Zhang Mengjing's intracranial cholesteatoma is huge, encircling the trigeminal nerve, facial nerve, auditory nerve and glossopharyngeal nerve, and there are also important structures such as brainstem, oculomotor nerve, trochlear nerve, abducens nerve, vagus nerve, basilar artery and its branches, superior cerebellar artery and posterior cerebral artery.

Although this intracranial cholesteatoma is a slow-growing benign tumor, it is called a "tumor" because of its malignant erosion and destructive properties.

The location where it grows is too important, under the stimulation of inflammation, it will continue to expand, compress and invade the surrounding tissue structure, can drill bone cracks, gnaw bones, destroy human brain structure, although drug treatment can relieve temporary pain, but the symptoms are not cured.

If left unchecked and not operated on as soon as possible, it will cause very serious consequences and even life-threatening if it drags on for a long time.

When all the preoperative preparations were in place, Zhou Qiao took Elena, Ava, Murphy, Zhang Mengjing, and Zhang Jianjun to the University of California, San Francisco Medical Center.

In the clinic, Rachel was the only one left.

There is still a child in the ward who has not yet been discharged, and I ask her to take care of him more.

As for the safety of the clinic, there are people in the laundry at the side at any time, and Ariel and they are all paying close attention, so they don't have to worry about someone coming to the door to make trouble.

Zhou Qiao and the four of them had a car, while Zhang Jianjun drove his own car and followed closely behind with his daughter.

Although you have taken painkillers, you may have taken them for too long and developed resistance, and the drugs are not very effective. Zhang Mengjing still feels unbearable pain from time to time.

In addition, these drugs have side effects, and if taken for a long time, there will be serious adverse reactions such as dizziness, drowsiness, gastrointestinal discomfort, allergies, and even liver and kidney damage.

At the University of California Medical Center, a lady in the surgery office made a reluctant request to Zhou Qiao.

"Good afternoon, Dr. Zhou, there is a matter that we need to ask for your and the patient's opinions."

"Oh? What's up? Please speak! Zhou Qiao nodded.

The blonde lady said, "Yes, many doctors in our hospital are very interested in your operation, including some well-known experts, such as Dr. David Claudford of the Department of Hepatobiliary and Pancreatic Surgery, Dr. Alona McCrolin of the Department of Neurosurgery, etc., hoping to observe this operation in the monitoring room!" ”

"Huh?" Zhou Qiao was stunned, he didn't know that he came over for surgery and actually attracted the attention of so many people?

He also thought that not many people knew about it, that is, he brought Ava and others to fight for about an afternoon!

Listening to the other party's tone, it seems as if the whole hospital knows about it! Even doctors who aren't neurosurgeons are here!

When Zhang Jianjun and Zhang Mengjing heard this, their eyes also widened.

Zhang Mengjing beat the drum in her heart, and said in her heart that in fact, I don't want too many people to watch. She has only been in the United States for a few days, and she still doesn't understand the language, and she is full of strangeness and fear of foreign devils and the surrounding environment.

And Zhang Jianjun was even more at ease, and he was faintly a little excited.

Although he can trust Zhou Qiao's medical skills, there are more doctors and experts to observe, and the operation itself should be more secure. He didn't believe that if something happened, the experts would sit idly by.

In addition, these doctors and experts at the University of California Medical Center usually charge quite expensive, but now people come to "participate" for free, and they have earned it!

Zhou Qiao looked at Zhang Jianjun and Zhang Mengjing, meaning to ask for their opinions.

Before Zhang Mengjing could speak, Zhang Jianjun nodded again and again and said, "I'm fine." ”

Zhang Mengjing had no choice but to shut up. Heart, forget it, anyway, I "fell asleep" during the operation, and I didn't feel embarrassed.

When Zhou Qiao explained the operation to her, she said that general anesthesia was used, and the rest of the body, even the face, was basically covered. Only a small area of the head will be exposed.

In that small area, at the Iris Clinic, before she left, Elena helped her prepare her skin. She shaved off all the hair in that small area, and it was ugly, so she knew where she was going to go under the knife, and she wore a nice hat when she came over.

Zhou Qiao said to the staff: "I have no opinion, welcome colleagues from the University of California Medical Center to watch this operation." If I have the opportunity after surgery, I would also like to communicate with the experts at your hospital and share my experience during the operation. ”

His perfect-level skills are naturally full of confidence.

If you change to a normal doctor, I will probably have stage fright when I hear that there are so many people watching. However, anyone who has the courage to undergo this kind of surgery has real skills and is unlikely to have stage fright.

The staff member smiled and said, "Then I wish you a smooth operation." I talk to the experts about the exchanges. ”

"Thank you."

Zhou Qiao actually wants to fit in with his American counterparts, after all, opening a clinic in San Francisco and being affiliated with the University of California Medical Center, he will have to deal with him often in the future.

Soon, senior anesthesiologist Rebecca La Roque came over with the team and met with Zhou Qiao to communicate the anesthesia session.

Zhang Mengjing was pushed into the anesthesia room.

Zhang Jianjun waited nervously in the rest area outside. His wife's visa was not processed so quickly, and he was all supported by him alone during this time!

He felt a lot of pressure, so he sent a message to his wife, thinking that his wife had gone to bed, because it was currently late at night in China. But I didn't expect my wife to return in seconds!

"Brother Jun, I can't sleep either. Has the surgery started? ”

"Yes! But I'm waiting outside. It seems that the monitoring room can also be seen, and many experts from the University of California Medical Center have come to watch, but I dare not go. ”

"Why don't you dare?"

"It's too bloody, and it's my daughter again, I don't dare to look at it directly." Zhang Jianjun pondered for a while, and then sent another one, "If you want to watch, I can go into the monitoring room and open a video for you." ”

"Still no, I don't dare! Hopefully the surgery will be successful! ”

"Uh-huh, if you can sleep, go to bed early!"

"If you can sleep, this is destined to be a sleepless night! I just went out to the bathroom, and her grandparents were also chatting in the room and didn't fall asleep. ”

Zhang Jianjun: "......"

I took a deep breath and glanced around, people coming and going. Not far away, there are also people with sad faces, perhaps, like him, they are waiting for the good news of the success of the family's surgery!

"I hope Dr. Zhou will give me a little more strength!" Zhang Jianjun prayed secretly.

Zhou Qiao led Elena, Ava, and Murphy to change shoes, change clothes, brush hands, and disinfect...... After a series of procedures, I entered the neurosurgery operating room with many advanced equipment.

The operating rooms here are more advanced and in better condition than those in community hospitals, and the cost of use is naturally higher!

When she went in, Ava secretly asked Zhou Qiao: "What song are you waiting for?" ”

Because she also felt that today's operation was very difficult, her sister and Murphy didn't talk much, presumably Zhou Qiao was also under a lot of pressure, so she wanted to put on some tunes that Zhou Qiao really liked.

Previously, those Chinese songs she played, and judging from the feedback after the work, Zhou Qiao didn't seem to like it.

Actually, Zhou Qiao likes it, but he just thinks that it is not suitable for surgery.

But Zhou Qiao thought about it and said, "Whatever you want." However, today's surgery will take longer, in addition to Chinese songs, you can add a little English songs, French songs, or soothing pure music. ”

Ava nodded, "Okay!" ”

She figured that the volume could be as low as possible and adjusted to a more comfortable level.

In fact, Zhou Qiao is also an extremely serious and focused person, once he has surgery, he can completely ignore it, no matter what music can be used as a background.

The previous ones were because he was not the main driver, but only worked as an assistant to Murphy, so he had the leisure to pay attention to music.

The operation that lasts for four or five hours, if there is no music, the whole process is quiet, it is inevitably too dull and depressing.

As for diapers, Zhou Qiao and they don't wear them. After all, it's estimated to be four or five hours.

Patients should be fasted from food and water before surgery, but doctors and nurses should not stop water before surgery and go to the bathroom before surgery.

In addition, once you enter a state of high stress during surgery, you will feel thirsty, hungry, and want to go to the toilet.

This is because there is a hormone called adrenaline in the human body, and when the body encounters a stressful event, adrenaline is secreted in large quantities!

Stress can be understood as a response to stimuli, such as feeling high levels of stress, being very excited, being very tired, being highly alert, focused, exercising at high intensity, or being traumatized.

Adrenaline is developed by human beings in the process of long-term evolution, and our ancestors in primitive times secreted a large amount of adrenaline when chasing prey or escaping from prey.

This hormone can dilate the blood vessels of the body's skeletal muscle, supply energy and oxygen to the muscles, and when the blood demand is large, the output of the heart increases, the workload of the heart increases, and then the coronary arteries will dilate, increasing the blood supply to the heart.

At the same time, because it requires a lot of oxygen and needs to gasp for air, this hormone also relaxes bronchial smooth muscles.

Then, when chasing or escaping, you can't stop and pee after running two steps, right? So this hormone can also constrict the blood vessels in the kidneys.

Blood flow to the kidneys decreases, and urine output naturally decreases!

On the other hand, the temperature in the operating room is not as comfortable as we imagined, and the doctor wears a thick surgical gown, a hat, a mask, and gloves...... I didn't feel very cool, and coupled with a high level of mental stress, my body excreted a lot of sweat, and the water was excreted from the body through sweat, and the urine naturally decreased.

Ava is not only a itinerant nurse, but also has a part-time job, that is, to wipe Zhou Qiao's sweat.

In addition, the current operating room conditions are very good, with a bathroom, in case there is a real need, you can also let the assistant temporarily replace, the chief surgeon to solve it first. That's a matter of two or three minutes.

Of course, in the past, when the conditions were poor, there were also doctors who wore diapers.

Like Zhou Qiao, he has strong kidney function and a strong ability to hold urine, and for four or five hours, he basically doesn't need to go to the toilet.

Anesthesia is performed with endotracheal intubation under general anesthesia.

After the anesthesia is completed, the routine time out, which is translated, can be understood as three checks and nine pairs, and then, with an ethereal and agile song of "Cloud Palace Xunyin", the operation officially began!

Zhou Qiao was also slightly stunned, he didn't expect that Ava would play this song, which gave him a lot of surprises.

This song is really a classic among the classics, the fairy spirit is fluttering, Zhou Qiao looks forward to this difficult operation, and he can also exert the level of "fairy energy" beyond the gods.

At the same time, the monitoring room next door was crowded with people!

Most of them are neurosurgeons, but there are also some interested doctors from other departments, and there are some who simply come to join in the fun.

Seeing Zhou Qiao's operation, some doctors began to comment: "This is the posterior approach to the suboccipital sigmoid sinus?" This approach requires a very familiar anatomical relationship, and the advantage is that the trauma to the brain structure is small, but the scope of exposure is relatively small, and the technical requirements for the surgeon are relatively high! ”

"I've seen the patient's film, and the tumor is not small, with a diameter of 3 centimeters, if I were to do it, I would choose the temporal occipital transcerebellar tentorial approach, which has a larger surgical field."

"Just looking at this approach operation, Dr. Zhou's movements are smooth and very masterful. How did he learn such superb surgical skills at such a young age and not long after graduating? ”

"I've heard that the clinical and surgical standards in China are very high, but it's not like this for a young man, right?"

Some people came to watch, but they were actually unconvinced, thinking that Zhou Qiao should not receive such attention, nor should he have such a difficult operation, but after seeing Zhou Qiao's first few steps, these people felt bad.

It turns out that people really have a level!

As soon as the connoisseur makes a move, he will know if there is one! All of you here are elites who graduated from prestigious schools! The worst is also a senior attending doctor who has been in charge for more than six years!

The most senior and prestigious are Dr. David Claudford and Dr. Alona McCrolin, both of whom have more than 30 years of experience.

In particular, Dr. Alona McCrolin is the pillar of neurosurgery at the University of California, San Francisco Medical Center, and has very advanced attainments in the fields of neurosurgery and internal medicine.

Dr. Alona McCrolin, like Dr. David Claudeford, sipped, watched silently, and did not comment lightly.

However, they glanced at each other and bowed slightly, obviously approving Zhou Qiao's "starting style".

In the operating room, Zhou Qiao was methodical.

He uses neuroendoscopy, minimally invasive microscopy, and cranial nerve electrophysiology monitoring equipment.

3*3cm bone window, incision of cistern......

Releases cerebrospinal fluid, shrinks brain volume, and lowers intracranial pressure......

Cut through the thickened skull base dura......

Without fixed traction, the tumor is exposed......

Neuroendoscopy has a "fisheye effect", which can obtain a "huge" field of view and deep three-dimensional vision in a small space.

On the huge electronic display screen next to the operating table, with Zhou Qiao's operation, the corresponding field of vision is displayed.

Due to the large number of cameras in the operating room, far or near, there are eight or nine monitoring screens in the monitoring room, and the doctors and experts who observe can clearly see every subtle link of Zhou Qiao's operation.

At the same time, the recording in the background is also being synchronized.

Zhou Qiao quickly explored the tumor tissue, and a very beautiful "pearl" was suddenly displayed on the screen!

This pearl, about 3 centimeters in diameter, pink and smooth, in the monitoring room, there was an uproar!

A female doctor exclaimed in surprise, "God, is this cholesteatoma?" How is it so beautiful? ”

Another doctor said, "yes, it's much prettier than the cases I've seen before!" ”

"Oh my God, Goddess, if this wasn't a tumor, how nice it would be!"

"I've never seen it!"

"This little Chinese girl can't be God's illegitimate daughter, right? It's the condensation of divine power, but the potential has not yet been developed? ”

"Haha, it's possible! However, the medical stuff is less of a joke, we are now watching surgery, not fantasy movies! ”

Even Dr. Alona McCrolin's eyes lit up and she couldn't help but explain: "Generally speaking, it's not so good-looking, this is a special case!" ”

In the operating room, Ava and Elena couldn't help but exclaim!

"Wow~, tumors can be so beautiful!"

"Pearl mussels can't give birth to such beautiful pearls!"

"Can you dig it up and make jewelry?"

Murphy had been expressionless, and at this time he couldn't help but be surprised, and his blue eyes flashed with brilliance.

Even Zhou Qiao felt that the "impact was great"!

He is a skill of systematic empowerment, which is the first neuroendoscopic minimally invasive intracranial cholesteatoma resection in his life, which he has naturally never seen before.

"Making jewelry? Obviously not! It just looks as beautiful as a pearl, but it's not a pearl! Zhou Qiao said in his heart, if this is a pearl, it is at least an ancient royal tribute grade.

He suddenly remembered an ancient sentence he read in the university library: "There are mermaids in the waters of the South China Sea, and the water dwells like fishes. ”

I can't remember where the specific source is, but it means that there is a kind of merman in the South China Sea, who lives like a fish in the water, and never gives up the work of weaving, and when it cries, it can cry pearls!

If Zhang Mengjing cries, of course, she must not cry out of this tumor!

Careful exploration showed that the tumor completely surrounded the trigeminal nerve, facial nerve, auditory nerve and glossopharyngeal nerve, which was basically the same as in the preoperative examination, and the tumor had abundant blood supply and toughness.

There are also a large number of other nerves, blood vessels, and brainstems in the vicinity, and in the process of shunt revealing and removing the tumor, once damaged, the consequences are serious.

(End of chapter)