Tokyo, 1994, starting with medical training

Chapter 21 So Cool

Inside the German-made Martin shadowless lamp, several high-power halogen bulbs emit strong light, which is projected onto the operating table through hundreds of reflective mirrors distributed inside the lamp panel.

But the most dazzling figure at this moment is the trainee doctor who has only been in the position of assistant and has only been in the system for half a year.

Incredible skill.

After watching Kiryu Kazusuke's actions, Takikawa Takuhei, though unwilling to admit it, could only describe it in these four words after thinking for a long time.

The assistant surgeon is an extension of the lead surgeon, and a direct manifestation of their will and skill.

This position requires not only solid anatomical knowledge and operational skills from the surgeon, but also the ability to anticipate the surgeon's next move and cooperate in a timely manner.

Therefore, in any challenging surgery, the first assistant is the most crucial figure, second only to the lead surgeon.

He should have been the one standing there.

However, at this moment, he was outside the operating table, becoming a spectator.

but……

After watching Kiryu Kazusuke's moves, your brain might tell you, "I've already seen it, I can do it too," but your hands will say, "You know nothing! You're all you know!"

Takikawa Takuhei let out a long breath.

She had already accepted that she was a very mediocre person, that she wouldn't go very far on the path of becoming a doctor, and that perhaps even going to medical school was a mistake in the first place.

But why do I still feel excited after seeing this amazing skill?

He even considered getting another professional medical treatment.

It seems like when I first entered the medical department, I was also full of ambition, learning basic skills from my seniors, working shifts, writing medical records, applying casts...

He once thought that he was a gifted athlete and would soon pass the specialized medical exam and become a key member of the department.

Now that I've seen Kiryu Kazusuke, I finally understand what the word "genius" means.

Even Dr. Imagawa had never given him this feeling.

As Takikawa Takuhei's thoughts drifted away, he felt a surge of shame, like an electric current, shooting from the soles of his feet to the top of his head.

Just a few tens of minutes ago, in the corridor leading to the operating room, did I pat Kiryu Kazusuke on the shoulder and, in a senior's tone, tell him not to be nervous, to watch carefully, and to learn well?

……

Ligament tension reconstruction is not a concept that does not exist entirely in the field of orthopedics.

Top sports medicine experts occasionally mention this when dealing with complex joint injuries in elite athletes.

It requires the surgeon to have a god-like understanding of the biomechanics of the joints, and to be intimately familiar with the direction and strength of every ligament and every muscle.

Therefore, very few people are able to put it into practice in such a complex surgical setting.

And Kiryu Kazusuke did it.

Imagawa Ori looked up at Ichisuke standing opposite her.

Even through the mask and surgical cap, she could still sense the focus and calmness of this resident doctor.

It was as if everything that had just happened was a routine operation for him, nothing to be surprised about.

"Bring the C-arm machine over here, let's use X-ray to check the location."

Imagawa Ori's words brought everyone back to reality.

Soon, a beige, somewhat bulky mobile X-ray machine was pushed in by the circulating nurse.

This is a C-arm X-ray machine, named for its resemblance to a giant letter "C".

A C-arm machine can take X-ray images from different angles without moving the patient and display the real-time images on an adjacent CRT monitor.

It's like a surgeon's X-ray vision.

"Unrelated personnel evacuate."

The circulating nurse immediately brought out the lead apron and helped the anesthesiologist in the audience put it on.

In order to monitor the patient's heartbeat and breathing at all times, anesthesiologists must not leave their posts even if they are exposed to a few millisieverts of radiation.

As for the surgeons and assistants standing on the operating table, they had already put on lead aprons before scrubbing their hands and putting on sterile gowns.

They are even less likely to leave.

Once you leave the operating room or turn your back to the sterile area, your sterile gown will become contaminated, and you will have to wash your hands and put on a sheet again when you return...

As a result, a single surgery can take several days and nights to complete.

Under the operation of the radiology technician, the machine's C-arm slowly moved, aligning the X-ray tube and image intensifier with the patient's wrist.

In this gap.

Imagawa Ori quickly reviewed Kiryu Kazusuke's actions in her mind.

From the two cross-supporting needles on the dorsal side, to the prying and repositioning on the palmar side, to the four-needle ligament tension reconstruction, and finally the stroke of genius in releasing ligament stress with the tiny vibration of Kirschner wires!

Can I do it?

Imagawa asked herself this question in her heart.

She carefully considered what she would do if she were in the same predicament.

She might also realize that the problem lies with the ligaments.

After repeated failed attempts to pry open the ligament, she may give up and instead use a more radical and invasive incision method to directly repair the ligament under direct vision.

Or, as she initially judged, she could directly apply pressure with steel plates, sacrificing some functionality.

Kazusuke Kiryu's "ligament tension reconstruction technique" is the most elegant solution that achieves maximum effect with minimal trauma.

Ideas!

As a surgeon, proficiency in technique can be acquired through hundreds or thousands of repetitions.

But on the ever-changing operating table, the ability to discern the essence of a problem and devise the creative thinking to come up with the optimal solution is a gift!

Thinking about this...

Imagawa Orihime's expression became complicated.

Having grasped the concept, she is confident that she can attempt the "ligament tension reconstruction" procedure again if given the chance, and she is also willing to do so.

Copying the standard answer is not difficult.

However, she couldn't be as quick, accurate, and ruthless as Kazusuke Kiryu on his first attempt.

It was as if, in the few seconds he closed his eyes, he had already rehearsed the scenario a thousand times in his mind.

That's what makes him so terrifying.

If the operation is the "technique," then the thought process is the "principle." Judging from this surgery alone, Kiryu Kazusuke's technique and principle in using Kirschner wires are impeccable.

However, Imagawa Ori didn't say anything.

Because the fluoroscopic results were already displayed on the screen, the anatomical repositioning was practically perfect.

The joint surfaces were as smooth as ever, the bone fragments fit together perfectly, and the Kirschner wires that served as temporary supports were precisely positioned in their respective places.

"The reset was very successful."

Even the anesthesiologist couldn't help but exclaim in admiration.

Imagawa Ori nodded.

Her gaze fell on the joint surface, which had already stabilized.

Originally, she was prepared to sacrifice some of the joint surface flatness and use steel plates and pressure screws for forced fixation.

But now, everything has changed.

Kazusuke Kiryu's Kirschner wire tension network not only solved the problem of hidden ligament tears, but also made the entire surgical field well-organized.

Then, what needs to be done next becomes extremely simple.

Now it's her turn to perform the final reinforcement, placing the steel plates and screws.

She just needs to follow the standard procedure.

"Steel plate, T-shaped on the medial side of the tibia."

"Electric drill."

"Silk attack".

"screwdriver."

Imagawa Ori chose to lock the steel plate onto the palm side, where the entry point was already fully exposed.

First, place the plate on the radial shaft and adjust its position to ensure that the distal screw hole is aligned with the articular surface.

Then fix the proximal end using an elliptical hole to facilitate fine-tuning later.

Next, turn to the far end and screw in the locking screws one by one.

The entire process was smooth and unimpeded.

The bone fragments did not shift at all, the screw trajectory perfectly matched the preset anatomical position, the bleeding was minimal, and the field of vision was as clear as if a simulated surgery was being performed.

It has to be said, this is an intoxicating experience.

No more repeatedly checking the position of bone fragments, no more worrying about secondary displacement caused by applying pressure, no more being distracted by dealing with those annoying minor instabilities, no more...

This was supposed to be an extremely demanding and exhausting surgery.

But now...

Imagawa Ori felt as if she were not performing a highly complex C3 distal radius comminuted fracture surgery, but rather doing the final finishing touches on a perfect model that had already been built by a master.

This feeling...

So cool!

(End of this chapter)