The video continues to play.
Tao Le's hands were light and quick, and he quickly exposed the neck of the extra large aneurysm and the parent artery.
The picture is fixed here, leaving time for experts to think.
Director Le from the Third Hospital of Beijing City thought about it for a while and then said:
"It's too big. Simple clipping cannot be done. The tumor is in the anterior cerebral artery. Is it feasible to block the proximal end of the tumor and perform intracranial blood vessel in situ bypass surgery?"
This seemed to be a very appropriate plan. The experts present all fell into deep thought, but soon Hao Jun shook his head:
"You have forgotten the vascular variation of the anterior cerebral artery in this child." He reminded: "Two A1s merge into one A2, and the parent artery is this common A2."
As soon as this sentence came out, many people reacted immediately.
Isn't that right? The two blood vessels have been merged into one. Do you still need to build a bridge to go in and out by yourself?
"Indeed, because of this vascular mutation, if simple clamping fails, the opportunity to perform intracranial vascular in situ bypass surgery will also be lost." Director Le sighed himself: "This approach will not work."
Director Fang of Haishi No. 1 Hospital also spoke: "In fact, recently, our hospital has tried to use blood flow steering devices to treat giant aneurysms at this location, and achieved good results."
"Oh? I've heard about this. By inserting a dense mesh stent, which is a blood flow guide device, to reshape the local blood flow, aneurysms in the A2 segment of the front of the brain can be treated without craniotomy."
Director Liang from the Third Hospital of Ning City said with a bit of envy: "I didn't expect you to have already started trying."
Tony, who had been silent with his eyes fixed on the big screen, now spoke: "The emergence of blood flow guide devices has indeed changed the concept of aneurysm treatment."
"We have been carrying out this kind of surgery for some time. After the placement of a dense mesh stent, more than 85% of the cases in which the aneurysm was completely occluded within 1 year, the success rate is quite high."
"It's just a pity that this surgery is not suitable for this child." He shrugged regretfully.
"Why?" Director Liang asked immediately.
"It's very simple." Director Fang explained on his behalf: "The child is too young and the blood vessels are still developing, so he is not suitable for implantation of dense mesh - this is only one side of the problem."
"More importantly, this aneurysm is too big. It has formed an obvious mass effect, compressing the brain tissue of the right frontal lobe."
"You must know that the intervention of the blood flow guide device only changes the blood flow direction and causes the occlusion of the tumor itself, which will not cause rupture and bleeding-but it will always exist."
"So I'm very curious." He turned to Hope: "What is the surgical plan you made before?"
As the director of the department, Hou Bo did not participate in the pre-operative discussion, but he had personally reviewed the notice for such a major surgery, so he still had an impression in his mind.
"It's an isolated aneurysm surgery." He admitted bluntly: "It depends on the situation whether to perform side-to-side anterior cerebral artery anastomosis."
"Aneurysm isolation surgery?" Hao Jun said: "Isolate it first, and then use suction to shrink the aneurysm and reduce the compression?"
"Yes," Hope replied.
"With all due respect, this method may not be satisfactory." Tony said: "The huge aneurysms we encountered in the past were not as large as this, and there were also a large number of blood clots in the aneurysm."
And blood clots cannot be removed.
Hou Bo also figured it out: "Suction is of little significance in reducing the size of the aneurysm, and it cannot solve the problem of space-occupying compression."
When Gu Jiale heard this, he immediately interjected: "So the next step should be to follow the established plan step by step, right?"
The implication was clear that there was nothing worth paying attention to.
Indeed, now that the imperfect ending has been known in advance, all the previous amazing expectations have slowly faded away.
The video continues to play, and most people no longer pay all their attention to it as before.
"Mr. Tony." Hao Jun turned his head and said, "If you were to design this surgery, what method would you use?"
"I personally prefer to cut it off directly." Tony said, his eyes still focused on the big screen and did not move away: "But the specifics need to go through the overall design and modeling of the team, and consider various situations before making a plan."
"Resection?" Hao Jun thought about it and felt that it was indeed feasible: "If it is removed, the space-occupying problem will be perfectly solved. The only thing that needs to be considered is whether the vascular compensation function is good after cutting off the parent artery. question."
This time, Tony didn't respond to his words.
He jumped up from his seat and praised loudly: "Well done!"
This sound of admiration drew everyone's attention to the big screen.
It turned out that at some point, the huge aneurysm had left the child's brain and was lying on the tray.
Exclamations suddenly sounded:
"His!"
"Is this - a direct cut?"
"You didn't follow the plan at all! Is it okay to make your own decisions?"
"Oh my god! How could it be so fast!"
Many people are confused. Not only because Tao Le changed the surgical plan, but also because the progress was really too fast.
It has been less than three minutes since the video continued to play. How come such a large tumor has already been cut off?
Playback, must be played back, frame by frame as before - this is the voice of the masses!
When it was played back again, everyone's shortfall was made up.
Only then did they realize that it turned out that the work Tao Le was supposed to do was not the same, it was just that the speed was different times faster than everyone here.
The aneurysm neck was clipped to confirm that it did not cause stenosis of the parent artery and that there was no residual aneurysm.
A 1ML empty needle was used to puncture the aneurysm, and no obvious non-coagulable blood flowed out after withdrawing it - this confirmed Tony's judgment just now, that the large aneurysm was mostly filled with blood clots, that is, thrombi.
These thrombi flow with the blood and are likely to enter the parent artery, causing occlusion of the artery, which is dangerous and abnormal.
In the eyes of everyone in the conference room, it was precisely because of this temptation that Tao Le temporarily changed the surgical method.
Without any hesitation, she identified the main blood supply vessels of the aneurysm with lightning speed and blocked them one by one.
Next, use your hands to cut off the entire aneurysm body and the combined malformed blood vessels from the aneurysm neck.
The whole set of movements is stable and accurate, like flowing clouds and flowing water, clean and neat.
So there was the scene that everyone saw before.
The video did not stop and continued to play downwards. Something unexpected happened again.
(End of chapter)
