Healing Doctor

Chapter 393 Intraoperative Angiography

In a normal anterior cruciate ligament injury surgery, at this stage, forceps are used to remove the remaining anterior cruciate ligament, and then the medial and lateral menisci are explored to check for any obvious damage.

After exploration, a longitudinal incision was made on the medial side of the left knee, and the pes anserinus was dissected to the upper edge. The incision was made longitudinally, and the layers were dissected to expose the muscles. The semitendinosus tendon and gracilis muscle were freed and dissected 2 cm proximally. The tibial attachment was removed, and the entire length was excised proximally using a suture remover. The two ends were sutured together with No. 1 absorbable suture.

This means taking an autologous tendon and "transplanting" it into the patient's joint cavity to serve as the anterior cruciate ligament.

This is a well-established surgical technique in orthopedics, and it is now commonly used both internationally and domestically, so there is no doubt about it.

But the young surgeon in front of me actually started rinsing and cleaning the joint cavity and preparing to suture it!

Does he even know how to perform arthroscopic surgery?

Director Shi Shuo was amused and exasperated. "Director Sui, your surgical approach is truly unique."

Director Sui also frowned slightly.

"Professor Deng, what surgical procedure was performed?" Director Sui asked in a deep voice.

"Director, this is a ligament surgery specially designed for athletes by the USC sports medicine team." Deng Chaohong felt a little guilty, focusing intently on looking in the mirror. He could already feel Director Sui's gaze falling on his back like a knife.

For a moment, Deng Chaohong wanted to give up.

The tendon of the sartorius muscle isn't difficult to work with; it's not like I don't know how.

But the last patient with a rotator cuff injury came to Deng Chaohong's mind.

If I were to perform that surgery myself, the patient would still recover, but not all recoveries are the same.

The patient, who underwent surgery performed by Ji Xiang, has regained his motor function and is actively preparing for the National Games.

If I were to do it myself, the patient would probably have already retired from the military.

The postoperative results were vastly different.

Furthermore, after discussing with Ji Xiang last night, Deng Chaohong believes that Ji Xiang's idea is feasible. Although it will be a bit troublesome, requiring hybridization surgery.

He gritted his teeth and assisted Ji Xiang with the surgery, ignoring Director Sui's murderous gaze.

"USC's sports medicine program is number one in the world." Shi Shuo laughed in exasperation. "Today I'll broaden my horizons and see how world-class surgeries are performed."

His words were laced with sharp sarcasm, which made Director Sui somewhat embarrassed.

"Professor Deng, may I come for further training in a few days? I want to learn some of the world's top new techniques," Professor Fan asked jokingly.

Deng Chaohong's hands trembled slightly; the words and emotions of the people behind him put immense pressure on him.

"Snap!" The hemostat struck Deng Chaohong's radial styloid process.

"Focus your attention," Ji Xiang said calmly. "I'll leave this to you for now; I'm going to do the imaging."

"!!!"

"!!!"

"!!!"

Countless exclamation marks floated above the heads of the two directors and Professor Fan.

Imaging?

What the hell is that?

Normally, ligament surgery requires an MRI scan. Is this young doctor suffering from hysteria?

Director Sui immediately thought of Deng Chaohong's bloated body. Damn it! He cursed under his breath. Deng Chaohong was wearing a lead apron during surgery!

"Old Shi, are you looking from inside or from outside?" Director Sui asked.

Orthopedic surgeons are frequently exposed to radiation, so they don't share the same fear of interventional surgery as other doctors.

Moreover, Director Sui noticed that Ji Xiang had laid out a strange sterile sheet earlier. It turned out that he was going to have an interventional surgery early in the morning, which was why the sheet was laid out in such an odd way.

"Professor Ma, thank you for your hard work." Ji Xiang, wearing a sterile gown, bowed slightly from three meters away from Professor Ma in the corner.

Professor Ma was somewhat helpless. He knew very well that his purpose in coming here was to give Ji Xiang a reason to have the surgery—commonly known as taking the blame.

But Ji Xiang's surgery was at least two levels better than his own, which is why Professor Ma agreed to his request.

Professor Ma was curious and wanted to see what the relationship was between anterior cruciate ligament repair surgery and interventional surgery.

If it were anyone else, even if it were Director Zhao saying this, Professor Ma would scoff.

But Ji Xiang said it could work, and he just happened to be "bewitched" and believed him. Although Ji Xiang was just a resident trainee, the story of him pointing his finger at Boss Qin and cursing him at the annual meeting a few months ago had already spread throughout the industry.

Shi Shuo was also confused. He frowned and thought about the anterior cruciate ligament repair surgery again.

Not only when they performed the surgery themselves, but also when they attended academic conferences and listened to other people's reports, no one suggested the idea of ​​performing hybridization surgery.

The differences are only a few points—direct suturing has been largely phased out, and the choice of which muscle tendon to use for repair is crucial. As for using high-value ligament materials, they are too expensive, too stiff, and the results are generally mediocre.

Orthopedic specialists are focusing their attention on consumable manufacturers; to achieve further therapeutic effects, better ligaments are needed.

"Old Shi? Where are you looking?" Director Sui asked.

"Right here," Shi Shuo said in a deep voice. "I'm going to get dressed."

Soon, the three men, wearing lead aprons, walked in.

Professor Ma felt somewhat unfamiliar with interventional surgeries, as there are very few patients undergoing them.

Ji Xiang began the puncture and placement of the arterial sheath, followed by superselection.

Her skillful technique left Professor Ma unable to keep up, and he had no time to be distracted, focusing entirely on his assistant's work.

Soon, Ji Xiangchao selected the ligament branch of the middle patellar artery and began to create the contrast agent.

"Dr. Ji, you were able to select such a deep vein. I've never done this before," Professor Ma said.

"The blood vessels supplying the anterior cruciate ligament are small vessels from the ligamentous branches of the middle patellar artery and the infrapatellar fat pad. Let's take a look at the angiography," Ji Xiang said. "Whether the postoperative recovery goes well or not mainly depends on whether the blood supply can be re-established."

"Tsk tsk." Professor Ma could understand what Ji Xiang meant, but he couldn't think of how to proceed with the surgery.

Ligaments are supplied with blood, but the blood vessels are very thin, similar to capillaries.

An anterior cruciate ligament repair surgery turned into a hybrid surgery, which piqued everyone's curiosity.

The high-pressure injector delivered the contrast agent. After seeing the blood flow clearly, Ji Xiang said, "Professor Ma, thank you. The tube is removed. Thank you for your help."

Professor Ma sighed with admiration.

Although it was just a routine angiography, Ji Xiang performed it with extreme precision, superselecting the ligamentous branch of the middle patellar artery.

This level of skill is unmatched; at least within the Second Affiliated Hospital, no one can do it better than Ji Xiang.

"What's the point?" Shi Shuo asked.

"Yes, do you think you can reconnect capillaries by doing an angiography?" Professor Fan asked.

Ji Xiang turned around, glanced at the two of them, and narrowed his eyes slightly.

If you're not wearing a mask, it should be a smile, a smile that expresses goodwill.

"Xiao Ji, what's the next step?" Director Sui asked, full of doubt, without mockery or ridicule.

"When you see the blood vessels supplying the anterior cruciate ligament, just avoid them during suturing. Postoperative vascular reconstruction will be quick," Ji Xiang replied.

(End of this chapter)