Start with the emergency physician

Seeing that Wei Lili’s face was a little bad, Zhou Yuan’s expression also became solemn, and he looked at the inspection results.

MRI images showed that the brain tissue of the two children did not fuse and share, in other words, as long as the separation was appropriate, then the two children could develop like normal children.

This is a better situation, some unions even share brains, which cannot be separated at all, and some have double brains but some brains are incomplete, if you want to separate, only one person can preserve a more complete brain, and the other is a defective brain.

Fortunately, it is not the latter, otherwise, this choice would be too cruel for parents.

There is nothing wrong with MRI imaging, which is good news, but another cerebral angiography is not so optimistic.

It can be seen that the arteriovenous vessels of the brain of the combined child have cross-blood supply, and although some blood vessels are each owned, they are glued together to become double-chambered parallel blood vessels.

Some blood vessels may even have cavity fusion.

In other words, once separated, the parallel bonding blood vessels will split, potentially causing the blood vessels to rupture.

Obviously, the two results indicated that the pair of consortia is a conjugated malformation with high separation difficulty.

“Is the 3D printed model out?” Zhou Yuan asked.

He needs to determine the superior sagittal sinus in the brain of the combined child.

Once the superior sagittal sinus fusion occurs, the separation of the conjugated organisms becomes more difficult.

“It’s been scanned, and it’s still printing.” He Jingdao.

Zhou Yuan nodded, looked at the sleeping union in the ward, and asked, “How are the physical conditions of the two of them now?” ”

Wei Lili said: “Don’t worry, neonatal ICU students, specialist nurses, etc., are taking care of them carefully, paying close attention to the physical changes of the two of them, and there will be no problems.” ”

He Jing said: “We are also gradually improving the patient’s preoperative preparations. ”

Zhou Yuan breathed a sigh of relief, nodded, and looked at Xiao Xuebo, the director of brain surgery who was staring at the MRI image next to him: “Director Xiao, what do you think?” ”

Xiao Xuebo touched his chin, his brows furrowed, and asked rhetorically: “What do you think?” ”

“Soon after the birth of the combined children, although the phenomenon of blood vessels crossing, their respective brains are preserved intact and can be separated. The sooner the separation surgery is done, the better it will be for the two of them, and if it is delayed, their brains may grow together, and it will be almost impossible to separate again. ”

If the brain is really glued together, the knife may damage the functional area of the brain and bring lifelong trauma, and then you can only do it if you want to separate.

Zhou Yuan continued: “Take advantage of the fact that it is not yet growing together, and carry out separation surgery as soon as possible. ”

Xiao Xuebo nodded: “I also think it should be as soon as possible!” ”

Zhou Yuan: …

The patient’s father looked at Zhou Yuan with some uncertainty: “Yes… You do it? ”

“We have a whole team involved.” Zhou Yuan told the truth.

“You also participate in surgery at such a young age?!” The patient’s father glared, not very relieved.

“I’m the main knife.”

There is no way to hide this kind of thing, nor can it be hidden.

The patient’s parents’ eyes widened immediately.

“I don’t think you’re a great doctor! Just graduated from school, right? You come to the main knife, is our child still saved?! “The patient’s father was a little angry.

He felt that the hospital was perfunctory to him.

Zhou Yuan patiently explained: “We have a whole team, and when the time comes, neurosurgery, plastic surgery, brain surgery and other doctors will be involved, as well as many directors. ”

“We will choose the most suitable surgical method for your child, and likewise, we will choose the most suitable doctor!” Wei Lili said.

The father wanted to say something, but was held back by his wife.

“I believe in your hospital…” The mother of the joint child glanced at the child in the ward, and her voice gradually became quieter.

“Let’s take a look at the 3D printed model first.” Zhou Yuan said helplessly.

He Jing and Wei Lili stayed for the time being, ready to explain clearly to the patient’s family, and Zhou Yuan, Xiao Xuebo, and Lu Chenxi were ready to make the next step.

In the end, what worried Zhou Yuan the most happened-the 3D printed model clearly showed the fusion and sharing of the sagittal sinus in the consortia.

This is a structure located in the sagittal sinus sulcus at the superior sickle border of the brain and the midline of the intraparietal plate of the skull, belonging to a single dural venous sinus, which contains blood from the meridians of the brain, dural veins, and skull veins, which is particularly important.

At the same time, it also contains cerebrospinal fluid, and there are 10~15 meridians on the brain connected here, once the structure here is damaged, it will cause paralysis and even death.

Therefore, it is very difficult to separate the superior sagittal sinus of the conjugated child.

“Can’t do it.” Xiao Xuebo glanced at it and directly shook his head to admit that his ability was insufficient.

“To do a skull separation, this place will be cut, how to do it?” He sighed and looked at Zhou Yuan.

Zhou Yuan thought for a while and said, “Cut in the middle and back third of the superior sagittal sinus, and then perform repair. ”

“It can be, but the blood vessels are too dense, once you don’t grasp it well…”

“I’ll come.” Zhou Yuan said coldly.

Xiao Xuebo was stunned and nodded.

Soon, doctors from neurosurgery and plastic medicine also arrived.

Together with pediatricians, Wei Lili, He Jing, Lu Chenxi, nurses, anesthesiologists and others, the number of this team reached fifteen.

In just three days, the team held five or six meetings to discuss the specific plans and steps of this operation.

Finally, Zhou Yuan finalized the final surgical plan, which was briefly summarized, including four steps:

First: perform a strip skull resection.

This step involves the removal of part of the skull at the fusion of the conjugated child.

Second: perform soft tissue resection.

It is mainly to place a soft tissue expander under the skin to loosen and expand the fused skin to ensure that the separated head has more skin area, so as to facilitate the suture of the separated skin.

Third: cerebral hemisphere separation.

With the help of computer navigation technology and other technologies, the two brain hemispheres of the conjugated child were separated.

The last and most difficult step: the separation of the shared sagittal sinuses.

It was not only extremely difficult for Zhou Yuan’s team, but also an extremely difficult decision for parents.

Because…… The separation of the shared sagittal sinuses means that treatment is difficult, and only one baby can be selected to divide a little more, one baby to divide a little less, and the one with less will inevitably be stunted.

Zhou Yuan is a doctor and can’t make this decision.

Soon, the parents of the joint children were invited.

Zhou Yuan and the others introduced the entire operation process to them, and finally, Shen Shen asked: “Now, how do you plan to distribute the superior sagittal sinus?” “_

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