"I can only try my best."

Zhao Heng thought for a while and said.

Head penetrating injury + brainstem gliocytoma, anesthesia for this surgery, no doctor in the world dares to say that he is absolutely sure.

"Maybe some operations during the operation still need your cooperation, junior, this time, it will really be hard for you."

Liu Ziang said.

Zhao Heng has extremely high attainments in brain surgery, and this matter was shown by Zhao Heng in previous surgeries.

And this time, in addition to safely removing the steel bars inserted into the head and repairing the damaged tissues, it is also necessary to remove the brainstem gliocytoma, in Liu Ziang's opinion, only Zhao Heng has this level of operation to cooperate with him.

The most important thing is that for this patient, if he does not take this opportunity to have the brainstem tumor removed now, even if the steel bar inserted into the head is successfully removed, the patient will survive this operation, and the patient's time will not exceed three months at most as the brainstem tumor develops.

"It's fine."

Zhao Heng said disappreciatively.

If you wanted to be easy, you wouldn't have chosen the profession of a doctor.

An hour later.

In the operating room.

For this operation, Zhao Heng was in charge of anesthesia, the instrument nurse was Tian Zhen, the itinerant nurse was Sun Li, and Liu Ziang was operated on with two resident doctors.

At the workbench, Tian Zhen was preparing for surgery, and Liu Ziang was looking at the brain CT film.

On Zhao Heng and Sun Li's side, they are undergoing preoperative anesthesia.

"Doctor Zhao, what is the intravenous anesthetic used this time?"

Sun Li looked at Zhao Heng, who was pondering, and asked him.

Head trauma is not uncommon in brain surgery, but this kind of injury directly penetrated through the head by steel bars is the first time even Sun Li, who has participated in many brain surgeries.

Therefore, she knows better what kind of anesthesia is needed to be able to be responsible for this operation.

"Propofol plus refentanyl."

Zhao Heng thought for a while and said.

Propofol, known as a "cross-century" new anesthetic, is best suited for the targeted infusion technique (TCI) now used in this patient due to its rapid onset of action, rapid metabolism, and continuous use without accumulation.

Remifentanil, on the other hand, is the latest type of pure μ receptor agonist, which also has the advantages of fast clearance and low side effects after use.

The patient's condition is extremely unstable, and the anesthesia for this patient must be anesthetized with the least interference with the patient's physiology.

"Okay."

Sun Li nodded, the two anesthetic drugs that Zhao Heng said were basically new.

Ordinary anesthesiologists are still using the old anesthetic drugs, and they are generally not sure to use new anesthetic drugs such as propofol and remifentanil, let alone use them on patients with such complex conditions.

Next, Sun Li quickly prepared the intravenous anesthetic drug, and as the intravenous anesthetic drug was injected into the blood vessel, the patient entered a state of deep anesthesia.

However, Zhao Heng's heart was still tightly mentioned.

Ten minutes later.

Zhao Heng looked at the blood pressure and heart rate on the life monitor, and said to Liu Ziang: "Senior, you can start the operation." ”

"Well, good. ”

Liu Ziang nodded.

With Zhao Heng here, he still felt very relieved.

It's a wonderful feeling, and as a god of brain surgery, when he's always there, others feel at ease.

And now, the strong technical support that Zhao Heng can give him gives him this sense of peace of mind.

Liu Ziang settled down and started the operation with two resident doctors, although he is a master of brain surgery, but this operation is also very difficult for him.

It is imperative that the bars with burrs stay in the patient's skull now, and that the steel bars should be removed from the patient's skull as soon as possible, and that the damage to the patient's brain tissue should be minimized.

In this process, every step of the operation must be careful and walk on thin ice.

This requires a great deal of concentration and a great deal of stability in both hands.

To put it bluntly, the two resident doctors brought by Liu Ziang can only do the work of the hands-on operation, and the most critical and delicate operation must be completed by Liu Ziang himself.

Time passed minute by minute, although it was difficult, but in Liu Ziang's hands, two hours later, the steel bars inserted into the skull were still completely removed.

Next, the most difficult part is to remove the glioblastoma from the brainstem.

This surgery is almost one of the most difficult surgeries in brain surgery.

On the one hand, the brainstem is the center that controls the heartbeat and breathing of the human body, and once the brainstem is damaged during surgery, the patient's breathing and heartbeat will stop immediately.

It can be said that life and death are in an instant.

On the other hand, the process of removing gliocytoma is extremely difficult.

Figuratively speaking, glioblastoma that infiltratively grows in brain tissue is like a cauliflower growing in tofu, and it is necessary to completely remove the cauliflower little by little, and it cannot damage the tofu at all, which is the most difficult part.

Next, Tian Zhen also has to prepare the next instruments for brainstem tumor resection, which will take some time.

Liu Ziang sat next to Zhao Heng to rest and discuss the details of the next operation.

"Senior brother, what do you think about the next surgery?"

Sitting next to Zhao Heng, Liu Ziang asked.

Generally speaking, only others ask him for his share, and only Zhao Heng can get his approval, so he still values Zhao Heng's opinion very much.

"The patient's condition was very unstable, the surgery had to be done as quickly as possible, and the conventional stripping was too slow."

Zhao Heng thought for a while and said.

"What do you mean?"

Hearing Zhao Heng's words, Liu Ziang immediately nodded, this is also what he was worried about, the conventional brain tissue tumor resection will take too long, and it will not be able to be used on this patient at all.

It is necessary to end the operation as soon as possible to avoid further accidents, once the operation time is extended, in the case of this patient, the probability of complications, such as respiratory and cardiac arrest, is almost 100%.

"We can apply the excision technique for soft tumors, and use the N-YAG laser to cauterize the tumor tissue and then aspirate it."

Zhao Heng slowly said his thoughts.

This idea is a method summed up by combining his experience in brain surgery from Liu Ziang's body and some other disciplines.

"N-YAG laser? This device is available, but it has not been used to remove brainstem tumors before.

Hearing Zhao Heng's words, Liu Ziang's eyes lit up instantly, fell into thought, and muttered.

This YAG laser has the characteristics of high gain, low threshold, high quantum effect and small thermal effect, and has the advantages of small trauma and good healing when applied in medicine.

"Although YAG lasers are generally used in departments such as dermatology, cosmetology, and ophthalmology, I think it is more suitable for the removal of soft brainstem glioma."

Zhao Heng said again.

"Well, it is. Junior brother, you have given me another surprise. ”

Hearing Zhao Heng's words, Liu Ziang nodded again and again.

The laser excision method proposed by Zhao Heng was something that even he didn't expect.

But when you think about it this way, laser excision not only has less damage, but also greatly shortens the operation time.

It's just that no one has ever thought of applying lasers to such a critical location as the brain stem.

.

Favorite fried potatoes remind you: remember to collect after reading