At this point in the operation, according to the original surgical plan, the location of the interventricular foramen was determined and the choroid plexus was seen. It was only necessary to place the head of the shunt tube in the square of the interventricular foramen to avoid the choroid plexus, and the first small goal of the operation was achieved.
The problem is, since a ventriculoscope is used, a kind doctor will check the patient's lateral ventricles to see if there are any other problems in the patient's ventricular system.
This patient was previously suspected of having a communicating cerebral infarction. Is this really the case, or did the CT scan and other preoperative examinations fail to show anything? The accuracy of CT scans in this era is not very high, as mentioned in previous cases.
The ventriculoscopes used by doctors nowadays are hard scopes, not soft scopes. Doctors can replace the scopes with angled scopes to have a more comprehensive view of the ventricles. Pull out the ventriculoscope, change the head, replace the 30-degree lens, and reinsert it.
Practice makes perfect. When Xie Wanying rotated the camera 30 degrees, her hands were much steadier and there was nothing to be afraid of.
The original lens only looks straight ahead. When you replace it with an angled lens and then step back a little and rotate it, you can see the dome-shaped wall of the lateral ventricle.
The overall shape of the lateral ventricle is like a cavity, which medical students have seen in the anatomy teaching room at school. It is not a regular shape such as a perfect circle, but a bit like a strange-shaped cave.
There are many similar cavities in the human body, such as the trachea and the digestive tract, but most people don't think that there are also cavities in the human brain. It is difficult for medical students to experience this profound experience in the dissection room alone. The dissection room is full of dead objects, not living creatures, unlike the operating room where you can witness the life phenomena in the cavity with your own eyes. For example, on the monitor screen today, you can see the scene of cerebrospinal fluid flowing in the ventricles of the patient's brain.
After checking the lateral ventricle, we further checked the third ventricle. This time the camera had to pass through the interventricular foramen. It was my first time operating and I had no experience in this area. Fortunately, I used a hard endoscope. The mobility of the hard endoscope is very convenient for the surgeon. The main action is to insert or withdraw the endoscope. The tube is not like a snake that makes it difficult for the doctor to control it. At this time, as long as you enter slowly and slowly, according to the super slow speed shown on the monitoring screen, basically nothing will go wrong. There is not much difference between novices and veterans in this regard.
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At this point, Xie Wanying realized why Senior Brother Cao asked her to try the hard lens first.
It is said that the use of a hard endoscope is more likely to puncture tissue during manual operation. In fact, as long as the operator understands the upper limit of force and is cautious, it is much easier to operate than a soft endoscope.
From this point of view, Senior Brother Cao may be better at teaching students than Senior Brother Tao, and may be a hidden gold medal teacher.
She wasn't the only one who thought this.
The group of people from the General Surgery Department II who were watching also realized something, after all, laparoscopes were also hard to come by. They glanced at Cao Yong and thought: This guy, pretending to be serious on the surface, is actually taking care of someone in various ways.
Back to surgery, the hard endoscope seems to have many advantages. It seems to be very friendly to doctors and can make doctors easy to use. Why did we invent the soft endoscope? Wouldn't it be better to just use the hard endoscope?
The hard endoscope has its own shortcomings. For example, the first shortcoming is that when using a hard endoscope, the surgical incision is particularly important and must be accurate. If the direction of entering the lateral ventricle is wrong, it will be difficult to pass through the interventricular foramen and enter the third ventricle to continue the examination and operation.
The second flaw is even more fatal to the hard endoscope. After entering the third ventricle, using a hard endoscope, you will find that no matter how many angles you change the lens, you cannot penetrate the cerebral aqueduct.
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