160: Chapter 160 A Resident Physician? Performing Hepatic Artery Anastomosis?
"Professor Liu."
Lu Chen's voice rang out in the quiet Operating Room.
Everyone's eyes turned toward him.
Professor Liu Chongli looked up at him.
"Is there something you want to say?"
"The intima and media layers of this vessel wall have severely degenerated. No matter how you adjust the tension with conventional Suturing, it will cut through the vessel wall."
Professor Liu Chongli did not interrupt him.
"But if we switch to a Modified Parachute Suture, we can pre-place all the sutures 3 millimeters away from the anastomosis site without tightening them."
"Once all the sutures are threaded, we slide the donor vessel down the sutures to the recipient end for alignment, and then tighten them all at once."
"This can distribute the cutting force of each stitch across all the sutures, reducing the tension on a single suture to about one-sixth of the original."
Professor Liu Chongli's eyes narrowed slightly.
"Have you performed this procedure before?"
"I have practiced modified Suturing techniques in Vascular Anastomosis simulations. Given these vessel wall conditions, the Parachute Suture is the optimal solution reported in current literature."
Professor Liu Chongli fell silent for a few seconds.
He was an old professor who had been performing surgeries for decades.
He certainly knew about the Parachute Suture.
But this technique required extremely high precision from the operator.
Performing a Parachute Suture on a 1.8-millimeter vessel required precision that approached the limits of human hand control.
"Can you do it?"
The question exploded in the Operating Room.
Everyone was stunned.
A Resident Physician?
On a Living Donor Liver Transplantation table?
Performing a Hepatic Artery Anastomosis?
Lu Chen looked into Professor Liu Chongli's eyes.
"I can try."
Professor Liu Chongli stared at him for a full five seconds.
Then he looked at Director Li Sen, who was standing off the table.
Director Li Sen had entered the Operating Room at some unknown point and was standing on the periphery in surgical scrubs.
"He's your man, you tell me," Professor Liu Chongli said.
Director Li Sen glanced at Lu Chen.
"I have absolute confidence in his Vascular Anastomosis. The Vascular Anastomosis surgeries he has performed previously..."
"...were personally evaluated by Professor Xu Minhua, the provincial authority in hand surgery, who ranked him among the top three in the province."
Professor Liu Chongli's brow twitched slightly.
He knew Xu Minhua.
That woman was famous throughout the province for her high standards and harsh grading.
To receive a 'top three in the province' evaluation from her meant this young man's manual skills were at least not a bluff.
"Time is running out," the voice of Anesthesiologist Anesthesiologist Guo Zhengyang came from behind.
"The hepatic artery has been ischemic for thirty-five minutes. If blood flow isn't restored within an hour, the ischemic damage to the liver will worsen."
Professor Liu Chongli made a decision.
"Step up."
Lu Chen walked to the lead surgeon's position.
Professor Liu Chongli took half a step back, yielding the operating space.
At this moment, everyone's heart in the Operating Room was in their throat.
Lu Chen stood before the operating table.
His breathing became steady and slow.
He put on the surgical loupes.
In his field of vision, the two slender vessel ends were magnified several times.
Simultaneously, the holographic projection of the Eye of Truth was overlaid, making every microscopic layer of the vessel wall crystal clear.
He could see which areas of the intima on the recipient side were relatively intact and which had degenerated to a dangerous point.
This was information that the human eye could absolutely not obtain.
"9-0 Suture."
The scrub Nurse handed it over.
Lu Chen took the Needle Holder.
He first identified six entry points on the recipient vessel wall.
Each entry point was precisely selected in an area where the Eye of Truth showed a relatively intact intima.
He avoided all micro-damage zones.
He avoided all areas of elastic fiber degeneration.
"Starting now."
He whispered softly.
Then, he inserted the needle.
The first stitch.
The needle passed through the recipient artery wall.
The force used was as light as could be.
The passive effect of the God-level Suturing Technique allowed his fingertips to feel the subtle changes in resistance as the needle tip passed through each layer of tissue.
Intima layer, 0.1 mm.
Media layer, 0.3 mm.
Adventitia layer, 0.1 mm.
Penetration.
No cutting.
No tearing.
Perfect.
The suture was left in place, untightened.
The second stitch.
The same force, the same precision.
Through the recipient side, then out through the corresponding position on the donor side.
Placed, untightened.
Third stitch.
Fourth stitch.
Fifth stitch.
Sixth stitch.
Every stitch was precise to an incredible degree.
Professor Liu Chongli stood to the side, watching Lu Chen's operation through the loupes. The expression on his face shifted from initial scrutiny to gradual shock.
This young man's hands...
They were unnaturally steady.
When performing microsuturing on a 1.8 mm vessel, the magnitude of hand tremors should gradually increase over time.
This was a physiological limitation of the human body that even veterans of decades could not entirely avoid.
But Lu Chen's hands, from the first stitch to the sixth, showed absolutely no change in tremor magnitude.
It was as if those hands were fixed in mid-air.
All six sutures were pre-placed.
Lu Chen took a deep breath.
"Preparing for slide alignment."
This was the most critical step of the Parachute Suture.
Sliding the donor vessel down along the six pre-placed sutures to align precisely with the recipient end.
This process required extremely uniform force and extremely precise directional control.
The slightest deviation, even just 0.1 mm, would cause the vessel wall to twist or the sutures to cross, ruining the entire anastomosis.
Lu Chen's fingertips gently gripped the donor vessel.
Then, he began to push it down.
The Eye of Truth displayed the distance between the two vessel ends in real-time.
5 mm.
4 mm.
3 mm.
2 mm.
1 mm.
Aligned.
Perfectly aligned.
The six sutures were evenly distributed around the anastomosis site, with no crossing and no twisting.
The ends of the two vessels fit together seamlessly.
"Tightening."
Lu Chen tightened the sutures one by one.
The force of each was precisely controlled.
Neither too much nor too little.
Just enough to fix the vessel wall without causing a cut.
The tactile gain from the God-level Suturing Technique allowed him to feel the subtle changes in the tension of each suture, stopping the instant before reaching the cutting threshold.
All six sutures were fully tightened.
Lu Chen performed reinforcement sutures at each ligation point.
Then he straightened his back.
"Anastomosis complete."
The Operating Room was silent for two seconds.
"Open the blood flow," Professor Liu Chongli's voice had a trace of imperceptible trembling.
Lu Chen released the vascular clamps at both ends of the hepatic artery.
Everyone's eyes were fixed intently on the anastomosis site.
The blood flow rushed through.
Arterial pressure acted directly on the anastomosis.
One second.
Two seconds.
Three seconds.
Five seconds.
Ten seconds.
No oozing.
No leaks.
The anastomosis didn't budge.
The color of the newly implanted liver's surface was changing visibly to the naked eye.
From dark red to bright red.
Oxygenated arterial blood was perfusing the entire liver.
"Good arterial pulsation," Professor Liu Chongli touched the vessel distal to the anastomosis with his finger.
The pulse was strong and the rhythm was regular.
He checked the anastomosis site once more.
Six suture points, evenly distributed, consistent spacing, balanced tension.
No cutting marks on the vessel wall.
No twisting.
No stenosis.
Perfect.
This was the most perfect Hepatic Artery Anastomosis Professor Liu Chongli had seen in more than forty Living Donor Liver Transplantations.
And the one who completed this operation was a twenty-four-year-old Resident Physician.