top student at medical school

Chapter 82 is too highbrow! (Seeking first subscription)
"Brother Ye, the first two days were so comfortable."

"I feel that performing suturing on a patient is more intuitive than in the practice room," said Lan Tianluo, who had just finished tidying up the suturing practice equipment in orthopedic practice room 801, while putting on gloves.

As he spoke, he flicked his gloves, making a soft snapping sound.

“That’s natural. The direct contact object for all operations is the patient. No one can replace the opportunity to operate on the patient unless you cut yourself.” Fang Ziye was also tidying up his operating table and found that a pair of tweezers was missing from today’s instrument practice kit.

He was about to get up to get it, but Lan Tianluo was quick and nimble, deftly placing the tweezers from his workbench onto Fang Ziye's workbench: "Brother Ye, there's an extra pair in my bag. It must have been a mistake by the teacher in charge of the equipment when they packed it up after sterilization."

"It's a pity we won't have such a good opportunity today!" Lan Tianluo sighed slightly as she handed over the tweezers.

At this moment, Luo Tingzhu walked in from outside, carrying a piece of pork she had just brought back in her left hand, twisting the pork belly in her hand and examining it from side to side. In her right hand, she was carrying a box of aspic that Fang Ziye had brought to practice his sewing skills.

As he walked over, he said, "Senior brother, there have been fewer people in the practice room lately, so the teachers in the storeroom didn't keep any extra aspic. There's only this small box. The teacher asked me to tell you to use it sparingly."

"Thank you for your hard work, Tingzhu. I was going to go get it myself." Fang Ziye took it with both hands, without touching Luo Tingzhu's hands, and then took the square box off and flipped it over on the work surface.

The aspic was laid out on the work surface like braised pork belly.

On weekdays, the teachers in the warehouse would prepare extra when making aspic powder, so that students could practice every day.

The aspic powder is inexpensive and you can get it without spending any money, but each person can only get a maximum of two boxes. After cutting it open, if you save a little, you can barely make ten uses.

With the orthopedic annual meeting approaching, most senior physicians are either attending meetings or staying in clinical practice, and almost none of them come to the practice room.

As for the practice materials like aspic, I heard they are still used in the second practice room of several wards. It is understandable that the amount made each day is relatively small when these senior doctors are not present.

Today, Fang Ziye made seven even cuts on the aspic, so that both sides could be sewn up at the same time. This allowed Fang Ziye to complete fourteen sews, which was relatively economical.

"It was just something I did on the spur of the moment."

"By the way, senior brother, the cells you asked me to revive for you, I've already reviveed them and placed them in the third compartment on the bottom right of the cell culture incubator. It has your name on it. Please keep an eye on them and observe the passage later." Luo Tingzhu said this and turned to walk to the next room.

For the first two days, Fang Ziye and Luo Tingzhu practiced almost all their skills in the department and the emergency operating room, while the other two junior doctors in the professor's group practiced in the training room.

With three days left, Fang Ziye and his group had nothing to do.

At most, Senior Brother Gu Yi will perform some procedures in the operating room under the guidance of Dr. Qin Geluo.

Therefore, the trauma surgery practice room was currently reserved for Luo Tingzhu, Fang Ziye, and Lan Tianluo. Shu Lang, on the other hand, was on duty in the department.

After Fang Ziye finished cutting the aspic, he turned to Luo Tingzhu and said, "Tingzhu, tonight I'd like to invite Brother Jin Hongzhou to dinner. Are you and Tianluo going to split the bill? Or what do you say?"

Lan Tianlu nodded without much thought: "I can do it, senior brother."

Luo Tingzhu hesitated for a moment, blinked twice, and then nodded: "I can too, Senior Brother Fang. Have you already found a place? I hadn't even thought of that."

"You're so thoughtful, Senior Brother," Luo Tingzhu said in a clear voice, a little embarrassed.

The annual meeting lasts five days.

Jin Hongzhou gave Fang Ziye, Luo Tingzhu, and others two days of ample opportunity to operate, not out of respect for Fang Ziye and Luo Tingzhu, but out of respect for Professor Deng Yong, the ward director.

In contrast, the junior doctors in Jin Hongzhou's own teacher's group and Professor Han Yuanxiao's group only had three days to practice, so Fang Ziye and Luo Tingzhu benefited from this.

But Professor Deng Yong's reputation belongs to the professor, and to the ward director.

Jin Hongzhou offered him a chance to mentor him, so Fang Ziye should reciprocate in some way, though that doesn't mean he has to fawn over him.

Inviting someone to dinner is a way to make a good impression, a reciprocal gesture. It's not a big deal if you don't, but it would make Jin Hongzhou have a better impression of Fang Ziye and leave a more lasting impression.

In this way, Fang Ziye is reliable, so when they cooperate again in the future, Jin Hongzhou will definitely think of having such a clever and shrewd younger brother.

Moreover, it doesn't matter even if Jin Hongzhou couldn't think of it.

Fang Ziye thought this arrangement was quite good. Doing the right thing at the right time, in the right capacity, and doing things that are in one's own interest is what is called being worldly-wise and mature.

Fang Ziye felt there was no need for other aspects.

For example, at a big gathering, if you toast someone a few more times and they casually drink it all down, they may not remember you, nor will they feel that you are giving them any face.

“Brother Zhou is our direct superior. We can still seize this opportunity. Besides, Brother Zhou may not have the time or may not agree. I’m just thinking this from my perspective.”

"I'll send you the location later." After saying that, Fang Ziye focused his attention on the sewing of the aspic.

The stitching of aspic is more delicate than stitching the cut surface of tofu. If the force is not controlled properly, the aspic will tear, whether it is the needle tip or the sewing thread.

Furthermore, aspic is a bouncy substance, much less sticky than tofu, requiring less sewing force while precisely controlling the angle and force of needle insertion, threading, and passing.

Fang Ziye had tried this many times before and found it extremely difficult.

However, Fang Ziye's suturing skills have now reached level 4. Luo Tingzhu has already completed the jelly suturing stage, so he shouldn't be any worse.

Fang Ziye threaded a silk thread with a triangular needle, held a needle holder in his hand, gestured a few times in the air, and then picked up tweezers to assist.

When it comes to sewing up aspic, you need to be careful to control the force when using tweezers to hold it in place. If you use too much force, the aspic will definitely crack open.

The needle went through in one go, cleanly and decisively, without hesitation.

Fang Ziye felt that today's needle insertion and withdrawal, including the angle when the thread came out, were well controlled, and the jelly was just right, except that it left a hole that was equal to the maximum diameter of the needle.

Moreover, during the pulling process, the edges of the jelly did not break or 'scoop out' in a suture manner, which makes the stitching look more comfortable.

Next, we come to a crucial point.

Sew and tie knots.

Suturing and knotting are basic operations that complement the actual knotting technique.

Of course, the knot for sewing is slightly different from some special knots, and the knot for sewing does not require so many fancy techniques.

However, knotting in certain special areas, such as when the field of vision is insufficient and it is necessary to slide the knot down from the body surface to complete the binding operation, falls under the category of knotting techniques.

However, the operational space for sewing and knotting is very large.

But you have to control your strength, otherwise, the aspic, which is even more delicate than Luo Tingzhu's face, won't be able to withstand the strain.

Fang Ziye uses a mechanical knot-tying method.

After tightening the sutures just right and ensuring they are in close contact with the surface of the jelly, a temporary fixation without auxiliary fixation is required. This involves pushing the suture knot towards one of the entry or exit points of the needle to complete the temporary fixation.

Previously, Fang Ziye's operation was not so smooth, but today, Fang Ziye's technique seemed to have been touched by a god, so it was exceptionally smooth.

Even though the second fixing knot hadn't arrived, the first temporary fixing knot was pushed to the needle exit end and was tightly attached without loosening, giving Fang Ziye enough time and energy to properly prepare the second fixing knot.

Fang Ziye used the needle holder to wrap it in the opposite direction, and the second knot was instantly fixed.

With a snap, the thread cutter cuts out, and the first stitch is complete.

Fang Ziye was very satisfied after reading it. He even gently patted the surface of the aspic with the needle holder. The aspic bounced, but the sutures held the two pieces together, and the force was transferred to the other side of the aspic.

This proves that Fang Ziye's previous stitch fixed the two pieces of jelly together, and was able to tolerate the transfer of force and vibration between the two pieces of jelly, keeping them very close together.

This is a high-quality suture.

With the confidence gained from the first stitch, Fang Ziye obediently stitched up seven or eight more stitches, feeling quite pleased with himself.

Despite bending over, the stitching process remained flawless.

Just then, Lan Tianluo finished sewing up a piece of orange peel. With a sigh, he stretched.

At the same time, he also looked at the two big fingers with curiosity. He saw that Fang Ziye's first incision in the skin suture was about to be finished, and it was all done steadily.

Upon closer inspection, Lan Tianluo's pupils instantly contracted, and his eyelids closed.

He is no longer a newbie who just came to the training room. He has seen many senior brothers and sisters perform, so he is not so surprised. However, he knows that Fang Ziye's suturing skills have improved significantly again!
He exclaimed in a low voice, "Senior brother? You opened up the sutures so quickly?"

The last time was in August, when I had just joined the department. At that time, Fang Ziye had just finished suturing the orange peel, which was the suturing operation that I had just performed.

Then, Fang Ziye finished sewing up the tofu, and poked his way out of the first training room he had been practicing for his master's degree.

In just one month, Fang Ziye has truly passed his first training session in suturing.

Even in the first practice room of hand surgery, the last practice material is aspic.

Upon hearing this, Luo Tingzhu paused her work of cutting a piece of muscle from the pork and looked towards Fang Ziye.

His hands froze in mid-air, his eyes filled with utter disbelief.

When she was slightly agitated, her chest heaved more violently than before, but she didn't speak, because that would disturb Fang Ziye's operation.

Then, Luo Tingzhu temporarily put down the tweezers and scalpel in her hands, and together with Lan Tianluo, they turned around, just like before, when Fang Ziye watched her operation, she acted as Fang Ziye's audience.

In the practice room, everyone loves watching others practice.

I enjoy watching those who are better at the game than me, admiring their skillful and precise execution.

People who are less skilled than themselves are more likely to watch others take the driving test. This kind of thinking is somewhat similar to the feeling of watching others take the test after you've just passed your driving test—it's hard to describe.

In short, I love watching it.

On the contrary, people of similar skill level don't like to watch when they are practicing.

Damn, it's like seeing myself in Nana...

Five minutes later, Fang Ziye finished sewing all twelve stitches steadily and securely.

The aspic is not wide, only about eight centimeters.

Fang Ziye chose a suture spacing of about 5mm, which is even smaller than the customs requirements.

Because in general sewing, the stitch spacing is usually around 1cm. But this is for practice. When practicing, you should sew as many stitches as possible, since you need to use materials sparingly when they are scarce.

"Senior brother, congratulations!" Luo Tingzhu stood with his hands behind his back, gently patting his buttocks with the back of his hand to show his nervousness.

Because from this moment on, it was a landmark event, that is, all the corresponding operations that he was so proud of were caught up by Fang Ziye.

Fang Ziye, in terms of professional operation, research topics, breadth of skills, and even the number of articles, has surpassed her in all aspects, thanks to Lan Tianluo's semi-supportive and semi-cooperative approach.

Well, her manual repositioning technique is no longer as good as Fang Ziye's, and her only leading suturing technique has also been caught up by Fang Ziye.

At the same time, her incision technique is still not proficient enough to move to the next step, so being ahead of Fang Ziye's progress is completely meaningless.

In that case, if Fang Ziye really has to compete with her for a chance to stay in the hospital or something, the emergency department, pediatrics department, or anesthesiology department will be her destination!
The emergency department doesn't have high requirements for publications, and because it's tiring, many people are unwilling to go there.

Pediatrics needs no explanation.

The anesthesiology department has a very small number of doctors, and outstanding master's degree holders have a good chance of staying on as staff. Moreover, the hospital's surgical department is developing rapidly; where would we find so many PhDs to recruit?

Most anesthesiologists do not choose to pursue a doctorate and will choose to work as soon as possible.

"Yes, it took me a whole month of constantly asking Tingzhu and Senior Brother Yuanqi for guidance. You were both so patient, and that's why I am where I am today." Fang Ziye stood up straight, neither arrogant nor impatient.

After completing the procedure, put down the needle holder and tweezers. Calm yourself down.

If your mind is not at peace, it is not advisable to continue with any further actions.

Fang Ziye's words are both right and wrong.

That's right, Luo Tingzhu and Wang Yuanqi did indeed share a lot of techniques with Fang Ziye without holding anything back. Teaching in a teaching hospital is an atmosphere, and also a way of passing on knowledge and skills.

However, Luo Tingzhu not only gave guidance to Fang Ziye, but also to her senior brother Gu Yi, and even to Li Yuanpei, as well as to the newly arrived doctoral senior brother Yan Zhiming.

The guidance certainly has its value, but it's hard to say exactly how significant it is.

"Senior Brother Fang, it's because you have such good talent, much better than all of us." Luo Tingzhu squinted her eyes, a hint of envy mixed with admiration.

Fang Ziye then said, "Tianluo, do the math for me. I'm twenty-seven years old this year. Tingzhu is twenty-three. Our stitching skills are about the same, but how many times more talented is she than me?"

Lan Tianluo replied almost without hesitation, "At least 1.6 times."

"Sister Tingzhu has only been involved in medicine for five years, and less than five years. Brother Fang, you have been involved in medicine for less than eight years."

"Of course, we also have to take these factors into account. Senior Sister Tingzhu had already gone through the suturing of the skin jelly before you, and Senior Sister Tingzhu arrived very early after enrolling."

"If we were to calculate the specific number of days spent learning suturing techniques..."

Lan Tianluo actually went to calculate it, but Fang Ziye interrupted, saying, "Alright, alright! Bro, we don't need to be so serious."

Fang Ziye was a bit annoyed; he hadn't expected Lan Tianluo to actually be able to provide some evidence.

Luo Tingzhu smiled slightly and returned to her operating position.

After being interrupted, Lan Tianluo wasn't angry. He simply clenched his right fist and cheered himself on: "I can do it too!"

Because Lan Tianluo had also done some calculations for himself, he had actually only been learning suturing techniques for less than three months, since he had only been studying the theory before...

Two hours later.

Fang Ziye gained 0.2 knowledge points and finally managed to sew up all the cuts on the row of aspic.

There were seven incisions, seven cuts in total, and fourteen rows of sutures on both sides, with twelve stitches in each row, for a total of one hundred and sixty-eight stitches. Fang Ziye failed to suture three of them.

This success rate is already over 90%.

This suturing technique breaks through the requirements for suturing surgery and has been successfully implemented.

After Fang Ziye finished stitching, he couldn't wait to take a picture, then turned him over and took another one.

After all, it was my first project in my first practice room, so it's quite memorable.

While this was aided by the large number of patients treated, it also made Fang Ziye realize just how difficult it was to pass the first training room and how valuable it was.

How could his own teacher, Yuan Weihong, pass the exam before graduating with his doctorate without any assistance?

Moreover, other teachers who stayed at the hospital after Yuan Weihong's class were also able to pass the test. What talent!

Fang Ziye silently gave them all a thumbs up in his mind.

The time has come to 10:49.

Luo Tingzhu, on the other hand, had already completed her practice of the incision technique. Now, she was working on the artificial joint operating table, adjusting it with a series of clicks and clacks.

His forehead was covered in a fine layer of sweat.

Actually, relatively speaking, girls are at a huge disadvantage when it comes to manual repositioning.

After all, compared to their peers, girls are significantly weaker than men, except for certain groups.

Therefore, even the manual reduction exercises for artificial joints still proved quite strenuous for Luo Tingzhu. However, Luo Tingzhu did not give up and continued.

Fang Ziye stretched his shoulder joints, intending to go and collect some pork, and also practice his cutting technique.

Just then, a head poked its way in through the doorway of the training room. "Nobody here either?" it muttered to itself as it looked around.

Oh, yes!

Fang Ziye recognized this person; he was an attending physician in the hospital's hand surgery department named Yang Wenzheng.

"Brother Zheng." Fang Ziye greeted Yang Wenzheng politely when he saw him.

Fang Ziye is a first-year master's student, and he is doing his residency rotation in the hand surgery department.

Professional master's students need to be integrated into the standardized residency training rotation program, which lasts for 33 months. You need to spend at least one month in several specialties of orthopedics and spinal surgery to collect the disease information required during your residency training.

Of course, there are also general surgery departments such as gastrointestinal surgery and hepatobiliary surgery, which are all departments that orthopedic residents must rotate through...

Yang Wenzheng was not very familiar with Fang Ziye. Fang Ziye had only been there for a month. Even though he was only the chief resident at the time and had had contact with Fang Ziye, he still had no memory of it.

"Hello. Which of you three is free? Could you come over and help me out? The other practice rooms are empty." Yang Wenzheng asked.

Luo Tingzhu was a little tired at the moment, while Lan Tianluo didn't dare to speak at the control panel and continued operating. As an ordinary resident trainee, no one outside his current department knew him, so naturally he didn't dare to talk to him.

So it could only be Fang Ziye, and Fang Ziye even called out the other party's name in advance.

"Brother Zheng, can I come over after I tidy up the workbench a bit? Is it 807?" Fang Ziye asked.

Rooms 801-805 are the first practice rooms for the five subspecialties of orthopedics, while rooms 806 and 807 are the second practice rooms for trauma surgery and hand surgery, respectively.

"Okay, come over later. You mainly need to help me hold the mouse's tail and cut the thread." After giving these instructions, Yang Wenzheng said, "Don't leave either of you. We'll have dinner together at one o'clock."

Yang Wenzheng probably felt embarrassed to have asked someone to help him practice, so he should treat them to a meal as a token of appreciation.

Moreover, Yang Wenzheng was quite cunning; he called three people at once, making it difficult for any of them to refuse.

Fang Ziye stayed in Bengbu at the time, cursing inwardly that all his superiors were shrewd, including his own carefree master.

I've learned another skill.

Ten minutes later, Fang Ziye finished tidying up the workbench, cleaned and packed the instruments, and sent them back to the warehouse. After an old professor carefully counted the corresponding instruments, Fang Ziye washed his hands and went to room 807.
There was no one inside; most of the staff in the departments had left.

Because of the emergency department, a considerable number of people remained in the trauma surgery department. However, it is estimated that since the hand surgery department also performs surgeries such as finger replantation, most of them were in the operating room.

There are hardly any assistants in the practice rooms of joint surgery and bone disease departments.

As Fang Ziye went in, he symbolically put on a pair of examination gloves. However, it was just a training room, and there was no need to use sterile surgical gloves; it would be a waste.

After putting on gloves, Fang Ziye sat down properly opposite Yang Wenzheng.

The second practice room for hand surgery is truly luxurious; it even has two microsurgical endoscopes.

As Yang Wenzheng had Fang Ziye put on the glasses, he said, "You look familiar. What's your name, little brother?"

“Brother Zheng, my name is Fang Ziye. We were in the same group when I came here for my rotation in the hand surgery department.”

Upon hearing Fang Ziye's mention, Yang Wenzheng immediately recognized him: "Fang Ziye, that's you, Brother Wei's first disciple."

"You look quite handsome. I'll have to do you a little work today. I'm doing a tail replantation procedure, and I've only cut about a dozen pieces today."

"You mainly help me with securing it, then you just need to cut the stitches, and then these are..."

Yang Wenzheng first gave Fang Ziye a brief explanation of the relevant operating tools.

Actually, it's similar to the tools used in trauma surgery, but much smaller. And the sutures used for suturing practice are not silk sutures, but some kind of 12-0 suture, which is definitely not the kind of vascular or nerve-specific sutures used clinically for patients.

Are you kidding me? That stuff costs tens of dollars a shot, can you afford it in a training room?
"Okay, Brother Zheng." After sitting up straight, Fang Ziye began to assist his assistant.

Although he wasn't very skilled at coordinating naturally, Yang Wenzheng wasn't too frustrated. After patiently explaining it to Fang Ziye twice, Fang Ziye's fixed clamping technique was completed quite well.

Then, behind the microsurgical headgear, which resembled a miner's microscope, he watched as Yang Wenzheng used a fine needle to suture the blood vessels and skin of the mouse's tail, all the while saying this.

“Ziye, your trauma surgery department is really good. It doesn’t require such precision. In our department, Professor Ni said that for our group, the artery on the rat’s tail needs to have a patency rate of over 99% after suturing to be considered qualified. It takes another year or two of clinical experience before we can operate independently.”

Fang Ziye was instantly stunned.

The arteries on a rat's tail can be as thin as 0.2 millimeters. Only when the patency rate after suturing reaches 99% or more can it be considered acceptable.

In hand surgery, does that mean becoming a doctor who performs finger reattachment surgery? Wouldn't that be...?

"Besides practicing suturing, you also have to practice blinking. The surgeon must be able to blink a maximum of 3 times per minute!" Yang Wenzheng warned Fang Ziye as he watched him blink repeatedly.

Fang Ziye's first reaction was that if that were true, then he would really be blind.

However, since Yang Wenzheng had already said so, Fang Ziye decided to respect their customs.

However, after about ten seconds, Fang Ziye couldn't hold on any longer. After all, the light under the microscope is intense, and you have to practice that carefully.

Yang Wenzheng sewed it up stitch by stitch.

Similarly, they failed time and time again.

Either there is bleeding, or the blood flow rate of the real-time blood flow meter is insufficient. It's possible that during suturing, the blood vessel folded, causing poor blood flow and creating turbulence, which slightly reduced the flow rate.

Basically, Yang Wenzheng's success rate in vascular suture, without leakage, hovers around 70% to 75%.

When only the last two pieces remained of the sewing, Yang Wenzheng either got tired or didn't want to fail anymore, so he threw down the instruments in his hand.

"Alright, you can handle the remaining two sections. I'll make a reservation first. After you've done a couple of stitches, we'll go out for dinner together." Yang Wenzheng instructed as he unfastened his gloves, found a phone, and dialed.

It's just a reservation for a meal. It's a bit late, but that's okay. We should be able to leave around 1 p.m.

It's only 12:55 now.

Fang Ziye hadn't expected Yang Wenzheng to say that, but since the other party was giving him a chance to play around, Fang Ziye didn't mind and accepted the other party's microscopic needle holder and microscopic tweezers.

Slender and long was Fang Ziye's first impression of these two instruments.

Of course, the stitches are also very fine, perhaps even finer than a strand of hair.

The suture needle wasn't very big; if it weren't for a 20x microscope, it might have pierced into the flesh and wouldn't have been found.

Tail vessel suturing doesn't actually involve cutting off the tail. Instead, the blood vessels in the tail are separated beforehand, and suturing begins from the distal end to the proximal end. The rate of blood vessel passage is monitored while suturing.

Naturally, more skilled doctors will also check the blood vessel pass-through rate after all the sutures are completed.

The angle at which the stitches are made is extremely important.

Such fine blood vessels cannot tolerate multiple stitches; generally, four stitches are the limit that a blood vessel can accommodate.

Fang Ziye twisted the suture needle, then clamped the hemostat upstream of the blood vessel to cut off the blood flow. Fang Ziye quickly followed Yang Wenzheng's example and cut a clean incision again.

This operation is not difficult.

Yang Wenzheng saw that Fang Ziye was still operating and patiently put his gloves back on. He knew that young doctors like Fang Ziye were very curious about such a sophisticated technique as suturing a severed tail artery.

Such advanced technology is something that a junior doctor like Fang Ziye might never encounter in his entire life. Curiosity and a refusal to admit defeat are the best raw materials for suffering a severe beating.

Yang Wenzheng politely dripped a few drops of heparinized saline solution into Fang Ziye's blood vessels to flush away the blood near the severed ends and prevent the blood inside the vessels from clotting.

When practicing small blood vessel suturing, the first priority is to ensure that the blood vessels are clearly exposed and that the surgical area is kept clean.

Fang Ziye held the suture needle in the needle holder and his first reaction was, "Holy crap, how come it's so far away?"
The distance between the operating point of the needle holder and the gripping point is very long, which is not conducive to operation. However, after swaying in the air a few times, Fang Ziye felt that it was actually not so bad.

I gently pulled on one end of the blood vessel with tweezers to test its tension.

Because after a blood vessel ruptures, it will retract to both sides, the degree of retraction is related to the diameter of the blood vessel, the length of the anatomically freed tissue, and the placement of the limb. Before suturing, the two ends should be pulled together to check the suturing tension. Excessive or insufficient tension, or twisting, will affect the anastomosis result.

Although Fang Ziye didn't know how to perform the procedure, it didn't mean he was completely unaware of the intricacies of suturing small blood vessels.

Theory isn't learned for nothing.

Maintaining proper tension is especially important. Excessive tension can make it difficult to rotate blood vessels, thus affecting the operation, and the anastomosis is prone to tearing and thrombosis.

Fang Ziye then completed the operation of using a needle to puncture one end of the blood vessel, steadily and surely breaking the severed end of the blood vessel.

After that, Yang Wenzheng gave a soft "hmm." It wasn't surprising; completing the first acupuncture proved that Fang Ziye's abilities were quite good, possibly approaching the level of a doctoral student.

On a whim, Yang Wenzheng helped Fang Ziye stabilize the proximal end and lift the skin to facilitate Fang Ziye's operation, while saying:
"In the process of microvascular repair, it is essential to emphasize the need for stability, accuracy, gentleness, and dexterity. Students must remember that improper handling of even a single stitch can lead to adverse consequences and even surgical failure. Every suture must be accurate, requiring uniform stitch spacing and edge distance to avoid repeated needle pricks that could increase damage to the vessel wall. When performing vascular dissection, separation, suturing, and knotting, it is crucial to emphasize quick, light, and skillful movements, avoiding excessive pulling, pinching, or squeezing of the vessel, and avoiding clumsy, unnecessary repetitions, and awkward actions."

"Pull open the proximal end of the blood vessel and thread the suture needle through it to tie the knot!" After securing it, Yang Wenzheng continued to drip heparinized saline solution into the surgical field to rinse away any remaining bloodstains.

Upon hearing this, Fang Ziye casually threaded the needle through the severed end of a blood vessel and, somewhat awkwardly, completed the first stitch.

It's decent; at least they managed to tie one knot!

"Not bad. With your skill level, you should be able to sew up tofu without any problems, right? Your technique is quite steady," Yang Wenzheng asked.

"Brother Zheng, that's about right!" Fang Ziye nodded slightly, waiting for Yang Wenzheng to cut the thread.

"The suturing of severed blood vessels uses an end-to-end suturing method. This suturing method is suitable for suturing the severed ends of blood vessels with similar diameters, so as to maintain the maximum blood flow rate and volume. It is currently the most commonly used method for microvascular anastomosis."

“一般而言，缝合血管断端的常用的顺序有3点―9点定点法或12点―6点二定点法，以及2点―6点―10点三点缝合法，还有等距四定点缝合前壁法、先缝合后壁法、缠绕式缝合法等。”

"You're suturing the anterior wall now, so you can suturing the posterior wall next, similar to a two-point positioning between 12 o'clock and 6 o'clock."

Yang Wenzheng gave him some pointers.

Fang Ziye nodded hastily, and then, with the experience of the previous stitch, he stitched up the posterior wall with another stitch.

Having completed the two stitches with considerable skill, Fang Ziye felt more at ease and somewhat pleased, but he also knew that this was only the most basic suturing and did not represent a high level of quality.

Yang Wenzheng was able to successfully suture all segments, but the blood vessel pass-through rate was still only over 70%.

Next, the third and fourth stitches will be completed, around the 3-9 o'clock position.

The blood vessels are very thin, only enough to accommodate four stitches.

Pulling, inserting and withdrawing the needle, sewing, tying a knot, and cutting the thread.

Yang Wenzheng continued to administer heparinized saline solution, nodding repeatedly: "Ziye, you really are talented. Now I remember, you're the only master's student in our orthopedics doctoral class who passed the training room test, right?"

"Alas, it's a pity you're Brother Wei's student; otherwise, you would definitely be a very promising hand surgeon."

Yang Wenzheng felt a little regretful.

Fang Ziye's talent in finding the right suture points and completing the suture on his first attempt at suturing a severed blood vessel is already quite remarkable.

Then, immediately, Fang Ziye completed the fourth stitch, the suture at the nine o'clock position.

Yang Wenzheng also finished cutting the thread.

He smiled at Fang Ziye, asking with a hint of enticement, "How are you feeling? Are you looking forward to seeing your blood vessel patency level?"

Fang Ziye was a little nervous. His shoulders shrugged slightly, and his heart jumped a little. He looked at Yang Wenzheng with a bad expression and said, "Brother Zheng, why don't you just give me a quick answer? How many sutures can a typical doctoral student in hand surgery complete on their first attempt?"

Yang Wenzheng's right hand was already on the hemostat. If he released it and the blood flow was allowed to flow freely, the instant blood flow monitor would be able to detect the level of vascular patency.

He chuckled and said, "This is the first time for a hand surgery PhD. There's a saying that goes, 'Too high-class.'"

"A leak occurred!"

After saying that, Yang Wenzheng, as if to confirm this reality to Fang Ziye, then opened the hemostat.

Let Fang Ziye see for himself how the leak occurred.

But nothing happened a second later.

Two seconds later, there was still no sign of blood gushing out from the severed end of the blood vessel.

Three seconds later, the vascular patency measuring device beeped, and the data displayed was 81%, which was even higher than the patency rate of the blood vessels he had sutured before!
Fang Ziye, unaware of what was going on, stared intently at Yang Wenzheng with an innocent look and a calm expression, like a curious child waiting for answers.

Yang Wenzheng's eyes nearly popped out of their sockets. He looked at it incredulously for a few moments, then put on gloves and tapped the blood vessel real-time measuring device again.

After a few seconds.

The beeping sound rang again, still indicating 80%, not much different from 81%.

Fang Ziye instantly knew that, if there were no unexpected events, something unexpected had happened, and this unexpected event was exactly what he had guessed earlier.

Yang Wenzheng was momentarily flustered and didn't believe in bad luck.

He snapped the hemostat shut again and personally cut a section of the blood vessel for Fang Ziye.

"Come on, try it again?"

"Holy crap?" This time, Yang Wenzheng stared intently at Fang Ziye's actions.

This time, Fang Ziye's hands seemed to be more steady than before.

We still opted for the simplest end-to-end suture technique, using the two-point positioning method at the 12 o'clock to 6 o'clock positions, and then suturing at the 3 o'clock and 9 o'clock positions.

After four stitches, the suturing was completed in an orderly manner.

Yang Wenzheng nodded and said, "If you don't leak this time, you're going to be rich, you know that?"

Fang Ziye didn't know much about it at the time.

But when Yang Wenzheng released the clamps that had been clamping the blood vessels, the vascular measuring instrument beeped a few times and then displayed a super green number.

Vascular patency rate – 92%!

Yang Wenzheng's eyes bulged out, and he leaned forward slightly, quickly throwing away his gloves, still remembering how dirty they were in his haste.

Then, he clenched his fists and rubbed his eye sockets with the soft flesh at the base of his thumbs.

After clearing my vision, I pinched the fold of the glove and pressed the instantaneous blood vessel measuring device again.

The vascular patency rate measured again was 91%!

Yang Wenzheng stood up immediately.

"Don't move, sit here and don't move, I'll be right back!"

As Yang Wenzheng backed away, he said, "Don't move."

Fang Ziye thought to himself, "Are you trying to take advantage of me?" But seeing Yang Wenzheng's sudden change in expression and his hurried figure, he didn't dare to make any rash moves.

Yang Wenzheng ran out of the training room and shouted, "Professor Wen, Professor Wen, Master, Master..."

Fang Ziye was a little flustered at that moment.

Just as I thought!
(End of this chapter)