Great Doctor Ling Ran Chapter 196
196 Off With The Leg
The system's prompt did not bother Ling Ran. He wrote the medicine list as usual, and informed Lu Wenbin and the others to carry out preoperative preparation works.
Any assumptions were meaningless until the patient was sent over.
And after the patient was sent over
Ling Ran looked at the MRI scan, and still remained as unsure as ever.
What kind of finger replantation would be considered a perfect suture?
To leave no scars after the suture? That would be impossible. It would be impossible to even pay attention to that problem when one was performing a finger replantation surgery. Even if one did pay attention to the problem, one would not be able to handle the problem. It would be better for the patient to undergo further plastic surgery later on instead.
For the phalanx to not be shortened? A severed finger would basically need to have one portion lopped off. The huge force that severed the finger would also damage the severed end, and the alignment during the suture had to be accurate. The doctors could not hope to restore the finger to perfection, after all, humans were not Transformers.
When Ling Ran thought of this, he realized that it was difficult for the suture to be perfect from an aesthetic point of view.
If that was the case, perfection would need to be considered from a functional perspective.
To restore the patient's original hand function?
Ling Ran thought about it again. This level of finger replantation surgery had preceding cases to follow, but it was impossible to guarantee that he could restore the patient's original hand function.
However, when he thought about it from another angle, the mission probably did not expect him to completely restore the patient's hand function either.
Ling Ran could only put his all into it.
Ling Ran first thought of the consuming the Blue Serum, which would grant him a +1 for all skills, but after thinking about it for one second, he discarded the thought. There was still a wide range of uses for the Blue Skill Serum, and the mission description did ask him to make full use of the Perfect Level Finger Replantation Skill.
Ling Ran pursed his lips, but he was thinking about the Legendary Level he would gain after obtaining that +1 in his skill level...
He did not know what the blue serum tasted like.
"Doctor Ling, the patient has been sent over." Yu Yuan had been running back and forth. She came over to make a report.
Yu Yuan, as the oldest member of Ling Ran's team, was four feet and eight inches tall. She also knew that her surgical skills were lacking. Hence, she took the opportunity to do some chores and help everyone. Ling Ran was the doctor who taught her the most surgical skills, and he had excellent surgical techniques as well, which was a rare trait. Because of it, Ling Ran became the one doctor who was most suitable to mentor Yu Yuan in the Emergency Department.
Su Jiafu also rushed over and asked, "Doctor Ling, did your relatives come to consult you?"
He had been called over by Ling Ran, and he had to deliberately change his shift to make it over.
Ling Ran glanced at him and said, "The patient is a construction worker. Finger function in that line of work is very important. I want to do it as well as possible, so I wanted you to come over."
Su Jiafu was over the moon when he heard this. He almost laughed out loud, "Doctor Ling, you have great judgment. I won't be mocking you for the other things you said, then."
Ling Ran looked at Su Jiafu strangely and did not utter a word.
Lu Wenbin, who arrived after him, deliberately laughed and said, "Doctor Ling just wanted an anesthetist he's familiar with."
Ling Ran subconsciously nodded.
To perform a perfect surgery, a familiar anesthetist was still necessary. Of course, they might not always be useful, but when they showed that they were useful, it would all come full circle and pay off.
In this regard, the value of an anesthetist could be seen as someone who could reduce the chances of abnormalities happening during surgery by 10%.
Su Jiafu was very upset. "What do you mean by he just wanted a familiar anesthetist? Doctor Ling must still value my capabilities."
"Do you dare to say that you are the best in the Department of Anesthesiology?" Lu Wenbin fired back.
Su Jiafu huffed and puffed, but did not say a word.
There were a number of associate chief physicians and chief physicians ranked above him. Even if he meant it as a joke if he did say that he was the best, what would happen to him if the others took it seriously?
"Let's do a small consultation before surgery." Ling Ran did not bother himself with debating if Su Jiafu was the best. Ling Ran had long lost the wish for his team members to be the best since junior high. Not every member of the choir needed to possess the level of a professional singer. Sometimes, the lead singer's smile could conceal the countless mistakes his or her team members made.
Lu Wenbin felt something off. "Is today's surgery very complicated?"
Before this, they rarely did any preoperative consultations. This was the case for all surgeons. It was common for them to move to another operating theater right after completing a surgery, especially when the surgeon has performed a department's specialized surgical procedure. A chief surgeon who has been performing surgeries from a young age until he was old might perform the same surgery for twenty years. Even if he only performed one hundred to two hundred cases per year, which was considered low, such a surgeon would still have performed two thousand cases of the same surgery throughout the period of his career.
Then, in the face of his 2001st surgery of the same type, as long as the person lying on the operating theater was a human with normal anatomy or was a human with an anatomical structure that was not particularly strange, there was no need for the surgeon to perform any sort of preoperative consultation with his team.
The only exception was that if the surgery itself was very complicated, and it was especially so if it was a surgery that had not been adequately studied by mankind. It often required more consultations and examinations by the surgeons. In short, since they did not have the ability to handle the surgery through brute force, they could not act carelessly, and hence, they could only choose a suitable way to jump into the surgery and ensure success.
Ling Ran replied in a straightforward manner, "I just want this surgery to be completed in its best possible manner."
Lu Wenbin let out a hum of affirmation.
Su Jiafu, who was preparing the anesthetic, called out to Lu Wenbin and asked, "Don't you feel that it's strange, Old Lu?"
"What's so strange about it? People always want to make better pork trotters as well, right?" Lu Wenbin looked at Su Jiafu with a contemptuous look and said, "You don't have the experience of getting up at two o'clock in the morning to go to the market, do you? Don't you find your life too boring?"
"I'm someone who induces anesthesia on others at two o'clock in the morning. It IS indeed a little more boring than seasoning food." Su Jiafu very calmly countered Lu Wenbin in an equally contemptuous manner.
"Anyway, let's look at the MRI scan first." Ling Ran interrupted their squabble, pointed at the scans and said, "Doctor Lu, what can you see from this?"
"I..." Lu Wenbin was recently asked to study MRI scans. He did study hard, but Ling Ran's question still caught him off guard.
"Remember to study when you go back." Ling Ran first said, and he sounded very much like a senior doctor.
Lu Wenbin nodded obediently. If his superior had the ability to read MRI scans, then he must learn to read it with everything he had. He was already considered very lucky with the conditions he had for learning, especially when he considered the learning environment in the country.
Yu Yuan tiptoed and extended her arm from behind Lu Wenbin.
"It's a very clean cut. There should not be any displacement of bones. The bone density is relatively high. The nerve contusion is more severe..." Yu Yuan chose to point out what she knew.
"Focus on pointing out what is related to our surgery." Ling Ran interrupted Yu Yuan's long-winded nonsense with one sentence before he said, "Lu Wenbin, first look at the patient's anatomy. We will select a few blood vessels that can be used for anastomosis..."
Lu Wenbin nodded repeatedly. It was easier for him to chew and digest information that had been spoon fed to him.
Ling Ran no longer expected Lu Wenbin to review the information himself. He described the condition of some of the blood vessels via debriefing. His focus was on the location and the current state of the arteries and veins.
During the finger replantation surgery, the arteries must be anastomosed. If there were no arteries suitable for anastomosis, the replantation would not be successful. The exception would be when the palmar digital arteries were in a suitable condition to be anastomosed, but with the distal arteries being in inversely poor condition. Then, the surgeon could use the palmar digital arteries to connect the veins as a compromise.
The veins would not play a decisive role, but if they were stitched up quickly and well, it would also be very beneficial for the patient's postoperative recovery, especially in the case when there was a lack of blood flow. The vein could help delay the crisis a little, and it would serve similarly to a spillway.
Ling Ran first pointed out the position of some of the blood vessels in the MRI scan before he asked for a CT scan to explain to Lu Wenbin again. Finally, he began to discuss the strategy for the operation, which was the order of the blood vessels they would be suturing, and what should they do if things failed.
On normal days, these factors all lingered in Ling Ran's mind. He was too lazy to voice them out. Lu Wenbin could only look and ponder over them; he never had the chance to listen to Ling Ran's thorough explanations before.
As Ling Ran spoke about them, Lu Wenbin immediately had an epiphany after combining Ling Ran's words with what he usually saw during surgeries.
"I think I can go into battle now." Lu Wenbin could not help but to speak in a roundabout way.
"We'll see after today's surgery." Ling Ran did not refuse him. Lu Wenbin had performed many cases of finger replantations. It would be normal for him to have a desire to attempt the surgery himself.
After giving a clear explanation of the problems in the blood vessels to his first assistant, Ling Ran briefly talked about the other parts of the surgery before noting down the time they got to work.
In the end, he was still required to perform the surgery. Even if he pursued perfection, he could not ignore the basic operations in the surgery.
As the shadowless lamp was switched on, the operating theater fell into silence again.
"He's under general anesthesia." Su Jiafu looked at the monitor and gave a simple description of the patient's condition. After waiting for two minutes, he giggled again, "Pig's hooves at two in the morning? At two o'clock, the only thing I'm amputating are people's legs."