There is not much blood in the cranial cavity. Typically, there are two sources of blood from craniotomy. One is that the patient has an intracranial hemorrhage before surgery, resulting in an effusion.

The other is intraoperative bleeding, which is caused by surgery. Zhou Can's incision is already at the director level, and the feeling of anticipation is even more perverted.

It can identify blood vessels, nerves, tendons, etc. one by one. This kind of tactile ability is by no means available to ordinary surgeons.

Often, it is possible to have it only if the surgical experience is extremely rich and the level of incision reaches the chief physician or above.

Its role and benefits are self-explanatory. This allows the surgeon to minimize surgical bleeding during the procedure.

Zhou Can is now doing all kinds of major surgeries, and the bleeding control is enough to make every doctor feel envious. Someone else has a laparotomy and bleeds at least 300ml or more.

If Zhou Can operated on it, not only the operation speed was extremely fast, but the amount of bleeding was pitiful. In laparotomy surgery, he is generally able to control the amount of bleeding within 100ml.

In fact, his laparotomy usually bleed less than 50ml. This is not only as simple as incorporating the abdominal cavity, but also includes intraoperative removal of abdominal tumors or tails.

To the average doctor, this is almost unimaginable. Because it's so hard to do so little bleeding.

It can only be said that surgery requires not only good skills, but also special experience. Before Zhou Can resects a certain lesion, he can clearly know what larger blood vessels are around the lesion, and the ligation should be done in advance.

small blood vessels, during the operation, he can directly electrocoagulate to stop the bleeding.

"The source of the bleeding was found, and it was a broken artery." After the blood is drained, the bleeding point is clearly visible.

Of course, finding the bleeding point is completely logical and easy for Zhou Can to operate. With little effort or time, the source of the bleeding was easily found.

But if someone else is the chief surgeon, unless it is the chief physician of the divine surgery like Wu Baihe, ordinary people will not be able to reach this level at all.

It's easier to see than to do. Watching Zhou Can operate was extremely relaxed, but if he was operated by other doctors on the scene, it was likely to be as nervous as if he was facing a great enemy, and it was even possible that various problems would occur.

When doing such a fatal major surgery, it is definitely the luck of the patient to be able to let surgeons of Zhou Can and Wu Baihe take charge of the surgery.

Zhou Can didn't ask Wu Baihe at all this time, and directly electrocoagulated the bleeding point to stop the bleeding. The blood vessels are not large, and the blood supply route is highly substitutable.

After electrocoagulation of the arteriole blood vessel to stop the bleeding, the blood passage is blocked. But don't worry, there is an incomparably rich vascular system in the body, which is dense like tree roots, and is found in every corner of the body.

When this artery is blocked, other adjacent arteries and smaller blood vessels will automatically take on new blood circulation tasks.

It won't be long before a new bloodway is formed. However, larger blood vessels cannot be easily electrocoagulated or ligated to stop bleeding.

Sometimes you have to find a way to fix it. Because the larger blood vessels are equivalent to the taproot of the tree roots, cutting one is one less.

It is difficult to form a new alternative blood pathway in a short period of time. This can lead to rapid necrosis of ischemic organs and tissues, or severe functional effects.

"Hey, there seems to be a narrowing and occlusion of a blood vessel here." Zhou Can's words attracted everyone's attention.

When you look at the development screen, you can only see the crimson intracranial tissue, and the white one is the brain. The blocked blood vessels are not visible at all.

Wu Baihe kept staring at the screen. He himself assisted Zhou Can in surgery. Some brain tissue needs to be pulled apart, and it is basically operated by him.

Wu Baihe tried his best to see it, but he still couldn't find the problematic blood vessels.

"Where?" He asked, pulling his face down. Don't think that these top chief physicians don't care about anything, what they care about most is face.

In particular, the authority and status of their fields of expertise are even more important. Well, if you have studied in a certain field for most of your life, you must be proud of your achievements in this field.

Everyone is also mortal with the naked eye, Zhou Can has decades less medical experience than Wu Baihe, but Zhou Can found the problem, but Wu Baihe failed to find it.

His face must not have hung up. What's more, he also called some of his team members over.

There are doctors and nurses, and they worship him as a god on weekdays. Now that he's down, what do the doctors and nurses think of him?

"Actually, I'm just guessing. Do you think there's a problem with this piece of gray matter? Zhou Can peeled off part of his brain tissue in order to allow Wu Baihe to gain a larger field of vision and see more clearly.

When he said this, he was just saving face for Wu Baihe. Which doctor will guess if a blood vessel is diseased when performing surgery?

It's hard to guess what you can do. Wu Baihe stared at the gray matter in the brain and observed it carefully, and soon discovered the problem.

"Atrophy, there seem to be signs of degeneration...... This is clearly a problem with the supply of nutrients. From an anatomical point of view, this gray matter has only one large artery to provide blood circulation, and two venous circuits ......" Wu Baihe's eyes lit up as he spoke.

Yes, there must be something wrong with the arteries that supply blood to the gray matter. Only then did he understand that Zhou Can was giving him the stairs to help him save face.

"Zoom in on the patient's head exam. It would be more accurate to know that I should check a color ultrasound, but the CT film can barely make do. "One of the biggest advantages of color ultrasound is that it can scan the blood flow in the blood vessels in real time.

It is used to check whether the blood vessels are unobstructed, and its accuracy and diagnostic significance are even stronger than many high-precision instruments.

Some young doctors blindly advocate the high definition and high accuracy of MRI. In fact, this is an incorrect clinical diagnostic thinking.

Color ultrasound, B ultrasound, and X-ray, each with its own advantages, they can be used all the time, not eliminated, and naturally have their merits.

It only takes more than 100 yuan for a patient to take a color ultrasound, how much does an MRI get? At least a few hundred larger, and a little higher precision is as high as more than 2,000 yuan.

To check whether the blood vessels are patency, in addition to CT imaging, there should be no other examination method more intuitive than the diagnosis of color ultrasound.

Wu Baihe stared at the CT film of the patient's head and examined it carefully.

"Zoom this up a little bit." After zooming in and looking at it for a while, Wu Baihe was still a little undecided.

"The patient also had a head MRI done in the hospital, right? Check it out too. "He's very rigorous. Even if the problem has been found under Zhou Can's reminder, he still wants to get the inspection data to support it.

This is also the habitual thinking of the vast majority of old doctors. Just two words, safe. Why?

Because many old doctors have been sued by patients and their families, when they go to court, they must talk about evidence!

When the doctor defended, no one believed him when he said it. At this time, I provide the examination data, and then tell the judge or the competent authority that the basis for my treatment of the patient is based on the examination data.

I strictly followed the medical norms. Then the leaders looked at it, and it was indeed so. As long as it is found that the doctor is indeed not at fault in the diagnosis and treatment, the lawsuit will basically be won.

There are strict indications for surgery. The doctor should not think that there is a problem with the artery that supplies blood to the gray matter in the patient's skull, and directly operate on the patient.

That's certainly not in line. Problems must be identified from the examination data before the surgical solution is decided.

The lesion in this blood vessel was not found before the operation, which was actually a missed diagnosis. However, this is very common in clinical procedures.

Some lesions are so insidious that they are not easy to detect even when diagnosed by an experienced doctor.

There is a test called intraoperative exploration. It is during surgery that the lesion is further explored. It can also be seen from this that the doctor has a lot of power in the operation.

The rules and regulations in all aspects are also relatively lenient for doctors' operations. It's quite a bit of a strict access, and the meaning of complete decentralization after the start of surgery.

This is basically an unspoken rule of medical surgery at present. However, in recent years, the competent authorities have also formulated some relatively strict regulatory systems.

For example, during the operation, nurses, anesthesiologists, and medical assistants must sign for confirmation. And the procedure will be accurately recorded.

If the records are not standardized, or there is something hidden, after the investigation is found, not only the doctors and nurses involved will be held accountable.

And even hospitals are punished. It's just that the hospital is for doctors and nurses after all, and if there is any problem, it is usually dealt with behind closed doors.

So it's almost impossible to make the operating room truly transparent. It's like a kindergarten with monitoring, and parents ask to see how the teacher teaches their children at any time, but I'm afraid no kindergarten dares to agree.

"County-level hospitals are just unreliable, and they can't do an MRI. At this level, their medical technicians should be laid off and retrained. "Wu Baihe counted the number of county-level hospitals, and the MRI was not done.

Everyone was silent. Others are smiling.

"Although the examination is a bit ambiguous, I can vaguely distinguish that there is indeed a stenosis in this blood vessel, which looks quite serious. This blood vessel is not large, and the blood vascularization task of supplying blood to the gray matter of the brain is usually light. I didn't expect it to have problems, but we were negligent before the operation. Director Zhou, what are you going to do with this narrowed artery? "If you find a problem, the next step is to deal with it.

There are two sets of solutions. Zhou Can also had some difficulties.

"It's safer and quicker to place a vascular stent, but it can be a little more expensive. The cost of replacing this blood vessel directly will be lower, but it is difficult to operate, high risk, and traumatic to the patient. The patient's current condition is very weak, and I am afraid that it would be better to choose to have a vascular stent. "After much thought, he eventually leaned towards a more comprehensive and costly treatment.

This is basically the choice of all doctors as well. Because people don't want to have an accident.

"I also tend to place a stent to solve the problem, and the traveling teacher urgently adjusts the stent according to Director Zhou's needs."

"Okay." The itinerant nurse asked Zhou Can about the specific size of the stent he needed, and immediately called to start adjusting the length.

"Director Wu, I'll check here, if there is no problem, the endoscopic operation will be over." Zhou Can greeted.

"Hmm." Wu Baihe nodded. Zhou Can secretly sighed in his heart, fortunately, he didn't directly investigate the brain stem as soon as he came up.

Who would have thought that the problem is not in the brain stem, but in the gray matter of the brain. The patient has a hemorrhage in the thalamus, causing increased intracranial pressure, which then further compresses the already narrowed artery.

Directly causing the blood circulation of gray matter to be almost blocked, this is the main reason for the patient's unconscious.

Now the truth is in broad daylight. The next step is to do interventional surgery, insert a vascular stent, and unblock the almost occluded artery.

"Director Qu, are there any changes in the patient's brain waves?" Before Zhou Can removed the endoscope, he was still a little uneasy.

"The brain waves have become a bit more active and seem to be recovering." She replied. Under general anesthesia, brain waves are actually relatively flat.

However, as the patient's intracranial blood is removed, the bleeding stops, and the intracranial pressure decreases, the compressed arterial blood vessels slowly bounce up a little, and the blood vascularity also recovers somewhat.

Gray matter function that has been nearly stopped is restored again.

"It seems right, it's the gray matter that is to blame." Zhou Can's heart was a little more confident. …… Doing interventional surgery, that is Zhou Can's strength.

The whole process of placing the stent took less than twenty minutes. At the end of the operation, the patient was severely stenosis, the nearly occluded arteries were unblocked, and blood vessels were restored.

After the anesthesia woke up, good news came. The patient has woken up from a coma. This intracranial operation, which has gone through many twists and turns, has finally been a complete success.

It also gave Zhou Can a deeper understanding of intracranial surgery and extraneurologic surgery. He deeply felt that medicine has no end to it, and he can't finish it in a lifetime.

"Director Zhou, may I ask you, how did you find out that there was a problem with that artery during the operation?" A doctor in his forties outside the gods, his hair has turned half white, and he looks very steady.

After the operation, he looked for an opportunity to ask Zhou Can for advice. Watching Zhou Can do intracranial surgery today, he was shocked in many ways.

I also deeply saw what it means to be a master of surgery. Whether it is craniotomy, hemostasis in the cranial cavity, or finding lesions, Zhou Can's various endoscopic operations have opened their eyes.

What surprised them the most was that Zhou Can found that there was a problem with the artery. At that time, only a small part of the gray matter could be seen.

He thinks there is a chance that the arterial lesion will be inferred from the gray matter of the brain, but it is very small. At least even their teacher, Wu Baihe, had to pick up the brain tissue and carefully observe it for a long time before he came up with this diagnosis.

"If I say it's a feeling, do you believe it?" Zhou Can looked at this benevolent brother. There are many doctors with few bald heads in the clinic, and the pressure of studying, scientific research, and postgraduate entrance examinations is great, and the clinical pressure after practicing medicine is even greater.

Sometimes when a critically ill patient is treated, the most worrying person is not the family, but the doctor.

Every doctor who has gray hair at the age of thirty or forty is worthy of respect. Because they devote all their body and mind to the cause of medicine, and contribute their modest strength to the promotion of human medical progress.

"I believe it! Can you tell me more about it, I would love to feel that way too. After the doctor finished speaking, the other doctors, including the nurses, gathered around.

Like the stars holding the moon, Zhou Can was surrounded in the middle.

"You can go back and rest after asking Director Zhou for advice, you have worked hard today. I'm old, so I'll go home and sleep first. Wu Baihe actually had a little uneasiness on his face.

In today's operation, he was next to Zhou Can to check it. Even called most of the elite of the entire team over to help.

Unexpectedly, it became Zhou Can's home show. To say that jealousy is certainly not enough, but his authority has been shaken to a certain extent, it is certain.