Chapter 14: The Genius
Yang Ping quickly ate a piece of chocolate and a block of compressed biscuits, then rushed to the operating room.
In the room, Director Han, Song Zimo, Director Tian, Zhang Lin, and Fang Yan were already there, along with many young doctors and interns who had come to witness the rare and complex surgery of replanting a severed finger on an infant. After all, this kind of surgery was extremely difficult, and some would only encounter such a case once in their entire careers.
The circulating nurse was scolding some of the interns who weren't following protocol. "So many people? Who's your supervisor? Step back, maintain a sterile environment!"
Fortunately, the orthopedic operating room was spacious, so even with so many people, it didn't feel overly crowded.
"Split into two teams. Tian Yuan will take Fang Yan and Chen Xiaobo to debride the severed fingers and locate the blood vessels, nerves, and tendons. Song Zimo will lead Yang Ping and Zhang Lin to debride the proximal wound and locate the blood vessels, nerves, and tendons. The replantation will be handled by Song Zimo and Yang Ping, and the rest will be on standby," Director Han organized the team clearly.
"Which nurse is assisting today?"
"Su Yixuan."
"The orthopedic surgery specialist nurse?"
"Yes, Director."
The circulating nurse replied, and Su Yixuan was already at the sink, washing her hands.
The anesthesiologist was Liang Jing, a burly man who had accidentally been given a woman's name. After successfully inducing anesthesia, he gently pried open the infant's small mouth and carefully inserted the endotracheal tube. After pulling out the guide wire, he placed a stethoscope on the baby's chest, confirming the tube was properly placed. He then connected the anesthesia machine.
"Alright, anesthesia successful. You can scrub now," Liang Jing said, sitting beside the infant's head, recording and keeping an eye on the monitor screen.
"This is going to be tough, huh? So small. Even with the microscope magnifying fifty times, it's hard to handle. A slight tremor and the vessels will rupture."
"Yeah, I heard that replanting severed fingers is hardest with infants—the blood vessels are probably as thin as hair."
"I heard Director Han is doing this one. He used to work at Shanghai's Sixth Hospital, which is the birthplace of limb replantation in China. The world's first successful limb replantation was done there."
"Really? No wonder Director Han is so amazing."
"It's not him, it's Senior Song Zimo."
"Senior Song Zimo, wow!"
"He's incredible. I heard he's a genius. Haven't you seen how often Director Han brings him along?"
"He's tall, handsome, highly educated, and so talented. I heard so many girls like him."
A few female interns started gossiping quietly.
"Definitely. I heard his family is really rich."
"Could it be? He gets all the good things."
Once the gossip started, it quickly spiraled out of control.
"Quiet! Maintain silence! Finger replantation requires extreme focus. Open the video system in the next room. All observers, head over there once the surgery starts!" The head nurse came by to inspect the room.
This operating room was the main one, but it had adjoining rooms on either side—one for storage and the other a teaching room. The wall between the teaching room and the operating room was half transparent glass, with a high-definition screen mounted on the wall. The screen was connected to the high-definition cameras on the microscope and the surgical lights, allowing for real-time broadcasting of the surgery to the adjacent room when needed.
Su Yixuan had finished washing her hands, holding them in front of her chest. She picked up a sterile gown and walked to one side, facing the sterile table. With a quick shake of her hands, she slipped her hands into the sleeves. The circulating nurse quickly stood behind her, helping her adjust the gown and tie it in the back.
Then, Su Yixuan put on gloves and began preparing the instruments, organizing them into sections.
There were two operating tables.
On one side, Song Zimo and Yang Ping were cleaning the wound.
On the other side, Tian Yuan and Fang Yan were carefully cleaning the severed fingers, making sure not to lose them.
After cleaning, everyone went to wash up and change again.
Normally, the first assistant would sterilize and drape the patient, but today Song Zimo asked Yang Ping to don his sterile gown while he himself went ahead and sterilized and draped the patient.
The microscope was brought in and placed aside.
Both sides started the debridement process—removing foreign objects, necrotic tissue, and any dead tissue from the wound, and then trimming the edges of the skin to make it neat and clean.
The young doctors and interns were all sent next door to observe the surgery on the large screen.
The five fingers were handled one by one. Starting with the thumb, Fang Yan carefully handed the cleaned and irrigated thumb to Song Zimo. He used a drill to insert a steel pin into the phalanx to connect the bone, establishing the basic support structure.
The next step was to locate the blood vessels, nerves, and tendons and to sew them together. Simply put, this was the process. The blood vessels were the hardest to find and the most difficult to stitch. Nerves came next, while tendons were relatively easy to locate and sew—any orthopedic resident could do it with ease.
The microscope was moved over to the operating field and fixed in place. The focus, pupil distance, and magnification were adjusted. The blood vessels were extremely fine, so they were magnified fifty times.
Song Zimo used a fine micro forceps in his left hand and micro scissors in his right hand, starting the debridement and searching for the blood vessels under the microscope. His technique was impressive. Under the fifty-times magnification, his hands were steady, and his movements were fluid and practiced.
The guy definitely had the right to be proud, Yang Ping couldn't help but admit.
"The blood vessels are too fine. Steady your hands, take your time," Director Han encouraged Song Zimo.
Song Zimo didn't respond; he quietly continued operating, carefully searching for the blood vessels, nerves, and tendons under the microscope.
In addition to the large screen in the teaching room next door, there was also a smaller screen in the operating room. Director Han was seated in front of it, watching intently.
The blood vessels of the thumb were successfully located, and then the nerve and tendon were found. The next step was to carefully trim and clean the ends of the blood vessels so that they were clean and standard. The lumen should have no impurities or damage.
A wash with saline was done.
"Thread!"
The finest double-needle, no-damage suture for blood vessels, with a diameter just a fraction of the size of a child's hair.
The needle was cut in half. One part was handed to Song Zimo, and the other was kept by Su Yixuan.
Song Zimo began suturing the artery.
However, the baby's blood vessels were even smaller than expected. The diameter was far below 0.1 mm—probably around 0.05 mm.
Song Zimo took a deep breath, focused, and tried to steady his hands. At this moment, he was facing the pinnacle of microsurgery.
The first stitch began.
"Slow down, don't rush," Director Han said to Song Zimo.
At this point, even if he wanted to rush, it was impossible. The blood vessels were not only tiny but also had very thin walls, completely unlike the usual arterial walls.
Song Zimo's first stitch was much slower than his usual training speed, carefully handling the vessel with tweezers. The walls of the vessel were extremely fragile and could tear easily—this was a true test of skill.
The needle gently entered the vessel wall, the position perfect. Then, it exited from the other side, and with delicate movements, Song Zimo pulled the ends together and tied a perfect knot. The first stitch was flawlessly done.
Director Han gave a slight nod. Song Zimo's talent was certainly high. He had made rapid progress recently. Stitching a 0.05 mm blood vessel with such skill was impressive.
Yang Ping prepared to cut the suture, but Song Zimo refused. He picked up the micro scissors himself to cut the suture.
The second stitch, the third stitch—up to the sixth stitch. His rhythm was steady, and the spacing of the stitches was impeccable. The first blood vessel was successfully reattached.
If the operating room had allowed applause, the observers in the next room would surely have been clapping.