crazy scalpel

Xie Ke originally thought that after the diagnosis, the Guan couple would take the child to a pediatric hospital for treatment, but unexpectedly they insisted on staying in the city's first hospital.

The Pediatric Surgery Department of the No. [-] Hospital in the city generally only performs general surgery on children, and the classification is not very fine.

The illness Guan Yao suffered from was actually stenosis, a congenital skull disease.

The skull cover of a normal person is divided into four pieces at birth, bounded by the coronal, sagittal, and herringbone sutures.

From an anatomical point of view, the skull cover is like a ladybug. The places where the head and tail connect to the body are the coronal suture and the herringbone suture, and the symmetrical wings are the sagittal suture.

As a person grows, the sutures of the skull will slowly close, making the entire skull strong and complete.

Premature closure of the cranial sutures will limit the growth and expansion of the cranial cavity, which is insufficient to accommodate the rapidly developing brain tissue.In this way, the brain and cranial nerves will be squeezed and damaged. After all, the skull has no elasticity and cannot swell.Therefore, this disease is also called craniosynostosis or craniosynostosis.

The etiology of this disease has not yet been determined. It may be that the embryonic period in the mother's body is not well developed, or it may be that there is alienation in the tissue in the periosteum of the suture.

The cranial sutures of normal infants are zigzag and easy to expand. Generally, the growth will not slow down or stop until the age of 10 to 12, and the fusion and ossification of the sutures will not occur until adulthood.New bones continue to grow between the cranial sutures, while the skull grows in a direction perpendicular to the cranial sutures, and the cranial cavity gradually enlarges, leaving space for the brain to grow.

In babies with stenosis, one or more sutures may close prematurely, preventing the skull from growing perpendicular to it.As a result, the growth of the skull will take its place in other directions, or even stop growing.

If it grows in other directions, it will cause deformity of the skull.

For example, the ossification and early closure of the sagittal suture limit the growth of the skull to the left and right sides, and then it will grow longitudinally, becoming narrow and long, and becoming a scaphoid head.

And if the coronal suture is closed, it will restrict the growth of the head forward and backward, making it grow to both sides, which will become a flat head.Another situation is that half of the coronal suture is normal and half is ossified, then the growth of the skull will be asymmetrical and become oblique.

As for Guan Yao's situation, after Xie Ke's analysis, it should be all craniosynostosis.When all sutures are prematurely closed, the skull grows towards the bregma of least resistance, forming a pointed skull.

In either case, if it is not treated early, there will be deformity of the skull and a small volume of the cranial cavity in the future, affecting brain development and secondary intracranial hypertension.Brain development is not only related to appearance and IQ, but also closely related to survival and self-care ability. If it is delayed for a long time, it may even affect life expectancy.

Because people with this disease often have deformities in other parts of the body, Xie Ke remembered this disease after he learned that Guan Yao suffered from congenital pulmonary valve defect and saw the shape of Guan Yao's head. .When he was touching Guan Yao's head, he felt the ossified and raised bone ridge at the bone seam, and he was almost able to make a diagnosis.

Of course, it is also very easy to check for this disease. Just take a CT scan of the head to see whether there is early healing of the bone sutures and whether the edges of the adjacent bones are hardened.

To treat this disease, surgery is of course the most effective means.

The best period for surgery is within one year old, otherwise the longer the deformity lasts and the older you are, the greater the damage to the brain and the more serious the deformity will be.

But Xie Ke did not expect that the Guan couple actually wanted to be the chief surgeon and operate on Guan Yao.

Guan Yao temporarily stayed in the pediatric surgery ward, waiting for the operation to be scheduled.

The pediatric surgeon at the city's first hospital actually advised Guan Junwei and the others to go to Heping Children's Hospital.That is the best pediatric hospital in Tianhai, with extremely detailed departments.

But Guan Junwei and Jiao Zhenmei both recognized Xie Ke, thinking that the doctors at Heping Children's Hospital didn't even diagnose the disease, so naturally the level of surgery was not flattering.

Under the consultation of pediatric surgeons and brain surgeons represented by Wang Lei, Guan Yao's surgical plan was quickly placed on Xie Ke's table.

Xie Ke felt that this was simply a pie in the sky.

God knows, it's been a long time since he had a skull cut, and his hands are itchy.

Wang Lei teased him: "Tsk tsk, such a good thing happened to you again. Ordinary people don't have the opportunity to operate on babies."

As a surgeon, it is normal to like various uncommon operations, and it will become my own capital in the future.Doctors flock to many rare medical records, regardless of cost, because of this.

Just because you have cured diseases that others have not, you have more right to speak than others.

It is naturally more difficult to open the cranium of a baby than an adult.The baby's head is small, fragile, and many other factors.

But Xie Ke is obviously not afraid of the delicate work.

He once experimented with mice, and he was even able to successfully anastomose blood vessels in mice without a microscope.

In fact, Xie Ke has already discovered that his fingers have become more dexterous than before with the frequent virtualization, realization and various simulations.

Of course, if you are on the operating table, you should use the microscope when you should use it, otherwise other doctors and nurses will definitely regard him as a monster.

Since Xie Ke decided to take over this operation, he would naturally go all out.

So when he saw the surgical plan that was researched and formulated by the doctors of Children's Surgery and Brain Surgery, he fell silent.

To be precise, there is nothing wrong with this plan.

Since all of Guan Yao's cranial sutures were closed, the operation was performed in two phases.

In the first stage, the top coronal incision was used, the scalp was reversed forward, and the closed bone suture was bitten along the front half of the coronal suture and sagittal suture, and a new bone groove was re-established.

After the wound heals and the child's body recovers, the second-stage operation is performed. The original incision is made on the scalp and the flap is turned backwards, and the sagittal suture in the rear half and the herringbone suture in the temporal part are bitten open.

There is nothing wrong with this textbook-style surgical plan.

But what Xie Ke thought was that doing so could only slow down the growth pressure of the cranial cavity, so that the skull could continue to grow in the future.However, it cannot improve the deformity that has already formed.

Perhaps for most doctors, being able to perform this operation perfectly is already a matter of great pride.

But Xie Ke, he has always been perfect in terms of treatment!

Unless the family members of the patient were unwilling for various reasons, for example, Guan Junwei had no choice but to amputate his limb because he did not make a flap for the old man because of money.

Whether patients and their families accept it and how to choose it is one thing.

Whether Xie Ke can give himself a satisfactory answer is another matter.

There is no answer sheet that satisfies Xie Ke himself, he has already thought of it.

That is - not only the second issue, but also the third issue!

He wants to dismantle all Guan Yao's cranium, shape it and then reassemble it!

When Xie Ke expressed his thoughts, Wang Lei and the doctors at Erwai looked at him in disbelief.

This man is crazy!This is what everyone thinks.

Shayk knew he wasn't crazy.Perhaps, this scheme is a bit crazy, but it is the most perfect.

This is not only for head plastic surgery, but also for Guan Yao's skull to grow better and more normally in the future.

Guan Junwei hesitated, of course he hoped that the surgery on Guan Yao would be as successful as possible.But compared to the moment of worry when he heard that his son was sick, he now feels that it is good to be cured.As for the slightly pointed deformity of the head, it seemed to him of less importance.

But Jiao Zhenmei had a different idea from him.Jiao Zhenmei hoped to operate according to the plan Xie Ke said.She didn't want her son's life to go wrong at the beginning.She probably wouldn't have felt much better if Shayk hadn't brought up the idea.Like her husband, she will feel that the improvement of skull growth is a blessing in misfortune.

However, Xie Ke planted a piece of grass in her heart, and the grass grew rapidly, and in an instant it had a vast territory.

No matter what, Jiao Zhenmei couldn't erase this best plan for her son from her heart.Even judging from the attitude of other doctors, this third stage operation must be extremely difficult.

Due to some disputes between the couple, whether to do the third stage operation has not been decided yet.

But the day of the first surgery came soon.

Before Xie Ke went to the operating room, the old man Guan, who had undergone vertebral body shaping and was living in the extra-skeletal ward, specifically stated that he wanted to see him.

Old man Guan also knew about his little grandson a long time ago, and he treated Xie Ke with the same attitude as his daughter-in-law Jiao Zhenmei, thinking that Xie Ke had excellent medical skills.

Xie Ke thought he was just worried about Guan Yao's situation, and was already prepared to be asked various questions.But old man Guan didn't say anything, he just silently took out a stack of money from a cloth bag and handed it to Xie Ke.

"..." Xie Ke didn't expect this.

He knows that many family members like to give money to the surgeon before the operation, hoping that the doctor can take painstaking efforts to perform the operation seriously, and don't let a needle or a pair of scissors leak in the body like the TV news broadcast thing.

In fact, there are very strict procedures in the operating room of a regular hospital. Not to mention a needle or a pair of scissors, it is a thread or a sponge. It is clear where it is used and where it is stored.Before the operation is completed, the nurse has to count the equipment, and it cannot be finished if things are not in order.

Xie Ke: "We can't accept red envelopes, you can take it yourself. Guan Yao's surgery, I will do my best no matter what."

Basically, those who give red envelopes before surgery are ordinary people who are afraid that the doctor will not do a good job.For example, when Tong Shouye asked Professor Xu to operate on Tong Wenjie, he treated him afterwards and thanked him.

Of course, the latter kind of red envelope is not taken for free. As for the former, some doctors take it, and some doctors don't.

Xie Ke belongs to the kind of doctor who doesn't take it.

The old man Guan wanted to push him again, but Xie Ke stepped aside quickly: "Mr. Guan, rest well, I will try my best for your grandson. Besides, I am going to the operating room now, so I don't want to touch things. I I'm leaving."

Xie Ke, who finally escaped, took the elevator to the eighteenth floor.This floor is where the anesthesiology department and the operating theater are located.

He was about to brush his hands, but he met a reasonable and unexpected person.

Cai Tianqiao happened to have an operation today, and he was sitting in the waiting room with his eyes closed.