System Came When the Doctor was Thirty

Emergency Department, Operating Room.

Tong Yuan’an sat in the main operating position, eyes fixed on the surgical microscope, his hands moving swiftly yet methodically within the operating field, effortlessly smooth.

Lu Cheng sat at the assistant’s position, clearly able to see the motion of Tong Yuan’an’s needle holder and needle tip, steady when still, and arc-like when in motion.

His plump hands held the delicate microsurgical instruments, moving like a nimble rabbit, operating with boldness and delicacy within the cramped field.

This was an unfamiliar suturing technique, which showed traces of the Modified Tang Method and some concepts of the Tsuge Suturing Technique.

However, Tong Yuan’an did not take the time to explain to Lu Cheng what suturing technique this was.

Watching from the operating room, Chen Song was taken aback, silently sitting on a steel roller stool, gently shaking his head, with a complex expression.

Chen Song had understood from the time he chose his specialty that in terms of surgical techniques and specific procedures, an emergency surgeon could never surpass a specialist.

Emergency surgeons focus only on hemostasis techniques, where the timing is extremely critical.

Hemostasis is a matter of life and death, occurring in a split second. It’s not something that can be ”performed,” and often appears violent and bloody.

Chen Song never even considered the idea of comparing surgical techniques with Tong Yuan’an, only lamenting the growing disparity in skills between them...

Peng Kun was also entranced, eyes filled with envy, his mouth moving under his surgical mask, causing it to rise and fall with his rapid breaths.

If he had Tong Yuan’an’s skills, what would Lu Cheng amount to? And what about Xiang Dahong, the deputy director at the State People’s Hospital?

He’d heard of a limb replantation surgery; could he cut off this hand and attach it to his own? In frustration, Peng Kun could only fantasize, and then pay attention to Lu Cheng’s expression.

For Lu Cheng too, this was the first time he delved deeply into understanding the intricacies of such operating levels. During basic training, Lu Cheng’s fundamentals were poor, so watching many professors’ surgeries felt like a blur.

Lu Cheng, being in orthopedic basic training, had also visited the hand surgery department at Zhongnan Hospital.

Tong Yuan’an’s operating techniques differed from those used by the professors at Zhongnan Hospital, yet his proficiency was not beyond them; compared to Professor Liu, it was even slightly inferior...

But after all, Tong Yuan’an was just an associate professor, while Professor Liu was a seasoned hand surgeon of many years.

After completing the tendon suturing, Tong Yuan’an lifted his round face: ”Xiao Lu, please handle the remaining skin incisions.”

Lu Cheng immediately nodded: ”Alright, Teacher Tong.”

Once Tong Yuan’an put down the microsurgical instruments, Lu Cheng took a deep breath, then sat upright, slightly squinting before using the microscope to begin operating.

Previously unused to operating through a microscope, Lu Cheng felt a bit awkward at first, but after handling the microsurgical instruments a few times, he became familiar with the view...

Feeling sufficiently familiar, Lu Cheng used the micro-forceps to lift the skin’s surface and began interrupted suturing.

Once Tong Yuan’an’s face was lifted from the microscope, he immediately focused on the microscopic view.

As a hand surgery expert, he knew very well how to evaluate someone’s basic suturing skills, where the most basic skill was steady hands when lifting.

Even under magnification, no wrinkles should form. If this steadiness can’t be maintained, one cannot become a good hand surgeon.

Lu Cheng achieved this, as evidenced by his skilled operations.

If a person’s hand isn’t steady, handling surgical instruments will result in many lines being folded, clearly visible under the microscope...

Then, Tong Yuan’an raised his head again, noticing Lu Cheng’s frequent blinking, a clear sign of lacking formal practice.

Tong Yuan’an did not interrupt Lu Cheng, watching closely the suturing details.

The needle entry angle, choice of entry point, needle entry direction, exit angle, and the control of force during the entire process were all detailed, reflecting true suturing nuances...

The skin suturing process wasn’t long, finishing in about ten minutes when Lu Cheng allowed Tong Yuan’an to complete the final stitch and cut.

After finishing, Lu Cheng moistened gauze with saline solution, wiped the wound area, and with satisfaction, spread the sutured wound edges to show Tong Yuan’an that all the stitches precisely aligned with the skin, maintaining tensile strength.

This demonstrated that the sutures were bearing force, with consistent depth, without any instances of tension slippage.

”Teacher Tong, can I apply the sterile dressing now?” Lu Cheng asked.

”Yes, go ahead,” Tong Yuan’an confirmed after examining the details Lu Cheng presented to him, expressing no doubt.

In the department, even the most outstanding professional Ph.D. students don’t possess such a level of suturing proficiency; anything beyond excellence is abnormal and hard to generalize.

Lu Cheng’s current fundamental skills are solid, even better than mine at his age, and Tong Yuan’an could find no fault.

As Tong Yuan’an got up, removing his green sterile surgical gown, he commented: ”Xiao Lu, you have a foundation in hand surgery, but your eyes are not quite there.”

”You blink too frequently; if you really want to specialize in hand surgery, you should be able to go one or two minutes without blinking.”

”Practice is needed. Typically, until you shed a pound of tears, it’s hard to master it.”

”Especially during finger replantations, the timing for vascular suturing is fleeting. Missing it could mean having to wait, so mastering the no-blink basic skill is essential.”

”Moreover, with your current fundamental skills, the next step should be suturing the tail artery of athymic mice.”

”The key to progress here lies not only in managing suturing details but also in knotting details, or else minor creases will arise between vessels, creating turbulence!”

”The mouse tail artery has a tiny diameter, and blood flow isn’t plentiful. If you knot in a way that restricts blood flow, it could significantly impact distal limb vitality.”

”These are unacceptable...”

”However, with your current skill foundation, you’re ready to start practicing the Tajima Suturing Technique.”

”Once this surgery is over, I’ll take you to your hospital’s skills training room to explain the learning points of the Tajima Suturing Technique in detail.”

As Tong Yuan’an spoke, his gaze turned to Peng Kun, his tone jesting: ”Young Master Kun, do you want to join us?”

While Lu Cheng completed the suture dressing, he simultaneously applied an external plaster cast for stabilization.

Though tendon suturing ideally uses brace support, which is costly to custom-make and affordably available online, injuries are unforeseen, so a cheap plaster cast serves as temporary stabilization.

Peng Kun immediately shook his head emphatically, his voice dulled: ”Professor Tong, I’m afraid I’ll pass, I probably can’t learn it...”

”This task is best left to Brother Lu.”

Peng Kun didn’t even dare to compare learning speed with Lu Cheng; the thought never crossed his mind, primarily due to the vast difference in their fundamental suturing skills.

Even if Tong Yuan’an exaggerated one or two years, half a year is enough for Lu Cheng to learn, but by then, it would be too late.

Tong Yuan’an nonchalantly approached Chen Song, casually mentioning: ”Old Chen, shall we discuss?”

Chen Song smiled, politely replying with a single word: ”Gun!” (a playful, colloquial expression roughly meaning ”Go away!”).