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

Xu Qiu continued: "Because it is a stereotactic surgery, the reliability of the stereoscopic navigation system will be reduced during the movement. Therefore, the tumor resection is different. It is necessary to perform intratumoral resection first, then remove the tumor wall and clean the edges. At this time, The third key point is involved, watertight suturing of the dura mater! ”

Click.

As Xu Qiu pressed the page-turning pen, new content appeared on the screen.

Everyone's attention was attracted, carefully capturing Xu Qiu's every word.

"Another difficulty in this operation is that the dura mater needs to be tightly sutured, but it is not easy to do this clinically."

"So, here I propose a completely new approach: watertight suturing of the dura mater."

"It requires the application of fibrin glue, with its high adhesion, to ensure the watertightness of the dural suturing. Before suturing the muscles, a Valsalva test is first performed, and then the fascial layer and the external occipital protuberance are continuously sutured. Galea aponeurosis layer…”

Xu Qiu's words were very concise because they were spoken briefly.

Each step, even the key links, has only been touched on in a few strokes without being carried out in depth.

Otherwise, if you pick any of these thirteen approaches, you can teach for several days.

However, even so, the chief director and others listened with fascination. The previous irritation completely disappeared, replaced by concentration and obsession.

The answer they had been searching for for a long time was now placed in front of them, casually told by a young doctor in thirteen kinds of skulls...

"I have questions!"

At this time, the director stood up.

He swallowed and asked, "What should I do if the dura mater is incised during the operation and the cerebellum is found to be excessively swollen?"

According to Xu Qiu's method, once the cerebellum is excessively swollen, the following steps will not work.

Xu Qiu calmly gave the answer: "Two methods. First, use mannitol regularly, but this is too slow and generally not suitable for urgent surgeries, so I recommend the second treatment measure.

"That is, hyperventilation is performed to reduce intracranial pressure. Of course, this alone is not enough. The surgeon must also perform physical decompression, such as opening the medullary cistern of the cerebellum to release cerebrospinal fluid, or entering from Frazier's point and performing Puncture and drainage of the occipital horn of the lateral ventricle.”

The director's eyes lit up, and he looked surprised and shocked.

How ingenious... He never thought that these two drainage methods could be used to quickly reduce cerebellar swelling!

Although there are certain risks, patients have reached that point where swelling of the cerebellum is a dead end. Xu Qiu's desperate and violent decompression method has given the patient a way out!

"One more question." Director Liu also stood up.

He stared at Xu Qiu and asked: "The pressure is still too high, and the swelling of the cerebellum can be solved by the two methods you mentioned, but if you must do a suboccipital craniotomy to decompress, there is a high probability of complications after the operation." Encephalocele and cerebral edema are almost fatal for severely ill patients, so what should we do?”

Xu Qiu: "Expand the bone flap to the foramen magnum."

"This...is it over?"

"Um."

"Can it reduce the incidence of postoperative encephalocele?"

"right."

Director Liu's eyes widened in disbelief.

Afterwards, someone couldn't help but ask questions.

"If the venous sinus is injured, how should it be dealt with appropriately?"

"Routine repair and careful ligation."

“What if there is an intraoperative air embolism?”

"First irrigate the wound and lower the heart to the level of the heart. If it is effective, observe the patient's hemodynamics. If it is unstable, quickly loosen the head strap and adopt the left head-height position. If necessary, A central tube can be used to aspirate the air embolism to save life.”

"Since it's stereotactic, conventional methods shouldn't be able to deal with hematoma, right?"

"Yes. However, rather than responding, the surgeon should take precautions. Avoiding traction on the brain tissue during the operation can minimize the chance of hematoma. Once it occurs, it must be done slowly under a microscope with a small suction device, and the hematoma cannot be crossed. Surrounding edema zone, the entire process must be performed within the hematoma cavity..."

"..."

Questions were thrown at Xu Qiu intensively.

Everyone wanted to question this brilliant young doctor. However, Xu Qiu answered every question perfectly, and the doctor became even more dazzling.

…

After ten minutes of brief lecture, there was no longer any look of contempt in the auditorium. Everyone's expressions were extremely solemn, and they looked at Xu Qiu with extremely complicated eyes.

The chief director and others were immersed in this technology and found it difficult to extricate themselves.

"The other twelve types of craniotomy, should they be discussed together with the stereotaxic combined with occipito-median infratentorial craniotomy?"

As soon as everyone had this question, Xu Qiu started a new chapter.

The second one was Poppen's cranium.

Next, the posterior fossa bone flap craniotomy...

There are also endoscopic subtemporal approaches, ventral brainstem approaches, and so on.

During the hour and a half of the narration, the director never had the thought of leaving the meeting.

He sat quietly in the front row and listened carefully to Xu Qiu's lecture.

Others were equally focused, tirelessly absorbing various skills and experiences related to craniotomy.

They have even forgotten that the first craniotomy is at Annex 1. Since the craniotomy machine was introduced into Annex 1 seven or eight years ago, no one has dared to come to the hospital to teach courses related to craniotomy. Even the world-famous doctor Sen. Maeda retreated.

However, at this moment, everyone subconsciously ignored this point, only feeling that the content in front of them contained too much knowledge, and they lacked too much.

"Next, it is also the most important part of this academic lecture..." Xu Qiu drank a sip of water, giving everyone a chance to relax, and at the same time moistened his throat.

The director and others suddenly came back to their senses, and their faces suddenly became ugly.

What did they just do...

Isn't the First Affiliated Hospital the absolute leader in the field of craniotomy?

Tiandu Tiantan, one of the three brain surgery centers in the world, has to come to their hospital to learn from them. Union Medical College and West China have tried countless times to develop cooperative projects with the First Affiliated Hospital, trying to poach people and equipment from their hospital, but they were all rejected.

To this day, the First Affiliated Hospital is still at the top of this field, and no one or any hospital can shake their position.

This also led to the arrogance of the First Affiliated Hospital.

Outsiders, let alone teaching them, would be laughed at even if they put forward different opinions related to craniotomy.

However, in the past hour and a half, they listened to Xu Qiu's lecture devoutly and attentively like a student, without missing a single word.

The most terrifying thing is that even the director realized that the content and level of this academic lecture might have surpassed everyone present. If this academic lecture was given by Xu Qiu, it means that Xu Qiu's understanding of craniotomy is even better than that of the director!

"How is this possible?!"

"And... he said that the next step is the most important part of this academic lecture? What could be more critical than the thirteen paths?" The director's teeth were about to be crushed, and he was unwilling to believe what he saw.