This step is to open up the surgical field, enter the posterior fossa, and find the tumor.

However, the surgical field at this time was not clear as the automatic retractor was lifted, and the lower part was still blocked by bony structures!

This means that there will be a large number of blind spots in the field of vision during surgery.

Currently, there are only three choices for surgeons.

1: Remove the blocked bony structures.

But this will extend the operation time by about half an hour.

Important structures such as the bbe vein and the Sylvian vein of the sphenoparietal sinus.

What's more critical is that even if the bony obstruction is removed, there are still blind spots in the visual field in the center slope of the petrous bone, the posterior fossa area, especially the structures below the connection line of the internal auditory canal.

This feeling,

It's like taking the little blue pill at the risk of harming your body,

Work hard and sweat like rain,

In the end, the other party yawned and said, "It's better to use toys."

Thankless...

The second option is, of course, to abandon minimally invasive surgery and go directly to classic craniotomy.

This was rejected early in the consultation.

Using classic craniotomy is almost a dead end.

The last one is to change the minimally invasive approach.

Since the front door is blocked by a structure.

Then go through the back door!

"However, the extra side is the most advantageous surgical approach. If it is temporarily replaced by other places now, the risk will be greater..." Director Lin's pupils trembled slightly, and his brain was running rapidly, trying to find a solution.

This surgery is like walking through a dark minefield.

Everyone analyzed the most likely safe passage, but halfway through they discovered that there was a wall in the dark ahead!

If you rashly change another route at this time, you may detonate the mines under your feet at any time!

Want to give up?

"It can only be regarded as a 'switch operation'." Deputy Director Zhao looked at the stack of bony structures and felt his scalp numb.

Everyone's faces were also very heavy.

It's called switch surgery.

That is, after the operation goes deep into the human body, if it is discovered that the tumor has spread, anatomical structure abnormalities, multiple organ lesions and other serious conditions indicate that the patient cannot withstand further surgery, the operation will be abandoned after evaluation and the operation will be completed directly with flushing and suturing.

As soon as it was turned on and off, the doctor found that there was nothing he could do and could only end it without doing anything.

The anesthesiologist no longer played with his cell phone at this time, raised his head and said: "The area of ​​invalid exposure cannot be larger, otherwise the patient will not be able to get off the stage."

This statement is basically equivalent to a death sentence.

The incision is too large and the damage to the patient is beyond control.

but--

Can you find smaller incisions?

How can it be!

If it is really possible, it will be discussed during the consultation!

Just when the atmosphere was frozen to the extreme, a dull voice suddenly sounded.

"Scalpel."

Everyone's expressions changed at the same time, and they looked around in fear.

I saw Xu Qiu had already picked up the scalpel, and then dropped it without hesitation.

in an instant,

At the transition point between the transverse sinus and the sigmoid sinus, as the scalpel slides dexterously in a snake shape, an "S" shape appears in front of the eyes.

Immediately afterwards, the periosteum was widely pushed open...

The V-shaped flap opens the dural flap...

The incision is milled to lower the bone flap...

4-0 suture pulls the dural patch...

The hemostat is clamped and suspended from the edge of the head...

Gurgling——

As the cerebrospinal fluid is slowly released, a narrow keyhole-like entrance appears in front of you.

Everyone looked hesitant.

What's the use of opening such a small hole?

Still can’t see the field of surgery!

However, when Director Lin looked over, his pupils suddenly shrank, with a look of shock on his face!

"Is this... the door and window effect?!"

Director Lin was shocked.

The door and window effect is also called the cat's eye principle.

A simple understanding is that through a narrow cat-eye door mirror, you can see the outside clearly.

And now - the keyhole opened by Xu Qiu is the cat's eye!

With the tiny incision made in front of my eyes, the surgical field was not dark and narrow as expected, but was actually exceptionally bright!

The neurovascular structures on the ventral side of the cranial fossa are clearly visible inside!

Lin Xie, Academician Chen and others also opened their eyes wide, their expressions full of disbelief.

"Is this Dr. Xu?"

"Oh my gosh, this is so whimsical!"

"You can still save it, Dr. Xu, where is your limit?"

"Have you recorded it? I want to sleep with the video tape in my arms!"

In the operating room, everyone's mood seemed to be on a roller coaster, from the bottom to the top all of a sudden.

"Don't make any noise, Doctor Xu has found the trochlear nerve and is going to incise the tentorium!"

Director Lin suddenly stopped shouting, and the operating room immediately returned to silence.

After a few seconds.

Director Lin's eyelids suddenly jumped violently, and he said belatedly: "So... so strong..."

…

…

The difficulty of this operation is unprecedented.

Even Xu Qiu did not dare to be distracted in the slightest. He stared at the microscope and continued to separate under the microscope.

Drops of sweat broke out on his forehead.

The figure is like a sculpture, only the hand holding the knife is moving and peeling off in small steps.

"Doctor Xu, wipe your sweat."

The circulating nurse moved very gently, taking advantage of the gap between Xu Qiu's head and quickly wiped away the sweat.

Through her gloves, the traveling nurse touched Xu Qiu's face.

She specially put the gauze inside and rubbed Xu Qiu's face with her fingers pretending to be casual.ъìqυgΕtv.℃ǒΜ

She was immediately elated.

It turns out that you will really be happy if you rub it for a while!

On the operating table, Xu Qiu was unknowingly being taken advantage of.

He concentrated on identifying the tumor and the blood vessels surrounding the tumor under the microscope.

Director Lin and others looked heavy and did not dare to express their anger.

The situation is very serious - the tumor is densely covered with blood vessels. The only ones that can be distinguished are the internal carotid artery, the middle cerebral artery, the optic nerve and the ophthalmic artery below.

laugh--

Just when everyone was struggling with how to open the first knife,
To be continued...