Chapter 817 The Disappearing Parasite

Others also looked at Xu Qiu with expectation in their eyes.

"In recent years, with the development of neuroimaging, optical technology, microsurgical instruments and stereotactic neuronavigation systems, there has been a new treatment for reducing intracranial pressure..."

At this point, Xu Qiu looked at Director Lin.

"Third ventriculostomy!" He spoke slowly.

Heard the name of this operation, Director Lin was stunned at first.

This is a very primitive operation. When neurosurgery was still developing wildly, the third ventriculostomy was popular for a period of time and was also used as a surgical solution to communicate hydrocephalus.

However, the neuroendoscope had only appeared not long ago, and the surgical instruments were simple and the technical strength was insufficient, which led to an extremely high mortality rate of the operation and unsatisfactory results.

Especially after the emergence of a series of extracranial shunts, such as the ventriculoperitoneal shunt that had been ruled out, it was completely regarded as the tears of the times.

Extracranial shunts are safe, simple, and have a wide range of indications, so naturally no one would think of the third ventriculostomy.

As a result...it was actually solved by this method?

Director Lin felt it was incredible at first, but when he thought about it carefully, he was stunned.

Compared with ventriculoperitoneal shunt, ostomy does not have foreign objects such as shunt tubes implanted, so there is no need to worry about infection.

Moreover, with the three-ventriculostomy, the postoperative cerebrospinal fluid flows directly into the interpeduncular cistern and enters the subarachnoid space of the brain and spinal cord to be absorbed, which is in line with the physiological circulation state of cerebrospinal fluid!

Compared with ventriculoperitoneal shunt, the ostomy also has a very uniform rate of cerebrospinal fluid removal, and there will be no flow rate fluctuations caused by the siphon effect of the shunt tube, and it is almost impossible for cerebrospinal fluid to be over-drained...

So it seems... it's really feasible!

Director Lin's thoughts were mixed, and his eyes began to shine.

If the risks can be controlled, the operation can be completed without the patient's life being in danger, and the effect of this operation can be exerted, then it is indeed the best way to solve the disease!

It is even better than ventriculoperitoneal shunt.

"Doctor Xu, are you sure?" Director Lin said in disbelief.

This is an operation that has been abandoned for nearly fifty years!

"Does Tiantan Hospital have a director in our hospital?" Xu Qiu did not answer, but asked instead.

Director Lin thought for a while and said, "Yes, Director Ge, he was sent by Tiantan Hospital to discuss specific cooperation matters with us!"

"Please ask him to perform the operation as well." Xu Qiu said.

Director Lin immediately understood the meaning... He was going to show off his muscles to Tiantan...

He quickly agreed.

...

"There is another point." Xu Qiu looked at the gastroenterologist.

There are four difficulties in Xiaojie's operation. The first is intraocular infection, the second is liver abnormality, and the other two are intracranial lesions and intestinal parasites.

Now the first three have solutions, and there is still one intestinal.

He did not give time for discussion and said directly: "If it is delayed any longer, the patient will have a high chance of intestinal perforation. The best way is to remove the intestinal tube."

"Yes!" The gastroenterologist immediately agreed.

...

After the consultation, the preliminary surgical plan was also finalized.

The first is a closed-mouth three-incision vitrectomy to remove intraocular parasites.

This is the operation with the least risk. Even if it fails, at most one eye will be lost.

The second is the third ventriculostomy.

The last is intestinal resection and artificial liver replacement therapy.

The latter two are abdominal operations, so they are performed together.

The operation was finally scheduled for two days later.

On the eve of entering the operating room, Xu Qiu talked with the family again.

Compared with when he first came, the old man in the vest has become more haggard by several decades. His already hunched body is now even weaker. His face is full of traces of wind and frost. The wrinkles on the forehead, the corners of the eyes, and the crisscrossing grooves on the skin all tell of his vicissitudes of life.

A pair of turbid and irrelevant eyes, hanging on the lonely face, are extremely sad.

"Doctor, we only have this one child in our family. You must save him..." The old man in the vest thought for a long time and finally said this.

Although the same scene has been experienced countless times, Xu Qiu still has a throbbing in his heart.

In front of life, no matter how many times it is repeated, it is difficult for people to easily bear this heavy trust.

Xu Qiu's expression was solemn, and he said seriously: "We will do our best to save the patient."

...

Two days later, the joint operation began.

The first link was eye surgery.

To be precise, it was a closed three-incision vitrectomy + subretinal injection.

The former is to remove the worm body, and the latter is to clean up all the parts where the larvae have been to prevent future troubles.

"Ophthalmic surgical microscope, vitreoretinal surgical system, 23G/25G/27G and other minimally invasive vitreoretinal surgical kits, 1 ml microfluid control syringes, 8G and above subretinal microinjection needles..." In the operating room, Xu Qiu counted the prepared instruments one by one.

For this operation, the ophthalmology department even brought a microscope with integrated optical coherence tomography, which can be said to be fully armed.

"Get ready, do a three-incision vitrectomy." Xu Qiu's voice fell.

Since Xiaojie is a child, this operation is much more difficult than the usual one and there are many things that need to be paid attention to.

For example, the eye structure of children is slightly different from that of adults. When performing vitreous surgery, children's eyeballs are smaller and the flat part of the ciliary body is not fully developed, which will cause some anatomical structures to be inconsistent with the textbooks.

If the operation is performed according to the experience of adults, the consequences will be disastrous.

Therefore, the position of the scleral incision must be controlled at about 3.5mm from the corneal limbus.

Moreover, children do not have posterior vitreous detachment, and must use intraocular forceps or high negative pressure suction to form posterior vitreous detachment for surgical needs.

…

Routine surgical disinfection and draping anesthesia.

Use a 25G minimally invasive vitreoretinal surgery kit, and choose a scleral incision cannula that matches the diameter of the thick tube of the subretinal microinjection needle...

Routinely cut the anterior vitreous body and perform high negative pressure suction on the optic disc.

Click!

The vitreous body has completed posterior detachment.

At this time, everyone looked inside, and then their faces changed.

The white nematode that was fixed before the operation could not be seen after the incision was opened!

However, Xu Qiu began to look for it calmly.

Finally, he found the white nematode in the posterior vitreous membrane under the optic disc.

At this moment, the nematode had curled up into a ball, and its body was constantly wriggling.

Seeing this scene, everyone felt sick.

Xu Qi frowned.

This is a very bad signal!

But he couldn't care too much at the moment, he planned to attract the nematode out first.