In this half hour, Li Min was very cautious and very nervous.With a needle-like stripper in one hand and a knife in the other, she moves slowly between the tumor's membrane and brain tissue.Chen Wenqiang was more nervous than he did it himself, but he was willing to give Li Min this opportunity.
——If Li Min can independently and as a surgeon, the hemangiomatous meningioma can be completely nucleated, which indicates that Li Min has the ability to work independently in neurosurgery and is qualified to apply for membership in the Association of Neurosurgeons, and it also marks that the neurosurgery department of the provincial hospital has the foundation of the department."
Would you like to rest for a while?"
Chen Wenqiang asked Li Min."
No, I don't.The intern was still a little more spacious and not so hot. ”Lu Kevin, who was surrounding Li Min, immediately took half a step back.Wang vigorously moved his stiff fingers to the operating table, and Director Li stopped him: "Don't go over, you won't see anything after you pass, and they will give you a chance when they close the skull." ”Wang Dali was embarrassed, but he could only stop regretfully, and the conversation between Director Li and Dean Chen was full of guidance.He could only clasp his hands in front of his chest, his eyes were eager to wait, and he looked at Li Min who was busy with envy.
*Chan Man-keung continued to do his best to show his vision.He soon found out that the two of them had been operating together for a long time, and it was really a bit of a hindrance to have an extra intern.Without the hook-pulling Wang Dali, Li Min's movements became relaxed and light."
Be slow, be slow.Slow it down. ”Chen Wenqiang reminded Li Min, who was moving faster."
Yes.""
Do you want to change positions?""
Not for now.I slowly turned down from the top edge. ”The advantage of not changing positions is that the field is constant and immovable, which is conducive to operation.But as they continued to stare at the microscope, they both felt tired.Microsurgery is different from other surgeries in that the surgeon is more likely to feel fatigue when the surgeon is stressed and has a fixed field of vision.Li Min slowed down the movement of his fingers, and after half an hour and half an hour, the top of the hemangioma and the side close to Li Min were smoothly peeled out of the brain tissue."
Doctor Li, drink water."
Sister Feng chose a good time for Li Min and Chen Wenqiang to switch positions, and inserted a cut infusion tube into her mouth from the side of Li Min's mask."
Thank you."
Li Min held the infusion tube in his mouth and thanked him vaguely.I inhaled 100 milliliters of glucose candy in my mouth with my eyes closed, and I felt tired and was immediately driven away a lot.After Chen Wenqiang also drank some glucose, they began to devote themselves to the struggle to peel off the hemangioma.The minute hand turns again.Director Li stood up, and his steps gently and slowly moved to the middle behind Chen Wenqiang and Li Min.In front of me: the hemangioma that had been peeled off was trembling, like a raw egg yolk that had been peeled off, completely leaning on the thin membrane to wrap the translucent, jelly-like substance inside.The criss-crossed and filled blood vessels in the tumor are like thin red threads, mixed with transparent water-like substances."
Pug."
Li Min reached out and spread the needle-like ion-stripping in the palm of her hand, Xu Li took the ion-stripping and put the pug in her palm."
Come again.Again.Again......
One more. ”Li Min blocked all the arteriovenous blood vessels associated with the hemangioma with pugs."
Crocodile mouth scissors."
Xu Li slapped the scissors prepared in her hand into Li Min's open palm."
Broken?"
Li Min asked Chen Wenqiang.Chen Wenqiang reached out and replaced the two cup-shaped tweezers, gently clamped the transparent hemangioma adventitia, and then said decisively: "Broken." ”Li Min cut the blood vessels supplying the tumor, she held a few "pugs" steady with one hand, spread the scissors in the palm of her hand with the other hand and stretched out to Xu Li, and asked for "gauze" in her mouth.Prepare the silver clip. ”Chen Wenqiang lightly lifted the completely severe, trembling jelly ball from the brain tissue, and Li Min immediately put the gauze in his hand under it.She was too afraid that in the distance of more than ten centimeters from the surgical field to the medical record basin, the capsule of the hemangioma could not bear its own weight and the gravity of the pug and ruptured.She gently held the bottom of the hemangioma, followed Chen Wenqiang's hand and moved, and finally put the baby's hemangioma into the pathology basin handed over by Xu Li.She and Chen Wenqiang couldn't help but let out a sigh of relief.Everyone in the operating room, who was holding their breath like them, also let out a long breath.Sister Feng took the pathological basin containing the ball-pong ball-sized tumor, and said exaggeratedly: "Oh, why don't I think there is any weight." ”Director Li praised behind Chen Wenqiang and Li Min: "Okay.This surgery is done well, and Xiao Li can teach in the future. ”* "Dr.
Li, Silver Clip." ”Xu Li reminded Li Min, who shrugged his shoulders.Chen Wenqiang moved his shoulders twice and reached out to hold the pug, so that Li Min could get on the silver clip.The clean field is empty, leaving an empty nest the size of a ping-pong ball.The brain tissue, which had been oppressed for a long time, slowly filled up with this empty socket at a speed visible to the naked eye."
He doesn't have to wait to be discharged from the hospital, and he will be back to the state he was in when he didn't have a hemangioma.Before being discharged from the hospital, remember to take a brain CT scan for a before-and-after comparison. ”Chen Wenqiang pointed at the blood vessels and nerves as thin as a hair, and said: "If there is no microscope, or if we cut off these blood vessels, this operation can save an hour and a half, but the damage to the patient is incalculable." ”Li Min nodded and said, "Then doing so may cause ischemia in the brain cells in this area."
Sister Feng, help me remove the microscope. ”Sister Feng, the nurse who patrolled the station, immediately put down her work and walked over and took away the microscope on the heads of Li Min and Chen Wenqiang.Chen Wenqiang continued: "There are still many places in the cerebral cortex that have not yet determined the specific functional area, but there are many cases reported that meningioma in this sagittal sinus region can cause epilepsy. ”"The patient's first symptom was a headache, but I asked his daughter-in-law about how he had a severe headache that caused a small amount of urinary incontinence.I told you about it last time.Teacher, do you think he will have a headache that lasts for a certain period of time and will also have epilepsy?
”"Very capable.It took more than two years after he developed symptoms, and if he had had had a brain CT scan earlier, the tumor would not have grown so big. ”"Dean Chen, can you see a 1 cm brain tumor CT?""
Yes.Individual tumors less than 1 cm can be enhanced by CT if they are supported by clinical symptoms.But now with MRI, half a centimeter can be scanned.Especially this hemangioma. ”"This is the first time I've seen a hemangioma like this.It's much harder than fibroids in the past. ”"Xiao Li did a good job in today's surgery.Lao Chen, I think that's all you do. ”Director Li interjected."
It's better to do it with that neurosurgeon."
Chen Wenqiang is very satisfied.Li Min changed the topic a little shyly: "Teacher, it's still a binocular eyepiece."
Not only is it easy to judge the distance, but it is also not like a monocular, which always feels that the field of vision is limited. ”"I didn't have binoculars before, and I was already very satisfied with having a monocular."
The operation can now be considered over.Li Min stood for several hours, and at this time sat on the leather round stool made by Director Liu, constantly shrugging his shoulders and shaking his waist and back slightly from side to side.She was waiting for the instrument nurse to remove the tray of microscopic instruments and replace them with instruments for general neurosurgery.Xu Li's movements were very slow and cautious, but Chen Wenqiang walked over and stood opposite her and kept telling her: "Slow down, slow down."
My pipe knife costs more than 100 dollars, and this plate can cost thousands of dollars, don't drop it for me. ”"Do you still want to drain it?"
Li Min took Wang Dali to close his skull.Shuye was too clean to see any bleeding, and she didn't want to have a drain placed.After the bone window was treated with bone wax, Li Min asked Chen Wenqiang, who was sitting on the side, for advice."
What is the blood pressure?"
Chen Wenqiang asked Director Liu.“126/80。
Same as preoperative basal blood pressure. ”"Then don't let it go."
Chen Wenqiang was determined to take a gamble.Director Li wanted to say something behind them, but in the end he couldn't help but speak.* The dural suture at the back is simple.The skull fenestration is not too big, and no hose is placed for drainage, and after the bone plate hemostasis, Li Min immediately retracts the skull plate for fixation.It's a familiar job.And intern Wang Dali finally got a few opportunities to tie knots and cut all the threads."
Doctor Li, the dressing is ready for you here.""
Well, thank you.You can give the unused silk thread to the intern. ”"Okay."
The brittleness of the thread after repeated sterilization will increase, and it is generally thrown away as consumables.When Li Min was an intern, he often asked nurses to practice knotting such silk threads."
Senior sister, this operation is beautiful."
Director Liu first praised Li Min, and then congratulated Chen Wenqiang and said, "Dean Chen, you have a successor." ”Chen Wenqiang smiled proudly, but still said modestly: "It's just that Xiao Li is that material, otherwise she won't be able to do it if she is given the opportunity."
Lao Li, I'll show the hemangioma to the patient's family, and then take the patient back, and you can take the next one. ”Director Li also slowed down because of the success of the operation.He asked Li Min, "Do you want to make the next lung cyst?"
”Li Min immediately nodded and said, "Yes." ”"Hurry up and do it later, let's go to lunch when we're done."
*When Director Shi heard that the hemangioma was about to be completely discharged, he pushed the patient outside the operating room and waited.Then he was fortunate to witness the glorious moment when Li Min and Chen Wenqiang completely praised the hemangioma.At this time, seeing that Director Li wanted Li Min to be a surgeon, he immediately said, "Lao Li, you and Dr.
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Li will do it, and I will support the two of you." ”This kind of surgery is not as difficult as a segmentectomy, but it is to separate the entire cyst from the lung, which is not half as difficult as the cerebral hemangioma just now.Director Shi was happy to let go and give face to Director Li and Dean Chen.Director Li said: "Lao Shi, don't be lazy, you accompany Xiao Li for surgery and bring our two interns with you."
Lao Chen and Xiao Li's interns have both undergone surgery. ”"That's okay, I'll listen to your arrangement and set up a stage for Xiao Li."
Director Shi agreed with a smile, and then said to Li Min, "I'm going to brush my hands." ”Li Min hurriedly straightened his position, stopped Shi Lei and explained, "Director Shi, I'll disinfect it."
I'll look at the position next time. ”Director Shi smiled and stopped."
Okay, next time I'll accompany you to set up your position, hurry up today, don't delay lunch."
He is willing to set up a stage for Li Min, in addition to the reasons for Chen Wenqiang and Director Li, there is also Li Min's understanding - she has always rushed to disinfect and take over the patients.Although it is an inconsequential operation, although it has changed from being an assistant to Director Li to being an assistant to Li Min, the thoracic surgery is now Director Li's, but Li Min's performance is also comfortable.* The atmosphere in the operating room was peaceful, but the chaos in the operating room next door quickly spread throughout the operating room - Dr.
Wang's practice last night made the head nurse make an exception.When Li Qin was about to finish the operation, he "broke in" with oval forceps, leaving bruises on Dr.
Wang's back.Dr.
Wang screamed in pain and didn't dare to hide."
Do you dare next time?
Is the operating room a place to enter?
”The head nurse pressed him menacingly.Dr.
Wang put down the work in his hand, let Dr.
Liu continue to stitch up, and confessed to the head nurse and begged for mercy."
Head nurse, you brought me to the student last night.These interns were selected by the medical school, and they all passed the aseptic operation. ”"How's it going?
Your doctor has a set of hand washing clothes at a time, and I am comfortable with you on a hot day.But what about students?
Come in and change your handwashing clothes at a time, is it not your right to take those dozens of sets of handwashing clothes without you tidying up or packing them?
You're doing nothing in our operating room?!
”() The distance is a bit far