Chapter 222： Alternate path

The operating room gradually calmed down.

Ling Ran's heart was fiery, his face calmly hugged the blood vessels, pulling and stitching one by one, imagining the appearance of a vascular network in his mind, and constructing it in his hands.

It feels like building a city alone.

There is no certain rule about what the vascular network around the Achilles tendon looks like. Modern medical research is not much-unlike many people imagine, modern medicine seems to have thoroughly studied the human body. In clinical medicine, Most of the information that surgeons get is chaotic.

For example, did the posterior tibial artery radiate three or four perforating arteries? Anatomy shows that some people have three and some have four. why? What is the rule? not very clear. Where is the location and is it regular? not very clear. Does it have other functions, and how does it relate to other human tissues in the feet and legs? not very clear.

Academician Zhu Tongyi's plan, if successful, is used to publish a paper, is to use clinical medicine to explain the vascular network around the Achilles tendon, and explain the importance of the vascular network.

If it fails, there is no need to say more.

Ji Tianlu, who participated in the design of the scheme, was fiery, sending blood vessels to Ling Ran's matchmaking, watching him step by step to connect the broken pipelines, and a smile appeared on his face.

The plan requires maintaining a certain level of vascular network, and at the same time hopes to shorten the operation time, which requires the surgeon's speed to be fast and accurate.

Prior to this, Ji Tianlu made a special inspection tour, and the surgeons who could meet their requirements were almost all famous. This is not surprising. The quick and fierce accuracy they require is not the monkey-type main sword called king in local hospitals, but at least the top level of top hospitals.

Nowadays, young doctors have been climbing the technology tree since their twenties, and they dare to say that they are emerging when they reach the age of 40. They have the skills to perform a series of more important operations.

Among these 40-year-old high-tech doctors, they are also quick and ruthless doctors, and their fame is always significant.

Foreign hospitals are similar, even worse than domestic ones. Their hospital ecosystem is completely market-oriented, and no one will force a doctor to learn basic skills, or modify it, and be able to break through in this area. Either go home from the nightclub at 2:00 in the morning to practice or be superb Gifted talent.

Ji Tianlu did take the opportunity of an international conference to see a talented surgeon in an internationally renowned hospital. However, in the face of these successful surgeons, Academician Zhu Tongyi's plan was simply not attractive.

International surgeons, or sports medicine surgeons, perform operations in countries all over the world all year round. They have no psychological barriers to coming to China. However, the other party's schedule is so full and they earn so much. There is a lack of interest in participating in guided surgery.

No money.

In fact, Liu Weichen doesn't have to wait for a few weeks after the normal schedule for giving money. His high requirements are even more difficult for senior surgeons to agree with.

This is like Wang Haiyang went to Yiyuan County Hospital to make a flying knife. The first thing he asked was the other party's wishes. If the patient has an ultra-conventional requirement, such as wanting to fully restore the function of the finger after re-plantation of the broken finger, then Wang Haiyang must have said nothing and turned away.

Needless to say what the limits of modern medicine are, the surgeon only needs to focus on whether he can meet the needs of the patient. What's the point of forcibly performing surgery if you can't reach it.

Ji Tianlu was originally prepared to persuade Academician Zhu Tongyi to revise the plan.

They did plan B and plan C, but the value of plan A is always the greatest.

Ji Tianlu stared at the unexpected action and suddenly felt envious. Although medical research is the most important part of medical development, in real life, whether it is medical research or clinical medicine, it is ultimately implemented on the implementer.

A highly skilled surgeon is happier than a medical researcher alone.

"If you connect it here, one passage will be completed." Ling Ran's voice interrupted Ji Tianlu's reverie.

"Done?" Ji Tianlu was surprised.

"The first of the two channels, suture for a while ..." Ling Ran was still close to the microscope, while watching and operating, at the same time, he asked for tweezers, and gently clamped the sutured blood vessels. live.

Human blood vessels are very fragile. The blood vessels that can be manipulated are basically only a few aorta of the heart, which is the part of the bovine that is used for yellow throat.

In hand and foot surgery, the practice of clamping blood vessels is always a problem.

Clamping is the first priority, and it is also necessary to not damage the blood vessels. In the face of different thicknesses and different blood vessels, what kind of force should be used to clamp them, as Ling Ran did before, it can only be felt.

The "feel" comes partly from experience and partly from theory. For example, blood vessels that look indistinguishable to the naked eye, if there is a person with arteriosclerosis, it can obviously be clamped a bit more, and it must be clamped a bit more, otherwise the needle will pierce and it will not break.

In general, normal doctors are careful when they perform surgery. They try and try again. Only doctors of a certain level can dare to catch it and do it.

The accumulation behind it is likely to be obtained by hundreds or even thousands of operations.

Ling Ran repeated the previous operation, and the careful two small blood vessels were sutured together.

After completing this step, Ling Ran dropped the equipment and stood up.

"Well?" Ji Tianlu froze for a moment.

"Take a break, you first check the passage." Ling Ran said casually.

Ji Tianlu didn't help for a few days, and people who were taken for granted by Ling Ran were confused. When he looked down and examined the blood vessels, he suddenly thought: Don't I need to rest?

Ling Ran went to the surgical gown and gloves. While rubbing his neck, he turned around and washed his hands again.

Surgical gloves are not durable goods. Generally speaking, the physical properties of gloves will change after more than 3 hours of surgery. In general, they are not so close and there is also the risk of breakage. Studies have shown that when cardiac surgery is done for 3 hours, the perforation rate of gloves is 30%, and when it is performed for 5 hours, the perforation rate is as high as 65%.

In addition, the bacteria on the doctor's hands are also accumulating and prolonging over time.

Therefore, some hospitals recommend that doctors and assistants change gloves when the operation is more than 4 hours, while in the academic community, some people call for 1.5 hours to change gloves.

Ling Ran hadn't paid attention to this information before, in short, he didn't know. It is also relatively busy recently, and he has read a lot of papers before he noticed things in this regard.

Considering the total length of the operation today, Ling Ran decided to change the gloves now and take a good rest by the way.

Although the suture vessels are cool, the energy and energy consumption are also great.

Ji Tianlu carefully examined each blood vessel.

The first aid is to help the main knife to check the vacancies, or to be eligible for the main knife to check the vacancies, has already been paid attention to, and should be happy.

Ji Tianlu did not have a happy thought, but admired it.

How tired are the blood vessels that are so tired on examination?

He used to make bones and joints in the past, but in fact did not have a lot of experience in suturing blood vessels. The process of searching here, he gradually realized the complexity.

The path established by Ling Ran is not a simple loop, but takes into account the imperfect situation of vascular suture-even if the probability is very low, but considering that there are so many breakpoints, if there is only one loop In that case, as long as there is a problem with a breakpoint, the entire suture path is meaningless, which is equivalent to raising the difficulty to the level of replanting the broken finger.

Ling Ran, who has done too much replantation of broken fingers, knows the restrictions of such pathways. Therefore, the pathways he makes are more like an interchange system. It is not useful to simply build a backup blood vessel, because sometimes it may be a systemic injury, such as a fall injury or a collision or sprain during the recovery period, which may cause simultaneous damage to the backup system.

Therefore, the crisscross and alternate blood vessel pathways are the focus of Ling Ran's design.

This makes the stitching more difficult, but also shows the security that the solution does not have.

When Ling Ran came back, Ji Tianlu, who had checked the neck pain, said quickly: "There is no problem with vascular suture. I think the safety of this pathway is sufficient."

The implication is that there is no need to make a backup path.

Ling Ran didn't hesitate, re-dressed neatly, put on new gloves ~ www.novelhall.com ~ said: "Let's take a look."

The two sat back under the microscope, and Ling Ran gently released the clip that caught the posterior tibial artery.

The blood flowed through, was unobstructed, and there was no bleeding.

"No problem?" Lu Wenbin was also quite nervous.

In front of Ling Ran, there were task reminders on display:

Mission "Rise": 75% completion.

75% completion means that Liu Weichen's Achilles tendon function can recover about 75%. In terms of invasive surgery, this recovery ratio is very good. Moreover, if the rehabilitation and exercise in the later stage are done well There will be a certain degree of improvement.

However, to participate in world-class competition with 75% of the Achilles tendon, it is certainly not enough.

It can only be said that the current surgery is done well, but no miracle has occurred.

"Re-establish a backup path." Ling Ran no longer hesitated.