The next step is to clean up the brain abscess.

To be specific, it is brain abscess puncture, drainage and cleaning.

This surgery is similar to neuroendoscopic third ventriculostomy. It is also a minimally invasive surgery with very little damage.

This is also the key reason why Xu Qiu dared to carry out multiple combined surgeries on Xiaojie... The damage caused by multiple minimally invasive surgeries is much less than major surgeries. Three-incision vitreous surgery on the eye, subretinal injection, and then

Including third ventriculostomy, brain abscess puncture, drainage and cleaning, the four operations combined are not as big as a bowel resection.

However, in terms of risks, bowel resection ranks at the bottom.

For example, third ventricular floor fistula and brain abscess puncture and drainage, due to the deep location of some lesions, the risk factor is very high, and even the slightest carelessness may lead to death.

But fortunately...Xu Qiu did not use conventional intestinal resection.

…

After a short rest, Xu Qiu began puncture and drainage.

The brand-new brain puncture needle came into use again. Under Xu Qiu's control, it entered the drill hole from shallow to deep.

On the screen, the stereotaxic instrument showed that the puncture needle had reached the abscess.

At this time, Xu Qiu also felt the resistance from the puncture needle.

He increased his strength slightly, and the puncture needle gently penetrated the abscess cavity.

Gurgling——

Pus flows out slowly.

Xu Qiu fixed the brain puncture needle and then used the needle to suction to remove all the pus inside.

Then inject antibiotic saline and rinse repeatedly.

Finally, iodophenyl ester is injected for disinfection.

Throughout the process of puncture and drainage of the abscess cavity, Xu Qiu’s movements were slow and gentle.ωωw..net

After the disinfection was completed, he slightly accelerated the speed of removing the needle, and after the puncture needle was detached, he quickly pressed it gently with cotton wool to prevent the liquid from overflowing.

Continue the operation until all abscess cavities are cleared.

Then the scalp is sutured in sequence.

After taking a few samples, Xu Qiu handed over the suturing task to Director Lin.

He rushed to the bathroom without stopping.

The next step is abdominal bowel resection.

As Xiaojie's fourth surgery, even though it was the same patient, due to different statuses, the gloves were likely to be contaminated, so he needed to repeat hand washing and disinfection.

This period of time also happens to give Xu Qiu some time to rest.

Twenty minutes later, he re-entered the operating room.

At this time, the head surgery had been completed, but Director Lin, Director Ge and others were reluctant to leave. Even the ophthalmologist was still there, and everyone wanted to watch Xu Qiu's surgery.

"Get ready, the next step is laparoscopic colorectal surgery." Xu Qiu stepped into the operating room and ordered while putting on surgical clothes.

The fourth operation was originally a routine intestinal resection.

However, considering that Xiaojie could not tolerate it, Xu Qiu decided to switch to laparoscopic surgery after careful consideration.

The risk of death in combined surgery is very high, and it also poses a great challenge to the anesthetist. The difficulty is not as simple as 112. The risk of performing two surgeries separately or combining two surgeries skyrockets.

Four surgeries, even if the first three were minimally invasive, and a major laparotomy, even Xu Qiu could not guarantee that the patient could get off the operating table safely.

Therefore, he chose to take the difficulties upon himself, giving up the easy routine resection and challenging the difficult and skillful laparoscopic colorectal resection!

…

After putting on the surgical gown, Xu Qiu slowly came to the stage.

The operating table at this time has been replaced, and it is covered with a layer of sterile bean-shaped inflatable bags. After the patient lies on it, his legs are fixed on the Yellowfin footrests, and his arms are fixed on both sides of the body.

This is the standard position for laparoscopic colorectal surgery.

Xu Qiu stood on the right hand side of the patient, close to the ascending colon. There were monitors on both sides, all of which were adjusted by the assistant to a position suitable for Xu Qiu's viewing. The first assistant was on the patient's right shoulder, and the second assistant was on the opposite side.

A deputy director came from the Department of Gastroenterology.

Originally, the first assistant for this operation was Director Xiao, but he was a major abdominal surgeon and was good at all kinds of laparotomy surgeries. He was not very skilled in delicate laparoscopic surgeries, so he had to give up.

So he was replaced by another deputy director Chen from the Department of Gastroenterology who specializes in laparoscopic minimally invasive intervention.

"Improved Hassion method."

Xu Qiu didn't waste time and started the operation directly... The patient was still under anesthesia. The sooner the operation was completed, the smaller the risk and the smaller the patient's damage.

The Hassion method is a classic laparoscopic puncture under direct vision. The process of opening the abdominal wall structure is clearly visible. It can also avoid damage to the abdominal organs, and can achieve layer-by-layer separation and hemostasis. It is used by various laparoscopic techniques.

Surgery is widely used.

But there are also many shortcomings.

For example, if the distance between cannulas is unreasonable, the peritoneum is damaged, the space is small, and instruments are prone to collision and incision infection.

In short, although it can reduce damage to abdominal organs, it damages the peritoneum.

Although hemostasis is well done, the space is small and infection is prone to occur...

The improved Hassion method can overcome these shortcomings.

Moreover, it is also superior in other aspects.

For example, there is no need to make anatomical markings in advance.

The Hassion method requires marking the body surface in advance to find the lumbar triangle or the twelfth rib, which is not a problem for ordinary people. However, for some obese patients, it is difficult to locate it from the body surface, and sometimes it may even damage the pleura and costal nerves.

However, the modified Hassion method is about 1.5cm from the mid-axillary line to the anterior superior iliac spine. The anatomical position is very obvious. There is no need to consider obesity, fat and other issues, and it is easy to identify.

Second, and most importantly - large operating space!

Due to the limited finger detection range of the Hassion method, the distance between each cannula is likely to be insufficient.

As for the second channel, that is, the lens channel, often because the fingers are not long enough, the cannula travels under the skin and between muscles and then reaches the posterior abdominal cavity. The space in the posterior abdominal cavity is too small, and it can easily retreat into the muscles when withdrawing the lens.

However, the modified Hasson method has a large range of cavity expansion. Its operation method is to first complete the entry channel and enter the posterior abdominal cavity vertically, which can avoid passing through the muscles. The posterior abdominal cavity space established is very large, leaving enough space for the operator to operate.

.

If it is an ordinary laparoscopic surgery, such as an exploration or biopsy sample, the Hassion method has a small space, which is not a problem, and Xu Qiu can control it with technology.

But, this time it was a resection of the sigmoid colon!

There is not enough space, it cannot be opened at all, and the resection cannot be completed!

It is precisely because the modified Hassion method does not penetrate the muscles. Another advantage of this method is that it does not cut off the muscles. Unlike the Hassion method, which requires incision of the external oblique muscles and internal abdominal oblique muscles, the improved puncture avoids the muscles, so

There is no need to suture the muscle layer after the operation, and no sleeve incisional hernia will occur!

Gulu...

Seeing Xu Qiu making a vertical incision 1cm below the navel, Deputy Director Chen couldn't help but swallow his saliva.

Although he already knew the advantages of modified puncture before the operation, he still felt like he was in a dream at this moment.

The advantages of this technology are so great that while the industry was still doing the Hassion method, Xu Qiu had already started to do the improved method... There will be another paper to be published in the next issue of "Linhai Doctor"!

——
Chapter completed!