Chapter 214 - The female doctor who was convinced to give up! (1/2)

Zhang Fan was the primary surgeon for the surgery, with Chen Qifa as his surgical assistant. The patient was placed on the operating table, while Zhang Fan and Chen Qifa stood across from each other on opposite sides of the patient. The medical equipment nurse and table were also across from the patient. There was no room for a third doctor!

What could be done then? Tong Lili could only stand to the left of Zhang Fan. There wasn’t even any space for a stool for her to stand on. She would have to stand in order to participate in the surgery.

The anesthesiologist asked Zhang Fan what type of anesthesia to use because this surgery would take quite a long time to complete. Zhang Fan suggested general anesthesia instead of local anesthesia. In surgery, especially orthopedic surgery, cleaning the injury was incredibly important. It was a basic rule of surgery to completely clear away any tissue that had been infected or was dead already. Clearing away tissue couldn’t be done casually.

The surgeon would need to carefully study the patient’s X-ray before the surgery, and then determine how much tissue to clear away and how much to shorten the bone based on the hand’s specific circumstances.

The hand which had been cut off completely seemed just like a flesh-colored lump. It had no color to it due to lacking blood! If you placed it on the ground, it would be difficult to differentiate it from a rubber doll’s hand!

Due to technological advances in surgery, a medical equipment nurse was becoming ever more important. It would take at least one or two years of training for a medical equipment nurse to become skilled enough to help in surgeries. Although surgeons would only work on their specialty type of surgeries, medical equipment nurses would have to work on all types of surgeries. This meant that medical equipment nurses needed to be highly familiar with all the names and usages of every medical equipment type as well as the steps in all types of surgery.

This was because the medical equipment nurse would need to prepare the necessary medical equipment for various steps of the surgery. It would be bad for the nurse if she was unfamiliar with the surgery’s steps and didn’t have the proper medical equipment right away. Some doctors who had a bad temper would even throw the medical equipment onto the ground!

Older and more experienced medical equipment nurses would instantly be able to tell the skill level of the doctor. This was why younger surgeons would always intentionally try to get into the good graces of older nurses. This was because the older nurses might start bad rumors about them otherwise.

Two doctors would need to simultaneously clean the injury for a hand reattachment surgery. This was all in order to save time because time was extremely critical. Cleaning the injury would need to be done at an anatomical level. While cleaning the injury, it would also be necessary to locate the relevant nerves and blood vessels for the next step of the surgery.

The primary surgeon would need to figure out the steps even for something as seemingly simple as cleaning the injury. The order of what you cleaned would be critically important. To make an analogy, this would be as important as having a proper battle formation in war.

The most important muscle structure in the hand was the thenar eminence group. The thenar was a muscle that only humans possessed. While gorillas were the closest genetic relatives to humans, our hairy cousins didn’t have the thenar eminence. The thenar eminence was something that had evolved due to our ancestors’ use of the hands. What was the thenar eminence? In simple terms, that would be the fleshy portion between your thumb and index finger.

After cleaning the muscles, next would be the bones. For the bones inside the hand, the metacarpophalangeal joints were by far the most important. These joints were the biggest priority to preserve.

Zhang Fan had his head lowered as he worked on the surgery together with Chen Qifa. Tong Lili’s work was to maintain clear vision for the surgery. Basically, all she did was hold the surgical retractors and wipe blood. Every surgeon would have to start out like this, only observing the surgery, typically as the third or fourth surgical assistant. After becoming experienced in holding the surgical retractors, wiping blood, using the aspirator to drain blood, and watching a type of surgery several dozen times, the surgeon would then slowly work their way up to secondary surgical assistant, primary surgical assistant, and so on.

During this timeframe, doctors would slowly display differing levels of skill. Surgery was a job that required both talent and hard work. Some doctors would intentionally practice surgery techniques at home. For instance, for laparoscopies, maybe a doctor would continuously practice with two similar-sized bars at home. This doctor would then become far more skilled in one year than another doctor who didn’t do extra practice at home. This was the result of difference in work ethic.

If you paid close attention, many surgeons would commonly have the habit of constantly playing with something in their hands. This wasn’t a habit simply out of boredom. Many of them were actually practicing surgical techniques.

After cleaning the injury, it would be necessary to repair and affix the broken bone. This was something foundational. Only after affixing the bone would it be possible to restore other functions. If the bones weren’t affixed properly, even slight movement would cause a blood vessel which was just repaired to snap again!

After dealing with the bone fracture, next would be repairing the muscles. If some part of the body was accidentally cut off, the best possible scenario that surgeon could hope for was that a very sharp implement had done the cutting, because that would make it much easier to perform limb replantation surgery. But if the body part had instead been cut off due to a crush injury, that would be extremely troublesome. It would be highly likely that reattachment would no longer be possible, and that amputation was the only possible result.

Muscle repair would depend on the blood vessels. Zhang Fan and Chen Qifa began this work under the microscope. The thicker veins needed to match up exactly in order to reestablish a blood cycle. Artery repair would depend on the situation. The radial ulnar artery was one artery that was relatively easier to perform end to end anastomosis on.

Accidentally cutting off one’s hand was a known injury type that would occur around certain types of machinery. The success rate for hand reattachment surgery was the lowest out of all limb replantation surgeries. This was because of how difficult it would be to reestablish the blood cycle.