Great Doctor Ling Ran - Chapter 48

The M-Tang technique was also known as the multiple strand intratendinous suturing technique. Just as its name implied, it utilized many strands, usually three strands of full set nylon threads to suture the tendon. Its tractility far surpassed that of the Kessler suturing technique and the double Krackow suture technique. It would not destroy the blood circulation on the dorsal side of the tendon as well.

But the fact that the M-Tang technique required the use of three strands of full set nylon sutures for a tiny tendon made it an obviously harder technique compared to other suturing techniques used to suture tendons.

This was also the reason Ling Ran said that he could not stop. Ling Ran had completed one-third of the suturing process. If he were to stop now and suture the two other strands later, the surgery would become even more difficult. Other suturing techniques may also not be suitable anymore.

Similarly, this was also the reason Zhao Leyi could not take over.

He could suture flexor tendons too, though he could only do so with great difficulty. However, he had never come into contact with the M-Tang technique at all before this.

Unlike the run-of-the-mill simple interrupted suture, the M-Tang technique was both a suturing technique and a surgical method. It was a suturing technique used only on Zone II flexor tendon injuries. It had an extremely narrow field of application and was only useful for one-fifth of the human hand. Even though the technique was extremely difficult, the results it produced were outstanding.

As the Emergency Department’s training strategy was more towards producing all-rounded doctors, Chief Physician Zhao Leyi had never even come into contact with the M-Tang technique. He had only heard about it.

At this moment, when Ling Ran said that he could not stop because he was halfway through the surgery, Zhao Leyi found that he could not say anything to object to his statement.

What should he have said? Should he have forcibly ordered Ling Ran to stop?

Zhao Leyi looked around. The operating theater was not a lawless land. While chief surgeons possessed supreme power in the operating theater, they also had to be responsible for their choices.

He could forcibly order Ling Ran to stop, but then what would happen next?

What if the patient filed a lawsuit in the future because he could not recover hand function after receiving surgery at the Emergency Department?

At that time, even though Ling Ran would definitely get into trouble, Zhao Leyi would not be able to avoid disciplinary action as well.

He could not help but grumble internally, ‘Interns have no sense of priority.’

After thinking for a while, Zhao Leyi finally decided to look for doctors from the Hand Surgery Department and ask the experts to save the day.

The operating theater was extremely quiet.

Even though everyone’s minds were raging with gossip, they were a lot quieter on the surface.

“Skin retractor… surgical magnifying glasses… Forceps.”

Ling Ran put on the surgical magnifying glasses again and continued to call for each surgical instrument in a precise and unconventional manner.

Zhao Leyi could not restrain himself anymore. He turned and said, “Ask Department Director Huo to come to the operating theater.”

He had to first ask the expert of their own department to come. This was considered the fundamental law of saving the day, or the fundamental law of the workplace.

At the same time, the doctor from the General Surgery Department, who was watching the surgery in excitement, took two steps back and stepped on the lock screen at the bottom right corner of the door. He slipped out before the airtight access door was completely opened.

“Hou Kang, do you know the M-Tang technique?” The experienced resident doctor who was dispatched to the Emergency Department from the General Surgery Department made faces at Hou Kang.

The General Surgery Department and Hand Surgery Department were of the same category. It was just that the Hand Surgery Department was of an even narrower classification of general surgeries. All the resident doctors of both departments knew each other rather well.

Hou Kang raised his head, puzzled. “Why are you asking me this question all of a sudden?”

There could be applications for emergency consultation from the Emergency Department every day. Sometimes, there would be two or three applications a day. If the other departments were to dispatch chief physicians or more capable associate chief physicians every time there was such an application, those departments would not need to do anything else but wait all day for the Emergency Department’s applications.

Most of the time, upon receiving an application for consultation from the Emergency Department, other departments would first dispatch a resident doctor to take a look at the situation. If the resident doctor could deal with it on the spot, they would do that. If they could not deal with it on the spot, they would usually transfer the patient back to their own department’s operating theater. Or else, no matter how many pieces of equipment the resuscitation room had, it would not be enough to save the patient.

Today’s surgery was an emergency surgery where doctors from the General Surgery Department had to quickly take over from the Emergency Department. On the other hand, the doctor from the Hand Surgery Department could wait for a while before he had to handle the patient, since his injury to his hand could be considered an elective surgery. Hence, one of them waited inside the operating theater, and the other waited outside the door.

The resident doctor from the General Surgery Department said with a grin, “The M-Tang technique is being used inside.

“Impossible. Department Association Director Pan went to Japan for advanced studies.” Hou Kang immediately shook his head.

The resident doctor from the General Surgery Department immediately caught the main point. “Department Associate Director Pan is the only one in the Hand Surgery Department who knows the M-tang technique?”

Hou Kang corrected him. “Department Associate Director Pan is the only one who would use the M-Tang technique.”

With the advancement in surgery today, countless methods could already be used to achieve the same aim. Admittedly, the M-Tang technique was the first one to make a breakthrough in no man’s land [1]. But almost twenty years after the breakthrough had been made, other skills had also been developed. It would depend entirely on the patient’s condition as for which method wielded more advantages during his or her surgery.

Laymen thought that doctors ought to learn widely from other people’s strong points and learn all sorts of methods. But in reality, even though doctors usually became acquainted with various methods, they would only concentrate all their efforts on one method.

It was the same when it came to how students studied and solved problems. There were various ways to solve the chicken-rabbit math problem [2], but most students only knew one or two of them. Many years later, they would continuously and ceaselessly solve problems with the solution they were used to.

It cost doctors even more to practice a new skill. Hence, they would rarely learn skills that guarantee the same effects.

And when patients could only be treated with certain surgical methods, they would usually either enlist the help of “freelance surgeons” or simply recommend the patient to go somewhere else.

Department Associate Director Pan was the only doctor in Yun Hua Hospital’s Hand Surgery Department who was skilled in the M-Tang technique and often used it.

The resident doctor from the General Surgery Department let out a few chuckles and said, “Go in and take a look. From now on, Department Associate Director Pan won’t be the only one in Yun Hua Hospital who uses the M-Tang technique anymore.”

Hou Kang gathered his things, and in doubt, entered through the open airtight access door into the operating theater.

*Shick…*

As a resident doctor from the Hand Surgery Department, Hou Kang went quickly to a corner and stood, knowing full well what his place was in the operating theater for this surgery. He craned his head to look inside.

The surgical field was really clear while under the illumination of the surgical lamps. Hou Kang could see that the patient was receiving surgery on Zone II in his hand.

Hou Kang naturally recalled all sorts of details regarding the M-Tang technique in his mind. A series of thoughts then surged into the forefront of his head.

‘Who am I?

‘Where am I?

‘What am I doing?’

*Shick…*

Huo Congjun, who was dressed in green scrubs, walked into the operating theater.

“What’s the situation?” Huo Congjun had already received the news. His voice was low and deep.

“Ling Ran went beyond his boundaries and performed surgery without permission.” Zhao Leyi immediately complained.

“Is that so?” Huo Congjun looked at Ling Ran.

With his head lowered, Ling Ran said as he operated, “Yes.”

Zhao Leyi arched one of his eyebrows. He did not expect Ling Ran to own up to it immediately without arguing about whether he performed surgery on the entire arm or not.

Huo Congjun was also rather surprised. He lowered his head to look at the patient’s hand.

Zone II of the patient’s left hand was cut open. The two ends of a broken tendon were already cleaned and tightly bound together by a suture, which was looped around them. They fit together perfectly…

Huo Congjun marveled internally. He then coughed a few times, put on a stern expression, and said, “The chief surgeon has absolute authority in the operating theater. Other than working according to the chief surgeon’s requirements, you also have to inform the chief surgeon on what you want to do and obtain permission from him before performing any procedures, especially unconventional ones. Do you understand?”

“I understand.” Ling Ran did agree that procedures should be followed.

“Do you know what to do the next time you enter the operating theater?” Huo Congjun stared at Ling Ran with his hands behind him and asked stiffly.

Ling Ran contemplated earnestly for a few seconds and said, “Become the chief surgeon?”

“Let the doctor from the Hand Surgery Department take over.” Zhao Leyi felt like he was going to explode on the spot due to anger. He glanced at the onlooking doctors and asked, “Is the doctor from the Hand Surgery Department here?”

Hou Kang stepped forward and said in a soft voice, “I’m here. But our Department Associate Director Pan isn’t around.”

Translator’s note:

[1] No man’s land: Zone 2 in the hand.

[2] An ancient Chinese math problem. An example: there are 100 chickens and rabbits in total. The chickens have 80 more legs than the rabbits. How many chickens and how many rabbits are there?