Chapter 2871 【2871】Where to Put It

Well, how did this little girl do it.

At the head and neck that everyone was worried about before, the place where the three-dimensional space gap is the largest should be the most challenging section for doctors. I just remember that classmate Xie didn't seem to have done the pre-bending of the cleaning rod before.

What do you do with prebends? Neither the mastoid nor the subclavian relay point were opened.

The thrilling scene that a large group of people were worried about, it turned out after a while that it didn't happen.

One lift and one wear move forward steadily, the improvement of the loom continues, and the shunt tube passes through the neck steadily.

Dr. Wang's entire expression was only "Ahhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh"

"It's really—" Dr. Jin couldn't hold back his words. Like everyone else, he couldn't figure it out. It's really strange. Looking at it all the way, the chief surgeon, Mr. Xie, is very sure about the whole process of the piercing strip. Since the sad neck can be easily passed through, why open a relay opening under the xiphoid process.

Ask her to say that it is really possible to achieve zero relay ports. She used to have doubts, but now she fully believes that the chief surgeon has the ability to perform miracles.

About this question, you should ask a professional professional teacher.

It's not just about neurosurgery.

After all, neurosurgery may have to consult general surgery for even the steps of placing the shunt tube in the abdomen.

"Did someone come here?" 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 an intern in the Second General Foreign Language School.

"It seems that the operation outside the liver and gallbladder is not over yet." Someone replied.

The ones outside the liver and gallbladder did not come.

The people on the scene can only do the analysis on their own.

"Is this patient's liver enlarged?"

"I remember neurosurgery's shunt end can be placed in the liver."

There are many bosses on the scene, and the level of speaking is not at all the technical level that elementary school students are talking about.

It should be mentioned here again that the end of the peritoneal shunt tube is said to be placed in the abdominal cavity to allow the cerebrospinal fluid to be absorbed. It is the peritoneum that absorbs the cerebrospinal fluid.

What is the peritoneum, I mentioned it during the internship of the second hepatobiliary surgery in general surgery. What needs to be emphasized again in this operation is that the peritoneum migrates from the pelvic wall to the visceral surface and the mesomentum and ligaments are formed between the visceral surfaces. Among them, the greater omentum is a double-layered peritoneum hanging like an apron from the greater curvature of the stomach and the proximal duodenum. It is very mobile and filled with peritoneal fluid. This is where the end of the shunt is most likely to get trapped. Therefore, the doctor's operation is to keep the end of the shunt tube away from the omentum as much as possible.

If it avoids the greater omentum, where can it be placed? Perhaps the end of the shunt can be placed in the lesser omentum. The lesser omentum is much less mobile than the greater omentum, and will not move the end of the shunt around and trap it. The lesser omentum is the hepatogastric and hepatoduodenectomy ligaments.

For this reason, some doctors make a median or paramedial 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 septum of the liver, and sew the catheter to the round ligament of the liver to prevent it from falling off. This will not be trapped to death by the omentum.

The bosses are discussing, thinking whether the chief surgeon wants to put the shunt tube in the liver.

This possibility is very low. Because putting it here is usually not the first choice of neurosurgeons. This is due to the fact that the absorption of the peritoneum is stronger in the upper part of the abdomen than in the lower part. Clinically, patients with abdominal inflammation and postoperative patients often adopt the semi-recumbent position, which is one of the reasons.

For ventriculoperitoneal shunt patients, it is not a good thing if the absorption is too strong and the shunt tube is excessively shunted.