Doctor: It's reasonable to perform surgery on yourself.

This step is not difficult and can be done with a cutting head.

Taking a step back, direct suction through plastic tubes also works.

If neither of these two methods works, the only option is the most dangerous method - vitreous forceps to pick up the worm.

This operation can easily cause the insect body to fragment. Once it occurs, the consequences will be very serious.

Fortunately, Xu Qiu's technique was very skillful. As soon as he put on the cutting head, he quickly got the nematodes curled up into a ball and stuck them out.

The ophthalmologist looked excited. When he was about to further clean the remaining posterior vitreous membrane, he discovered that Xu Qiu was still looking for something.

There was a puzzled expression on his face... Could it be that it's not finished yet?

Soon he had his answer.

Xu Qiu's pupils shrank, and then he pointed out the problem: "Here."

Everyone looked around and saw a small black spot in Xiaojie's eyeball in the very center of the surgery area. They couldn't find it unless they looked closely, but after Xu Qiu reminded them, everyone noticed it.

Tunnel-like defect!

This is the trace left by Angiostrongylus after penetrating the eyeball structure, and it is also the path it passes from under the retina at the posterior part of the equator above the temporal part to under the posterior limiting membrane of the vitreous body.

"There needs to be some repairs here..." Xu Qiu reminded.

The ophthalmologist just woke up from a dream, with a layer of cold sweat on his forehead.

Fortunately, fortunately, Xu Qiu is here!

Otherwise, he is very likely to miss this important damage!

Maybe no one noticed until after the operation was completed, and the patient's vision was damaged or even blinded as a result. In the end, no one thought it was the surgeon's error, but just thought it was one of the normal sequelae of the operation...

"I'm not cautious enough!" the ophthalmologist immediately reflected.

Since the insect body travels from the retina to the posterior limiting membrane of the vitreous body, there must be a passage. Xu Qiu relied on this logic to deduct the location of the damage!

Beside the operating table, the rest of the waiting surgical team were also stunned.

The brain surgery team, Director Lin and Director Tiantan Ge were all amazed and filled with emotion.

The gastroenterology and hepatobiliary department teams were also stunned.

If it weren't for the fact that the operating room couldn't applaud, there would have been thunderous applause at this moment.

…

After finding the defect, Xu Qiu began to check whether there was an epiretinal membrane in the macular area.

This is preparation for subsequent retinal injection surgery.

The so-called epiretinal membrane is a proliferative disease, that is, an abnormal proliferation membrane on the surface of the retina. It is common in the elderly. Some patients also have idiopathic epiretinal membrane. It may be asymptomatic at ordinary times, but it will hinder retinal injection surgery. of execution.

Fortunately, Xiaojie's eyes had no other problems except angiostrongylus infection.

After the three incisions are made and the preparations are completed, the retinal injection is about to begin.

"Connect the injection system."

This step is more mechanical.

The subretinal injection system is very complex. First, the tail of the VFC syringe must be connected to the silicone oil infusion pipe, and the other end of the silicone oil infusion pipe must be connected to the vitrectomy machine; then the syringe is equipped with a filter needle, and in the silicone oil removal mode of the vitrectomy machine, Adjust the suction power to 650mmHg, control the foot pedal, constantly control the syringe, adjust the pressure, etc...

"Set the maximum bolus pressure to 20mmHg."

"The OCT scanning range is positioned to the fovea."

Xu Qiu stared at the screen and slowly controlled the micro-syringe.

As the treatment drug was injected, the foveal retina gradually bulged, and when it just expanded into a small oval, he stopped.

If the injection continues, the foveal contour will be reversed or overstretched. This is an overdose and secondary retinal holes or macular holes may easily occur.

"Removal of residual posterior vitreous limiting membrane."

"Intraocular laser sealing of retinal colobomas."

"Gas-liquid exchange, injection of C3F8 gas..."

Orders were given one by one, and the eye surgery finally came to an end.

The ophthalmologist still feels a bit dreamy... A three-incision surgery was just completed?

The difficult subretinal injection was successfully achieved without any risk!

Before being pushed onto the operating table, everyone was on tenterhooks, thinking that it would never go so smoothly!

"It's incredible..." the ophthalmologist sighed, a little reluctant to leave just like that.

He even wanted to bring in a few more patients and perform a few closed three-incision surgeries in Xu Qiu.

At this time, Director Lin couldn't wait any longer and said: "Quickly give up, quickly give way, it's our turn for brain surgery!"

Director Ge also cleared his throat and walked over with his head held high.

What Xu Qiu wants to do is third ventriculostomy?

This type of surgery was abandoned as early as the 1970s. Although it has not been completely abolished, basically no one in the industry takes it seriously, and they all choose the ventricular-abdominal surgery, which is safer, less difficult, and more effective. Shunt.

Now I am running for third ventriculostomy...

If it weren't for the fact that Xiaojie's condition was indeed not suitable for peritoneal shunt, Director Ge even thought that Xu Qiu was deliberately showing off his skills and using the patient's life as a prop to show off his medical skills!

However, even though ostomy is Xiaojie's only option, it does not prevent Director Ge from thinking that this method is too primitive.

"So Xu Qiu is trying to be a living doctor on a dead horse?"

"Since ventriculoperitoneal shunt is not feasible, the only thing that can be used now is ostomy, and he has to take risks..."

"Although it is not a modern operation, Xu Qiu's willingness to take risks to save the patient's life is something worthy of respect."

Director Ge's psychological activities were extremely rich. He looked at Xu Qiu several times, trying to see a trace of anxiety from this young doctor, and the tension when facing an incompetent patient.

However, there was none.

Xu Qiu's eyes were always calm, and there was no ripple in his expression, as if everything was expected.

"This... is too arrogant..." Director Ge couldn't help but worry.

...

Soon, the patient was placed in a supine position, with his head raised, and the skin on the forehead was placed at the highest point, which was also the most suitable position for the operator to operate.

Of course, the purpose of doing this is not only to facilitate the operator. Taking this special position can also reduce postoperative intracranial gas accumulation and reduce intracranial pressure more quickly.

Swish---

The sharp scalpel made a longitudinal incision 1 cm in front of the coronal suture on Xiaojie's forehead.

Then, the layers of the scalp were cut layer by layer and peeled off from under the periosteum.

After the mastoid retractor pulled the skin apart, the skull was exposed.

Xu Qiu took the drill and made a hole in the frontal bone. Then he cut the dura mater crosswise and electrocauterized the local cortex to stop bleeding.

"Why don't you use your craniotomy machine?" At this time, Director Ge couldn't help asking.

It is said that Linyi's automatic craniotomy machine has raised craniotomy to a new level and even revolutionized the entire field.

Why not use it in this operation?

As soon as the voice fell, the eyes of the whole audience gathered, and everyone in Linyi looked at Director Ge with strange eyes.

The latter was a little scared and asked bravely: "What...what's wrong, is there any problem?"

——

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