath of the flexor tendon did not pose as a problem, and postoperative adhesion was easier to handle.
In less than twenty minutes, Ling Ran finished the suture at an extremely slow pace.
He was familiar with most of the entire process. But even though he practiced many times before this, when it came to the real deal, he still had to be a little careful.
"Judging by the length of the blood vessels, you should directly anastomose them." Ling Ran made a quick judgment before he made a decision.
The same applied was applied to the replantation of a broken limb. If the length of the blood vessel was sufficient, vascular anastomosis could be performed. If the length was not enough, it would be necessary to reconstruct the blood vessel, which was also known as vasotransplantation. It would naturally be more difficult to cut out a section of a blood vessel from the patient's body and stitch it onto another part.
This was one of the reasons why debridement and suturing had to be done very deliberately and carefully.
It took half an hour for Ling Ran to slowly finish anastomosing a blood vessel.
On one hand, he did not deliberately pursue speed. He even intentionally slowed down to make sure that the stitches were close to each other. On the other hand, the blood vessels of severed fingers were indeed small, and each stitch should be done with adequate preparation. The pressure was stacked on top of him.
Upon the completion of the anastomosis of a blood vessel, Ling Ran's forehead was already covered in sweat.
"Is there any problem?" Huo Congjun's voice rang from behind him, and Ling Ran was shocked.
He turned his head around and saw Huo Congjun dressed in a white coat with his hands behind him. He was smiling like an old man who had just gone out on a walk with his pet bird.
"There's no problem with the operation." Ling Ran cast Huo Congjun a strange glance and asked, "Did something happen?"
"There wouldn't be so many accidents." Huo Congjun shook his head and said, "What's the matter? I allowed you to perform a surgery at three in the morning, but you would not allow me to come to the operating theater at five o'clock?"
"The surgery is still under your name," Ling Ran replied nonchalantly.
"It's good that you still remember that. So, how is the operation today?" Huo Congjun said, taking a stool from behind him and putting it under his butt.
Su Jiafu clenched both of his fists tightly. His heart was filled with indignation. 'He even took away the stool of an anesthetist. Where has humanity gone to nowadays?'
"We'll just need to perform another nerve anastomosis, and we'll almost be done." Ling Ran briefly explained in one sentence and continued to operate on the finger.
Huo Congjun said again, "I heard from the nurse that the patient has been smoking for fifteen years?"
"Do you think the patient will quit smoking?"
"I don't know."
"So, you don't care whether the patient quits or not?"
"You can say that." Ling Ran's eyes fell on the eyepiece and said, "I can't make decisions for others just because I stitched one of his fingers."
Huo Congjun was stunned for a few seconds before he chuckled.
Ling Ran cast the man one glance and continued with the operation.
Huo Congjun did not leave. He just stared at Ling Ran as he operated, and no one knew what lurked in his mind.
At seven in the morning, Ling Ran announced that the operation was finished.
Huo Congjun followed and stood up. He spoke as if he was deep in thought, "There is currently a child who needs a finger replantation surgery. Would you be willing to participate in it?"
Ling Ran looked at Huo Congjun in puzzlement, "What do you mean?"
"A five-year-old child had eight of her fingers crushed by a hotel's automatic door. She has been sent to the Hand Surgery Department of our hospital." Huo Congjun paused a little and continued, "The Hand Surgery Department plans to have four groups at the same time to aid in the finger replantation surgery. If you are willing to participate, you can make preparations now."
The amount of information from Huo Congjun was too much. Ling Ran only registered his words after a while. He then asked, "Eight fingers crushed? Is it completely severed or not completely severed? If there are four groups, that means each group is assigned to do two fingers, right?"
"Yes, they aren't completely severed, yes," Huo Congjun replied.
"The Hand Surgery Department is willing to let me join?" Ling Ran asked another key question.
Huo Congjun calmly said, "They are short on people."
"The number of doctors in the Hand Surgery Department is not fewer than the number of doctors in the Emergency Department, right?"
"There are just a few who can do finger replantations for children." As Huo Congjun said this, he could not help but smirk. "If you go, they have no reason to refuse."
A five-year-old child, an eight-fingered replantation, and collaboration between four groups. Such a large operation was an atypical surgery, even in Yun Hua Hospital.
In an atypical surgery, the department the surgeons who participated in the surgery was no longer important.
Ling Ran's skills were solid enough, so he was qualified to join.
At least, Huo Congjun thought so, and he had the ability to make it happen.