From small clinic to medical empire

Chapter 129 Status in the Jianghu in the operating room

The first step in nerve transplantation is not to intercept the sural nerve that can be transplanted, but to cut off the old radial nerve that was sutured.

Because there was a lot of scar tissue in the original suture, Zhang Zifan directly removed the 1.5 cm nerve and discarded it.

At the same time, the exposed two fresh wounds were fixed and protected with medical rubber bands.

After completing these preparations for the operation area, the required complex tissues are dissected and separated at the donor area.

In this tissue, only the nerves are not enough, it must also include microvessels that can support the nerves.

The nerve-capillary complex can only be used for the repair of the radial nerve.

Since the sural nerve can provide up to 40 centimeters of nerves, and Zhang Zifan only removed less than 4 centimeters, the remaining nerves can still be successfully sutured after long-distance anatomical reduction.

This 4-cm section of nerve is only a small section for the sural nerve, but it is life-saving for Kong Xiang’s damaged radial nerve.

The length of the previously removed radial nerve was 1.5 cm, and the length of the implanted nerve was about 3.8 cm. The extra 2.3 cm length completely eliminated the tension, so that the nerve was no longer tense.

All that's left is stitching.

This is also the most critical step.

The former master of microsurgery performed a highly complete epineurial suturing on both ends of Kong Xiang's radial nerve.

This suture method is also the mainstream nerve anastomosis method in the world.

Many people think that nerve sutures suture the nerve itself, which is actually wrong.

Nervousness is the synapse of nerve cells, and the needle and thread of suture will cause great damage to it, so it cannot be sutured.

What the doctor can sew is the perineurium and adventitia that wrap the nerve.

The epineurium suture method, that is, after the nerve is closely aligned, only the epineurium is sutured, and the specific perineurium inside is not sutured, and they are allowed to grow wildly.

From the principle alone, we can know that this suture method is definitely not as effective as suturing the perineurium.

However, a large number of clinical practices have shown that there is no statistical difference in the final effect whether it is the epineurium suture method or the perineurium suture method.

This is intriguing.

To use a popular metaphor, neural anastomosis is a bit like the butt joint of two cables.

This cable is relatively thick and is composed of many independent small wires, which are wrapped with a large insulating rubber.

The former method is to directly sew up the outermost large insulating rubber of the cable and it's done.

The latter is to separate the small wires from the large insulating rubber, and sew the insulating rubber of the small wires separately.

Theoretically speaking, the quality of the second connected cable must be better.

However, nerves are not cables after all, and the perineurium is not colorful wire rubber.

According to the color of the rubber, it is very simple to find two wires of the same nature and connect them.

But even with the help of a high-level microscope, it is difficult for doctors to accurately identify the nature of the two stumped nerve bundles (distinguishing motor from sensory fibers).

Therefore, the right or wrong suture of the perineum depends on the face, and the most experienced doctor can achieve four or six. If luck is bad, it may even be completely wrong.

At the same time, in order to separate the small nerve bundles, it is easy to damage the interfascicular nerve branches, and more scars will be caused at the postoperative anastomosis.

So the perineurial suture method looks very beautiful, but in fact it is just a fierce operation. Looking at the data, it is 0 bars and 5. It is better to just suture the epineurium honestly.

Of course, with this kind of surgical problem, meeting Dean Zhang is another story...

Identify things like motor bundles, sensory bundles...

Sprinkle water!

With the help of a blue-grade surgical microscope, the accuracy of Zhang Zifan's nerve suturing this time is even higher than that of Fang Guohua's last operation.

On the one hand, this is because the exam is open-book, and on the other hand, Zhang Zifan, a candidate, has also matured his surgical ability through repeated refinements.

When the perineurium of the last nerve bundle was sutured, Zhang Zifan breathed a sigh of relief.

"Okay, I'll leave it to you guys, do it well!"

After speaking, Zhang Zifan threw away the gloves, took off the surgical gown, and left in a cool manner.

Real man, never look back at the explosion!
This is the bearing of a big surgeon!

In the past, Zhang Zifan was the little brother who watched the backs of experts and professors leaving gracefully, and then sewed silently.

But now, the little brother finally became brave!
Yuan Qiang and Bao Tingwei handed over Zhang Zifan's remaining work.

However, the division of labor between the two is also different, which perfectly interprets the status of the operating room in the rivers and lakes.

Yuan Qiang was in charge of suturing the epineurium.

When the pericardium is completely sutured, suturing the outer membrane is very simple.

But no matter how simple it is, this is nerve stitching, which is much higher than skin stitching.

For the exercise of surgical techniques, it is not comparable to suturing the skin.

With Yuan Qiang's current surgical techniques, he is still competent to complete this level of suturing.

After the epineurium was sutured, Yuan Qiang patted his butt and left gracefully.

It's just not as arrogant as Zhang Zifan, he didn't dare to throw away his gloves, and he didn't dare to speak coquettishly.

The final task of suturing the fascia and skin naturally fell on Bao Tingwei.

But just like this, Bao Tingwei is also under a lot of pressure!

Although, in the eyes of doctors, every patient should be the same.

But people are not sages, who can really make all living beings equal?
Now lying on the operating table is Professor Kong Xiang, who is well-known in the entire medical circle!
Is Bao Tingwei not as good as facing the enemy?

Objectively speaking, the Department of Ophthalmology where Professor Kong Xiang works is a small department like Liu Jianming's Department of Dentistry.

Still in terms of the number of academicians, ophthalmology is the same as dentistry, and there is only one academician.

Therefore, even if Professor Kong Xiang is at the top of the domestic ophthalmology pyramid, he may not be well-known in the entire medical circle.

But the accident half a year ago, what happened to Professor Kong Xiang touched the hearts of countless people, and made his name familiar in the medical circle.

Now, surgical rookie Bao Tingwei is tremblingly suturing Professor Kong Xiang.

You must know that the other stitched scars on Kong Xiang's body were all made by famous experts, and it is not an exaggeration to say that they are works of art.

Poor Bao Tingwei, a rookie, even if he tried his best to imitate, his skills are still far behind.

He's about to cry, I'm an oral surgeon, why do I sew someone else's arm!
Thinking about it carefully, as an undergraduate graduate of my second university, I was treating a 36-year-old medical professor and doctoral supervisor in a community hospital. This matter itself is very wrong!
Bao Tingwei felt that since he got on the thief ship Haoran Hospital, his three views had been refreshed countless times.

However, the money given by Dean Zhang is really too much, and such growth opportunities cannot be bought with money. Telling the students will be blown out of their heads. Bao Tingwei can only hold tears in his eyes, carefully After suturing, I experienced the pain and the feeling of happiness.

(End of this chapter)