"Scalpel..."

Tanglou gave the order directly, without any stage fright, nor was he frightened by the fact that the two directors of the outer courtyard acted as assistants.

The equipment nurse is very familiar with the cooperation, and I admire it from the bottom of my heart. It is indeed Dr. Tang who performed the surgery before the big boss in each hospital!

Tang Lou chose the most commonly used Ji point approach. In order to reduce the incision as much as possible, Tang Lou used a more sophisticated pen-holding method to make a frontotemporal arc-shaped incision.

Seeing the operation in Tanglou, several chief doctors in the observation room were a little trembling: "Isn't he going to make marks?"

"This is an internal carotid artery-posterior communicating artery aneurysm clipping operation, not a simple appendicitis surgery with McLean's incision!"

Although I have seen videos of blind cutting operations like this in Tanglou before, the scene was still tense for no reason.

While all the doctors were on tenterhooks, Tanglou showed no hesitation in his hands.

The patient's head was shaved off one day before the operation, the scalp was washed, and the hair on the scalp was shaved off again before going to the operating table. Therefore, the head was very smooth and shiny, and the scars from the last surgery were still very obvious.

However, Tanglou did not spend much time thinking, and started directly 1cm above the patient's ear, upward over the temporal crest, curved forward, and finally beside the sagittal line.

One knife, another knife, another knife!

"Damn, so fast?"

"You see, the incision in Tang Lou is completely hidden within the hair. You actually consider the beauty and beauty afterwards. You are really confident."

"But, do you think that his incision is a little too small, and the surgical field cannot be clear with such an incision?"

Director Feng on the side was also worried about the tenement building. Although everyone wanted to make the incision smaller when designing the plan, it was too risky to make it so small.

"Dr. Tang, is the incision too small? Or should it be more conservative?"

Director Feng thought for a while and was ready to remind you that the smaller the incision, the more difficult the subsequent surgery will be, and the relative time spent will inevitably increase.

What responded to him was Tanglou's next command which was impenetrable: "Periosteum stripper..."

Under the super surgical field, Tanglou's eyes were as clear as an eight-fold mirror at this moment. If he had known this earlier, he might have made the incision smaller.

With his talent and concentration, Tanglou was completely immersed in the operation, and his aura was undeniable.

Director Feng frowned and surrendered.

I saw Tang Lou very skillfully using the periosteal stripper to push the temporalis muscle downward away from the bone surface to the upper edge of the zygomatic arch.

"Drill... milling cutter..."

In order to complete the operation as quickly as possible, Tanglou increased the speed on top of the usual operation, so the operations were closely connected, and it felt like watching the operation at 1.5 times speed in the observation room.

Soon, Tanglou completed drilling holes in the skull and milled out the bone flap.

In the observation room, Yang Ming and Li Yundi felt their hands itching as they looked at it. This was drilling holes in the skull. They were just turning the intestines and cutting the appendix.

The bosses from other hospitals are also paying full attention. I have to say that Tanglou's operation is really smooth and standard. It is a pleasure to watch him operate!

"How did you do it at such a young age? Does the prenatal education in Tanglou involve surgery?"

"Next, I'm going to incise the dura mater. Due to the second surgery, there will be cerebrospinal fluid or submeningeal blood outflow. I'm going to help..."

During the operation, apart from giving orders, the people around him did not deserve to have names.

Assistant A clicked, and quickly cooperated with Tang Lou to release the cerebrospinal fluid and subdural blood. The dural sac relaxed, making it easier to pull away from the sphenoid crest later.

"Rongeur...Second Assistant is ready..."

Assistant B immediately cooperated with Tang Lou to use rongeurs to remove the sphenoid crest.

"Micro drill..."

When they heard Tang Lou issue the next order, both the observation room and the two assistants became nervous.

The next step is to expose the aneurysm which is very critical!

The surgeon needs to control the strength, angle, length, and speed. Assistant A watched Tang Lou's powerful hands with bated breath, controlling the micro drill to continue grinding the sphenoidal crest.

"Dr. Tang must have been too harsh on himself. In order to reduce the patient's complications, he made the hole very small, so there is very little operating space. This requires very high finger flexibility and mental concentration."

"If I didn't have the courage to drill, if I shook my hand, my brain would drip all over the floor."

"Look carefully at Dr. Tang's path!"

On the screen, one could see that Tanglou's movement was grinding inward from the sphenoid crest to the orbito-meningeal artery from the orbit to the dura mater, and then suddenly stopped.

"sharp!"

In the observation room, Cheng Jian also sighed, this feeling was like driving a sports car and stopping just in front of a cliff, no more, no less.

Requires precise control and judgment!

Next, Tanglou made an arc-shaped incision into the dura mater with the sphenoid crest as the base.

"Huh~"

Assistant A was the closest and took a deep breath, even more nervous than the surgeon himself.

Even after decades of surgery, he admired Tanglou's decisiveness at this moment. His hands did not tremble at all and he entered the next step without a second's pause.

"Sutures...needle-holding forceps..."

They saw that Tanglou had suspended and sutured the dura mater to the temporal fascia and periosteum. On the screen, everyone could see a cone-shaped gap with the tip pointing downwards formed between the frontal lobe, the temporal lobe and the sphenoid crest.

"Did you notice that Dr. Tang didn't even use a microscope and just sutured it? How did he do it?"

"Is it familiar to you?"

A doctor answered, and then patted his mouth. Could it be that Dr. Tang's family sells human heads? Otherwise, how could there be so many skulls for him to practice with?

"Look, it's coming out!"

In the excitement of everyone, Tanglou separated the sylvian fissure along the gap in the previous step, and successfully exposed the aneurysms located in various parts of the arterial ring at the base of the brain.

Seeing the red, white, and bloody blood, Cheng Sisi felt a little uncomfortable in her throat.

At this point, the first step of the approach was completed, and all the doctors took a breath.

I looked at the time and saw that only ten minutes had passed!

"It's too fast. It's twice as fast as expected. Dr. Tang is really a genius."

"Yes, but this is the first step in a long march of thousands of miles. Let's continue to watch."

Observing doctors, when this point began to repair and take a breath, Tanglou in the operating room did not relax for a moment.

He gave the order directly to Assistant A: "First aid, hyperventilate, prepare to incise the dura mater..."

Tanglou directly issued the second order.

Generally speaking, there are two methods: hyperventilation or dehydration with mannitol, followed by incision of the dura mater.

However, Tanglou chose a faster method of hyperventilation, and only the assistant director could control the heat.

Soon, the patient's brain collapsed.

"Assistant B, next, always pay attention to the intracranial pressure and report the intracranial pressure nodes..."

Of course, it was impossible for Tanglou to perform surgery and monitor intracranial pressure at the same time, so Assistant B watched carefully.

"Intracranial pressure is low pressure, and the frontal lobe can be retracted..."

With the cooperation of the two chief doctors, Tanglou is naturally very handy. The first assistant is extraordinary, and the second assistant is comparable.

Tanglou opened the intracranial cistern artery very quickly and divided the Sylvian fissure posteriorly.

"Arachnoid knife...electrocoagulation preparation..."

Tanglou issued instructions one after another and quickly completed the frontal lobe incision of the arachnoid membrane, and then electrocoagulated the small veins from the frontal lobe to the Sylvian fissure vein.

"It's amazing. Tanglou's ability to identify veins is so strong."

"Yes, to be able to do it so skillfully despite such a poor surgical field, I can only say that he understands the structure of the affected area too accurately."

During this process, cerebrospinal fluid continued to flow out, and Tanglou was not affected at all, and separated along the frontal lobe and temporal lobe.
Chapter completed!