From Imagawa Ori’s perspective, the choice of first assistant for this operation had actually been decided as early as last night.
She had never seen a resident with such clear thinking and such strong hands-on ability.
His Kirschner-wire fixation plan was even more perfect than the one she herself had conceived, and afterward, when he built the eight-tier champagne tower, it had also proven that his hands could keep up with his brain perfectly.
However, she still could not directly make him the first assistant.
The reason was simple.
Kiryu Kazusuke had only been in the First Department of Surgery for half a year, while Takigawa Takuhei was a specialist resident who had already spent five years in the medical office.
If she bypassed Takigawa and directly appointed a newly arrived resident as first assistant for such a highly difficult operation, the others in the medical office would have objections.
That would affect her evaluation within the department.
Personally, she did not care much about that.
But the problem was that VIP patients who could offer large honoraria chose their doctors, and they looked at a doctor’s reputation.
When money was involved, Imagawa Ori would not let her temper have its way.
That was why she had given Takigawa Takuhei a chance.
As for whether it was a chance to make mistakes or a chance to prove himself, that would depend entirely on Takigawa Takuhei’s performance.
Of course, the patient’s interests came first.
If Takigawa Takuhei truly could not do it, Imagawa Ori would stop him in time before any irreversible damage was caused.
And at that point, if Kiryu Kazusuke took over, no one would have any objections.
After all, surgery was dynamic, and adjusting assistants was also common practice.
Still, Imagawa Ori very much hoped he could do the basic work expected of a first assistant.
She did not ask him to shine. It would be enough if he made no mistakes.
Unfortunately.
Imagawa Ori narrowed her eyes slightly and stared at the operative field.
As the chief surgeon, she saw the problem at a glance. The angle of insertion was off by at least five degrees, and the force was uneven as well.
“Change to another one.”
She took the pliers handed over by the nurse, clamped down on the tail of the K-wire, exerted a little force with her wrist, and pulled it out in one smooth motion before tossing it into the kidney dish.
The scrub nurse immediately slapped a new K-wire into Takigawa Takuhei’s hand.
He took a deep breath and placed the new K-wire beside the previous position.
Takigawa Takuhei moved with extreme caution, but his touch was still lacking. The needle tip probed several times against the bone surface, yet failed to find the optimal entry point.
“Angle it a little more.”
Imagawa Ori gave a word of guidance from the side.
Takigawa Takuhei adjusted accordingly, then began turning the crank.
The hand drill slowly rotated, and the tip of the K-wire finally succeeded in piercing the cortical bone.
Good!
His hand grew a little steadier. Delighted, he prepared to increase the force, wanting to drill the K-wire a little deeper to obtain sufficient purchase.
“Stop!”
But just as he was about to move, Imagawa Ori immediately spoke to stop him.
“If you move again, you’ll penetrate the opposite cortex and damage the blood vessels!”
“Y-yes. I’m sorry, Dr. Imagawa.”
Takigawa Takuhei’s hand froze in midair, and for a moment he was somewhat at a loss.
Imagawa Ori reached out, took the instrument from his hand, and personally made the adjustment.
Her movements were precise. First, she used a 1.2-millimeter wire to penetrate percutaneously from the ulnar side, passing transversely through the distal radius and stabilizing the overall structure.
But the tiny fragments of the articular surface were still unstable and required more support.
“Continue.”
She handed the hand drill back.
Takigawa Takuhei gritted his teeth and made a third attempt. This time, he chose to insert the wire through a small volar incision, trying to pry up the collapsed portion.
But the hand that had finally steadied began to disobey him again. The tip of the K-wire caught in the muscle layer and failed to accurately lift the bone fragment; instead, it caused a slight additional injury.
“Suction.”
There was no emotion audible in Imagawa Ori’s voice.
Takigawa Takuhei hurriedly picked up the suction device and reached toward the operative field, which had become somewhat blurred due to slight bleeding from the medullary cavity.
After it was dealt with,
Imagawa Ori suddenly said, “Step away.”
Takigawa Takuhei froze, then opened his mouth, wanting to explain. “Dr. Imagawa, I…”
Imagawa Ori also put down the tissue forceps in her hand and raised her head. “I said, step away. Do you not understand?”
When Takigawa Takuhei met her gaze, all the words in his throat became blocked.
This was Imagawa Ori’s operating table, and the chief surgeon possessed absolute authority.
So, even though his face flushed crimson, he could only lower his head and retreat one step, then another, leaving the operating table.
For a moment, no one in the operating room dared even breathe loudly.
The scrub nurse lowered her head to inspect the scalpel, and the circulating nurse lowered her head to check the monitor.
To be driven off the operating table by the chief surgeon in front of everyone was, for a surgeon, the greatest humiliation of one’s career.
But Takigawa Takuhei himself had failed to seize those three opportunities.
Imagawa Ori turned to look at Kiryu Kazusuke. “You’ll be first assistant. Any problem?”
“Understood,” Kiryu Kazusuke immediately replied.
He stepped forward and took Takigawa Takuhei’s place.
“K-wire, 1.2 millimeters.”
The scrub nurse handed him a new K-wire and the hand drill.
After Kiryu Kazusuke took them, he began operating directly according to the predetermined plan, without asking Imagawa Ori for her opinion.
After all, his K-wire technique was perfect!
He stretched out his left hand, lightly touching the distal radial bone fragments with his index and middle fingers, sensing their displacement and form.
Then, he moved.
The first K-wire entered percutaneously from the dorsal side.
There was not the slightest pause in his movements. The hand drill rotated at a constant speed.
The steel wire pierced the predetermined position with precision, passed through the main dorsal bone fragment at a perfect angle, and firmly fixed it onto the radial shaft.
Takigawa Takuhei, who had retreated to the side, had originally still been full of resentment.
If he couldn’t do it, then this resident could?
But when he saw Kiryu Kazusuke’s movements, the corners of his mouth could not help twitching.
This resident’s hands were not right.
They were too steady—so steady they seemed welded to the operating table!
“Second wire.”
Kiryu Kazusuke extended his hand, and the scrub nurse immediately passed it over.
The second K-wire was likewise inserted from the dorsal side, targeting another key articular-surface fragment.
Together with the first wire, it formed a stable crossed structure, restoring the entire dorsal articular surface to roughly its anatomical plane.
Two wires, completed in one smooth breath.
The entire process took no more than thirty seconds.
“Third wire.”
This time, he did not immediately operate. Instead, he picked up a pair of tissue forceps and gently separated tissue along the edge of the pronator quadratus on the volar side of the wrist joint.
A tiny incision was exposed.
“What is he going to do?”
Takigawa Takuhei, who had at some point moved closer again, could not help asking.
But no one paid him any attention.
Kiryu Kazusuke advanced the tip of the third K-wire through that small volar incision.
He did not use the hand drill. Instead, he directly gripped the tail of the steel wire with his hand, using it like a pry bar.
The needle tip accurately found the underside of the lunate fossa fragment, the one with the most severe collapse.
His wrist exerted the slightest force.
That collapsed bone fragment was steadily lifted upward.
Under the support of the two dorsal wires, it returned firmly to the position where it belonged.
“Fourth wire.”
Before his words had even fallen, he had already inserted the fourth wire percutaneously from the ulnar side.
This wire passed transversely through the entire distal radius, completely locking the bone fragment reduced by volar prying together with the structure already fixed on the dorsal side.
Four K-wires formed a stable three-dimensional frame.
The shattered articular surface was pieced back together into a complete whole.
The entire temporary fixation process took less than two minutes.