Chapter 49: Review!
Emergency Department, Operating Room.
Tong Yuan’an sat in the main operating position, his eyes resting on the microsurgery eyepiece holder. His hands moved swiftly but with discernible patterns within the surgical field, fluid and precise.
Lu Cheng sat at the end of the assistant’s eyepiece, able to clearly see the needle holder and needle tip in Tong Yuan’an’s hands. When still, they were motionless; when in motion, they moved like a curved saber.
His large hands held delicate microsurgical instruments, moving like agile rabbits in the narrow and confined operative field, opening and closing with grand gestures.
This was an unfamiliar suturing technique, with hints of the modified Tang technique visible within it, and also incorporating some concepts from the Jin Xia suturing technique.
However, Tong Yuan’an did not explain to Lu Cheng in detail what this suturing technique was.
Chen Song, who was observing from the side of the operating room, was visibly stunned. After watching for a while, he sat down on a steel-wheeled stool, shook his head slightly, his gaze complex.
In fact, as early as when he chose his specialty, Chen Song understood that in terms of surgical techniques and specific surgical operations, an emergency surgeon could never compare to a specialist.
Emergency surgeons only focus on highly time-sensitive hemostasis.
However, hemostasis is a matter of life and death, where life and death hang in the balance. It cannot be “performed” and even appears violent and bloody.
When it came to comparing surgical operation techniques with Tong Yuan’an, Chen Song had never even entertained such a thought; he was merely lamenting the ever-widening gap in techniques between himself and Tong Yuan’an…
Peng Kun was also engrossed in watching, his eyes full of envy. As his mouth moved, his surgical mask visibly rose and fell, his breathing rapid.
If he had Tong Yuan’an’s skill, who would Lu Cheng be? And who would Deputy Director Xiang Daihong at Zhou People’s Hospital be?
He heard there was a limb replantation surgery. Could he chop off this hand and attach it to his own? The helpless Peng Kun could only fantasize in secret, then pay attention to Lu Cheng’s expression.
Lu Cheng was also understanding the details of this level of surgical skill for the first time. During his standardized training, Lu Cheng’s basic skills were far too poor, and watching many professors’ surgeries felt like a fleeting glimpse.
As Lu Cheng was in orthopedic standardized training, he had naturally visited the hand surgery department at Zhongnan Hospital.
Tong Yuan’an’s operative techniques differed from those used by several professors at Zhongnan Hospital, but his proficiency in operation did not surpass theirs. In fact, compared to Professor Liu, he was slightly inferior…
But after all, Tong Yuan’an was only an associate professor, while Professor Liu was an experienced hand surgery old professor.
After Tong Yuan’an completed the tendon suturing, he raised his round face and said, “Xiao Lu, you handle the remaining skin cut.”
Lu Cheng immediately nodded, “Okay, Teacher Tong.”
After Tong Yuan’an put down the microsurgical instruments, Lu Cheng took a deep breath, then sat upright. After slightly narrowing his eyes, he began to operate using the eyepiece.
Lu Cheng had never operated with an eyepiece before, so operating through it was slightly uncomfortable at first. However, after a few movements with the microsurgical instruments, he became accustomed to this field of vision…
Feeling sufficiently accustomed, Lu Cheng used microsurgical tweezers to lift the surface of the skin and began to perform interrupted suturing.
As Tong Yuan’an raised his round face, his attention was immediately drawn to the eyepiece’s field of vision.
As a master of hand surgery, he knew very well how to judge a person’s suturing basic skills. The most fundamental skill of all is raising the hand; the hand must be steady when raised.
Even under magnification, there should be no creasing. If this level of control cannot be mastered, one cannot become a skilled hand surgeon.
Lu Cheng achieved this; it was evident from the few skillful small operations he performed.
If a person’s hand is not steady, many folding lines will be generated during the process of holding the instrument, which are very clear and visible in the eyepiece’s field of vision…
Then, Tong Yuan’an looked up again and noticed Lu Cheng’s eyelids blinking intermittently, clearly indicating that he had not undergone formal training.
Tong Yuan’an did not disturb Lu Cheng but intently watched the details of Lu Cheng’s suturing.
The needle entry angle, the choice of entry point, the direction of entry, the angle of exit, and the force control throughout the entire process were all extremely meticulous, reflecting the details of actual suturing…
For skin suturing alone, the entire process was not long, taking about ten minutes. Lu Cheng then had Tong Yuan’an complete the cutting of the last suture.
After the operation, Lu Cheng took gauze, dipped it in saline, and wiped the local wound. He satisfactorily manipulated the edges of the sutured wound, showing Tong Yuan’an that all the sutures were perfectly aligned with the skin, forming appropriate tension.
This demonstrated that the suture knots were under load, and the depth was consistent, with no signs of tension slippage.
“Teacher Tong, can we apply the sterile dressing now?” Lu Cheng asked.
“Yes, go ahead and cover it!~” After confirming the details Lu Cheng had shown him, Tong Yuan’an had no further doubts.
The quite excellent specialized doctoral candidates in the department did not have such suturing skills. Those beyond the excellent category were exceptional, and could not be generalized.
Lu Cheng’s current basic skills were already solid, even better than at the same age in his own past. Tong Yuan’an could find no fault.
However, as Tong Yuan’an stood up and removed his green sterile surgical gown, he said, “Xiao Lu, you have the foundation for hand surgery, but your eyes are not good enough.”
“You blink too often. If you truly want to specialize in hand surgery, you should only blink once every minute or two.”
“This requires practice. It’s difficult to achieve without shedding a considerable amount of tears.”
“Mainly, during digital replantation, the timing for vascular suturing is fleeting. If missed, you may have to wait again, so it’s essential to practice the basic skill of not blinking.”
“Furthermore, with your current basic skills reserve, your next step should be to practice suturing the artery of a naked mouse’s severed tail.”
“The key to progress in this step is not only in handling the suturing details but also in paying attention to the knot-tying details, otherwise, there will be slight creases between the blood vessels, causing turbulence!”
“The diameter of the mouse tail artery is already very small, and the blood flow is not abundant. If you were to indirectly retain some blood due to knot tying, it could significantly affect the vitality of the distal limb.”
“These are all unacceptable…”
“However, with your current reserve of basic skills, you are ready to start practicing the Tajima suturing technique.”
“After this surgery is finished, I will take you to your hospital’s skills training room and explain the key points of learning the Tajima suturing technique in detail.”
As Tong Yuan’an spoke, his gaze turned to Peng Kun, and he said teasingly, “Young Master Kun, would you like to come along as well?”
Lu Cheng completed the suturing and bandaging for the patient while applying a plaster cast for external fixation.
After tendon suturing, it’s best to use a brace for auxiliary fixation. However, braces are expensive to customize. While they are cheap to buy online, no one anticipates getting injured, so a cheap plaster cast is used for temporary fixation.
Peng Kun immediately shook his head vigorously, his voice hoarse, “Professor Tong, I’ll pass. I probably won’t be able to learn it…”
“This task should be left to Brother Lu.”
Peng Kun didn’t even dare to compare his learning speed with Lu Cheng, he didn’t even dare to have that thought, mainly because the gap in their suturing basic skills was too vast.
Even if Tong Yuan’an’s one or two years were an exaggeration, if he could learn it in half a year, by then it would be too late.
Tong Yuan’an’s expression remained unchanged as he approached Chen Song and casually said, “Old Chen, shall we discuss something?”
Chen Song smiled and politely gave a Pinyin response: “Gun!”
