Chapter 95 - Wrist Reconstruction \[2\]

Chapter 95: Wrist Reconstruction [2]
Translator:
 None 
Editor:
 One Mountain Guy
 
Ganghyuk wore gloves and a mask; he inserted a blade on the scalpel. The others were all busy preparing for the operation.
Yeoni and Dolseok cleansed the part for operation such as the right wrist and the hand of Gwanghae with Betadine.
The white futon became brown because of the brown anti-septic but nobody seemed to mind.
The eunuch standing behind looked anxious, but he could not do anything.
The operation had already begun.

He is breathing well.

Heo Jun checked the prince’s breathing nearly every second.
Ganghyuk told him it was not necessary a few times, but he kept doing it. Thus Ganghyuk did not bother to tell him not to do it too frequently.

He is good now.


He is breathing well.

Ganghyuk was bothered by his frequent notices so he asked him to do the notice with a gesture.

Dr. Heo, please show me
O
sign with your fingers. I cannot concentrate on…


Ah, yes. I am sorry.


Yes, like this with your two fingers.

It was Joseon.
They had no chance to know what the ‘OK’ Sign was.
Heo Jun did not quite understand what the ‘OO’ Sign was quick.
Ganghyuk showed how to make it and came back to the operation.
Ganghyuk looked at the wrist again, clicking his tongue.
Yeoju was sketching the preparation very quickly.
If she had a pencil, she could draw easier and quicker.

Am I waiting here, doing nothing?

Makbong was sitting in a corner, showing his boredom.
Ganghyuk did not like it as he looked like a supervisor, but he did not have a job in the operation scene.
‘Sometimes, it is good to be useless. He is as free as a cat.’
Ganghyuk nodded his head suppressing his impulsion to hit him while wearing his gloves.

Yes, wait there.


Yes, sir. Can I go out?


No. This is not a commoner’s house. We’re in the palace.


Yes, I see. I know.

Makbong leaned against the wall laughing.
He might sleep.
‘Yes. Sleep there. That is a lot better.’
Ganghyuk checked the scalpel, shaking his head.
‘It is good. The blade is good. Everything is perfect.’
While he was investigating the part he cut, Yeoni gave him the syringe with a local anesthetic.
It contains lidocaine and epinephrine, it has good effects.
The vessel contraction effect of epinephrine can amplify the anesthetic effects of lidocaine.

Sir, here we have prepared all of the anesthetics


Good. You are doing very well.


Dolseok and I see patients who need simple treatments, sir.


Yes, I know. You make good money.

Ganghyuk laughed and injected on the wrist of Gwanghae.
The incision size was about 5cm
Almost the whole wrist.
Nothing said big operation other than a wrist operation.

Ok…Dr. Heo. Is there any reaction?


No. He did not move at all.


Good.


He breaths well.


Yes, yes.


He is breathing well.

Ganghyuk did not answer anymore.
Heo Jun might let him know the status of the prince constantly if Ganghyuk kept answering.
Therefore, Ganghyuk decided to ignore him.
He cut the prince’s wrist with the scalpel.

No movement, right?


Yes, he is breathing well.


Ok. Anesthetic is good. I will open it.

Ganghyuk started the operation in full scale.
He cut the prince’s think skin.
The prince had little fat, as he was young and exercised much.
Ganghyuk could see his white ligament.
The thick and hard-looking ligaments encompass the wrist parallelly.

Ah, this is…

Dolseok asked, pulling the section of the palm’s direction.

Yes, they are the parallel wrist ligaments.


They look strong.

When Yeoni pulled the opposite section on the direction of the elbow, he could see the structure below.
Ganghyuk spoke, pointing at one of them.

Do you see the white and thick thing over there?


Yes, sir.


That is the nerve medians. If it is cut…One would not able to use the hand at all. These thick ligaments were here to protect them.


Wow, wonderful.

Dolseok nodded his head.
Yeoni showed a similar expression.
Watching them surprised, he was reminded of his past, when he was a first-year med-student.
He was really surprised when he first saw the muscles and nerves of the body with his own eyes.
‘There are some people who have come to believe in God when they saw the structure of the human anatomy.’
The human body has a systematic and scientific structure.
Ganghyuk showed the structures they should take care of with great consideration.

This one and that one. Do you see they are pulsing?


Yes.


They are arteries. You should not damage them.


I see.


These are ligaments. They should not be touched.


I see, but it seems we cannot touch anything.


Eum?

Dolseok made a good point. It made Ganghyuk irritated.
Ganghyuk could not rebuke him, because he made the right comment.
He might stay without doing anything if Heo Jun did not whisper.
Perhaps he thought it’s his inner monologue, but everybody could hear it.

He is breathing well.


Ahu.

Ganghyuk returned to reality and stared at Dolseok.

You are right, fellow. Don’t touch anything.


You should have said it from the beginning.


Makbong.


Eok.

Ganghyuk found the use of Makbong.
Ganghyuk could not hit Dolseok because he wore a mask and gloves.
If he did, they would be contaminated.
However, Makbong was ready to hit Dolseok.
Even though he was half asleep at that time, he did not miss the call of Ganghyuk.

We have a long way to go. This operation is not dangerous, but its a difficult one.


Yes, sir.


Hold what I give you.


Yes.

Ganghyuk decided to solve the problem from the palm which Dolseok pulled.

Lift it like this.


Yes.

He gave it to Dolseok lifting the skin over the parallel wrist ligament using a tweezer.
Dolseok had a talent in it, so he could follow Ganghyuk’s instructions well.

Good. Stay there.


Yes, sir.


Yeoni, please show me the insides of the organ with that light.


Yes.

Ganghyuk put the tiny scissors at the space Dolseok made for him.
He removed white connective tissues that held the ligaments and the skin.
It was a technique called tunnel making.

Hu.

Ganghyuk left the scissors and used his fingers to push the tissues.
As he cut hard sections with the scissors, he could push them.
With his movement, the tunnel became wider and deeper.
He could see the muscles and ligaments made up of the palm.
At the same time, Ganghyuk smiled with satisfaction.

Bingo!

He pointed at the white structure which spread like a top blade.
Dolseok could not see it because of his position, Yeoni, Yeoju and, Heo Jun could see it completely.
As they have not seen those structures, they were curious about it.

What is this?


It is palmar aponeurosis. It is hard tendon made up of four bands


What is this?


Look at this. Do you see the four ligaments inside?

Ganghyuk took pains to give an explanation by twisting his body.
‘I should educate them well for the future.’
Especially, Yeoju was important.
If she made a good drawing, others could learn easily.
Heo Jun could finish hemorrhoids operation.
Ganghyuk was assisting him only.
Ganghyuk thought he could be free from hemorrhoids operation sometime later.
Yeoni and Heo Jun nodded their heads without knowing what Ganghyuk really thought.
They showed innocent facial expressions.

Yes, I can see them.


They hold the ligaments fast. If not, the location of the finger ligaments can be changed.

Fingers were the parts that move frequently.
Therefore, they needed supplements.
One of them is the palmar aponeurosis.

Why did you find it? His Highness did not feel pain in that area.

Heo Jun asked.
As he mentioned, it was not the damaged part.
There was no damage in the palm except the damages Ganghyuk had just made during the operation.

Not all of the tendons are useful.


Ah, are they?


From the index finger to the pinky, they hold ligaments, but how about the thumb?


Ah…It looks like its attaching to the muscle.


Yes. It does not have any function. It is attached there without purpose.
Of course, future scientists might find the reason why it was there with the development of medicine.
However, as far as Ganghyuk knows, there will not be any abnormalities even when that part was cut.
It was a good news for a surgeon to have a spare part.

Then?


I will remove it.


Why?’

You will see.


Ah, yes.

Heo Jun did not ask anymore.
He checked if Gwanghae breathed.
Ganghyuk told him it was a safe dose that had gone through some clinic experiments.
However, Heo Jun was the type that made his best in his duty.
‘It is a good thing.’
Therefore, he did not worry about his breathing status at all and could concentrate on the operation.
He grabbed his palm, fixing his eyes on the palmar aponeurosis.

Give me a scalpel.


Yes…

Dolseok gave him a scalpel.
Ganghyuk used the scalpel to separate the minentia muscle from the palmar aponeurosis.
Under the ligament there were muscles, and they should not be damaged.
It was nearly impossible to do this precise work in such a narrow and dark tunnel.

Oh my God.

Even to Ganghyuk, it was very difficult, and he swore.
It surprised all the people around him because he had not shown such bad behavior during an operation before.
Heo Jun lowered his voice a step further.
He guessed this operation was indeed difficult on an extreme level.
He was now determined not to bother him.

Ao.

Heo Jun’s anxiety was groundless.
He had no time to listen to others.
‘Ah, this is difficult’
There were reasons why people did not perform this.
Who would perform reconstruction to the patient with carpal tunnel syndrome?
They might reduce pain by cutting the parallel ligament.
That was much easier.
‘If the patient was not Gwanghae…’
He would cut the ligament, but he would be the king of Joseon.
He could not simply cut it.
If he could not fight well during the Imjinwaeran, and if Joseon was defeated by the Japanese…
‘Oh, I am doing well. I think I am a genius. Haha.’
He could manage to cut small ligament piece.
He looked at the inside and found no damage at all.

Wow, I did it.

Ganghyuk shouted taking out the white and thick ligament.
Dolseok made a sigh of relief.
Yeoni had the same feeling as she watched the whole process.
Heo Jun asked a question.

Why did it stressed you out so much to remove that? Will you use it for some purpose?

He pointed at the small ligament.
Ganghyuk answered with satisfaction.

As I told him…His pain was caused by the pressure of other structures in his wrist ligament.


Yes, I heard it.


Therefore, I will lengthen his ligament.


Ah?


I will make it now.