Chapter 310: Time

When he stood in the shower room in the Operating Area, Ling Ran raised his head to face the shower head. His whole body was relaxed, and he tried to not think about anything as much as possible. He did not even say a word.

The hot water rained down upon Ling Ran’s body. It slowly made his mind wander.

After almost a quarter of an hour, Ling Ran slowly turned off the water, wiped his body with a towel, and then came out to wear brand new underwear that would cost 199 RMB at retail price and would cost 79 RMB at wholesale price

Once Ling Ran was completely dressed, he shone with the light of confidence.

From the moment he picked up the scalpel, he had been thinking nonstop.

Dong Xiaoning was not an active athlete. Therefore, her requirements for recovery time were not as strict as professional athletes such as Liu Weichen or He Xiufang. It would not make too much of a difference to her if she went back to competing in four months or in six months.

Her treatment requirements can be summed up in two points: to ensure functionality and a beautiful appearance. Dong Xiaoning did not have very high requirements toward the things doctors were more concerned about, such as recovery time, hospitalization time, and others. Similarly, Dong Xiaoning’s family clearly expressed the desire to use as much good medicine as possible. It meant that they had a greater ability to bear with medical expenses.

Such patients had higher demands for the functionality of their Achilles’ tendons than ordinary people or sports enthusiasts, but conversely had a lower tolerance for scars and a priority for aesthetics compared to athletes. They belonged somewhere in the middle.

As far as the current medical world was concerned, those in the middle were not given much attention.

On one hand, their demands were not high enough for research institutions to publish papers or request funding from Program 973. On the other hand, their medical expenses were not high enough to affect the hospitals or pharmaceutical companies’ standards.

Ling Ran cut a five-inch S-shaped incision and followed the surgical plan for a few minutes before he stopped at the critical step where he was supposed to strip the Achilles tendon.

“Show me her MRI scan again.” There were a lot of ideas floating in Ling Ran’s mind, but they required information to prove it.

Yu Yuan immediately took off her gloves and turned on the computer for Ling Ran.

During the surgery, Ling Ran would request to look at the MRI scan at irregular intervals. This request was not unusual. The core function of the intraoperative MRI scan operating theater, which cost over 100,000,000 RMB, was to let surgeons look at MRI scans image during the surgery. They would not need to be like Ling Ran, who needed to stop the surgery to see the scan.

However, even the Orthopedic and Sports Medicine Center could not afford to build an intraoperative MRI scan operating theater.

But Ling Ran needed the confirmation for some of his new ideas.

“The high signals for her T2 weighted image is more obvious here.” Ling Ran pointed at the upper part of the Achilles tendon and said, “The incision is small, you should consider picking out the Achilles tendon to suture.”

“Is this okay?” Yu Yuan was a little overwhelmed. Although she might be beginning to learn about Achilles tendon repairs, she had not even learned the original Achilles tendon repair technique. She possessed no basis of any sort of relatable knowledge to come up with any new ideas. She did not even know what was outdated, so, naturally, she would not know if she was launching a new technique. The same was true for the surgical method.

Ling Ran did not show any intention of getting into talks with Yu Yuan.

Some surgeons were not confident enough and liked to discuss with their assistants during surgery because they wanted to share the responsibility together with the assistant, and also because they knew it was very easy for them to make mistakes.

With Ling Ran’s current state, even if he looked for someone to discuss his ideas, he would go to Ji Tianlu. Discussing with Yu Yuan was a waste of time. If Yu Yuan wanted to learn Achilles tendon repair technique, Ling Ran would then give her a chance to learn it well, but he would not give her the authority that even an attending physician did not have.

Participation in the development of a surgical plan was naturally a type of authority.

“You need to reduce the effect of the surgery on the appearance of the legs. Pay attention to blood loss. One more thing, reduce the effect on the muscle tissues.” While Ling Ran talked to himself, he also provided explanations to Yu Yuan. But whether or not Yu Yuan understood what he said was beyond Ling Ran’s control.

Of course, Yu Yuan understood him. She graduated with a Master’s degree, went through her housemanship, and was a resident doctor for three years. Yu Yuan had also been studying. If she was given a tablet computer, Yu Yuan can make out a succinct outline of what Ling Ran said in half an hour.

However, understanding it and doing it was two different things altogether.

Moreover, it was precisely because Yu Yuan understood it, that she knew how difficult it was to do it.

Blood loss was an eternal topic in surgery. During the earlier years, there were thousands of articles about controlling blood loss during surgery. But now, when most surgeries already had the amount of blood loss reduced compared to before, it was not so easy to reduce blood loss even further.

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For surgeons, having someone asking them to reduce blood loss was like asking automotive engineers to reduce fuel consumption for a car. Everyone had already spent a lot of energy on this and would continue to invest a lot of time and money in it, but who could say that reducing fuel consumption was an easy task?

The idea of reducing the effect of the surgery on the muscle tissues was an even more abstract idea. Normally, it was best to not move certain muscle tissues. However, the Achilles tendon repair was a surgery that would move around muscles a lot. The muscles of the calf would undergo various changes after a patient received an Achilles tendon repair technique surgery. For most athletes, the impact would not be too great, but if someone wanted beautiful legs, then the effect on the muscle tissues would be very great.

“In this case, the difficulty of the surgery would skyrocket,” Yu Yuan said honestly.

The surgical method itself had not changed, but the difficulty had increased by leaps and bounds.

Ling Ran nodded. He watched the patient’s calf, which was exposed on the operating table outside the fenestrated drape sheet, and he said with a contemplative expression, “In truth, we should change our thought process for this surgery. We should also take into consideration the fact that some patients hope for a beautiful appearance.”

“Especially a patient with little hair?” Yu Yuan stepped on the stepping stool and raised her head to ask.

“Hmm… the patients’ requests all exist. If we can’t do everything, we should strive to perfect the more important parts,” Ling Ran said while he pondered, “I think I can do something to try…”

“Some patients may not care about aesthetics.” The anesthetist whose surname was not Pan listened, and he felt amused. He cut in and said, “For example, Wu Dalang would not care whether he has a scar on his leg or not. Pan Jinlian would definitely not.”

Ling Ran cast a profound look at the anesthetist whose surname was not Pan. Then, when the man felt a little alarmed, he said, “I want to control blood loss today, so the operation time will be extended, we need to redo our anesthetic plan.”

“How should we do it?” The anesthetist whose surname was not Pan did not expect that this matter would fall in his hands.

“The operation time is estimated to be more than four hours.” Ling Ran did not understand the workings of anesthesia. Once he made his request, he continued, “Please add hemostatic pouches on the instrument list… Yu Yuan, go and explain matters to the family outside.”

The length of surgery would naturally affect the use of anesthetics.

The patient’s family members would also become even more anxious while they waited.

According to a normal person’s thought processes, if the patient can leave the operating room quickly, it meant that the operation was very smooth. Otherwise, the more hours it took, the more problematic the surgery was.

The Achilles tendon repairs Ling Ran performed previously using Plan A only required him around two to three hours. When he factored in the time for the patient to be pushed in and out of the operating theater, he took around four hours to complete the surgery.

But Ling Ran himself was already not mulling over the problem of prolonging the operation time. He simply performed surgeries.

Compared to performing the surgery for Liu Weichen in the beginning, Ling Ran was now more focused on reducing blood loss rather than achieving anastomosis for the blood vessels.

After four hours, Ling Ran said again, “I still need an hour, Yu Yuan, please go and inform the family.”

Yu Yuan said with her head lowered, “Doctor Ling, the patient’s family members are on the verge of crying outside. If we prolong the time again, they will start howling.”

“You’re right.” Ling Ran thought a little and said, “Then go and inform them that we will need another two hours. If you do that, we won’t need to tell them that we’re extending surgery time anymore.”

Yu Yuan was completely stunned. She only spoke after a while, “Doctor Ling, haven’t we always been able to perform surgeries quickly?”

Ling Ran said at a leisurely pace, “In the past, even if we did the surgery quickly, we could not perfectly meet the patient’s demands. If that’s the case, we can only use other methods.”

“But isn’t six hours a bit too slow?”

Ling Ran exercised his neck and said, “We don’t have a lot of patients right now, isn’t it good to slow down on performing surgeries a little?”

“Are you seriously saying we don’t have a lot of patients right now? We already have six patients today, and we’re not going to finish them in time…”

“Then we’ll work overtime tonight,” Ling Ran said, matter-of-factly.

“That’s not it… I’m…”

“Go and notify them!”

After being shouted at, Yu Yuan jumped like a rabbit.