BXBX NOVEL Chapter 2871: 【2871】Where to put it
When we got to the head and neck that everyone was worried about before, the place where the three-dimensional space gap was the largest should be the paragraph that tests the doctor the most. I just remember that Xie didn't seem to have done pre-bending before.
What is the pre-bending of the strip? Neither the mastoid nor the subclavian relay point was opened.
The thrilling scene that a large group of people was worried about, it was discovered after a while that it did not happen.
One mention and one wear made steady progress, the improvement of the loom continued, and the shunt passed steadily through the neck.
Doctor Wang's whole look is just "Ahhh".
"Really—" Dr. Jin couldn't hold back his words. He couldn't figure it out like everyone else. It's really strange. Looking at it all the way, the chief knife Xie Xie is very sure of the whole process of penetrating the strip. Since the sad neck can be easily passed through, why should a relay opening be opened under the xiphoid process.
Ask her to say that it is possible to achieve zero relay ports. She was skeptical before, but now she fully believes that the chief knife has the ability to perform miracles.
Ask a professional professional teacher about this question.
is not just about neurosurgery.
After all, neurosurgery may need to consult general surgery for the steps of placing a shunt tube in the abdomen.
"Have you come from outside the liver and gallbladder?" Wei Tianlang looked back.
It stands to reason that Tao Zhijie's Buddha should come. Tao Zhijie stared at them as early as when they were intern at Puwai II.
"The surgery outside the liver and gallbladder doesn't seem to be over yet." Someone replied.
The outside of the liver and gallbladder did not come.
The people at the scene can only do the analysis by themselves.
"Is this patient's liver enlarged?"
"I remember neurosurgery they put the end of the shunt to the liver."
There are many bigwigs on the scene, and their speaking level is not the technical level that elementary school students are talking about.
It will be mentioned again here that the end of this abdominal shunt tube is to be placed in the abdominal cavity to allow the cerebrospinal fluid to be absorbed. It is the peritoneum that absorbs cerebrospinal fluid.
What is the peritoneum? I talked about it during the practice of general surgery and hepatobiliary surgery. The key point to be struck again in this operation is that the peritoneum migrates from the pelvic wall surface to the organ surface and forms the meso-omentum and ligaments between the organ surfaces. Among them, the greater omentum is a double-layered peritoneum that hangs over the greater curvature of the stomach and the proximal duodenum like an apron. 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 avoid the omentum as much as possible at the end of the shunt.
Where can it be placed if it avoids the greater omentum, perhaps the end of the shunt tube can be placed in the lesser omentum. The lesser omentum is much less mobile than the greater omentum, and will not be trapped by moving the end of the shunt tube around. The lesser omentum is the hepatogastric ligament and the hepatoduodenal ligament.
For this reason, some doctors make a median abdominal incision or paramedian 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 on the ligamentum teres to avoid falling off. This will not be trapped by the omentum.
The big guys were talking about it because the chief surgeon wanted to put this shunt tube in the liver.
This possibility is very low. Because this is usually the first choice for non-neurosurgeons. This is because peritoneal absorption is stronger in the upper part of the abdomen than in the lower part. This is one of the reasons why patients with clinical abdominal inflammation and postoperative patients usually take the semi-recumbent position.
For patients with ventriculoperitoneal shunt, it is not a good thing if the shunt tube is too shunted if the absorption is too strong.
(end of this chapter)