Chapter 393: Imaging During Surgery

For a normal Anterior Cruciate Ligament injury surgery, at this point, one needs to use a rongeur to bite away the remnant of the Anterior Cruciate Ligament, then probe the Medial and Lateral Meniscus to see if there is any obvious damage.

After probing, make a longitudinal incision on the lower medial side of the left knee, dissect to the upper edge of the pes anserinus, incise longitudinally, dissect layer by layer to expose, isolate the Semitendinosus Tendon and Gracilis Tendon, dissect proximally for 2cm, detach their tibial attachments, use a tendon stripper to perform subcutaneous resection of the full length proximally, and use a No. 1 absorbable suture to weave and stitch the two ends.

That is to say, taking an autologous tendon to "transplant" into the Patient's joint cavity to act as the Anterior Cruciate Ligament.

This is a very mature surgical technique in Orthopedics Department, currently used internationally and domestically, with no questions about it.

But the young operator before them actually started to flush and clean the joint cavity and prepare for suturing!

Does he even know how to perform Arthroscopy surgery!

Shi Shuo, Shi Zhuren, was so angry he laughed, "Sui Zhuren, the surgery on your side really takes a different approach."

Sui Zhuren also frowned slightly.

"Deng Jiaoshou, what is the surgical technique?" Sui Zhuren asked in a deep voice.

"Zhuren, it's a ligament surgery designed specifically for athletes by the University of Southern California sports medicine team." Deng Chaohong felt a bit guilty, focusing on watching the Endoscope; he could already feel Sui Zhuren's gaze landing on his back like a knife.

For a moment, Deng Chaohong wanted to give up.

Cutting the sartorius tendon, it wasn't difficult; it wasn't as if he didn't know how to do it.

But the previous patient with a Rotator Cuff Injury appeared in Deng Chaohong's mind.

If he had performed that surgery himself, although the patient would have recovered, recovery is not the same as recovery.

The surgery performed by Ji Xiang allowed the patient to have already regained athletic function and be actively preparing for the National Games.

If he had done it himself, the patient would likely have already retired.

The post-operative results were worlds apart.

Moreover, after communicating with Ji Xiang last night, Deng Chaohong believed Ji Xiang's approach was feasible. Although it was a bit troublesome, it required a Hybrid Surgery.

He bit the bullet and assisted Ji Xiang with the surgery, ignoring Sui Zhuren's murderous gaze.

"The University of Southern California sports medicine major is the best in the world, after all." Shi Shuo was so angry he laughed, "I'll broaden my horizons today and see how world-class surgery is done."

His words carried sharp sarcasm, which made Sui Zhuren feel somewhat embarrassed.

"Deng Jiaoshou, can I come for further studies in a few days? I'd like to properly learn this world-class New Surgical Technique," Fan Jiaoshou asked mockingly.

Deng Chaohong's hands were shaking; the words and emotions of these people behind him put immense pressure on him.

"Snap~" The Hemostatic Forceps tapped on Deng Chaohong's Radial styloid process.

"Concentrate." Ji Xiang said calmly, "I'll leave this side to you for now; I'm going to perform the Angiography."

"!!!"

"!!!"

"!!!"

Countless exclamation marks floated over the heads of the two Zhuren and Fan Jiaoshou.

Angiography?

What the hell is that?

Under normal circumstances, ligament surgery requires Magnetic Resonance Imaging; has this young Doctor gone hysterical?

Sui Zhuren immediately thought of Deng Chaohong's bloated body. Damn it! He cursed inwardly; Deng Chaohong was wearing Lead Clothing while performing the surgery!

"Old Shi, are you watching from inside or outside?" Sui Zhuren asked.

The Orthopedics Department is frequently exposed to radiation, so they are not as afraid of Interventional Surgery as other doctors.

And Sui Zhuren noticed the strange way Ji Xiang had draped the sterile sheets earlier; it turned out he was planning to perform Interventional Surgery from the start, which was why they were draped so strangely.

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

Ma Jiaoshou felt a bit helpless; he knew very well that the reason he was there was to give Ji Xiang a reason to perform the surgery—commonly known as being the scapegoat.

But Ji Xiang's surgery was at least two levels better than his own, which was why Ma Jiaoshou had agreed to him.

Ma Jiaoshou was quite curious; he wanted to see what the connection was between Anterior Cruciate Ligament Repair Surgery and Interventional Surgery.

If it were anyone else, even if Zhao Zhuren had said so, Ma Jiaoshou would have scoffed.

But because Ji Xiang said it could be done, he "lost his mind" and believed it. Although Ji Xiang was only a Standardized Training Student, the incident a few months ago at the annual meeting where he pointed at Qin and scolded him had already spread throughout the entire circle.

Shi Shuo was also confused; he frowned and rethought the Anterior Cruciate Ligament Repair Surgery again.

Not just his own surgeries, but even including the reports he heard from others at conferences, no one had ever proposed the idea of a Hybrid Surgery.

The only differences were a few points—direct suturing had been basically eliminated, and which muscle's tendon to take for repair. As for using High-value Consumables for ligaments, they were too expensive, relatively stiff, and the results were mediocre.

The attention of Orthopedics Department Experts was all on the manufacturers of consumables; to achieve better therapeutic effects, one needed better ligaments.

"Old Shi? Where are you watching from?" Sui Zhuren asked.

"Right here." Shi Shuo said in a deep voice, "I'm going to put on my gear."

Soon, the three of them walked in wearing Lead Clothing.

There are rarely so many people in an Interventional Surgery, and Ma Jiaoshou also felt it was somewhat unfamiliar.

Ji Xiang began the puncture and placement of the Arterial Sheath, followed by Super-selection.

The technique was so nimble that Ma Jiaoshou's mind couldn't even keep up; he had no time to be distracted and focused entirely on doing his job as an assistant.

Soon, Ji Xiang performed Super-selection to the Middle Genicular Artery Ligament Branch and began injecting the Contrast Agent.

"Xiao Ji, Doctor, to be able to perform Super-selection this deep... I have to say, I've never done this vessel before." Ma Jiaoshou said.

"The blood supply to the Anterior Cruciate Ligament comes from the Middle Genicular Artery Ligament Branch and some small vessels in the Infrapatellar Fat Pad; let's take a look with Angiography." Ji Xiang said, "Whether the post-operative recovery is good or not depends mainly on whether the blood supply can be re-established."

"Tsk tsk." Ma Jiaoshou could understand what Ji Xiang meant, but he had no idea how the subsequent surgery would be performed.

Ligaments have blood supply, but the supplying vessels are all very thin, similar to capillaries.

A simple Anterior Cruciate Ligament repair surgery had actually turned into a Hybrid Surgery; everyone was very curious.

The high-pressure Syringe injected the Contrast Agent, and after seeing the blood flow clearly, Ji Xiang said, "Ma Jiaoshou, thank you, withdrawing the catheter, sorry to trouble you."

Ma Jiaoshou was filled with emotion.

Although it was just a routine Angiography, Ji Xiang performed it with extreme precision, reaching the Middle Genicular Artery Ligament Branch via Super-selection.

This level of skill was truly peerless; at the very least, no one at the Second Affiliated Hospital could perform it better than Ji Xiang.

"What is the point?" Shi Shuo asked.

"Indeed, it's just an Angiography; are you actually going to perform Vascular Reconstruction on the capillaries?" Professor Fan also asked.

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

If he hadn't been wearing a mask, it would have been a smile, a smile expressing goodwill.

"Xiao Ji, what is the next step?" Sui Zhuren asked, not with sarcasm or mockery, but with full of confusion.

"I see the blood vessels supplying the Anterior Cruciate Ligament; I just need to avoid them during Suturing, and the post-operative Vascular Reconstruction will be very fast," Ji Xiang replied.

(End of this chapter)