Chapter 342: Arthroscopy

The patient… lay on a dark green surgical towel.

He was covered in a large, light blue sterile sheet, and only his knee was exposed.

Even though the patient was awake right then, his face was covered by the sterile sheet. He could only stare at the light blue sheet and listen to music broadcasted in the operating theater. He felt extremely bored.

“Why don’t we administer general anesthesia?” Zuo Cidian knew that Ling Ran did not like to chat with his patients, so he took the initiative to do so. Of course, it was also because Zuo Cidian liked to talk and was afraid of getting bored.

The patient was a sixty-two-year-old man. He anxiously and firmly shook his head while he was covered by the sterile sheet. “I don’t want general anesthesia. I know someone who never woke up after receiving general anesthesia, and that person died in the end,” he said.

“Someone died from anesthesia? That’s uncommon.” Zuo Cidian was astounded.

“The hospital said that he died from a heart attack and did not even want to give any compensation. We all knew Old Liu well. Even though he had high blood pressure and some problems with his heart, it was not to the extent that he would die from it.” The old man paused for a moment and spoke in a confident tone, “General anesthesia’s really harmful to the public.”

Zuo Cidian glanced at Ling Ran. All of a sudden, he no longer found chatting with patients a good idea.

“Inflate the tourniquet and check the patient’s condition,” Ling Ran said to Yu Yuan as he marked the patient’s knee with a surgical skin marker pen.

Knee arthroscopic meniscoplasty actually required only one assistant. However, as it was impossible for the doctors of Zhucheng People’s Hospital to let Ling Ran work without supervision, they assigned their attending physician, Zhang Pengyi, who was originally supposed to be the chief surgeon, as the first assistant. Hence, Yu Yuan became the second assistant. Zuo Cidian was only there to observe the surgery anyway, so he just stood aside and watched as the three doctors worked.

“The operative route will be on the side of the patellofemoral ligament,” Ling Ran explained to his assistants before he observed the patient’s knee. He then extended his hand and said, “Scalpel.”

*Slap.*

The scrub nurse, who was feeling extremely anxious, immediately placed a scalpel in Ling Ran’s palm. After she did that, she instantly grew even more anxious.

Ling Ran raised his head, glanced at her, and flashed a smile. He then turned and made a 0.2-inch incision in the position he marked with the surgical skin marker pen earlier.

The scrub nurse’s entire body was extremely tense, and she started to imagine endless possibilities.

“Skin pricker,” Ling Ran reminded her.

*Slap!*

The scrub nurse used all that she had learned in her career to place the skin pricker on Ling Ran’s palm at the fastest speed and the best angle with the most appropriate amount of strength. Just as the skin pricker was about to land on Ling Ran’s palm, she even drew the skin pricker back a little.

For a surgeon, that was the best a scrub nurse could do.

Ling Ran flashed a smile at the scrub nurse again before he immediately lowered his head and steadily pierced the skin pricker into the patient’s knee joint.

Ling Ran then inserted the arthroscope before he ordered. “Increase infusion of saline solution.”

Zhang Pengyi, who had just breathed a sigh of relief, immediately increased the amount of saline solution pumped into the patient’s vein.

He was a little worried that there would be problems with Ling Ran’s maneuvers earlier.

Verbally, he had been showering this specialist from another hospital with praises. However, the saying that different trades were mountains apart was especially true in the medical field. Even internationally renowned cardiologists may not have a thorough knowledge of the knee joint.

Take Atsushi Amano, who performed coronary artery bypass surgery for the Emperor of Japan, as an example. He was renowned for being the chief surgeon of six thousand cases of coronary artery bypass surgery. In addition, he had guided other surgeons in ten thousand cases of coronary artery bypass surgery. He performed an average of five hundred cases of coronary artery bypass surgery every year, which was almost ten times the average of ordinary Japanese doctors and five times the average of ordinary Chinese doctors.

However, aside from that, Atsushi Amano did not perform any other kinds of surgery. He did not need to know anything about knee arthroscopy or ankle arthroscopy. He probably had knowledge of their basic anatomical structure, but that was all.

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Zhang Pengyi only willingly allowed Ling Ran to take the position of a chief surgeon because Ling Ran had experience in arthroscopy, and also because he was a specialist from another hospital whom his hospital spent a large sum of money to hire. However, Zhang Pengyi’s name was written in the surgery form instead of Ling Ran’s. Hence, it was only natural for him to be worried.

However, now that Zhang Pengyi saw how skilled Ling Ran was, he was no longer worried.

Even though the use of skin prickers was only a small maneuver, it required plenty of practice and a deep understanding of the knee joint’s anatomical structure on the surgeon’s part. The skin pricker could be likened to an extremely large needle. The surgeon had to be able to control the depth at which the skin pricker was inserted while exerting a sufficient amount of force. Repeated attempts would lead to a bad prognosis.

You could more or less grasp a nurse’s abilities by looking at how skilled she was when it came to giving injections. A doctor’s ability when it came to inserting skin prickers was also a pretty good indicator of his skills when it came to arthroscopy.

Now that Zhang Pengyi was sure that Ling Ran was pretty capable, he was able to work at ease.

After the arthroscope was inserted into the knee joint, the condition within the knee joint was broadcasted live on the 42-inch screen above the operating table. It was much clearer compared with X-ray scans and even MRI scans.

Theoretically, diagnoses made using an arthroscope, especially for damage related to the meniscus and other components, had an accuracy of up to 98%. It was a very high figure when it came to medical diagnoses, especially in the field of western medicine. This was because, western medicine practitioners had to state the exact disease, unlike traditional medicine, where practitioners only needed to point out where the problem was.

Of course, the probability of misdiagnosis was still there. If a doctor was one hundred percent sure of the diagnosis he gave, it did not mean that he was confident. It only meant that he was an arrogant person.

Ling Ran spent a few minutes inspecting the damage in the patient’s meniscus before he said, “I estimate that we can retain around 0.28 inches of his original meniscus…”

Zhang Pengyi was still looking at the screen, and he was not able to respond to Ling Ran because with his experience, he still needed more time to think about the matter before he could make a decision.

Ling Ran did not wait for Zhang Pengyi to respond. Instead, he started to work on the patient’s meniscus.

The core aim of meniscoplasty was to restore the damaged meniscus to a normal or near-normal condition.

In the process, parts that bulged out had to be cut off using a pair of basket forceps, while uneven edges had to be evened out. Meanwhile, meniscus tears had to be smoothened. The patient Ling Ran was operating on right then had been opting for traditional treatment options, and he ended up with a seriously torn meniscus.

“The meniscus is already jagged.” Zhang Pengyi finally returned to his senses. He sighed as he gazed at the meniscus on the screen.

The patient could not help but yell out loud, “Is that a bad thing?”

“It is,” Zhang Pengyi said. “Because you’ve been opting for traditional treatment options, your meniscus has undergone plenty of wear and tear. As a result, it’s a little harder to treat.”

“My doctor was the one who wanted me to choose traditional treatment options.”

“You didn’t go for regular follow-up visits, did you?”

“Haih, everyone knows what’s going on with my knee. What’s the point of follow-up visits?” Even though the patient, who was lying on the operating table, did not dare to move around, he still wanted to argue with Zhang Pengyi.

Zhang Pengyi decided to stop talking.

Ling Ran finished the whole procedure in one go. He glanced at the clock when he was done, and realized that he only took fifteen minutes.

“Let’s go for the next one?” Ling Ran took off his gloves and exited the operating theater.

“How was it?” A group of doctors, including a chief physician, crowded around Zhang Pengyi.

“He’s better than me.” Zhang Pengyi chuckled a few times. There was nothing to hide.

“Better than you?” The chief physician repeated what Zhang Pengyi said and nodded slightly.

The hospital had just added arthroscopy to their repertoire, and they needed skilled specialists more than ever.

Since knee arthroscopy was a very effective type of surgery that inflicted very little damage on patients, the demand for it was rising. However, Zhucheng People’s Hospital had not trained enough doctors to perform knee arthroscopy.

You Fengyu found an opportunity to have a private conversation with Zuo Cidian, and he asked, “How much does Doctor Ling charge for each knee arthroscopy he performs?”