Chapter 526 Challenge the most difficult surgery, a glimmer of understanding

Author: Jiangbian Yuweng

Chapter 526 Challenge the most difficult surgery, a glimmer of understanding

Opening the barrier of the dura mater basically means driving straight in.

First drain the blood inside the skull.

Even though this is just the simplest step, Director Wu Yongming is still cautious. When aspirating the fluid in the cranial cavity, it is very easy to make mistakes and damage important brain tissue.

Deputy Director Lu's intracranial environment is even more severe, and he is far more prone to accidents than ordinary patients.

Not to mention anything else, just the serious aging, hardening, and brittleness of blood vessels is enough to make surgeons walk on thin ice.

After the intracranial blood is almost absorbed, the intracranial pressure will basically return to normal. In other words, it will be lower than the normal level.

Because the original cranial cavity was closed, two holes are now opened, which is equivalent to a semi-open type.

In medicine, this is called fenestration.

The operation is progressing smoothly.

But we soon ran into trouble.

Just sucking out the accumulated blood is definitely not enough. If the bleeding stops, you will be able to fill up the skull cavity very quickly.

Director Wu Yongming tried to repair the ruptured blood vessels. Not to mention anastomosis, even debridement was in trouble.

"No, this blood vessel is too close to the brainstem. The operating space is even narrower. I'm not sure that endoscopic hemostasis can be achieved."

Drops of sweat as big as mung beans appeared on his forehead, and he shook his head repeatedly.

It seemed like there was a terrible beast blocking the way ahead.

In terms of general surgery, everyone's level of surgical skill is actually about the same. At least as long as it reaches a normal level, the surgery can be completed successfully.

In the words of a certain surgical expert, surgery is about cutting out lesions and sewing them up.

Of course, this surgical guru still said this in the 1960s.

With the development of surgical medical technology, it is no longer just as simple as repairing and removing. Many new technologies have been used, such as artificial blood vessels, vascular stents, artificial hearts, etc.

Even if it is just the repair of blood vessels, organs, or tissues, it will extremely test the doctor's skills.

Not to mention performing vascular repair or endoscopic surgery in a narrow cranial cavity. It is simply a hellish level of difficulty.

Next to it is the brainstem, and there are other important brain tissues around it. Doctors with poor psychological quality will have their hands trembling with fear when operating the endoscope arm.

It's really not an exaggeration.

The psychological and mental stress that doctors, especially surgeons, endure during surgery is beyond imagination.

Because if something happens to the patient, the surgeon must be responsible!

"The damaged area of ​​this blood vessel is not particularly large, its length is short, and it is indeed very close to the brainstem. It is extremely inconvenient to operate. Master Wu, why don't you try a vascular stent to repair it?"

Director Gouqiong was standing by to offer him advice.

"If it's a small brain aneurysm, I can fix it by placing a coil. Even if it's a larger aneurysm, it can be repaired by placing a stent. But there is no way to use a stent in this blood vessel."

He shook his head repeatedly and rejected the proposal.

Drilling holes and opening windows in the skull must first be to drain intracranial fluid and reduce intracranial pressure.

The second is to repair blood vessels and stop bleeding.

Not all vascular repairs are suitable for stent placement.

First of all, stents are very expensive. Secondly, the operation difficulty is also extremely high. In particular, it is frighteningly difficult to place stents in intracranial arteries.

"How about... you can help me and move the brain tissue on the upper right side of the bleeding point a little, and let me try it!"

Zhou Can saw a hint of excitement in his eyes when he saw the bleeding cerebral artery.

It was completely different from the fear in Director Wu Yongming's eyes. Director Wu was full of fear and had no confidence at all to challenge, and he was indeed unsure. Zhou Can, on the other hand, was full of determination, like a fearless brave man.

"Dr. Zhou, you must act according to your ability! Don't show off. If it really doesn't work, we can have a joint consultation again to discuss other surgical options."

Wu Yongming said this, but he actually knew in his heart that there was no other surgical plan.

If there was a better surgical plan, it would not have been delayed without treatment.

If it is internal medicine, sometimes there may be other alternatives. For this kind of intracranial artery rupture, there are really not many options available. Just two or three kinds.

"I'll be extra careful."

Zhou Can answered sonorously and forcefully, with a serious expression.

After he was replaced as the surgeon, he first directed Director Wu to help move the brain tissue to the side. This operation had a certain technical content, and it was more of a physical work like pulling a hook.

Of course, with the help of the endoscopic arm, the actual physical exertion is not large.

Next, Zhou Can tried to operate in this extremely small and limited space.

"No, you have to move it a little further to the side. About 0.5cm should be enough."

"Okay, I'll try."

Director Wu gritted his teeth, his eyes were extremely focused, and he squeezed and moved the brain tissue little by little to make more room for Zhou Can to operate.

"It can't be moved any more. This is already the limit. If it moves any further, it may seriously damage the brain tissue."

Director Wu didn't dare to move his eyes away from the screen, and he was trying hard to control the volume of his speech, for fear of increasing the strength of his hands and damaging his brain tissue.

Whether it is in the abdominal cavity or the cranial cavity, moving the surrounding tissues during surgery is itself a kind of harm to the body.

Severe adhesion of various tissues and organs often occurs in the abdominal and thoracic cavities that have undergone surgery, which will bring a series of negative long-term effects to the patient. It can be called postoperative complications or sequelae.

For example, after a chest operation, some people will often feel chest tightness and shortness of breath. These are the sequelae of the operation.

There is no treatment and it will basically last a lifetime.

Experienced and skilled doctors often try to avoid touching other tissues and organs when performing thoracic and abdominal surgeries, and only deal with the lesions.

Of course, the idea is wonderful, but in actual practice, doctors have no choice at all.

For example, during an intra-abdominal appendectomy, if you don’t pull out the intestines, how can you perform the surgery?

Just looking for the appendix is ​​a lot of work.

"Keeping this operating space size should be enough."

After Zhou Can made some gestures, he showed a fairly satisfied expression this time.

"I would like to state in advance that when repairing this blood vessel, it will definitely cause some damage to some tissues on the upper left side. However, I think that in order to damage these brain tissues that are not fatal and will not cause disability, the blood vessel can be repaired smoothly.

, it should be worth it. The human body has a strong self-healing ability. I believe that as long as ten days and a half, these injuries can basically return to normal."

In order to avoid frightening Director Wu, Director Mingxin and others, Zhou Can vaccinated them in advance.

The ideas during surgery need to be ever-changing.

Surgical repair of arteries in such a small space is an almost impossible challenge in itself. It is equivalent to driving a car onto a narrow dead end and then making a U-turn on this dead end that is only two meters wide.

It is simply impossible for ordinary drivers to complete this task.

If you have superb driving skills, it is possible to complete this impossible task.

The challenge Zhou Can has to face now is to successfully complete the almost impossible task of vascular repair in an extremely limited space.

“Is the risk controllable?”

After hearing this, Director Wu still did not dare to turn his head or move his eyes.

"It's hard to say about other unknown risks. At least I can be sure that some damage to brain tissue within this range will not be fatal or disabling."

Zhou Can answered truthfully.

No one dares to make any promises or guarantees.

Even a first-level surgery is risky, not to mention this type of cranial endoscopic surgery.

“Dr. Zhou’s plan is highly feasible!”

Director Mingxin actually supported Zhou Can's adventure at this time.

Her words carry great weight.

After gaining her support, Director Wu Yongming did not hesitate and directly agreed, "You can start the operation! There is no need to have too much mental burden, just be bold and careful."

"I see, thank you!"

While Zhou Can nodded in agreement, he also thanked the two chief doctors.

Without their strong support, he would not have this opportunity for surgery.

He tried to manipulate the endoscope arm to start debridement and then anastomose the broken blood vessels. The whole process was extremely slow, revealing not only stability, but also a strong concentration that only top doctors possess.

This kind of determination is somewhat similar to commanding thousands of troops to fight on the battlefield, facing powerful enemies and complex battlefield environments, and always staying firmly in the Chinese army's tent.

[The experience point reward for suturing is +100, and the experience point reward for ligation is +100...]

His experience point bonus was taken lightly.
To be continued...