At this point in the operation, according to the original surgical plan, the position of the interventricular foramen was determined, and the choroid plexus was seen. Just put the head end 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.
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The problem is that since ventriculoscopy is used, well-intentioned doctors 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 to have communicating cerebral obstruction. Is this really the case, or the CT and other preoperative examinations failed to capture anything. The accuracy of CT in this era is not very high. This has been mentioned in previous cases.
The ventriculoscope used by doctors now is a hard mirror, not a soft mirror. To view the ventricles more comprehensively, the doctor can change to an angled mirror. Pull out the ventriculoscope, change the head, replace it with a 30-degree lens, and then reinsert it.
Once is familiar, twice is familiar. When Xie Wanying rotates the camera 30 degrees, her hands are more stable and there is nothing to be afraid of.
The original lens only looked straight ahead, but when the lens was replaced with an angled lens, and then slightly moved back and rotated, one could see the walls of the dome-shaped lateral ventricle.
The overall shape of the lateral ventricle is something that medical students have seen in the school's anatomy teaching room. It is like a cavity, but 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 expect that they are also present in the human brain. This is a profound understanding that medical students can hardly understand in the dissection room. There are dead things in the dissection room.
It is not a living creature, unlike in the operating room where you can witness the life phenomena in the cavity with your own eyes. For example, on today's monitor screen, you can see the scene of the cerebrospinal fluid flowing in the ventricles of the patient's brain.
After examining the lateral ventricle, we further examined the third ventricle. This time the lens has to pass through the interventricular foramen. It can be said that I have no experience in this aspect for the first operation. Fortunately, I used a hard scope. The mobile operation of the hard scope is correct.
For patients, the main action is to insert or move back. The tube is not like a soft mirror and is like a snake, making it difficult for the doctor to control. At this time, just enter slowly and slowly according to the super turtle speed displayed on the monitoring screen.
Basically nothing will happen, there is not much difference between novices and veterans in this regard.
After reaching this point, Xie Wanying realized why Senior Brother Cao asked her to try the hard mirror first.
It is said that the hard mirror is more likely to injure the tissue in manual operation. In fact, as long as the operator knows the upper limit of the strength and is cautious, it is much easier to perform than the soft mirror.
From this point of view, Senior Brother Cao may be better at educating students than Senior Brother Tao, and he is a hidden gold medal teacher.
She is not the only one who thinks so.
The group of second general foreign students who were watching, after all, laparoscopy is also a tough job, and they also realized something. They glanced at Cao Yong: This person, pretending to be serious on the surface, is actually taking care of someone in different ways.
Back to surgery, hard lenses seem to be full of advantages. They seem to be very friendly to doctors and can make them easier to use. Why should we invent soft lenses? Wouldn’t it be better to just use hard lenses?
There are flaws in the hard endoscope. For example, for the first hard injury, it is especially important to make the surgical incision accurately when placing the hard endoscope. 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.
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The second flaw is more fatal to the hard scope. After entering the third ventricle, using a hard scope will find that no matter how many angles the lens is changed, it can no longer pass through the midbrain aqueduct.