My Medical Skills Give Me Experience Points

Chapter 231: Chapter 128 Director Shen’s Advice, Growth in Orthopedics

“This is beyond me, you need to listen to Dr. Zhou’s own opinion, as well as Director Shen’s.”

Doctor Shan definitely did not want to let go of a talent like Zhou Can.

Declining outright would offend Dr. Chi.

She smartly passed the decision to Zhou Can and Director Shen.

Generally, training students have little say in whose guidance they are under.

Less capable trainees might have to resort to giving gifts or finding a backdoor to be assigned to a slightly better mentor.

The real decision-makers are the department heads and the deputy directors or chief physicians within the department.

Some departments, for convenience, appoint a designated teaching leader.

That person also holds considerable authority.

“Thank you, Dr. Chi, for your generous affection. One should not forget their roots, nor where they come from. If I have to choose, I’d still prefer to stay with Doctor Shan.”

Zhou Can has never been someone to forget his roots.

Doctor Shan takes good care of him, and he feels the kindness.

For him, three months of orthopedic training isn’t long. Following a trusted attending physician provides more training opportunities.

At this moment, choosing Doctor Shan over the more powerful Dr. Chi would surely deepen this trust.

“Ha-ha, just kidding, Dr. Zhou, don’t take it seriously. I did not expect you to be so appreciative.”

After testing the waters, Dr. Chi sees it’s futile.

He just laughs it off.

It’s evident that while there is competition within the team, overall, there is unity.

Director Shen has at this point preliminarily completed the construction of the skeletal interface at the implant site.

“Come, watch and learn attentively! For the bone junction, I chose this location. It maximally preserves the original thumb joint of the hand, which benefits greatly in restoring finger functions after the surgery.”

Zhou Can also moved closer to keenly observe and learn.

This microscopic Level 4 surgery demands extremely high technical skills.

There is a lot to learn.

“Having resolved the bone junction issue, we must also address the challenges of skin flap coverage, tendon, nerve, and arteriovenous connections, especially since the patient has a congenital deformity with a missing thumb. Years after, there might be contractions or absences of tendons, nerves, and blood vessels.”

Such surgeries bear greater unknown intraoperative risks.

The surgical difficulty multiplies.

It is an immense test for physicians.

“For bone connection, we can refer to digit replantation. Usually, internal fixation of bones is applied.”

Director Shen skillfully aligns the toe bone with the patient’s right thumb phalanx.

“In future similar surgeries, you can assess based on the patient’s phalanges. For instance, if the first phalanx of the thumb is intact, the right big toe can be harvested. If the phalanx is severely missing, consider taking the second toe (ring finger?).”

Director Shen, while joining bones, patiently explains.

Different scenarios require different transplant methods.

“Dr. Chi, why don’t you take over the tendon reconstruction? Feel free to ask me anything.”

After completing the bone grafting and ensuring everything is correct, Director Shen steps aside from the main surgery role.

Most lead surgeons only perform the key aspects of surgeries. The rest of the surgical tasks are delegated to other team members.

That’s why directors prefer to mentor highly gifted junior doctors.

Generally speaking, the higher the talent, the higher the rate of success.

After mentoring disciples, life becomes much easier for the master.

Especially in major surgeries that require a single person to complete, it’s almost unthinkable.

A physician qualified to lead surgeries above Level 3 must at least have a deputy director’s level.

They are generally older.

Their energy and physical strength are no longer like those of younger men, lacking the stamina to complete all steps of a surgery.

Entrusting tasks to disciples is the most ideal method.

Director Shen specifically entrusts this tendon reconstruction practice to Dr. Chi.

This is also to cultivate Dr. Chi’s surgical skills in this area.

After taking over, Dr. Chi begins searching for the tendon, then figuring out how to attach it.

Wherever he is unsure, he promptly consults Director Shen.

Even with Director Shen performing the surgery personally.

Zhou Can stands by and silently learns valuable core surgical techniques and methods of handling various problems. It’s a great opportunity for him to learn.

Jin Mingxi desperately worked to become a trainee at Tu Ya to seize these opportunities to learn core techniques.

…

This surgery continued for nearly four hours.

Its difficulty is beyond imagination.

Searching and rebuilding the tendons were exceedingly challenging, especially the absence of flexor tendons which nearly halted the surgery.

The subsequent neural anastomosis was also extremely tough.

In precision surgeries, Doctor Shan excels, yet connecting those nerves almost overwhelmed her.

Ultimately, the final two nerves succeeded through the hands of Zhou Can, thanks to his gift for neural anastomosis.

Otherwise, it might have required Director Shen’s direct intervention.

The subsequent vascular anastomosis was equally challenging.

Suturing a one-millimeter blood vessel under a microscope is incredibly difficult.

Moreover, there were instances where the blood vessels needing anastomosis were not the same size.

These issues all had to be resolved.

The final skin flap coverage was also full of difficulties.

Fortunately, with the entire team’s concerted effort, they managed to stumble through and complete the surgery.