This step is to open up the surgical field, enter the posterior cranial fossa, and find the tumor. However, the surgical field at this time did not become clear as the automatic retractor was lifted, and the lower part was still blocked by the bone structure! This means that there will be a lot of blind spots in the operation. At present, the surgeon has only three options. One: Grind off the obstructing bone structure. But this will extend the operation time by about half an hour. And it may damage important structures such as the Labbe vein between the lateral fissure and the transverse sinus, and the lateral fissure vein of the sphenoparietal sinus. More importantly, even if the bone obstruction is ground off, there are still blind spots in the petrous bone to the middle slope, the posterior cranial fossa area, and especially the structure below the line of the internal auditory canal. This feeling is like taking a small blue pill at the risk of physical damage, working hard and sweating profusely,
but in the end the other party yawned and said, "It's better to use a toy." It's a thankless job... The second option is naturally to give up minimally invasive surgery and do a classic craniotomy directly. This was rejected at the beginning of the consultation. Using a classic craniotomy is almost a dead end. The last option is to change the minimally invasive approach. Since the front door is blocked by a structure. Then go through the back door! "However, the front side is the most advantageous surgical approach. If it is temporarily changed to other places now, the risk is greater..." Director Lin's pupils trembled slightly, and his brain was working quickly, trying to find a solution. This operation is like walking through a dark minefield. Everyone analyzed the most likely safe passage, but halfway through, they found that there was a wall in the dim front! At this time, if you rashly change other routes, you may detonate the mines under your feet at any time! Should you give up? "It can only be regarded as a 'switch operation'." Deputy Director Zhao looked at the stack of bone structures and felt his scalp numb. Everyone's face was also heavy. The so-called switch operation. That is, after the operation enters the deep part of the human body, if it is found that the tumor spread, anatomical abnormalities, multiple organ lesions, etc. indicate that the patient cannot withstand further surgical blows, the operation will be abandoned after evaluation, and the operation will be ended directly by flushing and suturing. After one switch on and one switch off, the doctor found that he was powerless and could only end it without doing anything. The anesthesiologist stopped playing with his phone at this time and leaned over to say: "The area of ineffective exposure cannot be larger, otherwise the patient will not be able to leave."
This is basically equivalent to a death sentence. The incision is too large, and the damage to the patient is beyond the controllable range. But—— Can a smaller incision be found? How is it possible! If it is really possible, it would have been discussed during the consultation! Just when the atmosphere was frozen to the extreme, a plain voice suddenly sounded. "Scalpel." Everyone's face changed at the same time, and they looked at it with fear. I saw that Xu Qiu had already picked up the scalpel, and then put it down without hesitation. In an instant, At the transition between the transverse sinus and the sigmoid sinus, as the scalpel slid nimbly like a snake, an "S" shape appeared in front of us. Then, the periosteal stripper widely pushed the periosteum... The V-shaped flap opened the dura flap... The incision milled the bone flap... The 4-0 suture pulled the dura mater... The hemostatic forceps clamped and suspended on the edge of the head... Gurgle-- As the cerebrospinal fluid was slowly released, a narrow keyhole-shaped approach appeared in front of them. Everyone was hesitant. What's the use of opening such a small hole? I still can't see the surgical field! However, when Director Lin looked over, his pupils suddenly contracted and his face was full of shock! "Is this... the door and window effect?!" Director Lin was shocked. The door and window effect is also called the cat's eye principle. In simple terms, through a narrow cat's eye door mirror, you can see the outside clearly. And at this moment-the keyhole opened by Xu Qiu is the cat's eye!
The tiny incision opened in front of me, the surgical field is not as dark and narrow as expected, but exceptionally bright! The neurovascular structure of the ventral cranial fossa is clearly visible! Lin Xie, Academician Chen and others also widened their eyes, their expressions full of disbelief. "Is this Dr. Xu?" "Oh my God, this is too fantastic!" "It can be saved, Dr. Xu, what is your limit!" "Did you record it? I want to sleep with the videotape!" In the operating room, everyone's mood seemed to be on a roller coaster, rushing from the bottom to the top in an instant. "Don't make noise, Dr. Xu has found the trochlear nerve, and the tentorium cerebelli is going to be cut!" Director Lin suddenly shouted, and the operating room immediately returned to silence. A few seconds later. Director Lin's eyelids suddenly jumped violently, and he said after realizing it: "So... so strong..."
... ... The difficulty of this operation is unprecedented. Even Xu Qiu did not dare to be distracted at all, staring at the microscope, constantly performing microscopic separation. Drops of sweat appeared on his forehead. The figure was like a sculpture, with only the hand holding the knife moving and peeling with a tiny amplitude. "Doctor Xu, wipe the sweat." The circulating nurse moved very gently, and took advantage of the gap when Xu Qiu turned his head to wipe the sweat quickly. Through the gloves, the circulating nurse touched Xu Qiu's face. She deliberately pulled the gauze inwards and pretended to rub Xu Qiu's face with her fingers inadvertently. She was immediately overjoyed. It turns out that rubbing really makes you happy! On the operating table, Xu Qiu was completely unaware that he was being rubbed. He was concentrating on identifying the tumor and the blood vessels surrounding it under the microscope. Director Lin and others looked heavy and dared not breathe.
The situation was very serious - the tumor was densely packed with blood vessels. The ones that could be identified were the internal carotid artery and the middle cerebral artery, and the optic nerve and ophthalmic artery were below. Swish - Just as everyone was struggling with how to start the first cut, white smoke rose, and the smell of burnt flesh instantly filled the entire operating room. Xu Qiu took a bipolar electrocoagulator and electrocoagulated 2cm on the outside of the tumor, and then cut it open. He stopped bleeding while cutting until the tumor was hollowed out. Snap - At this moment, the tumor wall collapsed. Xu Qiu did not stop, and immediately took the knife and cut the tumor wall in pieces. Director Lin and others seemed to be holding their breath, staring at the surgical field. During the operation, Xu Qiu's scalpel passed over the brain stem several times, rubbing the cranial nerves. But, it always stopped at the last moment! Click -- Three hours later, a huge meat ball covered with burnt brown, with red tumor blood vessels, yellow-white tissue adhesions and black necrotic areas on the surface fell on the surgical tray. Gurgle. Suddenly, the sound of swallowing saliva was heard. After the electrocoagulation, the meat ball exuded the aroma of barbecue... This was undoubtedly a huge temptation for everyone who had not had time to eat dinner. "Why are you in a hurry? The operation is not over yet. Don't stare at the tumor and drool - I will treat everyone to supper after get off work!" Director Lin said. He also secretly swallowed his saliva. But his eyes were still on the surgical area, and his expression did not relax at all! Now there is still a tricky problem... Warm reminder: If you find that clicking the next page will force you to jump to other websites, please use the "Chapter Error" or "Contact Us" at the bottom to inform us, we will deal with it as soon as possible, thank you for your understanding!