Chapter 21: The Stunning Achievement (Part 2) – The Surgeon Didn't Falter, and the Challenge Was a Success!
Everyone was deeply moved, as if they had been on an emotional rollercoaster.
Hong Zhigang remained seated, motionless, growing increasingly curious about this junior fellow disciple whom he hadn't contacted in ten years.
The pair of steady hands continued progressing through the surgery at a remarkable speed, completing each bundle of sutures in just over ten seconds. Remarkably, it only took four to five minutes to suture a single nerve, meaning all three nerves were repaired in about ten minutes. This was the speed of a highly skilled hand surgeon employing the epineurium suturing method.
Hong Zhigang couldn't help but marvel. No wonder he dared to use the fascicular suturing method. To be frank, the results of fascicular suturing for peripheral nerve repair far surpass those of epineurium suturing. In replantation surgeries, if functional recovery isn't considered, mere survival of the limb has little meaning. Many patients who undergo limb replantation later opt for amputation due to the limb's dysfunction, as it becomes more of a burden than a benefit. Functional recovery, particularly nerve repair, is pivotal to the success of replantation. Without sensory nerve recovery, patients are prone to burns, frostbite, and recurrent ulcers; without motor nerve repair, the limb becomes a lifeless appendage.
The second amputation site on the forearm was addressed with the same sequence and technique.
As the procedure moved to the palm, the vessels grew finer. The surgeon proceeded to repair the superficial and deep palmar arches, four veins, and thirteen tendons.
Yet even this thrilling display began to lose its novelty. Viewers grew restless, the barrage of live-stream comments slowed, and everyone seemed to take a collective pause, awaiting what would come next.
When it came to the fingers, however, everyone's scattered focus was drawn back in. If fascicular suturing demonstrated advanced nerve repair skills, the intricate challenge of microvascular surgery—fingertip vessel anastomosis—was about to begin!
The live stream's chat slowed almost to silence as the audience focused intently, afraid to miss even the smallest detail.
Finally, someone exclaimed, "Here it is! He's starting on the finger vessels!"
"Need a break? Let Song Zimo take over for a while—I can scrub in, too," said veteran surgeon Lao Han as he leaned toward the operating table.
Yang Ping replied, "I'm fine for now. I'll let you know if I can't keep up."
Lao Han returned his gaze to the screen. He knew Yang Ping well enough to assess the situation.
If Yang Ping could handle replanting an infant's severed digit with ease, working on adult vessels—several times thicker—should be manageable. What concerned Lao Han was fatigue, as exhaustion could impair even the steadiest hands.
Perhaps due to fatigue or perhaps a deliberate attempt to finely control the force used, Yang Ping's pace slowed slightly. This allowed Song Zimo to step into the field and assist.
Song Zimo took a deep breath, centering himself. While Yang Ping may have been tired, Song had rested and was ready. A calm energy enabled him to seamlessly synchronize with Yang Ping's tempo.
Under the microscope, the instruments and suture threads seemed alive, darting through the tiny surgical field. They maintained a delicate balance: the thread's friction with the vascular wall was minimized to prevent unnecessary tension, while maintaining efficient progress.
Yang Ping resembled a machine, every movement directed by his brain in perfect harmony. Even his breathing was eerily steady.
From Lao Han's perspective, Yang Ping seemed almost statue-like, exuding composure and focus. Apart from the movement of his hands, his body was utterly still, his forehead devoid of sweat.
At that moment, it seemed as if not even an earthquake could disturb Yang Ping. He was utterly immersed in his own world—a world where surgery was everything.
"Perfection to the point of suffocation!" someone commented.
"I suspect the surgeon is not human but a cutting-edge surgical robot. Every stitch is so flawless it's almost mechanical."
"The lead surgeon hasn't switched out!"
"Is this an ad for Red Bull?"
"No, Viagra!"
"Finally, an assistant's hands enter the field."
"For the record, coordinates: Imperial Capital. One of the top three hospitals in the country. Their microvascular surgery chief bows down to this guy—I can say this with my name on the line."
"Look closely: not a single stitch needed adjusting."
"It's as if he's stitching skin—how is this even allowed? Are we supposed to go on living like this?"
"Ugh, the gap is just too wide between us."
"The world is vast—I want to go explore it!"
In the OR:
"Director Han!" said Chief Sun, who had quietly entered.
While Director Xia commanded operations from the conference room, Chief Sun oversaw the surgical theater.
"Everything is going smoothly!" Lao Han reported, turning briefly.
Chief Sun leaned closer to Lao Han and whispered. Lao Han rose and followed him out of the OR. The automatic doors swished open.
"They found the thumb!"
Dr. Lü from the ER promptly handed the severed thumb to Director Han. A group of firefighters stood nearby, their faces blackened with soot, still in their uniforms.
"It was just found—can it be reattached?" one of the firefighters asked anxiously.
Director Han inspected the thumb, noting the multiple avulsion injuries. There were two severance points, spanning three phalanges. The distal end had been crushed at the nail root, leaving a jagged edge.
The prospects for replantation were grim. This case would require extensive grafting of both arteries and veins, with a prolonged operating time and an extremely high risk of failure.
After a moment of silence, Director Han said, "We'll try our best, but our priority is the patient's life."
This type of injury was often deemed unsuitable for replantation. In such cases, a secondary reconstruction using a free transfer of the second toe to create a new thumb was a more practical option.
Re-entering the OR, Director Han checked the vitals on the monitor. "How's the patient holding up?" he asked.
"The patient's young, and aside from the blood loss, there are no other injuries. With transfusion and fluids, they should tolerate a few more hours of surgery without issue," the anesthesiologist responded.
Director Han then glanced at the wall clock. Over three hours had already passed. If they could complete the thumb replantation in under an hour, extending the surgery slightly might be feasible.
But was it worth the risk? The thumb's condition was so poor that the odds of success were dismal.
The patient was under general anesthesia and couldn't provide consent. Director Han paced the OR, his fingers drumming rhythmically on his thigh as he weighed the options.
Yang Ping was skilled, no doubt. But after several hours of intense focus, fatigue was inevitable. Tackling such a difficult and time-consuming challenge as this might be asking too much.
If it didn't work, he'd scrub in himself.