Early in the morning, when Tian Lu walked into the ward, Ling Feifei had already gotten up, and Yue Hua and Ling Zuo were already surrounded by the side of the hospital bed with heavy faces.

"Doctor Tian, why are you here?"

Seeing Tian Lu, a hint of surprise flashed on Yue Hua's face. According to Dr. Zhang Jie yesterday, because Ling Feifei is the first operation today, it will start very early, so today the doctors will go directly to the operating room, and Ling Feifei will be sent by the nurse. I didn't expect to see Tianlu so early today.

"Hehe, the road is smoother today, and I arrived at the hospital earlier. ”

Tian Lu smiled gently and said, "So before entering the operating room, I thought about coming over to have a look." How's it going? Did you do everything you told you yesterday?"

In the last sentence, Tian Lu had already turned to Ling Feifei's direction when he said it.

"It did!"

Being able to see Tian Lu before going to the operating room, the tension on the little girl's face suddenly dissipated a lot, but the little hand holding the sheet was still clenched into a ball, and the small mouth was pursed tightly.

"Hehe, that's good. ”

Even though he came early, there was a lot of preparation before the operation, and Tian Lu couldn't stay longer, so he had to smile at Ling Feifei encouragingly, and cheered: "Relax, when you fall asleep, there will be nothing to do." ”

"Hmm!"

Nodding heavily, Ling Feifei's face was not only nervous, but also with a look of perseverance, and her right hand was even clenched into a fist, waving it hard in mid-air, cheering herself up and cheering!

After another encouraging smile, Tian Lu turned to Ling Zuo and Yue Hua and said, "Someone will come to give Fei Fei an injection later, the medicine is lumina and atropine, which are mainly used for sedation and salivation." Oh, just to make him less nervous, and not to drool during the operation, hehe, don't worry. ”

"Thank you, Dr. Tian. ”

Glancing at each other, Ling Zuo opened his mouth and said gratefully. Tian Lu was not Ling Feifei's chief physician, and it stands to reason that these things were not in his charge, so he was a little suspicious at the same time, but he was also quite grateful.

Tian Lu simply showed his face, but the comfort for Ling Feifei and her parents was huge, at least after hearing the words "drooling", Ling Feifei's little face suddenly turned red, and she seemed to be extremely angry, as if if the other party was not a doctor, she would definitely have to argue, and Fang Cai's nervousness was also left behind for a while.

Seeing that he had achieved his goal, Tian Lu encouraged Ling Feifei again and left the ward.

It was not early, Tian Lu did not hesitate anymore, and walked quickly to the operating room.

Changing clothes, brushing hands, and making preoperative preparations, the doctors still have a lot of work to do before going to the operating table, until Ling Feifei was sent to the operating room, Tian Lu and they were just ready.

Next, it was naturally a three-way check, cold, and the nurse and anesthesiologist carefully checked Ling Feifei's information.

Taking advantage of this opportunity, Tian Lu once again walked to Ling Feifei's side.

"Doctor Tian, I'm a little scared!"

Seeing Tian Lu, Ling Feifei said a little timidly.

No matter how brave she was beforehand, when she really entered the operating room, all she saw was cold instruments and equipment, and the doctors and nurses who were tightly wrapped, the little girl's heart was still beating rapidly!

Tian Lu, who was wearing gloves, couldn't move, so he had to smile slightly, trying to calm the other party with his gentle gaze and calm tone: "Don't worry, the operation will be over soon, and after the anesthesiologist gives you a needle, you won't feel anything." ”

While speaking, after the three parties checked correctly, the nurse began to come over to establish an intravenous channel for Ling Feifei, and then the anesthesiologist began to anesthetize Ling Feifei with tracheal intubation.

As a member of the surgeons, the anesthesiologist's job is not only to make the patient "sleep", but also to ensure the safety of the patient during the operation, provide a good operating condition for the surgeon, monitor the patient's condition during the operation, such as blood pressure, heartbeat, breathing, etc., pay attention to the patient's condition at any time, and remind the surgeon in time. It can be said that the work content of an anesthesiologist is extremely important, and it is completely different from the imagination of ordinary people.

For example, in an operation like Ling Feifei, the anesthesiologist has to ensure that the tracheal intubation will not fall out, and once it falls off during the operation, it will be 。。。。。。

Therefore, clinically, anesthesiologists are also one of the most risky professions.

Today's front-line anesthesiologist is a deputy chief physician of the anesthesiology department, who has rich experience, and completed the preoperative anesthesia in three clicks and two clicks, and Tian Lu also silently issued instructions to the system in his heart.

"Activate the Clinical Operations Support System!"

"Surgical conditions: Preset operating room No. 4. ”

"Surgical personnel: one chief surgeon, one anesthesiologist, two assistants, and four nurses. The user acts as a second assistant. ”

"The patient, a 15-year-old female, presents a fourth ventricular neurocysticercosis and is scheduled to undergo a posterior foveal median craniotomy and a fourth ventricular cysticercosis. ”

。。。。。。

"The system is ready, and the user can start the operation at any time!"

"Let's get started!"

Almost at the same time as the system replied, Leng Yan also gave instructions to the two assistants to start the operation. For a while, Zhang Jie and Tian Lu began to get busy.

After Zhang Jie installed the headframe, Tian Lu held her and placed her in a prone position, and then put Ling Feifei's forehead on the headframe to fix it, with a soft pillow on the chest and an air circle at the pubic symphysis to keep the abdomen suspended in order to facilitate abdominal breathing. Both upper limbs are straightened and fixed at either side of her waist.

After fixing Ling Feifei's position, with the help of two assistants, Leng Yan completed the disinfection and towel laying work very skillfully.

Next, it's time for surgery!

"Scalpel!"

Taking the sharp scalpel, the cold right hand steadied slightly, and gently swiped towards the back of Ling Feifei's pillow.

After the usual scalpel incision, the monopolar electric knife is used to continue to cut the subcutaneous tissue and muscle. Tian Lu and Zhang Jie served as assistants to help fix the flap with a retractor.

After opening the foramen magnum and the posterior arch of the atlas vertebrae, the cisterna maximum is exposed, the dura mater is cut in a Y-shape, the arachnoid membrane of the cisterna magnum is cut, and the cerebral effusion of the cisterna magnum is released, which is retracted to both sides.

Although the cold operation is not very fast, and there is no superfluous movement like Tian Lu's surgery, it can be seen that his hands are very stable, every movement is also very clean, and there is absolutely no mother-in-law, showing decades of profound skills at the same time, it also shows his accurate understanding of the anatomy behind the occipital.

And the operation of the two assistants also wants to be perfect, especially Tian Lu, often do not wait for the cold to speak, what to do, what to pay attention to, and even which step to carry out the next step of the operation, are able to think of the front, do the front, so that the cold work is a lot easier.

Ling Feifei's cerebellar vermis was slightly widened, and Leng Yan slightly lifted the lower vermican with an instrument, and saw that the median foramen of the fourth ventricle was enlarged, and Tian Lu could already see the translucent cyst wall of the cyst inside at the opening.

took the suction device in Tian Lu's hand and gently touched the cyst wall coldly.

After entering the ventricles with the cerebrospinal fluid, the transformation of the hexagocyptose has been completed, so it is relatively large and cannot pass through the distal median or lateral foramen, so it remains. The cyst that Tian Lu saw was about two centimeters in diameter, the cyst wall was translucent, the cyst fluid resembled cerebrospinal fluid, and the cyst wall could be seen with a white head segment the size of a millet grain.

After a moment's hesitation, Leng Yan began to bluntly separate the subcerebellar vermisite and enlarge the median foramen.

"Next, the cyst is going to be removed. ”

Looking at Leng Yan's careful operation, Tian Lu's attention was also highly concentrated, and he hurriedly spread it with cotton pads with Zhang Jie to protect the normal brain tissue.

The surgery of neurocysticercosis requires the removal of the cyst as completely as possible, so as to avoid the direct contact of the protein-rich cyst fluid with the surrounding brain tissue after the rupture of the cyst wall, which can cause severe adverse reactions, and at the same time, it can also prevent the cyst head segment from flowing out with the cyst fluid, causing other parts to be planted.

But sometimes, it's not easy to do a complete removal!

The wall of the cyst is very thin, and the tension is relatively high, just like a raw egg that has peeled off the shell, but left the membrane inside, it is easy to rupture if you are not careful, and if there is adhesion between the cyst wall and the ventricle wall, it is even more difficult to remove it completely!

Taking a deep breath, Leng Yan gently touched the wall of the cyst with the small suction head, checked it, and found that there was no adhesion, and began to prepare to suction and remove the cyst.

Tian Lu also held another slightly larger suction device in his hand, and he was highly concentrated and ready at any time, in case the cyst accidentally ruptured, then he had to wash the leaking cyst in time.

Maybe it's because the cold feel is soft enough, or maybe it's Tian Lu's prayers that play a role, little by little, the cyst is attracted by the trembling!

"Whew。。。。。。 ”

When the cyst was completely sucked out, even though it was through a thick mask, Tian Lu still heard the long breath of Leng Yan!

Of course, now is not the time to completely relax, both the results of the puncture and the sight in front of you suggest that there should be another one inside!

Leng Yan looked inside, and sure enough, there was another one in the four ventricles.

However, when the suction device was slightly inserted and the other cyst was slowly sucked out, until it was sucked near the median hole, whether it was Leng Yan or Zhang Jie and Tian Lu, after seeing the scene in front of them, they couldn't help but gasp hard!

This one, it's so big!

It's at least about a third bigger than the one just now!

Suddenly, Tian Lu had an urge to snatch the suction device in Leng Yan's hand and operate it himself!

Fortunately, this cyst also did not have adhesions with the ventricular wall, so Leng Yan took a deep breath, and after calming down, he slowly stretched out the suction device in his hand.

Gently, softly, the suction device is like a feather swaying in the wind, attracting the cyst a little outward, then stopping, adjusting the position slightly, and then attracting a little outward again!

The cold movements are extremely gentle, just like the cyst is his most beloved lover, for fear that he will accidentally hurt the other party.

Slowly, the cyst "squeezed" out of the median hole silently!

"Whew。。。。。。 ”

This time, Tian Lu himself also let out a long breath, and the exhaled air flow was blocked by the thick mask, and his lips were suddenly warm and moist.

I don't know when, there was also a bead of crystal sweat on his forehead!

Finally attracted smoothly!

Leng Yan also breathed a big sigh of relief, and asked the nurse to help him wipe the dense beads of sweat on his head, and his eyebrows and eyes were slightly curved.

However, just when Leng Yan wanted to say a few light-hearted words and ease the atmosphere, his gaze suddenly stopped at a casual glance!

"Director, what's wrong?"

Zhang Jie asked a little strangely, and he also looked in the direction of the middle hole.

At a glance, Zhang Jie was also stunned!

"And another?"

From the reactions of the two, Tian Lu had already guessed the reason, and couldn't help but ask with some surprise.

"Isn't there another one!"

Leng Yan shook his head with a wry smile and said, "But it's okay, this one is about the same size as the first one at most, so it should be easier to do." ”

Since there is another one, everyone's work has not been completed, Tian Lu and Zhang Jie first helped clean up the field, and Leng Yan picked up the suction device again and stretched it into the middle hole.

"That's not right!"

Just touched the cyst wall a few times, Leng Yan suddenly shouted in a deep voice: "There are adhesions on the cyst wall!"

Zhang Jie and Tian Lu immediately became nervous when they heard this.

Adhesions and non-adhesions are definitely two concepts for the attraction of a cyst! If there is adhesion, the first thing to do is to separate, and the possibility of the rupture of the cyst wall will be greatly increased.

But no matter what, Leng Yan can only start to separate the capsule wall without hesitation.

Under the microscope, suddenly, suddenly, the cold movements were softer than just now, and the cyst loosened little by little.

Finally, after an unknown amount of time, the last cyst gently detached from the wall of the ventricle and slowly floated towards the median hole under the attraction of the suction device in Leng Yan's hand.

"Heh, it's finally down. ”

Zhang Jie said with a relieved smile: "There are three cysts in the ventricles, this is the first time I have seen them." ”

"Don't talk about you, I haven't seen you a few times. ”

Carefully operate the suction device in his hand, and said coldly without raising his head. However, it seems that the smooth separation of the cyst has made him feel quite relaxed, at least he can have the heart to answer the words of his assistant.

Tian Lu was the only one frowning tightly.

It seems that this cyst is about the same size as the first one, and it is not out of the median hole, and it is not time to relax!

However, after hesitating for a while, Tian Lu did not open his mouth to remind Leng Yan, looking at the situation of the first two cysts, Leng Yan's feel is really good, and as long as there is no accident, there should be no big problem with the next one.

But.......

This time, no one heard Taji's prayers!

"It's not good, it's broken!"

Suddenly, the cold body shook, and under a low cry, the atmosphere on the operating table immediately became tense!

Almost at the same time as the discoloration on the cold face changed, the suction device in Tian Lu's hand quickly stretched out, and the sac fluid that overflowed after the rupture of the cyst wall quickly disappeared at the mouth of the suction device!

"Prepare a hydrogen peroxide solution!"

With a gloomy face, he commanded in a cold and urgent voice.

Although Tian Lu attracted it in a very timely manner, after all, it was still not as fast as the speed at which the capsule fluid gushed out, and a small amount of capsule fluid touched the brain tissue, so in order to avoid irritating the brain tissue, Leng Yan decided to rinse it with hydrogen peroxide solution.

Hydrogen peroxide solution is a colorless and transparent liquid that can kill all microorganisms including bacterial propagules, spores, fungi and viruses, and is a commonly used irrigation solution in surgery.

Seeing a nurse hurriedly go to get the solution, Tian Lu's heart moved, and he hurriedly reminded in a loud voice: "Remember, warm to room temperature!"

The hydrogen peroxide solution is generally stored in the refrigerator at minus four degrees, the temperature is too low, and in Tian Lu's opinion, it is very necessary to heat it before use.

When the nurse went to get the solution, Tian Lu sucked the capsule clean, then coldly and then used the suction device to attract the capsule wall, gently pulled outward, and after a little separation, it was removed together with the white nodule.

Under Zhang Jie's somewhat strange gaze, Tian Lu hurriedly covered the surrounding brain tissue with cotton sheets, especially the bottom of the four ventricles, which was covered with two layers of cotton sheets!

After a few moments, the nurse brought the heated hydrogen peroxide solution.

"Rinse it!"

He commanded with a solemn face.

Zhang Jie was responsible for flushing, and Tian Lu was responsible for suctioning, so Zhang Jie hurriedly took over the hydrogen peroxide solution and prepared to start flushing.

"Director!"

Tian Lu hurriedly said: "Is it possible to consider alternating with saline rinsing? ”

"Is this necessary?"

Zhang Jie frowned and said, "I usually use a lot of hydrogen peroxide, what can go wrong?"

Leng Yan also hesitated slightly.

Vaguely, he remembered that there seemed to be such a clause in Tian Lu's preoperative plan, but because his attention was focused on other shocking content, he didn't pay much attention to things such as precautions during the operation, and he couldn't remember it clearly.

The operation had already lasted for a long time, and I didn't have time to think about it, so I nodded coldly and said, "Okay, alternate flushing, let's start!"

Leng Yan's first reaction was to believe in Tian Lu.

"Pay attention to the patient's breathing and heart rate!"

Immediately turned his head and explained to the anesthesiologist in the distance, Tian Lu turned his head and focused on Ling Feifei again.

Zhang Jie frowned, alternating between the hydrogen peroxide solution and normal saline, while Tian Lu continued to hold the suction device, attracting the rinsed liquid.

However, Tian Lu's brows quickly furrowed!

The operation in Zhang Jie's hand is a little uncoordinated, the amount of hydrogen peroxide flushing is large, but the amount of normal saline flushing is very small, and the two are very disproportionate.

This is not the meaning of "alternate rinse"!

After just a few seconds, Tian Lu couldn't bear it anymore, he suddenly looked up at Zhang Jie, and opened his mouth to speak.

It's just that before Tian Lu could speak, an exclamation from the anesthesiologist suddenly came from a distance!

"Stop the operation immediately!"

"The patient's heart rate plummeted!"

"Oh no! It's down to 15 times per minute!"

In an instant, there was absolute silence on the operating table!