My Medical Skills Give Me Experience Points Chapter 1332 - 526: Challenging a Top-Tier Surgery, A Glimmer of Insight

The dural barrier’s opening is, in essence, a direct passage.

The initial action involves draining the blood within the skull.

Despite this being the most straightforward part of the procedure, Director Wu Yongming proceeds with utmost caution. Missteps can easily occur when aspirating intracranial fluid, potentially causing damage to critical brain tissue.

The intracranial environment of Deputy Director Lu presents even greater challenges, with risks far exceeding those of a typical patient.

To begin with, the advanced age, rigidity, and fragility of his blood vessels alone necessitate extreme precision from the surgical team, akin to treading on thin ice.

After a significant portion of the intracranial blood has been removed, the pressure inside the skull returns towards normal levels, or perhaps even drops slightly below.

This is because the originally sealed cranial cavity now features two openings, essentially making it a semi-open state.

In medical terms, this technique is referred to as fenestration.

The surgical procedure is proceeding without a hitch.

However, complications are imminent.

Merely draining the blood proves insufficient; without staunching the source of the hemorrhage, the cavity will inevitably refill rapidly.

Director Wu Yongming endeavors to mend the ruptured blood vessels. Beyond the complexity of anastomosis, even the debridement process proves difficult.

"No, the precise location of this blood vessel is far too close to the brainstem. The available surgical space is exceedingly confined, and I lack the confidence for endoscopic hemostasis."

Droplets of sweat, as large as mung beans, appear on his forehead as he repeatedly shakes his head.

It feels as though a formidable beast stands as an insurmountable obstacle.

The skill level required for routine surgical operations is remarkably similar across practitioners. At the very least, achieving a standard level of proficiency allows for the successful completion of most surgeries.

To quote a renowned surgical expert from yesteryear, surgery is fundamentally about excising abnormalities and performing repairs.

Of course, the same expert uttered these words during the 1960s.

With the advancement of surgical medical technology to its current state, operations no longer solely involve patching and tissue removal. Numerous innovative technologies have been integrated, including artificial blood vessels, vascular stents, and artificial hearts, among others.

Even the seemingly simple tasks of repairing blood vessels or organs present immense challenges to a surgeon’s expertise.

Mending blood vessels within the constricted intracranial space, particularly through endoscopic techniques, escalates the difficulty substantially—approaching a hellish level of complexity.

Positioned directly adjacent to the brainstem and surrounded by other vital brain tissues, surgeons with lesser psychological resilience might find their hands trembling uncontrollably when manipulating the endoscopic instruments.

This is not an exaggeration.

Medical professionals, especially those in surgery, confront psychological and mental pressures during operations that are almost beyond comprehension.

The reason is simple: any adverse outcome for the patient rests squarely on the surgeon's shoulders!

"The extent of damage to this blood vessel isn't particularly extensive, its length is quite short, and its proximity to the brainstem renders surgical manipulation extremely inconvenient. Director Wu, why not attempt a repair using a vascular stent?"

Director Gou Qiong offers a suggestion from his position nearby.

"If it were a small cerebral aneurysm, I could employ coils for repair. Even for a slightly larger aneurysm, a stent might suffice. However, this particular blood vessel is entirely unsuitable for stent placement."

He reaffirms his negative assessment with repeated headshakes, rejecting the proposed solution.

The primary objectives of drilling holes and creating fenestrations in the skull are to alleviate intracranial pressure by draining excess fluid.

The secondary, and crucial, objective is to repair the blood vessels and halt the bleeding.

It is important to note that not all vascular repairs are amenable to stent application.

Firstly, the cost of stents is considerably high. Secondly, the surgical complexity involved is also exceptionally demanding, especially when attempting to place a stent within intracranial arterial vessels—a feat that is dauntingly challenging.

"Alternatively... perhaps you could assist me by gently adjusting the brain tissue situated above the bleeding point, allowing me to attempt the repair myself!"

Observing the hemorrhaging cerebral artery, Zhou Can's eyes betray a flicker of excitement.

In stark contrast to Director Wu Yongming's visible apprehension and lack of confidence, a profound dread clouding his expression, Zhou Can radiates unwavering determination, embodying the spirit of a fearless warrior.

"Dr. Zhou, you must exercise the utmost care and absolutely refrain from any reckless actions. Should this attempt prove unsuccessful, we can reconvene for further consultation and explore alternative surgical strategies."

Even as Wu Yongming voices these words, he harbors a grim certainty: no viable alternative surgical plans exist.

If a superior surgical approach were available, the procedure wouldn't be postponed indefinitely without treatment.

While internal medicine might occasionally offer alternative treatment paths, options for ruptured intracranial arterial vessels are exceedingly limited—typically numbering only two or three.

"I will exercise extreme caution."

Zhou Can replies with resolute conviction, his expression serious and unyielding.

The newly appointed chief surgeon then instructed Director Wu to gently shift the brain tissue aside. While this surgical maneuver demanded a degree of finesse, it largely involved a mechanical action akin to retraction.

Naturally, with the assistance of the endoscope arms, the physical strain was considerably minimized.

Following this, Zhou Can began his work within the exceptionally confined surgical field.

"No, a slight adjustment is needed; it must be shifted approximately 0.5 CM further."

"Understood, I will proceed with that."

Director Wu clenched his jaw, his gaze fixed on the monitor, meticulously maneuvering the delicate brain tissue to afford Zhou Can greater room for operation.

"Any further movement is impossible; we have reached the absolute limit. Exceeding this point risks severe damage to the brain tissue."

Director Wu, his voice hushed in apprehension, dared not avert his gaze from the screen, mindful that any increased pressure could irrevocably harm the neural matter.

Whether within the abdominal cavity or the cranial vault, the act of retracting surrounding tissues during surgical procedures invariably inflicts some level of trauma upon the body.

Consequently, patients who have undergone abdominal and thoracic surgeries frequently develop significant adhesions between their tissues and organs, leading to a cascade of adverse long-term effects, commonly identified as postoperative complications or sequelae.