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

When he first arrived in Yunhua, the Medical and Political Science Department sewed up the tail of a rat to show off his power.

Now that I think about it, it is equivalent to having new recruits compete with special forces in sniper target shooting. 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, which refers to the main arteries and veins. The perforating arteries branched off from the posterior tibial artery or peroneal artery are not so wild, and many of them are thinner than the arteries in the fingers.

The number of blood vessel sutures required for suturing a broken finger is only two, three, or three or four.

Of course, the actual difficulty is that the suturing of broken fingers is more difficult. Because the suturing of broken fingers has extremely high requirements on the quality of blood vessel suturing, the tolerance for low-quality sutures is very low. One disadvantage is thrombonecrosis.

The vascular network around the Achilles tendon does not have such high requirements. Academician Zhu Tongyi’s Plan A simply requires the reconstruction of 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 that every

As long as two perforating arteries are obtained, the lowest perforating artery is obtained, and a certain number of small blood vessels are ensured, the basic requirements are met.

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

As for the failure of the original plan, for such an experimental operation, there are many explanations for success, but there is no explanation for failure.

Zhu Tongyi quietly stared at Ling Ran's movements, seemingly even more nervous than Ling Ran.

Ling Ran's operation became more and more relaxed.

His wrist was soft and his fingers were sliding lightly under the microscope. In just a few strokes, he sutured one blood vessel, pulled out another blood vessel, brushed it a few times, and sewed it up again.

Ji Tianlu cooperated hurriedly, and even the second assistant Lu Wenbin kept circling the operating table, sometimes pouring salt water to moisten the blood vessels, sometimes making gauze, sometimes suctioning, and sometimes pulling hooks. The level of effort was comparable to that of a self-service barbeque.

status.

Everyone frowned, feeling the pain of fighting in a bloody battlefield and staying up late to catch up on homework.

Only Ling Ran, who remained unchanged on the surface, felt so happy in his heart.

This is to sew the blood vessels of a living person, and you can sew one net at a time. How cool is that?

If the severed finger was to be replanted, Ling Ran would first have to carefully debridement, then fix the bones, and then suture the tendons. Then he would have the opportunity to play with the two or three most critical blood vessels. After that, he would sew up the nerves.

Then throw the sewn skin to other animals.

From Ling Ran's point of view, debridement is no longer so interesting. Internal fixation of bones is more like carpentry work. If the tendons are sutured, the flexor tendons are still fun, but ordinary tendons are lackluster. The remaining blood vessels and nerves are considered

The most interesting part of replanting a severed finger.

And what kind of situation did Ling Ran encounter today?

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

In other words, the best part of the replantation of the severed finger was taken out for Ling Ran to play with.

Ling Ran's mood was beyond happy.

This is not the rat tail in the practice room. Perhaps for newcomers, it is very happy to be able to sew a rat once. However, Ling Ran has already passed that newcomer stage.

There is a living person who can do the suturing, and there is the cooperation of one assistant and two assistants. There is a nurse who delivers the equipment and a circulating nurse who helps with the suturing. It is much more comfortable than sitting alone in the exercise room alone.

"Change the suture to a thinner one." Ling Ran was so happy that he sutured three perforating arteries in one breath. When faced with the thinner fourth one, he simply changed the suture again.

Academician Zhu Tongyi had to remind him: "The key for you is to pay attention to dynamic balance."

The implication was that it was impossible for him to resew the entire blood vessel network. He could only select important blood vessels to form a barely usable blood vessel network.

It's like after a war, most of the original meticulous and orderly logistics lines were destroyed. The task of the general responsible for reconstruction is not to restore every original logistics line bit by bit, but to focus on restoring one.

supply chain to ensure the supply of the most important materials. The restoration of the remaining supply chain can be left to others and carried out slowly over a longer period of time.

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 was in good condition, not only wanted to restore one supply chain, he also wanted to create another one.

"Is it too late?" Zhu Tongyi looked up at his watch and looked a little more relaxed.

Ordinary Achilles tendon surgery takes about one or two hours, and the time on the operating table can range from two hours to thirty to forty minutes.

Zhu Tongyi's plan A is much more complicated. He plans to give the surgeon four hours of operation time. This time is not just mentioned casually, but is a "dynamic balance" based on the degree of exposure of the Achilles tendon 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 progressing smoothly, Zhu Tongyi hopes that the operation can be completed within three hours to ensure a more efficient recovery.

Looking at Ling Ran's progress, Zhu Tongyi felt very hopeful. Even if a backup path was built, it would be possible if the current speed could be maintained.

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

Ling Ran was also very familiar with Zhu Tongyi's plan. He stared at the microscope and was so happy that he didn't want to leave. He said: "We have not cut off many small blood vessels. There is hope that 30 to 40% of the vascular network will be restored. It would be useful to restore more."

There are benefits, right?”

"Of course, but the quality must be ensured as much as possible." Zhu Tongyi reminded: "The risk of spasm still exists, and open blood vessels are useful blood vessels."

The more blood vessels that are restored, the more nourishment the Achilles tendon will receive during its recovery.

The reason why you can leave the hospital quickly and try rehabilitation after minimally invasive Achilles tendon surgery 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 return to normal.

Large open surgeries performed to ensure the strength of the Achilles tendon do not have such advantages. Especially for some special approaches, such as Achilles tendon repair with posterior midline incision, the complications are obviously higher than those of the Achilles tendon.

The reason for the midline incision is that the latter has less blood supply, so the incision destroys fewer blood vessels.

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

It doesn’t have to be as high quality as the blood vessels replanted from severed fingers, but it still has to be of a certain quality.

In fact, Zhu Tongyi's plan A was basically to suture Liu Weichen's Achilles tendon and replant the blood vessels. The difficulty increased by more than ten times. It was even more difficult to maintain quality and quantity.

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

This is the most common problem among young people.

Once words such as rough and impetuous appear in blood vessel suturing, problems will arise.

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

Ji Tianlu couldn't help but raise his head at this time and said: "Doctor Ling is fine."

Zhu Tongyi came to his senses and said quickly: "Care leads to chaos. I care a little too much about our plan."

Shown in the classroom.

Hearing the boss of the research center and the absolute leader, Academician Zhu Tongyi, say such words, all the doctors were in an uproar.

Dr. Qu could no longer suppress his emotions and said angrily: "It's true that the foreign monk is so good at reciting sutras, and the director is so easy to talk to."

"That is to say, the tone is not right."

"Hey, hey, hey, don't go online. Our Academician Zhu didn't say anything wrong?"

"What do you want to say, Academician Zhu? What you said is enough. You have to understand that the plan is ours, Academician Zhu. This is to guide the operation, and Ling Ran is just the surgeon."

The 203-pound resident doctor giggled while holding the mineral water: "Is Ling Ran just the surgeon? Just?"

Several doctors who were 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 have something to say, but when you are facing your own people, your position will be relatively clear.

It can be said that Ling Ran's chief surgeon was given by the research center, or it could be said that the research center could not find anyone and was supported.

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

The 203-pound resident 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 and his talent is good. He may be a first-class surgeon in the country, but... doctors will continue to grow!

The 203-pound resident doctor has already set detailed goals for himself. As soon as this happens, he will practice in seclusion and catch up with Ling Ran's skills in the shortest possible time.

When that time comes, he will definitely find another opportunity to defeat Ling Ran, and then bring a pair of purebred French lop-eared rabbits to find Xiaoyun.

Thinking of this, the 203-pound resident doctor excitedly drank a bottle of Nongfu Spring, and burped comfortably as only a 204-pound fat man could.
Chapter completed!