Chapter 17: Chapter 0016: Perfection
The two arteries and four veins have already been anastomosed, smoothly done with no clumsy or duplicate motions, and each action was seamlessly connected without a hitch.
Next finger!
Hmm! Song Zimo barely had any of his pride left.
The sterile, refrigerated small box was opened and Song Zimo personally went to claim the severed finger. He reached in, took the broken middle finger and placed it carefully on the operating table.
“Vital signs?” Yang Ping asked.
“Stable! Rest assured, you can go on.” Liang Jing confidently responded, proud to participate in such a challenging surgery.
This kind of tension was restrained, quiet, and calm, unlike those noisy, chaotic resuscitations.
It was like a person walking a tightrope without any protection, with the rope stretching across a chasm between cliffs, one misstep leading to a deadly fall.
“Do you want to take a break?” Director Han asked with concern.
“No need!”
Old Han looked at the time display on the wall panel. The anastomosis of six blood vessels just now had taken about twenty minutes, meaning each vessel took only about three minutes.
Next was the nerves. The anastomosis of nerves was much easier than that of blood vessels. The nerves, being solid structures instead of hollow, did not need to worry about patency. Plus, all the nerves in the fingers were sensory nerves, with a relatively high tolerance for error, and there was no risk of sensory nerves and motor nerves growing in a mix.
Tian Yuan, Song Zimo, and the other doctors temporarily turned their eyes away from the screen, taking a short rest before watching the next vascular anastomosis.
The most exciting and challenging part of the entire surgery was the vascular anastomosis. They would reserve their limited visual power for this most essential part. When the nerves are on edge, people get tired easily.
After the two nerves were anastomosed, they moved on to anastomosing the flexor and extensor tendons, which was even simpler process that could be completed without a microscope.
Lastly, they stitched up the skin, sealing the wound completely, and announced the successful reattachment of the index finger.
Starting from the vascular anastomosis to the final suturing of the skin took only around thirty minutes. This remarkable speed was sure to leave everyone speechless.
The index finger was done, and the rubber band tourniquet around the base of the finger was removed. The pale fingertip gradually turned rosy and there was no bleeding at the anastomosis sites.
Next was the middle finger, and it was again Song Zimo who brought the severed piece. If he still had a shred of arrogance last time, it had now completely disappeared.
He placed the severed finger on the operating table and silently returned to his seat.
They repeated the previous steps – stabilizing the fracture, anastomosing the vessels, nerves, and tendons, and finally suturing the wound.
“Want to take a break?” Director Han suggested again.
“Thank you, Director, I’m still okay.” said Yang Ping.
And the vessel anastomosis started again!
The nerves that had just been relaxed instantly tightened again. For some who hadn’t had enough rest, the sudden tension was quite uncomfortable. They all focused on the screen again, not daring to look away for even a second.
The surgical movements maintained their previous consistency and speed. After the middle finger was completed, they moved on to the ring finger.
Old Han relaxed, his back sinking in relief. After the ring finger, there was only one finger left. Even if it failed, it was only the pinky, which would not greatly affect the function of the hand.
By now, Song Zimo had completely succumbed. Medicine, especially clinical medicine, and surgery, were all tangible things. There was no room for pretension or bragging – everything was right there, clear and palpable.
Finally, it was the pinky.
“Pinky!”
Song Zimo placed the pinky on the operating table, now willingly doing this job.
Yang Ping stretched his neck a bit and loosened his grip on the tools, adjusting his posture slightly to relax for a moment.
“This severed finger has a slight problem. The vessels seem a bit adhered to the surroundings.” Yang Ping said quietly.
“Premature infant, blood vessels are underdeveloped, the surrounding tissues didn’t develop properly either, causing scar-like adhesions!” Old Han reminded Yang Ping while looking at the video.
“Hmm.” Yang Ping also agrees.
Yang Ping tries to find the blood vessels, carefully separating the hard adhered tissues bit by bit, exposing the ends of the blood vessels. The forceps pinch the outer membrane while the scissors carefully separate them. The adherence is too tight, making it difficult to separate, and could easily rupture the blood vessel wall.
Yang Ping’s scissors stop.
“Don’t rush, we have already connected four, there is no issue with its function, we have achieved adequate success already,” Director Han says.
“I will try again.” Yang Ping does not plan to give up.
He is not a perfectionist, but he is not one to give up easily either. He likes challenges. When he was at university, he enjoyed running, from one thousand five hundred meters, to three thousand, to five thousand, to ten kilometers, to finally forty plus kilometers marathon. He likes the feeling of constantly challenging himself, he always believes that giving enough effort can achieve the goal.
The scissors start to separate again, the speed obviously slows down. One bit at a time, each time he separates a little, he stops. The forceps hold up the blood vessels, and stay steady, while the scissors carefully open and close along the blood vessel wall.
“Have you done this kind of severing finger?”
Song Zimo gently asks.
“Hmm.”
Yang Ping just hums a single note.
Song Zimo does not like the temperament of this young man.
Possibly having found the feel to separate such tissue, Yang Ping mastered the strength of the surgical tools better, the speed of the scissors gradually increased.
The first blood vessel is freed from the adhesion, and gained sufficient length. Then the second blood vessel started getting separated. At least four blood vessels are needed, two arteries and two veins so that the blood flow can be guaranteed
The veins are harder to separate because the vein walls are thinner than the arteries. However, the operating surgeon apparently quickly learned from the previous separation experience. With each cut, the scissors can accurately separate between the blood vessel wall and the adhered tissues.
Four blood vessels, two arteries, two veins, both proximal and distal ends were separated completely intact.
The blood vessels separated from the adhesion, the vessel walls are more fragile. The little finger’s vessels are even smaller. The difficulty of stitching it up is several fold.
“This is too hard to sew, feels like it will break at any slight mishandle.”
Someone speaks in the room next door.
Everyone follows the voice to locate the speaker, glaring at them, the person speaking immediately shuts up, and everyone again focuses on the video.
Su Yixuan is a professional surgery nurse in orthopedics, her understanding of surgery is much deeper than the average nurse.
As there was nothing for her to do on the stage for now, she also turns her body to watch the screen. With such high-level skill, no wonder everyone is silent, only left with the sound of the anesthesia machine’s air delivery.
From Su Yixuan’s position, she can see Yang Ping’s profile, even Yang Ping’s eyes looking into the eyepiece.
Those pair of eyes deeply move Su Yixuan, his determination, confidence, and focus.
Uncontrollably, her face feels a little heated, what is wrong with me? Su Yixuan quickly shifts her gaze.
The vascular anastomosis begins, the stitching of this finger’s blood vessels is slower, the surgeon is finding the feeling. The second one is obviously much faster. The third, getting into the groove, he has completely found the technique for stitching this special kind of blood vessels.
Yang Ping’s sutures are still as smooth as they were, quality is not compromised at all.
Once the last stitch of the vascular anastomosis is completed, Yang Ping puts down the needle holders and the needle thread. Su Yixuan catches them steadily, then carefully puts the tiny needle back on the needle panel.
“Shall I stitch the nerves and tendon?” Song Zimo suggests.
Director Han declined: “No, let him finish it.”
Not for anything else, but to allow this surgery to end perfectly in the end, anyone replacing Yang Ping at this time, even for stitching a single thread, will be considered a flaw by him.
Yang Ping continues, stitching all in one breath, nerves, tendons, and skin.
Releasing the rubber tourniquet, after a few seconds, the distal part of the little finger turns red.
Apply dressing, cast for fixation, the surgery ends perfectly.