"With help, open the Sylvian fissure and release the cerebrospinal fluid."

Tanglou gave the order directly, and Assistant A immediately cooperated.

Tang Lou performed simultaneous separation operations, proximally along the middle cerebral artery, and a complex and tough arachnoid cord appeared at the bifurcation of the internal carotid artery. Tang Lou skillfully cut the posterior sylvian fissure and opened it.

After the carotid cistern and chiasmatic cistern are opened, more cerebrospinal fluid will flow out immediately.

In the observation room, young doctors Yang Ming, Li Yundi, and others were all frightened by what they saw. They were operating close to their brains!

They all saw the ravines on the patient's white brain and the dense red bloodshot network.

Under Tanglou's precise operation, the traffic aneurysm was fully exposed.

"You see, outside the optic nerve is the internal carotid artery. If you trace it backward, you can find the aneurysm."

A director of the Second Hospital explained the secrets of this operation to several young doctors: "The neck of the tumor is usually outside the internal carotid artery, and the top of the tumor can extend under the tentorium of the cerebellum or above it. The former often compresses the oculomotor nerve.

The latter is often adhered to the inner side of the temporal lobe and is easily torn when the frontal lobe is lifted or the temporal lobe is stretched..."

Everyone followed the explanation of the director of the Second Hospital and understood a lot after seeing the operation of the Tanglou again.

Seeing everyone's reaction, the director of the Second Hospital was very proud. Young people really need to watch it accompanied by elders like himself.

The director continued: "You see, this patient's tumor extends to the subtentorial cerebellum, which will compress the ocular nerve. Now Dr. Tang is performing dissociation, which pays great attention to the entire dissociation sequence, strength and understanding of anatomy.

, if not controlled well, it can easily lead to rupture of the tumor roof."

Sure enough, on the screen, Tang Lou first chose to free the internal carotid artery wall on the opposite side of the aneurysm neck, then separated the proximal and distal corners, and separated the two sides of the aneurysm neck to a width sufficient to extend the two blades of the aneurysm clip.

and depth, without separating the tumor top to prevent its rupture.”

Seeing Tanglou's clear thoughts and precise operations, the director of the Second Hospital kept praising: "Amazing, Dr. Tang's understanding of this technique is so pure and sincere."

The young doctors behind him nodded in understanding.

"With your current eyesight, it is indeed a bit shallow. When you actually start to try this surgery, you will know how skillful Dr. Tang's operation is."

The director of the Second Hospital thought for a while and looked at Cheng Jian very politely: "Director Cheng, can you share the video of this operation with us so that we can take it back for study and research later?"

Several directors from other hospitals also looked at Cheng Jian, their eyes full of expectation.

Cheng Jian pondered for a while, took a sip of tea, and then said lightly: "Okay."

"Hahaha, Director Cheng is more particular. From now on, we must let all the doctors in our department study hard."

"Hahaha, easy to say, easy to say."

Director Cheng was extremely helpful.

After all, Tanglou belongs to his department, and with so many directors begging for surgery videos, he, as an old director, still has a good reputation.

In the operating room, Tang Lou had already begun to use a sharp knife to cut the dura mater on the surface of the anterior protrusion of the bed.

"Body stripper... micro drill..."

Tanglou didn't pause for a moment, and went directly to the next step. This rapid connection ability also made the two assistant directors tremble in their hearts.

"At this speed, the operation can really be completed ahead of schedule!"

While the two directors were impressed, Tanglou had already used a bone stripper to push the dura mater away from the bone surface on both sides, and then used a micro drill to grind away the anterior clinoid process.

After the anterior bed was resected, the proximal wall of the posterior aneurysm was exposed, and then the exciting instructions were given:

"Close the tumor neck!"

A minute later, Tanglou steadily separated the tumor neck.

"Tumor clip..."

In the observation room, the director of the Second Hospital exclaimed:

"Everyone is optimistic, the next step is the clipping operation. You see, Dr. Tang's selection of tumor clips is very precise. The blades of the tumor clips should be opened wide enough to avoid inserting the tumor neck. At the same time, the tips of the blades should exceed the tumor neck.

This is to avoid incomplete clamping. At the same time, the clamping should not be done too fast to avoid tearing the tumor wall."

As soon as the director of the Second Hospital finished speaking, he saw on the screen that the tenement building was quickly closed.

Various junior doctors: "???"

Director of the Second Hospital: "Meow meow meow!"

After pondering for a while, the director coughed a few times and then said awkwardly: "Dr. Tang is very talented and different. You should just shut him up slowly and honestly. Do you hear me?"

The junior doctors thought for a while and nodded sadly. They looked at Tanglou's cool movements and were really envious!

On the screen, everyone saw Tang Lou begin to puncture the tumor sac with a fine needle and start drawing blood.

"Director, what is Dr. Tang doing?"

The director of the Second Hospital did not speak until Tang Lou completed the operation and carefully confirmed that the car would not roll over, then he said: "Dr. Tang is after clipping the tumor neck to verify whether the clipping is complete. The common method is to use a fine needle

Puncture the tumor sac and draw out a small amount of blood

Empty and no longer filling means the clipping is complete. If the amount of blood drawn exceeds the capacity of the tumor sac, and blood spurts out from the needle hole after pulling out the needle, it means the clipping is incomplete, and the tumor clip needs to be adjusted until the clipping is complete. Generally speaking,

It takes several tries before it can be completely clamped."

The director of the Second Hospital said firmly: "Look carefully, as soon as Dr. Tang pulls out the needle hole, blood will spurt out, indicating that fine adjustments are needed."

Sure enough, on the screen, Tanglou pulled out a thin needle.

One second, two seconds, three seconds...

What I fear most is the sudden silence in the air.

The director of the Second Hospital also opened his eyes in disbelief and was speechless for a long time.

Shouldn't it?

Even a skilled driver like himself has to adjust his posture to ensure complete clamping.

Could it be that Tanglou was so lucky that it was shut down in one go?

Sure enough, the picture on the screen and the ruthless reality defeated the director of the Second Hospital's cognition.

"Wow, Dr. Tang is so amazing, he got it right in one go."

A female doctor clenched her fists and sighed.

"Yes, you are indeed Dr. Tang. Director, don't worry, we understand that you and Dr. Tang are different."

When he saw that he was still his junior doctor, the director of the Second Hospital suddenly shut himself up in the face of such straightforward complaints.

Tanglou has already started suturing the dura mater after hemostasis, which means that Tanglou has completed the most dangerous operation.

"Bone fragment reduction..."

Tanglou's calm instructions resounded in the operating room, and the two chief doctors also cooperated quickly.

"Director, why does the bone fragment need to be restored..."

The director of the Second Hospital saw at a glance that it was the junior doctor asking questions again, took a step forward, and covered his mouth.

"No, you don't want to know!"

"Hmm~"

Next, the observation room fell into silence, with occasional hums.

Only Tanglou's smooth operations on the screen and his various clear instructions are left.

"Titanium connectors...micro drills...metal wires..."

Tanglou continued to operate quickly.

Half an hour later, the connection and fixation of the free bone flap was completed.

After another half an hour, Tanglou completed the suturing of the scalp and the placement of the bone flap for drainage.
Chapter completed!