Zhang Mengjing's intracranial cholesteatoma was huge, surrounding the trigeminal nerve, facial nerve, auditory nerve, and glossopharyngeal nerve, as well as the brainstem, oculomotor nerve, trochlear nerve, abducens nerve, vagus nerve, and the basilar artery and its branches on the cerebellum. Important structures such as arteries and posterior cerebral arteries.
Although this kind of intracranial cholesteatoma is a slow-growing benign tumor, it is called a "tumor" because it is as erosive and destructive as a malignant tumor.
The location where it grows is too important. Under the stimulation of inflammation, it will continue to expand, compress and invade surrounding tissue structures. It can drill into bone seams, gnaw at bones, and destroy human brain structures. Although drug treatment can temporarily relieve the pain, Painful, but treating the symptoms rather than the root cause.
If left unchecked and the surgery is not performed as soon as possible, if it is delayed for a long time, it will cause very serious consequences and even be life-threatening.
When all the preoperative preparations were in place, Zhou Qiao took Elena, Ava, Murphy, Zhang Mengjing, and Zhang Jianjun to the University of California, San Francisco Medical Center.
In the clinic, Rachel was the only one left.
There is a child in the ward who has not been discharged yet, so please take care of her.
As for the safety of the clinic, there are always people at the nearby laundromat, and Ariel and the others are keeping a close eye on it, so they don’t have to worry about anyone coming to make trouble.
Zhou Qiao and the others were in a car, while Zhang Jianjun drove his own car and followed closely behind with his daughter.
Although I have taken painkillers, I may have taken them for too long and developed drug resistance, so the drugs are not very effective. Zhang Mengjing still feels unbearable pain from time to time.
In addition, these drugs have side effects. Taking them for a long time can cause serious adverse reactions such as dizziness, drowsiness, gastrointestinal discomfort, allergies, and even liver and kidney damage.
When they arrived at the University of California Medical Center, a woman in the surgery office made an unkind invitation to Zhou Qiao.
"Good afternoon, Dr. Zhou. There is something we need to ask for your opinion and the patient's opinion."
"Oh? What's the matter? Please tell me!" Zhou Qiao nodded.
The blond lady said: "That's right, many doctors in our hospital are very interested in your surgery, including some well-known experts, such as Dr. David Claudeford from the Department of Hepatobiliary and Pancreatic Surgery, and Aaron from the Neurosurgery Department. Dr. Na McLoughlin and others hope to observe this operation in the monitoring room!"
"Ah?" Zhou Qiao was stunned. He didn't know that his coming over for surgery would actually attract so many people's attention?
He thought that not many people knew about it, that is, he brought Ava and others over to fight for about an afternoon!
Judging from the other party's tone, it seemed as if the entire hospital knew! Even doctors who are not neurosurgeons are here!
Zhang Jianjun and Zhang Mengjing also widened their eyes when they heard this.
Zhang Mengjing was beating the drum in her heart, saying that actually I don’t want too many people to watch. She had only been in the United States for a few days, and she still didn't understand the language. She was full of strangeness and fear towards the foreign Japanese and the surrounding environment.
Zhang Jianjun, on the other hand, felt more at ease and a little excited.
Although he trusted Zhou Qiao's medical skills, with more doctors and experts coming to observe, the surgery itself should be more secure. He didn't believe that if something happened, these experts would just sit back and watch.
In addition, the doctors and experts at the University of California Medical Center usually charge quite high prices, but now they come here for free to "participate", so you are making money!
Zhou Qiao looked at Zhang Jianjun and Zhang Mengjing, meaning to ask for their opinions.
Before Zhang Mengjing could say anything, Zhang Jianjun nodded repeatedly and said, "I have no problem."
Zhang Mengjing had no choice but to shut up. I thought to myself, forget it, I "fell asleep" during the operation anyway, so I didn't feel any embarrassment.
When Zhou Qiao explained the surgery to her, he said that general anesthesia was used, and the rest of the body, including the face, was basically covered. Only a small area of the head will be exposed.
In that small area, Elena helped her prepare the skin before setting off at the Iris Clinic. The hair in that small area was shaved off, and it was very ugly, so she knew where the surgery would be, and she even wore a nice hat when she came over.
Zhou Qiao said to the staff: "I have no objection. Colleagues from the University of California Medical Center are welcome to watch this operation. If there is a chance after the operation, I would also like to communicate with the experts from your hospital and share what happened during the operation." Experience.”
With his perfect skills, he is naturally full of confidence.
If it were an ordinary doctor, I heard that so many people were watching, he would probably have stage fright. However, anyone who has the courage to undergo this kind of surgery has real abilities and is unlikely to suffer from stage fright.
The staff member smiled slightly and said, "Then I wish you a smooth operation. I will communicate with the experts regarding exchanges and discussions."
"Thanks."
Zhou Qiao actually wanted to integrate into his colleagues in the United States. After all, he opened a clinic in San Francisco and was affiliated with the University of California Medical Center, so he would have to deal with them frequently in the future.
Soon, senior anesthesiologist Rebecca LaRocque came with her team and met Zhou Qiao to discuss the anesthesia process.
Zhang Mengjing was pushed into the anesthesia room.
Zhang Jianjun waited anxiously in the rest area outside. His wife's visa was not approved so quickly, so she had to rely on him alone to support her during this period!
He felt a lot of pressure, so he sent a message to his wife. He originally thought that his wife had gone to bed because it was late at night in China. But unexpectedly, my wife responded instantly!
"Brother Jun, I can't sleep either. Has the operation started?"
"Yes! But I'm waiting outside. It seems that you can also go to the monitoring room. Many experts from the University of California Medical Center have gone to watch, but I don't dare to go."
"Why don't you dare?"
"It's too bloody. It's my daughter again. I dare not look directly at it." Zhang Jianjun pondered for a while and then sent another message, "If you want to watch it, I can enter the monitoring room and open the video for you."
"It still doesn't work, and I don't dare! I hope the operation can be successful!"
"Yeah, if you can sleep, go to bed early!"
"I can't sleep, this is destined to be a sleepless night! I just went out to use the bathroom, and her grandparents were also chatting in the room and didn't fall asleep."
Zhang Jianjun: "..."
He took a deep breath and looked around, seeing people coming and going. Not far away, there were also people with sad faces. Perhaps, like him, they were waiting for the good news that their family members' surgery was successful!
"I hope Dr. Zhou can be more helpful!" Zhang Jianjun prayed secretly.
Zhou Qiao led Elena, Ava, and Murphy to change shoes, clothes, brush hands, disinfect... After a series of procedures, they entered the neurosurgery operating room with many advanced equipment.
The operating rooms here are more advanced and in better condition than those in community hospitals, and the usage costs are naturally higher!
When entering, Ava secretly asked Zhou Qiao: "What song will be played later?"
Because she also felt that today's surgery was very difficult, and her sister and Murphy had not spoken much. Zhou Qiao must have been under a lot of pressure, so she wanted to play some music that Zhou Qiao would really like.
Judging from the feedback afterwards, Zhou Qiao didn't seem to like the Chinese songs she played before.
In fact, Zhou Qiao liked it, but he just felt that it was not suitable for surgery.
But Zhou Qiao thought about it and said, "It's up to you. However, today's operation will take a long time. In addition to Chinese songs, you can add some English songs, French songs, or soothing pure music."
Ava nodded: "Okay!"
She thought that the volume could be as low as possible and adjusted to a more comfortable level.
In fact, Zhou Qiao is also an extremely serious and focused person. Once he starts an operation, he can completely ignore it and use any music as the background.
For the previous ones, it was because he was not the chief surgeon, but only worked as an assistant for Murphy, so he had time to pay attention to the music.
A four- to five-hour operation would be too dull and depressing if there was no music and the entire process was silent.
As for diapers, Zhou Qiao and the others don't wear them. After all, the estimate is only four or five hours.
The patient must eat and drink before the operation, but why don't the doctors and nurses not eat and drink before the operation and go to the bathroom before the operation?
In addition, once you enter a highly stressful surgical state, your thirst, hunger, need to go to the toilet, etc. will disappear.
This is because there is a hormone called adrenaline in the human body. When the human body encounters a stressful event, adrenaline will be secreted in large amounts!
Stress can be understood as a response to stimuli, such as feeling high-intensity pressure, being very excited, being very tired, being highly alert and focused, engaging in high-intensity exercise, or experiencing trauma, etc.
Adrenaline was developed by humans during the long process of evolution. Our primitive ancestors would secrete large amounts of adrenaline when chasing prey or escaping from predators.
This hormone can expand the human body's skeletal muscle blood vessels to supply energy and oxygen to the muscles. When the blood demand is greater, the cardiac output will increase, and the heart's workload will increase. Then the coronary arteries will expand, increasing the blood supply to the heart.
At the same time, because a large amount of oxygen is required and a large amount of breathing is required, this hormone can also relax the bronchial smooth muscle.
Then, when chasing or escaping, you can't just take two steps and stop to pee, right? So this hormone can also constrict blood vessels in the kidneys.
The blood flow to the kidneys is reduced, and the urine output will naturally be reduced!
On the other hand, the temperature in the operating room is not as comfortable as we imagined. The doctor wears thick surgical clothes, hats, masks, gloves... and does not feel very cool. Coupled with the high mental stress, the body A large amount of sweat is discharged, water is excreted from the body through sweat, and urine is naturally reduced.
Ava is not only a traveling nurse, but also has a part-time job, which is to wipe Zhou Qiao's sweat.
In addition, the conditions of the current operating rooms are very good, and they have attached bathrooms. If there is a need, you can also ask the assistant to temporarily take care of it while the surgeon takes care of it first. That's just two or three minutes.
Of course, when conditions were poor in the past, some doctors also wore diapers.
Like Zhou Qiao, her kidney function is strong and her ability to hold in her urine is also strong. She basically doesn’t need to go to the toilet for four to five hours.
General anesthesia and tracheal intubation were used for anesthesia.
After the anesthesia is completed, the routine time out, which when translated, can be understood as three checks and nine pairs, and then, with the ethereal and smart song "Yun Gong Xun Yin", the operation officially begins!
Zhou Qiao was also slightly stunned. He didn't expect that Ava would play this song, which gave him a lot of surprises.
This piece of music is truly a classic among classics. It is full of fairy energy. Zhou Qiao hopes that in this difficult surgery, he can also display his "fairy energy" to a superb level.
At the same time, the monitoring room next door was crowded with people!
Most of them are neurosurgery doctors, but there are also some interested doctors from other departments, and there are some who just come to join in the fun.
After seeing Zhou Qiao's operation, some doctors began to comment: "Is this the suboccipital retrosigmoid sinus approach? This approach requires very familiarity with anatomical relationships. The advantage is that it causes less trauma to the brain structure, but exposes The scope is relatively small, and the technical requirements for the surgeon are relatively high!”
"I have seen the patient's X-ray, and the tumor is not small, with a diameter of 3 centimeters. If it were me, I would choose the temporo-occipital transtentorial approach with a larger surgical field."
"Just looking at this approach operation, Dr. Zhou's movements are smooth and he has the style of a master. How did he learn such exquisite surgical skills at such a young age and not long after graduation?"
"I've heard that China's clinical and surgical standards are very high, but it's not like a young guy can be so good, right?"
Some people came to watch. In fact, they were unconvinced. They felt that Zhou Qiao should not receive such attention and should not undergo such a difficult operation. However, after seeing Zhou Qiao's first few steps, these people felt Something bad happened.
It turns out that they are really good at it!
As soon as an expert takes action, he will know if there is one! Everyone here is an elite graduate from a prestigious school! The worst ones are senior attending doctors with more than six years of experience!
The ones with the highest qualifications and reputation are Dr. David Crawford and Dr. Alonna McLoughlin, both of whom have more than thirty years of work experience.
In particular, Dr. Alonna McLoughlin is the backbone of the Department of Neurosurgery at the University of California, San Francisco Medical Center. She has very profound attainments in the fields of neurosurgery and internal medicine.
Dr. Alonna McLoughlin, like Dr. David Crowderford, drank coffee, watched silently, and would not comment easily.
However, they looked at each other and nodded slightly, obviously approving of Zhou Qiao's "starting gesture".
In the operating room, Zhou Qiao is orderly.
He used neuroendoscopy, minimally invasive microscopy technology, combined with cranial nerve electrophysiological monitoring equipment.
3*3cm bone window, cut the brain cistern...
Release cerebrospinal fluid, reduce brain volume, and reduce intracranial pressure...
Cut through the thickened dura mater at the skull base...
Without fixed traction, the tumor is exposed...
Neuroendoscope has a "fisheye effect" and can obtain a "huge" field of view and deep three-dimensional vision in a small space.
On the huge electronic display next to the operating table, the corresponding field of view is displayed as Zhou Qiao operates.
Since there are many cameras in the operating room, both far and near, and there are eight or nine monitoring screens in the monitoring room, the doctors and experts observing can clearly see every detail of Zhou Qiao's operation.
At the same time, the recording in the background is also going on simultaneously.
Zhou Qiao quickly detected the tumor tissue, and a very beautiful "pearl" suddenly appeared on the screen!
This pearl was about 3 centimeters in diameter, pink and smooth, and there was an uproar in the monitoring room!
A female doctor exclaimed in surprise: "God, is this cholesteatoma? Why is it so beautiful?"
Another doctor said: "Yes, it is much more beautiful than the cases I have seen before!"
"Oh my God, Goddess, what a blessing it would be if this wasn't a tumor!"
"I've never seen that!"
"Could this little Chinese girl be God's illegitimate daughter? She was the result of divine power, but her potential has not yet been developed?"
"Haha, it's possible! But don't joke about medical stuff. We are watching a surgery now, not a fantasy movie!"
Even Dr. Alonna McLoughlin's eyes lit up and she couldn't help but explain: "Generally speaking, it's not so beautiful. This is a special case!"
In the operating room, Ava and Elena couldn't help but exclaimed!
"Wow~, tumors can be so beautiful!"
"Pearl clams can't produce such beautiful pearls!"
"Can it be dug out and made into jewelry?"
Murphy had always been expressionless, but at this time he couldn't help but be surprised again and again, his blue eyes flashing with color.
Even Zhou Qiao felt "a big impact"!
His skills were systematically taught. This was the first neuroendoscopic minimally invasive intracranial cholesteatoma resection in my life, and it was naturally something I had never seen before.
"Making jewelry? Obviously not! It just looks as beautiful as a pearl, but it is not a pearl!" Zhou Qiao thought to himself, if this is a pearl, it is at least an ancient imperial tribute.
He suddenly remembered an ancient passage he read in the university library: "There are sharks in the South China Sea. They live in the water like fish. They do not waste time weaving, and their eyes can weep."
I can’t remember the exact origin. It means that there is a kind of shark in the South China Sea. It lives like a fish in the water and never gives up the work of weaving. When it cries, it can weep pearls!
If Zhang Mengjing were to cry, of course, she would definitely not be able to cry out the tumor!
After careful examination, it can be found that the tumor completely surrounds the trigeminal nerve, facial nerve, auditory nerve and glossopharyngeal nerve, which is basically consistent with the film taken during the preoperative examination. The tumor has rich blood supply and is tough.
There are a large number of other nerves, blood vessels, and brain stems in the periphery. During the process of shunt exposure and tumor resection, once damaged, it goes without saying that the consequences will be serious.
(End of chapter)
