Inside the German-made Martin shadowless surgical lamp, several high-power halogen bulbs emitted intense light, which was cast onto the operating table through hundreds of reflective surfaces distributed within the lamp head.
Yet at this moment, the most dazzling thing was the resident who had entered the department less than half a year ago, standing in the first assistant’s position.
Godlike skill.
After watching Kiryu Kazusuke’s maneuver, Takigawa Takuhei was unwilling to admit it, but after thinking for a long while, those were the only four words he could use to describe it.
The first assistant was an extension of the chief surgeon, a direct embodiment of their will and technique.
That position not only required the operator to possess solid anatomical knowledge and technical skill, but also to anticipate the chief surgeon’s next intention and coordinate in time.
Thus, in any difficult operation, the first assistant was the core figure second only to the chief surgeon.
The one standing there should have been him.
And yet at this moment, he was outside the operating table, reduced to a spectator.
But…
After watching Kiryu Kazusuke’s technique, his brain might tell him, “I’ve seen it now. I get it. I could do it too,” but his hands would say, “Like hell you can.”
Takigawa Takuhei let out a long breath.
He had clearly already accepted that he was an exceedingly mediocre person, that on the path of becoming a doctor, he would not be able to go very far—perhaps even that taking the medical school entrance exam in the first place had been a mistake.
But why was it that, after seeing such godlike technique, he still felt his blood surging?
Why had the thought of making one more push for specialist certification even arisen in him again?
It was as if when he had first entered the department, he too had been full of ambition, following his seniors to learn basic skills, taking night shifts, writing medical records, applying casts…
For a time, he had believed he was the talented type, that he would soon pass the specialist examination and become a pillar of the department.
Only now, after seeing Kiryu Kazusuke, did he understand how the word “genius” was written.
Not even Dr. Imagawa had ever given him this feeling.
Takigawa Takuhei’s thoughts had drifted far away, but in the next second, shame surged from the soles of his feet to the crown of his head like an electric current.
Dozens of minutes ago, in the corridor leading into the operating room, hadn’t he even patted Kiryu Kazusuke on the shoulder and, in the tone of a senior, told him not to be nervous, to watch carefully, and to learn well?
…
Ligament tension reconstruction was not a completely nonexistent concept in the field of orthopedics.
Top sports medicine specialists would occasionally mention it when dealing with complex joint injuries in elite athletes.
It required the surgeon to possess a god’s-eye understanding of joint biomechanics, to know by heart the direction and force of every bundle of ligament and every muscle.
That was why very few people could put it into practice in such a complex surgical scenario.
And Kiryu Kazusuke had done it.
Imagawa Ori raised her head and glanced at the first assistant standing opposite her.
Even through the mask and surgical cap, she could still sense the resident’s focus and calm at this moment.
As if everything just now had been nothing more than an ordinary procedure to him, not worth making a fuss over.
“Bring the C-arm over. Let’s check the position under fluoroscopy.”
Imagawa Ori’s words pulled everyone’s thoughts back to reality.
Soon, a beige, somewhat bulky mobile X-ray machine was pushed in by the circulating nurse.
This was the C-arm X-ray machine, named because it resembled a huge letter “C.”
The C-arm could take X-ray images from different angles without moving the patient and display real-time images on the CRT monitor beside it.
It was essentially the surgeon’s see-through eye.
“Nonessential personnel, step out.”
The circulating nurse immediately picked up the lead apron and helped the anesthesiologist below the table put it on.
In order to monitor the patient’s heartbeat and respiration at all times, the anesthesiologist could not leave their post even if it meant taking a few extra millisieverts of radiation.
As for the chief surgeon and assistants standing at the operating table, they had already put on lead aprons underneath before scrubbing in and donning sterile gowns.
They were even less likely to leave.
Once they walked out of the operating room or turned their backs to the sterile field, the sterile gowns on their bodies would be contaminated. When they came back, they would have to scrub in again, drape again…
If that happened, one operation would take days and nights.
Under the radiology technician’s operation, the C-shaped arm of the machine slowly moved, and the tube and image intensifier aligned with the patient’s wrist.
During this interval.
Imagawa Ori rapidly replayed Kiryu Kazusuke’s maneuvers in her mind.
From the two crossed supporting pins on the dorsal side, to the prying reduction on the volar side, to the four-pin ligament tension reconstruction, and finally that inspired stroke of using the tiny vibrations of the Kirschner wires to release ligament stress!
Could she do it?
Imagawa Ori asked herself inwardly.
She carefully worked through it. If it had been her, faced with the same predicament, what would she have done?
Perhaps she would also have realized that the problem lay with the ligament.
After repeatedly failing at prying reduction, she might have given up and turned to a more aggressive, more traumatic open approach, repairing the ligament under direct vision.
Or, just as she had initially judged, she would have directly applied plate compression, sacrificing part of the function.
But Kiryu Kazusuke’s “ligament tension reconstruction” was the most elegant solution, achieving the greatest effect with the smallest trauma.
The thinking!
As a surgeon, technical proficiency could be acquired through hundreds and thousands of repetitions.
But on an operating table where circumstances changed in an instant, the creative thought process of seeing through to the essence of the problem and conceiving the optimal solution—that was talent!
At this thought.
Imagawa Ori’s gaze grew complicated.
Now that she knew the reasoning, if she were asked to do it again, she would also dare to attempt “ligament tension reconstruction,” and she was confident that she could complete it.
Copying the standard answer once was not difficult.
But she could not do what Kiryu Kazusuke had done: on his very first attempt, be so fast, so precise, so ruthless.
It was as if, in those few seconds when he had closed his eyes, he had already simulated and rehearsed it thousands of times in his own mind.
That was the most terrifying thing about him.
If technique was “art,” then thinking was “the Way.” Judging from this operation alone, in the use of Kirschner wires, Kiryu Kazusuke’s art and Way were already beyond reproach.
However, Imagawa Ori said nothing.
Because the fluoroscopy results had already appeared on the screen: an anatomical reduction that could be called perfect.
The articular surface was as smooth and even as before, the bone fragments fit together without the slightest gap, and the Kirschner wires serving as temporary supports were precisely distributed in their respective positions.
“The reduction is extremely successful.”
Even the anesthesiologist could not help but praise it.
Imagawa Ori nodded.
Her gaze fell on the now stabilized articular surface.
Originally, she had already prepared to sacrifice part of the flatness of the articular surface and use plate compression screws to force fixation.
But now, everything had changed.
Kiryu Kazusuke’s Kirschner wire tension network had not only solved the problem of the hidden ligament tear, but also made the entire operative field orderly and clear.
Then what came next had become exceptionally simple.
Now, it was her turn as the chief surgeon to complete the final reinforcement and place the plate and screws.
She only needed to proceed according to the standard process.
“Plate, medial tibial T-type.”
“Electric drill.”
“Tap.”
“Screwdriver.”
Imagawa Ori chose the volar approach, which had already been fully exposed, and took the T-shaped plate whose curvature had been manually pre-bent in advance.
First, she fitted the plate closely against the radial shaft.
Using the molded conformity of the plate, she adjusted its position, ensuring that the distal transverse arm could support the articular surface like a palm.
Then she fixed the proximal end, placing the screw in the neutral position of the oval hole.
The entire process flowed as smoothly as drifting clouds and running water, without the slightest obstruction.
The bone fragments did not shift in the slightest. The trajectory of the screws perfectly matched the preset anatomical positions. Blood loss was minimal, and the field of vision was as clear as if she were performing a simulated operation.
It had to be said: this was an intoxicating experience.
There was no need to repeatedly confirm the position of the bone fragments, no need to worry that compression would cause secondary displacement, no need to divert attention to deal with those irritating tiny instabilities, no need…
This should have been an operation that was extremely draining and laborious.
But now…
Imagawa Ori felt as though she were not performing a highly difficult C3-type comminuted distal radius fracture surgery, but carrying out the final finishing touches on a perfect model already constructed by a master.
This feeling…
Felt amazing!