Chen Dayong's words cheered everyone up.
How fast is faster than we can comprehend?
Li Zheng quickly cut off the affected flexor tendon.
Then carefully and thoroughly remove the local diseased tissue.
After confirming that there was no residue, Li Zheng asked for saline solution and rinsed the area thoroughly.
"Take the tendon!" said Li Zheng.
"Which tendon should be taken?" Bao Youshan asked in a low voice, feeling very ignorant.
"Palmari longus tendon!" Li Zheng replied.
Bao Youshan wanted to ask why the palmaris longus tendon had to be removed, but he didn't dare to ask.
The palmaris longus tendon is one of the two tendons in the middle of the wrist, the slightly thinner tendon on the little finger side.
Li Zheng saw Bao Youshan's intention and said as he operated, "The palmaris longus tendon is a degenerative tendon. It's relatively weak and doesn't contribute much to wrist flexion. Harvesting it will have minimal impact. It's the most commonly used tendon for left finger tendon transplants, and its size is similar to the finger flexor tendon, making it the most suitable."
Bao Youshan nodded repeatedly. Although he was an orthopedic surgeon, he knew very little about microsurgery.
This was also the first time that Chen Dayong had such in-depth contact with tendon transplantation, and he found it very novel.
Although he was curious about why Li Zheng knew so much, he resisted the urge to ask. If he had asked, he would have said that someone had taught him skills in a dream.
Zhu Qidong also nodded in approval of Li Zheng. He himself majored in microsurgery, and his understanding of these knowledge was acquired after internship and further training. However, Li Zheng used to be engaged in general surgery, and he was so familiar with this aspect, which was rare.
Li Zheng made a longitudinal incision on the palm side of the wrist and quickly separated the palmaris longus tendon.
The tendon that was cleaned off from the thumb was about 2.5 cm long, and Li Zheng took 3 cm of the tendon.
Chen Dayong asked curiously, "Doesn't the thumb have two flexor tendons? 3 centimeters isn't enough!"
Zhu Qidong sneered, "Don't question Dr. Li, you layman. He cut the length just right, and the extra length is for trimming."
Except for Duan Jianhui and Xiang Yuanzhong, everyone else present was confused.
If a 3cm tendon is folded in half, wouldn't each be 1cm shorter? How can we say it's just right?
Zhu Qidong said proudly, "This involves a very professional point of knowledge. It's true that there are two flexor tendons in the fingers, but the insertion point of the flexor digitorum superficialis tendon is at the base of the proximal phalanx, while the insertion point of the flexor digitorum profundus tendon is at the base of the distal phalanx. Therefore, only the flexor digitorum profundus tendon needs to be transplanted and repaired to bend the entire finger. It basically meets the function of the finger, but the strength is a little lacking."
Bao Youshan nodded repeatedly after hearing this.
Chen Dayong curled his lips, letting this kid take advantage of him.
Li Zheng added, "The main reason is that the insertion point of the thumb's superficial flexor digitorum tendon is too close to the metacarpophalangeal joint. The possibility of adhesion after reconstruction is extremely high, so reconstruction is generally not an option. Other fingers are longer, and if the tendons are not damaged too close to the insertion point, reconstruction is still possible. Reconstructing both tendons can minimize the impact on finger function."
Everyone nodded after hearing this.
Chen Dayong glanced at Zhu Qidong and smiled faintly, "Did you hear that? This is the difference in realm. To save trouble, you would rather sacrifice function and only transplant one tendon. Except for the thumb, other fingers can transplant two!"
Zhu Qidong felt a little uncomfortable in his chest and snorted coldly, "I know all this, I just didn't express my meaning completely!"
"Hey, who would believe that!" Chen Dayong said with a faint smile.
"Dayong, focus on the operation." Li Zheng said.
Chen Dayong put away his urge to argue and concentrated on cooperating with Li Zheng in the operation.
After all, the tourniquet only lasts a limited time.
Thinking of this, Chen Dayong asked again: "Why not transplant the blood vessels first? That way we can restore the blood supply first, even if the operation is a little slower!"
Li Zheng shook his head and said, "If we transplant the tendon after the blood vessels, it will easily damage the blood vessels, so we usually transplant the tendon first."
After understanding, Chen Dayong stopped asking questions and focused on following Li Zheng's rhythm.
Li Zheng cut off a small section at both ends of the removed tendon and put it into the defect, making it just the right length.
"4-0 damage-free nylon line." Li Zheng said.
Lin Xiaomei was already prepared. She clamped it with a needle holder and handed it to Li Zheng.
Li Zheng began to suture the tendon using the "8" suture method.
While suturing, he explained, "This suturing method involves inserting the needle from the cut surface, then exiting from the side, and then reinserting the needle about 5 mm from the cut end... After making a full circle, the needle finally exits from the other cut surface. The entire route resembles a figure 8, hence the name figure 8 suturing. This is the most commonly used method for circular tendons."
Chen Dayong and Bao Youshan were a little confused.
"Brother, you're really too fast. We couldn't see clearly!" Chen Dayong laughed again, "But it doesn't matter. Dean Zhang has already purchased some pork legs. You can teach us how to practice then!"
Bao Youshan also nodded repeatedly and said, "I want to practice this too!"
Xiang Yuanzhong stood behind them and laughed, "I'll practice with you too!"
Zhu Qidong curled his lips and said, "Director Xiang, you are already so old and have missed the best time to learn microsurgery. Don't waste resources!"
Xiang Yuanzhong was furious when he heard this.
I am only 40 years old, how can I be considered old?
Seeing Xiang Yuandong's grim expression, Zhu Qidong chuckled and said, "Director Xiang, don't be unconvinced. What does microsurgery require? It requires steady hands, good eyesight, and excellent energy and stamina. Furthermore, you often have to stay up late to perform emergency surgeries. Isn't it too late for you to start learning now? Wouldn't it be more effective to give the same learning resources to younger doctors?"
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