Big Doctor Live Room

Chapter 1188 Cerebral Vascular Bypass Surgery

"I saw the main artery of the base! Prepare for projection and correction!"

In less than 3 minutes, Chen Qun issued another instruction.However, today’s projection lacks the support of CT data and is less accurate.After all, if thoracic and cranial surgeries are performed at the same time, the space is too narrow, and there is no space at all for CT scans of conventional interventional surgeries.

The data this time are all provided by the endoscope and several small monitoring instruments. Anyway, the patient's body structure simulation demonstration map has already been prepared, and now it is enough to add the data.The first round of data was completed an hour ago, and there will be no major changes.

For Chen Qun, the top of the abasal artery is located in the deepest part of the human brain. Because the patient's artery ruptured, he had to search for the main artery of the abasal artery in the sea of ​​blood.Now Chen Qun has found the main trunk of the basilar artery under the microscope hanging from above, which means that he has made a good start.

If it were anyone else, given an hour, he might not be able to find the base artery in the brain. The patient would have already destroyed the nervous tissue and died directly before the instrument was even penetrated deep into the brain.

Ye Hanlin, who is a family member, lost his usual elegance and composure at this time, and closed his mouth twice, ready to say something, but he was afraid of causing unnecessary trouble to Xiao Chen and delaying the operation instead.

Yang Xiaoquan next to him naturally knew what Lao Ye was thinking, so he unceremoniously picked up the microphone, turned it on, and asked about the situation in the operating room.

"Did you find the left and right superior cerebellar arteries?"

"It has been confirmed, and now we are looking for the left and right posterior cerebral arteries. OK, the target is confirmed, Qi Hong, pay attention to the direction of my catheter. The left SCA left superior cerebellar artery has been marked with fluorescence, see if it is displayed in the projection? The SCA on the right side is also marked and confirmed, pay attention to the pressure of the brain platen!"

A surgical forceps and a catheter seem to have become spiritual things in Chen Qun's hands. They carefully peeled off the brain tissue from the blood vessels in the deepest part of the brain by blunt dissection, revealing a clear vision.

The camera at the front of the instrument presents everything on the side of the large floor-to-ceiling screen in the operating room, so that everyone can see clearly.On the other side, it shows Gu Ning's heart surgery.

Chen Qun's movements are not only gentle and delicate, peeling off the gray matter and white matter of the brain, which is as delicate as tofu, like peeling an egg, but also at a very fast speed, which makes people have to think of a fact in their minds, that is, how much Chen Qun has accomplished? Brain surgery?It seems that there are no more than one hundred in total, and no matter the technology or the details, they all show a feeling of weightlessness.

This is something that ordinary people cannot do, let alone accomplish.

"I have also completed the pruning of the blood vessels in the central part, and I am preparing to remove the blood vessels in the peripheral parts. Huh?"

Gu Ning, who was interjecting next to him, said half a sentence, and just as soon as the Mei's scissors in his hand cut the outer membrane of the pericardium, he stopped all movements in his hand.

"what's wrong?!"

Yang Xiaoquan, who is most familiar with student behavior, asked directly and loudly from the stands.

"There is also cancer at the distal end of the arch. If an anastomosis is performed at this place, the cancerous tissue will spread sooner or later, and there is a greater possibility of rupture after surgery."

Gu Ning answered the teacher's question with some regret.

"However, if it is treated, the aortic arch replacement cannot be completed during the cessation of circulation. After all, it is absolutely too late for you to rebuild the three major branches of the artery."

Yang Xiaoquan made an analysis directly from a strategic position.

"Or adding elephant trunk stent surgery? That would solve the problem."

Ye Hanlin hastily gave another answer.

"In this way, even if there is cancer at the end of the aortic arch, it will be easier to reconstruct through the left thoracotomy."

"Stitching, I still need to do extra stitching, the same as the previous choice, and there is not enough time."

Yang Xiaoquan denied Lao Ye's proposal again.

Gu Ning below directly stopped the quarrel between the two old men and said directly.

"Dean Ye, don't worry, we have already formulated a plan to deal with this situation in advance. I performed the stent implantation under the naked eye. At first, I thought it would not be necessary. It seems that the younger sister and the others really thought more about it. , This time, the real thing is to be prepared, and immediately add a stent-type blood vessel implantation under direct vision. Prepare for the fourth plan, Xiao Chen, and you have to cooperate a little bit, give me an extra minute."

"Understood! My side has confirmed the oculomotor nerve, and several blood vessels have been completely confirmed."

The atmosphere in the operating room became more and more solemn, and Ye Hanlin took the initiative to turn off the microphone on the observation platform, so as to prevent these old fellows from using outdated concepts to interfere with these young people's operations.

"The aortic arch anastomosis is completed, and the preparation for entering the artificial blood vessel."

"The left posterior cerebral artery and the right posterior cerebral artery are separated, and the top of the basilar artery is found!"

The words of Chen Qun and Gu Ning calmed down Ye Hanlin who was a little flustered. In the case of his wife's acute rupture, he reached the top of the basilar artery in 10 minutes. It was a laparoscopic surgery. This technique is simply amazing. What's more, Xiao Chen's peeling technique is so clever that it's at its peak. All the peelings keep the meninges, which is a little thinner than the egg membrane, between the tissues without any damage. It seems extremely easy, but it must be done. It is simply difficult to reach the sky.

When Jiang Ming saw the condition of the top of the basilar artery displayed on the big screen, he immediately jumped up and said excitedly.

"It's true that the arteriosclerosis at the entrance of the aneurysm is severe, so follow the No. [-] plan directly and perform flow control surgery!"

This diagnosis was a serious plan that Chen Qun and the others had assumed during their discussion last time. Now that it appeared as scheduled, it no longer posed any threat to Chen Qun.

Qi Hong below has already seen the situation, and directly implements small changes according to the prepared plan.

"Prepare to adjust the position of the operating table and tilt it thirty degrees to the left. First, cut off the vascular tissue."

"Prepare the best vascular tissue, and begin to intercept the internal thoracic artery. Hojo Orei, you only have 5 minutes!"

Before Chen Qun issued the order, Yang Xiaoquan from above immediately asked.

"Why not use the reserved radial artery? If you intercept the internal thoracic artery, the operation on the aortic arch will not be possible."

"Teacher, don't worry, we still have an additional plan No. 2, which can ensure that I can complete the aortic arch operation!"

"It's impossible, even if it's Xiao Chen, it's a bit rushed, and you can't do it!"

Yang Xiaoquan directly denied the apprentice's statement.

"If I don't need to anastomose the three aortas on the aortic arch, but use the island en bloc anastomosis to reconstruct, I can shorten the time to anastomose three aortas, and only need to anastomose one cap-shaped T-shaped vessel."

Yang Xiaoquan immediately closed his mouth twice and shut up.He knew that the reason why Chen Qun wanted to use a better internal thoracic artery for anastomosis was to ensure a better quality of life for the patient.Generally, the radial artery at the wrist is used for cerebrovascular bypass surgery. However, there is a difference in the diameters of the slender cerebral vessels and the radial artery. Even if the surgical anastomosis is successful, rupture may occur later.

In contrast, the internal thoracic artery has a smaller diameter, softer blood vessels, and is easier to anastomose with cerebral blood vessels.Heart surgery and brain surgery are performed at the same time. It is precisely because the patient is in a thoracotomy state that the best tissue and blood vessels inside the chest can be harvested!
This kid has used everything possible and everything available.

(End of this chapter)