When the Doctor Uses A Hack

The main core of stereotactic surgery lies in the use of a targeting device.

This is also the difficulty of Parkinson's surgery.

Precise localization is needed to find the surgical target point for stimulation or other operations using the targeting device.

Chen Cang actually considered initially whether to use local anesthesia.

However, after much deliberation, he opted for a small amount of general anesthesia.

Then he switched to local anesthesia for maintenance!

After all, a surgery like this requires observation of the patient's condition.

Moreover, during the surgery, especially during target point manipulation, collaboration between the lead surgeon and the patient is necessary.

Constant observation of the patient's condition is needed to judge the surgery.

Performing intracranial surgery under local anesthesia.

Just thinking about it feels challenging!

But...

Reality is just so cruel!

Thus, a surgery that requires precise control of anesthesia is quite difficult!

Even Chen Cang felt a bit apprehensive about this surgery!

After all, risk is something that always accompanies you.

If this were ancient times, one would need to burn incense to Lord Hua Tuo thrice before starting!

Chen Cang said to Wu Hui: "Shall we?"

Wu Hui nodded, eager to try.

Chen Cang appreciated Wu Hui for his willingness to do what needed to be done without hesitation.

Only by daring to act can one achieve something!

How can hiding achieve anything?

These past two days, Wu Hui had spent almost all his time, other than sleeping, playing with the targeting device.

Have to admit, having been separated from his wife for half a year, he had a lot more time.

No need to worry about those annoying things anymore.

The only different thing is, he needs to quickly get custody rights!

He longs for success!

He hopes to become a superhero in his child's heart.

He stood in front and adjusted Zhou Hongguang's head position, aligning the ear plugs on both sides of the frame with the external ear canal, and the head midline with the central pore of the frame, which is the midline of the instrument.

The targeting device is a great invention in neurosurgery!

There's no doubt about that.

After Wu Hui's meticulous operation, the head was positioned at the center of the frame in the anteroposterior direction.

Actually, the installation of the external cranial targeting device doesn't seem to have much technical content, but to minimize positioning errors, it is quite intricate!

Also need to avoid the frame tilting backward, forward, or rotating.

Wu Hui, after these few days of learning, mastered it very well!

Chen Cang nodded: "Very good, perfect!"

Wu Hui stepped aside quietly.

At this moment, Chen Cang began his operation.

He took the scalpel and made a vertical incision of 4cm in length 2.5cm lateral to the midline of the surgical side, before the coronal suture.

Then, he drilled a hole in the skull at the center of the incision, made a cruciate incision in the dura mater, and electrocoagulated a point on the cortical surface for ventricular puncture and target point puncture.

A rather troublesome thing in neurosurgery and orthopedic surgery is the frequent need for imaging during surgery.

These orthopedic surgeons get quite exposed to radiation due to this!

After all, you can't wear a lead apron during surgery, considering how tiring it is to stand for such a long surgery wearing it?

And it gets all sweaty!

After completing these operations, Chen Cang needed to use ventricular imaging to show landmark structures such as the third ventricle, interventricular foramen, aqueduct, pineal recess, and anterior and posterior commissures.

This is a crucial step in stereotactic surgery: ventricular imaging!

At this time, the radiology department director came over personally and nodded to Chen Cang.

Then, through the drilled hole in the skull, he punctured the anterior horn of the lateral ventricle and performed pressure pneumoventriculography or injected 10ml of positive contrast medium.

This was a complex, multidisciplinary collaborative surgery.

Chen Cang did not dare to be reckless.

The hospital also attached great importance to this.

Wu Tongpu personally wore surgical clothes and came to the operating room this time.

Accompanying him were neurosurgeon Hu Chuanbang and neurologist Zhao Furun.

When they came in, they happened to see the contrast agent being injected.

The radiology department director said: "Everyone, step back a little."

The crowd retreated behind the screens.

Wu Tongpu looked at Chen Cang and couldn't help but ask: "How confident are you?"

Chen Cang looked at the tense Director Wu and thought for a moment: "Half."

Wu Tongpu breathed a sigh of relief: "That's fine! Half is quite high!"

Chen Cang uttered an "Hmm": "Either success or failure!"

Wu Tongpu was instantly speechless!

Really wanted to carve a capital "Z" on Chen Cang with the scalpel.

Damn it, I'm so nervous, and you're joking with me?

Actually, Chen Cang wasn't to blame; since the surgery hadn't started and the target point hadn't been determined, how could there be a success rate?

If stereotactic surgery were really this simple, it would be great!

However... Hu Chuanbang couldn't help but say: "Director Wu, this is... Parkinson's surgery!"

Zhao Furun nodded: "That's right, if Parkinson's surgery ever gets a fifty percent success rate, Professor Chen might have a chance to go for a Nobel Prize!"

How many years has Parkinson's troubled the nervous system?

Everyone has been collectively stuck outside this huge gate, unable to move forward.

Is it that simple?

Wu Tongpu froze for a moment, finally understood!

He took a breath: "Don't worry about failure either, just do your best!"

Over there, after the radiology department director finished the imaging, the report was quickly produced, very fast and precise!

"Professor Chen, the images are ready!"

Chen Cang's eyes immediately brightened: "Right away!"

After saying this, he glanced at Wu Tongpu and the others: "I'll go to the surgery first!"

After speaking, he eagerly walked outside.

Wu Hui followed closely.

And Wu Tongpu, watching Chen Cang's back, suddenly fell silent:

"Chen Cang, this kid... working too hard!"

This was rare for Wu Tongpu to call Chen Cang a kid.

Back then, when this boy came to find him, it was only a year ago.

Comparatively, the changes are really huge!

"Yes!" Hu Chuanbang nodded.

Wu Tongpu sighed a long sigh.

The greater the glory, the harder it gets behind the scenes!

Success often means sacrifice.

"He just rested for a short while, and now he's already immersed in Parkinson's research, sigh..."

"Compared to this kid, I really am too comfortable!"

Wu Tongpu couldn't help but express his sentiment.

The other two blushed; why does it suddenly feel like Wu Tongpu is talking about them?

Indeed, the two turned around and found Director Wu staring straight at them.

Chen Cang looked at the intracranial images and couldn't help but praise: "Very nice!"

To confirm the landmark positions such as the interventricular foramen, aqueduct, and pineal recess inside the skull.

Images are essential.

To determine how to perform intracranial surgery and find the crucial target point location, it needs to combine the targeting device with the images and start calculating!

Moreover, precise calculation!

The target point selected is the ventral lateral nucleus of the thalamus.

Because here it has a significant effect on tremor and rigidity.

While the medial part of the globus pallidus has obvious effects on rigidity and bradykinesia caused by Parkinson's, but is generally ineffective for tremor.

However, the difficulty of localizing the ventral lateral nucleus of the thalamus is a bit higher than the medial part of the globus pallidus.

How to locate it?

It's particularly important!

Chen Cang couldn't help but lament the backwardness of the equipment, if MRI+PET+digital analysis technology could be used, it could precisely guide surgery.

Even with MRI and thin-slice scanning's high resolution, it could clearly display the images of the deep brain structures in the basal ganglia region, providing conditions for directly accurate localization of targets.

But, with the current conditions, who needs a bicycle?

Chen Cang could only use the most primitive technique to perform this surgery.

If it truly succeeds, it would be a miracle indeed.