With the entire surgical plan confirmed, the next step was to assign roles and responsibilities.
"Director Lu, I’ll handle the tendon sutures."
In response to Wu Ting’s bold request, Lu Xiong glanced at Dr. Qin. After all, he was unfamiliar with Wu Ting’s surgical skills.
Qin Donglai had seen Wu Ting perform a few tendon repairs, and his skill was certainly on par with his own. However, the suturing plan Wu Ting had designed this time was highly complex, involving a modified double-plane Kessler tendon suture technique and even a partial autologous tendon graft.
"Wu Ting, are you sure you can handle this? This is no joke. Alternatively, we could perform the initial steps according to your plan while we wait for the specialist from Xiao City. Having a solid plan and getting the preliminary work done would already be far more efficient than what we were doing before."
Qin Donglai’s caution was understandable. After all, if something went wrong with the surgery, there would be liability.
"Dr. Qin, I can do it."
Wu Ting turned to the patient. He was under a brachial plexus block, an anesthesia that temporarily blocks sensory nerve signals in a specific area while leaving motor functions intact. As a result, Officer Liu was fully conscious.
"Officer Liu, with my surgical plan, I’m ninety percent confident I can get you back to a normal life and back to work. But if we wait for the specialist from Xiao City, we’ll miss the optimal treatment window. I estimate your chances of recovery would drop to fifty percent. You’d probably regain enough function for basic living, but your chances of ever working as a detective again would be practically zero."
Wu Ting spoke to Liu Ping with utmost sincerity. At a time like this, the patient’s own will was crucial.
As long as he obtained the patient’s consent, there would be no procedural issues with Wu Ting taking the lead on the tendon repair.
Wu Ting had earned his medical license a while ago, so performing a Tier 1 surgery like tendon repair was perfectly within his qualifications. Furthermore, with Director Lu and Dr. Qin present to authorize it as his superiors and the patient’s consent, all procedural requirements were met.
Hearing he had a ninety percent chance of returning to his job as a detective, the light returned to Liu Ping’s eyes. He had all but given up hope. Now, hearing Wu Ting’s words, he gave a solemn nod.
"Dr. Wu, I’m in. I agree to your surgical plan, and I consent to you performing the tendon repair."
"Dr. Wu, I trust you. And please, don’t feel any pressure. Regardless of the outcome of my hand’s recovery, I won’t hold you responsible."
As a detective, Liu Ping felt he had to be worthy of his uniform. He believed doctors felt the same way about their profession.
Detectives, doctors... Liu Ping believed that people in such professions all shared a powerful sense of conviction!
"Alright, let’s begin."
Wu Ting looked at Lu Xiong and Qin Donglai. "Director Lu, I’ll start with the longitudinal fasciocutaneous incisions and debridement on the palmar and dorsal sides. Once that’s done, you can handle shortening and fixating the ends of the radius and ulna. After that, I’ll take over again for the tendon sutures."
Given Wu Ting’s calm and methodical approach, Lu Xiong no longer hesitated. He glanced at the young Liu Ping on the table, then at the equally young and brilliant Wu Ting.
"Okay, let’s get started."
"Scalpel... Bone rasp... Locking plate..."
Wu Ting quickly and professionally completed the debridement incisions. Watching his technique, both Lu Xiong and Qin Donglai began to relax.
Once Wu Ting finished his part, Lu Xiong took over immediately. With his own superb skill, he quickly shortened the bone fragments and secured the locking plate.
"Dr. Wu, it’s all yours now."
Lu Xiong yielded the primary surgeon’s position to Wu Ting, who decisively stepped into the role.
"Scrub nurse, needle holder... 4-0 Prolene suture..."
Depending on the thickness, shape, and location of each severed tendon, Wu Ting began to employ a variety of suturing techniques.
The first stitch was placed 0.5 cm from the tendon end, the second 1.2 cm away. The two suture threads formed a cross pattern inside the tendon, and he deftly used a figure-eight stitch to reinforce the stump.
Watching Wu Ting’s deft movements, Qin Donglai was taken aback. ’The kid’s tendon-suturing skills have clearly taken a quantum leap!’
Lu Xiong watched without blinking, thoroughly stunned. ’This Dr. Wu’s suturing skill is even more incredible than I imagined.’
’His suturing technique really does keep the tendon ends smooth, which is an excellent precondition for post-operative recovery. Incredible!’
After repairing one tendon, Wu Ting moved to the next, which had a section missing.
Without a moment’s hesitation, Wu Ting selected the palmaris longus tendon, as if the entire procedure had already been rehearsed in his mind countless times.
"Scalpel... Tendon stripper..."
Using a precise grip on the scalpel, Wu Ting made a small transverse incision along the patient’s wrist crease, perfectly exposing the palmaris longus tendon.
Next, he identified the palmaris longus tendon on the ulnar side of the extensor carpi radialis longus, transected it, and pulled the severed end through the ring of the tendon stripper.
Watching Wu Ting’s masterful performance, Qin Donglai and Lu Xiong felt completely at ease. It looked like the emergency operating room of City First Hospital was about to witness a truly astounding arm reattachment surgery.
The thought that the provincial specialists would be arriving soon filled them both with a certain sense of anticipation.
While the two senior doctors were lost in their thoughts, Wu Ting had already clamped the tendon and was advancing the stripper proximally up to the first third of the forearm.
"Surgical scissors... Forceps..."
Following Wu Ting’s precise commands, the scrub nurse worked in perfect, rapid coordination.
Quickly, at the junction where the exposed palmaris longus met the muscle belly, Wu Ting made a clean cut. He then turned to Luo Ming.
His assistant, Luo Ming, immediately took the harvested tendon to hold it in reserve.
Assisting Wu Ting, Luo Ming felt an instinctive deference, as if he were following a top department head. Even Director Lu and Dr. Qin were playing supporting roles. Luo Ming didn’t have the experience to fully understand the techniques, so he could only cooperate obediently, simply in awe of the spectacle.
With the autologous tendon harvested and ready, the even more complex repair work began.
And so, on the operating table, Wu Ting’s dazzling and varied performance began!
For the first tendon, Wu Ting used a figure-eight stitch for an end-to-end suture. This was the simplest technique and the most common for multi-tendon repairs, significantly reducing the time required.
Next, Wu Ting began suturing two tendons of unequal thickness. Here, he cleverly employed a weaving technique. First, he made a small slit in the thicker tendon with his blade, then inserted the thinner tendon into it.
He then changed the scalpel blade and motioned for Qin Donglai to help by clamping different sections of the tendons.
Wu Ting first sutured the thin tendon where it passed through the slit. Then, a short distance away and perpendicular to the first slit, he made a second one, wove the thin tendon through again, and placed another stitch.
The entire sequence was seamless. A moment later, he trimmed away the excess length of the thinner tendon.
Luo Ming immediately took the trimmed piece to hold in reserve.
Wu Ting then concealed the sutured end within the thicker tendon, promptly changed his scalpel blade again, made a slit in the thin tendon, and inserted the end of the thick tendon.
Then, he repeated the process: slit, suture, trim the excess tendon, and suture the end...
Watching Wu Ting work, the expression on Lu Xiong’s face changed from one of relief to one of utter admiration.
’Incredible! This whole series of maneuvers... not only is every step executed with absolute precision, but more critically, in such a complex situation, he’s making maximum use of the patient’s own tendon. Every move is pushed to the limit, not wasting a single shred.’
’Such a cool head, such brilliant calculative ability... I have never in my life seen surgical talent like Wu Ting’s!’