Great Doctor Ling Ran
Chapter 236 - It Will Be Better
Panda Novel
Once she lay on the operation table, He Xiufang raised her head and asked Ling Ran, “Doctor Ling, are you the one responsible for performing the surgery on me?”
Ling Ran had his hands placed together while he read the MRI scan for the umpteenth time. He nodded but remembered that He Xiufang could not see him. Then, he said, “I’m the chief surgeon. Academician Zhu Tongyi will be guiding the surgery.”
“When you perform the surgery, could you give me a smaller wound?” He Xiufang lowered her voice a little and said, “I’ll try to lose weight after I retire and will definitely be more good-looking than I am now. I don’t want to have a scar behind my calf.”
“The wound can’t be small,” Ling Ran replied very stiffly. He then said, “You can get a tattoo when that happens…”
“I can’t have a tattoo. In our hometown, it’ll be even harder for those with tattoos to get married than those who have to be remarried.” He Xiufang raised her voice.
The surgical nurse who was making preparations was not happy when she heard the comment. “What’s wrong with having a tattoo? I won’t marry a man who doesn’t want me to have a tattoo on my skin. I’d just filter out these types of people.”
“I don’t want a tattoo!” He Xiufang was very firm.
“After the operation, I’ll give you a suture. If the prognosis is good, it won’t be too obvious.” Ling Ran looked at the film, closed his eyes, and tried to recall the image in his head. He then turned around and asked, “Is there any other problem?”
He Xiufang thought for a moment and said, “Your operating table is so small. Can you change it to a bigger one? I’m afraid that I’ll turn around when I fall asleep and fall to the ground. I move around a lot when I sleep, and I snore…”
“Anesthetize her.” Ling Ran felt that they were done with preparations.
The anesthetist who made sure he had enough sleep the day before smiled and came over. He held a laryngeal mask and said, “Could you tell me your name again.”
“He Xiufang.”
“A discus thrower?”
“Yes.”
“Come, eat a biscus.”
“Huh?”
The people in the operating theater and the doctors in the demonstration room silently watched the anesthetist’s performance.
“I thought about this the whole night.” The anesthetist was so delighted that he could not help but throw his head upwards and cry out.
Ji Tianlu and Zhu Tongyi looked at each other. They did not even have the desire to understand what he meant.
Ling Ran waited a little before he asked for a pen. He drew a line from He Xiufang’s ankle to her calf. The line was seven inches long.
The surgical nurse could not help but cry out before she quickly lowered her head.
Ji Tianlu frowned and asked, “Must it be that long?”
“The edge of her Achilles tendon is a bit uneven. It’d be safer to have the cut a little longer,” Ling Ran said according to the information on the MRI scan.
“All right, you make the decision.” Ji Tianlu paused for a while before he said a little regretfully to the anesthetized He Xiufang, “The scar will be a little longer but there is no other way. Treating her is our top priority.”
Ling Ran did not say a word. He was never a doctor who liked to do small incisions to begin with. When he was studying, he had seen and heard too many cases where accidents happened because the opening was too small. Now that he had accumulated more knowledge, he was even more afraid of accidents that could occur during surgery.
Since the edges of the Achilles tendon in the MRI scan was not clear, there were many possibilities. If the condition were to be serious, she could even have a malignant tumor there. A lighter condition would just be a damaged Achilles tendon. As the chief surgeon, since Ling Ran was the one to open the surgical field, he rather took a look at it himself.
“The Achilles tendon isn’t completely disconnected.” As the S-shaped knife cut into her skin, the doctors in the operating theater were relieved. The doctors in the demonstration room also let out a sigh of relief.
The key difference between a completely ruptured Achilles tendon and a partially ruptured Achilles tendon was not how much the Achilles tendon was injured, but how atrophied the muscle attached to the partially ruptured Achilles tendon was.
It was a troublesome problem among Achilles tendon ruptures. The ruptured Achilles tendon would shrink inwards, and in bad cases, it shrunk 2.3 to 2.7 inches inwards when surgeons opened up the leg.
It would be very difficult to suture an Achilles tendon that was attached to such atrophied muscles. The surgeon may not even be able to pull the two ends of the tendons together. They could only do an Achilles tendon transplant, which was to take a piece of tendon from other parts of the body to make up the missing length.
It was easy to imagine that the resulting tendon strength of such Achilles tendon transplants were definitely not enough for high-intensity training and could only be enough to support daily life. Not only that, the person had to be very careful. It was impossible for them to participate in high-intensity competitive sports.
They could tell from He Xiufang’s MRI scan that her Achilles tendon was not completely ruptured, but only when it was completely opened could they confirm the specific details of how much her tendon had ruptured.
Based on what they could see at the moment, there were no signs of extremely severe injuries, and the ends of the tendon were not too uneven as well. The injury was lighter than all the other Achilles tendon injuries Ling Ran had dealt with.
Even if he were to use the standard surgical plan for normal people to suture her Achilles tendon, he could score an easy eighty for it. That would be the level where He Xiufang may be able to receive high-intensity training, and the total time he needed would not exceed half an hour.
Many athletes accepted similar operations, and after the surgery, they would have to rely on their own efforts to heal. Only then could they once again compete with the others on the field.
With Zhu Tongyi’s Plan A, Ling Ran’s confidence was even greater. Although he was not certain if he could reproduce the results from Liu Weichen’s recovery, the success rate would inevitably increase for an Achilles tendon that was not completely ruptured.
“Take out the Achilles first. Hmm… I’ll do it myself.” Ling Ran did not let Ji Tianlu do it. Instead, he chose to do it himself.
Zhu Tongyi frowned and asked, “Ling Ran, what do you mean you’ll do it yourself?”
“I memorized the position of the blood vessels earlier and I’m prepared to avoid touching the blood vessels as much as possible to take out the Achilles tendon.” Ling Ran cocked his head and said, “After I take it out, I’ll just follow the same steps in Liu Weichen’s surgery.”
The thought emerged in Ling Ran’s head after he went back to the hotel and analyzed Plan A once he used the surgical plan on Liu Weichen.
From Ling Ran’s perspective, many of the blood vessels that he severed the last time could have been avoided. In other words, he could reduce the complexity of rebuilding the vascular network by avoiding the small blood vessels, or he could even build a similarly complex vascular network but with more blood vessels to supply blood.
However, such an operation was even more difficult. The surgeon’s understanding towards MRI scans had to be rather high, otherwise, he would not be able to justify his actions.
Ji Tianlu thought for a while before he understood what Ling Ran meant. He gasped in astonishment. “You couldn’t have remembered all the positions of the blood vessel, could you?”
“How’s that possible?” Ling Ran laughed.
“That’s what I said…”
“I just remembered those around the Achilles tendon.” Ling Ran smiled.
Ji Tianlu chuckled awkwardly and did not have the drive to talk to Ling Ran anymore.
Zhu Tongyi also coughed and tried to regulate the atmosphere. “Chief Physician Ji, Ling Ran may be young, but his score in his batch was among the top three in Yun Hua University. He wouldn’t be able to do it if he had a bad memory, right?”
Doctors were different from other professions. Even if they had left school for many years, their academic qualifications still had considerable value, especially for medical students from well-known universities. Not only did it make it easier for them to look for jobs, it also made it easier for them to get promoted. Even after a few years, those who graduated from Peking Union Medical College Hospital and Xiangya School of Medicine, as well as those overseas returnees, still garnered a lot of attention from hospitals.
Of course, at that time, their academic qualifications may not be the only thing that made other hospitals pay attention to them. It could be because of their specializations.
Zhu Tongyi had only recently looked at Ling Ran’s file, which was why he remembered it very clearly. Right then, he took the opportunity to gossip.
Ji Tianlu was interrupted, but he decided not to be bothered by the issue any longer. He stared at Ling Ran’s operation and pondered silently.
Ling Ran slowly performed the incision. His movements were very slow, but the incision was done very precisely. He made sure that the blade went around the edge of the blood vessels, and he gradually peeled off the ruptured part of the tendon.
It took Ling Ran thirty minutes to complete this step.
However, when it was completed, everyone was relieved.
The next step to employ was Plan A, which everyone had already performed before. This time, the operation would be even simpler. In comparison to what Ling Ran just did, Plan A was much more relaxed.
Ling Ran swung his arm in a circle before he began to suture at lightning speed.
He had sutured at least eighty or ninety Achilles tendons over the past few days if not one hundred. Hence, with the addition of the Perfect Level Achilles Tendon Repair Technique on top of the numerous Achilles tendons he had worked on, he had accumulated a lot of information on the Achilles tendon.
Forget the other aspects, Ling Ran had gained more knowledge on the tissues around the Achilles tendon than anything else, and because of that, he grew more familiar with its tissues in terms of its toughness and hardness, among other things.
Such experiences would affect how a person handled suturing the Achilles tendon. Different experiences led to different actions. It was like how a work of calligraphy would show different styles on different types of rice paper.
Ling Ran familiarized himself with the tissue organization around the surgical field, and the remaining portion of the surgery became a very stable recreation of Liu Weichen’s surgery.
It was still the same vascular anastomosis.
Ling Ran performed the same outstanding anastomosis.
However, Ling Ran did not do anything special. He just steadily followed the procedure step by step.
When it was time to perform the layered closure, many of the young doctors in the demonstration room still had to wrap their heads around the fact that Ling Ran’s surgery was completed.
“It’s done.” Ling Ran put his equipment aside and gave up his position.
“How do you feel?” Zhu Tongyi was in an extremely good mood. The two consecutive cases performed using Plan A were successful, which vastly increased the value of Plan A.
Ling Ran only treated Zhu Tongyi’s question as him asking about the contents of the surgery. After Ling Ran briefly thought about it, he said, “She should have a better recovery than Liu Weichen.”
“That’s great.” Lu Wenbin and the young nurse both clenched their fists in celebration.
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