Well, how did this little girl do it?
When it comes to the head and neck that everyone was worried about before, the place with the largest gap in the three-dimensional space should be the most challenging part for doctors. I just remember that Xie didn’t seem to have done any pre-bending of the pipe before.
What kind of pre-bending is done? There are no mastoid and subclavian relay points.
The thrilling scene that a large group of people were worried about, only to find out later that it didn't happen.
Lifting and threading forward steadily, the improved loom continued, and the shunt tube passed steadily through the neck.
Dr. Wang's entire expression was like "Ahhhhhh".
"It's really——" Dr. Jin couldn't hold back his words. He couldn't figure it out like everyone else. It was really strange. Looking along the way, the surgeon, Mr. Xie, was very confident about the entire procedure of threading the thread. Since the painful neck could be threaded easily, why was it necessary to open a relay opening under the xiphoid process.
Ask her to say that it is really possible to achieve zero relay port. She had doubts before, but now she completely believes that the surgeon has the ability to perform miracles.
You should ask professionals and teachers about this question.
Don't just ask neurosurgery.
After all, neurosurgery may require consultation with general surgery even on the steps of placing a shunt into the abdomen.
"Is the liver and gallbladder disease coming?" Wei Tianlang looked back.
Logically speaking, Tao Zhijie’s Buddha should come. Tao Zhijie had been staring at him when he was interning in General Foreign Language 2.
"It seems that the extrahepatobiliary surgery is not over yet." someone replied.
Those outside the liver and gallbladder did not come.
People on site can only do their own analysis.
"Is this patient's liver enlarged?"
"I remember that the neurosurgery department put the end of the shunt into the liver."
There were many big guys at the scene, and their speaking skills were not at the technical level that elementary school students are talking about.
It should be mentioned here again that as mentioned before, the end of the peritoneal shunt is to be placed into the abdominal cavity to allow the cerebrospinal fluid to be absorbed. It is actually the peritoneum that absorbs cerebrospinal fluid.
What is the peritoneum? I talked about it during my internship in general surgery and hepatobiliary surgery. Another important point to note in this surgery is that the peritoneum migrates from the pelvic wall to the surface of the organs and forms the meso-omentum and ligaments between the surfaces of the organs. Among them, the greater omentum is a double-layered peritoneum hanging from the greater curvature of the stomach and the proximal duodenum like an apron. It is highly mobile and filled with peritoneal fluid. This is the end of the shunt tube where it is most likely to become trapped. Therefore, the doctor's operation is to keep the end of the shunt tube away from the greater omentum as much as possible.
Where can it be placed to avoid the greater omentum? Perhaps the end of the shunt tube can be placed in the lesser omentum. The lesser omentum is much less mobile than the greater omentum and will not trap the end of the shunt tube by moving it around. The lesser omentum is the hepatogastric ligament and the hepatoduodenal ligament.
For this purpose, some doctors will make a midline or paramedian abdominal incision under the xiphoid process to expose the left lobe of the liver, place the end of the abdominal catheter of the shunt on the septal surface of the liver, and sew the catheter to the round ligament of the liver to prevent it from falling off. This way you won't be trapped by the omentum.
The big guys were talking about whether the surgeon wanted to put the shunt tube in the liver.
This possibility is very low. Because putting it here is usually not the first choice of neurosurgeons. This is because peritoneal absorption is stronger in the upper part of the abdomen than in the lower part. Clinically, patients with abdominal inflammation and postoperative surgery often adopt a semi-recumbent position. This is one of the reasons.
For patients with ventriculoperitoneal shunts, it is not a good thing if the absorption is too strong and the shunt tube overflows.
