System Came When the Doctor was Thirty

July 21, Tuesday.

In the emergency department of Long County People’s Hospital, Chen Song’s palms were flat on the fringe of his hair and eyebrows, his palms pushing his hair up so vigorously that it was completely deformed:

”Xiao Lu, what did you just say? You want to try flexor tendon suturing in Zone 2?”

”Do you know what you’re talking about? Do you know what Zone 2 flexor tendon was called in the past?”

Lu Cheng had a pretty good memory, knowing the development history of hand surgery, he replied, ”No Man’s Land tendon.”

The so-called No Man’s Land tendon (no man’s land) is a title filled with the bloody history of surgery.

This name first appeared in early 20th-century battlefield medical records. At that time, firearm injuries caused tendon damage in the hands, and military doctors found the survival rate for repairs in this area was almost zero: post-operation either ruptured or adhered, like a forbidden zone set by the Grim Reaper.

Bunnell’s classic textbook in the 1940s directly called it the ”forbidden repair zone,” and this sense of despair was first named ”no man’s land” in 1950 by Littler, the father of American hand surgery.

In the 1960s to 1970s, hand surgeons attempted staged reconstruction using silicone rods, still facing a 50% chance of infection and joint stiffness...

From 1980 to 1999, the Tang Method and Tsuge Suturing Technique appeared, which improved the situation.

But even until 2020, the excellent functional recovery rate for Zone 2 flexor tendons remained only 88%, and the probability of a second surgery release was still 12%!

These cold, hard data are not just filled in for fun; they’re statistical data derived from millions or even tens of millions of patients’ ’stiffness and re-rupture.’

It was only this year, 2023, that the No Man’s Land was corrected in paper literature as a ”Repairable Zone,” after seventy years of effort by countless hand surgery predecessors.

Learning the Modified Tang Method is extremely difficult, and even now not every hand surgeon is skilled or specialized in it.

”Since you know this, do you still dare to say you want to try flexor tendon suturing in Zone 2?”

”I’ve also read the relevant literature recently. Scholars still define tendons in this area as being in a ’No Man’s Land’ without microsurgical technology and rehabilitation team support!”

”Even I can’t handle it! ~” Chen Song, like a cat whose tail was stepped on, put down his ’proud cat’ demeanor.

Although he had done tendon rupture and damage surgeries at Xiangya Second Hospital, he had never done suturing for damage in the Zone 2 flexor tendon.

Lu Cheng calmly looked at Chen Song, with a crisp and smiling voice: ”Teacher Chen, based on what you just said, can I understand that even Director Xiang, if he came to the countryside, might not dare to handle this Zone 2 tendon suturing either?”

”Whether he dares to try or not is one thing, but he certainly wouldn’t do it lightly.”

After shaking his head, Chen Song stared at Lu Cheng: ”Don’t tell me you’ve already learned the Tang Method and Modified Tang Method suturing?”

”If you’re not proficient enough in the pure Tsuge Suturing Technique, it’s very difficult to handle the Zone 2 flexor tendon properly.”

The first choice for suturing in Zone 2 flexor tendon is the Modified Tang Method, followed by the Tsuge Suturing Technique, and when there’s no other choice, you’d opt for the Modified Kessler Technique.

You could say that the majority of the re-surgery rates for Zone 2 flexor tendons come from the Modified Kessler and Tsuge Suturing Techniques, whereas the second surgeries contributed by the Modified Tang Method aren’t many.

Regarding the tendons in Zone 2, the Modified Tang Method is like a cat catching a mouse, perfectly matched; however, it’s not the only method capable of handling the Zone 2 tendon.

If the dog chasing the mouse is smart enough, it could barely be used too.

”It seems about right...” Lu Cheng seriously looked at his panel and smiled knowingly.

[Suturing Skills: Suturing Skill (Specialization 4/20) (Skill Points -2), Tendon Suturing Skill (Proficient 7/10) (Skill Points -2), Modified Kessler (Proficient 5/10) (Skill Points -2), Tsuge Suturing Skill (including sliding type) (Proficient 3/10) (Skill Points -2), Modified Tang Method (Proficient 6/10) (Skill Points -16)]

[Current Remaining Skill Points: 0.1]

This was already the culmination of skill points accumulated by Lu Cheng over a period of time.

Lu Cheng was well aware of the high difficulty in suturing the Zone 2 flexor tendon, so he hadn’t informed Chen Song even when reaching a proficient level in the Modified Tang Method initially.

Instead, he waited until the Modified Tang Method reached (Proficient 6/10) before giving Chen Song such a hint, given the history of the no man’s land.

For safety reasons, Lu Cheng planned to wait until his Modified Tang Method reached at least (Proficient 10/10) or even a specialized level before attempting the Zone 2 flexor tendon suturing.

Being prophylactic, prioritizing safety, aiming to minimize failure rates and re-surgery rates.

As a surgeon, Lu Cheng knew that no surgery guaranteed ”success” aside from suturing skills; high-difficulty surgical techniques always carried a chance of failure.

As long as your surgical failure rate isn’t higher than the local average, you’re an ’expert’!

Now, discussing Zone 2 flexor tendon suturing, aside from Hua Country’s top teaching hospitals, any one of the top-tier hospitals has a second surgery rate of seven to eight percent, even top-tier hospitals have around five percent...

The tendons in this area’s rupture are challenging to treat, and it demands a very high level of technique from doctors, not that the doctors’ skills are lacking.

”No way, are you tricking me?” Chen Song’s hand continued to slide up, and the hair pressed down inch by inch stood up again—

Chen Song’s voice was sharp: ”Lu Cheng, are you deliberately setting a trap for me because you think I haven’t tried learning the Modified Tang Method?”

Lu Cheng’s micro-expression was serious, his voice earnest: ”Teacher Chen, how could I possibly trick you? You’ve been so considerate in teaching me operations for gallbladder and spleen preservation surgery, giving me so many surgical opportunities...”

”It’s not like I’m planning to do the Zone 2 flexor tendon suturing right now. It’s either going to be next month or the month after.”

Chen Song had fought for many operational opportunities for Lu Cheng, such as operations in gallbladder preservation and spleen preservation surgery that Lin Qianlong couldn’t handle, including incision, suturing, and hemostasis, allowing Lu Cheng to perform them himself.

This surgery was well beyond Lin Qianlong’s range of capabilities, so Lin Qianlong and others didn’t covet or aim too high.

Lu Cheng took the opportunity to step in for some small operations within his reach.

Chen Song, with irritation: ”As if doing it next month or the month after isn’t outrageous?”

”For you to perform the Modified Tang Method after I’m gone, this learning efficiency is kind of outrageous, isn’t it?”

”This suturing technique is hard to learn...”

Earnings of hundreds of thousands per day or month are already considered outrageous to ordinary people.

Chen Song’s gaze and expression were exceptionally serious, scrutinizing: ”I’m also unsure if you can do it; it’s better if you record your operation techniques as before and send them to me.”

”This time I must send them to a more specialized person for review. If he also believes you can operate, then there will be no issue!”

”Mm, okay!~” Lu Cheng nodded lightly, replying with caution.

Chen Song asked again: ”Does your hospital have micro-operative instruments? Zone 2 tendon suturing requires the aid of micro-instruments.”

After listening, Lu Cheng nodded towards Young Master Kun, thinking Chen Song’s question was a bit ”silly”!

Chen Song immediately understood Lu Cheng’s meaning.

Peng Haibo is the director of the orthopedics department, overseeing orthopedic development, and with his own son (Peng Kun) pursuing a path in hand surgery, how could hand surgery’s micro-instruments not be procured in a set?

Moreover, they are brand new, already delivered, and once ”Director Xiang” arrives next month, they can be used directly.

Chen Song stood up, his body straight, hands behind his back, lowering his voice: ”This brother having a peer like you is quite unfortunate...”

After speaking, Chen Song, the ’proud cat,’ walked away with pride, turning his head slightly to glance at Lu Cheng, eyes wandering...