I am a kryptonian doctor
Chapter 160
At this moment, Yang Tian’s experience of a master-level surgery for a huge intracranial aneurysm flashed through his mind again.
After the branches of M1 and M2 are exposed, the next step is to separate the proximal and distal ends of the aneurysm neck. Temporary occlusion has great benefit in softening the aneurysm when dissection is difficult or dangerous, and is especially helpful in dissecting branch arteries and perforating arteries attached to the aneurysm.
The temporary occluding clip must be placed distal to the lenticulostriate artery without interfering with the construction of the aneurysm clip. Giant aneurysms require isolation of the aneurysm, followed by intratumoral thrombus removal or reduction of the aneurysm sac. After successful temporary occlusion, the aneurysm neck must be fully exposed, the annular aneurysm neck needs to be loosened from adhesions, and the body needs to be separated from the surrounding brain tissue.
If the tumor sac has not been opened, it is preferable to temporarily block the proximal M1 before performing the separation operation.
Every 5 minutes of blockage, give 2 minutes of reperfusion at intervals.
Calcified plaque in the M1 segment will affect temporary blockade.
In this case, it is necessary to consider���Temporarily block the supraclinoid internal carotid artery, provided that this internal carotid artery is not affected by calcified plaque.
In elderly patients and those with severe atherosclerosis, temporary occlusion should be avoided or used with caution.
Before incising the tumor sac, Yang Tian skillfully used a puncture needle to puncture the tumor body to eliminate the parts of the tumor that were not thrombosed.
"One shot successful!"Qian Sen was shocked again!
Generally speaking, even his director would need to puncture more than 4 times. The director is an experienced doctor with more than 20 years of surgery. Yang Tian could actually puncture the right needle with one needle. How terrifying!
Yang Tian Then use a blade to cut the tumor sac filled with thrombus. After the tumor sac is opened, use pituitary forceps or ultrasonic suction to remove the intratumoral thrombus. The aspiration of the intratumoral thrombus continues until active bleeding is seen from the cyst cavity. The movements were smooth and smooth, without any sloppiness.
After the treatment was completed, the next step was the clipping. The MCA aneurysm was clipped without affecting the outlet of the M2 trunk.
"Use sutures to close the tumor?"Qian Sen was slightly startled when he saw Yang Tian's operation. Because he had seen countless intracranial aneurysm operations, even the director used curved aneurysm clips to clamp the aneurysm instead of suturing. Because suturing is more convenient. It takes time!
But the next second, Qian Sen’s eyes were kicked!
In just five seconds, Yang Tian’s hands flew up, as if they turned into shadows, and the tumor was sutured like art in just five seconds. same product
"This... is actually faster than using an arc clamp!"
This speed and suturing skills make Qian Sen really don't know what to say! This must be the devil's talent. His most basic suturing skills alone are beyond his reach!
The final stage of the operation is here, then It's vascular reconstruction!
Yang Tian chose the simplest and most practical solution based on his master's experience in intracranial large aneurysm surgery: using end-to-side anastomosis for the threatened M2 proximal end. or distal cortical branch blood supply, which is technically relatively simple and effective! Fifteen minutes later, the operation was completed without any mistakes!
Everything was so amazing!
The door was opened!
Director Hu, that is, Director Hu Dongxu from the Department of Neurosurgery, came in in a hurry because he had left the surgery to a doctor halfway through. A patient came in with a ruptured intracranial aneurysm. He knew that the other two deputy directors were unavailable, so he had to rush over to have a look.
He knew that other attending doctors could not perform this operation, but he heard on the way that he had just been transferred. When an intern who came over was performing an operation, he immediately became angry!
Isn't this nonsense?
Although he had heard about this intern Yang Tian, it was said that he was a genius and could even perform pancreaticoduodenal surgery. And he did a very good job, at a world-class level, even top international experts like Professor Anderson were outclassed by him.
He didn't know why Yang Tian was so outrageous, but you just came to their neurosurgery. Starting the fourth-level surgery on the first day - surgery for intracranial aneurysm!
This surgery is no less difficult than pancreaticoduodenectomy!
You have never experienced neurosurgery, so you are not doing it right. Is this a joke about the patient's life?
This is irresponsible to himself, the patient, and the hospital!
At the same time, he was also angry that Qian Sen was so stupid that he actually allowed this intern to undergo surgery. If you say yes, why don't you let me go? People say you can be reborn by jumping off a building.
"Qian Sen, what's the matter with you? How do you ask an intern to perform surgery?"Hu Dongxu glared at Qian Sen fiercely.
The latter's eyes shrank. It seemed that he was still very afraid of this director!
"Yang Tian, right? Get out of the way quickly. I will settle your matter with you later. How far has your operation progressed now? Leave it to me now."Hu Dongxu suppressed his violent temper. He still knew that it was better to complete the operation on the patient now and then settle the scores later!
The patient's operation could not be delayed because of this!
"Director, this, this operation has just been completed."Qian Sen said weakly.
"What? finished!"Hu Dongxu was shocked!
Then he looked in disbelief and saw that the wounds were all sutured!
How long did it take? Half an hour!
According to his previous operation process, it should be the third stage of the operation now. , this operation has five stages, the last two stages take the longest, but the first three stages of surgery are not short!
But Yang Tian has completed all the operations?
"Yes, director, the operation was a success! Really, this Yang Tian, oh no, Dr. Yang’s surgery for huge intracranial aneurysm was really great! I think even the videos in textbooks are not that good.……"Having said this, Qian Sen became excited again and foamed at the mouth.
After hearing this, Hu Dongxu looked at Qian Sen, then at Yang Tian, and finally asked a nurse:"Was the operation really successful? No problems were encountered?""
"Yes, Director, there were no problems during the operation and it was a success."The nurse nodded.
After listening, Hu Dongxu still didn't want to believe it!
An intern who had only been intern for three months could actually perform this operation! It was just the first day he came to neurosurgery!_Fei
Lu reminds you: Three things about reading - collection,
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