Practicing Medical Skills in a Small Clinic

Taking the surgical knife, Li Jingsheng appeared calm and composed.

On the contrary, Director Chen Anchen beside him had his heart leap to his throat, eyes fixed on the knife in Li Jingsheng’s hand.

It was as if what Li Jingsheng was about to cut was not the patient’s foot, but a piece of raw jade.

One cut leads to wealth, another to poverty.

Now, one cut would lead to either success or failure, all in Li Jingsheng’s hands.

He started by cutting at the deformity point near the ankle, with an incision about three centimeters long. The precision was impeccable, and he cleverly avoided the deformed venous blood vessel.

What seemed like a simple cut revealed remarkable cutting skills at the finest level.

If he went just a little too far, he could possibly sever the vessel.

Although severing it wouldn’t greatly impact the surgery, it could be repaired during the arthrodesis. However, in a competition, any mistake could lead to losing points.

Normally, this cut should run from three or four centimeters on the ankle joint along the side of the tibialis anterior tendon to the base of the third and fourth metatarsals.

It’s equivalent to making a vertical incision.

The total incision length is about ten centimeters.

Li Jingsheng now is essentially choosing the deformity point, cutting towards the ankle joint first.

Then he cuts down from the incision at the deformity point.

The incision is opened in two passes.

It’s a bit of a hassle, but it can avoid many unnecessary risks.

The best part is, after the four-joint arthrodesis is completed, the deformity will largely disappear, allowing for one complete stitch at that time.

His movements are as smooth as flowing water, and his gestures display the calmness and confidence only a seasoned lead surgeon possesses.

The opened incision is beyond reproach.

If it must be described, it is just right.

Whether it’s the incision’s depth, length, or neatness, they’re all extraordinary.

The cutting technique is mature to perfection and truly powerful.

He should have the ability to challenge highly difficult neurosurgeries.

In terms of precision, neurosurgery is actually above cardiac surgery. However, the complexity of cardiac surgery sometimes even surpasses that of neurosurgery.

Take the famous Tetralogy of Fallot, for example.

Li Jingsheng now mastering such a strong cutting technique, is fully qualified to participate in some top-tier surgical operations and serve as a valuable assistant to the lead surgeon.

As for allowing him to be the lead surgeon, he is not yet capable enough.

To be a lead surgeon in third-level operations, at the very least requires a senior associate chief physician.

The existence of such individuals really doesn’t differ from that of senior chief physicians.

They might be held back by slightly lower academic qualifications, weaker papers, and less research, ultimately being stuck. There are many such associate chief physicians in larger hospitals.

Their practical experience is rich, with at least one or two specialized fields.

Such as proficiency in medication, or excelling at diagnosing certain diseases, or strong surgical abilities.

Compared to such individuals, Li Jingsheng still lacks experience.

Additionally, other surgical skills must continue to improve.

To perform a major surgery, merely having great cutting skills is definitely insufficient.

Hemostasis, suturing, knotting, anastomosis, separation — all must keep up, so one wouldn’t have to rely on others. And one can handle situations independently.

"Alright, the patient’s joint is now exposed, allowing the two directors to perform the key operations of the surgery."

Li Jingsheng not only refrains from claiming credit but also cares for the dignity of the two directors.

As much as possible, he says things that are pleasant to hear.

"Dr. Li, well done! The cut was excellent! The surgical approach was indeed innovative."

Chen Anchen praised him endlessly.

Luckily, Li Jingsheng was invited for this surgery, whether for the crucial points gained from competing for surgical qualification or the current incision, all bringing hope for this team’s award.

"I’ve seen an eye-opener with such minimal blood loss." Hu Jia also showed full admiration beside him.

The more skillful the cutting technique, the less blood loss during surgery.

Some surgeons, with one cut, cause blood to splash all over their face and body, marking a grand opening.

This demonstrates poor skill and insufficient experience.

Most likely, they have severed an arterial vessel.

The more mature the doctor, the more cautious the operation.

The subsequent operations were mainly performed by Director Chen Anchen and Associate Director Hu Jia as the lead surgeons, while Li Jingsheng acted as an assistant, learning surgical knowledge along the way.

Director Chen Anchen carefully severed the joint capsule and ligaments around the talus, then excessively plantarflexed the forefoot.

This allowed the talus to protrude backward.

After severing the attached ligaments, the bone could be levered out violently using a periosteal elevator.

Hu Jia clamped it with a towel forceps beside him, and Director Chen Anchen cut out the entire articular surface of the talus.

...

The entire surgical process was bloody and brutal.

Orthopedic surgeons have always been despised and cursed for being crude, and there’s a reason for it.

Li Jingsheng learned a lot of practical surgical knowledge by watching on the side, and methods for dealing with joint trauma, deformities, and necrosis.

For instance, as the surgery moved onto later parts, the patient’s talus and surrounding bone were not tightly fitting.

At this point, Director Hu Jia chose to fill in the bone with cancellous bone chips.

This maneuver was learned by Li Jingsheng.

Regarding the healing of bone trauma, he gained deeper insight.

"Dr. Li, you handle the remaining suturing."

Director Chen Anchen entrusted the closing work to Li Jingsheng, showing his trust.

"No problem."

Li Jingsheng’s suturing skill ranks high in the second group of orthopedic surgery.

But during such provincial and municipal-level skill contests, Minor Achievement-level suturing skill is far from sufficient.