Chapter 220 Vascular Network

Once Ling Ran started the operation, he was extremely focused. {щww{suimеng][lā}

The average operation time for Achilles tendon repair is very short. For example, the five operations he performed last night, plus the two operations performed this morning, a total of 7 operations, all of which took less than 7 hours.

Of course, the time for each operation is longer. After all, there are pre-operative preparations and post-operative suturing, but Ling Ran's participation is not necessary. It was when it was time to feed the medicine that Ling Ran began to appear in the operating room.

And his work mainly started from the moment the incision was opened.

"Pull it off." Ling Ran dropped the scalpel, and together with Ji Tianlu, pulled Liu Weichen's outer skin away.

"It's the same when we slaughtered sheep in our hometown." Ji Tianlu suddenly said, which opened the joke moment in the operating room.

Ling Ran operated silently, just like he did before.

Lu Wenbin quickly joined in and asked curiously, "How long is the Achilles tendon of a sheep?"

"I don't know, it's not tasty anyway." Ji Tianlu curled his lips and said, "The sheep's trotters are the worst. Hey, the Achilles tendon is quite long."

It was Ling Ran who picked up the exposed Achilles tendon with tweezers.

"The broken end is in the shape of a ponytail." Zhu Tongyi frowned as expected.

This is the worst type of tendon rupture.

"Cut it off." Ling Ran set up the ruptured part of the tendon that had turned into a ponytail, flipped through it twice, and then cut it straight with scissors.

"Cut it off." Zhu Tongyi still hugged his chest, watching Ling Ran's operation.

For ordinary people’s tendon sutures, there is no need to cut off the broken tendon in the shape of a cauda equina. Some surgeons are accustomed to using it as a material for strengthening sutures.

However, athletes have different requirements for tendons. Such scattered tendons are not enough to support high-intensity training, that is, the parts that are not conducive to competitive sports can only be cut off.

"Dalang's tendon is missing by three centimeters." The anesthetist finished his work, stretched his head to look, and was also a little curious.

Lu Wenbin turned the tray around and said, "Almost, maybe more than that."

"Can I keep running like this?"

"If it is stitched well,

no problem. "Zhu Tongyi's answer itself is very positive, but the content is full of uncertain factors.

For the final question and answer, the people in the operating room were concerned, and the audience in the classroom were more concerned.

Zhu Tongyi's plan is not a secret in the Bone Joint and Sports Medicine Center, and many senior residents have come into contact with it. Therefore, when Zhu Tongyi talked about "good stitching", many people's faces were not very good.

"It seems that plan A is going to be used."

"It's a bit perverted."

"Can it work?"

Several doctors couldn't help discussing in low voices.

"Why is Plan A abnormal?" A little nurse sat on the table in the demonstration classroom and asked the attending doctor next to her worriedly.

A 30-year-old man couldn't refuse the young and lively girl's request. The attendant showed a smile of being single for 30 years, and said: "Academician Zhu's plan a is to protect the blood supply. This can ensure the strength of the tendon after stretching."

"Then what?"

"Then?" The attendant showed a hehe smile and said, "Then hands are bound."

"Why?"

"Because..." The attending doctor didn't know what to say, thought for a while, and said, "Let's put it this way, the blood supply to the inside of the Achilles tendon comes from the posterior tibial artery, which is divided into three to four perforating arteries. What you can't see, the vascular area on the outside of the Achilles tendon is similar, but the source is the peroneal artery, you have to bypass them all."

"A total of 8 small blood vessels to bypass?"

"There are still countless small branches of small arteries. Academician Zhu hopes to bypass them and keep the vascular network around the Achilles tendon. The blood vessels supply nutrients to the Achilles tendon. If the vascular network is preserved, the Achilles tendon can supply a large amount of nutrients. Can recover faster, open surgery, and then get the effect of minimally invasive surgery. The idea is very good, but it is basically impossible to realize it." The attending doctor laughed out loud.

"It's not just a good idea, it's idealism." Another resident felt the same way.

The 202-pound resident doctor gulped down the mineral water, and said with a sad face: "It's always good to have ideals. I wish the academician knew the difficulty when he came up with the plan, so he pushed it until now."

"It will be useless after 10 years. Can you believe in avoiding all the vascular networks? Impossible. Even if the current Da Vinci and other machines mark all the vascular networks, what should be cut off is It will be cut off, everyone's blood vessels are different, where is it so easy to avoid."

"So, in plan a, I remember saying that the vascular network should be restored in the end. If there are too many small blood vessels accidentally cut, blood vessel sutures must be done?"

"Crazy!" The attendant scoffed. It's not that he has any opinions on the plan itself. On the contrary, the attending doctor has a considerable understanding of the horror and effect of the plan.

The so-called vascular network is really a fine and dense network structure.

Theoretically, small blood vessels are compensatory, that is, they are cut, and after a period of time, the body will reconfigure the blood vessels and reconnect them.

However, Academician Zhu believes that this kind of compensation is too slow, which not only affects the recovery speed of athletes, but also affects the quality of recovery.

The position of the Achilles' heel is precisely the position with the worst blood supply in the human body. To perform a destructive open surgery here, but want to recover quickly and with high quality in the end, is to seek a fish from a tree.

It can be seen from the effect of minimally invasive surgery on the Achilles tendon that ordinary people often do. Because minimally invasive surgery preserves the tissues around the Achilles tendon as much as possible, the recovery is not only fast, but the quality is also very good.

However, minimally invasive surgery cannot achieve the effect of high-strength suturing of the Achilles tendon. Therefore, Academician Zhu Tongyi's plan is simply an open minimally invasive surgery.

In the case of incomplete theoretical foundation and incomplete equipment, we hope to achieve the goal by the surgeon's own technical level.

This kind of thinking mode is also tried by Zhu Tongyi many years ago. Sometimes it fails, and sometimes it succeeds.

But whether it is success or failure, the difficulty of the program is obvious.

The sneer of the attendant and the others is actually because they have a great understanding of the difficulty of the plan.

The surgeons of the research center, like a student with good academic performance on weekdays, took part in a test of the Olympiad level with confidence. After being beaten to pieces, they found a transfer student nestled in the back of the classroom doing the Olympiad.

Even if they are not specialized in Achilles tendon repair, even if they are not going to rely on Mathematical Olympiad in the future, but for the doctors of the Orthopedics and Sports Medicine Center, the basic sense of shame and competitiveness are essential.

Even a 202-jin resident doctor is a man with both strength and perseverance. Apart from drinking water, he gains weight and has no weaknesses.

The experience of being beaten to pieces is something that many surgeons here have never experienced.

It can be said that none of the doctors in the Orthopedics and Sports Medicine Center is weak, but none of them is a surgeon who can perform miracles.

There are not many such surgeons in the world.

And most doctors don't even think about it at all.

"Microscope." Ling Ran strictly followed the plan, and began to dissociate the Achilles tendon more carefully, so as not to break more blood vessels after a while of suturing.

This is a serious and meticulous job, and I don't know if it will be effective.

However, since Ling Ran believed in Zhu Tongyi's plan, he tried his best to complete it.

Trivial tasks, seemingly endless, make people feel bored.

Ling Ran operated silently without saying a word.

A little bit at a time, a little bit at a time, slowly, the workload is accumulated.

When Ling Ran really started to sew up the Achilles tendon, many melon-eating doctors watching did not even wake up.

"The Achilles tendon has been strengthened and sutured." Ling Ran's movements were extremely skillful, and it only took a few minutes to pull together the Achilles tendon that others had been playing with for a long time.

However, for this operation, although the core of the operation is the Achilles tendon suture, the difficulty of the operation is the reconstruction of the vascular network.

"It's really complicated." Ji Tianlu looked into the microscope, a shattered but unclear vascular network, and a lawsuit all over his head.

Injured blood vessels due to ruptured Achilles tendon, cut open blood vessels due to open wounds, torn blood vessels caused by pulling the Achilles tendon, etc., just spread out a bloody surgical field, like a complex set of dominoes , as if destroyed by accident.

Restoring the vascular network is to reorganize a set of usable dominoes with the minimum workload.

This work, compared to the workload of severed finger replantation, and whether it can be successful is another matter.

"It's started." Ling Ran remained silent, straightened the microscope and started to get busy.

Ji Tianlu looked up at the time, lowered his head silently, and decided to cooperate with Ling Ran and do a good job as a first aid.

In the demonstration classroom, some of the doctors who had been watching for more than an hour couldn't help but yawned. However, when they looked at Ling Ran, their expressions changed unexpectedly, let alone started sewing. The vascular network is gone, just seeing that complicated scene is enough to make people dizzy, not to mention, Ling Ran is not simply restoring the vascular network.

He had to rebuild it, not only to allow it to exert immediate combat power, but also to allow it to have room for self-healing and extension.

The surgeons who visited on the spot suddenly realized that the Olympiad scrolls that everyone saw may also be graded.