Start as an Emergency Physician

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

Let the parents choose which child has the better chance of development, and 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 you have to choose..."

Xiao Xuebo sighed: "There is no craniotomy yet, so we can't be sure if the sagittal sinus can be well distributed." However, according to the previous head separation surgery of conjoined children, once the shared sagittal sinus is encountered, one is more divided and the other is less. "

"Doctor, I beg you!"

The patient's mother knelt down and pleaded.

Xiao Xuebo's face was embarrassed, and he looked at Zhou Yuan with a distressed gaze.

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

Hearing this, the patient's parents' faces softened a lot.

"If it really doesn't work, then ask the doctor to make a decision! Give whoever has the most insurance!" said the patient's father through gritted teeth.

Zhou Yuan nodded, and after reassuring the family, he began to make preoperative preparations.

An extracorporeal stretching device is placed at the area where the skulls are connected, which will pull the skull at a speed of 2.1 mm per day to stimulate the growth of the skull and soft tissues, which can reduce the difficulty of the separation operation.

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 child will not feel too much.

Two weeks later, everything was in place and all the preparations were done.

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

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

Zhou Yuan informed the patient's family in detail about the way of surgery, the possible risks and so on.

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

There are many postoperative complications such as amnesia, blindness, visual field defects, etc., and even personality changes, IQ reduction, etc.

Every complication has happened at one time and is a bloody lesson.

Soon, the patient's parents signed the consent form for surgery, treatment option selection form, consent for the use of special materials, and so on...

In the afternoon of the next day, the conjoined children's physical indicators reached the best state, and they were pushed into the operating room by the nurses, and the team of fifteen people, including Zhou Yuan, was ready.

In the operating room, there were fifteen people crammed into the space of only six people.

Zhou Yuan is in the main surgical position, the neurosurgeon cooperates with the anesthesiologist, and the plastic surgeon waits for the grinding of the skull in the later stage, and the plastic surgery of the neonatal skull separation.

"Let's start anesthesia. Zhou Yuan said.

Particular attention should be paid to the dosage of anesthesia in neonates, and the anesthesia regimen chosen after the final discussion is intravenous and inhalation combined anesthesia.

The use of a combination of static and suction anesthesia can avoid the pain of simple intramuscular injection or venipuncture, and similarly, it can also avoid the large dose of anesthetic gas that can cause respiratory depression, dry mouth and nose, and even mental trauma.

"The anesthesia is done. The anesthesiologist's voice rang out.

Zhou Yuan nodded, "Start counting the instruments."

The instrument nurse counted carefully next to her: "One, two, three..."

Because the patient is a newborn, Wei Jing, two doctors who are good at dealing with babies, are also in the operating room.

At the moment, also help count.

"The count is complete. The instrument nurse said.

"Okay, the operation begins. Zhou Yuandao.

The atmosphere in the operating room instantly became heavy, and only the sound of instruments and the breathing of everyone remained.

"Lateral decubitus position. "

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

After positioning himself, Zhou Yuan drew an incision line at the junction of the two skulls.

"Preparing for minimally invasive chest surgery. "

This step was carried out by Lu Chenxi and another director of thoracic surgery.

The two went to the conjoined children separately and prepared for minimally invasive chest surgery.

In the event of excessive blood loss during surgery, they must 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 then reported.

"Scalpel. "

Zhou Yuan took the scalpel and slowly cut his scalp along the previously drawn incision line.

"Hemostat!"

Zhou Yuan moved quickly and immediately began to stop the bleeding after making an incision on the scalp.

The most dangerous thing about this surgery now is excessive blood loss, and if you can bleed less, you will bleed less.

After stopping the bleeding, Zhou Yuan cut the subcutaneous tissue and muscle tissue layer by layer, and finally opened the skin flap, revealing the skull underneath.

"Electric drills. "

The instrument nurse handed over a medical electric drill.

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

"Milling cutters. "

It has been agreed that the operation will be performed with a manual milling cutter.

Electric milling cutters are not easy to grasp the force, 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, their own strength and skill are not up to the mark.

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

Soon after, the skull was dissected and the underlying dura mater was exposed in the surgical field.

"In the first step, the strip skull is removed halfway and the soft tissues are removed. Zhou Yuandao.

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

It can be clearly seen that the brains of the two 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 was relatively easy, but because it was intracranial, it required extremely delicate manipulation, and if other structures were accidentally touched, it was likely to cause irreparable trauma.

After a long time, Zhou Yuan breathed a sigh of relief, put the tissue scissors on the table, and said, "The soft tissue is complete." "

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

Now it's time for the separation of the cerebral hemispheres.

This is the longest step in the operation, and although the brains of the conjoined children are not connected, it still takes five or six hours to separate one hemisphere.

Zhou Yuan put on his eyes and carefully separated them.

All of them held their breath.

At this time, no one dared to disturb Zhou Yuan, once the strength was slightly greater, the fragile brain tissue could be damaged, and the brain damage was almost irreversible.

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

"Dr. Zhou, there is too much blood loss!"

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

"Quick!!" said the chief of thoracic surgery, hurriedly.

"No, don't have a blood transfusion yet!" Zhou Yuan stopped him.

"Why?!"

At this moment, everyone was stunned.

If you lose too much blood and don't have a blood transfusion, what does Zhou Yuan want to do?!_

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