Chapter 140: Watching!
“Hook it down a little further, expose more of the tendon’s path, so I can suture it!~”
“Yes, just like that.”
“Thank you, Director Song.” Chen Song’s tone was polite yet unyielding.
The shadowless lamp not only cast no shadows on the patient’s wound but also illuminated Lu Cheng’s hands, held above the wound, with extreme clarity.
Handling limb replantation is far more difficult than simple tendon suturing, and it takes considerably longer.
The muscles and tendons alone that require suturing are numerous, and they also need trimming and preparation before suturing.
However, the tendon suturing and handling in limb replantation are derived from tendon suturing techniques and do not require significant adaptation.
As Lu Cheng was nearing the end of his tendon suturing, the microsurgical instruments arrived in room three, with the circulating nurse and Xiang Pengcheng setting up sterile sleeves on the side.
The circulating nurse, Lan Yueru, recognized Lu Cheng. As the surgery entered its groove, she quietly asked with gossip, “Doctor Xiang, when did Doctor Lu learn limb replantation?”
Xiang Pengcheng glanced at Lu Cheng, his Adam’s apple bobbing, “I don’t know either. He went to the Emergency Department in July!”
“Later, I only heard that Lu Cheng was doing tendon suturing in the Emergency Department; I never heard that he also did limb replantation.”
“In the last two months, after Professor Tong Yuan’an from Xiangya Hospital came, Ward One performed a few cases. Perhaps Lu Cheng also participated in the surgeries?”
Actually, Xiang Pengcheng was mistaken. Lu Cheng did not participate in the surgeries, but whether he participated or not was not important; what was important was that Lu Cheng could be the chief surgeon for such an operation.
The ability to perform is the fundamental logic.
If Lu Cheng can still be the chief surgeon after Tong Yuan’an leaves, then how the orthopedic department’s landscape will change in the future is unpredictable.
Hospital leadership would not tolerate a doctor who can perform limb replantation being idle!
One hundred percent, they’ll be covered.
The County Health Bureau would also not allow such a situation to exist.
Long County would definitely want to snatch the title of the first unit to perform limb replantation in XXzhou County People’s Hospital. This is their legitimate “performance” and “reputation” in the open.
At this moment, Xiang Pengcheng even imagined Lu Cheng possibly returning to Orthopedics to lead a team, or leading a team under someone else’s name.
No one can stop him because everyone else won’t.
Lan Yueru secretly glanced at Lu Cheng again, her eyes sparkling, and said, “Is limb replantation a particularly difficult surgery in Orthopedics?”
“With such ability, if Lu Cheng wanted to go to Xiangzhou Traditional Chinese Medicine Hospital, it would be easy!~” Xiang Pengcheng replied cryptically.
Nothing else, it’s just a comparison.
Xiangzhou Jishi City has several tertiary hospitals, all claiming to be the top brothers. Brother Xiangzhou People’s Hospital and Second Brother Jishi People’s Hospital can now perform limb replantation.
The Third Brother can’t do it yet, but he definitely wants to, possibly dreaming about it every night, constantly trying to learn, but still hasn’t succeeded.
After another fifteen minutes or so, Lu Cheng picked up the mirror and, after asking the circulating nurse for vascular suture material, placed the needle holder and suture into the curved tray.
He meticulously checked the severed ends of the blood vessels again.
Seeing Lu Cheng about to pick up the needle holder again, Song Hongtu cautiously advised, “Xiao Lu, if you need to revise after the needle is inserted, the difficulty won’t be small?”
Lu Cheng nodded, “I know, Director Song.”
“This is an anastomosis of the brachial artery; the required immediate patency rate may not be as high as for digital artery suturing.”
“Even if a branch anastomosis is completely interrupted, it won’t affect local viability. As long as the immediate blood flow rate of the main branches is above ninety percent, it won’t affect distal viability.”
“It’ll be fine!~”
Lu Cheng didn’t dare to guarantee that his current suturing would ensure a ninety-nine percent immediate patency rate, but over ninety-five or ninety-six percent was definitely achievable.
Lu Cheng’s tone was not exaggerated or arrogant, but simply confident. It stemmed from confidence in his hands-on skills and his abilities.
Song Hongtu sniffed and felt he had fulfilled his duty to warn. But since Lu Cheng remained confident, it wasn’t “showing off,” but genuine capability for this surgery.
Therefore, Song Hongtu could only watch as Lu Cheng completed the vascular suturing, branch anastomoses…
After another twenty minutes or so, Song Hongtu stood up and made way, as Professor Tong Yuan’an returned from the Emergency Operating Room. However, he did not snatch the chief surgeon’s position from Lu Cheng. Instead, he nudged Song Hongtu aside and personally assisted Lu Cheng with the nerve suturing.
“The ulnar nerve originates from the medial cord of the brachial plexus. The number of fascicles within the ulnar nerve at this point is 11, primarily mixed nerve fascicles.”
“Continuing downward along the medial side of the brachial artery to the level of the deltoid insertion, it penetrates the medial intermuscular septum to the posterior compartment of the arm. At this point, the number of fascicles within the ulnar nerve increases to 16, of which 13 are mixed nerve fascicles predominantly composed of motor nerve fibers, and 3 are mixed nerve fascicles predominantly composed of sensory nerve fibers.”
“Therefore, it is crucial to precisely match the functional fascicles and then perform perineural suturing.”
“Of course, you can also use the epineurial-perineurial suturing technique. What I’ve told you are just the techniques we commonly use,” Tong Yuan’an’s voice was professional and delicate, offering advice, not commands.
Lu Cheng thought seriously for a moment and replied, “Teacher Tong, I think using the combined epineurial-perineurial suturing technique here would be better.”
“The upper arm portion of the ulnar nerve is relatively thick and offers sufficient space for manipulation. Although it will take longer, the local tension will be reduced after combined suturing.”
“The fundamental principle of nerve suturing is tension-free suturing!” Lu Cheng articulated the core meaning and essential concept of nerve suturing he had learned at Xiehe Hospital.
“Mm, tension-free suturing is paramount for nerve suturing. Please continue,” said Tong Yuan’an.
Lu Cheng proceeded with his operation, while Tong Yuan’an watched carefully and meticulously assisted Lu Cheng with fascicle alignment, offering occasional, patient guidance.
Many people gradually entered the operating room and then crowded around the operating table.
Director Liu Xia from Ward Two, Luo Changwu, Xiang Kuihua, and Tian Shan from Orthopedics Ward One were all present.
However, as they watched Lu Cheng’s suturing become increasingly smooth, their expressions varied.
Director Liu Xia hesitated for less than half a minute before turning his head and saying, “Peng Chen, send me Xiao Lu’s phone number.”
Peng Chen was another deputy chief physician in Ward Two.
Peng Chen nodded, without any particular thoughts, and immediately took out his mobile phone to search for Lu Cheng’s number…
After Lu Cheng finished this surgery, if he were the department head, he too would be unable to sit still. And if Lu Cheng could be brought to Orthopedics Ward Two by Liu Xia, Ward Two would thrive in the future.
This is not just finger replantation; it is an overall hand surgery disease type.
It’s clear that Lu Cheng left Ward One, and the reasons are well-known to everyone.
After a while, Tong Yuan’an got up, “You all continue. I’ll go to room two to finish the remaining tendon suturing so everyone can rest early.”
“Was the rescue in General Surgery successful?” Tong Yuan’an asked Liu Xia.
“Professor Tong, it was successful. Professor Chen had to run back and forth many times!” Liu Xia blushed slightly.
The reason Chen Song had to keep running back and forth even after starting his own surgery was that the general surgery doctors at the county hospital were too incompetent when faced with complex disease types.
Fortunately, everyone was saved.
Tong Yuan’an directly exited the operating room and murmured, “This blue-eyed blue-hearted old classmate has some skills…”
