Great Doctor Ling Ran Chapter 224
224 Judgment In The Surgery
"Doctor Ling, I think the vascular channel that you sutured is sufficient. Should we consider to end the surgery earlier? Shortening the surgery time can quite beneficial," Ji Tianlu said it in an indirect manner.
From his perspective, one vascular channel was already enough, and the contingency plan Ling Ran left behind in his sutures had made it more than enough.
If they ended the surgery now, it could be said that the surgery time was short and ended with a good result. If they analyzed this from the benefits the patient would receive, this would be the perfect time to end the surgery. As for the alternate vascular channel by Ling Ran mentioned? To Ji Tianlu, that was already overtreatment.
If Ling Ran did not get the notification of the completion rate from the system, he would probably hesitate as well.
In fact, at the moment, he was not sure if the second vascular channel could definitely increase the functionality of Liu Weichen's Achilles tendon.
The plan made by Academician Zhu Tongyi was actually an experimental plan. There were no other plans that could be used as a reference for the plan. In other words, no one could confirm whether the establishment of the first vascular channel was useful. They could only guess after Liu Weichen recovered.
Perhaps more surgeries would be required to truly judge the clinical value of the plan, and they would then need to compare the results with normal surgeries to be certain.
However, this plan was not meant for a normal person. It was meant for an athlete who had high demands on the recovery time and strength of his Achilles tendon. Similar demands would usually only be made by professionals like soldiers. So, even if they wanted to add chief sources, it would take time.
By that time, if the value of this plan was really proven, it would probably benefit blue-collared workers and sports lovers. But at the current stage, these people could still not bear with the high risk on their health and financial status. After all, an experimental surgery plan was not covered by local and foreign medical insurance companies. Subsequent risks on their health in the future was also a problem. At the moment, Liu Weichen was willing to bear the high risk of not being able to run or jump again after few years time, but it would actually be better for a normal person to wait for another few years before they tried the surgery.
"The blood flow capacity in the vessels we sutured is at most the same to the blood flow capacity in two fingers. Are you sure it's sufficient?" Ling Ran spoke in a probing tone. It was normal for the function of the Achilles tendon to recover to around 75%. But if he wanted to reach a higher recovery level, suturing more blood vessels was not the only way he could go about it.
Theoretically, Ling Ran could still continue to increase the strength of Achilles tendon, he could also consider the problems in the bones and their surrounding muscles. Furthermore, there was a risk for infection, and adhesion was always the biggest problem in tendon sutures. Liu Weichen might also have genetic problems that could affect recovery. Some people would have a better recovery if they underwent invasive surgery, while some people recovered much slower. For example, those who had inherited hemophilia would not be suited to undergo the surgery.
But based on Ling Ran's judgment, he would rather consider the problem of blood flow capacity.
He agreed with Academician Zhu Tongyi's plan. And with the plan as his basis, he was certain that the blood supply chain network he connected with the vascular channel he sutured just now could not provide sufficient nutrients to the Achilles tendon. It was more than enough for normal recovery, but it would not be sufficient for a miraculous recovery.
This was like the demands of an army when it came to logistics. A limited number of the supplies was the basis of survival, a large number of supplies allowed the army to defend the line during war, but only a sufficient amount of supplies could allow them to attack.
Ji Tianlu found himself at a loss for words. He frowned for half a minute before he answered, "Judging from our experience, the blood flow capacity right now is much more than what we've seen in our previous patients."
"Not necessarily."Ling Ran had been thinking about this. He then said, "This is similar to the blood flow capacity of the patients who receive Achilles tendon surgery with a midline incisionsince the damage to the vascular network in those surgeries is low. The previous patients with Achilles tendon ruptures did not really pay a lot of attention to the blood supply, right? What if some people recovered faster because their wounds and surgical conditions were better?"
"Hmm it's possible." Ji Tianlu had to admit that there was logic in this question. But he then said, "However, if you continue to suture it, you'll still need at least ninety minutes, right? Is it really beneficial for the patient? If the wound is exposed for three to four hours, it is no longer a small surgery."
The longer the wound was exposed, the greater the chances for complications to arise. A surgery that lasted for more than four hours would usually have complications arise. For a short-distance runner, edema or inflammation would cause a huge problem to him.
Ji Tianlu was also worried that they had placed too much of an emphasis on the unimportant stuff and neglected what was important.
Ling Ran previously worked on finger replantations, so it was normal for him to place an importance on the problem of blood supply. Together with his previous consideration, Ling Ran replied without any hesitation, "Making sure that bloody supply is ensured must always be our most important goal. We can treat the complications you're worried about with medication later. What if the blood supply is not sufficient? Do we have any remedies for it?"
Ling Ran's words reflected Zhu Tongyi's thoughts.
Without waiting for Ji Tianlu to reply, Zhu Tongyi immediately said, "Ensuring a sufficient blood supply is the core of this entire plan. Continue the surgery."
In the surgery today, Ling Ran's position as chief surgeon was ranked second in power instead of the usual first. The final decision still had to be made by Academician Zhu Tongyi. If he wanted to continue, there was nothing much Ji Tianlu could say. He then said, "Let me change my gloves, too."
"Sure. Lu Wenbin goes and changes as well. I can continue first." Ling Ran stopped for a while before sitting in front of the microscope. He said, "Wipe my sweat."
The scrub nurse who wore small a gray rabbit surgery cap used forceps to hold the gauze and dabbed gently at Ling Ran's forehead. She whispered, "There isn't any sweat, but you do have a strand of hair on your forehead. That's why you felt itchy, wait for a while"
The scrub nurse with the small gray rabbit surgery cap put down the gauze and changed to another pair of forceps. She came closer to Ling Ran and stood on her tiptoes to take the hair off Ling Ran's forehead. She said, "Let me check for you again."
Hair was a very tedious existence for a surgeon. Ling Ran stood still obediently to let the young nurse wipe his face.
As the young nurse wiped his face, her face started to turn red. If she had not been not educated with the aseptic principles in the operating theater, she would stick her body closer to Ling Ran.
The doctors and nurses in the demonstration room smiled while they talked to each other. Everyone's attention shifted from Liu Weichen to Ling Ran.
"I never thought that Doctor Ling would be so stubborn."
"If he dares to argue with Chief Physician Ji, he must be quite confident."
"What confidence? He's just being young and competitive."
"Young and competitive? Then why would Academician Zhu agree with his plan? Isn't it easier to just support Chief Physician Ji?"
"Should we really be talking about who supports who right now? Did any of you not notice that Doctor Ling is about to construct the second vascular channel? This is even scarier, okay?"
Many doctors became excited when the topic shifted to the specific skill used in the surgery. However, none of them said anything for the time being.
"Ah, if I were the one who performed it, I might end up constructing that channel until the next day." One resident doctor started the conversation by teasing himself.
"I will also end up doing it until tomorrow night."
"I don't think I can finish it before I faint."
Everyone started to speak.
Microsurgeries were famous for making surgeons exhausted. If they were to compare all microsurgeries, the Achilles tendon surgery was more relaxing. No one would ever think that this surgery, which already had a very complicated design, to begin with, could become even more complicated.
"Wipe sweat." Ling Ran's voice was heard from the display screen. It could be seen that he had used up a lot of his stamina. Sweat beaded on his forehead.
The young nurse who wore the small gray rabbit cap used the gauze to wipe the sweat underneath Ling Ran's small yellow rabbit cap.
The surgery continued.
The young doctors continued with their discussion.
"Wipe sweat." Ling Ran sounded slightly tired.
The nurse with the small gray cap remained energetic.
The fat resident doctor who weighed 225 pounds held tightly on to the mineral water which was half-empty. Right at the moment, he was about to finish the water, his phone rang. "I didn't have a life like that, it will never be my turn"