Chapter 220： Vascular network (1/2)
Once Ling Ran started the operation, she was extremely focused. ｛Щww {suimеng] [lā}
The average operation time for Achilles tendon repair is very short, such as the five he performed last night, plus the two operations performed this morning, a total of 7 operations, which took less than 7 hours.
Of course, the length of each operation is a bit longer. After all, there is preparation before surgery and suture after surgery, but it is not necessary to participate in Ling Ran. It was when the medicine was fed that Ling Ran began to appear in the operating room.
And his work mainly started from the moment the incision was opened.
”Pull it apart.” Ling Ran dropped the scalpel and, with Ji Tianlu, pulled the skin outside Liu Weichen.
”It was also the same when we slaughtered sheep in our hometown.” Ji Tianlu suddenly said something, which was the beginning of a moment in the operating room.
Ling Ran kept silent, as he had done before.
Lu Wenbin quickly joined in, asking curiously, ”How long is the Achilles tendon of a sheep?”
”I don't know, it's not delicious anyway.” Ji Tianlu said with a skeptical, ”Sheep hoof is the most unpleasant. Well, the Achilles tendon is quite long.”
However, Ling Ran clamped the exposed Achilles tendon with tweezers.
”The broken end is like a ponytail.” Zhu Tongyi frowned as expected.
This is the worse type of tendon rupture.
”Cut it off.” Ling Ran erected the portion of the tendon that had become ponytail-shaped, looked it over 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, it is not necessary to cut off the ponytail-shaped tendon suturing. Some surgeons are used to using it as the material for strengthening sutures.
However, athletes have different requirements for tendons. Such scattered tendons are not enough to support high-intensity training, that is, parts that are not conducive to competitive sports can only be cut off.
”Dalang's tendon is three centimeters less.” The anesthesiologist did his job, looked up, and was a little curious.
Lu Wenbin turned the tray and said, ”It's almost, maybe more than that.”
”Can you continue to run this way?”
”If the stitching is good, it won't be a problem.” Zhu Tongyi's answer was positive, but the content was full of uncertain factors.
For the final question and answer, the people in the operating room showed concern, indicating that the audience in the classroom was more concerned.
Zhu Tongyi's plan is not confidential at the Bone, Joint and Sports Medicine Center, and many senior residents have been in contact. Therefore, when Zhu Tongyi said ”good stitching”, many people's faces were not very good.
”It seems to be using plan a.”
”A bit perverted.”
”Can you do that?”
Several doctors couldn't help whispering.
”How is scheme a perverted?” A little nurse sat at the desk in Shi's classroom and asked the attending doctor nearby.
The request of the young and lively girl cannot be refused by the 30-year-old man. The attendant showed a single smile for 30 years and said, ”I wish Academician a plan to provide blood supply. This will ensure the strength of the tendon after being pulled.”
”and then?”
”Then?” The governor smiled and said, ”Then he put his hands and feet together.”
”why?”
”Because ...” The attendant didn't know what to say, thought about it, and said, ”Let's say, the blood supply on the inside of the Achilles tendon comes from the posterior tibial artery, and it is divided into three to four perforating arteries. You can't see the blood vessel area on the outside of the Achilles tendon, but the source is the peroneal artery. You have to bypass them. ”
”A total of 8 small blood vessels need to be bypassed?”
”There are countless small branches of small arteries. Academician Zhu also hopes to go around and keep the vascular network around the Achilles tendon. The blood vessels supply the Achilles tendon, the vascular network is maintained, and the nutritional supply of the Achilles tendon is large. It can be recovered faster, a bit of open surgery, and then the effect of minimally invasive surgery is obtained. The idea is very good, but it is basically impossible to achieve. ”The attendant laughed loudly.
”It's more than just a good idea, it's idealistic.” Another hospitalization felt the same.
The 202-pound resident doctor gurgles mineral water and says sadly: ”It is always good to have an ideal. When the academician made the plan, he also knew the difficulty, so he pushed it to the present.”
”It's useless after 10 years. Can you believe that you can avoid the whole network of blood vessels? Impossible. Even with machines like DaVinci, all the blood vessels are marked. It ’s going to be cut off. Everyone ’s blood vessels are in different positions, so it ’s better to avoid them. ”