Start From Emergency Doctor

Chapter 102

The young couple glanced at each other, and both were stunned.

Let parents choose which child has a better chance of development, no matter how they choose, they will both feel guilty when facing another child who is stunted in the future.

After a long time, the patient’s father raised his head and said: “Doctor, really… do I have to choose…”

Xiao Xuebo sighed: “We haven’t had a craniotomy yet, so we can’t determine whether the sagittal sinus can be allocated well. However, according to previous conjoined head separation operations, once we encounter a shared sagittal sinus There are more points for one and less points for the other.”

“Doctor, I beg you!”

The patient’s mother knelt down and pleaded.

Xiao Xuebo looked at Zhou Yuan with a distressed look.

Zhou Yuan walked over, helped the patient’s mother up, and said, “I promise you that even if there is no equal distribution, the IQ of the other child will not be affected!”

Hearing these words, the patient’s parents’ expressions eased a lot.

“If it really doesn’t work, then ask the doctor to make the decision! Give to whoever gives the most insurance!” The patient’s father gritted his teeth.

Zhou Yuan nodded, and after pacifying his family members, he began to prepare for the operation.

An external distraction device is placed on the joint part of the skull of the conjoined child. This device will pull the skull at a speed of 2.1mm per day. The purpose is to stimulate the growth of the skull and soft tissues, which can reduce the difficulty of separation.

In addition, the subcutaneous soft tissue expander also needs to be placed in advance to stretch and relax the skin.

In these two processes, the conjoined body will not feel much.

After two weeks, everything was ready and all preparations were completed.

The day before the operation, Zhou Yuan had another conversation with the patient’s family.

Generally speaking, this link will be handed over to an assistant, and the chief surgeon will not be able to do so, but this operation is very difficult and Zhou Yuan must be present.

Zhou Yuan informed the patient’s family members of the operation methods, possible risks, and so on.

The risks of brain surgery are too great and must be explained one by one.

Amnesia, blindness, visual field defects, etc., and even a major change in personality, lower IQ, etc., there are many postoperative complications.

Every complication has happened before, and it is a bloody lesson.

Soon, the patient’s parents signed a surgical consent form, a treatment plan selection form, a consent form for the use of special materials, etc…

In the afternoon of the next day, Conjoint children reached their best physical indicators and was pushed into the operating room by the nurses. A team of 15 people including Zhou Yuan was ready.

In the operating room, fifteen people were crowded into the space that was originally only six people.

Zhou Yuan is in the main knife position, the neurosurgeon cooperates with the anesthesiologist, and the plastic surgeon waits for the later grinding of the skull and the plastic surgery of the newborn’s skull separation.

“Start anesthesia.” Zhou Yuan said.

Special attention should be paid to the amount of anesthesia for newborns. The anesthesia plan chosen after the final discussion is intravenous and inhalation combined anesthesia.

The use of combined static and inhalation anesthesia can avoid the pain of simple intramuscular injection or venipuncture. Similarly, it can also avoid large doses of anesthetic gas that can cause respiratory depression, dry mouth and nose, and even trauma.

“The anesthesia is complete.” The anesthetist’s voice rang.

Zhou Yuan nodded, “Start counting equipment.”

The equipment nurse carefully counted by the side: “One, two, three…”

Because the patient is a newborn, two doctors, Wei Lili and He Jing, who are good at dealing with babies, are also in the operating room.(Read more @ wuxiax.com)

At the moment, also help count.

“The inventory is complete.” The equipment nurse said.

“Okay, the operation begins.” Zhou Yuan said.

The atmosphere in the operating room became heavy in an instant, leaving only the instruments and the sound of everyone’s breathing.

“Side position.”

Because the patient is a newborn, the operating bed can accommodate both of them.

After setting up his position, Zhou Yuan made an incision line at the joint between the two skulls.

“Prepare for minimally invasive chest surgery.”

This step comes from Lu Chenxi and another director of thoracic surgery.

The two went to the front of the conjoined body, preparing for minimally invasive chest surgery.

In the event of excessive blood loss during the operation, they will immediately stop the function of the heart and stop the blood supply to the body.

“Ready.”

Lu Chenxi and the director of thoracic surgery made a small incision on the two conjoined children and reported later.

“Scalpel.”

Zhou Yuan took the scalpel and slowly cut the skin along the incision line that was previously drawn.

“Hemostatic forceps!”

Zhou Yuan moved quickly and immediately started to stop the bleeding after cutting the skin.

The most dangerous thing about this operation is to lose too much blood. If you can bleed less, you can flow less.

After hemostasis was completed, Zhou Yuan sliced ​​through the subcutaneous tissue and muscle tissue layer by layer, and finally opened the flap to reveal the underlying skull.

“Electric drill.”

The instrument nurse handed a medical electric drill.

Zhou Yuan took it, and carefully made a small opening in the skull.

“Milling cutter.”

It has been negotiated before that the operation uses a manual milling cutter.

Electric milling cutters are not easy to grasp the strength, and they are not as fine as manual milling cutters.

Of course, this is for Zhou Yuan.

Most people don’t use manual milling cutters. On the one hand, this thing is tiring to use, on the other hand, the speed is very slow. Of course, the most important point is that one’s own strength and skill are not enough.

In order to maximize the success rate of the operation and reduce the risk, Zhou Yuan chose a manual milling cutter.

Before long, the skull was cut open, and the underlying dura mater was exposed in the surgical field.

“In the first step, half of the strip craniectomy is completed, and the soft tissue is removed.” Zhou Yuan said.

As he said, he slowly cut open the hard dura mater, exposing the brain inside his skull.

It can be clearly seen that the two brains grow next to each other, but they are not connected together, and there is a possibility of separation.

Zhou Yuan carefully separated the surrounding brain tissue-this step is relatively easy, but because it is in the skull, extremely delicate operations are required. If you accidentally touch other structures, it is likely to cause irreparable trauma.

After a long time, Zhou Yuan breathed a sigh of relief, cut the tissue on the table and said, “The soft tissue is complete.”

After asking the nurse to wipe off the sweat, Zhou Yuan took a deep breath.

Now it’s time to separate the brain hemispheres.

This is the longest step in the operation. Although the brains of the conjoined are not connected together, it still takes five or six hours to separate the hemispheres on one side.

Zhou Yuan put on his eyes and separated carefully.

All people held their breath.

At this time, no one dared to disturb Zhou Yuan. Once the strength is slightly stronger, the fragile brain tissue may be damaged, and the brain damage is almost irreversible.

Just after the operation went on smoothly for more than three hours, the anesthesiologist who had been monitoring the baby’s physical signs suddenly changed his face.

“Doctor Zhou, too much blood loss!”

Zhou Yuan’s face changed and he immediately raised his head.

“Quick! Blood transfusion!” said the director of thoracic surgery hastily.

“No, don’t have a blood transfusion yet!” Zhou Yuan stopped him.

“why?!”

At this moment, everyone was stunned.

What does Zhou Yuan want to do without a blood transfusion if he has lost too much blood? ! .