Chapter 221 Weaving Webs

Suturing blood vessels was a very familiar task for Ling Ran.

When he first arrived in Yunhua, the Department of Medical Affairs used to sew up the tail of a rat as a prestige.

Now that I think about it, it is equivalent to letting recruits and special forces compete in sniper shooting, and the difficulty is already at the top of the industry.

However, suturing the vascular network is still a difficult challenge beyond the normal level.

The blood vessels in the feet are thicker than those in the hands, that is to say the main arteries and veins, the perforating arteries that branch off from the posterior tibial or peroneal arteries are not so wild, many of them are thinner than the arteries in the fingers.

And the blood vessel sutures needed to suture the amputated finger are only two or three, three or four.

Of course, the actual difficulty is that it is more difficult to suture severed fingers. Because severed finger sutures have super high requirements on the suture quality of blood vessels, and the tolerance for low-quality sutures is very low. One bad thing is thrombosis and necrosis.

The vascular network around the Achilles tendon does not have such high requirements. Academician Zhu Tongyi's plan a is to rebuild the vascular network. There are three or four perforating arteries on the inner side of the Achilles tendon, and three or four perforating arteries on the outer side of the Achilles tendon. Academician Zhu Tongyi hopes to get two perforating arteries on each side, the lowest one, and ensure the existence of certain small blood vessels. Require.

The most important thing is that even if Ling Ran fails to suture one or two blood vessels, it will not cause too serious an impact, at least it will not cause the failure of the Achilles tendon suture.

As for the failure of the original plan, for such an experimental operation, there will be many explanations for its success, and no explanation for its failure.

Zhu Tongyi quietly stared at Ling Ran's movements, as if he was even more nervous than Ling Ran.

Ling Ran's operations became more and more relaxed.

I saw his wrist was gentle, and his fingers slid lightly under the microscope. With just a few strokes, one blood vessel was sutured, and another blood vessel was pulled out, brushed a few times, and sutured again.

Ji Tianlu hurriedly cooperated, and even the second assistant, Lu Wenbin, kept circling around the operating table, pouring salt water to moisten the blood vessels, making gauze, suctioning, and pulling the hook. status.

Everyone was frowning, carrying the pain of bloody battles and staying up late to make up homework.

Only Ling Ran, who appeared unchanged on the surface, was so happy in his heart.

This is sewing blood vessels for the living.

And being able to sew a net, how cool is that?

If the severed finger was to be replanted, Ling Ran would have to carefully debride the wound first, then fix the bone, then suture the tendon, and only then would he have the opportunity to play with the two or three most critical blood vessels. After playing, sew up the nerves and throw the slits to other animals.

From Ling Ran's point of view, debridement is not so interesting anymore. Internal fixation of bones is more like carpentry. If the tendon is sutured, the flexor tendon is still fun, but the ordinary tendon is useless. The remaining blood vessels and nerves are considered The most interesting part of finger replantation.

And today, what kind of situation did Ling Ran encounter?

There is a large network of blood vessels, and the thin and small blood vessels are difficult to suture.

It was equivalent to taking out the most essential part of replanting severed fingers for Ling Ran to play with.

Ling Ran's mood, let alone how happy he was.

This is no rat tail in the practice room. Perhaps for a novice, being able to sew a rat once is already a very happy thing, however, Ling Ran has already passed that novice stage.

There are living people who can suture, and there is one assistant and two assistants to cooperate, there are equipment nurses to pass things, and there are patrol nurses to help suture. It is much more comfortable than sitting alone in the practice room alone.

"Change to a thinner suture." Ling Ran had fun, and sutured three perforating arteries in one go. Facing the thinner fourth one, he simply changed the suture again.

Academician Zhu Tongyi had to remind him, "Your key is to pay attention to dynamic balance."

The implication is that it is impossible for him to re-suture the entire vascular network, and he can only select important blood vessels to form a barely usable vascular network.

It's like after a war, most of the originally meticulous and orderly logistics lines were destroyed. The task of the general in charge of rebuilding is not to restore every original logistics line little by little, but to focus on restoring one The supply chain is to ensure the supply of the most important materials, and the recovery of the rest of the supply chain can be handed over to other people, and it will take a longer time to proceed slowly.

Ling Ran understood Zhu Tongyi's order very well. He nodded and explained, "I want to make an extra backup path."

Unlike ordinary "generals", Ling Ran, who is in good condition, not only wants to restore one supply chain, he also wants to create another one.

"Is it in time?" Zhu Tongyi looked up at his watch, his expression relaxed a little.

Ordinary Achilles tendon surgery takes about one or two hours, and the time on the operating table can be as long as two hours and as short as thirty or forty minutes.

Zhu Tongyi's plan a is much more complicated. He plans to give the chief surgeon four hours of operation time. This time is not casually stated, but a "dynamic balance" based on the degree of Achilles tendon exposure and so on.

If the time is too short, the surgeon cannot complete the operation; if the time is too long, the effect of the operation may be compromised.

Now, seeing that the operation is going well, Zhu Tongyi hopes to finish the operation within three hours, so as to ensure a more efficient recovery.

Looking at Ling Ran's progress, Zhu Tongyi felt very hopeful. Even if he made another backup path, it would be possible if he could maintain the current speed.

Considering that there will be no benefit if the operation is completed too early, Zhu Tongyi might as well agree with Ling Ran to sew a few more blood vessels.

Ling Ran is also very familiar with Zhu Tongyi's plan. His eyes were fixed on the microscope, and he didn't want to leave. He said, "We don't cut many small blood vessels, and we hope to restore 30 to 40 percent of the vascular network. Restoring more will be beneficial." right?"

"Of course, but we must ensure the quality as much as possible." Zhu Tongyi reminded that "the risk of spasm still exists, and only the blood vessels that are opened are useful blood vessels."

The more blood vessels that are restored, the more nourishment the Achilles tendon will receive as it recovers.

The reason why minimally invasive Achilles tendon surgery can be discharged from the hospital quickly and try to recover is because the vascular network around the Achilles tendon is still there. As long as the Achilles tendon is sutured and the adhesions are dealt with, it can be restored to its original state.

Large open surgery to ensure the strength of the Achilles tendon does not have such an advantage, especially for some special approaches, such as Achilles tendon repair with a posterior median incision, the complications are obviously higher than that of the Achilles tendon Midsection incision. The reason is that the blood supply of the latter is less, and the blood vessels destroyed by the incision are less.

In Zhu Tongyi's plan, the sutured blood vessels must have a certain quality in order to play a role.

The quality of blood vessels does not need to be as high as that of replanted severed fingers, but it must be of a certain quality.

In fact, Zhu Tongyi's plan A was to suture Liu Weichen's Achilles tendon and replant the Achilles tendon, which made the difficulty more than tenfold. It is even more difficult to maintain quality and quantity.

Zhu Tongyi looked at the young Ling Ran, afraid that he would lose his temper or lose his focus.

This is the most common problem with young people.

Once words such as so-called rough and impetuous appear in blood vessel sutures, problems will arise.

Ling Ran didn't care about Zhu Tongyi's instructions at all, he stitched up the blood vessels steadily, and said, "Guarantee the quality."

At this moment, Ji Tianlu couldn't help but raised his head and said, "Doctor Ling is fine."

Zhu Tongyi came to his senses, and quickly said, "If you care, you will be chaotic. I care a little too much about our plan."

In the classroom.

Hearing the head of the research center, Academician Zhu Tongyi, the absolute banner, say such words, the doctors were already in an uproar.

Dr. Qu couldn't hold back the emotions in his heart anymore, and said angrily, "It's really a foreign monk who is easy to chant scriptures, and the director is also very easy to talk."

"That is to say, the tone is wrong."

"Hey, hey, don't go online, our academician Zhu didn't say anything, did we?"

"What do you want to wish the academician? What you said is enough. You have to understand that the plan is our wish for the academician. This is to guide the operation, and Ling Ran is just the chief surgeon."

The 203-jin resident doctor hugged the mineral water and smirked, "Is Ling Ran just the chief surgeon? That's all?"

The few doctors who were still impassioned just now wisely shut up.

It is very difficult to show off among colleagues, let alone a professional doctor in a department.

If you are facing outsiders, you may still have something to say, but when you are facing your own people, you will be relatively clear about your respective positions.

Ling Ran's main surgeon can be said to be handed over by the research center, or it can be said that the research center was supported because the research center couldn't find anyone.

But no matter how you look at it, Ling Ran currently occupies the strongest position.

The 203-jin resident doctor is unwilling to belittle his opponent.

He is also afraid of the strength of his opponent, but he is willing to face up to the gap between himself and Ling Ran. Ling Ran's skills are strong, his talent is good, he may be a first-class surgeon in the country, but...doctors will continue to grow!

The 203 catties resident doctor has already set a detailed goal for himself, and just waiting for this matter, he will practice in seclusion and use the shortest time to catch up with Ling Ran's skills.

At that time, he will definitely look for another chance to defeat Ling Ran, and bring a pair of purebred French lop-eared rabbits to find Xiaoyun.

The 203-jin resident doctor thought of this, excitedly poured a full bottle of Nongfu Spring, and comfortably burped like a 204-jin fat man.

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