Great Doctor Ling Ran Chapter 526
"Even though the damage to the patient's index finger is relatively serious, it isn't considered that serious among fingers that require ectopic transplantation. It is a lot more serious than severed fingers that can be fixed by finger replantation surgery, though. Under these circumstances, when performing ectopic transplantation, we should prioritize the facilitation of healing using the flap." Wang Haiyang who was acting as the chief surgeon was high-spirited.
Ectopic transplantation could be considered one of the toughest microsurgeries.
Because of this, it could also be considered one of the toughest medical procedures in human history.
And this was one of the reasons why the Hand Surgery Department of Yun Hua Hospital was renowned.
Of course, it was tougher to perform ectopic transplantation of palms and arms compared to fingers. But it still showed how skilled those in the Hand Surgery Department of Yun Hua Hospital were.
The difficulty level of the surgeries and the various problems faced during post-surgical care were basically the same, with a little bit of quantitative difference.
Even if you disregard the skills of the surgeons, most hospitals in the country would still be unable to perform ectopic transplantation due to their inability to provide adequate post-surgical care. Even hospitals in Beijing and Shanghai might not be able to carry out such surgery if the doctors in their Hand Surgery Department or Orthopedics Department were not professional enough.
Wang Haiyang who had mastered ectopic transplantation had the right to flaunt his skills.
He was one of the pioneers in Yun Hua Hospital when it came to research regarding ectopic transplantation twenty years ago.
Wang Haiyang said as he looked at Ling Ran, "This is the basis of ectopic transplantation. The first key question is, how do we choose the appropriate spot to create a flap?"
"Usually, when it comes to ectopic transplantation of fingers, it would be easier to get a desirable result by creating the flap on the radial artery, instep or ulnar artery. This is because the structure and function of these parts are similar to those of fingers. We'll be creating the flap on the patient's instep today.
"The three aims of ectopic transplantation is to rebuild the blood circulation, repair the tissues and recover the function of the severed fingers. Usually, the first transfer would determine the success of the ectopic transplantation."
Wang Haiyang found it extremely addicting to provide guidance to "Doctor Ling".
By this time, Guan Fei was already done disinfecting the patient's foot.
Guan Fei wore a strange expression as she gazed at the patient's little foot. "Are we growing the index finger on the patient's instep?"
Wang Haiyang who had just uttered a long string of sentences was planning what to say next. He immediately glanced unhappily at Guan Fei who cut him off and asked, "Do you want to listen to me or not?"
Wang Haiyang was relatively patient toward beautiful young women. If an idiotic male intern were to say what Guan Fei did, Wang Haiyang would not have even asked him whether he wanted to listen. He would have just said, "Get out of here." He would not have said "fuck off", as there was less testosterone in his body now that he was older, which made his temper better.
Guan Fei who did not really know how to hold her tongue had met Chief Physician Wang Haiyang a few times. She had always seen him as a chief physician with a good temper. She did not expect to be scolded this time around.
Guan Fei could not help but lower her head. It was obvious that she was not completely used to the environment of the hospital even after spending a year here doing her internship.
Wang Haiyang turned away after he was done scolding Guan Fei.
He was not in the mood to enjoy the sight of this beautiful young woman.
At this moment, Wang Haiyang was indulged in the most mysterious, joyful and elusive feeling that a Chinese could feel: being a teacher.
Wang Haiyang happily raised his head and asked Ling Ran, "Doctor Ling, you should have no problem making a flap, right?"
"Do I cut open the muscle tissue and make a flap? I can do this."
"If you have the choice, where would you make the flap?"
Ling Ran said as he recalled, "Somewhere that's connected to the dorsal artery, I guess."
"Hmm, not bad. Did you come out with this, or did you read this somewhere before?"
"I read about it once." This time, Ling Ran could answer this question because he had been reading up on the subject.
Not only could bottles of Energy Serum give him more energy to carry out surgeries, but it could also make him focus better when studying.
As a young doctor, Ling Ran could still use a lot of studying.
It was very normal for an established doctor to need to read a stack of books that added up to his own height in order to level up.
Wang Haiyang stomped his foot hard against the ground. "That's right. Looks like Doctor Ling came prepared. Alright, let's carry on. The second transfer is a very important and difficult part of ectopic transplantation. Usually, if the situation calls for it, we'll remove the pedicle flap with the transplanted finger attached to the flap. This is mainly to ensure the connectivity between the blood vessels in the transplanted finger and the dorsal artery"
Wang Haiyang gave a very detailed explanation. He never even bothered being so detailed in the Hand Surgery Department.
Everyone, including Ling Ran, Lu Wenbin, and the medical interns listened very earnestly to him.
However, Ling Ran was the only one who was truly qualified to carry out ectopic transplantation.
Among the other people, even Lu Wenbin who was the best in finger replantation surgery had never carried it out alone. Hence, it was impossible for him to carry out ectopic transplantation, which was way tougher compared to finger replantation surgery.
Wang Haiyang spent half an hour explaining things before getting started.
Of course, he never stopped speaking when he was carrying out the surgery. It was to the point that the nurses often had to hold up a water bottle in front of him so that he could soothe his throat.
Wang Haiyang was so excited that there was no stopping him at all.
After Wang Haiyang was done making the flap, he was feeling so good that he could hardly contain himself from stripping around naked and dancing around the operating theater.
"Not bad at all. The ectopic transplantation today is going pretty well." Wang Haiyang, who was the chief surgeon today, held all the power, and due to the fact that Ling Ran, who did not utter a single word, executed the great spoon-feeding technique to the surgery, he put on such a good performance that he himself was shocked.
Surgical skills were related to one another, after all. Even though Ling Ran did not know how to carry out ectopic transplantation, he possessed experience in one hundred feet anatomical dissections and three thousand upper limb anatomical dissections. With such abundant anatomical dissection experience, Ling Ran could tell from one glance how the tissues around a blood vessel were like. It was to the point that he only needed to glance at the muscle tissue and tendons around the blood vessel to know how much stress would be exerted on the blood vessel if he were to move those tissues.
This basic knowledge, coupled with Wang Haiyang's detailed explanation, allowed Ling Ran to have a grasp of how ectopic transplantation was like as a whole, even though he did not really know the exact steps of the surgical method. This was why he was able to perform so well as Wang Haiyang's assistant that Wang Haiyang felt as if he was on cloud nine.
Theoretically, unless Wang Haiyang was 80% as skilled as Ling Ran, put full focus into carrying out the surgery speedily and allocated all the miscellaneous tasks to his assistants, Ling Ran's presence would contribute greatly to the progress of the surgery. Besides, after Ling Ran participated in a few more ectopic transplantations and acquaint himself further to the surgical method, even if Wang Haiyang were 90% as skilled as Ling Ran, Ling Ran's presence would still contribute greatly to the surgery.
Assistants were under a lot less pressure compared to chief surgeons to begin with.
Chief surgeons had to take all kinds of things into consideration, such as the patient's condition, how much stress the tissue they were working on could take and the steps that had to be followed during the surgery. All the assistants had to do was to work together with the chief surgeons.
Sometimes, ordinary junior attending physicians or resident doctors might not be able to work together well with the chief surgeons. This rarely happened when senior attending physicians who had been carrying out surgeries for a number of years acted as assistants.
After working on the ectopic transplantation for a while, Wang Haiyang felt extremely good. He looked around and said to someone he knew, "Doctor Zuo, can you go over to the Hand Surgery Department and ask the doctors of my treatment group to come over to watch this surgery?"
Zuo Cidian had nothing to do after he was done debriding one of the fingers a while back. He immediately answered, "Only doctors from your treatment group?"
"Doctors from other groups can come over too if they want to. Oh, by the way, you can also ask doctors who had just transferred to the Hand Surgery Department as well as medical interns to come over. After all, cases of ectopic transplantation are quite hard to come by." Wang Haiyang decided to show off in front of more people so that he could feel even better.
To be watched by other doctors when surgery was going well was the best part of being a surgeon.
Correspondingly, surgeons hated it the most when they performed badly with other people around.
Zuo Cidian reluctantly took a few steps backward and left the operating theater.
He kind of wanted to finish watching this surgery too. Like what Wang Haiyang said, cases of ectopic transplantation were pretty hard to come by. Besides, under usual circumstances, chief physicians like Wang Haiyang would not have so much patience to provide such a detailed explanation.
Most surgeons preferred to engage in small talk when they were carrying out surgeries.
They only provided guidance when they were in the right mood.
Wang Haiyang would not have provided such detailed guidance if Ling Ran was not here today.
After a short while, doctors from the Hand Surgery Department entered the operating theater one by one.
The circulating nurse drew a boundary in front of the operating table in a panic and set a limit to the number of people allowed in the operating theater. In the end, Xiang Xueming and the other medical interns were chased out of the operating theater.
Wang Haiyang could not have cared less. All he wanted was for there to be people around to admire his skills. The fact that so many people were taking turns to watch the surgery made him feel even better, and even his voice had become louder. "It's not easy to suture the blood vessels of children to begin with. This young patient is only ten years old. You don't often get to see ectopic transplantation performed on such a young person.
"If I'm not mistaken, the youngest patient who had received ectopic transplantation in our hospital was seven years old. The result was mediocre. However, technology has evolved a lot since then. Even microscopes nowadays are a lot better. Unfortunately, my eyes are getting old
"I reckon that this surgery will take three hours. Whoever wants to pee, please do it now. I don't want you guys to pee in my operating theater. I'm just joking, you guys can pee into your diapers. Please don't pee too much too, because if your pee ends up dripping on the floor, you will have to lick it clean with your tongues."
Ling Ran pondered as he listened to everything Wang Haiyang was saying.
As the surgery progressed, he had become even more familiar with the surgical method. Hence, he began operating with even more ease.
Now that he was not under so much pressure, he had more time to think about things.
Ling Ran did not expect the system to give him the ability to carry out ectopic transplantation either. This was why he was earnestly trying to pick up the surgical method with his own effort. In truth, most doctors who knew how to perform ectopic transplantation were pushing their own boundaries when they did it for the first time.
The demand for ectopic transplantation was so low that a surgeon who had performed three to five cases of ectopic transplantation could call himself a national expert.
Of course, there were surgeons who had performed more cases of ectopic transplantation than that. However, at the end of the day, even though ectopic transplantation belonged under the umbrella of hand surgery, it was mostly used in emergency situations. Even doctors who were extremely good at it might not be able to put his skills to use for long stretches of time.
Right now, Ling Ran was already more skilled in ectopic transplantation compared to most doctors who had done it. The only thing he lacked compared to those doctors was experience.
"Make sure that the blood vessels of the transplanted part match well with the blood vessels of the finger. It must be a spot that's easily reachable, as this would be beneficial when we carry out the second transfer.
"Try your best to match the thickness and color of the flap to the finger too."
"There's no need to give too much consideration to the supply area, as we are only removing a small part of it. It wouldn't affect the supply area much."
Wang Haiyang was so excited that he started swinging the surgical instrument in his hand in the air.
The doctors around them had their gazes fixed on the operating theater as well as Ling Ran.
A few young medical interns who were standing at the back could not see the operating area clearly. Hence, they merely looked at Ling Ran and whispered to one another.
"Doctor Ling looks truly handsome when he's operating on a patient."
"Look at the way Doctor Ling holds the pair of forceps. Wow, he looks so professional."
"Look at the way he stands. In my opinion, we should leak the footage of Doctor Ling operating on patients. This would solve all doctor-patient disputes."
"I think this would increase the number of doctor-patient disputes. Some promiscuous women would probably place a curse on their husbands so that those men would die. After that, they would sue Doctor Ling and ask for his hand in marriage as compensation. Oh my, I even came out with an entire plot"