Tokyo, 1994, starting with medical training

Chapter 19 Replacement

From Imagawa Ori's perspective, the first assistant for this surgery was actually decided last night.

She had never seen a resident physician with such clear thinking and strong practical skills.

His Kirschner wire fixation method was even more perfect than his own design, and later, when building the eight-tiered champagne tower, it proved that his hands could keep up with his mind.

However, she still couldn't directly appoint him as her first assistant.

the reason is simple.

Kiryu Kazusuke has only been studying at the First Foreign Language Institute for six months, while Takikawa Takuhei has been a medical student at the institute for five years.

If she bypasses Takikawa and directly appoints a new resident doctor as the first assistant for this highly complex surgery, the other staff members in the medical department will have objections.

This will affect her evaluation within the medical institution.

She personally doesn't really care about this.

The problem is that VIP patients who can offer large sums of money are selective about their doctors and consider their reputation.

When it comes to money, Imagawa Ori won't act on impulse.

That's why she gave Takikawa Takuhei a chance.

Whether it's an opportunity to make a mistake or an opportunity to prove himself depends entirely on Takikawa Takuhei's performance.

Of course, the patient's interests come first.

If Takigawa Takuhei is truly incapable, Imagawa Ori will stop him before irreparable damage is done.

At this point, no one would object to having Kiryu Kazuya step in.

After all, surgery is dynamic, and adjusting assistants is a common occurrence.

However, Imagawa Ori still hopes that he can do his job as Ichisuke well.

I don't need to be outstanding, just avoid making mistakes.

But it's a pity.

Imagawa Ori narrowed her eyes slightly, staring at Jukuno.

As the attending surgeon, she immediately spotted the problem: the needle insertion angle was at least 5 degrees off, and the force was uneven.

"Change to another one."

She took the pliers handed to her by the nurse, clamped them around the end of the Kirschner wire, and with a slight pull of her wrist, pulled it out and dropped it into the curved plate.

The scrub nurse immediately placed a new Kirschner wire into Takikawa Takuhei's hand.

He took a deep breath and placed the new Kirschner wire next to the previous position.

Takikawa Takuhei moved cautiously, but his feel for the needle was still lacking. He tried to probe the bone surface several times but couldn't find the best entry point.

"Turn the angle a little more."

Imagawa Ori offered a suggestion from the side.

Takikawa Takuhei adjusted it as instructed, and then began to turn the crank.

The hand drill slowly turned, and the tip of the Kirschner wire finally successfully pierced the bone cortex.

you can!

His hand became steadier, and he was delighted. He prepared to increase the force, wanting to drill the Kirschner wire deeper to gain sufficient grip.

"stop!"

But just as he was about to make a move, Imagawa Ori immediately stopped him.

"If you move it again, you'll penetrate the opposite cortex and damage the blood vessels!"

"Yes, I'm sorry, Dr. Imagawa."

Takikawa Takuhei's hand froze in mid-air, momentarily at a loss.

Imagawa Ori reached out and took the equipment from his hand, adjusting it herself.

Her movements were precise. She first used a 1.2 mm needle to penetrate the skin from the ulnar side, then transversely through the distal radius to stabilize the overall structure.

However, the small bone fragments on the joint surface remain unstable and require more support.

"continue."

She handed the hand drill back.

Takikawa Takuhei gritted his teeth and tried for the third time, this time choosing to insert the needle through a small incision on the palm side in an attempt to pry open the collapsed part.

But his hand, which had been steady, started to become unruly again. The tip of the Kirschner wire got stuck in the muscle layer and failed to lift the bone precisely, causing minor additional damage instead.

"attract."

Imagawa Ori's voice was devoid of any emotion.

Takikawa Takuhei hurriedly picked up the suction device and extended it into the surgical field, which had become somewhat blurred due to slight bleeding in the bone marrow cavity.

After processing.

Imagawa Ori suddenly spoke up: "You may leave."

Takikawa Takuhei hesitated for a moment, then opened his mouth to explain, "Dr. Imagawa, I..."

Imagawa Oriya put down the tissue forceps in her hand and looked up: "I said, get down, don't you understand?"

When Takikawa Takuhei met her gaze, all the words stuck in his throat.

This is Imagawa Ori's operating table; the surgeon has absolute authority.

So even though his face turned bright red, he could only lower his head, take a step back, and then another step, and leave the operating table.

For a moment, no one in the operating room dared to breathe loudly.

The scrub nurse bends down to inspect the scalpel, and the circulating nurse bends down to inspect the monitor.

Being kicked off the operating table in front of everyone by the surgeon is the greatest humiliation in a surgeon's career.

However, Takikawa Takuhei himself failed to seize these three opportunities.

Imagawa Ori turned to Kiryu Kazusuke: "Any problem with you being Ichisuke?"

"Okay," Kiryu Kazusuke replied immediately.

He stepped forward and took over Takikawa Takuhei's position.

"Kirschner wire, 1.2 mm."

The scrub nurse handed him a new Kirschner wire and a hand drill.

After receiving the order, Kiryu Kazusuke immediately proceeded with the plan without consulting Imagawa Ori.

After all, his Kirschner wire technique is perfect!

He stretched out his left hand and gently touched the distal radius bone with his index and middle fingers, feeling their displacement and shape.

Then, he moved.

The first Kirschner wire was inserted percutaneously from the dorsal side.

The operation continued without pause, with the hand drill rotating at a constant speed.

The steel needle was precisely inserted into the predetermined position, passing through the main dorsal bone block at a perfect angle, and firmly fixed to the radial shaft.

Takikawa Takuhei, who had stepped aside, was still indignant.

If you can't do it yourself, then this medical training program will do?

But when he saw what Kiryu Kazusuke did, he couldn't help but twitch his lips.

Something's wrong with the hands of this resident physician.

His hands were so steady, as if they were welded to the operating table!

"The second one."

Kiryu Kazusuke extended his hand, and the surgical nurse immediately handed it to him.

The second Kirschner wire, also inserted from the dorsal side, targets another key articular bone fragment.

It forms a stable cross structure with the first needle, restoring the entire dorsal articular surface to a roughly anatomical plane.

Two needles, done in one go.

The entire process takes no more than thirty seconds.

"The third one."

This time, instead of operating immediately, he picked up a pair of tissue forceps and gently separated the pronator quadratus muscle on the palmar side of the wrist joint.

A tiny incision was exposed.

"What is he going to do?"

Takikawa Takuhei, who had somehow gotten close to her again, couldn't help but ask a question.

But nobody paid him any attention.

Kazusuke Kiryu inserted the tip of the third Kirschner wire through the small incision on the side of his palm.

Instead of using a hand drill, he directly grasped the end of the steel needle with his hand, treating it like a crowbar.

The needle tip precisely located beneath the most severely collapsed segment of the lunate articular surface.

Apply slight force to the wrist.

The collapsed bone fragment was steadily pushed upwards.

With the help of the two support pins on its back, it steadily returned to its proper position.

"The fourth one."

Before he finished speaking, he had already inserted the fourth needle percutaneously from the ulnar side.

This needle pierced horizontally through the entire distal radius, completely locking the palmar-side bone fragment that had been pried and repositioned with the dorsal-side structure that had already been fixed.

The four Kirschner wires form a stable three-dimensional frame.

The shattered joint surfaces were reassembled and put back together.

The entire temporary fixation process took less than two minutes.

(End of this chapter)