crazy scalpel

After being hung up, Lao Youjun continued to dial without giving up, but was never answered by Xie Ke.He didn't dare to call the hospital to harass everyone, so he had no choice but to send a long text message to Xie Ke.

【Xie Ke, in fact, don't resist this kind of thing too much. Yaqiong is really strong and won't treat you badly.And I also want to congratulate you for having thoroughly caught the attention of our boss, who said he would meet you in person.When the time comes, you seize every opportunity to make a condition!I mean it. 】

Xie Ke only opened it once and then deleted it. Almost only the nightly menu that Li Shiguang sent him was left in his text messages.

As for the general manager of Lao Youjun Dai Yaqiong, Xie Ke knows that it is not that simple with his toes.Yu Tengcong was able to sit in this position because she was Jing Haoran's sister-in-law at the time and played a pivotal role in Yaqiong.Why is Lao Youjun?The son of a bankrupt real estate developer who wanted money, no money, no skills, no skills, no knowledge, and was swept out of a serious hospital, Yaqiong didn't run a charity hall, on the contrary, he was a blood-sucking hole. Why should he be used?

But Xie Ke quickly left Lao Youjun and Yaqiong behind, these are not the most urgent things to solve at present.Right now, nothing is more important to Xie Ke than Professor Xu's operation.

Although Xie Ke said it very simply, Professor Xu readily agreed, but he knew in his heart that Professor Xu did not show any worries to give him confidence.

In fact, compared with craniopharyngioma, which is also a common tumor in the sellar region, pituitary tumors are more difficult to deal with.

First of all, craniopharyngioma is an independent tumor, which can be completely removed, while pituitary tumors are difficult to distinguish between tumor tissue and normal tissue, and pathological tissue and normal pituitary tissue can grow mixedly, resulting in many cases that cannot be completely resected—according to The consistent principle of neurosurgery is that it is better not to cut clean enough than to cut more normal parts.

Second, although pituitary adenomas have always been classified as benign tumors, they are actually quite aggressive.Because pituitary tumors themselves originate from normal pituitary tissue, some of them expand along the pituitary stalk—the place that connects the hypothalamus and pituitary gland—so that the pituitary stalk is squeezed and degenerates, or even disappears.Fortunately, from a functional point of view, Professor Xu's pituitary stalk has not reached this point yet, but surgery is urgent.

Finally, pituitary tumors generally grow relatively large when local symptoms appear, and the blood vessels supplying the pituitary gland, pituitary stalk, or hypothalamus can all become the blood supply source of the tumor, so its blood supply is very rich.Another one is that the cystic changes of pituitary tumors are less, which means that it is more difficult to remove the solid part of the tumor.

For those who are used to surgical operations, cystic degeneration is generally not a bad thing, just carefully open an opening, and then use a suction device to suck out the fat, fluid and pus inside, and be careful not to get it in the operation area.Wang Lei once compared this method to eating raw fried buns. Although saying this made a lot of people sick, it is actually somewhat similar.

The good thing about having a cystic degeneration is that once you suck out the bag of juice, oh no, the pus, the tumor will immediately shrink to the point where it is very easy to cut off.

The pituitary gland is a small oval body on the ventral side of the hypothalamus, which is the endocrine control center of the whole human body.Due to the particularity of its anatomical location, it is not only located in the cranium, but also located in the arachnoid and extradural mater of the skull base, and is only separated from the sphenoid sinus cavity by a layer of sellar base bone about 1 mm thick.Therefore, the resection of pituitary adenoma can be done by intracranial resection or extracranial resection.

Xie Ke still remembers that when Professor Xu taught the transnasal-sphenoidal approach in school, he said that the development of this operation was a long and tortuous process.

In fact, more than 100 years ago, someone entered the sellar area to remove pituitary tumors through extensive resection of the ethmoid bone and sphenoid bone. After the success of this method, many surgical masters at that time perfected and promoted it.Unfortunately, due to the outdated surgical instruments and lighting facilities at that time, the tumor resection was not thorough enough, and due to the lack of effective antibiotics, the incidence of postoperative intracranial infection and patient mortality were high, which greatly limited the application of this operation. develop.

Until recent decades, due to the advancement of microsurgical instruments, the development of lighting equipment and intraoperative image monitoring technology, the transsphenoidal approach has been widely used and even become the first choice.

Xie Ke needed the shortest time, the least damage, and the most direct path to remove the pituitary tumor in Professor Xu's skull, and of course he chose this surgery.

Professor Xu often said that human imagination is unlimited, and it is often limited by tools.

The brain can often do some incredible things first when the conditions are not available, and then realize the real possibility by inventing various appliances and technologies.

Xie Ke looked at his finger, it seemed to feel Xie Ke's gaze, and it changed back and forth happily again.Xie Ke can clearly feel that he has become more and more proficient in controlling it recently.At the beginning, this thing seemed to be a foreign object connected to his hand, Xie Ke had to concentrate all his energy on it to order it to make a little change.

But now, it has almost completely become a part of itself, accepting the instructions from Xie Ke's brain.

Xie Ke typed the last word on the computer and printed it out.With his prepared operation plan, Xie Ke came to Professor Xu's hospital bed.

The girl in the bed next to her was happily discharged from the hospital with her beautiful and intact face. Xie Ke said softly, "Teacher, this is the plan I made, please show me."

Professor Xu took it and flipped it casually, then closed it. Xie Ke's ability on paper has always been beyond doubt. "Is the day arranged?"

Xie Ke nodded: "You started taking prednisone and nasal drops of chloramphenicol the day before yesterday, so I just took pictures of your operation in the morning of the day after tomorrow."

Professor Xu asked him jokingly: "So fast, wouldn't it be opening the back door for me?"

"Where," Shayk shook his head: "I also had a pterional-transtemporal-transtentorial operation into the petroclival that day and a clipping of an internal carotid bifurcation aneurysm. You know, these two Both of them take a little longer, so I put your operation first. Although your operation is added temporarily, but because the time is short, I don't need to postpone other operations, so don't worry about it. "

Professor Xu also felt that this arrangement was quite appropriate, and Xie Ke was too much work for those who can, so he nodded: "Well, let's arrange it like this."

Xie Ke originally came here to finalize the date of surgery with Professor Xu. As for the surgical plan, he just handed in his homework habitually, but even though he was very confident in his homework, he just glanced at it when he saw Professor Xu. , I am still a little dissatisfied, at least give a [-]-point comment.

Professor Xu was surprised when he saw that the boy still didn't leave: "What are you still doing here? Here, take the plan back and get familiar with it. My old bones can't stand you messing with it casually."

Xie Ke smacked his lips, "You didn't read it?"

Professor Xu was speechless: "This is an operation to be performed on me anyway, can't you give me some space, bastard! But after the operation, I have to check the video, hehe, if you are not good enough, you can Give me back to the First Affiliated Hospital and rebuild it!"

Xie Ke shook his head: "Originally, I wasn't sure, but recently I have performed several such surgeries in succession. I dare say that the anatomical structure centered on the sphenoid sinus includes the sphenoid sinus below the sella, the hypothalamus above and the optic nerve. The cross, the upper trapezoid bone of the posterior slope, the cavernous sinus and contents laterally, and the pituitary gland, pituitary stalk, and sellar septum in the sella, no one is more familiar than me!"

Professor Xu shook his head: "Just blow it up. I know that Director Cai's surgery in this area is absolutely second to none."

Xie Ke shrank his neck and muttered: "Cai Tianqiao, he is not bad. If he was the best half a year ago, but now, I am definitely not worse than him." If Xie Ke didn't have fingers to help If so, he would never be convinced by Cai Tianqiao.But now he has cheats!The people who drive the plug-in and the people who don't have the plug-in are just about the same, Xie Ke is embarrassed to say more.

Although Xie Ke generally does not use virtual fingers during surgery, virtual fingers are very useful for him to familiarize himself with the anatomical structure, and make him highly sensitive to the space of the operation area, which is not common to ordinary people.So in the final analysis, Xie Ke still benefited a lot from this.

Professor Xu glared at him: "Why are you so indifferent to Director Cai? You shouldn't, I think you have always respected your teachers. Aren't those half-assed teachers in the medical school still coaxed by you?" ?"

"How should I put it?" Xie Ke thought for a while, "I don't know either. It stands to reason that he treats me pretty well. But I always feel that he is weird and a little sinister... Many of his actions are ordinary people. I can’t understand it. For example, he turned down the offer of New York Presbyterian Hospital and returned to Tianhai to start as the deputy director. It doesn’t make sense to come back at this time. If he is interested in medicine itself, he should stay In the United States, he can learn more things there. If he just wants to be a petty official, he should spend two years in the Presbyterian Church before returning, and then he can choose whatever position he chooses. But he just came back to the city. After that, I didn’t move, and it seemed that I was a little too quiet.”

What Xie Ke was thinking in his heart was, and he completely ignored his first love—Feng Da said that Cai Tianqiao asked him to wait for him before he left!But this is someone else's *, so Xie Ke didn't say it.

Professor Xu was also interested in what he said: "Yeah, it's quite strange to be analyzed by you like this. Why?"

Xie Ke held his chin: "I think Cai Tianqiao should be the kind of person who will not offend me and I will not offend others, but he will never have too high a consciousness. If you want to repay the motherland, you don't have to think about it. So I think "There must be a secret in him."

"..." Professor Xu's lips moved slightly.

Seeing that he hesitated to speak, Xie Ke asked strangely, "Teacher, what exactly do you want to say?"

Professor Xu looked up at him, and finally sighed: "Don't you have a secret?"

Xie Ke couldn't help but startled.