The bullet screen lit up with a flurry of comments.
"Multi-stage avulsion and replantation!" someone in the orthopedics conference room at Shanghai's Sixth Hospital screamed.
The livestream, initially about to be closed, was left open.
"Professor, isn't it time for lunch?" A student approached and whispered as a reminder.
Ah, right—it was long past lunchtime. The entire morning had flown by as they were glued to the livestream, completely forgetting to eat.
Hong Zhigang checked his watch. It was already past 2 p.m.
"Didn't we order boxed lunches?" he recalled.
The student's meaning was clear—was it finally time to distribute them?
Hong Zhigang nodded. "Distribute them. Let's eat while watching. Everyone seems pretty excited."
He himself was thoroughly engrossed.
Graduate students carried baskets of boxed lunches and handed them out one by one. Each box contained three dishes and a soup: beef, fried egg, tofu skin, some seasonal vegetables, a pork rib soup, a bottle of mineral water, and a pack of tissues.
Some left the lunch unopened, fixated on the screen. Others mechanically brought chopsticks to their mouths, unaware of the taste. Regardless, the meal passed in a haze of focus on the surgical broadcast.
"What do you think?" Hong Zhigang turned his head.
Wen Rentao didn't respond directly but instead asked, "Could this be the work of Master Han?"
Realizing his slip, he immediately regretted the question. Han Jianggong was a taboo topic in Hong Zhigang's conversations—none of his students dared mention the name in front of him.
But this time, Hong Zhigang didn't get angry. Instead, he sighed and said, "Who else could it be?"
"Professor, but you're a Golden Scalpel Award winner!"
Hong Zhigang fell silent.
"I've already ordered takeout. We're staying till the end of this."
"This guy is overconfident."
"He's skilled, no doubt, but he's overstepping."
"I hope the organizers track the success rate and functionality post-replantation."
"Is this just showing off?"
"Hello from Shanghai Sixth!"
"Of course, follow-ups are expected."
"Xiao Yang, are you okay? Should I scrub in and take over while you rest?" Old Han looked worried, but they had reached the most critical point.
Performing a multi-stage avulsion replantation was fraught with risk. It was entirely justifiable to stop, and no one would fault the surgeon for abandoning the procedure.
"I'm fine. Let's finish this before resting—it's just another hour," Yang Ping replied casually.
Old Han glanced at him. Kid, you've got guts.
Across from him, Song Zimo softly said, "We've done enough. Let's not push it. Ending here would still adhere to medical principles. If—"
He hesitated. While he admired Yang Ping's ambition to attempt the replantation of multiple avulsion injuries, breaking through contraindications came with immense risk. Should anything happen to the patient, the repercussions could be disastrous.
"What about you, Tian Yuan? What's your take?" Old Han prompted. This was a quick internal discussion among their small group.
Tian Yuan, who had been watching the screen, remarked, "It's not entirely suitable; this could be deferred for a second-stage reconstruction. But considering Xiao Yang's state, he might just pull it off."
Old Han was torn, drumming his fingers before finally deciding. "Proceed with the multi-stage avulsion replantation. Tian Yuan, Fang Yan, scrub in and assist with the arterial and venous grafts."
Tian Yuan and Fang Yan immediately began prepping, disinfecting and draping the left foot. They quickly found suitable arteries and veins for the thumb replantation, carefully harvesting vessels for bridging.
Meanwhile, Yang Ping and Song Zimo worked on the hand, locating the radial artery branches and nerves within the anatomical snuffbox for vascular anastomosis. Replanting the thumb, now in three pieces, posed extreme difficulty due to the severe damage to blood vessels caused by avulsion.
Despite the almost insurmountable challenge, Yang Ping meticulously sought viable blood vessels. Where appropriate, he planned to bridge connections; for areas where vessels were irreparably damaged, he intended to use techniques similar to neonatal finger replantation, connecting as many viable microvessels as possible.
If they could successfully reconnect even ten or more vessels, it would be sufficient to restore blood flow.
The thumb was crucial, accounting for 40% of hand functionality. Losing it meant near-total hand impairment.
While thumb replantation was already challenging, a multi-stage avulsion replantation was akin to executing a backflip on a tightrope—insanely difficult. Even with ideal conditions, the surgery could take over ten hours.
Hong Zhigang stared intently at the screen, faintly sensing that this was his junior's way of challenging him.
If the earlier fasciotomy relied purely on speed without compromising surgical timing, this procedure, with its high failure risk, could ruin an otherwise stellar performance if it failed—bringing potential disgrace to the surgeon.
Blood had to flow through numerous reconnections; a single flawed stitch could spell disaster.
The audience collectively held their breath.
"They're really going for it?"
"Yeah, it's happening!"
"If this succeeds, it'll make it into medical textbooks."
"I'm speechless."
"I support the surgeon. Surgeons must be bold and meticulous, constantly challenging the limits. Progress in surgery demands this. Respect!"
"Respect!"
"This is the most spectacular academic conference I've attended—unforgettable."
The operation proceeded smoothly, resolving everything within an hour with the two teams working together.
"Vital signs?"
"Stable."
"Urine output normal."
"Sponge and instrument count confirmed."
"Irrigation, drain placement, suturing!"
Under the microscope, the final hemostasis was achieved with bipolar cautery. After placing the drain and suturing the skin, sterile gauze was gently applied, followed by a loosely wrapped bandage.
The prepared upper limb brace was brought over, and the injured limb was carefully secured within it.
The blood flow in all five fingers was excellent!
"Operation complete!"
"Begin anesthesia recovery!"
"Spontaneous breathing restored, successful extubation!"
"Transfer to the Trauma ICU for monitoring!"
The surgery lasted a total of 8 hours and 11 minutes.
"Is it over?"
"It's over!"
"Will there be another livestream like this at the next conference?"
"Respect! Truly, the hands of God!"
"Which hospital was this?"
"Oh, crap! How is my Coke still here? What did I just drink—"
The final bullet screen comment.
The video feed cut off.