Chapter 994: Pork Brains
The incision made by Ling Ran today was only one-third of the usual ones he made, which was about two inches in length.
Compared with minimally invasive surgery, an incision like this was still a very huge wound, and it was still very difficult to control the post-surgery scar healing. However, compared with large incisions of more than five inches, which were commonly made in the Zhu-Ling Achilles Repair Technique, incisions that were two inches long could still be covered by various methods.
Of course, the most important of these was the strength of the Achilles tendon after the surgery.
If the patient did not pursue strength in the Achilles tendon to ensure corresponding motor ability, the patient would not need to take on the challenge of undergoing the Zhu-Ling Achilles Repair Technique and receive a large incision. She could just go straight for minimally invasive surgery.
As a result, Ling Ran always faced patients who belonged to two extremes. At one extreme, there were athletes and sports enthusiasts placed first importance on their motor ability. At another extreme, there were non-professionals more concerned about their wound and appearance, and they could give up some motor ability.
Pei Baoer then revealed to Ling Ran another type of demand, the type that fell in between the two extremes.
On the one hand, she needed her Achilles tendon to have extremely strong motor ability, because dancers really required it. On the other hand, she needed the scars on her legs to be as small as possible and the skin to be as smooth and complete as possible because dancers also really needed their skin to look good.
Just reaching either one of these goals would be extremely detrimental to Pei Baoer’s career; this was a contradiction that was rare in other patients.
Ling Ran had performed Achilles tendon repairs for many female athletes, and among them were young female athletes who had beautiful and smooth skin. But even if they were not willing to have a huge incision, they would eventually make a rational choice to undergo Zhu-Ling Achilles Repair Technique or just simply retire.
However, Pei Baoer was first willing to escape reality by sitting in a wheelchair without undergoing surgery. Then, she endured the pain and returned to the operating table voluntarily, which showed her psychological dilemma.
Ling Ran never cared about what others said, but cared more about what others did.
Approaching Pei Baoer’s situation made Ling Ran become aware of how to further improve the Zhu-Ling Achilles Repair Technique, or rather, he became aware of another sort of demand for the Achilles tendon repair technique.
The Zhu-Ling Achilles Repair Technique was originally designed according to Liu Weichen’s needs. Liu Weichen was a world-cla.s.s male track and field athlete. He had extremely high requirements for his Achilles tendon’s strength and no requirements for his calf’s appearance. Therefore, a four-inch or six-inch incision was not a problem for him. As long as his Achilles tendon’s strength was guaranteed, it was enough. If an extra 2 inches meant that it would increase his Achilles tendon’s strength by one percent, he was willing to go through it.
However, dancers like Pei Baoer obviously needed a balance between both.
In other words, with dancers like Pei Baoer, he could use a new plan and concept to redesign the surgery.
This was unimaginably difficult for ordinary doctors, but for Ling Ran and Academician Zhu, it was not that complicated.
Would it take time to improve a technique? Of course, it would! Would it be a little difficult? Of course, it would! Could it be done? Of course, it could!
Ling Ran lowered his head and sutured the blood vessels gracefully.
The core of the new technique was still blood supply. To be precise, this was the core of the Achilles tendon repair technique. Only by ensuring blood supply could the strength of the Achilles tendon be maintained. In fact, for ordinary doctors, only by ensuring blood supply could the Achilles tendon’s vitality and success of the operation be guaranteed.
However, different surgical methods produced great differences when it came to ensuring blood flow.
Minimally invasive surgery could cause the least wound on the skin, and the blood vessels that were lost during the surgery would be given up by all involved in the surgery in a tacit agreement. As long as the reconnection of the Achilles tendon was completed, the remaining blood vessels would be used to maintain a certain degree of motor ability to ensure that the patient could live a normal life. That was the goal of the surgery.
Open surgery had another direction. It was more of a reconstruction of the system surrounding the Achilles tendon. If the Achilles tendon was ruptured, then everything would need to be sutured back in place. Whenever there was insufficient blood supply, one had to suture the blood vessels and even perform a blood vessel transplant…
The Zhu-Ling Achilles Repair Technique was the best in this regard. It would try not to miss out on even the small blood vessels, which made it more effective and outstanding, but also made it even more difficult. It had almost become a surgery unique to only Ling Ran. The doctors who could perform this kind of suture would rather use it in neurosurgery. They were too lazy to do such an intricate suture on an Achilles tendon.
Ling Ran and Academician Zhu re-discussed the surgery’s design and adopted a plan that could compromise the demands from both sides.
In the case of open surgery with a small incision, the blood vessels should still be sutured as much as possible, but the selection had to be better and had to be focused on the more important ones. If the Zhu-Ling Achilles Repair Technique was compared to a sudden downpour of st.i.tches on the ruptured blood vessels, then this suture was irrigation aimed at only the core places.
That was the most stable plan discussed by Academician Zhu and Ling Ran within a short time. However, if they were to really look into it, the length of time did not play into a major factor behind why they could only come up with this plan. Clinical medicine was not like natural science, in which the scientist could take his sweet time to come up with various best plans. Clinical medicine often forced the surgeon to perform surgery because they had no other alternative. The time taken to wait for the right patient was often longer than the time needed for the doctor to design a plan. It was also not uncommon for them to revise a plan when they were about to conduct the surgery.
Pei Baoer was very suited for this modified version of the Zhu-Ling Achilles Repair Technique. Not only did she have realistic and exact requirements, but from the MRI scan and other imaging information, her Achilles tendon’s physical conditions were also suited for the surgery.
Ling Ran grabbed a ruptured end of Pei Baoer’s Achilles tendon and nodded with satisfaction while tr.i.m.m.i.n.g it.
A ruptured Achilles tendon was hairy. In medical terms, it was described as a horsetail, but Pei Baoer’s Achilles tendon was not completely ruptured; less than a quarter of it remained connected. The ruptured part was also not in a uniform shape. So, it was not really like a horsetail but was more like chicken feathers. Some of the thicker ends were like plumage, and some were thin like down feathers. It was a mess.
Ling Ran tidied them up patiently before he began suturing it. After that, he sutured the blood vessels, which varied in thickness. He also focused on protecting the key blood vessels.
Since this was a two-inch incision, the surgeon would have to face a lot of problems regardless of whether it was suturing the Achilles tendon or suturing the blood vessels. To a certain extent, this actually increased the surgery’s difficulty.
However, since there were fewer blood vessels that needed to be sutured, the total operation time could be reduced. From this perspective, the difficulty of the surgery was reduced.
After all, no matter how difficult it was, it was just an orthopedic surgery. Besides needing to pay attention to infection, an orthopedic surgery’s overall difficulty could not be any higher. It was difficult to suture the blood vessels, but it was not more difficult than a craniocerebral surgery; it would take a long time to suture blood vessels, but it was not as long as a craniocerebral surgery; there were a lot of problems when it came to suturing blood vessels, but it was not as complicated as a craniocerebral surgery…
Ling Ran demanded himself to perform by the standards of a neurocranial surgery while performing the Achilles tendon repair surgery. Besides the corresponding equipment not being able to compare to a neurocranial surgery, his a.s.sistants’ technique not comparing to the a.s.sistants in a neurocranial surgery, and the people were not as careful as those performing a neurocranial surgery… the environment was basically the same.
Ling Ran operated silently. He held an Achilles tendon in one hand and sutured the blood vessels in the other.
Somewhat, it felt a little lonely… Especially when the atmosphere in the operating theater was always lacking in seriousness.
Ma Yanlin, who was accustomed to Ling Ran’s operating theater, was now talking about Lu Wenbin’s pork trotter, “Pork is indeed expensive, but the price of Lu Wenbin’s pork trotters is rising too fast. The price is adjusted once a week, and the magnitude of the price adjustment every week is not low as well. Seriously, he really doesn’t want to suffer the slightest bit of loss when it comes to this business.
“The pork trotters have also become a little smaller, and the number of large pork trotters like the ones in the past has reduced in number.
“The amount he sells is large, but when he sells it at such a large scale, he can’t just increase his price just because he wants it. Furthermore, once he increases the price, will he reduce it? I refuse to believe that he will.”
“Let’s eat hot pot at night,” Ling Ran suddenly said and interrupted Ma Yanlin’s complaints.
“Okay, I’ll make a reservation later.” Ma Yanlin agreed quickly before he asked, “Do you want to order dishes in advance?”
“I want to eat two pork brains.” Ling Ran patiently pushed the needle in a blood vessel and pulled the thread. All he could think in his mind right now were pork brains.