Surgery Godfather - Chapter 23

Chapter 23: Chapter 0022 – Remarkable (Continued)

A gasp of surprise, and the barrage of comments immediately revived.

“Emergency reconstruction! Emergency reconstruction of the thumb is required!” Someone in the orthopedic conference room of Magic City Sixth Hospital shrieked.

The live broadcast that was originally intended to be shut down was kept going.

“Professor, shouldn’t it be time for lunch?” A student came over and whispered a reminder.

Oh yes, lunchtime had long passed. They had spent the whole morning watching this live broadcast and had forgotten to eat.

Hong Zhigang looked at his watch and realized it was already past two o’clock.

“Didn’t we order boxed meals?” Hong Zhigang remembered.

What the student meant was – could the boxed meals be distributed now?

Hong Zhigang nodded: “Go ahead, let’s eat and watch. Everyone seems to be enjoying this.”

Hong Zhigang himself was quite interested too.

A few graduate students carried several baskets of boxed meals and started to distribute them one by one. The meal sets, which consisted of three dishes and a soup — beef, fried eggs, tofu skin, additional vegetables, a rib soup, a bottle of mineral water, and a pack of tissues.

Some placed the boxed meal in front of them without opening it; others kept their eyes on the screen, mechanically feeding themselves with chopsticks, barely registering whether they were eating or not. In any case, they consumed this meal without tasting it.

“Any thoughts?” Hong Zhigang turned his head to ask.

Wen Rentao did not reply but asked, “Is this another masterpiece by Uncle Han?”

He immediately realized he had said something he shouldn’t have, but it was too late. Han Jiangong was a taboo subject when chatting with Hong Zhigang. None of his students dared to mention this name in front of him.

However, Hong Zhigang did not get angry. He sighed and said, “Who else could it be besides him?”

“Professor, you are a Golden Knife Award winner!”

Hong Zhigang said nothing more.

—

“I’ve ordered takeaway, let’s stay on this until the end today.”

“This lunatic is too confident.”

“Indeed impressive, but a bit too arrogant.”

“I hope the organizers track the survival and function of the severed limb.”

“Can it be defined as showing off?”

“A quick hello from Mo Sixth.”

“Of course, we will follow up later.”

—

“Xiao Yang, can you still hold up? Or should I wash my hands and take over the stage? You can rest for a while.” Old Han was concerned, but at this point, it was crucial.

Even if this five-segment limb replantation fails or necrosis occurs later, it would not tarnish their reputation.

However, in a situation like this, to carry out an emergency toe-to-thumb transplantation, if the operation fails, they would be drowned in their colleagues’ spit. Even top-tier hospitals in the industry dare not make such a decision.

That’s why people believe that this is an explicit challenge, a display of recklessness, a form of blind confidence, ignorant arrogance, and craziness that disregards consequences.

“It’s okay, I will rest after completion. Half an hour more wouldn’t make a difference,” Yang Ping casually said.

Old Han gave him a quick glance and thought: this kid has some spunk.

Song Zimo was across from him, quietly saying, “Isn’t it enough? Should we call it quits? The way we are wrapping up is entirely in line with medical principles. What if–”

He did want to challenge Yang Ping on an emergency thumb reconstruction, but what if something goes wrong? All their efforts would be in vain, and they would face the blame from their colleagues.

“What about you? Tian Yuan, what’s your opinion?” Old Han urged. This was a small-scale and straightforward discussion.

Tian Yuan had been watching the screen too, she said, “It isn’t quite appropriate, the reconstruction can definitely be done in a second phase. But from what I just heard you saying, I think, if it were me, I would take the risk and continue.”

Old Han tapped his fingers again, thought for a moment, and stood up, “Tian Yuan, take Fang Yan, prepare to disinfect, and remove the second toe of the left foot.”

As they had not planned for an emergency thumb reconstruction, the left foot hadn’t been disinfected and was covered by a large sterile sheet.

Tian Yuan and Fang Yan began to remove their surgical gowns and rewashed their hands to disinfect and prep the left foot. Being familiar with the routine, they quickly completed the preparation.

“Ready to start?” Tian Yuan asked.

“Begin!” Old Han decisively said.

Tian Yuan held the scalpel right, made a neat V-shaped incision near the metatarsophalangeal joint of the second left toe, dorsal and plantar side, then skillfully began the dissection.

While freeing the dorsal vein connected to the second toe, she gradually moved proximally to dissect out the dorsal venous arch and the great saphenous vein, extending to the front lower part of the medial malleolus, cutting and ligating branches, and transecting.

The dorsalis pedis artery was completely freed to plantar perforating branch, continued to the first dorsal metatarsal artery, and along the first dorsal metatarsal artery, the dissection was extended to the bifurcation at the web, cutting and ligating unnecessary branches, roughly equivalent to transecting the dorsalis pedis artery at the level of the vein.

Then she dissected out the nerve of the second toe and cut it at the required length.

She chose a sufficient length, cutting both the long and short extensor tendons of the toe, and the long and short flexor tendons of the toe.

Finally, the buzzing sound of the saw cut off the bone.

The second toe was successfully removed. Why choose the second toe? Because its size is close to the thumb.

Fang Yan began to trim and stitch the skin. Tian Yuan handed over the removed toe, which Song Zimo took. In fact, the removal of the second toe causes minimal visual impact. Whether it is four toes or five, it’s often hard to tell at a glance, and if you put on shoes, it’s even less of a problem.

The hollow section where the thumb meets the wrist is where the toe is typically attached in thumb reconstruction surgeries, to connect the blood vessels.

Yang Ping had already opened up this hollow section, and the cut off region of the palm had conveniently avoided this area, making the locating of the blood vessels very easy.

However, even though this was ideal, the blood vessels for the reconstructed thumb would still need to pass through three cut-off points.

Performing a simple thumb reconstruction using a toe is not difficult for a hand surgeon, and is in fact a standard operation that every hand surgeon must master.

However, the situation today is different. Five severed parts, and it’s an emergency reconstruction.

It’s like, for a motorcyclist daredevil, a single flip is not difficult, but to do it on a tightrope is a considerable challenge.

Hong Zhigang stared at the screen. He had a faint feeling: was this his junior colleague’s challenge to him? The fascia suturing just now could be done swiftly enough not to affect the surgery time.

The emergency reconstruction now is not just a matter of technique anymore. One could completely opt not to do it this way, to do a secondary reconstruction later, and no one would have any objections to that.

If the emergency reconstruction fails, then this operation, which could have been the pinnacle, would be branded as foolish, and criticisms would be legion. This could do great harm to a doctor’s reputation.

The blood vessel for the reconstructed thumb needs to flow through three cut-off points. Even a single poorly placed stitch could lead to failure.

The viewers’ focus was no longer on the technique but on whether he dared do it, and where his courage came from.

—-

“He’s really doing it?”

“Yes, he is!”

“If this is successful, it could go down in textbooks.”

“I don’t even know what to say.”

“I support the surgeon, a surgeon needs to be bold and meticulous, always challenging difficulties. If everyone just rigidly follows the rules, how will surgery progress? Salute!”

“Salute!”

“The most incredible academic conference I’ve ever attended, I will remember this forever.”

—

The surgery proceeded without a hitch and was completed within half an hour.

“Vital signs?”

“Normal.”

“Urine volume is normal.”

“Count the gauzes, instruments”

“Rinse, place a drainage strip, and suture!”

Under the microscope, they performed the final round of hemostasis using the Bipolar Electrosurgical Pencil, placed in a drainage strip, and then sutured the skin. The gauze was loosely applied, followed by loosely fitting sterile bandages.

The prepared arm support frame was handed over, and the injured limb was carefully secured in it.

The blood circulation in all five fingers was excellent!

“The procedure is completed!”

“Begin anesthesia recovery!”

“Recovery of autonomous breathing, successful extubation!”

“Send the patient to the trauma ICU for monitoring!”

The entire operation lasted 8 hours and 11 minutes.

—

“Is it over?”

“It’s over!”

“Will there be such live broadcasts in the next conference?

“Salute! The Hand of God!”