221 Vascular Network (1/2)

Once Ling Ran started on a surgery, he would be extremely focused.

The average surgery time for an Achilles tendon repair surgery was very short. For example, the five surgeries that he performed the night before and the other two surgeries he performed early in the morning amounted to a total of seven surgeries. That did not even take seven hours to complete.

Naturally, the duration for each surgery would be slightly longer if preoperative preparations and postoperative sutures were included. However, Ling Ran's participation in those phases was not compulsory. Only when anesthesia was about to be performed would Ling Ran enter the operating theater.

His main job only started when the incision began.

”Retract the skin.” Ling Ran threw away the scalpel. Then, he along with Ji Tianlu retracted Liu Weichen's epidermis.

”This looks like when we slaughter goats in my hometown,” said Ji Tianlu all of a sudden. That opened up a topic of conversation in the operating theater.

Ling Ran remained silent and continued to perform the surgery, just as he performed his previous surgeries.

Lu Wenbin quickly participated in the surgery. ”How long is a goat's Achilles tendon?” he asked out of curiosity.

”No idea. It tastes awful anyway.” Ji Tianlu twitched his lips and said, ”Goat trotters taste the worst. But their Achilles tendons are quite long.”

At that moment, Ling Ran used a pair of forceps to bring out the exposed Achilles tendon.

”The amputated ends are in the shape of a horsetail.” Zhu Tongyi frowned, even though he had expected it.

Among the types of tendon ruptures, that was considered quite terrible.

”Shall I cut it?” Ling Ran hung a part of the ruptured, horsetail-like bundle out and flipped it around a little to observe it. Then, he trimmed it using a pair of scissors to make the ends smooth.

”Cut it then.” Zhu Tongyi crossed his arms over his chest and looked at Ling Ran's operation.

If that had been a suture for a normal person's tendon, the ruptured, horsetail-like bundles would not need to be trimmed. Some surgeons even used the bundles as a material to strengthen the suture.

However, an athlete's requirement on the tendon was different.

Scattered tendon bundles like that were not sufficient to support high-intensity training, so they were useless in competitive sports and had to be trimmed so that the tendon was smooth.

”His tendon is at least 0.4 inches shorter now, right?” the anesthetist asked out of his curiosity after he finished his work and took a look at the tendon.

Lu Wenbin rotated the plate and said, ”It's about that length, or maybe more than that.”

”Will he still able to run with this length?”

”If the suture is performed well, it shouldn't be a problem,” Zhu Tongyi replied very confidently, but his answer was still full of uncertainty.

The last question was not just a concern for the people in the operating theater, it was also a concern for the audience in the demonstration room.

Zhu Tongyi's plan was not really a secret in the Orthopedic and Sports Medicine Center, as many resident doctors had come across it before. Therefore, when Zhu Tongyi said that Liu Weichen would be able to run if the suture was performed well, many people's expressions turned pale.

”It seems like they're going with plan A.”

”That's kind of crazy, though.”

”Can it work?”

A few doctors discussed in low whispers.

A young nurse who was sitting on the table in the demonstration room was worried, and she asked the attending physician beside her, ”Why is Plan A crazy?”

The request from a young and energetic girl was often irresistible to a thirty-year-old man. The attending physician wore the smile of a man who had been single for thirty years and said, ”Academician Zhu's Plan A aims to ensure sufficient blood supply guarantees the strength of the tendon after it's stretched taut.”

”What happens after?”

”Haha! What happens after?” The attending physician laughed and said, ”Our hands and feet will be tied.”

”Why?”

”Because…” The attending physician did not know how to explain it. He thought about it for a while and said, ”Let me explain it this way. The blood supply on the medial side of the Achilles tendon comes from the posterior tibial artery, and it is further distributed into three to four of the perforating arteries, which are practically invisible to the naked eye. The vascular zone of the lateral side of the Achilles tendon does not differ much; the only difference is that the blood supply comes from the peroneal artery. You have to bypass all of them.”

”Bypass a total of eight small vessels?”

”And there are a lot of small branches in the small arteries. Academician Zhu also hopes to bypass the small vessels in order to protect the vascular network surrounding the Achilles tendon. The vessels provide nutrients to the Achilles tendon. If the vascular network is protected, the nutrient supply for the Achilles tendon will be higher and it will recover sooner. This is like an open surgery that wishes to obtain the effects of minimally invasive surgery. The idea is actually pretty good, but it is quite impossible to make it happen. Haha!” the attending physician laughed.

”It's not 'good', it's basically idealism.” Another resident doctor felt the same.

The resident doctor who weighed 222 pounds was still drinking a bottle of mineral water. He said sadly, ”Being ambitious is always positive! When Academician Zhu came up with this plan, he knew that it wouldn't be easy to accomplish. That's why he delayed it until now.”

”It won't be possible even after ten years. How can you believe that you can bypass all the blood vessels in the vascular network? It's impossible. Even if you use a device like the da Vinci Surgical System [1] to mark all the vascular networks, what should be cut will still be cut off. Besides, the locations of the vessels in every individual are different. It's not easy to avoid them.”