Laparotomy and many general surgical surgeries are not clear during examination, but many can be clarified by opening the abdomen.
For example, is it a problem with the appendix or other intestinal problems? If you open your stomach and see with your own eyes, you will understand everything.
After all, the gas and liquid inside the abdominal cavity, like the coiled intestines of a giant python, are layered and can affect the test results.
But it's different outside the brain. For example, if the lower right side becomes necrotic and degenerated, the physical signs often displayed after the onset of the disease are not the physical signs at the lower right side.
It was like the necrosis of the thalamic tract, but the physical symptoms were that the patient was talking nonsense, as if he was possessed by a god.
One moment he said that he was Sun Dasheng, and the next moment he insisted on grabbing his husband and said that he was the Sea Dragon King, and insisted on making him take out the hidden golden hoop!
Another example is that some patients are as quiet as virgins, sitting there as gentle and graceful, and their temperament is so elegant. When they hold a tea cup, they can be called gentlemen.
But once the disease occurs, it will be like taking off a rabbit. The brain is a very fragile organ. Ordinary people may not be able to climb up a three-meter-high wall even with a bench.
But at a critical moment, when the dog pushed its butt and opened its mouth to bite, the two-hundred-pound fat man suddenly jumped up. If he tried it again under normal circumstances, he would not be able to get up even to death.
Just because the brain is a thief, this thing is also very lazy and cannot easily mobilize all the organs to cooperate. Isn't it good to just lie down and be an uncle?
After a brain disease, the brain can no longer control the body, and the body's reserves sometimes burst out.
If a girl gets sick, three big men may not be able to hold her down.
Doctors have no way to determine what is wrong and can only judge based on examination and their own naked eyes, so more advanced equipment is definitely a benefit for diagnosis.
The panting doctor came to the operating room with the examination results and looked at his teacher. Dr. Guo stared at him like a wolf looking at a sheep, as if he wanted to skin him and devour him.
The young man's heart was filled with chills, "This guy is going to vent my anger on me again. I won't wait for you from TN. I'll apply to change the team when I get out!"
I have already begun to plan to change jobs and groups! Since he was no longer afraid, and since he was willing to risk everything, he stood in the operating room regardless and began to observe the operation.
The operation begins with a craniotomy. This craniotomy operation is quite boring to explain in a serious way. Even if you are a doctor, let alone a doctor, your head will be dizzy hearing the awkward terms and the sky-breaking positioning.
Frontal lobe, temporal lobe, pineal gland, inner hard part, outer hard part, arachnoid membrane, movement, smell, sight and sound, almost every noun is coined by foreigners, and then translated into Chinese, it is just a matter of little tongues. of.
These are the simplest medical terms and jingles. Doctors outside the brain not only want to figure out the tissues in the brain that have been forcibly named by others.
We also need to understand the muscles and levels outside the brain.
To put it simply, for example, if there is pain near the collarbone, after the ejection organ mutates, which nerve is causing the pain here? Oh, the area around the clavicle is managed by the nerves coming from the fifth cervical branch.
Does it hurt near the bird? Oh, it turns out it’s the nerve that comes from the first lumbar vertebra, so the old saying goes, it’s useless if you have a sore back!
As for extracerebral surgery, it is also quite cruel. This thing is exactly the opposite of general surgery.
Before the surgery, the doctors were like Chinese nobles pretending to eat Western food.
First, wash your belly clean. Not only do you wash it clean, but you also need to apply some butter (iodine, alcohol) and prepare a knife and fork. It feels quite high-end.
Once it enters the abdomen, its true nature is clearly revealed. Taking the knife and fork, it goes towards the fat intestines, cecum and appendix, and the taste must be strong, otherwise it will not show its hobby.
But it's different outside the brain. Before the brain surgery is performed, it's the same as that of the nouveau riche.
First, shave your head until it glows blue. No matter you have black hair or a thick heart, we will shave it for you.
Then get an iron frame to fix it for you. What does this thing look like? Those who have seen some disgusting videos probably know that it is exactly the same as the nouveau riche eating monkey brains.
Just like the iron frame for building a building, first fix the head tightly, how to fix it?
In fact, it is a fixed bracket, which is used to fix the brain. This thing is actually three brackets, and each bracket has a short nail, and the rotating nut is directly nailed to the skull for fixation.
It is equivalent to three nails nailing the head to the cross.
Then draw a circle with gentian violet where the hole is to be made.
Then, hammers, pneumatic drills, bone chisels, and bone knives began roughly like orthopedic carpenters.
First, use a knife to peel off your scalp. It will look clean even with the hair and skin, just like a pig's head that has lost its hair and is full of bones.
Then, the pneumatic drill opened the eyes in the skull, squeak! Squeak! At the edge of the circle, start drilling holes along the line.
It can be made into a round shape, a fan shape, or a heart-shaped shape, just like some people's hairstyles.
Bone meal is flying everywhere! The fat and blood in the bones evaporated instantly, giving off the fishy smell of barbecued meat.
Sometimes, when the skull is opened, I don’t know whether it’s because the doctor’s skills are not good, or because the skull looks like the top of luncheon meat, and the quality is not up to standard.
Opening your eyes is like making a pull-tab, but the pull-tab finally breaks and falls apart! The lid didn't pry open and the tab broke!
That can only be used more roughly, rongeurs come on.
This thing treats the skull like nail clippers cutting nails. Only after biting off all the bones bit by bit can the brain inside be revealed.
How do you put it in a normal brain? It's actually like a fat meatball. It's really like a big pile of blood-streaked fat meatballs, rolling slowly in a simmering pot.
This thing is inside the skull, slowly twitching, and like contracting, like an alien brood in some alien movie.
Open the brain, and the normal brain is like a young girl who has not yet left the palace. She will be shy when meeting strange men, and her movements will slow down, as if she wants to hide.
And this kind of brain that mutated due to (a) drug inhalation is like Erha letting out the door. He can't hold it back. When he opens the skull and sees the brain.
This thing is not only squirming excitedly, but also seems to be squirming in and out, like an exploding pellet, constantly shouting: Come on, come on, let’s see if I don’t hit you.
It's really just a big fat piece of flying meat, as if there are countless parasites squirming inside.
Zhang Fan led Xue Xiaoqiao to enter the skull very neatly. After all, Zhang Fan was also an orthopedic surgeon. It was very easy to do this kind of bone opening, which was very clean and easy.
Lao Li was using a suction device to inhale the green smoke from the electric drill as if he were making soy sauce.
Lao Guo had not yet recovered from his embarrassment. One moment he watched the head nurse gnash his teeth, and the other moment he watched his subordinate doctor gnash his teeth.
I guess I fantasized about being the dean and doing what the head nurse did, and becoming the director and doing what the doctor did, and I was still stuck in the endless feeling.
The young doctor who was determined to change teams looked at him without blinking. He didn't know anything else, but one thing he was sure of was that a doctor who could perform surgery in a tertiary hospital in the provincial capital must be very skilled.
"Turn the fixation bracket!" After entering the skull, Zhang Fan looked at the squirming brain and said softly to the circulating nurse.
The circulating nurse carefully turned the angle.
"Okay! Zhang Yuan, how about this angle?" Xue Xiaoqiao kept directing the traveling nurse from the side to fix it.
"Okay!" Zhang Fan looked at it and nodded.
"Adjust the shadowless lamp!" After setting the position, Xue Xiaoqiao was busy instructing the nurse to set the lamp.
After everything is ready, it is considered that the skull has been inserted at this time, and all the rough instruments have been used at this time.
At this step, the elegant, delicate and precise side of the brain surgery doctor comes out.
Equipment, such as a suction device, a conventional suction device is actually a large straw, just like a thick straw for drinking bubble milk tea.
You put your mouth on the other end of the straw and suck hard, and you can suck out any feces or blood clots in the abdominal cavity. Sometimes if you are not careful, you can also suck in the intestinal wall.
But the suction device outside the brain doesn't work. It's not straight, but looks like the picture in the Brazilian anti-smoking advertisement that scares men.
The suction device hangs down and is at right angles, and the suction mouth is quite thin. If the ordinary external suction device is a straw for drinking pearl milk tea, then the external suction device is the straw for drinking the wife's oral liquid.
The width units of all instruments, tweezers and pliers are in millimeters, which are quite fine. Moreover, although these instruments may look narrow, their hardness is unimaginable. It is estimated that the materials used for these devices outside the brain are more difficult to manufacture than other ordinary instruments. higher.
Holding the Rhoton gun, which was more than ten centimeters long, Zhang Fan began to prepare to attack the lesion.
This thing is like a long needle, long and thin. The 0.5mm needle has cross-shaped serrations on it. This is to prevent the too thin needle from causing cutting stress on the organs.
"Electrical stimulation, wake up the patient!" After getting ready, Zhang Fan began to give orders to the anesthesiologist.
"Okay, Zhang Yuan, wake him up immediately!" The anesthesiologist immediately turned on the switch of the electrode attached to the patient's body.
Extracerebral surgery is a weird thing. Are many of the organs that need to be removed the functional areas of the patient's brain?
Sometimes it's really hard to tell what to do. I can only try it bit by bit under semi-anesthesia.
A 6mA current passed through the patient's body. The girl convulsed for a while and did not wake up.
"Uh!" The anesthetist was embarrassed. This electric current would definitely make ordinary people's eyes widen, but this girl just twitched her buttocks!
"Uh!" Zhang Fan was also embarrassed. He had the needle ready, but he didn't wake up.
"Increase the current?" Zhang Fan asked uncertainly.
In the past, most anesthesiologists were actually surgeons who worked part-time. Later, as the disciplines became more and more refined, such as brain surgery, it would be impossible for a non-professional anesthesiologist to administer medication.
Therefore, Zhang Fan had no problem with conventional anesthesia, but with this high-level anesthesia, Zhang Fan was a little unsure.
"Zhang Yuan, no, if the current is increased, it will cause abnormal heart rhythm!"
The anesthesiologist said awkwardly that he also had a doctorate after all, and he had never seen such a patient before.
"Where's the short-acting barbiturate hydrochloride for stimulation?" There was no other way but to take medicine.
Compared with electric current, drugs have a depletion period and drug resistance, and are not as stable as electric current.
Therefore, conventional surgeries generally use electric current stimulation instead of drug stimulation, which is no solution.
A little bit of medicine was dripped into the girl's lesion. The girl's stimulation became more and more severe, and then she woke up after twitching.
"Start!" Zhang Fan said quickly when he saw the patient opened his eyes, and then said to Xue Xiaoqiao: "Start the conversation!"
Surgery to remove brain lesions is so troublesome. Sometimes, the doctor actually makes the decision while testing.
Dialogue, what to do.
First, determine whether she can speak, second, determine whether she can think clearly, and third, whether she can move.
For example, what is your name, and the other party answered correctly, which shows that the stimulation area is not related to thinking and language. If you ask the other party, what is your name, she will say: I eat hot dry noodles.
If it is broken, this area cannot be cut, and everything will be cut into pieces!
Also, for example, come and move my eyes and fingers, but I kept talking for a long time with my eyes wide open.
While Zhang Fan was stimulating, he asked Xue Xiaoqiao to talk, "What's your name!"
"Give me a bite! Quick, give me a bite!"
"Uh!" Xue Xiaoqiao looked at Zhang Fan helplessly.
Zhang Fan glanced at Xue Xiaoqiao, his meaning was obvious, please find a way to ask me.
This kind of illness is really difficult!
Xue Xiaoqiao rolled his eyes, just like Brother Yixiu, they were bright!
"Okay, let me take a sip. Not only will I give you a sip, but I will also give you some pethidine. Did you see it? There is pethidine in this syringe, and there is also estazolam. Do you want to take it? Be obedient. What am I asking? Whatever you say, I’ll give it to you!”
"Okay, okay, okay!" The bone nail was staring at her head, and the girl who couldn't move was drooling, really, it was dripping down. Just like a clear nose with a cold, it pulls at the thread and keeps pulling at it.
Zhang Fan and Xue Xiaoqiao glanced at each other. Zhang Fan blinked, meaning: Ask a general question. How can a doctor from the Provincial Central Hospital write a medical record with your question?
Could it be written: Experts use drugs to seduce patients?
"May I have your name?"
"xxx"
"do you have a boyfriend?"
Zhang Fan immediately glared at Xue Xiaoqiao.
In fact, this kind of private question can only be asked in the obstetrics and gynecology department. Generally, other departments will also ask whether they are married.
Xue Xiaoqiao curled his lips and said to himself: "What do you want me to ask? Apart from these questions, what else can such a person ask? Should he ask about the history and geography of China?"
"Yes, both boyfriends and girlfriends. We sometimes..."
"Ask someone else!" Zhang Fan glared at Xue Xiaoqiao. He didn't expect that Xue Xiaoqiao was in trouble now!
"Um, where did you go to kindergarten?"
As he probed step by step, Zhang Fan stabbed the opponent's brain with a spear, and then cut it bit by bit.
At this time, the young doctor in charge of the surgery noticed it.
"This expert's level is very high!" Not only was Zhang Fan's surgery performed in an orderly manner, but he could also determine the patient's brain function. To be honest, they could only see this when they invited experts from the capital.
Although he couldn't tell how high-end it was, he knew that Zhang Yuan was very high-end.
Then, he rolled his eyes and turned around and left the operating room, without even looking at Lao Guo when he left.
"Teacher Wang! If you are not busy, come to the operating room and have a look!"
"What's wrong? The patient is dying?" Another deputy chief physician was also paying attention to the operation.
"No, no, Zhang Yuan's level feels very good, but I can't tell how good he is. I think you can, so I'll call you as soon as possible."
"Good boy, I'm interested. I'll be right away." After hanging up the phone, Dr. Wang hurriedly ran to the operating room.
There are several brain surgeries in the hospital, and there are many deputy directors and informants in the departments.
The news spread from the operating room, and then the phone calls came in one after another.
"Xiao Li, how did the operation go?" This is the deputy director of the department.
"Director, I was just about to call you. I observed that the operation went very smoothly. The patient did not appear comatose, asphyxiated, or have a heart rate spike. The patient's vital signs have been particularly stable from the beginning to now."
The bed doctor said on the phone.
"Okay, I understand." After hanging up the phone, the deputy director couldn't figure it out, "Orthopedic surgeon? General surgeon? Do they have the same name?"
Although I didn't seem to understand in my heart, I didn't slow down.
The deputy directors entered the surgical observation room one by one, "Turn on the camera!"
"Hiss!" A stream of sounds came out between them, like a toothache sucking air.
"This is amazing."
Immediately afterwards, when the deputy directors entered the operating room one by one, the directors could not sit still.
"How is it? How is the other party?"
"Amazing, no less than the director of the capital."
"Director, I think our department should communicate more with this dean!"
This time, the directors in the office stopped looking for excuses to hold meetings and rushed to the operating room one by one.
Lao Guo's superior, Director Chen of the Second Department of Neurosurgery, who was looking for an excuse to have a meeting, entered the operating room wearing a mask and hand-washing gown.
He glanced at Lao Guo first, and then gently stood opposite Zhang Fan.
"Zhang Yuan, is everything going well?"
Zhang Fan didn't even turn his head. He was never distracted during the operation!
Time, one second, ten seconds, half a minute, Director Chen was embarrassed.
Lao Li was extremely embarrassed. He knew about Zhang Fan's problem, underwent surgery, and refused to recognize his relatives!
"Director Chen, it's okay. Our dean is a bit focused on doing surgery, so don't think too much about it!"
"Haha, it's okay, it's okay, it's the same, so am I. How about, how about, I also go on stage to help?"
Lao Li looked at Zhang Fan, thought for a moment, and said, "Okay, you come and take over from me! I'll take a rest."
The good old man stepped down and was replaced by Old Chen, Director Chen. In the face of technology, to be honest, doctors are actually quite active, especially in tertiary hospitals. In this industry, it's like sailing against the current or retreating if you don't advance.
"Have you finished the meeting, Director Chen?" Xue Xiaoqiao asked jokingly as he was a little annoyed when he saw his director get off the stage.
"Xiao Xue! It's surgery, can't you learn from Zhang Yuan?"
Lao Li feels very warm in his heart, but for young doctors, he not only needs to provide technical help, but also needs to check his character and temperament. This is how the old-school masters behave.
"Oh!" Xue Xiaoqiao still respected Director Li very much.
The operation continues. This kind of operation is shocking, but it is actually simple.
First test to see if it is a functional area or not, then stop the bleeding and tie off the surrounding blood vessels.
Even though the brain is only a small amount, it has a lot of blood supply!
After ligating the blood vessels, the rest is simple.
First, use a spear to jump off the outer membrane, and then pick up a bone scraper. This kind of thing is not the thick and black one used in orthopedics.
This thing is like a silver ear pick, very delicate.
Use a bone scraper to scoop out the lesions bit by bit, just like a child eating strawberry ice cream with white cream, and put it into your mouth.
Looking at Zhang Fan's technique, Director Chen couldn't help feeling envious, "MMP, it's better to be young. This technique is so stable. How do you practice this technique~!"
"Zhang Yuan, haha, your skills are really great. You seem to have a shadow of Director Zhongyong, but it seems different. I also stayed at Zhongyong for a year. I didn't know you were..."
This is preparing to build relationships and get closer.
"Oh, I'm just a little interested in things outside my head, so I usually figure it out on my own!"
The operation went smoothly, and Zhang Fan finally said a word.
"Uh!" Director Chen was sweating. Not only Director Chen was sweating, but also a group of directors and deputy directors in the observation room, one by one, shouting in their hearts: TN is so good at pretending!
Lao Chenxin said, "You might as well not say anything! This is so awesome!"
The original desire to build relationships was gone, and the original desire to learn some skills was gone.
He felt that this young man was too arrogant and proud.
To be honest, he was regarded as a braggart, but who asked him to ask Zhang Fan on the operating table? Zhang Fan on the operating table could answer pretty well!
As for other people's feelings, I'm sorry, I'm undergoing surgery and have no intention of fooling you!
