Read Novel Full Chapter 1240 - 489: Another Level 6 Medical Skill, the Meaning of Being a Doctor
Chapter 1240: Chapter 489: Another Level 6 Medical Skill, the Meaning of Being a Doctor
"Doctor Yang, let me test you. Why do we intentionally leave some peritendinous tissue when harvesting the transplant tendon?"
Zhou Can threw this question to Yang Zhi.
"Is it for better fixation of the tendon?"
Yang Zhi clearly didn’t quite understand either.
According to common reasoning, leaving some peritendinous tissue when taking a tendon can facilitate suturing and fixation.
"Let me ask you, what is the function of a tendon?"
Zhou Can answered with a question of his own.
"It’s to help the limbs perform movements! For example, the flexor and extensor tendons help the fingers perform flexion and extension actions."
Yang Zhi answered without hesitation.
Anyone who studies medicine knows the function of tendons, right?
"Why can the finger flexor and extensor tendons help finger movement?"
Zhou Can asked further with a hint of a smile in his eyes.
"This...isn’t it because they help the fingers bend and straighten through contraction and relaxation?" Yang Zhi’s confidence wavered under Zhou Can’s questioning.
"Doctor Yang’s answer is not quite on point. For a tendon to assist limb movements, it must first ensure it can glide smoothly and freely. If there is a bone deformity or muscle atrophy leading to tightening, it may not move properly, affecting the relevant part of the body’s function. So, when I separate the plantar tendons, I deliberately leave some peritendinous tissue so that the transplanted tendon can glide flexibly."
Zhou Can was in a good mood, so he patiently explained the surgical intricacies to the two of them.
These surgical insights are not easily learned from books; they are valuable experiences accumulated by surgeons in clinical practice.
"I see! Thank you for the lesson!"
Yang Zhi and Pu Dingdong nodded repeatedly, finding the insights extremely beneficial.
Following Zhou Can in surgeries, they could often learn a lot of practical valuable knowledge.
And it’s not just about surgery; sometimes rescue experiences and problem-solving approaches greatly benefited them.
"Remember, after fixing the distal end of the transplant tendon properly, you must immediately test its reliability. If problems are identified, the reasons must be found and addressed immediately. Do not be careless. If you find a problem but ignore it and directly suture the wound, it will directly result in the patient not regaining the expected finger function post-surgery."
Zhou Can advised the two.
What defines a good mentor?
Someone who can teach by example, sharing their virtues, experience, and skills. That is a true mentor.
He tested the secured plantar tendon and found no problems.
Only then did he proceed to suture the incisions on the fingers one by one.
He did not ask the two surgical assistants to take over, as this surgery involved precision and a high technical demand.
Yang Zhi and Pu Dingdong could not meet these demands.
Next, he placed the wrist in a neutral position, and traction on the free tendon ends flexed the fingers into a position 15° greater than the functional position.
Then, from the radial side to the ulnar side, the degree of flexion in each finger increased.
Though it sounded simple, there were many nuances in the operation.
For the dynamic muscle, it required sewing a traction line on its tendon and pulling the tendon to test its sliding range until it met the requirements.
Moreover, it required that under higher tension, a needle be transversely passed through the skin to keep it in place. The two tendons were temporarily sutured and fixed, the fixation needle removed. Then the wrist joint was flexed at 40°, and the fingers should be able to fully extend, while in maximum dorsiflexion of the wrist joint, the fingertip should be within 4cm of the palmar transverse crease.
After testing, everything passed, and a hint of a smile appeared in Zhou Can’s eyes.
The main task in transplanting hand tendons is patience; the surgical procedure needs to be extremely meticulous, and all intraoperative tests must be performed thoroughly.
One must not take shortcuts.
Furthermore, after determining the tendon length, the proximal end of the free tendon is anastomosed with the deep finger flexor tendon.
When performing tendon anastomosis, considering the disparity in thickness between the retained superficial flexor tendon and the transplanted plantar tendon, he used the Pulvertaft weaving method for fixation. If the tendons were the same size, the conventional suturing method would suffice.
[Suturing Skill Experience Points +1, +1... Bonus Experience Points +10.]
[Ligation Skill Experience Points +1, Bonus Experience Points +10.]
As he continued suturing, the experience points rapidly increased.
The Suturing Skill had long advanced to Level 6, and the Ligation Skill was not far behind, but it was getting close.
He was eager for the Ligation Skill to also advance to Level 6 soon.
Because Suturing Skill and Ligation Skill are like close allies; one cannot do without the other.
It is insufficient if only the Suturing Skill is strong while the Ligation Skill remains weak. In some high-difficulty surgeries, a weak Ligation Skill would significantly lower his surgical level.
The advancement of the Ligation Skill was slow, mainly because it was difficult to earn large experience point rewards.
The most common reward was like the 10 experience points earned earlier.
Also, there might be ten suturing experience rewards for every single ligation reward.
This was why this medical skill’s experience points lagged far behind the Suturing Skill.
Nevertheless, there was no need to worry too much; in various surgeries, the frequency of using Suturing and Ligation Skills was extremely high. Almost every surgery, big or small, utilized them.
Based on the current progression, the Ligation Skill should soon advance to Level 6.
Soon, he completed the anastomosis of the two tendons.
[Anastomosis Experience Points +1, completed a highly difficult tendon anastomosis, Bonus Experience Points +1000.]
The high difficulty of the anastomosis was mainly in two aspects. One was the size discrepancy between the transplanted plantar tendon and the retained superficial flexor tendon. The other was the small operation platform for the fingertip anastomosis, requiring extremely high precision.