My Medical Skills Give Me Experience Points Chapter 1240: 489: Another Level 6 Medical Skill, the Meaning of Being a Doctor

Chapter 489: Another Level 6 Medical Skill, the Meaning of Being a Doctor

"Doctor Yang, let me put your knowledge to the test. Why do we deliberately preserve some peritendinous tissue when harvesting a tendon for transplantation?" Zhou Can directed this query toward Yang Zhi.

"Is it to improve the fixation of the tendon?" Yang Zhi seemed uncertain, clearly grasping at straws.

It was general knowledge that keeping a bit of peritendinous tissue usually simplifies the process of suturing and anchoring the graft.

"Let me rethink your perspective. What is the fundamental function of a tendon?" Zhou Can countered with his own question.

"It is meant to facilitate limb movement! For instance, our finger flexor and extensor tendons enable the digits to flex and extend," Yang Zhi replied instantly. Every medical student worth their salt understood the basic purpose of a tendon.

"And why exactly do these flexor and extensor tendons allow for such movement?" Zhou Can inquired, a slight smile playing on his lips.

"Well… isn't it because they govern the bending and straightening of the fingers through contraction and relaxation?" Yang Zhi’s confidence faltered under Zhou Can’s pointed scrutiny.

"Doctor Yang, that answer is somewhat superficial. For a tendon to effectively assist in movement, it must glide fluidly and without resistance. If bone deformities or muscle atrophy cause tightening, the movement becomes hampered, directly impacting bodily function. This is precisely why I leave peritendinous tissue intact when isolating the plantar tendons—to ensure the graft has the necessary flexibility to glide smoothly." Zhou Can, currently in a patient mood, took the time to explain these surgical subtleties.

Such pearls of surgical wisdom are seldom found in conventional textbooks; they are the hard-won practical experiences refined by surgeons through years of clinical work.

"I see! My thanks for the instruction!" Yang Zhi and Pu Dingdong both nodded vigorously, clearly finding the lesson invaluable.

By following Zhou Can in the operating theater, they frequently acquired practical insights that were otherwise unavailable. It wasn't merely about the surgery itself; their lessons in rescue strategies and diagnostic problem-solving were just as beneficial.

"Keep this in mind: once the distal end of the graft is secured, you must verify its reliability immediately. If any irregularity exists, identify the cause and rectify it right away. Never be lax. Choosing to overlook a flaw and proceeding to close the wound will lead to the patient failing to recover the expected finger function post-operation," Zhou Can warned.

What truly defines an exemplary mentor? It is someone who leads by example, freely sharing their skills, ethics, and hard-earned wisdom. That is the hallmark of a true mentor.

He checked the secured plantar tendon, confirmed it was stable, and only then moved to suture the finger incisions one after another. He did not delegate this task to his assistants, as the surgery demanded a degree of precision and technical finesse that Yang Zhi and Pu Dingdong had yet to master.

Next, he placed the patient's wrist in a neutral position. By applying traction to the free tendon ends, he flexed the fingers to a point 15 degrees past the functional position. Each finger showed a cascading degree of flexion from the radial side to the ulnar side.

Though it sounded straightforward, the operation was filled with nuances. For dynamic muscle, one must sew a traction line onto the tendon, pulling it repeatedly to test the range of motion until it satisfies all requirements. Furthermore, it requires passing a needle transversely through the skin under tension to hold the position. Once the tendons were temporarily fixed and the fixation needle was withdrawn, with the wrist flexed at 40 degrees, the fingers remained fully extended. At maximum dorsiflexion of the wrist, the fingertips had to land within 4cm of the palmar transverse crease.

Everything passed the test, and a satisfied smile touched Zhou Can’s eyes.

The secret to transplanting hand tendons is patience; the procedure requires meticulous attention to detail, and every intraoperative test must be conducted with absolute precision. Taking shortcuts is not an option.

After standardizing the length of the tendons, he moved on to bridge the proximal end of the free tendon with the deep finger flexor tendon. Because the superficial flexor tendon and the plantar tendon graft were of different thicknesses, he opted for the Pulvertaft weaving technique. Had they been equal in size, standard suturing would have sufficed.

[Suturing Skill Experience Points +1, +1… Bonus Experience Points +10.]

[Ligation Skill Experience Points +1, Bonus Experience Points +10.]

As he worked, his experience points climbed rapidly. His Suturing Skill had already reached Level 6, and his Ligation Skill was quickly following suit.

He looked forward to his Ligation Skill hitting level 6. Suturing and Ligation are two halves of the same whole; a surgeon cannot perform at the highest level if one lags behind the other. Weak ligation skills would inevitably drag down his overall surgical performance in high-stakes environments.

The progression of his Ligation Skill was admittedly slow, mostly because it rarely triggered high-value experience rewards, yielding only smaller increments like the ten points he had just received. Furthermore, for every ligation interaction, he might accrue ten suturing rewards. This discrepancy was why the Ligation Skill trailed behind.

Regardless, there was no cause for alarm. Given how frequently both skills were employed in even the most minor operations, he was confident that the Ligation Skill would reach Level 6 soon.

Soon, the anastomosis was finished.

[Anastomosis Experience Points +1, highly complex tendon anastomosis completed, Bonus Experience Points +1000.]

The complexity of the task stemmed from both the significant diameter mismatch between the donor plantar tendon and the recipient flexor, as well as the microscopic workspace available at the fingertip, which demanded extreme surgical accuracy.