Start From Emergency Doctor

Chapter 101

Seeing that Wei Lili’s face was a little bad, Zhou Yuan’s expression also became serious and looked at the inspection result.

MRI images showed that the brain tissues of the two conjoined children did not fuse and share. In other words, as long as they are properly separated, the two children can develop as normal children.

This is a relatively good situation. Some conjoined children even share brains and cannot be separated at all. Others have dual brains but part of the brain is disabled. If you want to separate, only one person can save a more complete brain. One is the defective brain.

Fortunately, it is not the latter, otherwise, this choice would be too cruel for parents.

There is no problem with the MRI, which is good news, but another cerebrovascular angiogram is not so optimistic.

It can be seen that the cerebral arteriovenous blood vessels of the conjoined children have a cross-supply situation. Although some blood vessels have their own, they are glued together to form a double-lumen parallel blood vessel.

Some blood vessels may even have cavity fusion phenomenon.

In other words, once separated, the parallel adhering blood vessels will split, which may cause the blood vessels to rupture.

Obviously, the two results indicate that this pair of conjoined children is a conjoined deformity that is more difficult to separate.

“Has the 3D printed model come out?” Zhou Yuan asked.

He needs to determine the condition of the superior sagittal sinus of the conjoined child’s brain.

Once the superior sagittal sinus fusion occurs, the separation of conjoined children will become more difficult.

“After scanning, printing is still in progress.” He Jingdao.

Zhou Yuan nodded, then looked at the sleeping conjoined children in the ward, and asked, “How are the physical conditions of the two of them now?”

Wei Lili said: “Don’t worry, the neonatal ICU doctors, specialist nurses, etc., are taking care of them carefully, paying close attention to their physical changes, and there will be no problems.”

He Jingdao: “We are also gradually improving various preoperative preparations for patients.”

Zhou Yuan heaved a sigh of relief, nodded, and looked at Xiao Xuebo, the director of brain surgery, who was staring at the MRI image next to him: “Director Xiao, what do you think?”

Xiao Xuebo rubbed his chin, frowned, and asked, “What do you think?”

“Since the birth of the conjoined children, although the blood vessel crossover phenomenon occurs, their brains are preserved intact and can be separated. The sooner the separation operation is performed, the more beneficial it will be for the two of them. Once it is delayed, their brains may grow longer. Together, it is almost impossible to separate again when that time comes.”

If the brain is really stuck together, and if the knife is moved randomly, it may damage the functional areas of the brain and bring lifelong trauma. At that time, you can only give up if you want to separate.

Zhou Yuan continued: “While we are not growing together now, perform separation surgery as soon as possible.”

Xiao Xuebo nodded: “I also think it should be as soon as possible!”

Zhou Yuan:…

The patient’s father looked at Zhou Yuan with some uncertainty: “Is…you do it?”(Read more @ wuxiax.com)

“Our whole team will participate in the operation.” Zhou Yuan told the truth.

“You are so young to participate in the operation?!” The patient’s father stared, not at ease.

“I am the chief sword.”

There is no way to conceal this kind of thing, nor can it be concealed.

The patient’s parents immediately opened their eyes.

“I don’t think you are like a great doctor! You just graduated from school, right? You come to the doctor, is our child still saved?!” The patient’s father was a little angry.

He felt that the hospital was perfunctory.

Zhou Yuan explained patiently: “We have an entire team, and then neurosurgery, plastic surgery, brain surgery, etc. doctors will be involved, and there will be many directors.”

“We will choose the most suitable surgical method for your child, and we will also choose the most suitable doctor!” Wei Lili said.

Conjointly’s father wanted to say something, but was held back by her wife.

“I believe in your hospital…” Conjoined children’s mother glanced at the child in the ward, and her voice gradually became quieter.

“Let’s take a look at the 3D printed model first.” Zhou Yuan said helplessly.

He Jing and Wei Lili stayed here for the time being, ready to explain clearly to the patient’s family, Zhou Yuan, Xiao Xuebo, and Lu Chenxi are going to make the next step.

In the end, the thing that worries Zhou Yuan the most still happened-the 3D printed model clearly shows the fusion and sharing of the upper sagittal sinuses of the conjoined body.

This is a structure located in the sulcus of the sagittal sinus located at the midline of the upper edge of the falx and the midline of the inner plate of the skull. It belongs to a single dural venous sinus, which contains the blood of the upper cerebral meridian, dural vein and cranial vein, which is especially important. .

At the same time, it also contains cerebrospinal fluid. There are 10 to 15 meridians connected to the brain here. Once the structure here is damaged, it will cause paralysis and even death…

Therefore, it is very difficult to separate the superior sagittal sinus of conjoined children.

“I can’t do it.” Xiao Xuebo took a look and shook his head directly to admit his lack of ability.

“If the skull is separated, what should I do?” He sighed and looked at Zhou Yuan.

Zhou Yuan thought for a while, and said, “Cut the middle and posterior third of the superior sagittal sinus, and then repair it.”

“It can be, but the blood vessels are too dense. Once you can’t grasp it…”

“I’m coming.” Zhou Yuan said coldly.

Xiao Xuebo was taken aback and nodded.

Soon, the doctors from the neurosurgery and plastic medicine department also arrived.

In addition to the pediatrician, Wei Lili, He Jing, Lu Chenxi, nurses, anesthesiologists, etc., the number of this team reached fifteen.

In just three days, the team held five or six meetings to discuss the specific plans and steps of the operation.

In the end, Zhou Yuan finalized the final surgical plan, a brief summary, including a total of four steps:

First: perform strip craniectomy.

This step is mainly to remove part of the skull at the fusion of the conjoined child.

Second: Perform soft tissue resection.

The main purpose is to insert a soft tissue expander under the skin to relax and expand the fused skin, so as to ensure that the separated skull has more skin area, so as to facilitate the suture of the separated skin.

Third: separation of the cerebral hemispheres.

With the help of computer navigation technology, the two brain hemispheres of the conjoined are separated.

The last and most difficult step: the separation of the shared sagittal sinus.

Not only was it extremely difficult for Zhou Yuan’s team, but it was also an extremely difficult decision for the parents.

Because… the separation of the shared sagittal sinus means that it is very difficult to deal with. You can only choose a baby with a little more and a baby with a little less, and the lesser one will inevitably be developmental delay.

Zhou Yuan is a doctor and cannot make this decision.

Soon, Conjoint’s parents were invited over.

Zhou Yuan and others introduced the entire operation process to them. Finally, they asked in a deep voice: “Now, how do you plan to allocate the sagittal sinus?”.