When it comes to the head and neck area that everyone was worried about before, the place with the largest gap in three-dimensional space should be the most challenging part for doctors. I just remember that Xie didn’t seem to have done any pre-bending of the through bar before.
What should I do to pre-bend the bar? There is no mastoid and subclavian relay points.
The thrilling scene that a large group of people were worried about turned out to not have happened after a while.
Lifting and threading forward steadily, the improved loom continues, and the shunt tube passes steadily through the neck.
Dr. Wang's entire expression was like "Ahhhhh".
"It's really..." Dr. Jin couldn't hold back his words. He couldn't figure it out like everyone else. It was really strange. Looking at it all the way, the surgeon Xie was very sure about the whole step of threading the thorax. Since the sad neck could be easily
It's easy to pass through, so why open a relay opening under the xiphoid process?
Ask her to say that it is really possible to achieve zero relay. She had doubts before, but now she completely believes that the surgeon has the ability to do miracles.
You should ask professionals and teachers about this issue.
Don't just ask neurosurgery.
After all, neurosurgery may require consultation with general surgery for even the steps of placing a shunt into the abdomen.
"Has the liver and gallbladder disease come?" Wei Tianlang looked back.
It stands to reason that Tao Zhijie's Buddha should come. Tao Zhijie had been staring at him when he was interning in the Second General Foreign Language School.
"It seems that the extrahepatobiliary surgery is not over yet." someone replied.
Nothing outside the liver and gallbladder came.
People on site can only do their own analysis.
"Does this patient have enlarged liver?"
"I remember they put the end of the shunt in the neurosurgery department at the liver."
There were many big guys at the scene, and their speaking skills were not at the technical level that elementary school students are talking about.
It should be mentioned here again that as mentioned before, the end of the peritoneal shunt is placed into the abdominal cavity to allow cerebrospinal fluid to be absorbed. It is actually the peritoneum that absorbs cerebrospinal fluid.
What is the peritoneum? I talked about it during my internship in the Department of General Surgery II.
Ligaments. Among them, the greater omentum is a double-layered peritoneum hanging from the greater curvature of the stomach and the proximal duodenum like an apron. It is highly mobile and filled with peritoneal fluid. This is the end of the shunt tube that is most likely to be trapped.
place. Therefore, the doctor's operation is to keep the end of the shunt tube away from the greater omentum as much as possible.
If you want to avoid the greater omentum, where can you place it? You may choose to place the end of the shunt tube inside the lesser omentum. The lesser omentum is much less mobile than the greater omentum and will not trap the end of the shunt tube by moving it around.
.The lesser omentum is the hepatogastric ligament and the hepatoduodenal ligament.
For this purpose, some doctors will make a midline or paramedian abdominal incision under the xiphoid process to expose the left lobe of the liver, place the end of the abdominal catheter of the shunt on the septal surface of the liver, and sew the catheter to the round ligament of the liver to prevent it from falling off.
This way you won't be trapped by the omentum.
The bosses were discussing, wondering whether the surgeon wanted to put the shunt tube in the liver.
This possibility is very low. Because placing it here is usually not the first choice of neurosurgeons. This is because the absorption of the peritoneum is stronger in the upper part of the abdomen than in the lower part. This is one of the reasons why patients with clinical abdominal inflammation and postoperative surgery often adopt a semi-recumbent position.
.
For patients with ventriculoperitoneal shunt, it is not a good thing if the absorption is too strong and the shunt tube is over-shunted.