Zhao Yuan wants to use two brand-new techniques in this operation.
First, nerve fiber dissection.
This technique removes all gliomas in the brain along the nerve fibers.
Normal tumor resection is to remove the tumor in pieces. This method can easily lead to residual tumors. In addition, it can also easily damage the nervous system, causing hemiplegia, coma, or other adverse effects.
It sounds a bit confusing.
In fact, it boils down to the difference between two words, one is cutting and the other is peeling.
The glioma was removed en bloc along the nerve fibers.
It not only removes the tumor to the greatest extent, but also keeps the nerve integrity and function intact.
This technology has been proposed internationally, but it is rarely widely used.
Regina lamented, "Supporters of the Yasargil School have tried this technique before, but the success rate was too low and the operation was too difficult, so it was not accepted by the academic community."
Wang Enlin said, “According to some research results, gliomas will invade and spread along the anatomical structures of white matter nerve fiber conduction bundles in the central nervous system.
By re-synthesizing the white matter fiber tracts, the spatial relationship between the fiber tracts and the tumor can be clearly displayed to clarify the boundaries.
But although there are many auxiliary means now, such as navigation drift, intraoperative MRI, etc., the most important thing to find the boundary of tumor dissection is to rely on the doctor's hands and eyes. "
Professor Cheng agreed, and Wang Enlin’s explanation was more professional.
To put it simply, if you want to perform nerve fiber dissection, the doctor's experience is particularly critical, and the auxiliary system cannot play a role.
Professor Cheng began to break down Zhao Yuan's technical moves.
“Since gliomas grow invasively or expansively, Zhao Yuan first chose to perform partial resection within the tumor to achieve volume reduction, which can protect the surrounding brain tissue to the maximum extent and is not conducive to the subsequent tumor dissection operation.
The tumor is then peeled off along the nerve fibers. Usually, the tumor tissue is gray-white, gray-yellow or gray-red, while the normal brain tissue is lighter in color, white or yellow-white.
Of course, the most important thing is to rely on feeling. When approaching the boundary, the texture of the tumor is often harder and tougher, and as it goes outward, the texture becomes softer. This soft and hard area is the boundary of the tumor. "
If you were a layman, you would probably be confused when faced with Professor Cheng's interpretation.
However, Professor Cheng's explanation in the observation area can play a good guiding role.
The doctors in the observation area are some of the best in the field of neurosurgery in China.
Maybe I was a little confused at first, but after Professor Cheng's analysis and dissection, it gradually became clear.
Unknowingly, Zhao Yuan has entered the most critical part - peeling off the tumor.
Professor Cheng started teaching again: "There are two more difficulties here.
First, the peeling needs to be completed by controlling equipment, which is different from normal people peeling orange peels.
Secondly, the peeling needs to be extremely precise and gentle, just like tearing off a stamp to completely tear off the tumor. If the lesion is accidentally torn, it will be a big problem to find the edge to remove again. Not only is it easy to damage the brain tissue, but it is also easy to cause the residue of the tumor. "
In the operating room, Zhao Yuan was also giving a small class, operating the instruments while sharing the feel with Qin Yi.
"Low-grade gliomas have a very tough texture, while high-grade gliomas have a soft texture in the center of the tumor and a harder and tougher texture on the periphery. It should be noted here that the relatively hard and tough areas around the tumor are also tumors, and tumor tissue migrates along nerve fibers.
Do not mistake it for the gliosis zone causing residual tumor.
Dissection of both high- and low-grade tumors along nerve fibers can effectively avoid tumor residue and nerve damage. "
Qin Yi silently kept it in mind, and followed Zhao Yuan's request by controlling the instrument to touch the periphery of the glioma.
This experience is so valuable.
Any other surgeon would not spare the energy to teach you step by step how to identify the characteristics of different gliomas on such a critical occasion.
Wang Enlin's eyes flashed with strange light.
Judging from the smoothness of the operation, Zhao Yuan's operation has basically achieved its purpose.
At the same time, he demonstrated the advantages of nerve fiber dissection.
During the process of tumor removal, it plays a protective role in nerve function.
There is little bleeding, which can easily occur if the tumor is removed traditionally.
In addition, it helps reduce stress.
The tough outer layer of tumor tissue in malignant tumors supports and binds brain tissue like armor.
Traditional tumor resection generally does not remove this part of the tissue.
But peeling can also be considered “peeling.”
The peripheral sclerotic tumors will be uprooted, which is more conducive to the patient's recovery.
Four hours passed.
Tumor tissue was removed one after another.
The experts in the observation area realized that the operation was basically successful.
“Being able to see such high-level surgery on site makes the trip worthwhile.”
"Zhao Yuan's ability is too strong. Just now, he directly created a new technique. Alas, I feel that the innovation of the technique is as simple as eating for him."
"The main thing is that the basic skills are solid enough. With this confidence, you can challenge the restricted area."
"Hey, it seems like the operation isn't over yet."
"And a new technique?"
Just when everyone thought the operation was coming to an end, Zhao Yuan brought another surprise.
Generally speaking, after tumor removal, the next step is the final finishing touches.
But Zhao Yuan added a completely new element here.
Intraoperative radiotherapy!
It is difficult to completely remove a brain tumor by simple surgery. The remaining cancer cells will be scattered around the lesion, and some are very hidden. Therefore, it is difficult to deeply remove the cancer cells.
Zhao Yuan put the adapter into the brain and then used low-energy X-rays to irradiate brain tumor tissue in the human body in a targeted manner.
The radiation energy produced will not harm the patient's brain, allowing the patient to avoid having to undergo multiple radiotherapy treatments after surgery.
In addition, during intraoperative radiotherapy, through precise target positioning, there will be fewer toxic side effects caused by radiotherapy.
A smile appeared on Wang Enlin's lips.
When locating the target area, Zhao Yuan consulted Wang Enlin.
Because Wang Enlin is a top expert in this field, as for intraoperative radiotherapy, Wang Enlin has also been studying this idea recently.
Seeing yourself reflected in other people's surgeries gives you a strong sense of involvement.
It seems that great achievements also have their own merits.
"It's amazing. One operation combines multiple brand-new techniques. The value is too high."
“After watching this surgery, I don’t feel anything like watching other people’s surgeries.”
"No wonder they are qualified to host the national summit. With this technology, who else is dissatisfied?"
The experts who had performed demonstration surgeries before were secretly thankful that their surgeries had been completed. The experts who would perform demonstration surgeries next would be under great pressure and would inevitably compare with Zhao Yuan's surgeries.
Although they are all well-known celebrities in the country, the innovation of techniques is not as simple as making dumplings.
An operation has so many unique "labels" interspersed with it!
So cool!
It’s so outrageous!
Gu Yong stood in the crowd, and the little hostility he had towards Zhao Yuan completely disappeared.
Gu Yong admired Zhao Yuan from the bottom of his heart.
How can you be bright when you are good? This is the feeling between opponents of the same level.
In front of Zhao Yuan's astonishing talent and outstanding skills, he was completely like a younger brother.
"Please give me a guaranteed ticket, it will be wasted if it expires!"
