Chapter 222: Alternate Pathway

The operating room gradually returned to calm.

Ling Ran's heart was hot, and he calmly hooked the blood vessels, pulling and suturing them one by one, imagining the appearance of the blood vessel network in his mind, and constructing and implementing them in his hands.

There is a feeling of building a city by one person.

Is there a certain rule for the vascular network around the Achilles tendon? There is not much research in modern medicine—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, are there three or four perforating arteries radiating from the posterior tibial artery? Anatomy shows that some people have three roots, while others have four roots. Why? What is the law? not very clear. Where is the location and is there a pattern? not very clear. Does it have other functions, and what is its relationship to other body tissues in the foot and leg? not very clear.

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

If it fails, it goes without saying.

Ji Tianlu, who participated in the design of the scheme, was very enthusiastic. He sent blood vessels to Ling Ran and watched him connect the broken pipelines step by step, with a smile 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 to be fast enough and accurate enough.

Prior to this, Ji Tianlu made a special investigation, and almost all the surgeons who could meet their requirements were relatively well-known. This is not surprising, the speed, ruthlessness and accuracy they require are not the monkey-shaped chief surgeons who are called kings in local hospitals, but at least the top level of top hospitals.

In this day and age, young doctors start to climb the technological tree in their twenties, and they dare not say that they are budding until they are around 40 years old. They have skills and are able to perform a series of more important operations.

Among these high-tech doctors who are in the prime of their 40s, they are fast, ruthless and accurate doctors, and their reputation is always important.

Foreign hospitals are similar, even better than domestic hospitals. Their hospital ecosystem is completely market-oriented, and no one will force a doctor to learn basic skills, or make improvements. Those who can break through in this area, either come home from the nightclub at two o'clock in the morning to practice on their own, or they are excellent. Gifted genius.

Taking advantage of the opportunity of the international conference, Ji Tianlu did meet talented surgeons in internationally renowned hospitals. However, in the face of these accomplished surgeons, Academician Zhu Tongyi's plan is not attractive at all.

International-level surgeons, or sports medicine surgeons, perform operations all over the world all year round. They have no psychological barriers to coming to China, but the other side has such a full schedule and earns so much , lack of interest in participating in guiding surgery.

Even giving money will not work.

In fact, Liu Weichen doesn't even have to wait until a few weeks to arrange the schedule for money. His high requirements are even more unapproved by senior surgeons.

It was like when Wang Haiyang went to Yiyuan County Hospital to make flying knives, the first thing he asked was the other party's wishes. If the patient has an unconventional request, such as wanting to fully restore the function of the finger after replantation, Wang Haiyang will definitely turn his head and leave without saying anything.

There is no need to say what the limit of modern medicine is. Surgeons only need to pay attention to whether they can meet the needs of patients. What's the point of going for an operation if you can't achieve it?

Ji Tianlu was already planning to persuade Academician Zhu Tongyi to revise the plan.

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

Ji Tianlu stared at unexpectedly's movements, and suddenly felt a little envious. Although medical research is the most important part of medical development, in real life, whether it is medical research or clinical medicine, it must be implemented by the person who implements it.

A skilled surgeon is much happier than a mere medical researcher.

"If they are connected here, a passage will be completed." Ling Ran's voice interrupted Ji Tianlu's reverie.

"Is it finished?" Ji Tianlu was a little surprised.

"The first of the two passages, suture a section..." Ling Ran was still leaning against the microscope, operating while watching. At the same time, he asked for tweezers in a calm voice, and gently clamped the sutured blood vessel firmly. live.

Human blood vessels are very fragile, and the blood vessels that can be played with are basically only a few aortas in the heart, which are the parts used to make yellow throats in cattle.

However, in hand and foot surgery, the practice of clamping blood vessels is always a topic.

Clamping is the first priority, and it is also necessary not to damage the blood vessels. Faced with the blood vessels of different thickness and different people, what kind of strength should be used to clamp, just like what Ling Ran did before, can only be based on feeling.

"Feeling" comes partly from experience and partly from theory. For example, if there is a person with atherosclerosis of blood vessels that look indistinguishable to the naked eye, it is obviously possible to clamp them harder, and the clamp must be stronger, otherwise the needle may not be able to pierce it.

Generally speaking, normal doctors are cautious when performing surgery, trying again and again. Only doctors who have reached a certain level dare to do it immediately.

The accumulation behind it is likely to be obtained through hundreds or even thousands of surgeries.

Ling Ran repeated the previous operation, carefully suturing the two small blood vessels together.

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

"Huh?" Ji Tianlu froze for a moment.

"Take a break, check the passageway first." Ling Ran said very casually.

Ji Tianlu hadn't been a helper for a few days, and the people who were taken for granted by Ling Ran became confused. When he lowered his head to check the blood vessels, he suddenly thought: Don't I need to rest?

Ling Ran went to the surgical gown and gloves, massaged his neck, turned around and went out to wash his hands again.

Surgical gloves are not a durable product. Generally speaking, after more than 3 hours of surgery, the physical properties of the gloves will change. Generally speaking, they are not so close to the hand, and there is a risk of damage. According to a study, the perforation rate of gloves is 30% when the heart surgery is performed for 3 hours, and the perforation rate is as high as 65% when it is performed for 5 hours.

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

Therefore, some hospitals recommend that doctors and assistants change gloves when the operation exceeds 4 hours, while in the academic circle, some people call for changing gloves within 1.5 hours.

Ling Ran didn't pay attention to this information before, in short, he just didn't know. It was also recently that he was relatively free and read more papers, so he noticed this aspect.

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

Although it is cool to sew blood vessels, it consumes a lot of energy and attention.

Ji Tianlu carefully checked each blood vessel.

The first aid is to fill in the gaps left by the chief surgeon, or in other words, the one who is qualified to fill in the gaps left by the chief surgeon is already valued first aid, and he should be happy.

Ji Tianlu didn't have the idea of ​​being happy, but he had some admiration.

It is so tiring to check blood vessels, how tiring is it to suture?

He himself used to do bone and joint work, but he didn't actually have a lot of experience in suturing blood vessels. During the search process here, he gradually realized the complexity inside.

The pathway established by Ling Ran is not a simple loop, but takes into account the situation that there are imperfect sutures in blood vessels - even if the probability is very low, but considering that there are so many breakpoints in the suture, if there is only one loop If so, as long as there is a problem with one breakpoint, the whole set of suture pathways will be meaningless, which is equivalent to raising the difficulty to the level of replanting a severed finger.

Ling Ran, who has done a lot of replanting of severed fingers, is well aware of the limitations of such a passage, so the passage he made is more like a set of interchange systems. It is useless to simply establish a backup blood vessel, because sometimes it may be a systemic injury, such as a fall or bump or sprain during the recovery period, which may cause damage to the backup system at the same time.

Therefore, the criss-crossing blood vessel access that can replace each other is the focus of Ling Ran's design.

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

When Ling Ran came back, Ji Tianlu, who had already noticed a pain in his neck, said hastily, "There is no problem with the suturing of the blood vessels. I think the safety of this passage is enough."

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

Ling Ran was noncommittal, dressed neatly again, put on new gloves, and said, "Let go and have a look."

The two sat back under the microscope, and Ling Ran gently loosened the clip that was holding the posterior tibial artery.

The blood flowed well, was unobstructed, and did not ooze.

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

Before Ling Ran's eyes, there was a task reminder:

Task "Upcoming": 75% completion.

The completion rate of 75% means that Liu Weichen's Achilles tendon function can recover about 75%. In terms of invasive surgery, this recovery rate 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, it is definitely not enough to participate in world-class competitions with 75% of the Achilles tendon.

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

"Build an alternate path." Ling Ran no longer hesitated.