Medical conjoined skull malformation is actually quite rare, with an incidence rate of approximately 0.6 per million in newborns.

Also because there are too few cases, there are very few studies on craniocerebral fusion records and treatment guidelines at home and abroad.

The classification is also very rough, only divided into partial fusion and complete fusion.

Partial fusion is simply the connection between the skin, brain and dura mater.

This kind of separation is actually very simple. The brain tissues of the two people develop independently and do not affect each other. They can just saw off the bones.

Later, it will be filled with artificial materials. After it grows, it will be basically the same as ordinary people except that there will be no hair.

But the bad thing is that Siping and Si'an are completely integrated.

Their subdural blood supply and brain tissue are all connected, and the sagittal sinus is shared.

Although the MRI examination showed that the brain tissue of the two people was not fused and shared, the information provided by the cerebral angiography was not optimistic.

The twins' cerebral arteries and veins cross blood supply!

The 3D printed model shows it more clearly - the anatomy of the superior sagittal sinus is merged together!

Clinically, there is no precedent for conjoined conjoined deformity that separates and shares the sagittal sinus...

Gao Denggui sighed and said: "This pair was sent to our hospital not long after they were born.

We formed a medical team of more than 30 people at that time. Brain surgery, plastic surgery, anesthesiology, neuroimaging, neonatal ICU, etc. all participated in the discussion of the surgical plan.

Previously, we had tentatively made preoperative preparations."

Xu Qiu nodded.

Indeed, a lot of work has been done in Jinghai City.

The separation of the skull and brain is by no means a simple cut, and the disease will be cured by medicine.

Like a marathon, it takes a long time and spans a long time. The surgery needs to be carried out in stages and the peeling is completed step by step.

When he was three months old, Jinghai People's Hospital performed a strip craniectomy to remove the fused skulls of the two conjoined babies.

Afterwards, an extracorporeal distraction device was designed and produced based on the 3D printed model.

It was originally expected to take three weeks to stretch the skull at a rate of 2.0mm per day to stimulate the growth of the skull and soft tissue.

As a result, the twins' treatment ended early due to pressure ulcers on their heads just one week later.

This is also the direct reason why it is directly announced that the difficulty of this operation has reached the extreme.

Even if it goes according to plan, it would be extremely difficult to save the lives of the two babies, not to mention - accidents keep happening along the way.

The plan given by the hospital is to give up one and try to keep the other.

However, the real situation is that even the one who survives is very likely to face the risk of blindness, paralysis, or even death on the operating table!

…

Snap.

Finally, Xu Qiu breathed a long sigh of relief after reading this thick pile of information.

The patient's condition was worse than he imagined.

The biggest difficulty in performing cranial separation is that although Siping and Sian each have independent brains, they are both malformed.

The right hemispheres of their brains were squeezed upward and extended, sticking together like tofu cubes that were close together.

also,

According to the growth site, there are a large number of shared arteries and veins, and the anatomical structure of the superior sagittal sinus is completely shared.

To separate, these arteries and veins must be redistributed.

The most critical problem is that there is no way to separate the shared sagittal sinus.

Gao Denggui sighed quietly.

Xu Qiu was only talking about the difficulties in surgical operation.

In addition, there is almost no solution to anesthesia.

Conjoined twins have severe blood supply problems, which will not only lead to abnormal drug effects but also unexpected blood pressure abnormalities.

Blood transfusion, infusion, and drug administration are all uncontrollable. After the medicine enters the body, it is very likely that one side will have high blood pressure and the other side will have low blood pressure, making it difficult to balance the medication.

Any mistake in any detail will cause the already fragile conjoined children to die on the stage.

All in all, this is a dead end.

However, at this moment, Xu Qiu, who had just put down the information, spoke again: "If the sagittal sinus cannot be separated, then it will not be separated."

Gao Denggui nodded: "We think so too. Just give up one and leave the sagittal sinus to the one who has a chance to survive."

Xu Qiu thought to herself: "What I mean is to establish a venous shunt circuit."

Since there is no way to separate,

Then simply build a new intravenous channel and use human power to give the patient hope of living!

Gao Denggui was stunned for a long time before he realized what Xu Qiu was going to do: "You mean...to perform brain separation surgery to save the two babies? This is impossible!"

Establishing a venous circuit?

Even the experts at Tiantan Hospital dare not say they can do this kind of technology!

Besides, so what if it can be done?

This is not a water pipe. Just buy a new one and you can connect it to the water.

The veins in the head are filled with blood all the time, maintaining consciousness and life - how can it be said that reconstruction can be done!

Xu Qiu pulled out the patient's 3D model and angiography results.

In order to avoid name confusion, Xu Qiu marked No. 1 and No. 2 on it.

Then he pointed to one of them and said:

"The high-speed drill enters here and enters the skull to create a new venous circulation for patient No. 1, and some of the separated blood vessels and sagittal sinus are given to patient No. 2, who is more fragile.

As for the new cycle, it was cut from the thigh of Patient No. 1..."

Xu Qiu calmly described her plan.

Gao Denggui was completely impressed.

He didn't know whether Xu Qiu was really capable of doing it, but this idea had already solved the unshareable sagittal sinus problem.

"So, what about anesthesia? How to coordinate the anesthesia between the two?" Gao Denggui asked again.

This is actually something that the anesthesiology department should consider.

Xu Qiu didn't mind. After thinking about it, he gave the answer:

“Use the medicine based on the weak patient No. 2.

The two groups of anesthesiologists performed anesthesia at the same time, lying on their sides with intubation and inhalation to administer drugs, preferably shallow rather than deep.

In addition, two sets of monitoring measures are provided, including invasive detection and real-time dynamic monitoring of hemodynamics.

I will solve the problem of blood vessel separation and circulation crossing as soon as possible to avoid hypovolemic shock caused by blood stealing."

Gao Denggui fell silent.

The other party seemed to have thought about everything a long time ago and was determined to win this brain separation surgery.

but……

Is it really possible?

Could it be that Xu Qiu alone is more professional than the evaluation of the entire Tiantan Hospital expert team?!

When everyone was silent, Tang Yunshu took a deep breath and said, "Director Gao, you may not have seen Xu Qiu's abilities. But if he thinks he can do it, I will choose to believe him."

Gao Denggui looked shocked.

How could this irritable expert who once kicked open the door of the conference room have such a soft attitude towards Xu Qiu?

He couldn't figure it out.

What is it about a twenty-four-year-old doctor that makes so many people praise him so much?

"Okay, if you want to do it, I can take you to communicate with your family, but if something happens, you will be responsible." Gao Denggui thought about it and relaxed.

The conjoined twins are now a hot potato. Taking into account the special status of the patient's ancestors, the province insists on saving the lives of the two babies, but does not consider the medical difficulties at all.

Xu Qiu took the initiative to ask for medical treatment, which allowed the hospital to absolve some of its responsibilities.

On the other side, Xu Qiu didn't have so many ideas.

He constantly simulates the structure and distribution of new venous circulation, perfecting the most critical steps of this surgery.

Master-level cranial venous circuit reconstruction surgery played an unexpected role at this time.

After the meeting, Xu Qiu followed Gao Denggui and contacted the patient's family, who finally agreed to Xu Qiu's surgical plan.

For the family members, they didn’t understand anything about sagittal sinus and vein reconstruction. What made them make this decision was Xu Qiu’s white coat.

The operation was scheduled for the morning of the next day.

After learning that he was going to undergo a craniocerebral separation operation, the entire Jinghai People's Hospital was in a state of excitement.

Many doctors in brain surgery began to regret it.

Just because they refused to attend that academic conference, they also lost the opportunity to observe the surgery.

This is the only case in the world of extremely difficult brain separation surgery for conjoined twins!

Some brain surgery experts in the industry once said that cranial separation surgery is the basis for head transplant surgery - when one day ordinary doctors can also master cranial brain separation surgery, perhaps there will be a basis for the birth of head transplant surgery.

One can imagine how incredibly difficult it is to separate a completely fused brain!

This is also the biggest challenge Xu Qiu has faced since starting his career.
Chapter completed!