The ti on the operating table was two hours and twelve minutes, each step was completed successfully in one go, without any rework, hesitation, or any redundant "let’s take another look" operations.
Gao Yuan took off his surgical gown and gloves, flexing his fingers, which bore deep indentations from long hours of holding the instrunts.
Robert also removed his surgical gown. The two stood side by side at the operating table, looking at the last freeze-fra on the screen. The reconstructed anterior and posterior cruciate ligants were clearly visible in the joint cavity, two pink cord-like structures crossed at the center of the knee joint, full in form, accurate in position, and moderate in tension.
The door of the observation room opened.
The experts filed out with varied expressions, so still watching the video replay on their phones, so quickly jotting down notes, so shaking their heads as they walked—not in denial, but in a disbelief of amazent.
A middle-aged expert ca over, shook Gao Yuan’s hand, and said, "I’ve been doing this for twenty years, I’ve never seen anyone navigate positioning so quickly without navigation equipnt. How did you do it?"
Gao Yuan looked into his eyes and replied, "Experience and intuition!"
The expert was taken aback, perhaps expecting a more technical answer, like angles, references, or calculation thods. But Gao Yuan gave him the least "technical" answer.
Experience and intuition—this answer might sound like a cop-out, but in Gao Yuan’s gaze, the expert saw not a cop-out, but a realm he had never attained. In that realm, surgery was no longer a pile of techniques, but beca an instinct, an intuition, sothing as natural as breathing.
An elderly professor with a head full of white hair ca over, and Gao Yuan recognized him, the director of a well-established dical center on the East Coast, one of the pioneers in anterior cruciate ligant research, a figure written into textbooks. As the old man approached, the surrounding people automatically made way.
He stood before Gao Yuan, did not shake hands or exchange pleasantries. He rely looked at Gao Yuan.
"I’ve been doing anterior and posterior cruciate ligant reconstructions for forty years, thinking I’d seen it all. Today, I saw sothing in this surgery I’d never seen before. Your anterior and posterior cruciate ligant tibial tunnel positioning—I’ve not seen anyone describe this thod in any literature. Is it your original creation?"
Gao Yuan shook his head: "It’s not mine, it’s my teacher, Professor Yang Ping."
The old professor nodded, so that’s it.
In the changing room, Gao Yuan sat on a bench, resting.
"In the afternoon," Robert said, his voice slightly hoarse, "they’ll have a lot of questions."
"Yes!" Gao Yuan said.
"Have you thought about how to answer them?"
"I’ll speak honestly," Gao Yuan said, "Just as Professor Yang taught ."
After resting for a while, they went to the hospital restaurant for lunch.
At two in the afternoon, the small eting room was full.
It was not an official academic presentation, no podium, no naplates, no agenda. Just an email sent by Robert—"Doctor Gao is here, you can co and ask questions." Then everyone ca if they were free, even that old professor who had sat silently throughout in the observation room yesterday. The room didn’t have enough chairs, so were standing, so leaned against the wall, so simply sat on the floor.
Gao Yuan sat at the front, without notes, without a PowerPoint, only a bottle of mineral water. He was very casual, not looking like a surgeon who had just brought collective silence to the top sports dicine experts in Arica, but more like a neighbor dropping by.
Robert sat next to him, cross-legged, twirling a pen in his hand. He wouldn’t answer questions for Gao Yuan, but he would help translate those professional terms when needed. However, he was ntally prepared that Gao Yuan might not need his translation. Gao Yuan’s English was good enough, good enough to discuss any technical detail with anyone.
A young resident physician sitting in the corner raised a hand, and before Gao Yuan could point at him, he couldn’t wait to speak.
"Doctor Gao, during yesterday’s surgery, for the femoral tunnel positioning of the anterior cruciate ligant, you didn’t use any navigation equipnt, how did you ensure the precision of the tunnel position? What anatomical landmarks did you use?"
Gao Yuan did not answer imdiately. He stood up, walked to the whiteboard at the front of the eting room, picked up a black marker, and drew a lateral outline of a knee joint. He spoke while drawing, his pace not fast, but each word was clear and powerful.
"The textbooks tell you that the femoral attachnt point of the anterior cruciate ligant is located on the dial wall of the intercondylar notch, behind the intercondylar ridge. This statent isn’t wrong but it’s not precise enough. Because the intercondylar ridge is often worn flat in patients with chronic injuries, you can’t find it. Moreover, even if the intercondylar ridge is intact, it only provides a front-back reference, not an up-down reference."
He drew an arrow on the board, pointing at the dial surface of the lateral femoral condyle.
"I use the most ordinary ’resident ridge.’ It’s a bony protrusion located at the upper rear part of the dial wall of the intercondylar notch, proximal to the intercondylar ridge. This structure is more constant because it’s outside the joint capsule, unaffected by intra-articular diseases. No matter how damaged a patient’s joint is, this ridge remains. Find it, then move seven milliters forward and two milliters down—right at the center of the native footprint. Actually, my description isn’t very precise—I’m just describing it in a way everyone can understand. When I truly operate, I don’t use seven milliters or two milliters for positioning; rather, I rely on the tactile feel of the probe. The ligant’s footprint and non-footprint react differently under the probe, and its chanical center differs as well."
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