Start with the emergency physician

The little couple looked at each other, both frozen.

Let parents choose which child has a better chance of development, no matter how they choose, they will both feel guilty in the future when facing another child with developmental delays.

After a long time, the patient’s father raised his head and said, “Doctor, really… Do I have to choose…”

Xiao Xuebo sighed: “We haven’t opened our head yet, so we can’t be sure if the sagittal sinus can be well distributed.” However, according to the previous joint pediatric head separation surgery, once the situation of shared sagittal sinus is encountered, it is one more and one less point. ”

“Doctor, I beg you!”

The patient’s mother knelt down directly and begged.

Xiao Xuebo looked embarrassed and looked at Zhou Yuan with a pleading gaze.

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

Hearing these words, the patient’s parents eased their faces a lot.

“If it really doesn’t work, then ask the doctor to decide!” Give a little more to whomever is the safest! The patient’s father gritted his teeth.

Zhou Yuan nodded, and after reassuring the family, began to prepare for the operation.

An extracorporeal stretching device is placed at the junction of the skull of the consortia, which pulls the skull at a rate of 2.1 mm per day to stimulate the growth of the skull and soft tissue, which can reduce the difficulty of separation.

In addition, the subcutaneous soft tissue expander also needs to be placed in advance to stretch and loosen the skin.

These two processes, the combination will not feel much.

Two weeks later, everything was ready 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 main knife will not come out, but this operation is very difficult, and Zhou Yuan must be present.

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

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

Amnesia, blindness, visual field defects, etc., and even personality changes, reduced IQ, etc., there are many postoperative complications.

Every complication has happened before, and it’s a bloody lesson.

Soon, the patient’s parents signed the surgical consent form, the treatment option selection form, the consent form for the use of special materials, and so on…

In the afternoon of the next day, the physical indicators of the joint child reached the best state, and the nurses pushed into the operating room, and the fifteen-member team including Lian Zhou Yuan was ready.

In the operating room, fifteen people were squeezed into the space that originally had only six people.

Zhou Yuan was in the main surgical position, the neurosurgeon cooperated with the anesthesiologist, and the plastic surgeon waited for the later grinding of the skull and the plastic surgery of the separation of the newborn’s skull.

“Let’s start anesthesia.” Zhou Yuan said.

The anesthesia of the newborn should pay special attention to the dosage, and the anesthesia protocol selected after the final discussion is intravenous and inhalation compound anesthesia.

The use of static and inhalation combined anesthesia can avoid the pain of simple intramuscular injection or venipuncture, and likewise, it can also avoid large doses of anesthetic gas that can cause respiratory depression, dry mouth and nose, and even mental trauma.

“Anesthesia complete.” 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.

“Inventory 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 everyone’s breathing remained.

“Side decubitus position.”

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

After taking the position, Zhou Yuan drew an incision line at the junction of the skulls of the two.

“Prepare for minimally invasive chest surgery.”

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

The two went to the front of the joint child separately, preparing for minimally invasive chest surgery.

Once excessive blood loss occurs during surgery, their side should immediately temporarily 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 in the two conjoined children, and then reported.

“Scalpel.”

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

“Hemostats!”

Zhou Yuan moved quickly and began to stop bleeding immediately after cutting the scalp.

This operation, now the most dangerous is excessive blood loss, can shed less bleeding less.

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

“Electric drill.”

The instrument nurse handed over a medical drill.

Zhou Yuan took it and carefully opened a small opening at the skull.

“Milling cutter.”

It had been discussed that the operation would be done with a manual milling cutter.

Electric milling cutters are not easy to grasp the strength and are not as fine as manual milling cutters.

Of course, this is for Zhou Yuan.

The average person does not use a manual milling cutter, on the one hand, this thing is tired to use, on the other hand, the speed is very slow, of course, the most important point, its own strength and skills are not good.

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 cut and the underlying dura mater was exposed.

“In the first step, the strip skull is removed halfway and the soft tissue is removed.” Zhou Yuandao.

Saying that, 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 is relatively easy, but because it is in the skull, it requires extremely delicate operations, and once it mistakenly touches other structures, it is likely to bring 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 the 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 joint child are not connected, it still takes five or six hours to separate one of the hemispheres.

Zhou Yuan put on his eyes and carefully separated them.

Everyone held their breath.

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

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

“Doctor Zhou, excessive blood loss!”

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

“Quick! Blood transfusion! The director of thoracic surgery said urgently.

“No, don’t get a blood transfusion yet!” Zhou Yuan stopped him.

“Why?!”

At this moment, everyone was stunned.

Excessive blood loss and no blood transfusion, what does Zhou Yuan want to do?! _

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