Based on his surgical experience, it was almost impossible for this patient's finger tendon to be repaired, and the only way was to transplant a tendon.

Normally, a person will have flexor superficial tendons, flexor digitorum deep tendons, and extensor tendons in one finger.

With their contraction or relaxation, they help the fingers to flex or straighten.

Medical anatomy may seem simple, but in cases like this, adhesions can be frighteningly difficult to operate. It is a delicate operation, which tests the skills and experience of the surgeon.

No matter how confident Zhou Can is, he is also stunned when he encounters this kind of second-level surgery.

Seeing Zhou Can's hesitation, the patient couldn't help but beg Zhou Can to do his best to help and think of a way. Even if the treatment fails, he will not go to the hospital for any trouble.

At this time, the patient's father told Zhou Can that he had come early when he came to see him, and they stayed in the hotel for four days.

Since he had very few numbers, he couldn't grab them at all.

In the end, I spent 200 yuan to buy a number from a scalper.

There is such a child in the family, who is twenty-five years old, but because of an accident, his right hand is disabled. It has seriously affected job hunting, marriage, and life. This time, the patient's father contracted 17 acres of land to treat his son's illness, and also found a logging job in the forest farm in his hometown.

He also told Zhou Can that no matter how hard and tired he was, he was not afraid.

As long as he can heal his son's hand, he is willing to spend as much money as he wants.

Then he told Zhou Can that after his son's hand was injured and disabled, he had been studying hard and endured many unimaginable pains.

In the end, Zhou Can was moved by the father and son.

Dr. Xu was invited to consult with him and formulate a surgical plan.

The patient was admitted to the hospital yesterday, and all the examinations that should be done were done, and then the nurse and the doctor in charge of the bed shaved the hair on the patient's hands and feet, and cut off the nails. Prepare for surgery.

Regarding the source of the transplanted tendon, there are three options, the first is allogeneic, which requires donation from the deceased.

The procedures are complicated and there is a certain waiting period.

However, in general, tendons are not as scarce and sought-after as organs such as the cornea, kidneys, and heart, and the waiting period is generally not very long. The cost is also not high.

However, there is a risk of rejection with allogeneic tendon transplantation.

For such difficult families, the cost is still not low.

The second, artificial tendons.

With the continuous progress of human science and technology, artificial tendons have been developed, and the technology is relatively mature.

The cost is also not low, and there may be rejection, inflammation, etc.

All allogeneic transplants, whether artificial or other organs or tissues, carry a risk of rejection. Many people who have undergone an organ transplant need to take lifelong medication to combat rejection.

It can be seen that neither of the above transplant options is suitable for this patient.

This, combined with the fact that the patient has already had two corrective surgeries, only makes the transplant more difficult.

After discussion with Dr. Xu, according to the patient's comprehensive condition, Zhou Can finally decided to take the plantar tendon or extensor toe tendon from the patient's foot to complete the autologous transplantation.

Doing this surgery is very risky.

If it is not done, the patient's right hand function is not restored, and the toes also lose their flexion and extension function.

We discussed a lot with the family and the patient themselves, and got their consent, which led to today's surgery.

"You two are optimistic, and the incision is generally made from the Brunner on the palm side of the finger to make a serrated incision."

While operating, Zhou Can taught the two of them the surgical skills.

Tilting the jagged incision on the finger to one side has the advantage of keeping the scar from falling on the tendon and making it easier to suture in the flexion of the fingers.

After dissecting the patient's finger, the marks left by the previous doctor's operation can be seen.

The doctor's surgical skills were not bad, and the operation was done very delicately.

It's just that this doctor's correction method is a little puzzling.

Zhou Can naturally did not comment on the previous doctor's surgery. Instead, after quickly completing the dissection of the fingers, begin to take tendons from the patient's feet.

At present, Yang Zhi and Pu Dingdong have not been able to help Zhou Can with such a difficult surgical project.

If the medical assistant's surgical ability is strong enough, it can even operate at the same time as Zhou Can.

When Zhou Can completed the preparation for the hand transplant, the medical assistant also happened to remove the plantar tendon.

[Incision XP +1, Dissection XP +1, Complete the higher difficulty plantar tendon separation, reward XP +100.] 】

Seeing the experience value of the separation technique skyrocket, Zhou Can was overjoyed.

As for the incision, it has now been promoted to the director level, and if you want to advance to the next level, you need a full million experience points. If you can only earn 1 point at a time, it is estimated that you will not be able to upgrade for the rest of your life.

Even if you occasionally award 10 or 100 points, the difficulty of promotion is also terrifying.

However, Zhou Can is confident that it will take five years and ten years to upgrade all the major surgical skills to level seven.

Because as his surgical team continues to expand, some simple surgeries will be left to other doctors in the team. And he is constantly challenging more difficult surgeries.

For example, this hand tendon transplant right now.

Don't look at it as a second-level operation, but the difficulty is extremely high. The level of finesse and surgical skill is not inferior to that of fourth-level major surgery.

Relatively speaking, the risk of secondary surgery is lower, and the surgical process is less complicated.

That's all.

If you purely think that first-level surgery is very simple, you can do it with a surgeon. Fourth-level surgery is particularly difficult, and only the chief physician can perform the surgery, which is too narrow and superficial.

There are also extremely difficult first-level surgeries.

Level 4 surgery may also have some modest surgery. However, it is impossible to say that there is no simple thing about surgery above the third level.

When Zhou Can completed the tendon separation of his fingers just now, he had already received a lot of separation rewards.

After all, the adhesions were very serious, and in order to preserve the patient's superficial flexor tendons, Zhou Can spent great effort.

The difficulty is even higher than just to remove the plantar tendon.

After separating the plantar tendon, he proceeded to separate one of the blood vessels next to him.

This blood vessel is quite small, but it cannot be cut off directly. Because it is responsible for part of the blood supply to the feet.

There is an old saying that a man moves to life, and a tree moves to die.

Why is it easy for trees to die when transplanted?

Because it is easy to hurt the roots.

It is also the same to operate on patients, and the blood vessels, nerves, tendons, and even subcutaneous tissues that can be preserved should be preserved as much as possible. In this way, the physical harm to the patient can be reduced.

Some irresponsible doctors, in order to save trouble, directly do everything.

This is extremely unethical.

Patients may spend the rest of their lives because of all this by doctors, leaving many inconveniences in their lives, and even causing lifelong pain to the body.

[Dissection XP +1, +1...... Bonus Dissociation XP +100. 】

[Congratulations on your successful promotion to level 6 in the separation technique, with a current experience value of 1/1000000, and a primary level of chief physician.] 】

With his unremitting efforts, he was finally able to advance to the sixth level.

Zhou Can found that after this medical skill was promoted, he obviously had a new experience of separating and dissociating the organs and tissues of the human body. At this moment, the main trunk of this blood vessel has been basically separated by him, and only a few branches are left that are connected to it.

This is already considered a terminal blood vessel.

It's not a capillary, it's equivalent to a capillary.

Originally, according to Zhou Can's previous surgical ability, if such a small blood vessel wanted to be successfully separated, it would not only be time-consuming and labor-intensive, but also not necessarily successful. It's not a question of wearing magnifying glasses or not at all.

Rather, it is because the smaller the blood vessel, the thinner the blood vessel wall will be, and the more delicate it will be.

If you're not careful, you can break it.

In medicine, even if it is a godly Wu Baihe, who is called the pinnacle scalpel, it is all the right thing to encounter such tiny blood vessels.

At most, pick one or two important ones and separate them from the roots, and then go down, don't even think about it.

Zhou Can's separation technique was promoted to level six, but he wanted to take this opportunity to challenge it.

You can also experience how powerful the sixth-level separation technique really is.

He didn't dare to use the word 'cow'.

Because the sixth-level medical skill is only the director level, the seventh-level is qualified to be called 'Niu B'.

"Give me a No. 27 scalpel blade!"

Zhou Can said to Qiao Yu.

"Ah...... I didn't even know you wanted such a small blade. Xiaolan, can you please go and pick it up for me in the equipment room? ”

“OK！”

Ma Xiaolan ran to get the blade in a hurry.

There are common instruments and consumables room in the operating room, and all kinds of commonly used surgical consumables and blades are stocked.

In the past, when he was operating in the old operating room, Dr. Xu also lost his temper once because the consumables packaging bag in the equipment room was opened but not used.

"With such a small blade, you don't want to separate the peripheral nerves, do you?"

Qiao Yu didn't know why Zhou Can was about to complete the separation of the plantar tendons, so why he suddenly needed such a small blade.

Normally, the use of an 11-gauge blade is sufficient to separate the blood vessels. For peeling, 10 blades are used.

"I want to keep as many small blood vessels as possible for him, so that it can reduce the damage to his feet."

Zhou Can smiled.

Soon, Ma Xiaolan ran over with the No. 27 blade.

In fact, there are also No. 34 blades and No. 36 blades.

For now, though, using number 27 should be enough.

After replacing it with a small blade, Zhou Can held it in his hand, thinking that he would be a little uncomfortable. Unexpectedly, after the separation technique was promoted to level six, there was no sense of disobedience in his hand.

And there's a familiarity of an 'old man'.

It seems that I used to hold such a small blade to separate blood vessels and nerves.

I tried to separate the first small branch blood vessel, and the knife was unusually smooth. One knife after another, his hand was as steady as Mount Tai, but the knife was like lightning.

The fast knife method and the stable knife method can be called a perfect combination at this moment.

With his incision and separation techniques all promoted to level six, it seems that even with his fast knife method and steady knife method, there has been a new breakthrough and growth.

No, it's a great feeling.

It was something that Zhou Can had never done before.

Finally, thanks to his efforts, the first subdivision of the branch was successfully separated.

I was mentally prepared for the possibility of cutting the blood vessel wall, but in the end I succeeded.

It's just that it's far from perfect.

In fact, there is no need to pursue the so-called perfection for surgery. It is enough to be able to make the surgery successful and ensure that the patient recovers well after surgery.

Of course, after having a very good surgical foundation, it is natural to go to the next level and pursue more excellence.

Zhou Can is very self-aware, and now he has just been promoted to the sixth level, and he is only at the primary level of chief physician, if he blindly pursues perfection, it is absolutely undesirable.

First of all, this will greatly prolong the operation time.

Secondly, the technology is not up to that level, and if you have to pursue perfection, you will have an accident if you don't do it well.

In the words of the old man, it is to eat whatever you can do.

If you don't have that ability, you have to think about eating delicacies from the mountains and seas, and you are destined to have a heart higher than the sky and a life thinner than paper.

[Dissection experience +1, you successfully separate a small blood vessel, experience point reward +100.] 】

Zhou Can's eyes lit up suddenly, and he seemed to have found a new way to earn a large amount of separation experience points!

In the future, as long as conditions permit, the patient can be separated from several small branch blood vessels. Not only can you earn 100 dissection experience points, but you can also reduce the damage caused to patients by the surgery.

Kill two birds with one stone.

……

Once the plantar tendon has been successfully removed, the next step is to transplant it into the patient's finger.

This surgical process is also an extremely delicate process.

And it is a great test of the experience and planning of the surgeon.

"Doctor Zhou, why do you need to reserve some surrounding tissue when you take the plantar tendon?"

Dr. Pu Dingdong was puzzled and asked Zhou Can for advice.

Under normal circumstances, it is best not to ask questions during the main operation. Because sometimes the operation is too difficult, the patient's condition is not very good, and the pressure on the surgeon is very high.

It is conceivable that the main knife was in a very irritable mood at this time, like a powder keg pressed in his heart.

If you don't look for something, you may be scolded, and if you dare to ask questions at this time, you will most likely be scolded.

When Zhou Can was interning before, he had an operation, and the chief surgeon was a grumpy deputy chief physician. I was stunned to put the instrument nurse from the beginning of the operation and scolded until the end of the operation.

At that time, the instrument nurse was also a thirty-year-old woman, and she was so stunned that her eyes were full of tears when she was scolded.

Even so, she insisted on completing the surgery.

Then he ran out to hide in the toilet and cried.

Sometimes, it is also a kind of happiness for medical assistants and surgical nurses to meet a good-natured surgeon.

Speaking of which, I would like to reveal another interesting phenomenon.

Basically, whether it is a large hospital or a small hospital, the nurses in the operating room are often the most beautiful among the nurses.

There should be many reasons why this phenomenon occurs.

First of all, the status of the surgeon is often very high. In any clinical department, the doctor who does a good job of surgery will have a high status.

There is no dispute about this.

Because people do have this capital, it is not only the 'box office' guarantee of the department, but also the core of the department's income generation.

Even in the internal medicine department, doctors who do a good job of intervention are also in a higher position.

The second reason is that the surgeon is usually a male doctor.

Ten men have a few colors, it has nothing to do with character, this is just the nature of men.

I believe that no surgeon is willing to cooperate with a female nurse with a particularly low appearance during surgery. The surgery itself is a nervous, physically demanding, and stressful job. In order to complete a difficult surgical task, it is necessary to stare at a bloody area for an hour or two, or even hours.

How tired your eyes must be!

In addition to surgery, you can look at a good-looking female nurse to relieve the visual fatigue of the eyes and make you feel better.

As for the hypocrites, if they have to put the doctors in the temple of morality and define them as not eating the fireworks of the world, then they can only say, young man, you are a little too young.

Whether it is a male leader or a surgeon, as long as it is a man, he hopes that the women around him will have good looks.

Some business owners, in order not to make certain mistakes, hire a male secretary, which in itself is actually a sign of lack of self-confidence.

(End of chapter)