Back at the ward, Su Yun stood beside the patient, staring at the ECG monitoring with his eyes tightly.

"How about it?"

"Not optimistic." Su Yun said, "Iabp can't give the heart enough rest."

Zhao Yunlong put the signature form in the medical record. Su Yun saw it and then breathed a sigh of relief.

"Director Lin will arrive soon. Boss, what are you going to do?" Su Yun asked.

"I think about it." Zheng Ren did not directly answer Su Yun's question, but inserted the patient's magnetic film into the reader.

Smoke disease is a cerebrovascular disease with unknown cause, characterized by chronic progressive stenosis or occlusion at the end of the bilateral internal carotid artery, the anterior cerebral artery, and the beginning of the middle cerebral artery, and secondary to abnormal vascular network formation at the skull base.

Because this abnormal vascular network at the skull base resembles "smoke" on the cerebral angiography image, it is called "smoke disease".

The MRI clearly shows the pathological morphological changes of the patient's brain blood vessels: old cerebral infarction, localized cerebral atrophy is the most obvious in the base of the frontal lobe and the temporal lobe. The abnormal vascular network at the base of the skull is honeycomb or reticularly low-signal vascular images due to the flow-vacuum effect.

A more obvious smoke disease, Zheng Ren felt a little worried when he looked at the hyperplasia of blood vessels that looked like smoke that was vomited out after smoking.

Forget it, no matter how the patient's family chooses, it's better to go to the system operating room to try it.

Although there is not much hope to save the patient, Zheng Ren doesn't want to give up as long as there is a glimmer of hope.

If the patient can be rescued in the system operating room, Zheng Ren also wants to give it a try.

The big pig's hooves are simply abominable. If you have such a serious illness, don't you issue a task?

Zheng Ren habitually placed his left hand under his right armpit, and held his chin with his right hand, looking at the patient's MRI image.

After he made a judgment, he went directly into the system space.

When clicking to buy the surgical training time, Zheng Ren was a little hesitant.

If the patient's family says he doesn't agree with the surgery, the surgical training time he bought will be wasted. The key is that this is not general surgery, but neurosurgery that he has never performed before!

At least you have to "waste" a master-level skill book.

A while ago, I was doing the task and the reward I accumulated was three master-level skill books. At that time, Zheng Ren thought he would use it for a long time, but he didn't expect that he would use the last one so soon.

I am about to go to Europe and face the ancient and mysterious vampire family...

But what if the patient's family agrees but cannot solve this problem with surgery?

After hesitating for less than a second, Zheng Ren made a judgment.

Click to purchase the surgical training time, and click to use the last master-level skill book.

Neurosurgery is the most sophisticated of all surgical procedures.

When Zheng Ren was in school, he heard from his teacher that when conditions were not good, a drainage strip was left after drilling and drainage. When the drainage strip was not smooth, he was generally accustomed to applying negative pressure to discharge redundant drainage materials.

But even such a process of applying negative pressure may cause several milliliters of brain tissue to be sucked out.

This leads to the patient's symptoms such as being unable to speak after surgery, hemiplegia, and walking weakness due to the lack of these brain tissues.

Therefore, Zheng Ren has always avoided contact with neurosurgery, which is a very difficult procedure for him.

But today I have no choice, so I have to try it anyway.

After all, he is a master-level skill, so there should be no problem, Zheng Ren thought to himself.

In 1967, yasargil first successfully anastomized the superficial temporal artery in the middle cerebral artery to treat cerebral ischemic diseases. Since then, many countries have carried out such surgery.

Zheng Ren doesn't believe that his surgical techniques are not as good as the surgical level in the 1960s and 1970s.

After entering the system operating room, Zheng Ren saw the experimental subject lying on the operating table.

He was not in a hurry to operate, but first observed the position of the experimental subject. After all, it was an unfamiliar neurosurgery, and no matter how cautious it was, it was necessary.

The system adopts general anesthesia method of intubation in the patient's supine position and is given intravenous medication at the same time. It is also punctured with radial artery, connected to invasive arterial pressure monitoring, which facilitates timely observation of the dynamic changes in blood pressure during the operation, providing a reliable basis for controlling and regulating blood pressure.

He can monitor arterial pressure anytime and anywhere, and it seems that the big pig's hooves are also very cautious, so Zheng Ren made a judgment.

The head of the experiment subject is tilted to the healthy side, and a microscope is placed in the operation area.

Zheng Ren glanced at Zeiss! He was a little excited.

According to Su Yun's description, Zeiss' microscope can help him avoid the trouble of underdeveloped vestibular nerves as much as possible.

Otherwise, every time you have a microsurgery, you will feel as uncomfortable as if you were riding a roller coaster after the operation.

Zheng Ren hates roller coasters!

It should be OK, start the operation. Thinking of this, Zheng Ren noticed that the experimental subject had already done the skin preparation work.

The preparation of skin in neurosurgery is to shave your head. An experienced nurse will shave quickly and stably. If you are inexperienced, you will either leave a hair nod or cut your scalp.

Zheng Ren glanced at the big pig's hoof was an experienced nurse and was almost perfect in skin preparation.

Conventional brain surgery disinfection, sterile dressings are covered, local anesthetics are injected subcutaneously around the incision edge, and wing point incision of the scalp and subcutaneous tissue and bipolar hemostasis.

The blood circulation of the scalp is so rich. Although Zheng Ren is a master-level surgical skill, he is forced to grow by the system and is not proficient. At this step, a considerable amount of time was wasted.

Then Zheng Ren began to free the superficial temporal artery, incised the reverse top of the temporal muscle with monopolar and covered with normal saline gauze.

Use the ao dynamic system and milling cutter to remove the skull bone flap, cut the dura mater, and free the middle cerebral artery and its branches under a microscope.

The microscope is good, 40 times, Zheng Ren is very careful in every move.

But it was the first time he did it, and he failed 12 times in this step.

The operation failed, the experiment died...

The operation failed, the experimental subject was paralyzed...

Zheng Ren was almost numb when he saw this kind of prompt.

However, after all, he has experience in microsurgery, and the operation range of neurosurgery is narrow, and the microscopic movements are as gentle as possible. He quickly mastered the characteristics of being able to fully understand it.

During the 13th surgical training, Zheng Ren finally completed the free steps perfectly.

Select the appropriate receptor, and the fracture end of the superficial temporal artery is anastomotic to the middle cerebral artery end-side, and suture it with 10/0ploene thread. During the suture process, soft needles and heparin saline are used to repeatedly rinse the field and lumen and prevent thrombosis.

After the anastomosis, thoroughly rinse the surgical field, flip the dural, count the surgical objects, apply the inner layer of the temporal muscle to the surface of the meninges and fix it with the dura on the bone margin.

Retracted bone flap, 3/0 absorbable thread sutures the scalp, covering the iodine yarn head.
Chapter completed!