Chapter 220： Vascular network

Once Ling Ran started the operation, she was extremely focused. ｛Щww {suimеng] [lā}

The average operation time for Achilles tendon repair is very short, such as the five he performed last night, plus the two operations performed this morning, a total of 7 operations, which took less than 7 hours.

Of course, the length of each operation is a bit longer. After all, there is preparation before surgery and suture after surgery, but it is not necessary to participate in Ling Ran. It was when the medicine was fed that Ling Ran began to appear in the operating room.

And his work mainly started from the moment the incision was opened.

"Pull it apart." Ling Ran dropped the scalpel and, with Ji Tianlu, pulled the skin outside Liu Weichen.

"It was also the same when we slaughtered sheep in our hometown." Ji Tianlu suddenly said something, which was the beginning of a moment in the operating room.

Ling Ran kept silent, as he had done before.

Lu Wenbin quickly joined in, asking curiously, "How long is the Achilles tendon of a sheep?"

"I don't know, it's not delicious anyway." Ji Tianlu said with a skeptical, "Sheep hoof is the most unpleasant. Well, the Achilles tendon is quite long."

However, Ling Ran clamped the exposed Achilles tendon with tweezers.

"The broken end is like a ponytail." Zhu Tongyi frowned as expected.

This is the worse type of tendon rupture.

"Cut it off." Ling Ran erected the portion of the tendon that had become ponytail-shaped, looked it over twice, and then cut it straight with scissors.

"Cut it off." Zhu Tongyi still hugged his chest, watching Ling Ran's operation.

For ordinary people, it is not necessary to cut off the ponytail-shaped tendon suturing. Some surgeons are used to using it as the material for strengthening sutures.

However, athletes have different requirements for tendons. Such scattered tendons are not enough to support high-intensity training, that is, parts that are not conducive to competitive sports can only be cut off.

"Dalang's tendon is three centimeters less." The anesthesiologist did his job, looked up, and was a little curious.

Lu Wenbin turned the tray and said, "It's almost, maybe more than that."

"Can you continue to run this way?"

"If the stitching is good, it won't be a problem." Zhu Tongyi's answer was positive, but the content was full of uncertain factors.

For the final question and answer, the people in the operating room showed concern, indicating that the audience in the classroom was more concerned.

Zhu Tongyi's plan is not confidential at the Bone, Joint and Sports Medicine Center, and many senior residents have been in contact. Therefore, when Zhu Tongyi said "good stitching", many people's faces were not very good.

"It seems to be using plan a."

"A bit perverted."

"Can you do that?"

Several doctors couldn't help whispering.

"How is scheme a perverted?" A little nurse sat at the desk in Shi's classroom and asked the attending doctor nearby.

The request of the young and lively girl cannot be refused by the 30-year-old man. The attendant showed a single smile for 30 years and said, "I wish Academician a plan to provide blood supply. This will ensure the strength of the tendon after being pulled."

"and then?"

"Then?" The governor smiled and said, "Then he put his hands and feet together."

"why?"

"Because ..." The attendant didn't know what to say, thought about it, and said, "Let's say, the blood supply on the inside of the Achilles tendon comes from the posterior tibial artery, and it is divided into three to four perforating arteries. You can't see the blood vessel area on the outside of the Achilles tendon, but the source is the peroneal artery. You have to bypass them. "

"A total of 8 small blood vessels need to be bypassed?"

"There are countless small branches of small arteries. Academician Zhu also hopes to go around and keep the vascular network around the Achilles tendon. The blood vessels supply the Achilles tendon, the vascular network is maintained, and the nutritional supply of the Achilles tendon is large. It can be recovered faster, a bit of open surgery, and then the effect of minimally invasive surgery is obtained. The idea is very good, but it is basically impossible to achieve. "The attendant laughed loudly.

"It's more than just a good idea, it's idealistic." Another hospitalization felt the same.

The 202-pound resident doctor gurgles mineral water and says sadly: "It is always good to have an ideal. When the academician made the plan, he also knew the difficulty, so he pushed it to the present."

"It's useless after 10 years. Can you believe that you can avoid the whole network of blood vessels? Impossible. Even with machines like DaVinci, all the blood vessels are marked. It ’s going to be cut off. Everyone ’s blood vessels are in different positions, so it ’s better to avoid them. ”

"So, in plan a, I remember to say that the vascular network should be restored at the end. If there are too many small blood vessels inadvertently cut, do you need to perform vascular suture?"

"Neuropathy!" The attendant scoffed. He did not have any views on the plan itself. On the contrary, the attendant had a considerable understanding of the terrible and useful role of the plan.

The so-called vascular network is really a fine and dense network structure.

In theory, small blood vessels are compensatory, that is, they are cut open. After a period of time, the body will configure the blood vessels and reconnect them.

Academicians wished to believe that such compensation was too slow, affecting both the speed of recovery and the quality of recovery.

The location of Achilles' heel is precisely where the human blood supply is the worst. Here, a destructive open operation is performed, but the result is fast recovery and high-quality recovery.

It can be seen from the effect of the Achilles tendon minimally invasive surgery that ordinary people often do. Because the minimally invasive surgery retains the tissue around the Achilles tendon as much as possible, the recovery is not only fast, but the quality is also very good.

However, minimally invasive surgery cannot achieve the effect of high-intensity suture of the Achilles tendon. Therefore, Academician Zhu Tongyi's plan is simply an open minimally invasive surgery.

In the case of incomplete theoretical foundations and inadequate equipment, the hope is based on the surgeon's own technical level to achieve the goal.

This mode of thinking is also what Zhu Tongyi tried many years ago. Sometimes it fails, sometimes it succeeds.

But whether it is a success or a failure, the difficulty of the solution is obvious.

The scorn of the attendants and others is actually because they have a great understanding of the difficulty of the plan.

The surgeons at the research center are like a student who has a good academic performance on weekdays. He took a math test with confidence and found that there was a transfer student's nest behind the classroom to brush the math.

Even if it ’s not a professional Achilles tendon repair, even if you do n’t plan to eat by the Mathematical Olympiad, but for the doctors of the Bone Joints and Sports Medicine Center, basic shame and compassion are indispensable.

Even the 202-pound resident was a man with both strength and perseverance. He had gained weight except drinking water, and had no weaknesses.

The tortured body experience has never been manifested by many surgeons here.

It can be said that none of the doctors at the Bone, Joint and Sports Medicine Center are weak, but neither is a surgeon who can do wonders.

There are not many surgeons like that around the world.

And most doctors don't even think about it at all.

"Microscope." Ling Ran strictly followed the plan and began to loosen the Achilles tendon more carefully, so as not to suture for a while and break more blood vessels.

This is a serious and meticulous job, and I don't know if it will work.

However, since Ling Ran believed in Zhu Tongyi's plan, he completed it as perfectly as possible.

Trivial work, seemingly endless, makes people look bored.

Ling Ran was silent and silent.

Little by little, little by little, slowly accumulating workload.

When Ling Ran really started to suture the Achilles tendon, many of the doctors who watched melon didn't even wake up.

"The Achilles tendon has been stitched up." Ling Ran's movements were extremely skilled, and it took only a few minutes to pull the Achilles tendons that others have been playing with for a long time.

However, for this operation, although the core of the operation is suture of the Achilles tendon, the difficulty of the operation is the reconstruction of the vascular network.

"It's really complicated." Ji Tianlu looked into the microscope and saw a broken but unclear vascular network, a lawsuit against his brain.

Blood vessels injured due to rupture of the Achilles tendon, blood vessels that were cut because of an open wound, blood vessels that were torn due to pulling the Achilles tendon, etc., just diffused a scarlet field, like a complex set of domino ~ www.novelhall.com ~ It was ruined by accident.

To restore the vascular network is to hope that with a minimum amount of work, a usable domino can be reformed.

This work has a larger workload than the replantation of broken fingers, and whether it can be successful is a matter of opinion.

"It's started." Ling Ran was still silent, straightening the microscope and getting busy.

Ji Tianlu looked up at the time, bowed his head silently, and decided to cooperate with Ling Ran to do a good job.

In the classroom, the doctors who watched for more than an hour couldn't help but yawned. However, the expressions they looked at Ling Ran changed unexpectedly. The vascular network is just dazzling enough to see the complicated scene, let alone, Ling Ran is not simply restoring the vascular network.

He must rebuild it, not only to allow it to show its immediate combat power, but also to allow it to heal and expand.

The surgeons who visited the site suddenly realized that the maths volumes you saw might also be graded.