Chapter 3182        【3182】Different superposition

Therefore, doctors are required to keep the operation smooth and not to poke the wrong place or make bleeding casually, as that will turn into a medical accident.

Doctors must keep the whole process smooth and without any obstacles, reach the target without getting lost, and must first find out the way of walking like driving.

How to follow this surgical approach, such as conventional practices for other types of surgery (if you take a car map navigation while driving), and have accrue the surgical experience of peers and your own (have experience of other drivers or have their own experience of driving this path as a foundation).

There are two types of conventional positions for the transnasal butterfly retracting route, one is the supine position and the other is the semi-sitting position.

If you only look at the patient's position in the latter part, you will know that the patient's supine position in the former cannot be a horizontal line supine position, but only a supine position with a high head and a low foot.

This is determined by human anatomy. The nasal butterfly approach has been discussed earlier, and it enters the brain through the nasal cavity through the special anatomical mouth of the sphenoid sinus.

Comparison of gastroscopy and colonoscopy.

Gastroscopy is a tool for doctors like a snake walking around in a tunnel. There is an advantage in walking the tunnel. When you walk in the wrong way, you will retreat and advance. As long as you don’t hit a wall, there is no high risk.

Nose butterfly surgery is not. After passing through the sphenoid sinus, the surgical instruments directly enter a ball of "tofu". Since they do not go through the tunnel, they retreat and advance. They need to re-open the "tofu ball", which is very easy to accidentally hurt the surrounding "tofu brain".

But these nearby "tofu brains" that are prone to accidental injury are particularly important in anatomically, so the sequelae of surgery are particularly terrifying.

If the position is wrong, if you run down, you will encounter the brain stem. If you accidentally, you can directly kill the stem.

I moved up a little and got blinded by the patient when I was damaged by the optic nerve.

If you go wrong and deviate from the midline, break through the cavernous sinus and internal carotid artery, you will definitely die of severe bleeding during the operation.

In order to avoid these terrifying events, the best way is to get into the lesion after the doctor enters the "tofu brain" and does not need to explore it.

To do this, the doctor needs to find the entry angle of the butterfly sinus, and accurately operate the "tofu brain". Both are indispensable.

In the front, doctors can calculate the angle based on imaging films, such as neural three-dimensional navigation software.

It is necessary to do it later. It is too difficult to just let the doctor use tools to adjust the angle.

If it is difficult to understand, it can be compared to brushing a strange-shaped cup with a long handle at home with a narrow mouth. If you want to clean the stubborn stains at the bottom of the cup and the brush cannot reach it no matter how hard the brush is, do you actually have to calculate and adjust the angle of the cup early in the morning so that the cup brush can easily reach the point?

Adjusting the angle of the cup and placing it in neurosurgery is equivalent to adjusting the patient's head position. Therefore, the head is always high and low in the transnasal butterfly surgery mentioned earlier. The specific height of the head is tested by the doctor's previous calculation.

Not all doctors can calculate accurately. More clinicians use a large number of clinical mice to practice their skills to accumulate experience values.

Doctors with particularly high IQs do not need to be counted by guinea pigs. Unfortunately, it is rare for doctors to achieve such perfect goals.

“only        one        operation        position?”

(Is there only one surgical position?)

Dr. Charlie then raised his finger to Dr. Tong to verify whether it was really a position for the entire operation.
Chapter completed!