Chapter 173 - 0167: First Step Out of the Hut

In Cheng Liquan’s office, Su Nanchen and Cheng Liquan stood in front of the light box to review the medical images.

“Young Master Su, what do we do? I didn’t look carefully at the time, and now we’re in this mess,” Boss Cheng’s face was flushed with embarrassment.

Su Nanchen responded calmly: “Don’t worry, we’ve merely approached the pit, we haven’t fallen in. You can’t blame yourself for not being careful. Few people have experience with such extraordinary cases. It’s extraordinarily rare.”

Cheng slapped himself lightly, “It’s all my fault for being too hasty. If I had listened to you and temporarily refused such patients, none of this would have happened.”

“There’s no point in second-guessing now! When he comes tomorrow, we can discuss it together. We haven’t performed the surgery yet, we needn’t be afraid. If it’s really unfeasible, we simply won’t do it,” Su Nanchen tried to reassure him. It was pointless to blame people retrospectively.

Surgery can’t be performed halfway. If it’s not promising, one should admit defeat. If one doesn’t admit defeat before the surgery, one has to face the bitter consequences after the surgery without any opportunity to back out.

Last time Su Nanchen came, he was in a hurry and didn’t examine the patient or study the patient’s imaging data. This time, he found that the patient’s condition was extremely unusual. The knee joint was badly deformed, bone overgrowth had filled up the intercondylar notch, and the posterior part of the tibial plateau was defective. The defect was precisely at the original point where the posterior cruciate ligament attached. The patellofemoral joint was also underdeveloped. Consequently, he urgently took a 3D reconstructive CT scan of the knee joint.

Su Nanchen and Boss Cheng were looking at the CT 3D reconstruction with their brows furrowed. The basic quadruplicate reconstruction surgery was challenging enough, and the only addition of this unusual case had multiplied the surgical difficulty.

This surgery requires, on top of a demanding quadruplicate reconstruction, forming a new intercondylar notch, which was highly precarious. Merely restoring it was not enough. The surgeon needed to design a specific intercondylar notch shape to meet the various needs of the surgery. Otherwise, the surgery would fail and trigger dire consequences.

If it weren’t for doctors with experience in performing multiple ligament reconstructions of the knee joint, they wouldn’t even be aware of the severity of the ensuing consequences. Fortunately, Su Nanchen had such experience; otherwise, they would have stepped on a landmine.

“I looked it up afterwards. This patient was previously under Yunjian’s care. They claimed that they were fully booked, but in reality, that wasn’t the case. They had sought advice from Professor Ye. After Professor Ye reviewed the patient’s imaging data, he deemed the surgery too challenging, especially the intercondylar notch reconstruction which he thought was unfeasible. As such, he declined. This is why they shoved this patient my way – they deliberately put me in a tight spot. How unethical of them,” Cheng Liquan regretted not being more cautious. He was dripping in sweat, fully aware of the severity of the situation, and grateful to Su Nanchen for the help. Had it not been for Su Nanchen, he wouldn’t even be aware of the perilous consequences.

“Those guys are devious! They dug a pit and nearly made me jump in it. One misstep with this surgery would have damaged my reputation,” Cheng Liquan still felt a chill run down his spine.

“The surgery is definitely a no-go. Even the most skilled surgeon I have recommended to you wouldn’t be able to perform this particular surgery. Nevertheless, let’s still have him come over tomorrow and study the case together. I have already made the arrangements,” Su Nanchen believed this case was too unique, which was why he had insisted on bringing Yang Ping. Even if they didn’t end up performing the surgery, it was crucial for them to examine the patient and discuss the case.

“I’ll listen to you, Young Master Su. I’ll still pay your friend according to the surgical fee despite the cancellation. I won’t let you be placed in a difficult situation,” Boss Cheng mopped his sweat.

Su Nanchen stayed silent, still scrutinizing the images on the light box, confirming that no matter how skilled Yang Ping was, it was impossible to perform this kind of surgery.

Forming an intercondylar notch was impossible. If the surgery proceeded as usual, it was bound to cause patellofemoral joint instability and render the posterior cruciate ligament reconstruction useless. This was the reason why Professor Ye didn’t dare to take up the case.

If they still insisted on performing the surgery, they would have to design a specialized software, set up a model, reprint this intercondylar notch in 3D simulation technology on the computer. Through trial and error algorithms, they could then design an intercondylar notch. However, even after using 3D printing or virtual reality technology to create the surgical model would still require the surgeon to have strong spatial imagination to make a barely passable intercondylar notch.n/o/vel/b//in dot c//om

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Su Nanchen sent the patient’s information to Yang Ping’s email. Yang Ping was playing ball and didn’t see Su Nanchen’s message.

“Ding Dong! Task: Starting from scratch, perform one multiple ligament reconstruction in the knee joint as a chief surgeon at a foreign hospital. Attain perfection in the surgery and get rewarded forty thousand points. Task deadline: Within twenty-four hours!”

In the middle of the game, the system assigned a task. It was strange. His quintuplicate reconstruction didn’t trigger a single task, but this quadruplicate reconstruction did, and the reward was two thousand points. Could this quadruplicate reconstruction be even more complicated?

Now the system was adept at picking challenging tasks with high reward points. It wouldn’t even bother with a surgery that wasn’t extremely demanding. High difficulty for high reward seemed to be the principle of the system currently.

After the game, during the break, Yang Ping roughly read through the patient’s information on his phone. As expected, this quadruplicate reconstruction posed a higher challenge than the quintuplicate reconstruction he had performed last time.

When he found the time later in the evening, Yang Ping began to study the case in depth.

In reality, it was a hidden quintuplicate reconstruction, even more complicated than the quintuplicate reconstruction he performed a few days ago. Why? Because, on top of the quadruplicate reconstruction, they had to form an intercondylar notch.

The quintuplicate reconstruction he performed involved a quadruplicate reconstruction plus a habitual patellar dislocation. This case involved a quadruplicate reconstruction plus forming an intercondylar notch. He had previously performed an anterior cruciate ligament reconstruction that involved forming an intercondylar notch.

But forming an intercondylar notch for this case was more challenging. For the previous patient, they simply needed to reproduce the intercondylar notch based on the shape on the opposite healthy knee.

This case required more insight. The entire intercondylar notch was severely deformed, a part of the posterior tibial plateau was missing and the patellofemoral joint had an underdevelopment issue. These three factors on top of a quadruplicate injury felt like adding frost to the existing snow.